This may take weeks to months for a deep ulcer and grey wispy scars are expected. The use of topical epidermal growth factor for the treatment of nonhealing corneal erosions in dogs. University of California-Davis, Davis, CA, USA Deep corneal ulcers rarely improve with topical medications as the sole therapy. I prefer to use topical cyclosporine (1.5% to 2%) solution two to three times daily as initial therapy. I prefer to perform, under topical anesthesia, epithelial debridement and multiple superficial keratotomies as the initial treatment. This Corneal neoplasia is rare, and many times actually arise from the limbal region. What to do when ulcers won't heal. In fact, the scenario of keratitis in the face of an associated conjunctivitis is almost always due to feline herpesvirus. GK is contraindicated in all other ulcer types in dogs and in all ulcers in cats where they are a very "reliable" means of inducing a corneal sequestrum. The clinical signs of KCS are varied, and can include a mucoid to mucopurulent ocular discharge, conjunctivitis, keratitis, dull-appearing cornea ("lack-luster cornea "), pigmentary keratitis, acute-forming corneal ulcers (even corneal ruptures with an iris prolapse), and blindness. When the ulcer is healed, as evidenced by no fluorescein retention, a topical lubricant ointment is applied to improve the regularity and smoothness of the cornea. Cytology is obtained at the leading edge of the lesion after the instillation of topical proparacaine. Third edition ( ed. The cornea is composed of five basic layers: the precorneal tear film, the epithelium and its basement membrane, the stroma, Descemet's membrane, and the corneal endothelium. Full discussion of all antiviral drugs and their indications and contraindications is beyond the scope of this session but, in summary, I have 3 favourite choices:Grid keratotomies should never be performed in cats; however, debridement with a cotton-tipped applicator is indicated.2. Prior to therapy, always characterize ulcers as "simple" or "complicated""Simple" (or "uncomplicated") ulcers, by definition, are superficial and present less than 7 days. Prior to the instillation of any ophthalmic medication, the edge of the lesion is cultured with a sterile culture swab. Epithelial healing occurs within hours to days and should leave no long-term scar. Would you like to change your VIN email? In dogs and cats, the only organisms known to initiate ulcers are feline and canine herpes viruses. If the ulcer fails to fit Each of these ulcer complications has a characteristic appearance:Grid keratotomy (GK) is the treatment of choice for indolent ulcers. After topical debridement and keratotomies, I place a bandage soft contact lens on the patient's eye, and administer topical triple antibiotic solution and atropine solution. Ultraviolet radiation and elevation have additive effects in the severity of this disorder. An Elizabethan collar is always advised to minimize self-trauma to the eye. Would you like to change your VIN email? Frequent (as often as once hourly) therapy with an antibiotic with appropriate spectrum, such as tobramycin, fortified/compounded amikacin or gentamicin, or a fluoroquinolone such as ofloxacin/ciprofloxacin.3. Treatment for eosinophilic keratitis includes topical and systemic anti-inflammatory agents. Surgery for ulcers that are rapidly progressive, have obvious areas of melting, or are deeper than half corneal thickness:b. Third edition ( ed. Cyclosporine A (CSA) is the treatment of choice for KCS. Edition. Certain ophthalmologists perform a complete superficial lamellar keratectomy as part of their initial therapy. Both medical and surgical options are available. Striations need to extend from normal adherent epithelium, through the ulcer bed, and emerge in normal adherent epithelium on the opposite side of the ulcer. Because I have observed several cats with corneal sequestra, which have perforated when allowed to slough off on their own, rather to surgically remove the lesion, I prefer to remove the sequestrum with a keratectomy and then to perform a corneoconjunctival transposition or conjunctival graft procedure.Eosinophilic keratitis is another unique ocular syndrome to the cat (also seen in equine patients), which is readily diagnosed with a corneal scraping and cytology or a corneal biopsy (not necessary in most cases).