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Corneal Ulceration
Types of Corneal Ulcers
1. Corneal ulcer
2. Slow healing (indolent) corneal ulcer
3. Deep corneal ulcer / descemetocele
Possible Causes
1. Trauma
2. Eyelid disease (oversized eyelid opening, i.e. entropion)
3. Extra eyelashes
4. Ectopic cilia
5. Inflammation
6. Dry eye
7. Prominent eye
8. Inherited factors (breed predisposition)
9. Defect in the cornea
10. Infection
Management
Indolent ulcers may take months to heal. It may be
necessary to remove diseased cornea from around the ulcer, with
the aid of the operating microscope. We use either a Grid Keratotomy
(GK) or a Superficial Keratectomy (SK) to remove the diseased cornea.
Following this surgery over 90% of ulcers are healed within 10 days.
Boxers, Corgis, Golden Retrievers and Samoyeds are most commonly
affected.
The eye may be "bandaged" by the use of a third eyelid
flap. The third eyelid is brought across the eye. It is held in
place by a long suture and a piece of tubing which sits on the upper
eyelid.
In some cases we may use a contact lens to aid corneal
healing. To keep the contact lens in place we generally need to,
whilst the patient is sedated, stitch the eye partially closed.
Some of the more severe corneal ulcers may be covered
with a conjunctival graft.
We can use 2 different types of conjunctival
grafts
o 360 degree conjunctival flap. This is done to cover
the all of the cornea. This flap is generally removed 2 to 3 weeks
after surgery. The eyelid is usually temporarily stitched partially
closed to help healing.
o Conjunctival pedicle graft. The conjunctiva is stitched
directly into the cornea permanently. Sliding corneal grafts or
synthetic corneas may be used in some cases.
After Surgery
Antibiotic drops may be required.
Do not allow the patient to rub at the eye. A bucket
or collar may be needed to protect the eye. Elizabethan Collars
are available from Animal Eye Care or your local Veterinarian.
Possible complications
1. Scarring of the cornea
2. Inflammation of the eye
3. Perforation of the eye
4. Infection
5. Loss of the eye
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