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Corneal perforation

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Introduction

  • Cause: perforated corneal ulcer, trauma, foreign body.
  • Signs: unilateral blepharospasm, ocular discharge, change in corneal appearance, conjunctivitis, epiphora.
  • Diagnosis: history, clinical signs, ophthalmic examination.
  • Treatment: broad spectrum antibiotics, topical serum, pain relief, third eyelid flap, corneal graft, enucleation.
  • Prognosis: good if early treatment and no damage to deeper ocular structures.

Presenting signs

  • Usually unilateral.
  • Ocular pain: blepharospasm
  • Red eye.
  • Conjunctivitis.
  • Neovascularization.
  • Ocular discharge.
  • Self-trauma.

Cost considerations

  • If surgery is required cost can be moderate to high.

Special risks

  • Anesthetic risk if surgery required.

Pathogenesis

Etiology

  • Trauma.
  • Perforated ulcer.
  • Infection, eg Chlamydia caviae.
  • Foreign body.

Predisposing factors

Specific

  • Traumatic injury, eg grass seed perforation.
  • Progression of corneal ulcer.

Pathophysiology

  • If Descemet's membrane is breached, then loss of aqueous humor and iris prolapse occurs.
  • The anterior chamber may collapse.
  • Uveitis occurs.

Timecourse

  • Usually seen as an acute problem.
  • Healing tends to be slow.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Millichamp N J (1997) Management of ocular disease in exotic species. Semin Avian Exotic Pet Med (3), 152-159 SciDirect.

Other sources of information

  • Williams D (2012) The Guinea Pig Eye. In: Ophthalmology of Exotic Pets. Wiley-Blackwell, UK. pp 56-72.