During my clinical rotation with ophthalmology, I began to feel that every patient assigned to me was destined to have a corneal ulcer. Even patients presenting for other issues began to surprisingly also have an ulcer. But as unfortunate as it was for each of my patients, with every additional corneal ulcer I saw I became increasingly more confident in my ability to assess the problem, confirm my diagnosis and develop a successful treatment plan. For those of you lucky enough to not be familiar with corneal ulcers, they are in simple terms an open wound on the outermost layer of the eye; however, they can become anything but simple to manage and resolve.
One of my corneal ulcer patients was presented on an emergency basis to our service following trauma from another dog in the household. All that the owner knew was that the dogs had been playing and then one of them seemed to be in pain and refused to open its eye. We weren’t entirely sure what we would discover when they arrived. Fortunately for the dog, the owner brought him in within the first 24 hours following the injury. We examined the eye and diagnosed the corneal ulcer by seeing the uptake of fluoroscein, a bright green stain placed on the eye. Places where the layers of the cornea have been damaged or lost will take up the stain and appear as bright green islands outlining the ulcer.
We placed the dog on topical broad-spectrum antibiotic drops and serum every two hours to prevent the ulcer from becoming worse. We also added systemic pain control, as ulcers can be incredibly painful. I was fortunate to be able to see the dog again three days later for a re-check and the eye was well on its way to healing.