More On Eye Injuries
More On Eye Injuries
Prompt Treatment = Good Results
Our previous discussions have covered various injuries and conditions of the eye. The most common condition of the eye is inflammation of the tissue surrounding the eye (conjunctivitis). The most common indications of an injury to the eye are the lids being held tightly closed and tearing. The last article demonstrated the importance of prompt treatment of eye injuries. We also discussed staining the injured eye to determine the extent of damage. This very brief summary outlines the highlights of what took us three weeks to discuss. Perhaps I was a little long winded!
When we examine an injured eye we place drops of stain under the eye lid. Shortly thereafter we shine a light on the eye looking for the green stain. The green will only be taken by the eye where there is a break in the tissue. It may appear as one deep green line along the surface or show up as green specks all over the eye indicating it was scraped. We treat the eye based on how the stain is dispersed.
If the eye does not take stain, we treat to protect it from infection, reduce discomfort to the horse, clear the conjunctiva of redness, and reduce the swelling in the white of the cornea (the clear part of the eye). A combination of drugs within one ointment will do much of this. The antibiotics protect against infection. The steroid will make the eye feel better and remove redness from the conjunctiva. I t also works to prevent the blood vessels from invading the clear part of the eye which would turn it white. The ointment provides lubrication between the eye and the lid so blinking will not irritate it.
If we do see green after staining, our objective is to prevent an infection from becoming established and invading the open wound on the eye’s surface. Antibiotics will provide protection against infection and the ointment will provide lubrication. However, we cannot use a steroid which would ease the discomfort and take the redness out of the conjunctiva. Steroids in the eye slow the healing process by restricting its blood flow. We must wait for healing to progress to the point where no more stain is absorbed. Unfortunately during this time the eye may become progressively whiter. We will actually see blood vessels invading the eye like small vines creeping across the surface and pulling a white cloud along with them. They are providing blood to repair the injury. These will go away with treatment after the wound is healed.
For pain relief, we treat the horse orally or by injection. Along with antibiotics we provide Dobbin with anti-inflammatories or pain medication to relieve the discomfort of the injury and allow him to open his eye.
With any injury there is a protective response by the eye. This response is the contraction of the muscles to the lens, much like the response from walking into a brightly lighted room. This contraction is so severe it is a source of constant discomfort. A second eye medication may be necessary to relax these muscles during the initial stages of the injury.
Depending on the extent of the injury, the eye may heal in as little as a week. It will be much faster than a skin injury. Occasionally, we may encounter a horse that does not like having ointments placed in its eye several times each day. If this becomes such a struggle it is a risk to the life and limb of the handler and the horse, we may use a catheter to provide a route of treatment. The tip is sutured under the upper eyelid. The medication can be injected into an attached tube and it will come out the tip. This greatly relieves the agitation to the horse and the owner!
We are beginning to see the light at the end of the tunnel!
Next week we will discuss changes that naturally occur in the eye.
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