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Corneal Sequestrum

By: Dr. Alexandra Van der Woerdt

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Several eye diseases may look similar to a corneal sequestrum, but treatment of those diseases is usually very different from the treatment of a corneal sequestrum. Establishing the correct diagnosis is therefore very important. Diseases that may appear similar to corneal sequestration include:

  • Corneal ulceration. A corneal ulcer is an abrasion on the surface of the cornea or a break in the surface that appears as an indentation in the cornea. There is no brown discoloration associated with an uncomplicated corneal ulcer. The eye is red and painful and should be treated by a veterinarian as soon as possible. Corneal ulceration can occur along with corneal sequestration.

  • Corneal foreign body. Tiny pieces of plant material or wood can adhere to the surface of the cornea and resemble the black appearance of a corneal sequestrum. These foreign bodies should be removed as quickly as possible.

  • Corneal pigmentation. The cornea can become pigmented secondary to chronic irritation. In the cat, corneal pigmentation is a very rare event. In the case of simple corneal pigmentation, the underlying cornea is still living, healthy tissue. In a sequestrum, the involved piece of cornea has died.

  • Iris cyst. Iris cysts are also very rare in cats. These are dark brown fluid-filled structures that form inside the eye near the pupil. They may burst in the eye and coat the inside of the cornea with pigment. This may resemble the brown color seen in a sequestrum. Iris cysts are generally harmless.

  • Adhesions between the iris and cornea. After severe injury to the cornea, adhesions may form between the iris (the colored part of the eye) and the cornea during the healing process. These adhesions may become permanent and leave brown spots in the cornea.

  • Corneal scar. After an injury to the cornea, the resulting scar tissue may sometimes accumulate harmless pigment, although this is much more common in the dog than it is in the cat.

  • Corneal perforation. This is a very serious condition that requires immediate attention. In the case of a corneal perforation, a hole is present in the cornea, exposing the inside structures of the eye to the outside environment. The risk of infection is high and the eye may lose vision. When a hole is present in the cornea, the iris often comes forward to fill the defect, resembling the black appearance of a sequestrum. Fluid may be present on the cheek.

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