A six months old throughbred female race horse was received presenting events of mucous purulent discharge from the right eye for two days. Close examination of both eyes revealed bilateral mucous purulent conjunctivitis, more severe on the left eye where discharge was more profuse, with tarsal and bulbar chemosis and blepharospasm. This animal also had a fluoresceine fixing superficial linear ulcer on the left eye. It was performed culture of material from the botton of conjunctive sack, which revealed an infection by Pseudomonas spp, sensitive to tobramycine. Based upon microbiological tests, tobramycine eye drops (15 mg/ml) and ophtalmic ointment (15 mg/g) was given for three weeks, and a two percent atropine and one percent dichorphenac eye drops were given for five days. At the end of the treatment, the right eye was calm and without alterations while the left eye displayed a tarsal membranous conjunctivitis with minimal serous ocular discharge. The presence of an allergic conjunctivitis was suspected and four percent dissodium chromoglicate eye drops were given. In spite of the decrease of inflamation observed, the conjunctive membranes remained. Surgical débridement of the membranes was performed and representative material was collected and sent for histological examination. Based upon human and canine reports and histological findings, the most probable diagnosis was ligneous conjunctivitis. After biopsy, the drug chromoglicate was replaced by one percent prednisolone eye drops for three weeks. After this, the eye showed a discreet dorsal tarsal chemosis and hyperemia but no membranous conjunctivitis. As supporting therapy a daily morning instillation of corticoid for 30 days was ordered. Five months later, a recurrence of the membranous conjunctivitis was verified and these membranes invaded the cornea, causing temporal pigmentary keratitis. A two percent cyclosporine ointment was then given and a new biopsy asked. The diagnosis of recurrent severe ligneous conjunctivitis was evident, and a wide surgical resection of the membranes and vascular cauterization was decided. Postoperative treatment was composed by one percent prednisolone, one and a half percent tobramicine eye drops together with 5,000 IU /ml heparin. Treatment proceeded for 30 days when the antibiotic was taken off, corticoid frequency was reduced and topic heparin kept. Ligneous conjunctivitis is a chronic membranous conjunctivitis with presence of membranes mainly in the tarsal superior conjunctives, of ignored etiology. Up to the present, two months after the surgical resection of the membranes, the topical use of corticoid and heparin satisfactorily controls the case, now eleven months old.
A three years old quarter mile mare weighing 500 kilograms and on the last third of pregnancy was received showing signs of severe pain in the left eye. The right eye was normal. This animal was treated, before consultation, with gentamycin eye drops with no success. On the instrumental ophtalmic examination, using biomicroscope, direct ophtalmoscope and flattening tonometer, was observed widespread conjunctivitis, hiperemia involving conjunctive and episclera, edema of cornea, hypopyon, myosis, blackened iris and ocular hypotonia. No changes were seen in the subsequent segment. This signs allowed the diagnosis of anterior subacute uveitis. The treatment, objectifying the ocular imunossupression and maintenance of iris rest, begun. For that it was given: two percent atropine eye drops, tem percent phenylephrin eye drops, one percent prednisone eye drops and one percent prednisone ointment. On the first day of treatment a injection of a two percent solution of bethametasone was given into the sub-conjuctive bulbar space. To the end of fourth week, the eye was calm and the patient was sent home. Three weeks later, the same left eye repeated the same symptoms and the treatment was the same as before except for the replacement of prednisone ointment by a two percent cyclosporine ointment. After 10 days symptoms were gone and the treatment was maintained until the 25th day, when both eyes started to present photophobia, epiphora and blepharospasm. Biomicroscopic examination revealed, in the central area of both corneas, ulcers with a white grayish infiltrate and satellite lesion without vascularization and presenting endothelial plates. It was suspected that ulcers could have a mycotic origin and current treatment was stopped. Cytological exam and biopsy of both the conjunctives and the corneas was carried out. These exams revealed the presence of Aspergillus spp. and Gram positive cocci allowing the diagnosis of mycotic ulcerous keratitis. The treatment was performed by use of itraconazole ophtalmic ointment in a thirty percent dimetilsulphoxide base and one percent cyprophloxacine and condroitine sulphate eye drops. After 15 days of treatment, the signs were gone and only the left eye ulcer still exist. Then it was decided to perform a superficial keratectomy together with a 180 degrees bulbar conjunctival autograft. In this case, probably the imune supressive chronic treatment modified the ocular biota, favoring opportunistic infection with Aspergillus spp. After 45 days of antifungical treatment, the animal left the Hospital both the two eyes showing minimum leucoma but without visual deficit.
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