Treatment Of Simple Corneal Ulcers Part 1 A simple corneal ulcer could be defined as a small, superficial ulcer in an eye that has minimal to no uvei
Treatment Of Simple Corneal Ulcers Part 1
This dog has an uncomplicated corneal ulcer.
A simple corneal ulcer could be defined as a small, superficial ulcer in an eye that has minimal to no uveitis, in a breed that does not have a high complication rate with ulcers.
There are many causes for a simple corneal ulcer. It is important to always check for an underlying cause. Dry eye, extra eyelashes, eyelid problems e.g. entropion, oversized eyelid openings. With a simple corneal ulcer the cornea should be otherwise normal i.e. not oedematous or vascularized. Generally there is minimal uveitis; however some degree of hyperaemia and miosis may be present. The eye should be relatively comfortable.
The ulcer in this case has loose epithelial edges, this is a sign of epithelial basement membrane disease.This ulcer needs debriding and a grid keratotoly.
As long as the edges of the ulcer are not under-run (i.e. the ulcer is indolent), treatment is simply:
1. A broad spectrum antibiotic such Tricin® triple antibiotic ointment TID for 5-7 days
2. Oral Non Steroidal Anti-Inflammatory SID for 7 days
3. Atropine 1% drop – may be administered in the consult or if the pupil is small a 1ml Atropt Minim® may be dispensed – one drop daily for 5-7 days
If all is going well the eye should be rechecked at the 5-7 day mark. Generally most simple corneal ulcers are healed within 7 days.
At the revisit examination recheck for dry eye as an underlying cause of the ulcer. Sometimes mild cases of dry eye will present with excessive epiphora with an ulcer as reflex tearing is at a maximum rate, and once the ulcer is healed they may have subnormal tear readings. At the same time check the other eye!
