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Persistent corneal erosions
Introduction
- Superficial defects in the corneal epithelium that do not heal within two weeks with appropriate therapy.
- Cause: undetermined in the cat.
- Signs: persistent superficial nonhealing corneal ulcer.
- Diagnosis: ophthalmic exam.
- Treatment: numerous treatments available.
- Prognosis: good with persistent therapy, but can be frustrating to treat.
Presenting signs
- Mild epiphora Epiphora.
- Tear tract onto face at the medial canthus.
- Variable blepharospasm.
- Variable photophobia.
- Possible red eye.
- Pawing or rubbing at eye (infrequent).
Acute presentation
- Noticeable tearing and mild discomfort from the eye.
- Change in appearance of the cornea.
Age predisposition
- Middle aged, mean age = 7.75 years.
Breed/Species predisposition
- Possibly Persian and Himalayan cats (brachycephalic cats).
- Occurs much less often in the cat than in the dog.
Cost considerations
- Inexpensive to diagnose.
- Can be inexpensive to moderately expensive to treat, depending upon how quickly the erosions heal and what treatment is used.
Pathogenesis
Etiology
- In many instances an inciting cause is never delineated.
- Primary disorder of the basement membrane of corneal epithelial cells has not been confirmed in the cat.
- Feline herpesvirus-1 may play a role. Many affected cats have a prior history of upper respiratory signs or chronic conjunctivitis (LaCroix, 2001) Conjunctivitis.
Predisposing factors
General
- Potentially, low tear production.
- Potentially, poor health from some other disease, eg diabetes mellitus Diabetes mellitus, herpesvirus infection Cornea: herpesvirus keratitis.
Pathophysiology
- Unlike the dog, the mechanism of development of persistent erosions has not been elucidated.
- In addition, the histopathologic changes have not been extensively studied.
- This is partly due to the low incidence of this type of ulcer in cats, compared to dogs.
Timecourse
- A nonhealing ulcer of at least two weeks duration.
- May persist for weeks to months.
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.
- Bromberg N M (2002) Cyanoacrylate tissue adhesive for treatment of refractory corneal ulceration. Vet Ophthalmol 5 (1), 55-60 PubMed.
- La Croix N C, van der Woerdt A & Olivero D K (2001) Nonhealing corneal ulcers in cats: 29 cases (1991-1999). J Am Vet Med Assoc 218 (5), 733-735 PubMed.
- Turner A G & Blogg J R (1997) Multiple striate keratotomy: a treatment for corneal erosions caused by epithelial basement membrane disease. Aust Vet J 75 (1), 27-30 PubMed.
- Gaiddon J, Kaswan R L & Hirsh S G (1996) Radial keratotomy and third eyelid flap: results of a novel approach to treatment of nonprogressive stromal ulcers and defects among dogs and cats. Vet Comp Ophthalmol 6 (4), 218-219 VetMedResource.
- Morgan R V & Abrams K L (1994) Comparison of six different therapies for persistent corneal erosions in dogs and cats. Vet Compar Ophthalmol 4 (1), 38-43 VetMedResource.
Other sources of information
- Petersen-Jones S & Crispin S (2002) BSAVA Manual of Small Animal Ophthalmology. 2nd edn. British Small Animal Veterinary Association. ISBN 0 905214 54 4