Joshua Broadwater, DVM, DACVO describes how to treat corneal ulcers when medical management is insufficient
In this dvm360® interview, Joshua J. Broadwater, DVM, DACVO, with Charlotte Animal Referral & Emergency in North Carolina, explains when surgery is appropriate for corneal ulcers and how the most commonly used methods help support the eye.
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The following is a partial transcript of the video.
Joshua J. Broadwater, DVM, DACVO: When we're speaking about those infected ulcers and those stromal ulcers that are getting deeper, and when there's a thought that they can't be managed medically, when they're deeper—usually 60%, 70% deep in the cornea—that's when they should be referred for surgical management to try to save the eye and prevent rupture. And there's a couple surgeries that are done.
The most common ones, what they're meant to do, before a rupture has occurred is they're meant to provide a structural support over that deep ulcer, so that we're at less risk of rupture with an expulsive type injury where everything kind of leaks out of the eye. And it's such a devastating loss to the eye, that either surgery becomes much trickier, or sometimes you can't save the eye at all because there's been too much damage from the rupture.
So, some of the techniques that give the best structural support, the one that I use most frequently is a conjunctival graft where a portion of the conjunctiva is grafted over top of that deep ulcer, which does several things. It provides that structural support, if a rupture occurs, we still have that graft there. It also eventually gets a blood supply in there to help fight that infection, and thicken up that cornea, so it's not at risk to rupture. So, my surgery of choice for deep ulcers is a conjunctable graft.
In this respective interview, Broadwater discusses medical treatment options for corneal ulcers in dogs.