Pigmentary keratitis

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Introduction

  • Cause : chronic keratitis → melanin deposition in cornea.
  • Signs : superficial corneal vascularization and pigmentation.
  • Common in brachycephalic breeds.
  • Diagnosis : history, clinical signs, breed, ophthalmic examination.
  • Treatment : remove cause, corneal lubricants, keratectomy if severe.
  • Prognosis : guarded - may only be able to control signs.
  • See also keratitis .

Diagnosis

Clinical signs

  • Unilateral or bilateral.
  • Brown pigmentation of cornea.
  • Visual impairment (depends on extent of pigmentation).
  • Identification of potential underlying causes of trauma.

Differential diagnosis

  • Other causes of corneal opacity :
    • Corneal scar.
    • Corneal edema.
    • Corneal lipid.
    • Corneal melanoma.
  • Non-corneal opacity:
    • Mass in anterior chamber.
    • Iris melanoma.

Outcomes

Prognosis

  • Guarded - most lesions are controllable not curable.

Expected response to treatment

  • Pigmentation may not regress - response to therapy based on lack of further pigment deposition.

Reasons for treatment failure

  • Side effects developing as a result of chronic steroid therapy.
  • Incorrect diagnosis.
  • Inadequate owner compliance with long-term therapy.
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