Bilateral cataracts were diagnosed in a 38-yr-old male African elephant. Within 6 mo, eyesight deteriorated such that the animal could no longer navigate the exhibit, necessitating confinement to a holding area. Over the next several months, behavioral depression, lethargy, and dramatic muscle mass loss were noted.
Eighteen months after presentation, the cataract in the left eye was removed via phacoemulsification. Prior to surgery, the eye was imaged via spectral-domain optical coherence tomography (Envisu R2300, Bioptigen, Research Triangle Park, North Carolina, USA). The second cataract was removed 6 mo later. Despite easy removal of cataracts, lens capsule damage prohibited installation of prosthetic lenses. Though ocular discomfort was not evident and visible inflammation was minimal, post-surgical treatments included the following medications: oral flunixin meglumine (1,500 mg; Banamine paste, Schering-Plough Animal Health Corp., Union, New Jersey, USA) and topical prednisone acetate (1%, Pacific Pharma, Irving, California, USA), nepafenac (Nevanac ophthalmic suspension, 0.1%, Alcon Laboratories Inc., Fort Worth, Texas, USA), tropicamide (1%, Bausch & Lomb Inc., Tampa, Florida, USA), moxifloxacin (Vigamox 0.5%, Alcon Lboratories, inc., Fort Worth, Texas, USA) and ciprofloxacin (0.3%, Pack Pharmaceuticals, LLC., Buffalo Grove, Illinois, USA).
Vision improved incrementally post-procedure. The elephant remains aphakic and far-sighted, but easily navigates its enclosures and locates food. Quality of life and body condition have improved dramatically since access to exhibit. Contact lenses (Acrivet, Hennigsdorf, Germany) have been fabricated in an attempt to further improve eyesight; placement will not be considered until late 2012.
The authors thank the elephant keepers and veterinary technicians at the North Carolina Zoological Park as well as our colleagues at North Carolina State University’s College of Veterinary Medicine for all of their hard work in management of this case.