4095. REYNA. A rabbit has a painful eye ulcer. Chronic ulcerative keratitis. A case of corneal lipidosis

DRAFT

20 Feb 2020. The rabbit has a painful eye ulcer. Pt 1/2. Chronic ulcerative keratitis Treatment by antibiotic eyedrops for several days at Toa Payoh Vets in December 2019. The ulcer had 'disappeared' . The owner got the rabbit home but the rabbit was furious with the Elizabeth collar and pulled it out. The owner did not make the rabbit wear the Elizabeth collar. The eye ulceration returned. The rabbit has lost weight and needs to be warded for a few days for treatment and to recuperate to regain weight. The owner opted for eyeball removal as this would stop the daily eye pain, but the rabbit had to gain weight to be fit for anaesthesia and surgery. In this consultation, the ulcer is deep and the cornea is very cloudy. The rabbit is quite old and healing may not be possible if eye surgery is performed. An option will be to remove the eyeball (enucleation) so that the rabbit does not suffer from any more eye pain and loss of appetite. There is anaesthetic risk as the rabbit is 9 years old, towards the end of life. The owner will wait another 7 days of inpatient treatment to think about it.

Dec 2019 images

20 Feb 2020 images

27 Feb 2020 images

The rabbit's routine is freedom to roam in the apartment. Dust and air irritate the ulcerated right eye, leading to more rubbing. The cornea became infected and inflamed. A cloudy cornea with a central ulcer existed.  It can be painful, leading to more rubbing to relieve the itchiness.  Eyeball removal is the treatment of choice. The owner is worried about anaesthetic risks. Wanted to wait another week. 

TIPS AND ADVICES

1. Early detection

2. Early treatment within 24 hours of injury is best

3. Diagnosis - Fluorescein eye stain test
4. E-collar

5. Review

Save eye

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Rabbit eye disease


CORNEAL DYSTROPHY OR ULCERATION?

Article from:

Corneal lipidosis - also called corneal dystrophy or lipid keratopathy - is a condition where excess lipids (usually cholesterol esters) or minerals (calcium) are deposited under the surface of the cornea. The infiltration usually starts at the edge of the cornea and can be observed in the anterior stroma, the epithelial basement membrane and the epithelium.

Corneal lipidosis is not associated to a disease; it is not breed or gender dependent.

Etiology

A lipid rich diet and/or trauma are the main causes for lipid deposits into the cornea. Congenital factors cannot be ruled out.

Clinical signs and diagnosis

It is based on a complete ophthalmic examination and a discussion with the owner about the food fed to the rabbit.

Both eyes are usually affected (bilateral) but not necessarily to the same degree. Unilateral lipidosis has rarely been reported. The fat deposits, which usually start near the third eyelid, can be opaque, raised, subtle and pale, bright white, silver or grey colored areas. Vascularization is observed in the affected part of the cornea. 

 

While the cornea is mainly affected, fat deposits have also been noted in the lens, iris and ciliary body of a Dutch rabbit. Often it is accompanied by macrophage invasion. An inflammatory process has been observed, but does not always seem to be present.

Unlike in dogs, corneal lipidosis is associated with a gradual loss of vision in rabbits. If the deposit is severe, it can lead to ulceration of the cornea.

There is no pain associated to this condition.

 

 

AN EXAMPLE OF A SEVERE CORNEAL DYSTROPHY IN A YOUNG RABBIT SEEN FROM A PET SHOP IN SEP 2017.