Ophthalmic emergencies

Ocular emergencies can be very intimidating for veterinarians. Most ocular emergencies can be stabilized by the veterinarian until an ophthalmologist can be consulted if necessary. Proptosis, or forward displacement of the globe, can occur secondary to any blunt trauma to the head. The two options for a proptosed eye are enucleation or replacement with tarsorrhaphy depending on the viability of the extraocular tissues and eye. Glaucoma, or increased intraocular pressure (above 35 mm Hg), is diagnosed by measuring the intraocular pressure using a Shiotz or electronic tonometer. Emergency treatment includes intravenous mannitol and topical pilocarpine. Uveitis, or inflammation of the iris, ciliary body and/or choroid, can have many underlying causes such as neoplasia, infection, lens induced, and trauma. The treatment consists of treating the underlying cause, and administering topical atropine to alleviate pain and topical corticosteroids to decrease inflammation. Corneal ulcers, or defects in the corneal epithelium, are classified according to the depth of the defect. The treatment consists of topical antibiotics and topical atropine. If the ulcer is deep, is melting, or is a descemetocele, then a third eyelid or conjunctival flap is usually necessary. The cornea should be sutured if it is perforated or lacerated. Hyphema, or blood in the anterior chamber, can occur secondary to trauma, neoplasia, infection, or a coagulapathy. The treatment consists of treating the underlying cause and topical corticosteroids with or without antibiotics.