Corneal sensitivity and aqueous tear production in dogs undergoing evisceration with intraocular prosthesis placement

OBJECTIVE: To determine whether there is an association between evisceration with intraocular prosthesis placement via a dorsal scleral approach and decreased corneal sensitivity or aqueous tear production in dogs. DESIGN: Prospective study. PROCEDURE: Twenty-one dogs scheduled to undergo unilateral evisceration with intraocular prosthesis, and with a normal normotensive contralateral eye, based on slit-lamp biomicroscopy, indirect ophthalmoscopy and applanation tonometry, were included in the study. Central corneal sensitivity was measured with a Cochet-Bonnet esthesiometer prior to (week 0) and 2, 7, 14 and 28 weeks following surgery. Other pre- and postoperative data collected were Schirmer's tear test (STT I), Schirmer's tear test with topical anesthesia (STT II), corneal fluorescein retention, and intraocular pressure (IOP; postoperative control eye only). Axial globe length was determined for both eyes. Scleral incision length in the surgery eye was also recorded. RESULTS: Corneal sensitivity was significantly lower in eyes undergoing evisceration with intraocular prosthesis than in control eyes both preoperatively and postoperatively at all time points. There was no significant difference between preoperative and postoperative corneal sensitivity within the two groups. There was no significant difference in STT I or STT II-values between control eyes and surgery eyes preoperatively. There was a significant difference between preoperative and 2-week postoperative STT I in the surgery eye. There was a significant difference between the preoperative and 28-week postoperative STT II in the surgery eye. The 28-week postoperative STT I-values differed significantly between control and surgery eyes. Corneal sensitivity tended to decrease with increased degree of buphthalmos or with increased scleral incision length, although neither relationship was statistically significant. CONCLUSIONS: Eyes that have sustained chronically elevated intraocular pressure had decreased axial corneal sensitivity compared to normal eyes, which persisted even after intraocular pressure was reduced. The presence of buphthalmos appeared to be a factor in globes developing decreased corneal sensitivity. Evisceration via a dorsal scleral incision did not result in a significant further reduction in axial corneal sensitivity. A mild reduction in aqueous tear production occurred over time in globes following evisceration with intraocular prosthesis.     

Corneal sensitivity in healthy, immature, and adult alpacas

Objective To determine the corneal sensitivity of healthy, immature, and adult alpacas to establish normal reference values for this species. Animals studied Six normal crias and 18 normal adult alpacas. Procedures Corneal sensitivity was determined by evaluating the corneal touch threshold (CTT) in five regions of the cornea using a Cochet–Bonnet aesthesiometer. The nylon filament length in cm was then converted to applied pressure values in mg/0.0113 mm² and g/mm² using a conversion chart. Results The central region of the cornea was the most sensitive, and the dorsal and temporal regions were the least sensitive in alpacas. There were no significant differences between the right and left eyes or between values in males and females at any site. Crias had significantly greater corneal sensitivity compared with adult alpacas in all five regions of the cornea that were evaluated. Conclusions Normal reference values for CTT in alpacas were established using a Cochet–Bonnet aesthesiometer. The central region of the cornea is the most sensitive in alpacas, and crias have higher corneal sensitivity than adult alpacas.     

Cochet-Bonnet aesthesiometer-determined corneal sensitivity in neonatal foals and adult horses

Corneal touch threshold (CTT) was measured in sick neonatal foals, healthy foals, and healthy adult horses with a Cochet-Bonnet aesthesiometer. The mean overall CTT for the adult horses, sick foals, and healthy foals was 4.82 +/- 0.87 cm, 3.21 +/- 0.24 cm, and 5.01 +/- 0.61 cm, respectively. The central cornea of adult horses was more sensitive than the limbal cornea. Corneal sensitivity was significantly reduced in sick neonatal foals compared to adults. The mean Schirmer I tear test values were significantly lower in foals than adults, and were 14.2 +/- 1.0 mm, 12.8 +/- 2.4 mm, and 18.3 +/- 2.1 mm wetting in sick neonatal foals, normal neonatal foals, and adult horses, respectively. Reduced corneal sensation and lower tear production may be associated with ulcerative keratitis and slow corneal healing in some foals.     

Effects of trimethoprim-sulfadiazine on tear production and the fluctuations of Schirmer tear test values in horses

The objectives of this study were to observe the effects of trimethoprim-sulfadiazine on equine tear production and to determine normal fluctuations in Schirmer tear test (STT) values in horses. A randomized, placebo-controlled, blinded clinical trial measuring STT values in 15 horses over an 8-week period was performed. The treatment group (eight horses) received 30 mg/kg trimethoprim-sulfadiazine orally once a day and the control group (seven horses) received placebo (flour) at the same time. All horses were housed outdoors throughout the study. Schirmer tear test values were measured at 0, 2, 4, 6 and 8 weeks, and 4 weeks after discontinuation of treatment. There were no significant differences in tear production between the treated and control groups. Fluctuations in STT were observed and may result from individual and environmental variations. Trimethoprim-sulfadiazine did not decrease tear production in the horses in this study. Horses normally experience periodic fluctuations in STT values.     

Schirmer tear test, phenol red thread tear test, eye blink frequency and corneal sensitivity in the guinea pig

OBJECTIVE: To establish reference values for Schirmer tear tests (STT) I and II, phenol red thread (PRT) tear test and eye blink frequency, and to determine corneal sensitivity for normal guinea pigs. ANIMALS STUDIED: One hundred and eight eyes of 54 adult Duncan-Hartley guinea pigs. PROCEDURE: Schirmer tear test (STT) I and then STT II were performed in 36 guinea pigs. PRT and STT I were compared in 18 adult Duncan-Hartley guinea pigs. Corneal sensitivity was determined in 23 guinea pigs by evaluating the corneal touch threshold (CTT) of five different regions using a Cochet-Bonnet esthesiometer. Eye blink frequency was measured in 10 guinea pigs over a period of 20 min and in 17 guinea pigs over a period of 10 min. RESULTS: Mean STT I was 0.36 mm +/- 1.09 mm (wetting/min) and mean STT II was 0.43 mm +/- 1.29 mm (wetting/min). There was no significant difference between mean STT I and mean STT II (P = 0.79). The mean PRT-value was 16 +/- 4.7 mm (wetting/15 s), and the mean STT I-value in the same guinea pigs was 0.6 +/- 1.83 mm (wetting/min). Corneal sensitivity was significantly higher in the center than in the four limbal regions. The mean CTT for central, ventral, nasal, temporal and dorsal regions was 2, 1.7, 1.7, 1.7 and 1.6 cm or 3.7, 5.2, 5.6, 5.7 and 6.4 g/mm(2), respectively. Eye blink frequency was between two to five (mean 3.4 +/- 1.04) blinks per eye over 20 min in guinea pigs in their home environment, while in handheld and restrained guinea pigs eye blink frequency showed a variation between 0 and 17 blinks per eye (mean 3.24 +/- 3.64 blinks per eye) over 10 min. CONCLUSIONS: As there were no significant differences between STT I and STT II results, reflex tear secretion in the guinea pig may not exist. The most likely explanation is a lower corneal sensitivity in the guinea pig than in other species, such as cats, dogs and horses. Because of the small amount of tears, PRT is the preferred test for tear measurement in the guinea pig.     

Corneal esthesiometry in the healthy horse

Objective To determine corneal sensitivity in healthy adult horses in order to establish reference values. Animals studied One hundred eyes of 50 healthy adult horses. Procedure Corneal sensitivity was determined by evaluating the corneal touch threshold (CTT) in five different corneal regions using a Cochet‐Bonnet esthesiometer. Results Comparing CTT values (in mm filament length) of the five prescribed corneal regions revealed regional variations in corneal sensitivity, with the central region (21.15 ± 6.23 mm) being the most sensitive, followed by the nasal (20.75 ± 5.14 mm), temporal (20.70 ± 5.37 mm), ventral (20.15 ± 5.88 mm) and dorsal (15.85 ± 3.70 mm) region. However, differences between the central, nasal, temporal and ventral regions were not statistically significant, whereas the dorsal region was significantly (P < 0.0001) less sensitive compared to the other regions. Division of the horses into three age groups revealed an insignificant decrease in corneal sensitivity with age in the nasal, temporal, ventral and central region, and an insignificant increase with age in the dorsal region. Correlation of corneal sensitivity with age was statistically significant in the central, ventral and temporal region. No statistically significant difference in the CTT was found between left and right eyes and between males and females. Conclusions CTT values in 100 eyes of 50 healthy adult horses evaluated with a Cochet‐Bonnet esthesiometer generated reference values. Reference values are necessary to determine alterations of corneal sensation accompanying various eye diseases or systemic diseases.     

Determination of tear break-up time reference values and ocular tolerance of tetracaine hydrochloride eyedops in healthy horses

Reasons for performing study: Tetracaine hydrochloride (THCl) has been reported to cause irritation in dogs. In man, some topical anaesthetics have been shown to disrupt the tear film. Tear break‐up time (TBUT) is a useful test allowing an assessment of the quality of the precorneal tear film. Only one TBUT value has been reported in horses with no information on the technique used. Objectives: To provide a method for performing the TBUT in horses and to report any side effects of a single application of THCl in clinically normal horses, particularly on the stability of the tear film. Methods: In Study 1, one drop of 0.5 or 1% THCl was applied to one eye of 20 horses divided in 2 groups. Treated eyes were assessed for the development of side effects 2.5 and 5 min after treatment. In Study 2, the TBUT was measured in both eyes of 2 groups of 10 horses, before and 2.5 and 5 min after, instillation of one drop of either 0.5 or 1% THCl. Results: No animals developed any ocular side effect after instillation. Basal TBUT was 8.3 ± 1.3 s. TBUT decreased from baseline 5 and 2.5 min after application of one drop of 0.5% THCl and one drop of 1% THCl, respectively. Conclusions: A technique to measure the TBUT in healthy horses is described and normal range values that could be used as a reference were obtained. Potential relevance: THCl is well tolerated in horses but lowers the TBUT.     

Effect of topical application of 2% lidocaine gel on corneal sensitivity of clinically normal equine eyes

Objective

To assess the degree and duration of corneal anaesthesia provided by topical application of a non-ophthalmic 2% lidocaine gel in horses.

Effect of topical 1% tropicamide on Schirmer tear test results in clinically normal horses

Objective  To observe the effect of topical 1% tropicamide on equine tear production as measured by Schirmer I tear test.
Materials and methods  Fourteen adult horses received one drop of 1% tropicamide ophthalmic solution in one eye and the opposite eye served as the control. The tear production in both eyes was tested at 1, 2, 4, 6, and 24 h after 1% tropicamide administration.
Results  Measurements made 1 h after treatment revealed a significant reduction in Schirmer tear test values in tropicamide treated eyes ( P  = 0.002). The observed decrease in tear production was maintained up to 4 h after treatment ( P  = 0.002). Although tropicamide-induced decrease in STT values was observed in the treated eyes, the contralateral eyes did not show significant changes in Schirmer tear test results.
Conclusion  Single dose of topical 1% tropicamide resulted in statistically significant reduction in Schirmer tear test values in clinically normal horses.     

Schirmer tear test results in normal horses and ponies: effect of age,season, environment,sex, time of day and placement of strips

Tear production was evaluated in 39 horses and 29 ponies using Schirmer tear test strips to determine whether diurnal or weekly fluctuations occur, whether location of strip placement has an effect, if values are the same for both eyes in an animal and whether sex, age, stabling vs. pasture and winter vs. summer had an effect. There was no test in which the raw score was less than 10 mm, although there were many occasions where tear wetting exceeded 35 mm. Analysis of the raw (continuous) scores by linear regression provided no evidence that signalment, housing or season or location of strip placement affected results. The distribution of tear test scores for a 'population' of eyes did not differ when the right eye was compared with the left eye or when the same eye was compared at different times on the same day. Individual test wetting values for opposing eyes measured at the same time, and also wetting values for the same eye measured at different times on the same day sometimes differed substantially. In winter maximum tear wetting exceeded 35 mm more frequently in the STT I than in the STT II even in housed horses and ponies, but there was no consistent significant difference. There appears to be wide variability in the STT I in normal horses and ponies.     

Profiles of matrix metalloproteinase activity in equine tear fluid during corneal healing in 10 horses with ulcerative keratitis

OBJECTIVE: Levels of tear film matrix metalloproteinases (MMPs) activity are significantly elevated in horses with ulcerative keratitis and contribute to the excessive breakdown of stromal collagen. Changes in the amount of proteolytic activity in horse tear film during corneal healing and stromal remodeling have not yet been reported, but we hypothesize they should decrease. In the present study we analyzed serial tear fluid from horses with ulcerative keratitis to identify any changes in MMP activity during corneal healing and stromal remodeling. PROCEDURES: Samples of tear fluid were obtained from both eyes of 10 horses with ulcerative keratitis on the day of admission (day 1) at the hospital and then at various time points until complete healing of the cornea. Tear film MMP2 and MMP9 activity was determined by quantitative gelatin zymography. In all cases medical treatment included topical applications of equine serum, antibiotics, atropine and systemic administration of anti-inflammatory drugs. Surgical procedures were performed in several cases on day 2 in addition to the medical treatment. RESULTS: The mean total MMP activity (+/- SD) measured in relative standard units (RSU) in the tear fluid of the ulcerated eye (2.44 +/- 1.44) of the 10 horses was significantly higher than the mean in the contralateral eye (0.81 +/- 0.68) (P = 0.006), on the day of admission at the VMTH. The mean MMP activity in these ulcerated eyes significantly decreased (-82.4%) between the first day of admission and the day when the ulcer had completely healed (P = 0.0002). The activity level in the healed eye (0.43 +/- 0.17) was not significantly different to the one in the contralateral eye (0.36 +/- 0.18) on the day of complete corneal healing (P = 0.374). The level of MMP activity in the contralateral eye also decreased from 0.81 +/- 0.68-0.36 +/- 0.18 but this decrease (56%) was not significant (P = 0.069). CONCLUSIONS: Ulcerative keratitis in horses is associated with initially high levels of tear film proteolytic activity that decrease as the ulcers heal. The success of medical and surgical treatment of the corneal ulcers is reflected by the enzyme activity in tears. In horses successful treatment does lead to a rapid reduction in tear film proteolytic activity that corresponded with the improvement in the clinical signs of corneal ulceration. Measurement of MMP activity in the tear film might represent a way to monitor the progression of corneal healing in horses with ulcerative keratitis.