Corneal ulcer, or ulcerative keratitis, is one of the corneal diseases more frequently seen in my practice. By simple definition, a corneal ulcer is the loss of the surface layers of the cornea. This is a very painful disease that is manifested by tears, frequent blinking, and keeping the eye closed in brightly lighted areas. Diagnosis, as done by your family veterinarian, is determined by instilling an eye stain, Fluorescein, into the injured eye. Fluorescein eye stain is a dye that is reddish-orange before being instilled into the eye. If an ulcer is present, the stain outlines the ulcer in a bright green under the rays of a black light. The ulcer's extent and degree of involvement are delineated so that a therapeutic plan may be formulated. There are many things that can cause a corneal ulcer to form: 1) trauma from abrasion, such as facial hair rubbing on the cornea as well as eyelashes that have turned in (entropion); 2) chemical and thermal burns; 3) infectious organisms, such as bacteria, viruses and fungi; 4) drying of the cornea when tears are not being sufficiently produced; and 5) combinations of the above. Of course, there are breeds that are predisposed to the development of corneal ulcers due to hereditary defects (most of which are produced by humans to satisfy breed standards), such as dogs with bulging eyes (Boston Terriers, Pugs, Pekingese) and breeds with entropion (Shar Pei, Chow-Chow) to name a few. The size (depth and width) of the ulcer and the possibility of infection determine the prognosis and treatment protocols. With the more extensive ulcer, the treatment is naturally more involved. The ulcer must be contained to prevent rupture and loss of the eyeball itself. Being as the eye is a direct extension of the brain, the breaching of the corneal surface barrier by infectious organisms may produce serious complications. Depending on the severity of the ulcer, the conjunctival tissues may have to be sewn over the ulcer to act as an internal bandage; the eyelids are sewn shut also for support. Usually the sutures are left in for seven to 14 days. Soothing antibiotic and analgesic ointments are instilled into the eye through a gap in the closed eyelids. Frequently, supportive vitamins (riboflavin and Vitamin A) are dispensed to assist in the repair of the damaged cornea. If an infection is present, then oral antibiotics will be dispensed also. Once the sutures are removed, Fluorescein is used to test the healing process. If there is no longer any retention at the ulcer's site, healing is complete. However, if it fluoresces, more therapy is indicated. This is not a disease to be taken lightly. Your pet's ability to see and to keep its eyeball is at stake. Should your pet exhibit any signs of a corneal ulcer, please seek veterinary care as rapidly as possible. -Dr. John N. Case, Jr., is the owner of The Clinic for Animals small-animal practice located at 5201 N. State Road, Tamarac, Florida. Phone 954-739-4500. He can also be reached by e-mail at Jcase74683@aol.com.

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