Indolent Ulcers

Recurrent Corneal Erosions

Painful conditions involving the cornea are commonly observed in the canine, feline, and exotic breeds. The cornea is the transparent, avascular anterior portion of the outer fibrous coat of the eye. The cornea consists of surface epithelium, collagenous stroma, and Descemet’s membrane, and the endotheium. As the corneal is avascular (no blood vessels), nutrition is obtained from tears, aqueous humor, and limbal blood vessels. Corneal nerves are found throughout the epithelial layer.

Recurrent epithelial erosions (indolent ulcers) present a unique type of superficial corneal ulceration that is slow to heat often recurs, and is characterized by an edge of loose epithelium. These are observed in a variety of breeds (Boxer) and geriatric animals. Indolent ulcers are thought to be due to an abnormality in the adhesive qualities of the epithelial basement membrane.

Typically, these cases are challenging, and quite frustrating. Usually, the patient demonstrates ocular pain, as demonstrated by excessive tearing and eyelid blinking, with protrusion of the nictitans membrana. Often the pet is rubbing at the eye, as well.

A complete ophthalmic examination is necessary to rule out underlying etiologies, for chronic corneal ulcerative disease such as “dry eye”, distichiasis (abnormally positioned eyelashes), and mechanical trauma due to foreign body.

Various medical and surgical treatments are available to promote corneal reepithelialization. It is imperative to maintain a topical, and often times an oral antibiotic regime, to control any secondary bacterial involvement. Soft bandage contact lenses are routinely utilized to speed up corneal healing, and increase patient comfort.

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