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Discussion on ERU pupil not dialating
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Member:
sdhart
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Posted on Friday, Mar 7, 2008 - 1:58 pm:
Hello Dr. O.
I have a 12 yr old appendix gelding who was diagnoses with ERU last November. I have been treating him much along the lines described in your articles; however it has not gone to a quiet stage, that is, without symptoms.
Currently he gets Tobradex ointment in his eye twice a day. Over the past few months, whenever I try to decrease the frequency from twice a day to once a day, it seems to flare again. Since part of the treatment has been the use of atropine to dilate the pupil, and since we've had snow all winter, I have kept his eye covered during the day to reduce irritation.
The last treatment with atropine was 3 weeks ago and his pupil opened nicely but has taken this long to close again, and be of a similar size to his good eye. However, it is not responding normally to light, it is staying closed and so I treated him with atropine again this week and his pupil will no longer dilate.
My question is, do you think we have now reached a point where permanent damage has occurred and further treatment is futile. I have resigned myself to the fact that he will probably go blind but am hoping to keep his eye.
Any comments?
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Moderator:
DrO
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Posted on Saturday, Mar 8, 2008 - 8:21 am:
Hello Sue,
Though most cases of ERU have a history of responding to a week or two of treatment with quiescence for a period, they don't all work that way but it does suggest you should continue to look for other causes. I am uncertain what to make of your observations as the subtleties of the movements and the long term pharmacological interventions can lead to hard to see or unpredictable events. Really the most critical test, though difficult to do properly, is a menace reflex: does the horse blink when the eye is "threatened". This procedure is described in Horse Care » Routine Horse Care » Prepurchase Exam of the Horse.
To answer the questions about how seriously damaged is this eye and what other problems beside ERU might be present will require a good ophthalmic examination, including a opthalmoscope and possibly a tonometer (see glaucoma).
DrO
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