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Persistent corneal erosions

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Sections available in full article	Introduction, Presenting signs, Acute presentation, Age predisposition, Sex predisposition, Breed predisposition, Cost considerations, Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Subsequent management, Prevention, Control, Prophylaxis, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors	Dr Paul Gerding DVM MS DipACVO Dr Rhea Morgan DVM DACVIM DACVO Dr David L Williams MA VetMB PhD CertVOphthal FRCVS
Synonyms	Indolent ulcer, Boxer ulcer, recurrent erosions

A superficial defects in the corneal epithelium that do not heal within two weeks with apppropriate therapy.
Cause : basement membrane complex abnormality in Boxers and many other dogs, softening of the epithelium secondary to corneal edema.
Signs : persistent superficial nonhealing corneal ulcer.
Diagnosis : ophthalmic examination.
Treatment : varied.
Prognosis : good with persistent therapy, but can be frustrating to treat.

Traumatic corneal ulcer.
Corneal ulceration secondary to distichiasis , ectopic cilia, entropion and other eyelid effects.
Corneal ulceration due to exposure and drying.

Good for eventual healing.

Warn the owner that multiple recheck examinations and a variety of therapies may be necessary to accomplish healing.

With grid or punctate keratotomies, 75-85% are healed within one month.
With superficial keratectomy, approximately 85% are healed within 21 days.
Following application of Cyanoacrylate glue, 17/17 cases were healed within one month (Blomberg, 2002).
No uptake of fluorescein dye.
Decreased blepharospasm and tearing.

Inadequate debridement and scarification of the cornea.
The presence of corneal edema makes the lesion much more difficult to heal.
The presence of excessive granulation tissue may delay healing.
Presence of hyperadrenocorticism may decrease healing.
Indolent corneal ulcerations may reoccur in the same eye treated or occur in the fellow eye.

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Willeford K O, Miller W M, Abrams K L et al(1998) Modulation of proteolytic activity associated with persistent corneal ulcers in dogs. Vet Ophthalmol 1 , 5-8.
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Chavkin M J, Riis R C & Scherlie P H (1990) Management of a persistent corneal erosion in a boxer dog. Cornell Vet 80 , 347-356.
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