Page 1243 - Problem-Based Feline Medicine

60 – THE CAT WITH ABNORMALITIES CONFINED TO THE CORNEA 1235

● Florida keratopathy (“Florida spots”)/mycobacterial keratitis (p 1251)
Focal grayish opacities seen in the stroma caused by a mycobacterium. Only seen in the southeast
USA.
Inflammation:
● Keratitis secondary to uveitis** (p 1251)
Usually seen as a diffuse blue eye caused by corneal edema from a compromised corneal endothe-
lium. The eye may have an associated red injected conjunctiva. The anterior chamber may have a
hypopyon (accumulation of protein and white blood cells) and the inferior endothelium may have
keratic precipitates (focal accumulations of white blood cells and protein). Frequently associated
with systemic diseases such as cryptococcosis, toxoplasmosis, FeLV, FIV, FIP (young cats) and
systemic mycoses (USA).

Immune-mediated:
● Eosinophilic keratitis* (p 1245)
Seen as a cloudy, red cornea, sometimes with a muco-purulent discharge. A proliferative white to
pinkish plaque develops on the cornea, with superficial and in chronic cases, deep vascularization.
Usually a history of poor response to antibiotic therapy. Eosinophils demonstrated on cytology
from corneal scrapings are diagnostic.
Trauma:
● Neurotropic keratitis (p 1250)
Ulcerative keratitis results from denervation of the cornea or paralysis of the eyelids. The cornea
has a dry lusterless appearance, often with superficial ulceration and vascularization. The cat can-
not blink the eye, or there is no corneal reflex when the cornea is touched with a thread. Usually
seen after accidents that affect the facial and/or trigeminal nerve.
● Ulcerative keratitis (not associated with specific corneal disease or corneal
perforation)* (p 1246)
Appears as a very painful, cloudy eye with serous discharge. Edema, blepharospasm and ulcera-
tion, or a penetrating wound are typical. Usually occur secondary to corneal trauma. Foreign bod-
ies such as grass seeds and thorns or blunt trauma from motor vehicle accidents are the most
common causes of corneal trauma. Trauma may cause a superficial ulcer, deep ulcer or penetrating
wound. Melting ulcers appear as a very cloudy cornea with a soft gelatinous appearance. A black
area within the ulcer and a thin bulging membrane indicate a descemetocele.
● Ulcerative keratitis caused by corneal perforation (cat fight wounds)** (p 1242)
Very painful, closed eye with serous discharge and sometimes bleeding. Anterior chamber may be
full of blood and protein. Cats commonly attack their opponent’s eyes, usually causing a penetrat-
ing corneal wound with a claw. An iris prolapse is a common complication, and is seen as a light
to dark brown bulge in the center of the corneal wound (and distorted pupil if visible). Lens rup-
ture is a devastating complication that causes an acute uveitis, glaucoma and blindness.
● Blunt trauma* (p 1249)
Painful, cloudy and red eye. Cornea may have superficial ulcer or be ruptured (usually around the
limbus). The anterior chamber may be filled with blood (hyphema). Conjunctiva may be red from
subconjunctival hemorrhage. Eye may be bulging (exophthalmos) from edema and hemorrhage in
the orbit.