Treatment Options for Feline Corneal Ulcer: A Comprehen

Typical treatments for feline corneal ulcers include:

1. Elizabethan collars can be used on cats to prevent them from scratching their eyes or rubbing them against carpets or furniture, which can cause further damage to the eyes due to the irritation of the corneal ulcer.

2. Bacterial infections often worsen corneal ulcers, especially deeper ones. Preventing secondary infections is a crucial part of treating corneal ulcers. This involves applying local ophthalmic ointments or eye drops directly to the eyes until the ulcer heals. A common preparation is a combination of three antibiotics—neomycin, polymyxin B, and bacitracin or gramicidin—mixed together.

In cases of more severe ulcers, the choice of antibiotics can be guided by the results of culture and sensitivity analyses. It is crucial to avoid using any medications containing corticosteroids when corneal ulcers are present.

3. Antibiotics are ineffective against FHV1. If your cat develops ulcers after an FHV1 infection, it is advisable to use antiviral medications regularly, such as idoxuridine, trifluridine (Viroptic®), or acyclovir (iraA®).

4. In cases where the ulcer is deep upon initial discovery or progresses rapidly despite appropriate treatment, surgery may be necessary to save the eye and vision. This may require referral to a veterinary ophthalmologist.

5. For deep corneal ulcers or those at risk of perforation, the most common surgical procedure is a conjunctival graft under general anesthesia. A small piece of conjunctiva near the cornea is sutured over the ulcer. This provides healthy blood supply to the area and offers mechanical support to the affected corneal tissue. The graft can reduce the risk of perforation, improve comfort, accelerate healing, and is akin to the effect of skin grafts on severe burns.

6. For superficial ulcers, a bandaging procedure may be sufficient to promote healing. Sometimes, soft contact lenses are placed over the eyes to shield the ulcer. If contact lenses are not available, the third eyelid can be temporarily sutured to the upper eyelid to cover the cornea. While suturing the third eyelid can also protect the cornea, it hides the ulcer, making it difficult to observe whether it is improving or worsening. The animal can still see through the contact lenses, but when the third eyelid is sutured, it becomes blind.

7. Another protective surgical option is a partial eyelid suture, which temporarily closes the outer eyelid together. The eyelids can partially close to protect the cornea while still allowing for regular observation and treatment of the ulcer.

8. Treatment for dry eye syndrome may require surgical correction of eyelid inversion, in addition to removing extra or misaligned eyelashes. These steps can also limit the chance of future corneal ulcers.

AtHome Care for Feline Corneal Ulcers

Followup care for corneal ulcers is essential. First and foremost, always follow the instructions for any prescribed medications, and if you encounter any issues during treatment, be sure to notify your veterinarian. Optimal veterinary followup care includes:

1. Since simple ulcers typically heal within 7 days, all ulcers should be rechecked within this timeframe. More severe ulcers or any that worsen during treatment should be checked more frequently and quickly. During followup examinations, the ulcer outline is redrawn using fluorescein staining. Remember, any ulcer that worsens, even with appropriate treatment, requires further evaluation, and sometimes referral to a veterinary ophthalmologist may be necessary.

2. Followup checks can also monitor for any causes of irritation, such as regrowth of eyelashes, recovery of normal blinking responses, changes in tear production, and the proper positioning of the eyelids after inversion correction surgery.

3. Feline herpesvirus is a chronic recurrent disease in some cats and can complicate other corneal conditions, such as keratitis and chronic keratoconjunctivitis, as well as chronic intermittent conjunctivitis.