reptile - Articles
Corneal / spectacle perforation
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
- Conjunctivitis.
- Neovascularization.
- Ocular discharge.
- Self-trauma.
Acute presentation
- Less common in snakes as the spectacle protects the cornea.
Cost considerations
- If surgery is required cost can be moderate to high.
Special risks
- Anesthetic risk if surgery required.
Pathogenesis
Etiology
- Trauma.
- Perforated ulcer.
- Foreign body.
- Inappropriate management of retained spectacle (snakes) Retained spectacle.
- Retained shed with secondary infection (common in Leopard geckos Leopard gecko).
Predisposing factors
General
- Poor husbandry Chelonia husbandry Lizard husbandry Snake husbandry in reptiles (eg inadequate humidity, poor diet leading to hypovitaminosis A Hypovitaminosis A) leading to dysecdysis Ecdysis / dysecdysis and eyelid lesions which may predispose to corneal damage.
Specific
- Dysecdysis Ecdysis / dysecdysis leading to retained spectacle Retained spectacle (snakes) or retained shed building up under eyelids (common in Leopard geckos Leopard gecko).
- Inappropriate management of retained spectacle, eg forcibly removing it, leading to corneal desiccation and possible rupture.
- Traumatic injury, eg grass seed perforation.
- Progression of corneal ulcer Corneal ulceration.
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.
- May be more chronic in snakes.
- Healing tends to be slow.
Diagnosis
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Treatment
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Prevention
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Outcomes
Subscribe To View
This article is available to subscribers.
Try a free trial today or contact us for more information.
Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Munevar C, Moore B A, Gleeson M D et al (2019) Acremonium and trichosporon fungal keratoconjunctivitis in a Leopard Gecko (Eublepharis macularius). Vet Ophthal 22 (6), 928- 932 PubMed.
- Millichamp N J (1997) Management of ocular disease in exotic species. Semin Avian Exotic Pet Med 6 (3), 152-159 SciDirect.
Other sources of information
- Lawton M P C (2019) Ophthalmology. In: Mader’s Reptile and Amphibian Medicine and Surgery. 3r edn. Eds: Divers S J & Stahl S J. Elsevier, USA. pp 721-735.
- Williams D (2012) The Reptile Eye. In: Ophthalmology of Exotic Pets. Wiley-Blackwell, UK. pp 181-182.