Eye Treatment

Pete Wedderburn
2nd June 2020 - 7 min read

The eye is one of the most sensitive structures in the body. Eyes can be affected by a range of conditions that need to be treated by owners, and hence by kennel and cattery owners if they are caring for pets.

The following problems may commonly be seen, and the treatment for each is listed under each condition.

Signs Of An Eye Injury

Many dogs are prone to charging through dense undergrowth, rushing through bushes and brambles as they follow a scent. It is not surprising that their eyes become scratched and bruised from time to time. A minor injury will often heal by itself, but it is common for complications to develop.  The signs of an injured eye are usually obvious. Often there is a watery discharge as if the pet has been crying in one eye. The animal may blink more than usual, or the eyelids may even go into spasm so that the eye is completely closed all the time. Sometimes the structures surrounding the eye may have been injured, with swelling and puffiness of the eyelids and face. An injured eye is painful, and the animal may be dull and quiet. If somebody tries to look more closely at the sore eye, the animal will often move its head away. The body language is clear: “Leave me alone – my eye is very sore”. 

Minor Eye Injury

A minor injury can be treated simply with first aid. A teaspoonful of salt can be added to a pint of cooled boiled water, to produce a solution with a similar salt content to tears. A cotton wool pad can be moistened with this salty water, and this can be gently used to bathe the injured eye several times a day. The animal will often find this comforting, and within twenty-four hours, the eye will sometimes return to normal.

If an injured eye does not rapidly respond to this simple approach, it is important not to delay. A visit to the vet is essential since there are some occasions where early treatment can make the difference between saving and losing an eye. 

Scratch Or Ulcer

If there is a scratch or an ulcer on the front of the eye, this needs to be treated very carefully. The vet will usually provide drops or ointment, containing medicines such as antibiotics. These need to applied frequently as tears will wash them out rapidly. Disease-causing bacteria often colonise an injured eye, and they could transform a simple ulcer into a ruptured eyeball within a few days. 

Eye Drop Medication

  1. Artificial tears to keep the surface of the eye well lubricated
  2. Drops to widen the pupil (so-called “mydriatics”). If the pupil is dilated, this can relieve the equivalent of a “muscle cramp” in the muscle of the eye (the iris), making it more comfortable.

As well as these topical drops, systemic pain relief is often given (such as non-steroidal anti inflammatory drugs) in the form of injections, oral liquid or tablets. Eye injuries can be very painful and it’s important to address this.

Frequent rechecks by the vet are necessary to ensure that a significant eye injury is getting better rather than worse.

Sometimes immediate surgery is needed. A laceration to the front of the eye may need to be repaired, using special fine sutures. A deep ulcer may need surgical attention, and perhaps even a referral to a veterinary ophthalmologist.

Major Eye Injury

At the most extreme end of the spectrum, an eye may be severely affected during a serious head injury, most commonly after a road accident. It is often very obvious that the eye has been irreparably damaged. It can be very shocking to see such an injury, and it can be very difficult to give adequate first aid on the spot. An injured foot or tail can be wrapped in a bandage, but the eye cannot be helped in this way. It is generally a case of getting the pet to the vet as soon as possible. Immediate pain relief can be given by the vet while a full assessment of the injury is made. 

If the injuries are very severe, it is frequently kindest simply to remove the affected eye. Animals can cope very well with only one eye. Owners sometimes worry that their pet will be left with an ugly gaping eye socket where the eye used to be, but this is not the case. The edges of the eye socket are sewn together during the operation so that the pet is left with a smooth surface where the eye used to be. When the hair grows back after a few weeks, the area simply looks like the rest of the pet’s cheek. 

A prolapsed eyeball is another distressing injury to see. Some breeds, such as Pekinese, are prone to this. If you witness this, your aim should be to preserve the eyeball as delicately as you can while the pet is taken to the vet. Use a damp pad (e.g. a wad of kitchen roll soaked in warm water) to gently hold the prolapsed eyeball as close as possible to its natural position. Sometimes the eye can be pushed and sewn back into place during anaesthesia. 

Conjunctivitis

The lining of the eye is called the “conjunctiva” and when this is inflamed, the condition is known as “conjunctivitis”. There are many possible causes, but the general result is an eye that looks red and uncomfortable, often with discharge in the corners of the eye. 

In a mild case, simple treatment could involve simply gently bathing the eyes cotton wool moistened in slightly salty water (a teaspoonful in a pint of boiled water, cooled so that it’s warm). If the problem does not ease within a few hours or a day, a visit to the vet is essential, to determine the cause of the problem. There may be an initial inciting cause ( exposure to an irritant substance, an allergic-type reaction, or physical issues such as ingrowing hairs or reduced tear flow). After reviewing the problem, the vet will usually suggest some type of drops to treat the condition. These are often prescription-only drops or ointment, and the following may be suggested.

Antibiotic eye drops if bacterial infection is suspected as being part of the problem. These usually need to be applied up to four or five times daily, although there are specific formulations that may only need to be applied once daily.

Corticosteroid drops may be recommended for certain conditions but they need to be used with care, under close veterinary supervision, as inappropriate use can make some eye conditions worse.

Artificial tears are often recommended to optimise lubrication in a diseased eye, and in cases of reduced tear flow, they can be a central part of treatment (see next section)

Dry Eye Or Keratoconjunctivitis Sicca

Some dogs don’t produce enough tears to keep the eye moist. Affected animals are prone to continual eye problems because of the lack of lubrication in the eyes. Your vet will make this diagnosis by doing a simple test to measure the tear flow.

These dogs need specific eye drops to deal with this.

Artificial tears take the place of natural tears, but they need to be applied up to six times daily to be effective

An prescription only ointment containing cyclosporine (“Optimmune”) can sometimes restart tear production in affected dogs: this only needs to be applied twice daily, but it’s a pricey ointment, and it needs to be used under close veterinary supervision.

Follicular Conjunctivitis

In this specific sub-group of conjunctivitis, tiny pinpoint-sized nodules on the inner lining of the corners of the eyes can be seen under magnification. These nodules are made of lymphoid tissue: the eye-equivalent of miniature swollen tonsils. This finding suggests a common problem in young dogs, known as “follicular conjunctivitis”. The precise cause is usually difficult to find, but it’s often thought to be an allergic reaction to something in the dog’s environment. It could be house dust, pollens, or floor cleaners. It’s important to check for obvious substances that might be involved as well as giving simple treatment to help. This is a diagnosis that needs to be confirmed by the vet, and affected animals may need the daily use of anti-inflammatory steroid eye drops. These dampen down the allergic reaction, relieving the itchiness, stopping the discharge, and returning the eyes to normal. Most young dogs grow out of the problem as they mature, so the drops just need to be used for a few months.

Surgical Treatment For Eye Problems

Entropion is a condition where dogs have tiny ingrowing hairs on the inside of the eyelids. If these are present, they can cause a continual low-grade irritation, and treatment of the problem involves removal of the hairs by a vet under anaesthesia.

Ectropion occurs when one of the eyelids flops outwards, causing exposure of more of the lining of the eye than usual, making the eye more prone to irritation and infection. An operation to correct the shape of the eyelids may be needed.

Cataracts, where the lens of the eye degenerates, turning milky white and obscuring vision, can only be treated surgically: from time to time, drops are advertised that claim to treat these successfully, but there’s no evidence for their efficacy.

Specific Eye Problems

There is a wide range of specific eye problems – such as glaucoma, internal haemorrhage in the eye, and a long list of others. These may need particular types of eye drops and tablets as part of the treatment plan. It’s always best to speak to the vet who has diagnosed the issue so that you fully understand what treatment is being given. Examples of treatments that may be used include:

Mydriatics: these are drops that cause the pupils of the eye to dilate, turning from pinpoint to saucer-like pupils.

Meiotics: these drops have the reverse effect, causing the pupils to constrict, changing from saucer-like to pinpoint.

These are potent medications that can cause harm if used inappropriately, which is why they are prescription-only products.

It’s important to remember that eye treatments have a finite life span after opening: the rule of thumb is that drops and ointments should be discarded a month after being opened, to minimise the risk of bacterial contamination and degradation of the active ingredients. So if you have eye treatments in your first aid kit, remember to bear this in mind.