b'YOUR GUIDE TO THE 2017 AAEP CONVENTION SPONSORED BYAngry Corneasand ERUSTACEY OKE, DVM, MSCHow to Manage 6 Types ofCorneal Ulcersorneal ulcers are the most common ophthalmic condition equine practitioners see in the field. Some are simple scratches that heal quickly with appropriate treatment, while others are more complex, involve infection, and can take longer to heal. Regardless of their severity, they must be managed appropriately to prevent/treatBIANCA MCCARTYinfection, control pain, and speed healing.When an ulcer is slow to heal, oneand potentially missed without the useStreptococcus, Pseudomonas) and fungi must carefully examine the eye to deter- of a cobalt blue light. Cytology (viewing(Aspergillus, Fusarium), and;mine what kind of ulcer you are dealingcells under a microscope) performed6. Keratomalacia and stromal loss, the with, said Catherine Nunnery, DVM,on corneal scapings reveals eosino- dreaded melting ulcer.Dipl. ACVO, a large animal ophthalmolo- philsa type of white blood cell thatVeterinarians treat the first four types gist at the University of Pennsylvaniaresponds to allergic and/or parasiticof ulcers similarly; therapy generally School of Veterinary Medicine, in Ken- stimuli often without evidence ofinvolves administering systemic non-nett Square.infection in a relatively nonpainful eye; steroidal anti-inflammatory drugs (e.g., Corneal edemaClassifying ulcers correctly ensures4. , characterized byphenylbutazone or flunixin meglumine timely application of appropriate therapy.fluid in the stromal layer. These occurequivalent); the cycloplegic atropine to re-Nunnery said there are six types ofbecause either the corneal ulcer allowslieve ciliary spasm, which is essentially a equine corneal ulcers: fluid to reach the stroma or dysfunc- charlie horse in the muscle that controls Nonhealing (indolent) ulcers1. , whichtion of the deepest layer of the corneapupil dilation; antibiotics effective against occur due to abnormal adhesion of(e.g., glaucoma) causes fluid buildup inboth Gram-positive and -negative agents; corneal epithelial cells to the anteriorthe stroma and ulcers to form; antifungal agents; and antiproteases such Corneal infectionstroma (the layer of tissue beneath the5. , most commonlyas serum or ethylenediaminetetraacetic outer surface of the cornea); caused by bacteria (Staphylococcus,acid (more simply called EDTA). As your Corneal mineralization2.due to calciumveterinarian will warn you, never use any deposits. Patients with this type ofocular medication containing a cortico-ulcer have either recurrent anteriorsteroid to treat ulcerated corneas. (front of the eye) uveitis or chronic/ In some cases, a veterinarian might recurrent keratitis (corneal inflamma- need to remove the damaged tissue using tion). The calcium deposits appear asa process called debridement.multiple white opacities in horizontalThe underlying cause of ulcers can be patterns across the central or ventralvery difficult to ascertain, said Nunnery, (lower) cornea; adding that corneal cytology plays a key Eosinophilic keratitis3. , which research- role in diagnosing and treating it.ers believe results from exposure to either an allergen or parasites. One orERU: Your Best Chance for both eyes can be involved. FluoresceinCOURTESY DR. CATHERINE NUNNERY Successful Treatmentstaining (a test that uses dye to detectOne type of corneal ulcer is corneal mineraliza- Equine recurrent uveitis (ERU) is a corneal damage) results can be fainttion due to calcium deposits. nasty disease, causing searing pain and March 2018THE HORSE AAEP Wrap-Up TheHorse.com/AAEP2017 A41'