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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Don't Wait on the Red, Angry Eye

January 23, 2012 / (5) comments


The eye is a complex structure.

 

 

But, for all of its complexities, the eye tends to react to almost every insult in more or less the same way. A cat with a herpetic ulcer, a dog with glaucoma, a horse with a wound to the surface of the cornea, they’ll all have some combination of a red eye, pain (e.g., holding the eye partially shut), and drainage.

What this means for owners is that when your pet has these symptoms, your veterinarian really can’t tell you what is going on without performing an exam (we’re really not just trying to get you to come in so we can charge for our time). To make matters worse, we also can’t determine over the phone how serious the situation might be. Do I need to stay after hours or send you to the emergency clinic, or can you wait for an appointment that’s at a more convenient time for everyone? Hard to say.

I perform a little over-the-phone triage on eye problems. If it’s a chronic but stable issue, we can probably wait for the next appointment slot that works for you, but if this is a problem that you just noticed or something that you’ve been ignoring and is now getting worse … get your pet in ASAP no matter the inconvenience or extra cost that might be involved.

I don’t mess around with red, "angry" eyes for two very important reasons:

 

  1. They can "head south" in a hurry. For example, a dog with severe and rapidly progressing glaucoma can become permanently blind in the affected eye within 12 to 24 hours of the onset of symptoms. A melting ulcer can perforate the cornea leading to a ruptured eye. I’m okay emphasizing the negative on the phone and then being able to give you good news after an exam. I’m not okay with missing the potentially very short window of opportunity to effectively treat a sight-limiting condition.
  2. Eye injuries and diseases are often excruciatingly painful. I’m sure any of you out there who have suffered from a corneal ulcer, acute glaucoma, or even something as relatively benign as an eyelash stuck under a lid can attest to that. Pain is the body’s way of saying, "Do something about this before anything worse happens"; and that’s wise advice.

 

Under most circumstances, an ophthalmologic exam and a few relatively quick and cheap tests (e.g., a Schirmer tear test measuring tear production, a corneal stain to look for wounds/ulcers on the surface of the eye, and a check of eye pressure) will produce a diagnosis and treatment plan. There really is no benefit to taking a wait and see approach when it comes to eye problems in animals, and in people too, I suspect.

 

 

 

Dr. Jennifer Coates

 

 

Photo Credit: The National Eye Institute

 

Image: Alila Sao Mai / via Shutterstock

 

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COMMENTS (5)
1
Conjunctivitis in cats
by barbccl on 01/23/2012 10:49am

One thing people need to know that a lot of vets don't seem to realize is that steroids should not be used in a cat with conjunctivitis because if it's herpetic that can lead to a corneal ulcer. I foster kittens so deal with conjunctivitis a lot. The shelter vets always use ointment or drops with steroids and I've dealt with several corneal ulcers, one of which was the most refractory the ophthalmologist had ever seen, I ended up spending well over $1000 on him (and kept him, of course). When that was going on, I researched the subject since I know as an MD that it's basically considered malpractice for anyone except an ophthalmologist to prescribe ocular steroids due to the risk of herpetic keratitis. I often refer my other kitty-lover friends to this article which explains it well when they tell me about their cat's being prescribed an antibiotic/steroid combination and I'm strongly telling them not to use it:
http://www.vetoquinolusa.com/Studies/FHV/FelineInfectious.pdf
My brother and SIL's cat, with a known corneal ulcer that took a year to heal had his other eye become red when he was given systemic steroids for an indolent rodent ulcer. If that doesn't scream "herpes" nothing does. They went to their regular vet who gave them Neopolydex. I told my SIL don't use it, call the ophthalmologist, and even the receptionist there knew not to use steroids.

by annet on 01/23/2012 01:01pm

This is very interesting, thank you.

I have one cat that had recurrent "angry/goopy eye" - I don't think we ever actually determined one way or the other if it was herpes or chlamydia but all three (four?) times she was negative for ulcers with the fun dye test. I'm at work and the eye drops are at home so I'm not sure what she was eventually put on.

It's hard when it flares up because she's so obviously uncomfortable and there's so little I can do other than the drops (which she just adores /eye roll/).

2
Thank-you Doctor Coates
by kay morris on 01/23/2012 11:02am

The eyes, can be help, must be seen by their Doctor as soon as possible. Better be safe than sorry. Our Jordan has lost his sight, at 22 yrs. too old to be put under for any operation. Thank God for everyday, he is with us. He thinks he is still the Boss, most Chihuahua do..LOL

3
Eye problems
by doglover0305 on 01/23/2012 02:24pm

I feed a feral black cat and during the summer his eyes are senative to light and sometimes he his yellow drainage from his eyes is there anything that I can put in his food to help him?

4
Consider the Pain
by TheOldBroad on 01/23/2012 07:31pm

Put yourself in the critter's place. If YOUR eye hurts or is draining, are you going to "wait and see"?

Just having a hair in your eye will drive you crazy. Consider how awful it would be if it HURT, too.

Some years ago, my little Emma Jean had an eye injury (we never figured out what happened). Bless her heart, she got drops and ointment for a year. One was every 6 hours (I came home at lunch to put one drop in her eye) and one was every 8 hours.

She had a small residual inflammation so she went to the ophthalmologist every month for about 5 years.

Any time she started squinting, which is a sign of pain, she was whisked to the doctor. I'm so grateful that her eyesight was saved.

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About fully vetted

Jennifer Coates, DVM

Photo of Dr Coates

Image credit: Jim Piraino

...graduated with honors from the Virginia-Maryland Regional College of Veterinary Medicine in 1999. In the years since, she has practiced veterinary medicine in Virginia, Wyoming, and Colorado. She is the author of several books about veterinary medicine and animal care, including the Dictionary of Veterinary Terms: Vet-Speak Deciphered for the Non-Veterinarian. Dr. Coates also writes short stories that focus on the strength and importance of the human-animal bond, and freelance articles relating to a variety of animal care and veterinary topics. Dr. Coates lives in Fort Collins, Colorado with her husband, daughter, and various species of pets.

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