Equine Ophthalmology:

It is always an alarming sight when discovering a horse with a sore eye. In most cases, with early intervention, ophthalmic (eye) cases can be managed successfully without major complications. However, in some instances, a horse with an eye problem is a veterinary emergency. Merely waiting 24 hours without medical intervention can result in loss of the eye. The crux of the matter is being able to differentiate the simple from the complex cases. Unless an owner is confident it is always best to seek medical intervention early.

Blocked tear duct: Excessive tear production and conjunctivitis are seen in all ages of horses. Blocked tear ducts can be managed effectively by 'flushing'. This is when a small tube is placed up the nasolacriminal duct (connection between the eye and nasal passage) and water is used to irrigate the canal. Some horses require regular flushing whilst others will clear after just one treatment. Occasionally this blockage of the tear duct is due to a low-grade chronic infection and the animal will require medication directly into the eye for several days. 

 

Cornea damage: After digital palpation to determine if there are any foreign bodies within the eye (e.g a grass seed) the corner is examined for damage to the cornea will stain bright green or orange. Very deep ulcers, down to the deepest layer of the cornea (descents membrane), will not stain. This condition is called a 'descemetocele'. This is a serious condition that requires immediate medical attention. If this condition is eft untreated the globe (eyeball) may rupture and the eye may need to be removed. Medications with cortisone-based products should be used with cation in the equine eye. this is because, if an ulcer is present, healing may be severely impaired and secondary viral infections are even possible. An eye should always be stained with fluorescent prior to steroid based medications being used. A common complaint is that a horse will become very intolerant to receiving medications into the eye. Sub-palpebral lavage systems are used in such situations. Medications can be injected from a remote site. (e.g near the neck) and a direct line that is situated under an eyelid will dispense the medications into the eye.

Cancer of the third eyelid:

A condition that is frequently seen in draft breeds and grey/pale skinned horses is cancer of the third eyelid. The third eyelid, also known as nictitans membrane, is a structure that will flick from the inside to the outside aspect of the year in order to spread the tear film. The condition is usually caused by squamous cell carcinoma, a locally invasive tumor caused by sun exposure that can spread if not treated. this condition requires surgical removal of the majority of the third eyelid. Removal of this eyelid is tolerated extremely well and will almost always result in a cure of the condition and have no lasting negative effects.

 

Eye Removal:

In the worst-case scenario, when the eye cannot be saved or if radical surgical intervention is prohibited by economics, the eye must be removed. horses tolerate this procedure extremely well and in most cases it can be performed standing under local anesthetic. Some owners are alarmed at the final cosmetic result, however the horse never seems to be bothered. It is sometimes possible to insert prosthetic globes under the remaining skin in order to give the appearance of a normal eye. It may not be the most aesthetically appealing outcome but most athletic disciplines can still be performed successfully even if the horse has one eye (or vision in one). Some horses more easily spook and depth perception may be altered therefore caution is advised with competing in some sports. It should also be noted that with racing Thoroughbreds, the rules of racing state that the animal must have vision in both eyes.

Nasal and Sinus Issues:

It is always an alarming sight when discovering a horse with a sore eye. In most cases, with early intervention, ophthalmic (eye) cases can be managed successfully without major complications. However, in some instances, a horse with an eye problem is a veterinary emergency. Merely waiting 24 hours without medical intervention can result in loss of the eye. The crux of the matter is being able to differentiate the simple from the complex cases. Unless an owner is confident it is always best to seek medical intervention early.

Sinusitis:  Excessive tear production and conjunctivitis are seen in all ages of horses. Blocked tear ducts can be managed effectively by 'flushing'. This is when a small tube is placed up the nasolacriminal duct (connection between the eye and nasal passage) and water is used to irrigate the canal. Some horses require regular flushing whilst others will clear after just one treatment. Occasionally this blockage of the tear duct is due to a low-grade chronic infection and the animal will require medication directly into the eye for several days. 

 

Ethmoid hematoma: After digital palpation to determine if there are any foreign bodies within the eye (e.g a grass seed) the corner is examined for damage to the cornea will stain bright green or orange. Very deep ulcers, down to the deepest layer of the cornea (descents membrane), will not stain. This condition is called a 'descemetocele'. This is a serious condition that requires immediate medical attention. If this condition is eft untreated the globe (eyeball) may rupture and the eye may need to be removed. Medications with cortisone-based products should be used with cation in the equine eye. this is because, if an ulcer is present, healing may be severely impaired and secondary viral infections are even possible. An eye should always be stained with fluorescent prior to steroid based medications being used. A common complaint is that a horse will become very intolerant to receiving medications into the eye. Sub-palpebral lavage systems are used in such situations. Medications can be injected from a remote site. (e.g near the neck) and a direct line that is situated under an eyelid will dispense the medications into the eye.

Wounds and fractures:

A condition that is frequently seen in draft breeds and grey/pale skinned horses is cancer of the third eyelid. The third eyelid, also known as nictitans membrane, is a structure that will flick from the inside to the outside aspect of the year in order to spread the tear film. The condition is usually caused by squamous cell carcinoma, a locally invasive tumor caused by sun exposure that can spread if not treated. this condition requires surgical removal of the majority of the third eyelid. Removal of this eyelid is tolerated extremely well and will almost always result in a cure of the condition and have no lasting negative effects.

 

Sinus cysts:

In the worst-case scenario, when the eye cannot be saved or if radical surgical intervention is prohibited by economics, the eye must be removed. horses tolerate this procedure extremely well and in most cases it can be performed standing under local anesthetic. Some owners are alarmed at the final cosmetic result, however the horse never seems to be bothered. It is sometimes possible to insert prosthetic globes under the remaining skin in order to give the appearance of a normal eye. It may not be the most aesthetically appealing outcome but most athletic disciplines can still be performed successfully even if the horse has one eye (or vision in one). Some horses more easily spook and depth perception may be altered therefore caution is advised with competing in some sports. It should also be noted that with racing Thoroughbreds, the rules of racing state that the animal must have vision in both eyes.

The Equine Mouth

It is always an alarming sight when discovering a horse with a sore eye. In most cases, with early intervention, ophthalmic (eye) cases can be managed successfully without major complications. However, in some instances, a horse with an eye problem is a veterinary emergency. Merely waiting 24 hours without medical intervention can result in loss of the eye. The crux of the matter is being able to differentiate the simple from the complex cases. Unless an owner is confident it is always best to seek medical intervention early.

Common teeth issues:  Excessive tear production and conjunctivitis are seen in all ages of horses. Blocked tear ducts can be managed effectively by 'flushing'. This is when a small tube is placed up the nasolacriminal duct (connection between the eye and nasal passage) and water is used to irrigate the canal. Some horses require regular flushing whilst others will clear after just one treatment. Occasionally this blockage of the tear duct is due to a low-grade chronic infection and the animal will require medication directly into the eye for several days. 

 

Choke: After digital palpation to determine if there are any foreign bodies within the eye (e.g a grass seed) the corner is examined for damage to the cornea will stain bright green or orange. Very deep ulcers, down to the deepest layer of the cornea (descents membrane), will not stain. This condition is called a 'descemetocele'. This is a serious condition that requires immediate medical attention. If this condition is eft untreated the globe (eyeball) may rupture and the eye may need to be removed. Medications with cortisone-based products should be used with cation in the equine eye. this is because, if an ulcer is present, healing may be severely impaired and secondary viral infections are even possible. 

Jaw and dental fractures:

A condition that is frequently seen in draft breeds and grey/pale skinned horses is cancer of the third eyelid. The third eyelid, also known as nictitans membrane, is a structure that will flick from the inside to the outside aspect of the year in order to spread the tear film. The condition is usually caused by squamous cell carcinoma, a locally invasive tumor caused by sun exposure that can spread if not treated. this condition requires surgical removal of the majority of the third eyelid. Removal of this eyelid is tolerated extremely well and will almost always result in a cure of the condition and have no lasting negative effects.

 

Respiratory: 
It is always an alarming sight when discovering a horse with a sore eye. In most cases, with early intervention, ophthalmic (eye) cases can be managed successfully without major complications. However, in some instances, a horse with an eye problem is a veterinary emergency. Merely waiting 24 hours without medical intervention can result in loss of the eye. The crux of the matter is being able to differentiate the simple from the complex cases. Unless an owner is confident it is always best to seek medical intervention early.

Tie-back:  Excessive tear production and conjunctivitis are seen in all ages of horses. Blocked tear ducts can be managed effectively by 'flushing'. This is when a small tube is placed up the nasolacriminal duct (connection between the eye and nasal passage) and water is used to irrigate the canal. Some horses require regular flushing whilst others will clear after just one treatment. Occasionally this blockage of the tear duct is due to a low-grade chronic infection and the animal will require medication directly into the eye for several days. 

 

Tie-forward: After digital palpation to determine if there are any foreign bodies within the eye (e.g a grass seed) the corner is examined for damage to the cornea will stain bright green or orange. Very deep ulcers, down to the deepest layer of the cornea (descents membrane), will not stain. This condition is called a 'descemetocele'. This is a serious condition that requires immediate medical attention. If this condition is eft untreated the globe (eyeball) may rupture and the eye may need to be removed. Medications with cortisone-based products should be used with cation in the equine eye. this is because, if an ulcer is present, healing may be severely impaired and secondary viral infections are even possible. 

HeavesA condition that is frequently seen in draft breeds and grey/pale skinned horses is cancer of the third eyelid. The third eyelid, also known as nictitans membrane, is a structure that will flick from the inside to the outside aspect of the year in order to spread the tear film. The condition is usually caused by squamous cell carcinoma, a locally invasive tumor caused by sun exposure that can spread if not treated. this condition requires surgical removal of the majority of the third eyelid. Removal of this eyelid is tolerated extremely well and will almost always result in a cure of the condition and have no lasting negative effects.

Infectious respiratory disease:

Excerise enduced pulmonary hermitage 

 

Ears: 
It is always an alarming sight when discovering a horse with a sore eye. In most cases, with early intervention, ophthalmic (eye) cases can be managed successfully without major complications. However, in some instances, a horse with an eye problem is a veterinary emergency. Merely waiting 24 hours without medical intervention can result in loss of the eye. The crux of the matter is being able to differentiate the simple from the complex cases. Unless an owner is confident it is always best to seek medical intervention early.

Cyst:  Excessive tear production and conjunctivitis are seen in all ages of horses. Blocked tear ducts can be managed effectively by 'flushing'. This is when a small tube is placed up the nasolacriminal duct (connection between the eye and nasal passage) and water is used to irrigate the canal. Some horses require regular flushing whilst others will clear after just one treatment. Occasionally this blockage of the tear duct is due to a low-grade chronic infection and the animal will require medication directly into the eye for several days. 

 

Head shaking: 
It is always an alarming sight when discovering a horse with a sore eye. In most cases, with early intervention, ophthalmic (eye) cases can be managed successfully without major complications. However, in some instances, a horse with an eye problem is a veterinary emergency. Merely waiting 24 hours without medical intervention can result in loss of the eye. The crux of the matter is being able to differentiate the simple from the complex cases. Unless an owner is confident it is always best to seek medical intervention early.

Cyst:  Excessive tear production and conjunctivitis are seen in all ages of horses. Blocked tear ducts can be managed effectively by 'flushing'. This is when a small tube is placed up the nasolacriminal duct (connection between the eye and nasal passage) and water is used to irrigate the canal. Some horses require regular flushing whilst others will clear after just one treatment. Occasionally this blockage of the tear duct is due to a low-grade chronic infection and the animal will require medication directly into the eye for several days. 

 

Poll, neck and withers:
It is always an alarming sight when discovering a horse with a sore eye. In most cases, with early intervention, ophthalmic (eye) cases can be managed successfully without major complications. However, in some instances, a horse with an eye problem is a veterinary emergency. Merely waiting 24 hours without medical intervention can result in loss of the eye. The crux of the matter is being able to differentiate the simple from the complex cases. Unless an owner is confident it is always best to seek medical intervention early.

Fractures:  Excessive tear production and conjunctivitis are seen in all ages of horses. Blocked tear ducts can be managed effectively by 'flushing'. This is when a small tube is placed up the nasolacriminal duct (connection between the eye and nasal passage) and water is used to irrigate the canal. Some horses require regular flushing whilst others will clear after just one treatment. Occasionally this blockage of the tear duct is due to a low-grade chronic infection and the animal will require medication directly into the eye for several days. 

 

Shoulder:
It is always an alarming sight when discovering a horse with a sore eye. In most cases, with early intervention, ophthalmic (eye) cases can be managed successfully without major complications. However, in some instances, a horse with an eye problem is a veterinary emergency. Merely waiting 24 hours without medical intervention can result in loss of the eye. The crux of the matter is being able to differentiate the simple from the complex cases. Unless an owner is confident it is always best to seek medical intervention early.

Fractures:  Excessive tear production and conjunctivitis are seen in all ages of horses. Blocked tear ducts can be managed effectively by 'flushing'. This is when a small tube is placed up the nasolacriminal duct (connection between the eye and nasal passage) and water is used to irrigate the canal. Some horses require regular flushing whilst others will clear after just one treatment. Occasionally this blockage of the tear duct is due to a low-grade chronic infection and the animal will require medication directly into the eye for several days. 

 

Angular Limb Deformities:

Angular limb deformities refer to a deviation of the foal's leg/legs either outwards or inwards. Even slight angular limb deformities are undesirable in adult horses, as the abnormal angles on the joints will predispose them to orthopedic problems such as osteoarthritis. While many foals are born with some degree of limb deviation, mostly due to muscle weakness and lax ligaments, this will usually correct itself as the foals exercises. There is, however, always a risk that exercise may cause damage, depending on the cause of the limb deviation. To determine the most effective treatment for correction of this condition, it is best to have a veterinarian and / or farrier examine the foal.  

 

There are several causes of angular limb deformities and hence, many different treatment options. It is important to select the most appropriate treatment regime in order to maximize the outcome for horse and owner. 

1). Factors associated with pregnancy and the immediate period following birth; including genetic factors, incomplete bone formation  (ossification) of the cuboidal bones (small bones within the hock or knee joints) and laxity (slackness) of supporting joint structures (e.g ligaments) 

2) Development factors that occur following birth; including unbalanced nutrition and excessive exercise or joint trauma. A large proportion of these will straighten within the first week or two of life. For angular limb deformities  that do not self-correct there are both conservative and surgical options available;

The images on the left are cases of mild to severe outward deviation of the limb. All these deviations are originating from the growth plate. Most mild cases can be managed with conservative treatment while the more extreme cases require invasive surgical intervention. Moderate cases can be managed conservatively initially and depending on their response surgery may or may not be required Conservative management is usually attempted first in young foals or if the angulation of the deformity is only slight. Involving corrective rasping of the feet, confinement and sometimes the addition of therapeutic hoof extensions. These procedures will alter the biomechanics of the limb and straighten the leg over time. Occasionally these relatively conservative treatments are not appropriate to straighten the limb and surgical intervention is required. It is essential for foals that fail to respond to conservative treatment within the first month of life to be referred to a veterinarian to help make a decision in regards to further treatment. Surgical options must be performed prior to the limbs growth plates close, which are present in the bones of young horses however do disappear with time. Once growth plates are 'shut', correction of the angular limb deformity is almost impossible.

Soft Tissue Injuries:

Tendon Injuries - The Superficial digital flexor tendon.

Over-strain injury of the superficial digital flexor (SDF) tendon, which runs from the back of the knee/hock down to the level of the pastern, is common in performance horses. This type of injury is also know as tendonitis or a 'bowed tendon', and the damage that occurs is either due to chronic, low grade tearing of the tendon during fast work or, less commonly, to a one-off traumatic injury. (Image left: An ultrasound image of the flexor tendons of a forelimb. A grade 4 (severe damage) lesion of the superficial digital flexor tendon. This lesion takes up to approximately 50% of the maximal cross sectional area of the tendon). It should be noted that these horses are typically NOT lame but are painful on palpation of the tendon that is swollen land hot. What treatment a horse requires really depends on the type and severity of injury. No Matter what, a graded rehabilitation program is essential for a successful outcome. Recent research has turned the spotlight towards the use of mesenchymal stem cell, PRP (platelet rich plasma) or bone marrow aspirate. These cells are natural units of adult tissue regeneration, as opposed to simply repairing or replacing with scar tissue. Currently, use of one of the above treatments would be considered gold standard for management for this type of injury.

Windgalls - Effusion of the flexor tendon sheath

'Windgalls' are swellings of the digital flexor tendon sheath - which holds the tendons and the suspensory 

ligament in place on the horses legs. This flexor tendon sheath is normally filled with fluid that helps the 

tendons slide along the back of the fetlock joint. 'Windgalls' occur when this tendon sheath fills with an 

excessive amount of fluid. These swellings are usually similar in size between pairs of limbs and if the horse is not showing any signs of lameness, are usually no problem.