Eosinophilic Keratitis

 

Soxie, a Paint mare, was seen by Dr. Paul one autumn day because the owner noticed that she suddenly had VERY swollen and painful eyelids. The eyelids and tissues around the eyes were so swollen that Dr. Paul had a hard time looking at her eyeballs. Soxie was put on some anti-inflammatory medication to bring the swelling down. When Soxie was re-checked a few days later, the swelling had come down dramatically allowing Dr. Paul to see that Soxie actually had large but shallow ulcers in the exact same location near the outer edge of both eyes! Dr. Paul immediately started Soxie on aggressive eye ulcer medication.

 

Despite this treatment, Soxie did not seem to improve. When she was re-checked again, she had now developed thick white plaques over both the ulcerated areas. Worried that she was developing a serious fungal infection, Dr. Paul and Dr. Melissa recommended Soxie be referred to the University of Minnesota to see a veterinary ophthalmologist. At the hospital, Soxie was diagnosed with EOSINOPHILIC KERATITIS.

What is it?

Eosinophilic keratitis is immune-mediated inflammation of the ocular (eye) surface. The body’s immune system begins to attack the cornea and ocular tissue with a particular type of white blood cell called eosinophils. The affected areas tend to be the edges of the eye extending inwards towards the center of the cornea. As the condition progresses, the affected areas will be covered by white, necrotic plaques that are composed of white blood cells (mainly eosinophils).

It can occur in just one eye or both at the same time. Although it is not clearly understood what the cause of eosinophilic keratitis is, sometimes it is associated with hypersensitivity to parasites or other stimuli that can cause a large immune system response. Treatment consists of steroids, immune-system modulating drugs, and antibiotics applied to the eyes. Treatment may be required for 10-20 weeks. Some cases reoccur despite aggressive medical treatment and may need surgery to remove the affected area of the cornea.

In Soxie’s case, treatment was continued for months and over time, the plaques and abnormal areas of her corneas healed leaving small cloudy scar areas.  A year later, Soxie’s eyes look almost totally normal and she has not had a reoccurrence.

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