Page 1263 - Problem-Based Feline Medicine

61 – THE CAT WITH A CLOUDY EYE 1255

ANOMALY
● Corneal (stromal) dystrophy of Manx cats (p 1264)
A rare condition in young Manx cats that starts with axial stromal edema and progresses to a dif-
fuse corneal edema with a thickened stroma full of bullae (fluid-filled vesicles). It is a blinding
corneal disease with no treatment possible.
INFLAMMATION/INFECTIOUS
● Feline herpesvirus-1 keratitis*** (p 1259)
Cats may have a history of FHV-1 infection as kittens. Often appears as a unilateral disease in
older cats. The epithelium may show dendritic lesions (finger-like projections of thickened epithe-
lium that stain with rose bengal stain) in early cases. Chronic cases show irregular (geographic)
ulceration to the level of the superficial stroma. Scarring and vascularization of the cornea fol-
lows after repeated inflammatory episodes.
● Mycobacterial keratitis (“Florida spots”) (p 1264)
Focal grayish opacities seen in the stroma caused by a mycobacterium. Only seen in the southeast
USA.
INFLAMMATORY/NON-INFECTIOUS
● Ulcerative keratitis* (p 1262)
A very painful, cloudy eye with serous discharge, blepharospasm and photophobia. Usually
occurs secondary to corneal trauma. Superficial ulcers have loss of epithelium, which is seen as
an erosion of the surface, and stains green with fluorescein dye. Deeper ulcers have a hollow
caused by loss of stroma.

Immune-mediated:
● Eosinophilic keratitis* (p 1261)
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:
● Cornea scarring from injury* (p 1263)
Opaque areas on cornea, which vary in size and intensity. There is no pain or discharge associated
with these opacities, and usually there is a history of previous severe ocular inflammation or
trauma.
WHERE?
ANTERIOR CHAMBER

METABOLIC
● Lipemic aqueous (p 1270)
The anterior chamber looks milky, but intra-ocular architecture can be visualized. Signs may be uni-
lateral or bilateral, and may have a sudden onset. Occurs secondary to anterior uveitis in cats on a
high-fat diet, or is associated with hyperlipidemia. Idiopathic in Burmese cats.
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