An eye ulcer is a wound to the surface of the eye. The cornea is made up of layers of clear cells that cover the surface of the eye and protects the eye like the skin protects the rest of our body. When our skin is injured it becomes inflamed and turns pink, when the cornea is injured it becomes inflamed and turns cloudy. It is more serious if your pet injures their eye than their skin because an injury through the skin will take you to muscle but an injury through the cornea of the eye will puncture the eye ball and may cause rupture of the eye and blindness.
Causes of eye ulceration
Dogs – Dogs with protruding eyes e.g. brachycephalic breeds and boxers are very prone to eye ulcers. They can also be caused by hairs rubbing on the eyes, dry eyes, curled in eyelids or trauma.
Cats – Cats get ulcers secondary to cat flu and often they will have an ulcer if they have been fighting.
Signs of an Ulcer
- Holding the eye closed
- Shying away from light
- Very runny eye
- Rubbing the eye with their paw or along the carpet
- Being quiet and off colour
- The eye may look cloudy or red
The vet will examine the eye including the eye surface, the iris, the lens and the retina. We will check for any other ocular disease or anything that may have predisposed your pet to an ulcer.
We will then put an orange dye in your pet’s eye. This dye runs off the normal cornea but sticks to any deeper cornea where the surface has come off and here it will shine bright green. We will use this test to assess the size, position and depth of the ulcer.
The treatment will vary depending on the severity of the eye ulcer. Eye ulcers, like wounds to the skin will heal, usually in 7-10 days but you need to provide the right conditions and prevent any secondary infection.
Secondary infection in an eye ulcer can lead to the whole surface of the cornea melting away.
Antibiotic eye drops - These vary between twice daily use to hourly use depending on the type of drop and the severity of the ulcer.
Lubricants - We may also provide eye lubricants which act like a cream would on your skin to soothe and protect the eye.
Pain relief - Eye ulcers are very painful so usually we will prescribe oral pain relief to help control your pet’s pain.
Plasma – In deep or severe ulcers we use plasma eye drops. This requires taking blood from your dog or cat, spinning it down to remove the blood cells and keeping the pale yellow plasma. This plasma contains many natural healing properties and protective enzymes to speed up ulcer healing. The plasma will be given to you in ready made syringes for you to use usually four times daily. It must be kept in the freezer and only taken out and put into the fridge a few hours before use.
The above treatment may be insufficient if your dog has an indolent ulcer or a deep ulcer.
These are ulcers which are quite superficial but are very slow to heal. They usually occur on Boxers, West Highland Terriers and Pugs but other breeds may be affected. They may take many months to heal. To help them heal we use different techniques to remove the dead corneal tissue and freshen it up to aid healing. Some techniques can be done in the consultation and others require sedation. If this still isn’t working then referral is sometimes an option for more specialist debriding of the ulcer e.g. using a diamond burr.
Very deep ulcers (desmetocoeles) require a conjunctival graft. This is when a piece of conjunctiva is sutured over the ulcer to protect it and aid in healing. This is a specialist procedure and we would refer to the appropriate facility for this.
It is very important we regularly check eye ulcers and re-stain them to ensure they are healing and not getting any deeper. We ask you to bring your pet in for regular check ups, usually every 3 days, during this period until the ulcer has healed.