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Discussion on Pupil not contstricting - post injury | |
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Member: Kitz |
Posted on Monday, Nov 24, 2003 - 3:46 pm: While away on vacation (OF COURSE), my horse injured his eye this past Wednesday night (11/19). Farmsitters called to say there was a small bit of blood and an obvious tear in front of the eye but it appeared to be a simple tear to the lid, not the eye.I told them to check the eye with a flashlight - if the cornea appeared uninjured, to cover his face with his black, loosefitting fly mask anyway, and we discussed cold compresses and I instructed them to get my sterile, unopened conatiner of saline and do a wash 2x daily if possible. We also decided upon 2g. Bute daily. Finally, I emphasized that if they felt they had ANY cause to worry, then not to mess around, to just call the vet and I'd pay the bill upon my return. I found, when I got home Sat. night, a very swollen eyelid, and lots of gunky drainage -- but thankfully this was obviously external drainage from the torn lids and not infectious drainage from the eye. They said they had found another tear at the back of the eyelid on Friday, as well as the one they alredy knew about in the front (at which point I WISH they had called either me or a vet because logic tells me if the front and back are BOTH injured, then the middle - the main eyeball - is likely also injured!). Both tears to his eyelid were around a 1/4" and appeared to be healing nicely. Good girls, they managed every day from Wed. until Sat. to cold compress and apply an antibiotic salve into his eye, as well as the Bute. FWIW -- this anitibiotic salve is only a Triple Antibiotic FOR EYES, there is no atropine in it. When I got out my flashlight on Sat. night, I noticed the pupil on the injured RIGHT eye did NOT constrict normally. It did a little but not normally, and not the same as his uninjured Left eye. I couldn't see any blood in the eye, nor abrasions to the cornea. Sunday morning, I called the local vet teaching hospital and spoke with a vet -- I was concerned about the optic nerve, retina damage and overall trauma to the eye. He said since there was no blood nor apparent tearing of the cornea, and the horse was acting normally, that I would be OK to wait until today (Monday) to have it treated. The vet was out today and luckily our laymen's guesses were correct: there is no corneal abrasion. No appearance of anything wrong with the eye itself - no optic nerve problems she could see with her hand held scope, no infection, etc. She said she could NOT see any signs of trauma to the eye(ball) itself. My vet is totally bewildered as to why the injured eye is NOT constricting normally as the other eye. She prescribed some more Triple Antibiotic since I was running low, and said to give it a week to straighten up, or else we need to look further. Do I need to look further now, or wait that week? There is an equine opthamologist within 2 hours of me at MI State in Lansing. Any ideas as to why this pupil won't contstrict normally? |
Moderator: DrO |
Posted on Monday, Nov 24, 2003 - 7:16 pm: I don’t see any indication in your post that the horse is visual: does she have a normal menace? If so is the pupil on the trauma side slightly more constricted normally. Intra-ocular inflammation, it would be subclinical in your case, causes the iris to spasm. Perhaps the already spasmed iris is the reason for the difference?DrO |
Member: Kitz |
Posted on Monday, Nov 24, 2003 - 8:17 pm: Thanks for your timely response, Dr. O.By "visual" - I assume you are asking if the horse can see? Yes. He appears to be able to SEE. Whether or not his focus is there, or if he's lost any % of his vision, I can't say. What is meant by the term "normal menace?" Good question about whether or not this pupil is this way normally. I assume this is an ABNORMAL condition. I do check my horse's eyes occasionally, and I really hope I would have noticed if it was dilated before. So, can't say for sure. It DOES constrict some, but not as much as the other one, and I assume, not as much as NORMAL. If the iris is spasming, is this threatening to the horse's vision or comfort levels? Do I need to take more action than I am, or just allow Father Time to do his work? My obvious concerns are pain to the horse, and loss of vision. He is eating and drinking with his normal degree of enthusiasm. I assume he is in some degree of pain, however, as he's not cavorting like the normal 2 y.o. he THINKS he is (he's 14) while in the pasture. |
Moderator: DrO |
Posted on Tuesday, Nov 25, 2003 - 5:10 pm: The menace response is where you test a horses vision by “threatening” to hit him in the eye. You move your hand toward the eye quickly being careful that the other eye cannot see the hand and that you do not create a puff of wind the eye may feel. It takes experience but with care can test visual acuity pretty well. The spasm itself, as long as not accompanied by cloudiness or blood in the eye, is not a problem, just a indication of a problem. But you should be able to see the spasm: the eye that is spasmed has a smaller pupil than the other side when they are both in the same light.DrO |
Member: Kitz |
Posted on Tuesday, Nov 25, 2003 - 7:48 pm: Oh, I did that test and found that the horse definitely reacts. I just didn't know the name of it (normal menace). I will try it again tonight to make sure he isn't seeing my hand with his other eye, or feeling the wind.I called MI State today and spoke with their equine opthamologist. She agrees with you as well as my local vet -- basically no emergency .... give it a week and see if it clears up. She suspects the horse had trauma to the eye (I suspect he ran into a TREE of all things because he his pasture mate like to really get rough during play - they mock barrel race - he's a dressage horse! - amongst these pines. We have cut the boughs up to 14', but I think he hit the trunk! I could kick myself for not thinking of this before one of them hit a tree.). Anyway, she recommended I continue with the Bute in the event he has bruised his optic motor nerve. BTW - the dilated pupil (which will not contstrict) is happening in the injured eye, not the well one. I am crossing my fingers this thing works itself out over time! Thanks again for your help. This has been a SUPERB website and certainly some of the best money I have spent on resources in a long time. I am in a rural area with sort of older, backwards vets (who seem to HATE what they do), and I really rely on this site heavily every time something new or unfamiliar to me comes up. Thanks again for a SUPER resource, Dr. O! |
Moderator: DrO |
Posted on Thursday, Nov 27, 2003 - 4:17 pm: Thanks for the kudos but I grow more worried: a damaged eye with inflammation should constrict (spasm) not dilate, unless it is not preceiving light well. Did the opthamologist give you another reason this might be?DrO |
Member: Kitz |
Posted on Tuesday, Dec 2, 2003 - 3:36 pm: No. She did not.Thankfully, in the last few days, it is contstricting more normally again. About 90% of what it should be. No clue on this end, other than a potential concussion of a less severe nature. .... You got any more ideas? THESE HORSES! |