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EQUINE CASE: ACUTE EYE TRAUMA

Dave Kruger

Alfie is a 22 year old Kaimanawa gelding who had the misfortune of getting the wrong end of a stick during a wind-storm.

He presented with acute right eye pain – eyelids tightly closed with profuse tearing.   Once local anaesthetic and sedation was administered a full thickness perforating wound was evident through the cornea of his right eye.   Bleeding was present in the anterior chamber of the eye, and it was difficult to fully evaluate the iris and deeper structures.

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Alfie was given a full general anaesthetic and the cornea was sutured with a fine absorbable suture material.

The risk with these cases is uveitis – inflammation and infection of the iris, a common sequel to eye trauma in horses.  If this occurs complete loss of the eye is almost inevitable.

To mitigate this, an indwelling lavage catheter was placed to allow topical medication to be administered easily.  The catheter was secured to his head with sutures and superglue and plaited into his mane, allowing treatment to be carried out from the wither area. 

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Alfie was treated intensively for the first week post op, both with systemic antibiotics and anti-inflammatories and a cocktail of topical medications, including atropine.  This has the effect of eliminating iris spasm (very painful) and increasing drainage of the eye.

Four weeks after the accident Alfie’s eye is looking very promising. Whilst still some excessive tear production – likely due to irritation from the sutures which have not yet fully dissolved- the anterior chamber of the eye is clear and he has a normal menace reflex and pupil response.

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