Ocular emergencies (Proceedings)
An emergency involves anything that is vision-threatening and/or painful for the patient.
Ulcers: Melting and deep corneal ulcers or descemetoceles should be treated aggressively and hospitalization for appropriate treatment may be required. Surgery is generally recommended for these ulcers, however medical treatment may be necessary based on the owner's financial situation, the health status of the patient, or if the patient needs to be stabilized overnight. A basic treatment protocol is outlined:
Lacerations: Corneal lacerations that are simple may self-seal and require only medical treatment. Lacerations in which a flap exists may need surgery and depending on the size and location may be treated with a biomaterial, debridement and suturing of the cornea, or a conjunctival pedicle graft or corneal:conjunctival transposition. This basic protocol for medical treatment may also be used post-surgically:
• Same treatment as for corneal lacerations
• DO NOT pull objects out of the cornea
• If superficial, flush with steady stream of saline
Glaucoma=IOP > 25 mmHg. All cases of glaucoma require immediate treatment since permanent damage to the neurosensory retina may occur in as little as 30 minutes. Emergency treatment options are outlined below and if the eye is non-responsive the patient should be referred for further treatment and surgery. For those cases that respond to emergency treatment referral is still recommended on a non-emergent basis to perform gonioscopy and assess the risk to the contralateral eye.