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 different types of conjunctival grafts

Conjunctival 360 Degree Graft: This is done to cover 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.

360 degree graft

Conjunctival Pedicle Graft: The conjunctiva is stitched directly into the cornea permanently. Sliding corneal grafts or synthetic corneas may be used in some cases.

Graft during surgery

Pedicle Graft

Pedicle Graft

o Conjunctival Sliding Graft: Sliding corneal grafts or synthetic corneas may be used in some cases depending where the injury is located on the cornea. Healthy cornea is stretched to the injury site.

Sliding Graft

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