Lacerations or scratches of the cornea occur from trauma to the eye. The cornea is the thin clear covering of the eye. A common cause of cornea lacerations is a cat scratch or exposure to foreign bodies, sticks and other plant materials. Cat scratches are particularly common when a new puppy
meets the household cat for the first time.
Corneal lacerations or scratches are quite painful and require medical attention, and the prognosis depends on the depth and severity of the laceration. Partial thickness lacerations have the best chance of recovering without complications, while perforating lacerations have a fair-to-guarded prognosis for recovery and maintaining vision.What to Watch For Squinting
Pawing at the eye
Rubbing the eye or face
Bleeding from the eye
Cloudiness of the cornea
Redness or swelling of the eye
Inability to see the eye because the third eyelid is covering the eye.
Other signs of trauma to the face
To confirm the laceration, the animal must first be made comfortable so it will allow a thorough eye examination. This is accomplished by using local anesthetic drops on the eye. Extreme care must be taken when examining or treating an eye with a corneal laceration. Any excess pressure on the head, neck or eye can result in rupture of the eye. This worsens the prognosis for retention of vision and retention of the eye itself.
Fluorescein eye stain. Examination of the eye involves instilling a fluorescein dye (bright yellow-green) onto the surface of the cornea to highlight any abrasions or lacerations.
Other structures of the eye are also examined for damage, such as the eyelids, conjunctiva, and the front chamber of the eye. Evidence of corneal perforation or inflammation within the eye (uveitis) is a very serious finding.
Depending upon the severity of the corneal laceration, referral to a veterinary ophthalmologist may be indicated.
Superficial injuries may be treated like corneal ulcers with topical antibiotics, topical pupil dilators, and application of an Elizabethan collar to prevent self-trauma.
Lacerations that create flaps in the cornea or that involve the first 1/3 of the cornea may require surgery to trim these flaps and to clean the lesion. Following surgery, topical medications are then instituted.
Lacerations that are deep in the cornea and injuries that have penetrated into the eye are considered emergencies. The animal may require sedation to prevent his traumatizing the eye further and to improve his comfort level until surgery can be performed.
Any tissue/iris that protrudes from the corneal laceration is gently replaced within the eye or trimmed away if it is too unhealthy to replace. Extremely fine sutures are used to bring the edges of the wound together.
If any fluid has leaked from the eye, the front chamber of the eye may be injected with a balanced salt solution or an intravenous solution. These may help to reform the front chamber.
If the laceration is ragged or the cornea is weakened, then a conjunctival graft may also be placed over the sutured wound. This adds an extra protective layer to the site.
Any additional injuries to the eyelids and face are also repaired.
If the soft tissues around the eye are swollen and there is a danger the eyelids may not be able to blink properly and cover the cornea, then the eyelids may be partially sutured closed for several days. This is called a temporary tarsorrhaphy. A temporary tarsorrhaphy still allows medication to be applied to the eye and allows periodic examination of the eye to monitor healing.
Following surgery, oral antibiotics and nonsteroidal anti-inflammatory medications may be needed to decrease the chance of infection and to minimize inflammation. Topical medications are also used as noted above.
Home Care and Prevention
There is no home care for corneal laceration. If you suspect a corneal laceration, do not allow your pet to rub or paw at the eye. Seek veterinary assistance immediately.
Most pets are sent home with an Elizabethan collar to prevent self-trauma to the eye. Administer all medications as prescribed by your veterinarian. Notify your veterinarian immediately if you experience problems medicating your pet.
Proper home care is crucial for a successful recovery. Frequent veterinary rechecks are important to make sure the eye is healing properly. Examine your dog's eyes regularly and call your veterinarian if you note any pain or color change.
Keeping your puppy away from annoyed or frightened cats can reduce the risk of corneal laceration. When a new puppy is brought into the household, he should be introduced to the family cat under close supervision. Keep the puppy leashed and under control when around the cat until the cat is used to the dog. Clip the cat's nails short, or apply soft claws before the dog is brought home. Always allow the cat an escape route or a means of getting away from the dog when the dog is loose in the house. It may take several weeks for the cat to accept the presence of the new dog.
Pay particular attention to your dog's eyes after he has been running through long grass or brush. Clean and examine the eyes of all hunting dogs upon return from the field.