Keratitis

[oscarwild]

My vet has diagnosed my horse with keratitis in his eyes. His left eye has a cateract in it from before I bought him after a previous accident and he had a trauma ulcer in his right eye last year.

During the spring and summer his left eye keeps flaring up with keratiitis. He gets a steroid and anti inflammatory drops along with natural tears 2 to 3 x daily until his eye heals. He gets turned out with a fly mask on but occasionally he gets his mask off his eye flares up again. At present he is now stabled during the day and out in the field at night with his mask on.

I'm wondering if anyone has had dealings with this and how they go about treating it and if you have any more info on the condition.

 

[Box_Of_Frogs]

Superficial keratitis is a nasty disease. There is a recognised link between chronic conjunctivitis and keratitis but there are question marks over the herpes virus and fly spread too. Superficial keratitis is an auto-immune disease which means that the body's own immune system is attacking the tissues of the eye in the mistaken belief that there is an infection of some kind there. But there isn't, so the usual first attack is on the cornea. Corneas can be absolute horrors to heal because, of course, they don't have a blood supply. Treatment is usually a protracted course of immuno-supressant drugs (Optimmune) which is prohibitively expensive (4 years ago, a tiny tube that lasted about a week cost £35). In the early stages of treatment, the horse is likely to also be on atropine to dilate his pupil, otherwise the iris can scar and stop working properly. While he's on atropine, he needs to be kept out of bright light or the retina can be damaged. If the disease is caught early, the milky white patch/patches that you see on the cornea should start to shrink. They may or may not disappear completely but shouldn't cause the horse any problems. The horse may need to be on a maintenance dose of Optimmune for life.

Take enormous care with putting drops or creams into your horse's eye. The Optimmune suppresses the horse's response to an infection (because there isn't one there!) but if he DOES get an infection he's in BIG trouble immediately because his ability to fight it off has been stopped. A huge opportunity for infection is when drops or creams are being put in the eye. Keep the tube and your hands scrupulously clean. The safest way to put creams in is to apply the cream to the tip of your nice blunt fingertip and then squish your finger tip into the eye. Drops are harder. Pull the bottom lid out into a little pouch and, holding the tube PARALLEL to the eye (not at right angles) drip the drops into the little pouch. It's a 2-man job really. My horse Sunny developed superficial keratitis after chronic conjunctivitis that his previous owners didn't bother to clear up. He also had a mysterious injury in his stable that may or may not have contributed to it. He was admitted to a specialist horse eye hospital and after a week they managed to get on top of it and he was sent home with Optimmune and atropine, adminsitered 3 times a day. Sad story then because he was stabbed in his bad eye by the end of the Optimmune tube. Nobody told me it had happened so a very deep infection took hold. Back to the eye hospital. Poor prognosis. Back home. Tried everything but Sunny couldn't cope and after another 6 weeks of daily battles and call-outs and unrelenting pain for Sunny, he went back to the hospital and had the eye removed.

Please remember, with care and specialist treatment, your horse will probably be fine. But even if the worst comes to the worst, he will do FINE with only one eye. Sunny is the safest horse on the yard and hacks, jumps, does dressage and everything a 2-eyed horse can do! However, I'd ask for a referral to a specialist centre and do take great, great care over adminstering the drops/creams. PM me if you need any more info hun xxx

 

[Butterbean]

My horse (dark bay in my signature) had keratitis too in his left eye. Unfortunately it couldn't be stabilised (he was in hospital for a couple of months) and he had to have his eye removed. But as Box of Frogs says, it is not the end of the world for him, at least he is free from the pain now. When it was first diagnosed the vets did say that in their experience the condition was very hard to manage and was likely to keep flaring up. Wish you lots of luck for your horse and hope you manage to keep on top of it.