Topic:Cornea
The cornea in horses is a transparent, dome-shaped surface that covers the front of the eye, playing a vital role in focusing vision. It serves as a barrier against pathogens and physical damage while maintaining ocular hydration and transparency. The equine cornea is composed of several layers: the epithelium, stroma, Descemet's membrane, and endothelium, each contributing to its overall function and health. Conditions affecting the cornea, such as ulcers, infections, and trauma, are common in horses and can significantly impact visual acuity and comfort. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, physiology, pathology, and treatment of corneal conditions in horses.
Photodynamic therapy with infracyanine green induces keratocyte depopulation in the normal equine cornea. Use of photodynamic therapy (PDT) for the treatment of immune-mediated keratitis (IMMK) in horses is becoming common. The safety and morphologic impact on the normal equine cornea have not been investigated, and the mechanism of its efficacy is unknown. Objective: To investigate the morphologic effects and safety of in vivo PDT on healthy equine corneas. Methods: In vivo experiment. Methods: Six university-owned horses underwent unilateral corneal PDT with intrastromal infracyanine green (EmunDo®) and photoactivation with an 810 nm diode laser (500 mW for 2.5 min = 75 Joules). Compl...
Equine Corneal Stromal Invasive Squamous Cell Carcinoma: Clinical and in Vivo Confocal Microscopic Features of 7 Cases. To describe the clinical and in vivo confocal microscopy (IVCM) characteristics of horses with corneal stromal invasive squamous cell carcinoma (CSI-SCC). Methods: Retrospective study of 7 horses with histopathologically confirmed unilateral CSI-SCC. Methods: Horses with corneal CSI-SCC were examined by laser scanning IVCM. Signalment, clinical findings, and histopathology results were compared with IVCM findings. Results: Clinical ocular lesions in all horses included a heavily vascularized, opaque, gray or tan, anterior or midstromal opacity invading the cornea from the limbus. The corneal ...
Unilateral vision loss associated with corneal opacity and posterior lens luxation in the right eye of a Thoroughbred gelding: Case report. A 15-year-old Thoroughbred gelding was presented for examination due to chronic corneal opacity in the right eye, which had been noted for several years. An ophthalmic evaluation revealed dense, irregular corneal opacity; an absence of the direct pupillary light reflex; and a positive dazzle reflex. Fluorescein staining was negative and cytology of a corneal conjunctival swab identified nucleated squamous epithelial cells, but no inflammatory cells. Slit-lamp examination failed to visualize intraocular structure, and the lesion was deemed to be chronic and irreversible. An obstacle-avoidance t...
Polyhexanide, Povidone-Iodine, and Hypochlorous Acid Show High In Vitro Antimicrobial Efficacy Against Pathogens Commonly Associated With Equine Infectious Keratitis. To determine the in vitro antimicrobial activity of specific antiseptics against common equine ocular surface pathogens. Methods: Staphylococcus aureus (S. aureus) (n = 12), Streptococcus equi subspecies zooepidemicus (S. zooepidemicus) (n = 9), Enterobacter hormaechei (E. hormaechei) (n = 6), and Bacillus cereus (B. cereus) (n = 5) were collected from corneal samples of horses with ulcerative keratitis. Reference strains were included. Minimum bactericidal concentrations (MBC) of polyhexanide, povidone-iodine, and hypochlorous acid were tested using the microdilution method. ...
Reducing Recurrence in Equine Corneolimbal SCC: Outcomes of Adjunctive Cisplatin Biodegradable Bead Therapy. (1) Context: Squamous cell carcinoma (SCC) is the most prevalent ocular neoplasm in horses, with a reported 45% recurrence rate when managed by surgery alone. (2) Objective: To evaluate the effect of adjunctive cisplatin biodegradable beads (CBBs) on recurrence rates of equine corneolimbal squamous cell carcinoma (SCC) and to document associated adverse effects. (3) Methods: Seventeen cases of histopathologically confirmed corneolimbal SCC in horses were retrospectively identified. Masses were surgically excised by keratectomy and/or conjunctivectomy under general anesthesia, followed by impla...
Green Light-Activated Rose Bengal Cross-Linking in 81 Horses With Complex Corneal Ulcers and Stromal Abscesses. To assess the efficacy and safety of Rose Bengal and green light corneal cross-linking (RGX) as an adjunctive treatment for complicated corneal ulcers and stromal abscesses in horses. Methods: A retrospective analysis included 81 horses (82 eyes) treated with RGX between 2018 and 2024. Cases involved complicated corneal diseases such as melting keratitis, fungal keratitis, deep stromal defects, and stromal abscesses. Treatment consisted of topical or iontophoretic administration of 1% Rose Bengal followed by green light irradiation (550 nm; 150 J/cm) for 10 min. Most procedures (76.8%) w...
Ultraviolet C (UV-C) Light Therapy Inhibits Pathogens Associated With Equine Keratomycosis at Different Corneal Depths-An Ex Vivo Study. To assess if an inexpensive, commercially available ultraviolet C (UV-C) light device with a peak emission of 275 nm can inhibit equine keratomycosis-associated pathogens located at different corneal depths in an ex vivo model. Methods: A controlled, randomized experimental design. Aspergillus fumigatus and Fusarium solani isolates were inoculated in fresh bovine corneoscleral transplants, superficially or at 450 μm of stromal depth for the ulcerative keratomycosis or stromal abscess model, respectively. After a minimum of 18 h of incubation, treatment groups received 15 s of UV-C li...
Dexmedetomidine Prolongs the Duration of Ropivacaine Corneal Anesthesia After Subconjunctival Injection in Healthy Horses. To determine whether dexmedetomidine prolongs corneal anesthesia following subconjunctival ropivacaine injection in healthy equine eyes. Methods: Ten horses with normal ophthalmic exams were enrolled in a randomized, blinded, crossover experiment with a minimum 4-week washout between treatments. Baseline corneal touch thresholds (CTT, cm) were measured via esthesiometry and a subconjunctival injection was performed in the treatment eye with ropivacaine (R, 0.3 mL 0.5%) or dexmedetomidine-ropivacaine (DR, 0.1 mL 0.5 mg/mL + 0.2 mL 0.5%) and saline (control, 0.3 mL) in the contrala...
Computed Tomographic Assessment of Normal Ocular Dimensions and Densities in Cadaveric Horses (Equus ferus caballus). This study aimed to characterize the computed tomographic (CT) dimensions and contrast attenuation properties of the equine eye. CT scans from 21 horses without ocular abnormalities were analyzed to obtain detailed ocular measurements and attenuation values. In addition, cranial measurements, such as nasal-occipital length and zygomatic width, were incorporated to explore potential anatomical relationships between the skull and intraocular structures. Although most correlations between cranial and ocular parameters were weak, statistically significant associations-particularly those involving ...
Corneal Squamous Cell Carcinoma Arising From a Conjunctival Graft Scar in a Horse. To describe the case details of an equine corneal squamous cell carcinoma (SCC) arising from the central scar of a previous conjunctival pedicle graft. Methods: An 18-year-old Thoroughbred gelding, showing a progressive increase in diameter, depth, opacity, and pigmentation of a conjunctival pedicle graft scar of the left eye, 34 months after surgery. Methods: Complete ophthalmic examination, standard histologic and immunohistochemical evaluation of an incisional biopsy to formulate a definitive diagnosis. Carbon dioxide (CO) laser photoablation combined with topical mitomycin C treatment. R...
Methodology of easy-to-use horizontally centrifuged platelet-rich fibrin as a topical treatment for equine ulcerative keratitis in 5 horses. To describe the most efficient topical horizontally centrifuged platelet-rich fibrin (H-PRF) treatment protocol for equine ulcerative keratitis (EUK) that is easy to use, and to report the preliminary concentration of growth factors and cytokines in equine H-PRF. Unassigned: 5 client-owned horses diagnosed with EUK were enrolled over an 11-month period. Unassigned: 3 horses were geldings, and 2 were mares. The mean (± SD) age was 5.95 ± 5.01 years. The owners' main goal was to avoid surgery for EUK. Unassigned: H-PRF was used in 3 different protocols: solid H-PRF, sutured to the EUK area (n ...
Infracyanine Green-Based Photodynamic Therapy for Immune-Mediated Keratitis in Horses. To describe infracyanine green-based photodynamic therapy (InfraCG-PDT) and evaluate outcomes in horses with immune-mediated keratitis (IMMK). Methods: Medical records from 2014 to 2020 from the Equine Clinic Munich-Riem, Germany, and Auburn University Equine Ophthalmology Service identified horses diagnosed with IMMK following ophthalmic examination that had undergone InfraCG-PDT. Methods: Multiple intrastromal injections of EmunDo (InfraCG, A.R.C. Laser, Nuernberg, Germany) within an affected quadrant or the entire cornea were treated with diffuse diode laser energy (FOX A.R.C., Laser, Nuern...
Treatment of Iris Hypoplasia Using Semiconductor Diode Laser in the Horse Under Standing Sedation. This study is aimed at describing two unique case presentations of iris hypoplasia and the use of semiconductor diode laser for treatment in the horse. One 20-year-old American Quarter Horse gelding and one 11-year-old pony mare were studied. The presenting clinical signs, surgical technique, and postoperative results for two cases of iris hypoplasia treated with diode laser are described. Immediate postoperative complications-postoperative ocular hypertension (POH), corneal edema, and epithelial bullae-were possible anticipated effects but were controlled with topical medications in the fi...
A retrospective survey of equine ocular diseases evaluated at a referral hospital in Ontario (2011 to 2021). Our objective was to investigate the demographics and prevalence of ocular disease in a large referral population of horses in Ontario over a 10-year period. Unassigned: A retrospective analysis of medical records for 283 horses evaluated by Board-certified veterinary ophthalmologists at the Ontario Veterinary College (Guelph, Ontario) was conducted. Signalment and ocular disease were recorded. Unassigned: The 3 most common ocular abnormalities identified were uveitis (43.7%, 123 horses), ulcerative keratitis (42.0%, 119 horses), and cataract (25.1%, 71 horses). Uveitis was most often secondar...
Bilateral intraocular choristoma in a 2-day-old foal. A 2-d-old Warmblood colt was submitted for autopsy with a spectrum of bilateral ocular abnormalities. At postmortem examination, a constellation of lesions within the anterior segment included retention of ectodermal elements, compatible with choristoma. Ocular choristomas can be localized to different intraocular structures and are rare in equids. The morphologic features in our case were suggestive of abnormal corneal differentiation.
Ultraviolet C (UV-C) Light Therapy for Equine Ulcerative Keratomycosis-An In Vitro Study. To assess if an affordable, commercially available 275 nm ultraviolet C (UV-C) device can inhibit fungal pathogens associated with equine keratomycosis and to establish the optimal exposure time/dose required in vitro. Methods: Fungal inhibition zone surface areas of isolates from two fungal genera (Aspergillus and Fusarium spp.) were compared in triplicates after UV-C exposure at distances of 10, 15, and 20 mm with single or repeat doses (4 h apart) of 5, 10, 15, or 30 s duration after 24, 48, and 72 h of incubation. Inhibition zones were microscopically assessed, and regrowth chec...
Local anaesthetic delivery through indwelling retrobulbar catheters for ocular pain control in horses. Equine corneal disease is common and painful. Current pain mitigation strategies are often suboptimal, especially early in the disease. Objective: To evaluate the effects of local anaesthetic delivery via indwelling retrobulbar catheter on corneal sensitivity, pupil size, pupillary light responses (PLRs), and ocular motility in normal horses. Methods: Randomised, controlled crossover experiment. Methods: One eye was randomly selected from seven horses. A 20-gauge catheter was placed in the retrobulbar space and injected with 10 mL of 0.5% bupivacaine or 0.9% saline. Cochet-Bonnet esthesiomet...
Treatment of equine keratomycosis, part 2: reporting common systemic and ocular complications to enhance decision-making for equine clinicians and owners. The primary aims were to provide descriptive data on systemic and ocular complications associated with the treatment of equine keratomycosis. The secondary aims were to determine if complication rates differ between treatment types or are related to surgical and anesthetic factors. Methods: The study was a retrospective evaluation of 126 cases between 2004 and 2020 with confirmed fungal infection and recorded incidence of complications during hospitalization and surgical intervention if pursued. Additional information recorded included the size of the donor graft if utilized, time under genera...
Survey of ocular abnormalities in a population of Turkmen horses. The aim of this study was to detect and describe ocular abnormalities in a population of Turkmen horses. Methods: A total of 55 Turkmen horses (33 mares and 22 stallions) from one herd were evaluated in this study. Methods: Demographic data (Age, Sex, Coat color) were recorded. All animals underwent complete ophthalmic examination. The Schirmer tear test -I (STT-I) was performed for all horses prior to other diagnostic tests. Neuro-ophthalmic examinations (menace response, dazzle reflex, pupillary light reflex, maze test, and visual tracking) were carried out in different lighting situations (...
Clinical features and outcomes of horses presenting with presumed equine immune mediated keratitis to two veterinary hospitals in the United Kingdom and Finland: 94 cases (2009-2021). There is limited literature regarding equine immune mediated keratitis (IMMK) in Europe. North America-based publications describe minimal blepharospasm, rare corneal ulceration and no uveitis; clinical impression suggests these are seen in Europe. Objective: Assess the prevalence of blepharospasm, corneal ulceration and uveitis and their impact on outcome in horses diagnosed with IMMK in Europe (UK and Finland). Methods: Retrospective case series. Methods: Clinical records of 94 horses with IMMK were evaluated. The UK and Finland populations were comparable; therefore, descriptive statistics ...
Low-dose intravitreal injection of 4 mg preservative-free gentamicin and superficial lamellar keratectomy combined with modified Gundersen grafts to control chronic heterochromic iridocyclitis and secondary keratitis in horses. To describe a combined treatment approach for heterochromic iridocyclitis and secondary keratitis (HIK) in horses. Methods: A total of 15 horses (16 eyes). Methods: Sixteen eyes from 15 horses (mean age 14.1 years, range 6-26 years) received low-dose (4 mg) intravitreal preservative-free gentamicin injection (IVGI) and modified Gundersen grafts with standing sedation and local anesthesia following a clinical diagnosis of HIK. Additional therapies of suprachoroidal triamcinolone (8 mg) injection, episcleral bromfenac implants, and suprachoroidal cyclosporine implants were performed in i...
Current therapy and advancements in the treatment of equine fungal keratitis. Equine fungal keratitis represents a substantial portion of keratitis cases in horses, with fungal involvement identified in approximately half of all infectious keratitis cases. Despite its prevalence, more comprehensive retrospective analyses are needed to better understand this condition. Outcomes vary, with approximately two-thirds of cases achieving complete healing with retained vision, although enucleation is often necessary. Predominant pathogens include Aspergillus and Fusarium, with yeast reported in a minority of cases. Resistance to common antifungal agents among filamentous fungi ...
Equine Corneal Wound Healing Using Mesenchymal Stem Cell Secretome: Case Report. Corneal ulcers are a common and potentially vision-threatening condition in horses that can be challenging to treat with conventional therapies alone. This case report describes the successful treatment of a non-healing corneal ulcer in a 28-year-old Hispano-Bretón mare using the secretome derived from adipose tissue-derived mesenchymal stem cells (ASCs). Despite initial treatment with antibiotics, anti-inflammatory drugs, and surgical debridement, the corneal ulcer failed to heal properly, exhibiting persistent epithelial defects and stromal complications. As an alternative regenerative appr...
Ultrasound biomicroscopic imaging parameters associated with outcome in equine infectious ulcerative keratitis and stromal abscesses. To determine the predictive value of corneal ultrasound biomicroscopy (UBM) findings for the outcome of equine corneal disease. Methods: 46 horses with a clinical diagnosis of either infectious ulcerative keratitis or stromal abscess. Methods: Corneal UBM (VevoMD; UHF70; VisualSonics) of horses with infectious corneal disease presenting to the North Carolina State University Equine Ophthalmology Service from 2019 to 2023 were evaluated. Size and depth of lesion, presence of Descemet membrane disruption (DMD), corneal thickness, and aqueous humor cell counts (AHCC) were assessed. Comparisons of...
Approach to Immune-mediated Ocular Diseases. Immune-mediated ocular inflammation is a common clinical diagnosis reached for horses with keratitis and uveitis. This diagnosis is made as a diagnosis of exclusion following a thorough effort to rule out an underlying cause for the inflammation, most importantly infectious and neoplastic disease. Practically, response to ophthalmic and systemic anti-inflammatory or immunomodulatory medications is used to support a diagnosis of immune-mediated ocular inflammation; however, such medications are often contraindicated in the face of infection or neoplasia. This article will summarize our current ...
Adjunctive bevacizumab therapy in an equine corneal stromal invasive squamous cell carcinoma with a 53-months follow-up. A 17-year-old Appaloosa mare was referred for evaluation of presumed refractory keratitis of the left eye. Gross examination revealed ocular discomfort and corneal neovascularization with a nasal focal opacification affecting approximately 40% of the corneal surface. On ophthalmic examination, extensive subepithelial to mid-stromal vascular branching accompanied by a homogeneous white, dense opacification, which affected up to 80% of the total corneal thickness, were apparent. Signs of concurrent uveitis were absent. Deep-stromal lamellar keratectomy with a conjunctival pedicle graft was perfo...
Comparative efficacy of low-volume retrobulbar anesthesia using three commercial local anesthetics in adult horses. To compare the efficacy of low-volume (5-mL) locoregional retrobulbar anesthesia ("retrobulbar block") by use of 3 commercial local anesthetic formulations. Methods: 8 healthy adult mares. Methods: A block-randomized, masked, controlled design was used. A single ultrasound-guided retrobulbar block was performed with 2% lidocaine, 2% mepivacaine, or 0.5% bupivacaine (n = 5 eyes/group). Contralateral eyes served as untreated controls. End points performed at baseline and time intervals up to 24 hours postblock included the following: assessment of neurophthalmic reflexes/responses, intraocular p...
Comparison of first, second, and third versus the average of six probe-corneal touches for intraocular measurement of two rebound tonometers in healthy horses. The aim of this study was to evaluate the intraocular pressure (IOP) measurements obtained from first, second, and third probe-cornea touch (PCT) and compare them with the average of six PCTs using two rebound tonometers in horses. This study enrolled a total of thirty-eight stallions, comprising of 24 Arabian horses and 14 cross-breeds (with an average age of 8 ± 3 years). The IOP measurements of first, second, and third, as well as the average of six PCTs were obtained using either Tonovet (TV) or Tonovet Plus (TV+) rebound tonometers. The mean differences (95% limits of agreement) between ...