Deep Corneal Ulcer Treated with Ozone Saturated Solution and Direct Ozone/Oxygen Gas in Two Bottlenose Dolphins (Tursiops truncatus)
Complementary and/or alternative treatments have been used in different cultures for more than 3000 years. Ozone therapy has been used in the human medical industry since last century with Dr Erwin Payr. In 2004, ozone and oxygen mixtures became more commonly used in Mexico after the first international human ozone medicine meeting. Currently there are several methodologies and protocols in use.
In 2014, an adult female Tursiops truncatus, maintained in natural sea water at Xcaret Park, sustained a severe traumatic injury to the left eye. Treatment with topical tobramycin and acetylcysteine administered using a small diameter urethral catheter in between the closed eyelids was pursued. Topical treatment improved to the point of the eye lids opening, which then revealed a corneal perforation. Treatment was changed to direct ozone/oxygen gas, applied to the eye with a pediatric inhaler mask. The ozone dose was 52 mcg/ml for one minute, twice daily. Topical antibiotic treatment was suspended, and parenteral moxifloxacin 5 mg/kg PO BID was added to the gas therapy. The improvement showed by the cornea was immediate and two months later, the globe was intact with the cornea opaque due to fibrosis.
In 2015, a young adult male Tursiops truncatus, maintained in a 3 million liter artificial sea water pool and a life support system using ozone, protein skimmers, and chlorine, developed a small diffuse central corneal lesion of the right eye. Ocular exam, including biomicroscopy, fluorescein stain, cytology, bacterial culture and sensitivity were performed. Over the following three months, the lesion worsened with topical treatments of ofloxacin, neomycin-polymyxin-gramicidin, and natamycin. At this time there was a perforated descemetocele present, which appeared to have sealed with an iris plug and fibrin. The consensus opinion was that rupture of the globe was imminent and various treatments were considered, including various forms of a conjunctival flap, using either a local nerve block or general anesthesia. A corneal transplant was also considered. An initial trial using ozone was selected. The first applications were daily treatments lasting five minutes using 19 mcg/ml of direct ozone gas contact plus twice daily ozone gas saturation in distilled water at 34 mcg/ml reaching 1500 ORP used as drops. After two months using this treatment regimen, there were significant improvements of reduced depth and decreased diameter of the lesion. While there were net improvements, there were short periods of regression from those gains. A more aggressive application was initiated with direct gas contact at 53 mcg/ml for five minutes continued for an additional three months. After approximately five months, the defect was mostly resolved and the eye including the iris was functional, although photosensitivity persisted for approximately three additional months.
The use of ozone as a complementary and alternative treatment choice in these two cases brought successful resolution avoiding surgical procedures to the eye. Further investigation and experience will likely lead to improved outcomes.
We would like to say thanks to all the staff in Cabo Dolphins and Delphinus for their support, training and trust. We know that without their help none of these treatments will succeed.
* Presenting author
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