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Corneal Ulcers: a common, but serious, eye condition

By June 16, 2021 September 8th, 2021 No Comments

One day, Fynn’s owners suddenly noticed that her right eye seemed to be painful, she was “winking” at them with her right eye, and she certainly didn’t seem to be sharing an inside joke!  Wisely, they contacted us right away and brought her in. On her physical exam we noticed that she was squinting her right eye (the medical term for this is blepharospasm) and that her eye was red and inflamed. Ophthalmic exams will often require additional tests to get a full picture of the problem. These tests may include a fluorescein stain to detect any defects in the cornea or surface of the eye, a Schirmer tear test to assess for adequate tear production (a common issue in dogs is a condition known as keratoconjunctivitis sicca or “dry eye”), and/or an eye pressure test to test for glaucoma or another condition known as uveitis. In Fynn’s case, a fluoroscein stain was applied and this helped to clearly identify a large corneal ulcer (also known as ulcerative keratitis) in her right eye. 

 

The large, irregularly shaped green area in her eye is the corneal ulcer. In Fynns case, this is a superficial ulcer affecting only the top layer of her cornea.

Corneal ulcers are a common problem that we will see in our patients. The structure of the cornea is similar to that of our skin, however, it is made up of more specialized types of cells, made up of three layers of tissue. Dogs tend to develop ulcers more commonly than cats and the cause of ulcers in the two species tends to be different. Cats most commonly will get ulcers due to viral infections such as herpesvirus that manifest in the eye while in dogs ulcers are more commonly due to either trauma or secondary to dry eye conditions.  Breeds such as french bulldogs (like Fynn), pugs, boxers, and other breeds whose eyes tend to sit further outside their skull are particularly predisposed. These breeds are also at a higher risk of developing complications from corneal ulcers. In some cases, we may see poor healing that may necessitate debridement of the ulcer.  Debridement involves applying a numbing agent to the eye and removing any loose tissue that has failed to heal. This gives the ulcer another chance to heal normally. If this is not successful then referral to an ophthalmologist may be indicated for more advanced procedures. Unfortunately, corneal ulcers can become very serious and in some cases can become very deep, even to the point of rupturing the eye, which would mean the eye would need to be surgically removed.  For this reason, early intervention is vital when an ulcer is suspected.

After a few days of treatment, her ulcer had significantly improved, though not yet completely healed.

 

The good news is that, in many cases, corneal ulcers heal well with minimal intervention. In cases of superficial, uncomplicated ulcers (meaning the ulcer is only affecting the top layer of the cornea and the animal does not suffer from multiple eye conditions) treatment will typically include antibiotic drops to prevent infection, which could delay or complicate healing, as well as pain control for a few days. These ulcers can be quite painful! It’s also incredibly important that the patient be prevented from rubbing or scratching at their eye and therefore an e-collar is recommended to help prevent this. 

 

All better!

 

Luckily, Fynn was an uncomplicated case, and with regular eye drops her eye cleared up well. You can see in her follow-up visit the ulcer was much smaller. A few days later it was completely healed! If you ever have concerns about your pet’s eye, we recommend contacting us right away. The eye is a delicate structure so addressing issues in a timely manner can prevent much more serious issues from developing.

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