Corneal Lacerations in Small Animals

Penetrating foreign bodies and corneal lacerations can result from similar causes, but in the latter, the object is not retained. For example, cat claw injuries are a common cause of full-thickness lacerations in small animals.

Clinical signs and diagnostic testing are similar to those for a penetrating intraocular injury; it is particularly critical to assess the lens for concurrent involvement. The prognosis depends on size and position of the corneal laceration as well as involvement of the iris, lens, or sclera with concurrent iris prolapse, with lens injury and scleral involvement tending to have a poorer prognosis.

Full-thickness corneal laceration, cat

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Images courtesy of UC Davis Comparative Ophthalmology Service.

Corneal laceration with retinal detachment, dog

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Courtesy of Dr. K. Gelatt.

In patients with vision, the corneal laceration is apposed with simple interrupted 7-0 to 9-0 absorbable sutures; a continuous suture line may be placed for additional stability (see corneal laceration images). To provide additional protection and support, the sutured laceration may be covered with a bulbar conjunctival graft or partial temporary tarsorrhaphy. If the patient is blind (such as when the retina has become detached), enucleation should be considered, although some owners may elect for surgical repair for cosmetic purposes (see retinal detachment image).

Postoperative treatment to control the secondary iridocyclitis consists of topical and systemic antimicrobials, systemic NSAIDs, and mydriatics. Postoperative treatment is similar to that for penetrating intraocular foreign bodies and includes topical and systemic antimicrobials to prevent infectious keratitis or endophthalmitis, respectively, as well as systemic anti-inflammatories and topical mydriatics to address the reflex anterior uveitis.

Postoperative complications include the following:

• variable and often dense corneal scarring

• cataract formation with posterior synechiae

• secondary glaucoma

• phthisis bulbi

• bacterial keratitis or endophthalmitis