Corneal ulceration is commonly diagnosed by equine veterinarians. A complete ophthalmic examination as well as fluorescein staining, corneal cytology, and corneal bacterial (aerobic) and fungal culture and sensitivity testing are necessary for all infected corneal ulcers. Appropriate topical antibiotics, topical atropine, and systemic NSAIDs are indicated for all corneal ulcers. If keratomalacia (melting) is observed, anticollagenase/antiprotease therapy, such as autologous serum, is indicated. If fungal infection is suspected, antifungal therapy is a necessity. Subpalpebral lavage systems allow convenient, frequent, and potentially long-term therapy. Referral corneal surgeries provide additional therapeutic options when the globe’s integrity is threatened or when improvement has not been detected after appropriate therapy.
Corneal ulcers are commonly seen in equine practice because of the prominence of the equine ocular globe and its risk for traumatic injury. Over the past 10 years in our veterinary teaching hospital, corneal diseases/conditions have accounted for 50% of equine ophthalmology cases, most of which (75%) involved corneal ulcers. Other referral hospitals have observed that 24% to 76% of all ophthalmic evaluations involve ulcerative keratitis.1–3 Because of the high prevalence of corneal ulcers in referral centers, equine practitioners are likely to regularly encounter corneal ulcerations and need to formulate a diagnostic and therapeutic strategy for their patients.