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Corneal Injection
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Two Nickles
Reg. Mar 2015
Posted 2019-03-13 9:31 AM (#7424845)
Subject: Corneal Injection


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I have a guilding that developed a corneal ulcer last November.  Throughout the treatment process the ulcer turned into an abcess and as the epithelial layer healed, our team of veterinarians felt that injecting the eye would be the best course of treatment.  After about 3 months with a lavage line in, we are "in the clear," but there is still a small scar from the injection.  

I am just curious of any one else's experience with similar situations and how the scar healed, how much it affected their eyesight and performance over time, etc., or if there was anything we could give (that you had experience with) that might help clear the scar up, improve any vision loss, etc.  

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treasurehunter
Reg. Sep 2007
Posted 2019-03-17 3:18 PM (#7425110 - in reply to #7424845)
Subject: RE: Corneal Injection



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I don’t know if this helps or not but my eye doctor is suggesting a procedure on a scar in my eye that sounds similar.  He said the reason the scarring is continuing is the minerals deposited in the tissue.   I will have more details in a few days.

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oija
Reg. Feb 2012
Posted 2019-03-18 11:00 AM (#7425151 - in reply to #7424845)
Subject: RE: Corneal Injection



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We had one that got a fungal infection on their eye, had to have part of their cornea replaced with swine tissue. It left a large white scar but as the tissue has absorbed the scar has gotten smaller and smaller. This may happen with yours I hope.

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r_beau
Reg. Apr 2010
Posted 2019-03-18 1:36 PM (#7425166 - in reply to #7424845)
Subject: RE: Corneal Injection



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Two Nickles - 2019-03-13 9:31 AM


I have a guilding that developed a corneal ulcer last November.  Throughout the treatment process the ulcer turned into an abcess and as the epithelial layer healed, our team of veterinarians felt that injecting the eye would be the best course of treatment.  After about 3 months with a lavage line in, we are "in the clear," but there is still a small scar from the injection.  


I am just curious of any one else's experience with similar situations and how the scar healed, how much it affected their eyesight and performance over time, etc., or if there was anything we could give (that you had experience with) that might help clear the scar up, improve any vision loss, etc.  


I'm not a vet, but I am a human eye doctor.

I find it interesting the similarities and the differences between human eye talk vs equine eye talk. In the human world, we do not use the word abcess when refering to the cornea. But they do in the equine world. In a human, it could be referred to as an infiltrate (collection of white blood cells in the cornea) or hypopyon (collection of white blood cells in the anterior chamber).  The human eye also has a very small layer between the epithelium and stroma (called Bowman's) but the equine eye does not.

In humans, infiltrates are usually very successfully treated with steroids and, if needed, antibiotics. Of course, horses and steroid drops generally is not a good idea due to the risk of fungal infection and an NSAID is going to be a much better choice.

Did they determine, for your horse, if the abcess was fungal or bacterial in nature, or simply inflammatory? (just curious)

Do you remember what they injected with?

The cornea can and will scar from certain trauma. Even humans who get small ulcers will often leave a scar behind. Most of the time, as long as the scar is not located centrally, it does not have any impact on visual acuity or peripheral vision. Since there are similarities between human and equine eyes, it would make sense to me that our equine partners would follow that same "rule".

How large is the scar? (can you see it with the naked eye?)

Is it from the injection, or the abcess, or both?

What location? (central? perpheral?)

Those factors will determine if it will impact your horse's vision.

In general, just like a scar on any other part of your body, once a scar is there, it will not go away and there isn't anything you can apply to make it go away. Sometimes, yes, there are certain surgical procedures that can help lessen the scar. But usually if the scar is as deep as the stroma (which is likely in your horse's case, since he had an abcess) then surgical procedures aren't going to be as effective to get rid of the scar because it is so "deep". Unless, of course, you do a corneal transplant or a partial corneal transplants. Which isn't without its risks. Just depends how bad the scar is and what layers it is affecting.

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Two Nickles
Reg. Mar 2015
Posted 2019-03-19 3:22 PM (#7425276 - in reply to #7425166)
Subject: RE: Corneal Injection


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Posts: 82
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r_beau - 2019-03-18 1:36 PM


Two Nickles - 2019-03-13 9:31 AM


I have a guilding that developed a corneal ulcer last November.  Throughout the treatment process the ulcer turned into an abcess and as the epithelial layer healed, our team of veterinarians felt that injecting the eye would be the best course of treatment.  After about 3 months with a lavage line in, we are "in the clear," but there is still a small scar from the injection.  


I am just curious of any one else's experience with similar situations and how the scar healed, how much it affected their eyesight and performance over time, etc., or if there was anything we could give (that you had experience with) that might help clear the scar up, improve any vision loss, etc.  



I'm not a vet, but I am a human eye doctor.


I find it interesting the similarities and the differences between human eye talk vs equine eye talk. In the human world, we do not use the word abcess when refering to the cornea. But they do in the equine world. In a human, it could be referred to as an infiltrate (collection of white blood cells in the cornea) or hypopyon (collection of white blood cells in the anterior chamber).  The human eye also has a very small layer between the epithelium and stroma (called Bowman's) but the equine eye does not.


In humans, infiltrates are usually very successfully treated with steroids and, if needed, antibiotics. Of course, horses and steroid drops generally is not a good idea due to the risk of fungal infection and an NSAID is going to be a much better choice.


Did they determine, for your horse, if the abcess was fungal or bacterial in nature, or simply inflammatory? (just curious)


Do you remember what they injected with?


The cornea can and will scar from certain trauma. Even humans who get small ulcers will often leave a scar behind. Most of the time, as long as the scar is not located centrally, it does not have any impact on visual acuity or peripheral vision. Since there are similarities between human and equine eyes, it would make sense to me that our equine partners would follow that same "rule".


How large is the scar? (can you see it with the naked eye?)


Is it from the injection, or the abcess, or both?


What location? (central? perpheral?)


Those factors will determine if it will impact your horse's vision.


In general, just like a scar on any other part of your body, once a scar is there, it will not go away and there isn't anything you can apply to make it go away. Sometimes, yes, there are certain surgical procedures that can help lessen the scar. But usually if the scar is as deep as the stroma (which is likely in your horse's case, since he had an abcess) then surgical procedures aren't going to be as effective to get rid of the scar because it is so "deep". Unless, of course, you do a corneal transplant or a partial corneal transplants. Which isn't without its risks. Just depends how bad the scar is and what layers it is affecting.


Yes - I failed to mention that this all stemmed from a fungal infection.  We had initially been advised to treat with steroids after there appeared to be no physical damage, cuts, etc. to the eye (it appeared to be swollen from impact as though he hit/bumped it one something), but a few days later when symptoms weren't improving I called the vet school at Kansas State and we immediately went a different route.  

I do not remember what they injected with - I want to say atropine?? He was also receiving miconazole and ofloxacin -I will have to look at the paperwork when I get home.  

Yes, you can see the scar with the naked eye.  I would say the entire white area is maybe an 1/8-1/4" in diamenter and towards the forehead vs on the center (I'll try to get a picture tonight), but the opthamologist made it sound as though that entire area isn't necessarily without vision - just the very center where the injection took place.  Which makes me kick myself - had we not agreed to inject the eye, woud there be ANY vision loss or scaring, but how do we know they would have been able to clear up the fungal injection and save the eye without it?  It's a hard call... 

I've seen a few reviews for Simply Equine and Silver Lining Herbs that have helped with vision and various eye damages that I have been considering, but not sure that they will do much for scaring...  He doesnt seem to be phased by anything - I was acfraid he would become spooky from blind spots, but that doesnt seem to be the case at this point. 

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