Discussion on Recurrent Uveitis?
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| Author |
Message |
    
Debra Jahnke
| | Posted on Sunday, Jan 2, 2000 - 12:10 pm: |   |
Has anyone every been given an incorrect diagnosis of Recurrent Uveitis? I'm probably grasping at straws here but...I've had my Tennessee Walker gelding (6 years old)for only a few months. He had a swollen reddened eye with some clear tearing on Thursday night. I figured he'd gotten a piece of dirt or something stuck in there and bathed the eye three times a day with a warm boric acid solution. The eye was looking much better. On Saturday, he got into a galloping contest with my other Walker. It took 45 minutes to slow him down and catch him. This is really unusal exercise for him. At that point, although he was a sweaty mess and looked like a lunatic both eyes were perfectly clear. An hour later the entire eye had a yellow cast and I couldn't discerne the iris or pupil.It looked like a mist had settled in back of the entire surface of the cornea. I immediately called the vet and apparently I wasn't describing the symptom very articulately because our vet couldn't picture the problem and told me to continue to bath the eye and call him the next day if the problem hadn't improved. On Saturday, the yellow matter had settled to the bottom of the eye behind the cornea into a pretty solid mass. The vet came out and in about 5 minutes gave me the diagnosis. Actually, he said conjuctivitis, but when I looked at my bill the diagnosis was Recurrent Uveitis. Obviously, I immediately looked it up and got pretty upset. All the medications he prescribed were in line with the Doctor's article but it sounded like a pretty fast conclusion. Any similar stories or comments? |
Robert N. Oglesby DVM
| | Posted on Monday, Jan 3, 2000 - 10:08 am: | |
Hello Debra,
The condition you describe has a name, "hypopyon". It is WBC's and possibly some fibrin in the anterior chamber of the eye (see sagital cutaway in Reference section). The WBC's will eventually settle toward the bottom of the eye. Trauma is not likely to be a acute cause of hypopyon, usually that results in RBC's prior to the WBC's coming in but there may be exceptions.
That leaves you with infection and recurrent uveitis at the top of the possibilities. And this is an important differentiation to make because the treatments are different and there is no way I know of to be absolutely sure at this point which you have. In spite of that there are some differences that might help you decide:
1) Primary infection of the anterior chamber is pretty rare, usually coming from a penetration of the cornea. Leptospirosis may be an exception.
2) Primary infection would probably be more inflammed and painful than recurrent uveitis.
3) With recurrent uveitis you might see old signs of inflammation in the anterior chamber.
These are generalities however and a slow moving organism might look like RU and a real bad RU might look like infection. At this point treament should be aimed at preventing permanant changes that impair vision. What are you treating with?
DrO |
Debra Jahnke
| | Posted on Monday, Jan 3, 2000 - 12:14 pm: | |
Dear DrO:
Thank you very much for your informative reply.
Our Vet has me treating him with 1 gram bute (x 2) and Prednisolone 1-2 drops (x 2) and Bacitracin-Neomycin ointment (x 2). All meds to be given for 7 days.
The eye looks significantly better, with exception of the WBCs which seem to drift about in the chamber. I assume this interferes at times with vision, depending on it's position.
The Vet did not mention any old inflammation was observed (after checking both eyes)--it's a good point, and I will follow up with my Vet and ask him specifically.
During the entire episode, the horse has not exhibited any discomfort.
I also plan to ask my Vet about a possible preventative dose of Aspirin daily, as I believe it was mentioned in an article.
Again, thank you so much for your very helpful reply.
--Deb |
Robert N. Oglesby DVM
| | Posted on Monday, Jan 3, 2000 - 1:49 pm: | |
Hello Deb,
With signs of so much inflammation in the anterior chamber I would think a mydriatic like atropine would be very important. A frequent sequelae is synechia formation. This is where a strand of fibrin adheres to both sides of the pupil then during maturation contracts causing a functional closure of the pupil preventing normal sight.
The atropine causes the pupil to open wide (mydriasis) decreasing the chance a piece of fibrin will adhere across the opening. Information on treatment with atropine can be found at: Medications: Miscellaneous: Atropine.
DrO |
ae
New Member
Username: dusty05
Post Number: 2
Registered: 6-2009
| | Posted on Monday, Jun 1, 2009 - 7:35 pm: | |
Dr Gilger did implants on my horse with frequently RU. 1 1/2 years later and no recurrence. Wonderful doctor. Recommended a woman to care for her while recuperating and she did a great job. |
