# Eye weeping, scratch?



## beau159 (Oct 4, 2010)

You need to take your horse to the vet. 

If there is cloudy/white around the scratch, then there is an infilatrate around the corneal abrasion, or it is possibly already an ulcer. Your horse needs dilating drops, anti-biotic drops, and steroid drops. And to be kept out of sunlight. 

Don't mess around with this if you don't want your horse to lose the eye. Ulcers can be very dangerous. 

Call your vet.


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## Lucy14 (Aug 12, 2013)

I've been told that they usually heal within 7 days and the cloudiness is normal for right now. And if it hasn't subsided by then to seek more drastic measures. It's tiny tiny the scratch, so here's to hoping it will heal on it's own.
_Posted via Mobile Device_


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## Lucy14 (Aug 12, 2013)

Luckily for me I worked at a small animal vet and managed to get a hold of one of the vets. He's not supposed to work on large animals.. But He suggested neosporin/polysporin or BNP and sterile saline flushes BID. Starting tomorrow morning. Any other suggestions? The closest large animal vet has to come from two hours away.
_Posted via Mobile Device_


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## beau159 (Oct 4, 2010)

No, cloudiness is not normal. Cloudiness means that an inflammatory reaction is happening in response to the abrasion. Inflammation in the cornea, and inside the eye, is what leads to vision-threatening complications.

Not to mention that an open sore on the cornea (the abrasion) is very susceptable to an infection. You absolutely need to have some sort of antibiotic on it. But the antibiotic will do nothing for the inflammation, which is what you need the steroid for, and which is also what you need the cycloplegic (dilating) agent for. 

Saline flushes aren't going to do a whole heck of a lot, unless the eye develops an infection and the pus needs to be cleaned out. 

Why starting tomorrow morning? Why wouldn't you start right now? Certainly waiting a week before doing anything would be an absolute recipe for letting your horse lose its eye. 

It's your horse's eye. Your decision.

But I would have already called the vet, or hauled my horse in. My vet lives a good 45 minutes from me, but I wouldn't hesitate to haul to her if she was 2+ hours. Distance is not an excuse to deny your horse medical services, or not to at least CALL the large animal vet to see what you should do.


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## paintedpastures (Jun 21, 2011)

What Beau said,eye injuries are not type that you take the wait & see approach,they can go bad fast:shock:.A simple eye irritation the polysporin may help but if indeed there is a scratch or abrasion with cloudiness setting in that is MORE than simple irritation!!:-(. I just nursed a dog last week with a corneal abrasion,vet said they heal better than horse. I also have had a horse several years ago nearly lost her eye,so have had experience with eye injuries they are nothing to take lightly:-(


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## Lucy14 (Aug 12, 2013)

Steroids I was told by my vet make corneal abrasions much worse and inhibit the healing process. It was midnight, I can't quite afford the cash to have a vet come from 2 hours away on a Sunday night for 2am. It's resolved now, and treatment started.
_Posted via Mobile Device_


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## Speed Racer (Oct 21, 2009)

You asked for suggestions, but pooh-poohed all of them. Why did you even bother asking? Vet calls are part and parcel of animal ownership, and if you really work for a vet you already know that. Hope the mare doesn't lose her vision in that eye.


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## beau159 (Oct 4, 2010)

Yes, steroids will inhibit the healing process, but they are 100% necessary to control inflammation when there has been some sort of trauma to the eye. The abrasion will still heal even with the steroid being applied. If it's just an abrasion, the steroid can be applied right away when starting the antibiotic. If it is already an ulcer, you might want to do only antibiotic therapy (with a huge loading dose, round the clock) for the first 24 to 48 hours and then add the steroid. This is why a vet should look at the eye, instead of us just guessing. Sure, you can see a certain chunk missing, but instilling fluorescein dye (like the picture above) will show the true extent of the abrasion.

Resolved? No it's not. Just because you're starting an antibiotic treatment does not mean you are out of the woods. What did your horse get scratched on? You have no idea. It might have been vegetative matter, and your horse could be at risk for a fungal infection. If that happens, you do NOT want to put a steroid on it (one exception for steroid use) and antibiotics will do nothing to treat the fungal infection. Fungal infections are typically much more difficult to control than bacterial.

You are taking this _way too lightly_ for the possible complications that could occur. 

I know that life happens and things happen, but this is precisely why you should always have emergency cash for your horse (and for yourself) when emergencies health issues happen where it is in your horse's best interest to be seen by an equine vet. 

To possibly convey the seriousness of the situation to you, when I have a patient that has an abrasion, I am definately following up with them every day or every couple days, depending on the size and severity. An ulcer? I am seeing them in my office every single day until there is epithelium over the ulcer, and then every couple days until we see progress. Sure, more serious when we are dealing with a human than a horse, but the corneal layers are similar in both species and the risk is still great.


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## beau159 (Oct 4, 2010)

Speed Racer said:


> Why did you even bother asking?


I'm wondering the same thing, since everything I've said is just being brushed off like its no big deal. 

It's also very concerning to me that the OP continues to quote INCORRECT advice from his/her vet source that will put this horse's eye in harm's way.


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## HowClever (Feb 16, 2010)

I will never understand why people insist on messing around when it comes to their horses' eyes. Not worth the risk to me.


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## NdAppy (Apr 8, 2009)

I'm baffled by that as well HC. There was a lot of good information. 


I think of it this way... If I damaged my eye I would go in right away to the doctor. Why are our horses' eyes any less critical? They're not.


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## Lucy14 (Aug 12, 2013)

I worked at a SMALL animal vet 3 years ago..not saying I'm a vet or work at one anymore. Just clearing that up since somebody mentioned "you should already know that". 
I did have the vet out today. I'm not brushing this as lightly. And by resolved, I mean I don't need any more down playing from users. There is no more cloudiness right now and a very very small pinpoint indent is what is left on her eye. No weeping or squinting.
_Posted via Mobile Device_


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## Golden Horse (Feb 20, 2010)

What did the vet say?


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## jaydee (May 10, 2012)

The OP asked for advice and opinions
She has been given some very good advice
Whether she decides to take it or not is up to her now


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## Lucy14 (Aug 12, 2013)

Beau159, I was not incorrectly quoting my vet. You were not there, you don't know. He said to not put a steroid on it what so ever. For other eye conditions yes, but not for what my mare has, it will make it worse. I did attempt to take a picture to show you guys. Even in the picture you're unable to see the pinpoint indent. And the cloudiness and discolouration has completely disappeared from yesterday. I just checked her again 5 minutes ago. No squinting, no weeping, no heat. I've had two vet opinions and they both say the same. No corneal ulcerations. So I do appreciate all of your comments, even the snarky ones.
_Posted via Mobile Device_


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## Golden Horse (Feb 20, 2010)

What did the vet who saw her suggest/prescribe? Always good to know what treatments are recommended.


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## beau159 (Oct 4, 2010)

Lucy14 said:


> Beau159, I was not incorrectly quoting my vet. You were not there, you don't know. He said to not put a steroid on it what so ever. For other eye conditions yes, but not for what my mare has, it will make it worse. I did attempt to take a picture to show you guys. Even in the picture you're unable to see the pinpoint indent. And the cloudiness and discolouration has completely disappeared from yesterday. I just checked her again 5 minutes ago. No squinting, no weeping, no heat. I've had two vet opinions and they both say the same. No corneal ulcerations. So I do appreciate all of your comments, even the snarky ones.
> _Posted via Mobile Device_


I did not say that _you quoted_ your vet incorrectly. But I did say (and mean) that your source is giving you incorrect information. These things that you have been told are* false*:
1) Wait 7 days to treat because they usually clear up on their own anyway.
2) Cloudiness is normal.
3) Never use a steroid on a corneal abrasion.

I'm not going to pretend I am a vet, because I am not, but I work on human eyes for a living so I do know a thing or two about them.

_Snarky?_ Please show me where I was snarky because I've done nothing but try to help you and your situation. 

I'm glad your horse does not have an ulcer, but make sure you don't simply stop that antibiotic now that things are looking better. Antibiotic ophthalmic ointments ALWAYS need to be used for 7 days, minimum, to reduce bacterial resistance and leaving a few of the "strong ones" behind.


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## jaydee (May 10, 2012)

beau159 said:


> I did not say that _you quoted_ your vet incorrectly. But I did say (and mean) that your source is giving you incorrect information. These things that you have been told are* false*:
> 1) Wait 7 days to treat because they usually clear up on their own anyway.
> 2) Cloudiness is normal.
> 3) Never use a steroid on a corneal abrasion.
> ...


 You may work on humans eyes but you still need to accept other peoples opinions and decisions. You offered advice and if the OP chooses to not take it then that is their prerogative and not something to argue about
I have had two instances of 'scratches' to a horses eye. In the first case that happened 15 years ago - I have attached a photo - a mare that I still own was treated with a steroid and it made the injury much worse, as a second vet and eye specialist from another practice pointed out it was not the right way to treat it. She did not lose her eye but as you can see it is very cloudy and she only has partial sight in it. No treatment will change that.
In the second case the horse was not treated with a steroid and a complete recovery was made
I'm attaching 2 statements from sites that specialize in eye injuries. I've looked at quite a few and the general thinking is that steroids should not be used in a situation where there is any risk of infection present as they reduce the immune reaction. If there is inflammation then a non steroidal treatment should be used


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## JustDressageIt (Oct 4, 2007)

My friend's mare had a small scratch on her eye this past spring. She was put on two different ointments right away (as in that night after a 9pm emergency vet call) and needed them three times daily for a few weeks. She was on stall rest as even the wind outside could irritate it. She needed a fly mask for ages, as well. It healed up beautifully because of her diligence about the eye from minute one of day one. 
Eye injuries need special care, they can go bad in an extremely quick amount if time.
_Posted via Mobile Device_


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## Palomine (Oct 30, 2010)

Using steroids when not called for will blind a horse. And vet is only able to determine that they are needed after they see horse and do stain.

Eyes are not something to fool around with.


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## beau159 (Oct 4, 2010)

jaydee said:


> You may work on humans eyes but you still need to accept other peoples opinions and decisions. You offered advice and if the OP chooses to not take it then that is their prerogative and not something to argue about
> I have had two instances of 'scratches' to a horses eye. In the first case that happened 15 years ago - I have attached a photo - a mare that I still own was treated with a steroid and it made the injury much worse, as a second vet and eye specialist from another practice pointed out it was not the right way to treat it. She did not lose her eye but as you can see it is very cloudy and she only has partial sight in it. No treatment will change that.
> In the second case the horse was not treated with a steroid and a complete recovery was made
> I'm attaching 2 statements from sites that specialize in eye injuries. I've looked at quite a few and the general thinking is that steroids should not be used in a situation where there is any risk of infection present as they reduce the immune reaction. If there is inflammation then a non steroidal treatment should be used


Who's arguing? The OP misunderstood one of my statements and I elaborated. 

As I said above, steroids do nothing for treating infection just as antibiotics do nothing for inflammation. You need the right "cocktail" of meds to treat what's going on. And also as I said above, a _fungal_ infection is one of the _exceptions_ where a steroid _will _make it much worse (you can tell its fungal by the appearance of the ulcer edges and the ulcer location, among other things). Yes, NSAIDs do treat inflammation too and are usually a sufficient alternative, but sometimes they don't have enough "bang" to take care of out-of-control inflammation. Steroids are much more potent than NSAIDs. If you don't control the inflammation, the eye won't heal either. If you let the inflammation persist for too long, you run the risk of ending up with a recurrent uveitis, permanent cloudiness, or other complications. It's a delicate balance.

NSAIDs (non-steroidal anti-inflammatories) are still anti-inflammatories just like steroids. What makes them different is where they act in the inflammatory cascade. Without getting too chemistry technical here, steroids block inflammation very early in the chain of action (and in turn, can slow down healing). NSAIDs block later in the chain of action and are "reversible" (the exception here is that aspirin, also an NSAID, is not reversible). But that's why steroids are more potent and typically more effective in inflammatory treatment because they block all of the inflammatory cascade; provided there aren't any contraindications to using the steroid.

And the very first words that I said in this thread: *You need to take your horse to the vet. *I can only make generalized assumptions on what's going on with the eye over the internet. A vet needs to examine the eye and decide the appropriate route of treatment based on the physical signs. 

I cannot guess what possibly happened to your first horse Jaydee, and I'm sorry you didn't have a good outcome. Possibly it had a fungal component, or maybe no antibiotic was given along with the steroid; or who knows what. I wasn't there. But don't give the bad rap to the steroid; there'd be a heck of a lot more blindness in the world (humans and horses) if we didn't have steroid eye drops. 

As for your statements you copy/pasted from the internet, this last sentence is somewhat incomplete about the details:
_"If there is an ulcer present, steroids will allow bacteria and fungus to proliferate in the eye and worsen the corneal ulcer significantly."_

Again, as I already mentioned above, you don't put the steroid on the ulcer right away (provided it is NOT fungal, as we already established, where you would not add a steroid at all). You want to start with a heavy loading does of an antibiotic that is effective against the organism causing the ulcer. When the ulcer has started to get a layer of corneal epithelium over it (usually 24 to 48 hours, as long as the correct antibiotic was chosen in the first place....sometimes that's trial and error), then you add the steroid to help the body get rid of the excessive inflammation. Not only is there inflammation clearly showing as white/cloudiness in the cornea, but what you don't see with the naked eye is that there are cells and flare floating around in the anterior chamber of the eye that causes other issues (including iris synechiae, which is one of the reasons why we dilate the iris). There's a lot of debate and opinion on adding the steroid, but the research indicates that adding the steroid later during the treatment course leads to better results in healing and scarring. I go with what's been proven in the research.


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## Chevaux (Jun 27, 2012)

I, like Golden Horse, would like to hear what the vet who examined the eye had to say about treatment. Would you mind sharing, Lucy14?


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## jaydee (May 10, 2012)

Beau - My horses eye is like that *because* steroids were used
Steroids may be effective in knocking back inflammation but they also do a great job of dumbing down the bodies natural defense systems which allows for infections to increase at a much faster rate unlike the NSAID's which block the body chemicals that cause inflammation without affecting the resistance to infection
Since its very difficult to maintain a horses eye in a sterile state the use of steroids in equine eye injuries is not at all popular which is why this OP's vet was likely against using them on her horse
There's even a lot of skepticism about the use of them in humans


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## Lucy14 (Aug 12, 2013)

Since it wasnt an actual abrasion or lesion on the eye, sterile saline flushes and BNP ointment. She will heal fully with no loss of vision. Today, you cannot see anything on her eye. There's absolutely no weeping, squinting or heat. He thinks something just got in it and needed to work it's way out.
_Posted via Mobile Device_


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## jaydee (May 10, 2012)

Thank you for the update *Lucy*
I've had similar things happen with horses over the years. Always good to get them checked out 'just in case' but quite often nothing to worry about
Pleased to hear your horse is going to be OK


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## beau159 (Oct 4, 2010)

Also glad to hear it wasn't an abrasion, Lucy14. Hopefully whatever is in there will (or has) worked its way out.

Jaydee: I think you misunderstood me. I realize your horse's eye is scarred from the incorrect use of the steroid, but that's just it: It's not so much that the steroid should be abolished and never ever used again on any eye, but that it must be used in the correct circumstances and with the other necessary medications when the need and time calls for it. In your instance, something wasn't done correctly since it resulted in a scarred eye, although possible it would have scarred anyway even with correct treatment. Again, just speculating because I wasn't there. 

Not sure of the relevancy of your attached image since we're not talking about steroid injections (the title of the left piece) which is an entirely different ball game whether they are injected into the eye or injected elsewhere in the body. Oral steroids are also a totally different ballgame. The right image talks about an ophthalmic drop/ointment (which is what I _have_ been talking about, not oral and not injections). But there is no title on the right image (doesn't seem like the two subjects tie together), no author, no works cited, no sources, and no scientific data. Although it does basically say the same thing I've been saying all along: Topical steroids work fantastic when they are used under the correct circumstances. So I feel like we are discussing two ends of the same viewpoint. ??? I'm a little confused about what you were trying to get across with the images that is different than what I've been saying.


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## jaydee (May 10, 2012)

Beau I cant keep going over this
Steroids are steroids and have the same action regardless of if orally drops or injection. They work by inhibiting the immune system and that allows for bacterial infections to multiply very quickly - too fast for the antibiotic also used to keep up
I have to take steroids occasionally - have done for a lot of my life as I have Lupus. I cannot take them if I have any sort of infection at the time as the consequences can be serious
The problem with using them in a horses eye is that even if just used for inflammation a horse reacts in exactly the same way as a human does when they feel they 'have something in their eye' even if its is only inflamed - they want to rub at it and in so doing can easily introduce a tiny bit of grit that will get forced against the eye and cause a scratch that will rapidly turn into an infected area that will then be made worse by the steroid not allowing the antibiotic and natural immune response to be as effective
If you don't want to trust my word there are many websites out there if you do a search that discuss the pro's and cons


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## beau159 (Oct 4, 2010)

jaydee said:


> If you don't want to trust my word there are many *websites* out there if you do a search that discuss the pro's and cons


I base my judgement off of statistically significant scientific studies and the schooling/training I had for 8 years, not off of a Google search _website_. But thanks.


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## Shoebox (Apr 18, 2012)

A woman at my old barn had a scratch on her horse's eye from who knows what. The first vet she called out said no steroid drops. She didn't believe it so she called out a second one who said the exact same thing and prescribed two different creams to smear on. The second one said that if it's not better in three days, to call, and THEN they would consider a steroid drop.

That being said I don't know anything about eyes, really, aside from what I've read in this thread and that one eye injury instance. I think if it wasn't a serious scratch I too would want to forgo the steroid drops... But I would listen to what the vet told me. Humans are often treated medically different than animals (because like the above poster said they'll do things like rub, or chew their bandages, or what have you) for the exact same problem, so while you do know how one would treat a human eye with that specific blend of things (steroids, antibiotics, etc) there's probably reasons they don't do so with horses as often, even with the same injury.

When I'm in the treatment room at the wildlife rehab center, we use steroids for the animals right off the bat unless the eye isn't getting any better - usually 2-5 days is the recheck when they decide whether or not to amp up the treatment.

BUUUT I'm not a vet. So. I'll just drop off my two cents and back off:lol:

OP: I'm so glad your horse is getting better! Glad to hear it was a minor issue


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