Diamond burr debridement of calcific band keratopathy in 24 eyes of 22 horses.

PURPOSE: To evaluate the safety and effectiveness of diamond burr debridement (DBD) for the treatment of calcific band keratopathy (CBK) in horses. METHODS: Medical records from horses with CBK were reviewed over a period of 4 years. Diagnosis of CBK was based on slit-lamp examination findings, and DBD was performed on standing sedated horses. Follow-up was obtained by clinical reevaluation of the treated eyes or a telephone survey with the referring veterinarian. RESULTS: Twenty-two horses of different ages (median: 11 years; range: 5-23) representing 24 CBK-affected eyes (14 left eyes and 10 right eyes) were included in the study. The patients had a medical history of chronic and recurrent uveitis, which required repeated long-term treatments with various combinations of ophthalmic corticosteroids. DBD alone cleared the cornea in 22 affected eyes (92%), but it was combined with blade scraping in two cases with thick calcium plaques. The postoperative medication included a topical antibiotic, atropine drops, and oral flunixin meglumine. Corneal healing was achieved in 21 eyes (87%), 5-21 days (median time 13 days) postoperatively. The three remaining horses were lost to follow-up. Recurrence occurred in 5 of the 21 (24%) reexamined eyes, 3-12.5 weeks (median 8 weeks) postoperatively, and required a second DBD. Four of the 21 eyes ended up being enucleated due to sequelae of uveitis. The main limitations of the study include those inherent to all retrospective clinical data collections. CONCLUSION: Mechanical DBD can readily and safely clear the cornea in horses with CBK, but recurrence of calcium deposition is possible.

Pyogenic granuloma of the cornea in a pony: Uncommon complication of corneal wound healing.

A 6-year-old miniature Shetland pony mare was referred for evaluation of a left corneal mass, which developed from the healing tissue of a corneal traumatic ulceration that had occurred 4 weeks previously. On gross examination, a spherical, smooth-surfaced, and pink-colored lesion of about 1 cm in diameter was protruding from the left palpebral fissure. Ophthalmic examination revealed that it was attached to the scar tissue of the cornea, and that one corpora nigra was adherent to the posterior face of corneal wounded area, without sign of uveitis. The remainder of the ophthalmic examination was unremarkable. The mass was excised, and cryotherapy was used as an adjunctive therapy. Histopathology of the resected mass was consistent with a pyogenic granuloma on the basis of radially oriented proliferating capillaries, embedded in immature granulation tissue containing an infiltrate of neutrophils, plasma cells and eosinophils. There were no histological features of malignancy. 2 months after surgery, the ventral part of the fibrotic corneal scar was slightly raised by a pink tissue, suggesting possible recurrence of the initial lesion. A second cryotherapy was performed over the leukoma area. No recurrence has been noted for a follow-up period of more than 25 months. Pyogenic granuloma is a benign proliferative fibrovascular response that typically develops after trauma or surgery. Corneal involvement is rare in humans, and to the authors' knowledge has never been documented in veterinary ophthalmology.

Conjunctival calcinosis circumscripta in a dog: Treatment combining surgical resection and amniotic membrane grafting.

This report describes the clinical features, histopathology, and surgical treatment of a case of conjunctival calcification in a 5-month-old female English Setter, referred with a history of recurrent conjunctivitis in the right eye (OD). The ophthalmic findings were limited to multifocal white plaques embedded in a markedly inflamed conjunctiva of the eyelids and the anterior nictitating membrane OD. Calcification was suspected. The blood cell count, blood chemical profile, and urinalysis were within normal limits, and long-bone radiographs appeared normal. After removal of the affected area by means of a large conjunctivectomy, cryopreserved canine amniotic membrane (AM) was transplanted to fill in the defect. Multifocal ectopic calcium deposits in the conjunctival lamina propria were confirmed histopathologically. The postoperative healing was uneventful, and no recurrence was observed during a follow-up period of five years. Conjunctival mineralization is uncommon in canine ophthalmology, and the cause remained undetermined in the present case, for which AM transplantation was able to promote conjunctival healing after a large surgical excision.

Corneal anesthesia associated with topical application of 2% lidocaine nonophthalmic gel to healthy canine eyes.

OBJECTIVE: To assess the degree and duration of corneal anesthesia induced by topical application of 2% lidocaine gel to the healthy canine eye. ANIMALS: Nineteen adult Beagles free of ocular abnormalities. PROCEDURES: Baseline corneal touch threshold (CTT) was measured bilaterally with a Cochet-Bonnet aesthesiometer. The 2% lidocaine gel (0.1 mL) was applied to one eye, randomly assigned, and the same volume of a lubricant gel was applied to the opposite eye. The CTT measurements were repeated bilaterally within 1 minute, after drug application, and every 5 minutes, until the baseline corneal sensitivity was restored. The potential for local adverse effects was evaluated. RESULTS: Complete desensitization of the cornea (CTT = 0) was achieved one minute after lidocaine gel application and was maintained during 25.3 ± 12.5 minutes. Overall, the corneal sensitivity was significantly decreased for 58.4 ± 16.6 minutes compared with baseline level. Minor and reversible punctate epithelial erosions of the cornea were observed in the two treatment groups and were attributed to the anesthetic effect and the aesthesiometry procedure. CONCLUSIONS: In the current study, the 2% lidocaine gel provided a sustained, deep and well-tolerated corneal anesthesia in ophthalmically normal dogs.

Subconjunctival nodule due to Setaria equina erratic migration in a horse: First case report.

An 18-month-old Arabian-English filly resident in southwest France was referred for evaluation of a conjunctival mass in the right eye (OD). A pink, solid, and mobile nodular formation, measuring approximately 1.2 × 0.8 cm was found under the superior nasal bulbar conjunctiva during an ophthalmic examination that was otherwise normal. The mass was surgically removed using a standing procedure. Cytological examination of fine-needle aspirates from the mass revealed a mixed eosinophilic-lymphocytic inflammation. Histological examination confirmed the dense and diffuse eosinophilic-lymphocytic infiltrate of the mass, and it revealed several cross sections of a parasitic nematode. The morphometric diagnosis identified an immature form of a filarial worm, and molecular analysis of the mitochondrial cytochrome c oxydase subunit 1 (cox1) and 12S rRNA gene sequences led to further identification of the specimen as Setaria equina. Microfilaremia was not observed on fresh blood smears. There have been no signs of local recurrence after 18 months, nor any evidence of intraocular involvement. To the authors' knowledge, this is the first documented case of subconjunctival setariasis due to S equina in a horse.

Congenital lacrimal fistula in two prim'Holstein calves.

Two 4- and 8-month-old prim'Holstein calves were presented for chronic epiphora. Examination of the affected eyes revealed an abnormal duct opening inferonasal to the medial canthus. A diagnosis of congenital lacrimal fistula was made based on conventional and computed tomographic-dacryocystography findings. These revealed an ectopic channel connecting the nasolacrimal duct to the skin opening near the medial canthus. Both of the calves were surgically treated with resection and closure of the ectopic duct and placement of a nasolacrimal stent.

Changes in pupil size and intraocular pressure after topical application of 0.5% tropicamide to the eyes of dogs sedated with butorphanol.

OBJECTIVE: To assess changes in pupil size and intraocular pressure (IOP) following topical application of a 0.5% tropicamide solution in the eyes of healthy butorphanol-sedated dogs. ANIMALS: 12 healthy adult Beagles. PROCEDURES: In a randomized crossover study consisting of 2 treatment periods with a 1-week washout between periods, dogs received an IM injection of butorphanol (0.2 mg/kg) or an equal volume of sterile saline (0.9% NaCl) solution. For each dog, 1 drop of 0.5% tropicamide ophthalmic solution was topically instilled in one eye and 1 drop of artificial tear solution was topically instilled in the other eye 10 minutes after the IM injection and again 5 minutes later. Extent of sedation, pupil size, and IOP were evaluated from 20 minutes before to 80 minutes after the IM injection and compared among treatment combinations. RESULTS: Butorphanol induced mild (n = 9) or moderate (3) sedation in all dogs and slightly delayed the onset of, but did not prevent, tropicamide-induced mydriasis. Butorphanol caused a significant increase in IOP, which was not exacerbated by tropicamide-induced mydriasis; however, that increase was generally not sufficient to exceed the upper limit of the IOP reference range. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that butorphanol did not prevent tropicamide-induced mydriasis but did increase the IOP in ophthalmologically normal Beagles. Although the butorphanol-induced increase in IOP did not appear clinically relevant for the dogs of this study, that may not be true for dogs with glaucoma, and care should be taken when butorphanol is administered to such dogs.

Effect of topical application of 2% lidocaine gel on corneal sensitivity of clinically normal equine eyes.

OBJECTIVE: To assess the degree and duration of corneal anaesthesia provided by topical application of a non-ophthalmic 2% lidocaine gel in horses. STUDY DESIGN: Experimental, 'blinded', randomized prospective study. ANIMALS: Twelve adult horses without relevant ocular abnormalities. METHODS: Baseline corneal touch threshold (CTT) measurements were obtained bilaterally by use of a Cochet-Bonnet aesthesiometer just prior to topical treatment. A volume of 0.2mL of 2% lidocaine gel was administered in one randomly selected eye and the same volume of a viscous lubricant in the other eye to serve as control. The CTT value was measured on both eyes 5, 10, 20, 30, 45, 60, 75 and 90 minutes after drug application. The potential for local adverse effects following lidocaine gel application was also evaluated. RESULTS: Mean CTT baseline measurements were not significantly different (p>0.05) between the control eyes (3.41±0.56cm) and those subsequently treated with the lidocaine gel (3.50±0.64cm). In control eyes, no significant changes in corneal sensitivity (p>0.05) occurred over time during the study period. By contrast, a marked reduction in corneal sensitivity was observed after lidocaine application, with mean CTT values significantly lower (p<0.001) than those of the control eyes from 5 to 75 minutes. A steady-state maximal corneal anaesthesia was present from 10 to 45 minutes after lidocaine gel application with mean CTT values ranging from 0.21 to 0.45cm. Corneal epithelial irregularities were detected in three lidocaine-treated eyes, but spontaneous resolution occurred within 24hours. CONCLUSIONS AND CLINICAL RELEVANCE: Deep and sustained corneal anaesthesia is achieved after application of 2% lidocaine gel to the equine eye, with minimal changes in the corneal epithelium. It might be useful for minor ophthalmic surgeries performed in the standing sedated horse.

Effect of sedation with butorphanol on variables pertaining to the ophthalmic examination in dogs.

OBJECTIVE: To evaluate whether sedation with intramuscular butorphanol can interfere with different variables of the ocular examination in dogs. ANIMALS: Twenty-two beagles without ophthalmic abnormalities. PROCEDURES: Each dog was examined 20 min prior to and again just before administration of butorphanol to establish baseline data. The globe and nictitating membrane position was evaluated, and the following were recorded: menace response, dazzle reflex, corneal blink reflex, phenol red thread tear test (PRT), Schirmer tear test-1 (STT-1), pupil size (PS) measurement, and rebound tonometry. Then, butorphanol was injected intramuscularly at a dose of 0.2 mg/kg and these procedures were repeated 10, 20, 30, and 45 min postadministration. A sedation score graded 0 to 3 was also established at these time points. Statistical analyses were performed on quantitative data using ANOVA. RESULTS: The sedative effect was not associated with any changes in globe and nictitating membrane position; did not affect the results of the menace response, dazzle reflex, and corneal blink reflex; and had no significant effect on PRT values. However, butorphanol administration was associated with a statistically significant decrease in STT-1 and PS values (P < 0.005), and a statistically significant increase in IOP (P < 0.05). All these variations remained in the range of normal values. CONCLUSIONS AND CLINICAL RELEVANCE: Butorphanol administered intramuscularly at 0.2 mg/kg provided a degree of sedation allowing eye examination, but was found to interfere with STT-1, PS, and IOP values among the diagnostic tests studied. However, these values remained within normal limits.