Difference between revisions of "Fungal Keratitis - Donkey"
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| + | ==Introduction== | ||
| + | |||
| + | This is only diagnosed if specifically tested for. | ||
| + | |||
| + | ==Clinical Signs== | ||
| + | |||
| + | It often presents as '''chronic keratitis with blepharospasm, epiphora, corneal oedema and punctuate ulceration''' with a long history of antibiotic therapy. | ||
| + | |||
| + | ==Diagnosis== | ||
| + | |||
| + | * 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== | ||
| + | |||
| + | 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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Revision as of 16:17, 18 February 2010
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Introduction
This is only diagnosed if specifically tested for.
Clinical Signs
It often presents as chronic keratitis with blepharospasm, epiphora, corneal oedema and punctuate ulceration with a long history of antibiotic therapy.
Diagnosis
- Combined antibiotic/steroid therapy should be avoided; it is rarely indicated and allows fungal overgrowth
- Corneal scrapings are required for histology. However, cases at The Donkey Sanctuary have been diagnosed from swabs. Check with the laboratory first to ensure the correct medium is used.
Treatment
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 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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