Diagnostic and therapy of deep corneal ulcerations in the horse

Indeed deep corneal ulceration con result from superficial erosions of the epithelium but they have to be distinguished thouroughly in diagnosis and therapy. Besides historic considerations and the examination of the ocular adnexa an extensive and detailed elevation of clinical findings on the margin and the base of the corneal ulcer is essentiol. Ulcer swaps has to be collected to determine microbial causes for corneal ulceration or secondary complications in the ulcer before other diagnostic methods are established. Finally the extend of secondary uveal changes have to be examined and treated. Local therapy of the ulcer depends on the stage of stromal damage and pathophysiological reaction: removing of foreign material and detritus, reducing stromal melting (kerafolysis), antimicrobial treatment, mydriasis and pain control support the secondary stromal wound healing. Systemic treatment is indicated in secondary reflex uveitis and microbial endophtholmitis. Surgical intervention is indicated in retracted stromal healing: debriding of the corneal ulcer and lamellary ceratectomy to remove excess necrotic tissue and elpithelial layers, conjuncfival grafting to provide an instant corneal blood supply and temporary blepharorrhaphy to protect the conjunctival graft and the bulb.