Corneal ulcer

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Anybody have any ideas on my sad, sorry story?

Background:

My TB stallion started out with a tiny little ulcer in his left eye 10 weeks ago. It was treated with Octin and kept clean. Despite all my best efforts, before I knew it, his whole eye was 1 huge ulcer and my 1 prof at my veterinary college that I am friendly with kindly came out and had a look at him 2 weeks after the original ulcer appeared.

My prof put in a subpalpebral lavage system so we could put drops in his eye easily and he was treated every 2 hours, alternating between spun down serum and tobrex (gentamycin). His eye tested negative for both bacteria and fungi. I carried on with the antibiotic drops/serum for 2 weeks and then decided to give the eye a break for a few days so I stopped the antibiotics but carried on with the serum. It soon developed a stromal abscess which we then treated with tobrex and chloromycetin (chloramphenicol) and it seemed to drain and was looking better. Since then we have gone in reverse, he seems to have what looks like granulation tissue where the original ulcer was. Its now being treated with a steroid to try stop this yuck red tissue growing in his eye, we started this 1 week ago when I stopped the tobrex/chloromycetin combo. I have done absolutely everything that I can but I have stopped everything as from friday, for a few days to see if the granulation tissue isnt still actually an abscess as its formed a real point in his eye.

Any suggestions?

 

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[glenruby]

Has this subpalpebral lavage system been managed at home? You really need to have your horse admitted to a hospital for treatment. Alternatively have a specialist in ophthalmology examine him or if money is an issue have an enucleation.
Ets - cant see the photos.

 

[alsiola]

To be honest I don't think this forum is the right place to be looking for answers about a serious and complicated eye issue. If you are not getting anywhere after 10 weeks then as Glenruby says you need an ophthalmologist. Where in the country are you?

 

[oscarwild]

My previous horse had a eye ulcer if your interest in the pics there are some on the post images of horse veterinary conditions on here. Think my pics are on page 7.

Do you have any pics of the ulcer itself. My horse was on boxrest for 4 months with his ulcer and we tried everything on it from drops, serum, contact lens etc and in the end it abscessed to top it all off. He was left blind behind in the eye and was always left with a huge white blob that never went away.

Again all treatment was done on horse after things were discussed etc with a eye specialist and he was sent reguar pic and stuff. I would recommend you find a specialist and discuss with them if you havent already done so. Eyes are tricky.

 

[Box_Of_Frogs]

Other options are (don't know technical terms) thin slices off the cornea itself to get down to healthy tissue or use the membrane from underneath the upper eyelid as a graft and pull it down across the cornea. This brings a blood supply to the cornea although obviously vision would be affected but at least you have a healthy eye. My horse (search on my posts you'll find a ton of stuff) developed a corneal ulcer after his previous owners did nothing to properly address a chronic conjunctivitis. Diagnosis superficial keratitis which is an autoimmune disease. Began to resolve on Optimmune which is an immunosupressant. Vets thought would resolve to a small cloudy dot but would always be prone to flare ups. Then staff back at yard stabbed my horse in the eye with the pointy end of the bloody Optimmune tube for gods sake! Optimmune of course supresses immune response to this injury so all the ground we'd gained, we lost almost overnight. Back to hospital and this time wasn't such good news. Came home after 2 weeks on a tightrope management of stop Optimmune, start antibx if infection - stop antibx, start Optimmune when infection cleared up. But he only lasted a few weeks like this and it became unmanageable. The tissues at the back of the cornea were beginning to lose their ability to keep the fluid inside the eyeball. I had a terror of the eyeball rupturing. Uveitis started in the eye. At one point neovascularisation began to take place but it didn't grow right across. Couldn't do either the graft or the slicing of cornea as the causative agent was still unknown. In the end, enucleation was the only answer. My horse never looked back. Jumped, hacked, won dressage tests, brilliant. The only issues now are a) he came to me with BOTH eyes gungy and disgusting and because we never found out what caused the flip over into superficial keratitis, it could strike the other eye too and b) he now doesn't have a spare eye and I don't believe blindness is any quality of life for a horse.