Ophthamology
Eye injuries and infections can be common in horses, whilst often not serious, it is important to check all eye injuries to prevent a minor problem becoming more serious. Eye problems can include traumatic injury to the globe, bacterial or viral conjunctivitis, corneal ulcers and foreign bodies in the eye or under the eyelids.
With prompt treatment most ocular problems can be made completely comfortable within a few days, and completely resolved within a week.
Common symptoms of eye disease include:
Excess tearing
Squinting
Swelling
Coloured discharge
Rubbing of the ocular region on stable door, fence or front legs
ANY DEGREE of corneal odema/opacity
If you notice any of these signs in one or both eyes, or anything else unusual around your horses eyes you should contact Kingsfield Equine Vets immediately.
Our vets will usually sedate and possibly do a small and simple nerve block on the head to allow full visualisation and examination of the eye and surrounding tissues. Some stains or other diagnostic eye drops may be used, and an ophthalmoscope used to look at the back of the eye.
Occasionally we need to proceed to more advanced diagnostic procedures, including measuring a horses intraocular pressures, ocular ultrasound, corneal sampling for laboratory investigations or digital radiography of the orbit and head. All of these procedures are performed while the horse is sedated and pain free.
Treatment usually involves eye drops or eye ointment, to be put into the eye at regular intervals - these may be antibiotics, or pain relief, or otherwise. In some cases your horse may not like the eye drops being put in the eye, especially when the eye is still be painful, before the treatment has begun to work. In such cases we can discuss other options such as sub-conjunctival treatment deposits, or more commonly a sub-palpebral lavage system (“eye catheter”) This allows deposit of the treatment fluid onto the globe from a very small tube through the eyelid.
Short Case Studies -
- Severe corneal oedema caused by glaucoma (increased intraocular pressure) in this case
Corneal epithelial disruption, highlighted by the fluorescein stain, in a glaucoma case. Improved rapidly with appropriate medical treatment, now receives regular check-ups, but maintains full vision and a comfortable eye.
Horse with both upper and lower eyelid disruption following a probable trauma before being brought to the U.K. from Spain
Chronic white corneal ulceration and scarring, all caused by the compromise to the eyelids. This highlights why ALL eyelid lacerations should always be seen by a vet, so that if at all possible, the long term compromise can be minimised. An actual ‘Stitch in time saves nine’
The same eye during surgery, to try to partially correct the eyelid defects, and allow healing of the corneal ulcers. These ulcers healed, and the pony remains comfortable, but is monitored closely by the owner for possible relapse
A new case, showing a small compromise to the corneal surface, (the green is the stain on the ulcer) seen by David immediately after the pony started showing signs of discomfort
Despite immediate and intensive treatment the ulceration worsened over the following week
A pedicle graft was performed, stitching a small, thin section of the inner eyelid on to the surface of the ulcer, to bring blood supply, healing properties and structural support, to prevent further damage and facilitate healing. This eye was rapidly comfortable following the procedure.
Four weeks following surgery, with the ulcer fully healed, the blood supply (at the top of the image) to the graft has been cut, to start the process of the graft regressing.
Twelve weeks post surgery. This horse maintains full vision and is back competing at a high level. Without rapid veterinary intervention and the owners diligent treatment regime, this eye would have been lost. Eventually the graft area went completely black, and now remains almost impossible to identify on the surface of the eye.
An Iris Cyst – found on pre-purchase examination. Treatment options are available, but in this case we opted for monitoring, as they are not painful, and do not hugely interfere with normal vision.
Blood in the anterior chamber following trauma or acute inflammation (large reddish/brown blob in lower section of the eyeball). This horse needed ocular ultrasound by David, to fully assess the damage behind the clot, and thankfully all was well. The horse received regular anti-inflammatory eye drops and systemic pain relief for three weeks, while the blood resorbed into the system, and the eye fully returned to normal.
Sarcoid on the upper eyelid of the left eye. Sarcoids like these should be promptly seen by a vet, so a possible treatment plan can be instigated before the sarcoid grows to a size prohibitive of treatment, or ocular function becomes compromised.
- A different case, where an ocular sarcoid is very close to the medial canthus of the left eye. A rapid treatment plan was needed.
The ocular sarcoid is being treated with a cytotoxic cream, resulting in the sarcoid death before it interfered with vision or ocular function.
The sarcoid healed completely back to normal at the end of the long (but seemingly pain-free) treatment course. Only a small black discolouration remained
