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The conundrum of confusing corneal ulcers!

In this Vet Vision Center blog, Dr. Shelby Reinstein, MS, DACVO is going to tackle a common question she receives...what can we do with "the conundrum of confusing corneal ulcers!?"

Although most simple corneal ulcers heal within 5-7 days… we understand both the confusion and curiosity that accompany corneal ulcers which do not heal in the usual timeframe.

When a patient presents to the Vet Vision Center with a corneal ulcer that isn’t healing, Dr. Reinstein’s first goal is to determine the underlying cause. Many times, corneal ulcers form due to a primary corneal disease (like dry eye) or secondary to other abnormalities such as eyelid problems (like entropion or an eyelid mass).

The next step is to determine if the corneal ulcer isn’t healing well due to bacterial infection. Dr. Reinstein uses the microscopic eye exam to look for evidence of infection which would require aggressive medical treatment, or even surgery.

If no underlying cause is identified with the eye exam and there is no evidence of infection, Dr. Reinstein becomes suspicious of a special type of corneal ulcer called a spontaneous chronic corneal epithelial defect, or SCCED. Other common terms for these ulcers include “indolent ulcers” and “Boxer corneal ulcers,” since the Boxer is the most commonly affected dog breed. Other breeds with increased rates of SCCEDs include poodles, Welsh Corgis, and Labrador retrievers.

SCCED ulcers form spontaneously and are not the result of trauma or infection. These ulcers become refractory and fail to heal, even with appropriate medications. To achieve full healing, Dr. Reinstein performs a cotton swab debridement of the ulcer edges to remove the unhealthy cells. A special treatment called a Diamond Burr Debridement (DBD) is then performed to smooth out the irregular ulcer surface which allows new corneal surface cells to grow and the ulcer to heal. DBD is performed during the consult with numbing eye drops using a handheld ophthalmic polishing burr and has a success rate over 93%!

To request an appointment, please fill out the Appointment Request form or call the Vet Vision Center directly at (609) 418-EYES (3937).

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