Cataracts
A cataract is an opacity of the lens within the eye. The lens functions to focus light that enters the eye onto the retina. When a cataract develops, this focusing ability is reduced causing a slightly blurred vision initially, to complete blindness if encompassing the entire lens. The main form of treatment
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and restoration of your loved one’s sight is cataract surgery.
Cataracts can form within the lens due to hereditary (genetic) defects, systemic metabolic diseases (i.e. Diabetes Mellitus), long term inflammation, secondary to trauma, or as a function of age. Phacoemulsification cataract surgery has a 95% success rate for restoring your pet’s sight.
To determine if your pet is a candidate for cataract surgery the following presurgical tests are performed.
Pre-surgical Blood Tests
This is to ensure that your pet’s systemic health and organ functions are within the normal limits or as close to normal and safe for general anesthesia. Doppler Blood Pressure Measurement
This test is to ensure that your pet does not have underlying high blood pressure, as this is common in our older pet population. Gonioscopy
This test evaluates the iridocorneal drainage angle within the eye. Abnormalities of the drainage angle may mean that your pet is predisposed to secondary glaucoma (elevated pressure within the eye). If this is present, then adjunct endolaser surgery may be recommended. Ocular Ultrasound
This test allows us to visualize the posterior half of the eye that is blocked by the cataract. We rule out signs of a retinal detachment or congenital malformations within the eye. Electroretinography (ERG)
This test evaluates the function of the retina within the eye. This is to ensure that the retina is working and sending information to the brain appropriately. Your pet will dark adapt for 20 minutes and then a flash of light will be directed at the eye being tested. The retina converts this flash of light into an electrical response that is measured by a surface contact lens placed on your pet’s eye. Patients who have cataracts and are candidates for cataract surgery typically require pre- and post-surgical anti-inflammatory medications. With successful cataract surgery, most patients will receive a new artificial lens implant, providing focused vision. However, in some patients and certain situations an artificial lens may not be able to be implanted. In these cases, patients are still able to see, better than when cataracts were present, but the sight is far-sighted. Call Veterinary Vision Center today to determine if your pet is a candidate for cataract surgery. [/expand]
This is to ensure that your pet’s systemic health and organ functions are within the normal limits or as close to normal and safe for general anesthesia. Doppler Blood Pressure Measurement
This test is to ensure that your pet does not have underlying high blood pressure, as this is common in our older pet population. Gonioscopy
This test evaluates the iridocorneal drainage angle within the eye. Abnormalities of the drainage angle may mean that your pet is predisposed to secondary glaucoma (elevated pressure within the eye). If this is present, then adjunct endolaser surgery may be recommended. Ocular Ultrasound
This test allows us to visualize the posterior half of the eye that is blocked by the cataract. We rule out signs of a retinal detachment or congenital malformations within the eye. Electroretinography (ERG)
This test evaluates the function of the retina within the eye. This is to ensure that the retina is working and sending information to the brain appropriately. Your pet will dark adapt for 20 minutes and then a flash of light will be directed at the eye being tested. The retina converts this flash of light into an electrical response that is measured by a surface contact lens placed on your pet’s eye. Patients who have cataracts and are candidates for cataract surgery typically require pre- and post-surgical anti-inflammatory medications. With successful cataract surgery, most patients will receive a new artificial lens implant, providing focused vision. However, in some patients and certain situations an artificial lens may not be able to be implanted. In these cases, patients are still able to see, better than when cataracts were present, but the sight is far-sighted. Call Veterinary Vision Center today to determine if your pet is a candidate for cataract surgery. [/expand]
Dry Eye
Dry eye, also known as Keratoconjunctivitis Sicca, is a very common condition in our patients, as it is in humans. Dry eye occurs when there is a decrease in the fluid component of the tear film due to a lack of aqueous tear production by the lacrimal and nictitans glands. The clinical signs associated
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with dry are typically mild and include the development of thick green mucoid discharge, a dull or lackluster appearance to the eye, redness to the conjunctiva, and a mild degree of irritation that manifests as intermittent squinting. Severe untreated cases of dry eye can cause significant corneal pigmentation, vascularization and scarring that can diminish your pet’s site.
There are many causes of dry eye in our pet population. Some of the most common causes include immune mediated, congenital, hereditary, metabolic diseases (Hypothyroidism, Diabetes, Cushing’s), certain infectious diseases, neurologic, inflammatory, drug toxicity, or iatrogenic. Depending on the cause of dry eye, resolution of this a problem can be achieved. However, it is common that dry eye is a treatable condition and not curable. Dry eye is diagnosed by having a Schirmer Tear Test performed and the observation of concurrent ocular lesions that are consistent with dry eye.
The main treatment for dry eye consists of a combination of tear stimulant and tear lubricant supplementation therapies. Depending on the cause some additional medical therapies may be needed to aid in resolving this problem. In some cases, a combined workup with your primary veterinarian or a different specialist may be needed to aid in curing your loved one of this problem. We will be able to determine how successful and how much of an improvement medical therapy can achieve with subsequent examinations and monitoring. In some patients, Parotid Duct Transposition surgery may be beneficial to provide your pet a long-term comfortable and successful outcome to resolve the signs and symptoms associated with dry eye.
If you notice that your pet is having an increased amount of discharge and redness to the eyes call us for evaluation and medical therapeutic options.
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Corneal Ulcers
The cornea is the clear front part of the eye. The cornea functions to focus entering light onto the retina. The outside protective layer of the cornea is called the corneal epithelium. The epithelium protects the cornea from damage as well as infection. The phrase “Corneal Ulcer“ (aka Ulcerative Keratitis)
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refers to a break in the surface epithelial layer causing exposure of the underlying corneal stromal tissue.
Corneal ulcers can be very painful to your pet, causing signs of squinting, a red color change to the eye, and the development of discharge that can begin as excessive tearing to green mucoid discharge. It is common that corneal ulcers develop due to trauma in our patients, but some types of corneal ulcers are spontaneous in origin. Corneal ulcers are diagnosed by having a fluorescein stain tests performed. For some patients with severe ulcers, a corneal cytology and bacterial culture and sensitivity test maybe needed to determine the source of infection and to what antibiotic medication the infection is susceptible.
Corneal ulcers are a significant concern as they can progress rapidly and can become infected with either bacteria or fungal organisms. Typically, corneal ulcers heal within 5 to 7 days. However, several factors can prevent a corneal ulcer from healing, including foreign bodies, abnormal hairs contacting the cornea, delayed healing properties, or residual resistant infection.
The main form of treatment for corneal ulcers is medical therapy. Many corneal ulcers are medically treated and resolve within 2 - 3 weeks. If a corneal ulcer goes without treatment or if significant inflammation is present within the cornea as the body tries to clear the infection, then the corneal stroma can be digested or eaten away resulting in loss of corneal thickness and potentially the development of a hole within the cornea. If a corneal hole (rupture or perforation) develops then patients are suddenly in a significant amount of pain. In these circumstances surgical intervention may be required to preserve your pet’s eye, their comfort, as well as their site.
If your pet is experiencing signs of squinting, rubbing the face/eye, redness to the white part of the eye, or excessive discharge coming from the eye call us for further evaluation and therapeutic options.
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Glaucoma
Glaucoma is a blinding and painful condition of the eye. Glaucoma is a term used to signify a group of conditions that cause damage to the retinal ganglion cells and optic nerve and is typically associated with an elevation in the intraocular pressure of the eye. Clinical signs of glaucoma can be difficult
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to identify as some of our pets are very stoic with showing signs of ocular pain. Common clinical signs of ocular discomfort associated with glaucoma include squinting with elevation of the third eyelid, a diffuse blue color to the normally clear cornea, a midrange to dilated pupil, and diminished sight in the affected eye.
A determination of glaucoma is made with measurement of your pet’s intraocular pressure, called Tonometry. A complete ophthalmic examination along with gonioscopy, which is the evaluation of the iridocorneal drainage angle, aids us in determining if your pet's glaucoma is due to primary or secondary origins. Primary glaucoma is seen in numerous breeds of dogs and in some cats. Secondary glaucoma is caused by several conditions occurring within the eye, including an anterior lens luxation, cataracts, chronic inflammation, retinal detachment, or an intraocular tumor.
Treating glaucoma typically consists of administering a combination of medications that aim to reduce the amount of fluid (aqueous humor) produced within the eye and to enhance an alternate pathway for aqueous humor evacuation from the eye. Typically, glaucoma is a treatable not curable condition. If successful, some patients will be able to be managed and maintained on medical therapy alone. However, it is common that surgical intervention is needed. The recommended surgery for glaucoma may vary on your pet’s site within the affected eye. Some surgical options for glaucoma in sighted eyes include laser therapy targeting the cells that produce aqueous humor, implantation of an aqueous humor shunt device, or a combination of both. In blind eyes with untreatable refractory glaucoma alternative surgeries for comfort may be recommended.
If you believe that your pet is in significant ocular pain or may have signs that are associated with glaucoma give us a call for evaluation and recommended therapeutic options.
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