Eye Conditions

Surgery

Parotid duct transposition (PDT) can be considered when all alternative therapies have failed.
This is when: Over 80% of dogs are comfortable after this surgery. In about 5% of cases the eye is still dry after surgery, and in another 10% of cases the eye is too wet after PDT surgery. In these cases dermatitis may develop from the overflow of tears. This may require more surgery. Some dogs may require ointment after PDT surgery. Decreasing the size of the eyelid openings can help stabilise the tear film, and reduce corneal exposure e.g. medial and lateral canthorrhaphies, or a permanent mid tarsorrhaphy.

Without treatment

1. Profuse ocular discharge
2. Corneal scarring or ulceration
3. Blindness

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Diagnosis

Diagnosis
A diagnosis can be made on clinical signs. Other diagnostic tests that may be considered include conjunctival cytology. In rare cases bacterial culture and biopsy may be required. In cats a swab may be taken for PCR testing for Feline Herpes Virus and Chlamydia.

Management

Management in Dogs
* Wipe the eyes clear of any mucky discharge
* If the dog has other signs of allergy such as eczema, dermatitis or ear problems, it may be worthwhile doing allergy testing. This is generally done in conjunction with your local veterinarian.
* Most dogs with chronic conjunctivitis will require long term treatment. Unlike in humans, long-term cortisone drops will not cause cataracts or glaucoma. The only potential complication is if something else happens to the eye, the cortisone drops can make an ulcer or an infection worse. So stop the drops if the eye is suddenly more closed, watery, mucky, blue or red.

CONJUNCTIVITIS
* Most chronic cases of conjunctivitis in dogs can only be controlled rather than cured.

Management in Cats
* Most cases of conjunctivitis in cats are secondary to infections such as Feline Herpes Virus or Chlamydia. It is important to keep the eyes as clean as possible of any discharge. Chlamydia can in rare cases infect humans so it is important to wash your hands after cleaning the cat’s eyes.
* Cats with conjunctivitis will generally require a 3 week course of antibiotic tablets. We have found that double the recommended dose is required at twice daily to eradicate Chlamydia. Other cats can act as carriers, so it is important to treat all cats in the household.
* Most feline conjunctivitis cases settle well after the prolonged antibiotic course. In some cases it may be necessary to use anti-inflammatory medications to resolve an underlying reaction. Cats can occasionally get unusual reactions such as eosinophilic keratoconjunctivitis. These can be difficult to treat.

Potential Complications from Conjunctivitis Dry Eye (keratoconjunctivitis sicca): This is a deficiency of the tears which normally bathe the cornea and conjunctiva. Dry eye can either cause or can be the result of conjunctivitis. It is important to regularly check the tear readings in both eyes. Thick mucky discharge with a dry look to the eyes is characteristic of dry eye. The normal tear reading for a dog is >15mm, for a cat >10mm wetting in a minute.

Entropion: This is where the eyelid rolls onto the eyeball. It is seen most commonly in large breed dogs such as Rottweilers. In most cases eyelid surgery is required even if the primary conjunctivitis is treated.

Corneal scarring: In some severe cases of conjunctivitis, the inflammation can spread onto the cornea causing reaction in the cornea - keratitis. In most cases the conjunctivitis treatment will reduce the corneal reaction.

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Diagnosis

Diagnosis of blepharitis
Usually a thorough history and physical examination are sufficient to diagnose blepharitis. Sometimes a biopsy is required to determine the underlying cause of the blepharitis. A biopsy may be indicated if the response to therapy is poor.

Treatment

Treatment of Blepharitis
Treatment depends upon the underlying cause. If blepharitis is a result of other ongoing health conditions, those should be treated concurrently. It is usually recommended to use warm compresses - a hand towel soaked in plain warm water will aid in removing the discharge from around the eyelid. The hair around the eye must be clipped short. Bacterial blepharitis is treated with antibiotics for a minimum of 3 weeks.

Some dogs will also need to be treated with systemic anti-inflammatory medications. These may either be steroidal or non-steroidal drugs.

Prognosis

The long term prognosis depends upon the underlying cause. Many dogs will need some form of medication long term. Blepharitis is often something that is controlled rather than cured.

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