Vetnews | September 2024 40 « BACK TO CONTENTS We as veterinarians are routinely confronted with ocular foreign body injuries that would require first-aid treatment before referral. Various types of injuries may be presented to you, and a practical way to assess and treat these will be discussed. This is a frequent presenting complaint and may be a very important situation to deal with! The owner is often concerned and anxious and the pet may be in considerable discomfort. The presenting complaint is often one that sounds like this: “My dog/cat’s eye is sore”, “My pet’s eye has been red and weeping since we were out walking”, “My hunting dog’s eye has been closed since we came back after the weekend”, “My pet ran into a cycad and injured his eye”. Pain is the most common presenting clinical sign, often it is severe, and the symptoms can include conjunctivitis, blepharospasm, epiphora, third eyelid protrusion and enophthalmos. Epiphora will consist of a watery ocular discharge and not the typical mucoid yellow discharge seen with dry eye. Some blood may be present in the tears. The symptoms have an acute presentation and inflammation is often dramatic. Most often the actual incident is not observed but on the rare occasion, the owner will tell you they witnessed the pet running into a specific plant, such as a cactus or cycad or when asking them during the history they will mention they have these types of plants in their garden. Working dogs are especially prone to foreign body injuries, especially grass seeds stuck under the third eyelid. It is always advised to do a routine physical examination on any pet presented to you with pain, there may be other injuries, such as skin wounds, and this may be indicative of potential trauma and help guide us into the thought process before completing the examination with the eyes. When the eye is in extreme blepharospasm a very useful method to make examination easier is to apply a topical anaesthetic, such as Novasin Wander drops. Do this while you perform the physical examination, by the time you get to the eyes the spastic eye may be more open and easier to examine. Novasin Wander is very safe, and a few drops may be applied 2-3 minutes apart to relieve the spasm. Intravenous sedation with butorphanol/dexmedetomidine will also allow more thorough examination in anxious/aggressive pets. Eyes are often intimidating but as with the rest of the body, the eye should be approached in a systematic manner, starting from the outside first. Pay close attention to the eyelids, conjunctiva and third eyelid. Grass seeds and cacti glochids may be small but can cause extreme pain when touching the cornea. These are often lodged under the eyelids in the conjunctival tissues or deep in the ventral fornix under the third eyelid. The presence of a corneal ulcer is enough reason to spend some time to eliminate a superficial foreign body as the Regulars I Ophthalmology Column Practical approach to ocular foreign body injuries Dr Brent Sirrals, Specialist Veterinary Ophthalmologist Johannesburg and Cape Animal Eye Hospitals www.animaleyehospital.co.za Figure 1: Penetrating ocular foreign body injury in a cat. This patient presented with moderate blepharospasm and only a mild epiphora. The second image was after the application of topical anaesthesia. Note the marked anterior chamber flare present and the ability to open the eye for examination.
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