Ruptured Globe

Re: Ruptured Globe

Robert Lowe — Thu, 21 Jun 2012 22:04:20 GMT

The eye is not red (i.e. the conjunctiva looks pretty calm), I strongly suspect that the deficit has sealed, the lesion is vascularised and it looks comfortable. Left alone it will be fine and unless is gets a secondary infection I wouldn't necessarily enucleate even if anaesthesia was an option.

[quote user="Martin Atkinson"]

What about doing one of those purse-string circumferential conjunctival grafts Robert, would that not be of benefit now?

[/quote]

Treatment wise - it needed intensive anticollagenases and / or a graft of some description way before this if the aim was to save vision but the outcome appears pretty good from a cosmesis and comfort point of view now. Just not much fun for the dog to get to where it is now.

Re: Ruptured Globe

Mark Hedberg — Thu, 21 Jun 2012 21:45:01 GMT

[quote user="Michael Woodhouse"]

Treat it like a cow or sheep and remove eye under sedation with local anaesthetic?

[/quote]

I want to see these Shih Tzu's you have up there if they'll tolerate that!

Re: Ruptured Globe

Michael Woodhouse — Thu, 21 Jun 2012 21:12:36 GMT

Treat it like a cow or sheep and remove eye under sedation with local anaesthetic?

Re: Ruptured Globe

Martin Atkinson — Thu, 21 Jun 2012 16:48:42 GMT

What about doing one of those purse-string circumferential conjunctival grafts Robert, would that not be of benefit now?

Re: Ruptured Globe

James Laidlaw — Thu, 21 Jun 2012 14:20:46 GMT

At what point do these stop being painful? I would have thought these would usually need surgery or "the other treatment"?

Re: Ruptured Globe

Robert Lowe — Thu, 21 Jun 2012 11:12:47 GMT

As for topical serum - it would have helped a lot 4 weeks ago when it was melting but isn't going to make any difference now

Re: Ruptured Globe

Robert Lowe — Thu, 21 Jun 2012 11:11:14 GMT

Hi Mark

What happens when you fluorescein stain it? If there is still fluid coming from the eye then you should see it wash the fluorescein off the ulcer (positive Seidel test). If that is the case I would keep it on chloramphenicol drops and nothing else topically. If there is no leakage and no active ulceration (which would be my bet based on the picture) then you could stop all topical treatment. The hole should granulate in over the next few months as it looks like it has a good blood supply across the cornea and from the iris plug in the deficit. The eye is going to go phthitic and probably be quite comfortable at this stage.

Re: Ruptured Globe

Mark Hedberg — Thu, 21 Jun 2012 11:04:30 GMT

[quote user="Mark Rowland"]

Just thinking, I use topical serum lots for the rabbits, may well help here?

[/quote]

One of my colleagues had an outstanding success with autologous serum; that said your results may vary. I understand the logic behind it and in certain cases I understand it works very well.

Re: Ruptured Globe

Mark Rowland — Thu, 21 Jun 2012 10:46:39 GMT

Just thinking, I use topical serum lots for the rabbits, may well help here?

Re: Ruptured Globe

Mark Rowland — Thu, 21 Jun 2012 10:38:47 GMT

Todays pic is after 3 weeks of treatment (ie its been ruptured that long)

Re: Ruptured Globe

Hannah Wynne Richards — Thu, 21 Jun 2012 10:31:49 GMT

I'd apply topical antibiotics every 2 hours

Wynne

Re: Ruptured Globe

Mark Hedberg — Thu, 21 Jun 2012 10:17:34 GMT

While I'm not an eye specialist; keeping the eye highly lubricated does help; carbomer (fucithalmic, lubrithalmic, other brands are available) is 'stickier' and has a longer contact time on the eye. (Suggesting it in addition to the chloramphenicol, not instead of.) I've heard of warming up lacrilube so it flows better and administering that, as that is sticky as anything and stays for ages. (Really inconvenient to apply, though!)

If it heals up it will take quite a few weeks...good luck!