Gloria the Shar Pei
Gloria was rescued by the RSPCA and arrived in a terrible way. She was highly malnourished with terrible skin. She was also blind. Gloria was referred to me by her RSPCA case vet to see if her vision could be restored. I performed a full ophthalmic examination and diagnosed little Gloria with severe upper and lower eyelid entropion in both eyes. She was also diagnosed with severe scarring of her corneas due to the irritation caused by her malformed eyelids.
Entropion is a condition whereby the eyelids roll inwards towards the cornea (clear window at the front of the eye). This rolling inwards of the eyelids causes the eyelashes to rub on the cornea. This is highly irritating and can cause scarring, corneal ulcers and possible blindness. Gloria was one of the worst cases of entropion that I had ever seen but the prognosis for restoring Gloria’s vision and correcting her eyelids with surgery was excellent. Once Gloria was strong enough to have a general anaesthetic, I performed surgery to correct her upper and lower eyelid entropion.
At the post op check it was so lovely to see how much better Gloria felt. She could see! Her eyelids no longer fell in front of her eyes, she wasn’t squinting and most importantly she wasn’t bumping into anything!
Gloria was adopted by a lovely family once she was well enough to move on from the RSPCA and I am pleased to report that she couldn’t happier in her new home!
Louie the Cavalier King Charles Spaniel
Louie had a great deal of medical issues to contend with in the first few years of his life. By the age of 3 he had already undergone extensive orthopaedic surgery and was just starting to literally find his feet when his mum noticed that his eyes just weren’t quite right. They were red and a mucky discharge was appearing in both eyes. He would occasionally squint and look tired.
Louie was referred to us for this condition and after a full ophthalmic examination, a diagnosis was made of Keratoconjunctivitis Sicca (KCS), also known as dry eye. KCS occurs when the immune system attacks the lacrimal glands (tear producing glands) of the eye and causes a reduction in tear production below normal levels. Tears are vital for the health of the cornea (clear window at the front of the eye) and conjunctiva (membrane lining the white of the eye as well as the inner side of the eyelids and third eyelid). Without sufficient tear production, the lacrimal glands and conjunctiva become inflamed, a thick tenacious discharge is produced and scarring or ulceration of the cornea follows. Without treatment this condition is vision threatening, not to mention painful. Louie was prescribed an immunomodulator eye medication and despite diligent application by his mum, his tear readings refused to remain at a healthy level.
Louie was a great candidate for a new trial that we were undertaking into the treatment of canine dry eye with stem cells. He was one of the first to try the treatment after his mum decided to go ahead with the potentially life changing treatment. On the day of surgery and under general anaesthetic, mesenchymal stem cells were carefully injected into Louie’s lacrimal glands. Two weeks after surgery, Louie’s mum reported that his eyes were already clearer and he seemed happier. Ophthalmic examination supported these observations and after 4 weeks there was no further discharge and his tear readings continued to increase.
Louie was slowly weaned off the immunomodulator eye medication and now, 5 years later, his tear readings remain above normal and his eyes are free of redness and discharge. Louie was very well behaved for his eye drops but was understandably happier once we decided to stop the treatment altogether. Stem cells have many applications both in veterinary and human medicine and the results thus far for treatment of canine dry eye are very encouraging.
Dr Melissa presented a case series, including Louie’s results, on this topic at the Australian and New Zealand Royal College of Veterinary Surgeons Science Week conference in 2013.
Walter the Spoodle
Walter was in a great deal of pain when his veterinarian first called us. He had been a little quite the night before but when he woke his mum and dad noticed that his left eye was closed, red and mucky. Walter seemed depressed, he wasn’t interested in his breakfast and just wanted to sleep. We performed a full ophthalmic examination of both of Walter’s eyes and diagnosed glaucoma in the left eye. Glaucoma occurs when the pressure in the eye is elevated beyond normal levels. In dogs this conditon can arise very rapidly, without warning. It is a very painful condition and can rapidly result in blindness of the affected eye.
Emergency treatment can restore vision in many cases however, owing to a dogs ability to hide painful conditions, permanent damage to the sensitive cells of the retina can occur before they are diagnosed. We performed emergency paracentesis on the left eye to reduce the intraocular pressure and prescribed several eye drops to assist in keeping the pressure down.
Gonioscopy was also performed on Walter’s right eye and goniodysgenesis was diagnosed. This meant that he was born with an abnormal drainage angle in both eyes (primary glaucoma) and his remaining visual right eye was therefore predisposed to glaucoma. Knowing this vital piece of information we were able to prescribe prophylactic eye drops for Walter’s right eye to help delay the onset of glaucoma. Unfortunately Walter’s left eye never regained vision due to the devastating effects of high intraocular pressure on the delicate cells of the retina. The intraocular pressure spiked a second time and refused to respond to medications. With the eye already blind and now painful, we recommended intrascleral prosthesis surgery. This surgery would remove the painful internal stuctures inside the eye but keep the outer structures (sclera, cornea, optic nerve, extraocular muscles and eyelids).
After a detailed discussion Walter’s mum and dad decided to proceed with intrascleral prosthesis surgery for the left eye. The surgery went very well and at the post operative check Walter’s mum and dad reported that he was a much happier dog, almost back to behaving like a puppy! He continues to do very well with one visual eye, so well in fact that his mum often forgets that one eye is prosthetic! He will remain on prophylactic eye drops long term and return for reviews to ensure that the right eye intraocular pressure is well controlled.
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