Fungal Keratitis - Donkey - Revision history

Bara at 09:02, 21 October 2010

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Bara at 12:25, 7 March 2010

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2010-02-25T10:24:23Z

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Bara at 16:17, 18 February 2010

2010-02-18T16:17:47Z

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 ==Introduction==
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 * '''[[NSAIDs]], cycloplegics and anti-collagenase''' treatment should be used in conjunction with the [[Antifungal Drugs|anti-fungals]]
 * Clinical signs can worsen as fungal death occurs
 ==References==

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		+	==Introduction==
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		+	This is only diagnosed if specifically tested for.
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		+	==Clinical Signs==
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		+	It often presents as '''chronic keratitis with blepharospasm, epiphora, corneal oedema and punctuate ulceration''' with a long history of antibiotic therapy.
		+
		+	==Diagnosis==
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		+	* Combined [[Antibiotics\|antibiotic]]/[[Steroids\|steroid]] therapy should be avoided; it is rarely indicated and allows fungal overgrowth
		+	* '''Corneal scrapings''' are required for histology. However, cases at [http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary] have been diagnosed from swabs. Check with the laboratory first to ensure the correct medium is used.
		+
		+	==Treatment==
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		+	Unless '''aggressive treatment''' is initiated early, the eye can be permanently destroyed. The prognosis is guarded.
		+	* Try to use fungicidal rather than fungostatic treatments
		+	* Options for treatment include:
		+	** '''Natamycin ophthalmic preparation'''.
		+	** '''Miconazole''' (10 mg/ml i.v. solution) applied to the eye four times daily for up to six weeks.
		+	** '''Povidone-iodine''' (non-lathering, not alcohol-based) diluted to 1:20 (5 ml in 100 ml sterile saline), applied to the eye four times daily
		+	* Treatment should be continued until two negative swab results have been achieved. This can take six to eight weeks. Chronic corneal scarring often remains
		+	* '''[[NSAIDs]], cycloplegics and anti-collagenase''' treatment should be used in conjunction with the [[Antifungal Drugs\|anti-fungals]]
		+	* Clinical signs can worsen as fungal death occurs
		+
		+	==References==
		+
		+	* Grove, V. (2008) Conditions of the eye In Svendsen, E.D., Duncan, J. and Hadrill, D. (2008) ''The Professional Handbook of the Donkey'', 4th edition, Whittet Books, Chapter 11
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