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Eye: corneal ulcer

ffelis

Introduction

  • Corneal ulceration is a common presenting complaint in feline practice.
  • Cause: there are numerous causes of corneal ulceration although trauma and FHV-1 are the most common.
  • Prognosis: uncomplicated, superficial corneal ulcers usually heal rapidly (within days) with supportive medial treatment alone.
  • If an ulcer fails to heal rapidly then an exhaustive search for an underlying cause must be performed.
  • Successful healing of these ulcers relies on the identification and successful treatment of the underlying cause.
    Print off the owner factsheet on Corneal ulcers Corneal ulcers - a sore eye to give to your client.

Pathogenesis

Etiology

  • Trauma is the most common cause. Causes include:
    • Cat scratches.
    • Foreign bodies.
    • Chemical burns (alkali burns are more severe than acid burns).
  • Feline herpesvirus-1 (FHV-1 infection Feline herpesvirus disease):
    • Common cause of ulcerative and non-ulcerative keratitis Keratitis  Ulcerative keratitis.
    • History of upper respiratory tract infection and/or ocular discharge may be present.
  • Eyelid and hair abnormalities are less common in cats than in dogs:
  • Corneal sequestration Cornea: sequestration.
  • Acute bullous keratopathy is an infrequently reported condition in the cat.
  • Keratoconjunctivitis sicca Eye: keratoconjunctivitis sicca is rare in the cat.

Pathophysiology

  • Insult to the corneal epithelium results in its death and denudement.
  • Underlying corneal stroma is exposed.
  • Stroma may be destroyed by enzymes produced by inflammatory cells and opportunistic bacteria.
  • Progression of stromal damage can lead to a descemetocoele.
  • If Descemet's membrane is breached then loss of aqueous humor and iris prolapse occurs.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Goulle F (2012) Use of porcine small intestinal submucosa for corneal reconstruction in dogs and cats: 106 cases. JSAP 53 (1), 34-43 PubMed.
  • Gould D (2011) Feline herpesvirus-1: ocular manifestations, diagnosis and treatment options. J Feline Med Surg 13 (5), 333-346 PubMed.
  • Barachetti L, Guidice C, Mortellaro C M (2010) Amniotic membrane transplantation for the treatment of feline corneal sequestrum: pilot study. Vet Ophthalmol 13 (5), 326-330 PubMed.
  • Hartley C (2010) Aetiology of cornea ulcers: assume FHV-1 unless proven otherwise. J Feline Med Surg 12 (1), 24-35 PubMed.
  • Hartley C (2010) Treatment of corneal ulcers: what are the medical options? J Feline Med Surg 12 (5), 384-397 PubMed.
  • Hartley C (2010) Treatment of corneal ulcers: when is surgery indicated? J Feline Med Surg 12 (5), 398-405 PubMed.
  • Malik R, Lessels N S, Webb S et al (2009) Treatment of feline herpesvirus-1 associated disease in cats with famiciclovir and related drugs. J Feline Med Surg 11 (1), 40-48 PubMed.
  • Townsend W M, Rankin A J, Stiles J et al (2008) Heterologous penetrating keratoplasty for treatment of a corneal sequestrum in a cat. Vet Ophthalmol 11 (4), 273-278 PubMed.
  • Featherstone H & Sansom J (2004) Feline corneal sequestra: a review of 64 cases (80 eyes) from 1993 to 2000. Vet Ophthalmol (4), 213-227 PubMed.
  • Andrew S E, Tou S, Brooks D E (2001) Corneoconjunctival transposition for the treatment of feline corneal sequestra: a retrospective study of 17 cases (1990-1998). Vet Ophthalmol (2), 107-111 PubMed.

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