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Vet Talk

The Eyes Have It
September 7, 2015 (published)


It happened again this morning. As I was toweling off my face, I dislodged my contact lens. The typical mental dialogue in this scenario goes something like this:

‘Okay, no big deal, once I’m dry and can get to the mirror, I’ll take the lens out, rinse it, and put it back in. Meanwhile, I’ll just keep my eye closed.’

‘The itching is now a small bonfire. Why do I wear these things??’

‘Okay, mirror. It’s all going to be fi—NOOOOOOOOOoooo!’

The contact lens isn’t just dislodged. It has folded itself into an origami crane and migrated north to the Bermuda triangle of the junction between eyeball and upper lid. This zone is where contact lenses and sanity go to die.

Then panic sets it. ‘I need to get it out. I can almost reach it. Oh my god is it FURTHER back? It’s going to get sucked all the way behind my eye and into my brain. This is it. This is how I die. They’ll find me, collapsed over the sink with my eyeball rolling around the drain. Another unpublished death-by-contact-lens.’

At some point during the early panic phase this morning, I realized how veterinary patients must feel with eye trauma or foreign bodies. As I was trying to calm myself, I ran through the steps I use to retrieve foxtails (grass seeds for you non-Californians) from under horse eyelids. ‘Okay, I can just moisten a cotton swab---But I don’t have any DRUGS!!’ Yeah, this is why most of my patients get sedated for these procedures Saying Yes to Drugs.

I can’t begin to count the number of times someone has told me, “Oh, Fluffy’s had something going on with his eye for a couple of days. I don’t think it’s bothering him but he’s holding it closed and it’s tearing a lot. Do you think I should take him to the vet?”

I’ll be honest; in those situations, it’s challenging for me not to yell, “Stand here while I rub this stick on your cornea for a while then debate taking you to the doctor. Of course it bothers him. It. Bloody. Hurts!” That’s usually the moment when I realize we shouldn’t talk that way to friends and family, so I back down a few notches and say, “Yes, eye problems can get really serious pretty fast and they can be very painful. I think you should call your vet right now and get him in as soon as possible.”

Eyes are deceptively complex. They may look like simple marbles, but there’s a lot going on in there and a lot that can go wrong. Sometimes, one problem can even lead directly to another.

For example, my first horse had a condition called equine recurrent uveitis (ERU). This meant that periodically, the anterior chamber (the front part of the eye between the lens/iris and the cornea) would become inflamed due to a wonkiness in her immune system that caused it to attack her own eyes. ERU is incredibly painful. Affected horses squint, stream tears out of the eye, have swollen lids – and they rub their eyes. Now, because horse eyes stick out from their heads (all the better to see the wolf sneaking through the grass) and because horses in pain aren’t very discriminating about how hard or where they rub their eyes, it’s pretty common for that rubbing to also cause a scratch on the cornea. So, now, the eye that had one problem has two. And if that scratch gets infected, then you are into problem number three. A bad corneal infection can lead to blindness or loss of the eye.

How quickly can this happen? Well, let’s just say that it wasn’t unusual for Goldie to have a scratch on her cornea in the time it took for the boarding stable to call saying “She’s holding her eye shut again” and me to pull into the parking lot.

Hopefully this gives you of an idea why I’m not a fan of the “let’s wait and see if it gets better on its own” approach to eye care.

With the exception of working dogs, blindness in one eye may not be as much of a problem in a dog or cat as in a horse. Still, that’s no excuse for not getting eye issues addressed. Again, how would you feel if your eye was on fire and you had no way of making it better?

Don’t be fooled into thinking that you can diagnose your pet’s eye problem on symptoms alone. Very different problems requiring completely different treatments may look identical to the – dare I say it – naked eye. This means it is a BAD idea to treat your pet with drops or ointment’s left over from a previous eye incident. Even if Fluffy’s eye looks like it did last time or exactly like Mitten’s eye last month, this is an entirely new incident and treating with the wrong medication can have devastating consequences.

Treatment may involve applying drops or ointment multiple times per day. It may require systemic medications, or even hospitalization. The key point is following instructions exactly and letting your veterinarian know immediately if the eye isn’t improving or if all the drops are ending up in the ear or on your shirt. Remember the rapid progression from bad to worse. A day can make all the difference between successful healing and blindness.

And, just like with a horse, infection or other worsening eye problems in a dog or cat can lead to the eye needing to be removed. Now, instead of some drops and a few hundred dollars in treatment, you’re looking at surgery and a significant chunk of change in order to relieve your pet’s suffering.

Suffering? Yes. If you don’t believe me, I can demonstrate with a neatly creased contact lens.


 
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