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Fungal Keratitis - Donkey (view source)
Revision as of 16:17, 18 February 2010
, 16:17, 18 February 2010no edit summary
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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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