Mary Allen
The initial examination by the veterinarian is crucial.
Owners usually notice changes in the pet’s eyes very quickly. They are also too obvious to be overlooked: the eye looks different, is protected by tightly closed eyelids, and sometimes shows severe eye discharge or severely restricted function, i.e. the animal appears disoriented or stands around in the apartment.
However, even a more detailed examination of the eye proves to be much more difficult: the animal cannot be looked into the eye because the disease is extremely painful even without further manipulation by the veterinarian. Reasonable eye diagnostics require a particularly good overview. Take a look at the eye below: Only after lifting the third lid did the small thorn in the cornea (cornea) become visible, which was making life difficult for the dog.
The pupil of the anesthetized animal is still under the prolapsed eyelid.
However, the veterinarian must definitely come to diagnose these emergencies, because he doesn’t get a second chance: an acute attack of glaucoma should be treated properly within 2-3 hours, a “melting ulcer” can break through within a few hours, a penetrating foreign body can cause the stool to leak eye or lead to severe inflammation (uveitis) – and if a wooden spike penetrates the eye completely due to the constantly irritating paw, there is a violent tissue reaction so that the foreign body can no longer be seen. In any case, it can only be removed after opening the anterior chamber of the eye.
If the cause of an ophthalmological emergency cannot be determined in the awake animal – especially because the animal cannot be examined – anesthesia should always be performed. If the animal owner is made aware of the importance of the examination, he too will see that the low risk of anesthesia is in no reasonable proportion to the loss of sight. The equipment with ophthalmological examination devices is certainly not always necessary for the diagnosis, a good slit lamp or, if necessary, an otoscope lamp already does a good job. The use of an aqueous local anesthetic or fluorescein is permitted. Mydriatics should be used cautiously, as they can distort the examination by the specialized ophthalmologist for hours. If the emergencies described are then diagnosed, the patient must be referred for further treatment immediately.
As an emergency therapy, an antibiotic that can enter the eye is administered systemically, e.g. a gyrase inhibitor. Even in the case of perforating injuries to the cornea, the emergency injection of a steroid (e.g. 2-3 mg/kg body weight prednisolone) makes sense to control the inflammation (uveitis). Local medicines can interfere with further treatment or even make healing impossible. Eye ointments in particular interfere significantly with a later operation – regardless of their ingredients.
Rinsing the eye with physiological saline solution, full electrolyte solution, or Ringer’s lactate is indicated only in the case of chemical burns or high-grade contamination with dirt or dyes.
With this first aid, the patient can be treated more specifically. If a referral is necessary for this, the clinic providing further treatment should be informed in advance by telephone, stating the emergency treatment, since an ophthalmological team experienced in microsurgery may have to be mobilized there. This is possible at any time but can take 1⁄2 to 1 hour. If the patient is working on the eye, a cervical collar can offer very good protection.
After the detailed ophthalmological examination, the animal owner receives a statement on the cause, therapy, and prognosis of the disease. Often a statement can be made about the restoration of vision. Further treatment can almost always be carried out by the veterinarian.
Thanks to the extremely good cooperation so far, many animals have been helped well, even with serious injuries and injuries. The treatment not only has to consider the eye disease but very often also its systemic causes such as heart or kidney disease. The handed-over therapy plan motivates the pet owner to have the sometimes lifelong follow-up treatment carried out by the veterinarian.
Even damage to the eyes that looks hopeless has an excellent prognosis with adequate immediate treatment: As an example, we show you the eye of a black domestic cat that came home with a narrowed eye after a nocturnal excursion. She had probably gotten into a fight and was injured in the cornea with a claw. This injury had been infected by collagenase-producing germs. Within a few hours, a “melting ulcer” developed, i.e. a corneal ulcer whose edges literally melted away. At presentation, there was already a large connective tissue (stroma) defect, through which Descemet’s membrane protruded to a diameter of 3 mm. Any mechanical stress, no matter how small, e.g. the cat bumping into a piece of furniture, wiping with the paw, or palpation by the vet would have perforated this cornea and let the eye leak.
The cornea was carefully cleaned of dirt and dead cells and the pressure-tight supply was carried out using a conjunctival flap.
The result after 8 weeks (4 weeks after flap removal) was excellent for the cat.
The owner didn’t want to have the central scar removed because it didn’t bother the cat at all. After another twelve months, it had halved again anyway.