We recently had a patient present for cloudy, reddish eyes.
- An 11-year-old MN Bassett hound was presented for a cloudy appearance to the eyes and they were also irritated. Upon examination corneal erosions were detected.
- The patient was sent via referral to an eye specialist where he was diagnosed with corneal endothelial degeneration with corneal erosions, which I have heard can be quite painful.
- An 11-year-old MN Bassett hound was presented for a cloudy appearance to the eyes and they were also irritated. Upon examination corneal erosions were detected.
- The patient was sent via referral to an eye specialist where he was diagnosed with corneal endothelial degeneration with corneal erosions, which I have heard can be quite painful.
- The specialist recommended Thermokeratoplasty or Laser keratoplasty, but he also advised these can be painful procedures as well. Eye removal was also discussed as a way to end the ocular pain long-term.
We recently had a patient present for cloudy, reddish eyes.
I know nothing of eyes so it sounds fairly drastic to remove the eyes altogether, but again if it will alleviate excruciating eye pain? I had not heard of this before or the treatment options. Does anyone know about this problem and is there a less painful treatment, or a better way to manage eye pain in this situation? Thanks, our client was pretty upset by the diagnosis and pain factor. Not to mention the eye removal part! 🙂 Thank you in advance
Comments
Well, I’m not an
Well, I’m not an opthalmologist but the old treatment for corneal erosions when I was practicing was sewing the eyelid shut and treating topically and systemically for pain and infection. Most of the time it worked as the eyelid feeds and heals the cornea. Now that higher tech is available then i imagine less practical options are given owing to defensive medicine but again i am not an eye specialist but can only say what nearly always worked for me. Just no cortisone owing to the erosions but topical and systemic nsaids, pain meds and abs with a temporary palpebral closure (eyes wide shut) for 10 days and recheck may do the trick. Whats it going to hurt if they can’t afford other? Worse case you remove the eye(s) afterwards as long as there is solid pain management.
I would scan the eyes too to ensure the posterior chamber is in tact and ciliary bodies and retina are in place (see attached image form the normals dvd). If those structures are involved its a more complicated process.
Between 1997 and 2001 I would say I did about 10 of these and can only remember 1 that didn’t work and some had some scarring but maintained sight and periodic medical tx for the condition.
I am sure there is someone out there with more experience than “eye” ion this sector though:)
Well, I’m not an
Well, I’m not an opthalmologist but the old treatment for corneal erosions when I was practicing was sewing the eyelid shut and treating topically and systemically for pain and infection. Most of the time it worked as the eyelid feeds and heals the cornea. Now that higher tech is available then i imagine less practical options are given owing to defensive medicine but again i am not an eye specialist but can only say what nearly always worked for me. Just no cortisone owing to the erosions but topical and systemic nsaids, pain meds and abs with a temporary palpebral closure (eyes wide shut) for 10 days and recheck may do the trick. Whats it going to hurt if they can’t afford other? Worse case you remove the eye(s) afterwards as long as there is solid pain management.
I would scan the eyes too to ensure the posterior chamber is in tact and ciliary bodies and retina are in place (see attached image form the normals dvd). If those structures are involved its a more complicated process.
Between 1997 and 2001 I would say I did about 10 of these and can only remember 1 that didn’t work and some had some scarring but maintained sight and periodic medical tx for the condition.
I am sure there is someone out there with more experience than “eye” ion this sector though:)
Thank you Dr. Lindquist, that
Thank you Dr. Lindquist, that is some great advice even if it is “old school”. Sometimes going the more simple route can achieve the best outcome.
Thank you Dr. Lindquist, that
Thank you Dr. Lindquist, that is some great advice even if it is “old school”. Sometimes going the more simple route can achieve the best outcome.
The problem is with
The problem is with endothelial degen that the ulcers will likely recur. Permanent conjunctival flap might be a better option than what Eric recommends but difficult to do as a GP. Personally, I’d start ofloxacin, muro 128, tramadol PO and reeval in a few weeks. But I’d certainly defer to an ophtho and if the owner didn’t love what this one had to say, I’d call him and discuss possible other options.
The problem is with
The problem is with endothelial degen that the ulcers will likely recur. Permanent conjunctival flap might be a better option than what Eric recommends but difficult to do as a GP. Personally, I’d start ofloxacin, muro 128, tramadol PO and reeval in a few weeks. But I’d certainly defer to an ophtho and if the owner didn’t love what this one had to say, I’d call him and discuss possible other options.
Awesome Liz thx for helping
Awesome Liz thx for helping here its been a while since i did anything with an eye except put a probe on it:)
Awesome Liz thx for helping
Awesome Liz thx for helping here its been a while since i did anything with an eye except put a probe on it:)