Stormy got a visit from Rainland Farm Equine veterinarian Megan McCracken DVM earlier this month, including an eye examination to try to determine how serious her condition is. Below, you can read the report from Dr McCracken in all its clinical detail. Stormy has a condition called Uveitis in both her eyes. Uveitis is fairly common in Appaloosas, especially those that are grey or white like Stormy. Uveitis causes recurring inflammation and eventual blindness, and it’s pretty safe to say that this is something that Stormy has been facing for quite some time. She is definitely blind, and clearly in some discomfort.
Stormy’s left eye is often squinted or partly closed, with some clear discharge. The squinting indicates that there is some pain or discomfort in this eye. She does not react to movement or light, and her pupil is fixed and does not dilate. The pupil appears to be adhered to the lens, and she also appears to have a cataract on that lens as well, which would explain the lack of reaction to light being shined into her eye.
Stormy’s right eye appears enlarged, which could indicate glaucoma or increased pressure. There is no reaction to movement or light in this eye either. It is possible to see that her lens has become detached and is now resting at the bottom of the anterior chamber of the eye. This will also increase the pressure in the eye because there isn’t room enough for the lens in this part of the eye. However this eye does not appear to be causing her pain or discomfort.
Dr McCracken advised us to treat Stormy with a cortico-steroid ointment in both eyes to decrease the inflammation. We noticed an improvement right away in the appearance of swelling and Stormy seemed happier and more comfortable too. This has been quite a relief to us all!
We’ll continue to monitor the situation and work with Dr McCracken and possibly an equine ophthalmologist to determine the best course of treatment for Stormy. It’s very possible that one or both eyes may need to be removed at some point in the future if her discomfort can’t be controlled. We would like to find a companion for Stormy that be her eyes the way King is now. If we’re successful into introducing her to a suitable friend, the two would be adopted together to a home where they could live out their days in comfort.
ASSESSMENT NOTES : Stormy has evidence of bilateral Equine Recurrent Uveitis. This is a chronic condition of horses that results in recurrent inflammation of the uvea or structures within the eye). It is very common in Appaloosa horses and more common in Appaloosas with very pale coat colors.
Stormy’s left eye is currently more painful as evidence by her blethrospasm or squinting. There is also increased epiphora or clear ocular discharge from that eye. On evaluation, she does not have a menace (moving her head away in reaction to a hand moving toward her eye), a PLR (pupillary light response – the reflex contraction of the pupil when light is shone in the eye), or a dazzle (reaction to a bright light shone in the eye). There is significant increased corneal opacity (cloudiness in the outer layer of the eye), which makes evaluation of the inner ocular structures difficult. It is possible to see her pupil and it appears to be adherent to the lens. The lens also appears to have a cataract (increased opacity of the lens). These findings are all consistent with equine recurrent uveitis. The cornea is fluroscein stain negative meaning that there are no scratches or abrasions on the cornea.
Stormy’s right eye also has signs of severe recurrent equine uveitis. This eye is enlarged. There is no menace, PLR, or dazzle. There is increased corneal opacity (cloudiness). In addition to the overall cloudiness of the eye, there are several linear streaks if more opaque cornea. These are often consistent with increased ocular pressure (glaucoma). It is difficult to see beyond the cornea, however it is possible to see her lens resting on the floor of the anterior chamber. The anterior chamber is the front portion of the eye between the cornea and the iris. The lens should normally be suspended in the posterior chamber (behind the iris) behind the pupil. It is used to focus light the comes in through the cornea (front of the eye) onto the retina, which is at the back of the eye. In cases of chronic uveitis, lens luxations can occur. If it is a poster luxation, the lens remains within the posterior chamber. There is no change in pressure in the eye and there is just decreased vision. In Stormy’s case the lens has fallen into the anterior chamber, there is not space for it in this portion of the eye and it has therefore induced increased ocular pressure or glaucoma. A measurement of intra-ocular pressure would be needed to fully diagnose the presence of glaucoma. This eye does not appear to be as painful. Stormy is currently blind with evidence of severe recurrent uveitis in both eyes. She has one painful and one significantly abnormal eye. The eye with the presumptive glaucoma does not appear as painful, but it could become so in the future.
Stormy was started on antibiotic and corticosteroid ointment in both eyes to decrease the inflammation with her eyes. She also was started on two days of oral banamine to further decrease this inflammation. This should make her more comfortable. Measurement of intraocular pressure and treatment with glaucoma medications should be considered.
Spoke with Terry on 10-5-16 – Stormy is significantly more comfortable on the corticosteroid ointment. Plan to continue administration twice a day for a total of 14 days and then decrease to once a day.