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.

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

Treatment

Outcomes