Ectropion

Ectropion

What is Ectropion?
Ectropion is an outward rolling of the eyelid exposing the conjunctiva, potentially preventing complete closure of the eyelids (termed lagophthalmos). The lower eyelid is usually affected, commonly due to an excessively long eyelid opening. Sometimes patients with long eyelids may also have entropion (an inward rolling of the eyelids) in one or both eyes.

Pre-disposed Breeds
Ectropion can be seen in all breeds of dogs. The condition can be seen most commonly in the Bassett Hound, St. Bernard, Bloodhound, Great Dane, Newfoundland, Bull Mastiff, and several spaniel breeds. Many of these dogs are bred for their “droopy eyed” appearance.

Treatment
Determining whether a pet needs surgical correction is done with an examination by a family veterinarian or veterinary ophthalmologist. In some cases, ectropion does not require treatment. However monitoring is essential; long lower eyelids can be pockets for debris, discharge, and irritation. If conjunctivitis or corneal disease are present because of the ectropion, medical, and often surgical, correction is recommended.  There are many surgical procedures used to correct entropion and the surgeon will determine the best plan. In most cases, only one procedure is necessary to correct the eyelid conformation. In complicated cases, especially cases with eyelid scarring or previous trauma, multiple surgeries may be required to obtain successful results.

Why is My Dog's Eye Droopy?

Horner’s Syndrome

What is Horner’s Syndrome?
Horner’s Syndrome, affecting both dogs and cats, results from a disruption of the nerves that control parts of the eye. The autonomic nervous system controls the body functions that we do automatically, like our heart beat and gastrointestinal function. When this automatic innervation of the eye is disrupted along the pathway from the brain to the eye, it is termed Horner’s Syndrome.

The Nerve Pathway
The nerve begins in the brain and travels down the spinal cord until it reaches the start of the thoracic vertebrae and exits the spinal cord just inside the chest. The nerve then travels up the neck toward the head. It joins (synapse) with a new nerve below the inner ear, and continues to the eye. If nerve damage occurs anywhere along this pathway, the pet will exhibit the signs of Horner’s Syndrome.

Clinical Signs

· Pupil Constriction

· Drooping Eyelid

· Eye appears sunken back

· Third Eyelid Elevation

Causes of Horner’s Syndrome
Damage to the nerve can occur in one of three places:

1. Central lesion—the nerve has been interrupted somewhere before leaving the spinal cord. Other neurologic signs can be exhibited (head tilt, stumbling, incoordination). Tumors along the spinal cord or brain, blood clots, and trauma can cause a central lesion.

2.  Pre-ganglionic lesion—the nerve has been interrupted between the spinal cord and the synapse. Tumors in the chest/neck, or trauma to the neck (such as a strong jerk on the collar or leash) can produce this damage.

3. Post-ganglionic lesion– the nerve has been interrupted between the synapse and the eye. Middle ear disease (infection) or rigorous ear cleaning can cause damage. The majority (42-55%) of these lesions are idiopathic (unknown cause).

Diagnosis of Horner’s Syndrome
Diagnosis of Horner’s syndrome is usually accomplished based on the clinical signs. Localizing the lesion is important, as treatment will depend on where the damage has occurred.  An eye drop consisting of 1% phenylepherine should be put in both eyes and monitored for changes. If the lesion is post-ganglionic, all the clinical signs will temporarily resolve in the affected eye. If the damage has occurred in the central nervous system or in the pre-ganglionic nerve further diagnostics, such as radiographs or consult with a neurologist, may be necessary to identify the cause.

Treatment of Horner’s Syndrome
If the lesion is determined to be post-ganglionic with no evidence of ear disease, then treatment is not necessary. Post-ganglionic Horner’s Syndrome is non-painful, does not affect vision, and usually resolves on its own within 4-8 weeks, sometimes longer. If the lesion is not post-ganglionic, then treatment of the underlying condition is required.

Cut the Hassle, Make Eye Drops Easy!

Eye Drop Administration: How To

1.   Make sure the area around the eyes is clean and free of any discharge.

2.   Provide the chin rest for your pet and with the opposite hand rest on the forehead just above the eye.

3.   Using the base of your hand gently pull the upper eyelid up while grasping the bottle.

4.   Squeeze the medication onto the surface of the eye avoiding touching the dropper to the eye or eye surface.

5.   Wait until your pet blinks to release your hold.

*Only one drop is necessary*

Drops before ointments and always 5 minutes at least apart.

What it means when the lens is out of position

Lens Luxation

The lens is normally suspended in about the center of the eye by zonules (tiny strands of tissue).   When the lens moves out of position it can become painful.  This can result in high pressures inside the eye.   When the lens moves to the front of the eye it is called an Anterior Lens Luxation . When it moves to the back of the eye it is called a Posterior Lens Luxation. When it is only partially loose it is called a subluxation. 

Subluxations and posterior lens luxations can be managed medically with topical drops. Our goal is to prevent the lens from moving into the front of the eye and keep pressures in a comfortable range. If your pet suddenly develops squinting seek immediate medical attention with your veterinary ophthalmologist.

Anterior lens luxation is a surgical emergency.  Surgery to remove the lens as soon as possible is imperative to comfort and retaining vision.   About 10-20% of patients develop a complication from surgery (retinal detachment, glaucoma, uveitis), these will be discussed with you prior to surgery.  After surgery your pet will require multiple eye drops and some oral medications.

What is the Red Bump on My Dog’s Eye? Cherry Eye?

Nictitans Gland Prolapse
“Cherry Eye”

A nictitans gland prolapse is an abnormal eversion, or “flipping out”, of the tear gland located behind the third eyelid or nictitans. This gland is responsible for 30-50% of the tears needed to lubricate the eye.

Cause
The exact cause of this condition is unknown. It is believed to be a weakness of the fibrous attachment that holds the gland in it’s appropriate place. The gland may become cystic and flip out of normal position. Certain breeds of dogs are prone to developing a “cherry eye”, although many other breeds may be affected. Breeds commonly affected include the American Cocker Spaniel, English Bulldog, Lhasa Apso, Shar Pei, and Giant Breeds. The condition more commonly occurs in younger dogs than older dogs.

Symptoms
Most pet owners will notice a pink tissue in the inside corner on the affected eye. The gland can disappear and reappear, initially, before it finally remains in the abnormal position. The longer the gland is exposed, the redder it may appear.

Treatment
Prolapsed glands left untreated can become inflamed, cause excessive tearing, and may obstruct vision. If the gland is exposed for a prolonged period of time, the tear production can be decreased and dry eye syndrome may develop. Simply removing the gland may result in dry eye, especially in breeds predisposed to dry eye. For this reason, removal is not recommended and instead should be surgically replaced to the normal position. Occasionally, complications where the glad will re-prolapse occur, and a repeat surgery is recommended. Third eyelid swelling and ocular discharge is common for 5 to 7 days after surgery.

Breeding of Dogs with a Nictitans Gland Prolapse
Currently, the American College of Veterinary Ophthalmologists (ACVO) and the Canine Animal Eye Registry (OFA) have no restrictions for breeding of dogs with nictitans gland prolapse. However, if there is a familial history of this condition, restrictions of breeding should be considered.

Pannus? Red spots on my dogs eyes

Chronic Superficial Keratitis

What is Chronic Superficial Keratitis (CSK)?

CSK, commonly called pannus, is a slowly progressive disease of the canine cornea. This disease is characterized by pigmentation, vascularization, and opacification across an otherwise clear cornea. A form of this disease can also affect the third eyelid and is termed plasmoma.  CSK is seen predominantly in the German shepherd dog and greyhound, but infrequently can occur in other breeds.

Causes
The exact mechanism is unknown, but several factors are involved. Since certain breeds are more prone to the disease, genetic predisposition is suggested. Ultraviolet (UV) radiation plays a role in inciting and proliferating the disease. It is also common for dogs living at higher altitudes (where exposure to UV light is greater) to be more severely affected. The immune system is also a factor in causing the disease. Lastly, an allergic-type reaction to environmental allergens or against the cornea itself may be involved in the disease process.

Symptoms
The most common clinical sign is pigment and corneal vessels spreading across the cornea, causing a visible discoloration. Normally, changes will begin at the outside or bottom corner of the cornea and move inward. Occasionally, the change can occur across the entire cornea and cause vision loss. Changes such as mucoid discharge, reddening, thickening, and pigment loss of the third eyelid characterize a subclass of CSK, called plasmoma.

Diagnosis
Clinical signs may be enough for diagnosis. It is necessary to rule out other diseases that can be similar in appearance, as the treatment can be much different. In some cases, performing cytology will aid in diagnosis.

Treatment
There is no cure for CSK, but progression of the disease can be prevented with long term medications and prevention from UV light. The goal with medical treatment is to control the growth of blood vessels and pigment across the cornea. These may include steroids or T-cell inhibitors or a combination of both.  Initially frequent drop administration is necessary, but over time can be decreased to only once or twice a day ongoing therapy. Dogs on long-term medications should be monitored to prevent secondary changes. In very severe cases surgery may be recommended initially to reduce scarring already present on the cornea.

Monitoring

The condition waxes and wanes throughout life, so periodic recheck exams are indicated to ensure that the patient is on the most appropriate therapy and frequency.

This scratch won’t heal! Nonhealing ulcers can be frustrating, let us help!

The first type to discuss is in older patients:

Indolent Corneal Ulcers

General Information

Normally, large superficial ulcerations should heal completely in 5 to 7 days with minimal scarring. Indolent ulcers, however, can take six months to a year to heal without treatment. Excessive corneal vessel infiltrate and scarring may occur without treatment. Scarring may be severe enough to permanently limit vision in the affected eye. This type of ulcer commonly effects middle-age to older dogs, and Boxers are overrepresented.

Symptoms

• Increased tearing

• Squinting

• Frequent Blinking

• Corneal haziness

• Redness

Cause
Initially, an underlying cause for the ulcer (such as trauma, a foreign body under the third eyelid, or abnormal eyelashes) must be ruled out.

Although the exact reason indolent ulcers occur is unknown, dogs with this condition present with an abnormal layer in the superficial (upper) corneal stroma (2nd layer of the cornea). This abnormal layer is thought to prevent normal adhesion of the epithelium to the stroma below; simply the corneal cells have nothing to adhere to.

Simply blinking the eyelids may aggravate the epithelium to pull away from the abnormal stroma causing an ulcer.

Treatment
Several treatment methods exist for indolent ulcers, with the same idea in mind. Initially, the treatment involves rubbing the loose epithelium off with a cotton swab (debridement). Following debridement, a procedure to either remove the abnormal layer of the superficial stroma or a procedure to cut through the abnormal layer to give the epithelium specific places where it can stick down, is performed. Removal of the abnormal layer of the stroma can be performed with a diamond burr, which is similar to a tiny Dremel tool. The burr is specially designed for the eye and treats the entire cornea. The diamond burr procedure result in less scarring than other treatment methods. Another procedure, termed a grid keratotomy or anterior stromal puncture, involves making tiny scratches or pricks through the abnormal stromal layer with a blade or needle. After the procedure, one to two topical eye drops are recommended alongside oral pain medications.

Bandage Contact Lens

To aid in comfort, a bandage contact lens may be placed. This soft lens does not have any healing properties, but does show to help improve discomfort after the procedure. These will stay in place on their own and be removed at the follow up appointment.

Prognosis
Our goal with treatment is to heal the ulcer quickly and prevent scarring. Typically, the ulcer will heal within 2-3 weeks. Rarely, a second procedure may need to be performed if the indolent ulcer has not healed. Approximately 50% of dogs that develop an indolent ulcer in one eye will later develop it in the other eye. 

Dark spots on my cats eye! The color has changed! Iris melanosis? Benign? Malignant?

Feline Iris Melanosis

Iris melanosis is a pigment change to the iris specific to felines. The pigment is a result of melanocytes, or pigmented cells, inappropriately replicating and spreading over the iris’ surface. Iris melanosis is benign, but it can transform into malignant cancer. Close monitoring by an ophthalmologist is recommended to catch early changes in the disease that could potentially be fatal for the eye.

It is common to first notice pigment as a small, flat, and benign nevus, or “freckle” on the iris. Benign iris pigment is termed “iris melanosis”, and can stay as such for several years, but does have the potential to spread at any point. Increasing pigment across the iris can lead to secondary ocular complications (glaucoma and retinal detachments). More importantly, if the spreading melanocytes become aggressive in nature, they transform into cancerous or malignant cells. The condition is then termed “malignant melanoma or iris melanoma”. If malignant, the cells can spread to other areas of the body (e.g. lungs and liver) and be fatal.

Much research has been done on the disease, but we do not yet have a way to definitively identify when benign iris melanosis is on the verge of transformation into malignant melanoma. Most ophthalmologists do, however, consider the following changes to be “clues” that the pigment is becoming dangerous: rapid pigment increase or thickening and pigment growth to the edge of the iris. If these signs are noted, an enucleation (eye removal) may be recommended by your ophthalmologist. Despite the tough decision and controversy, eye removal will prevent the chance of melanoma metastasizing elsewhere in the body. The enucleated eye will also be sent to a pathologist to determine a definitive diagnosis and plan Some ophthalmologists recommend laser therapy – targeted destruction of the iris melanosis – in early stages of the condition. The goal of this therapy is to prevent or delay the transformation of iris melanosis into malignant melanoma. Though many ophthalmologists think laser therapy can be helpful, it has not yet been proven by a large-scale scientific study.

Each case of iris melanosis is different. Your veterinarian and veterinary ophthalmologist can help you decide what treatment approach is appropriate for your pet.

Bump on my dogs red eyes!

Scleral Mass, Episcleritis, NGE

Your pet has a mass on the white part of the eye (sclera).  There are multiple reasons for masses to develop around the eye and an accurate diagnosis is imperative to appropriate treatment.  

Causes include Immune Mediated (Nodular Granulomatous Episcleritis, NGE), Neoplasia (type of cancers), Infectious/Parasitic (Toxoplasma, Onchocerca, etc).

A biopsy of the abnormal tissue  tissue (episclera) of the affected eye is recommended to definitively diagnose the underlying cause. This is best performed under an operating microscope using microsurgical technique under general anesthesia.

Often at the time of biopsy your ophthalmologist may consider applying  cryotherapy to destroy any remaining microscopic abnormal tissue.  Biopsy results are typically available in 5-7 business days and treatment will be based on those results.

My dog went blind! Could it be Sudden Acquired Retinal Degeneration (SARDS)?

Sudden Acquired Retinal Degeneration (SARDS)

What is SARDS?
SARDS is a disease in dogs where rapid degeneration of the retina leads to complete blindness. On initial exam, the retina may appear normal due to how quickly the changes have occurred. It can take several months for the retina to begin to show evidence of degeneration upon examination. The disease is usually seen in middle-age to older dogs, more commonly females over males, and can also be overweight. SARDS may occur in any breed including mixed breed dogs; however, dachshunds and schnauzers appear to be overrepresented.  The disease is sometimes associated with an increase in thirst, urination, and weight gain. Further evaluation with your veterinarian or an internal medicine specialist is recommended if any of these systemic changes are noted.

What Causes SARDS?
The cause of SARDS is currently unknown. Inheritance is also unknown at this time, although there has not been any direct links. Much research is being done do determine more about this disease.

How is it Diagnosed?
Since the retina appears normal on initial evaluation, an ERG or Electroretinogram is essential to distinguish SARDS from other causes of blindness. These diseases can include central nervous system disorders of the optic nerve or the brain. An electroretinogram is an electrical function test of the retina. If a dog has SARDS, no retinal activity will be seen on the ERG.  If the retinal activity is normal, then the reason for vision loss is more consistent with central nervous system changes. In such cases, additional diagnostic testing and/or consultation with a neurologist may be recommended to determine the cause of the blindness.

What is the Treatment and What are the Expectations?
This is a non-painful condition that causes permanent blindness.  Currently, there is no proven treatment.  Occasionally medications can be tried, with limited success and can be discussed with your ophthalmologist. Because pets with SARDS have rapid vision loss, adjustment to their home environment can take time.  Dogs’ strong sense of smell, memory, and hearing are important during their adaptive period, but most adjust well to being blind.   

Helpful Information: 

• Caring for Your Blind Pet

• www.blinddogs.com

• Training Methods for Blind Dogs (Carol Levin, RN)

Big Eyes. Short Noses. Bulldogs, Bostons, Pugs, Shih tzu's, etc.... the fancy term is: Brachycephalic Syndrome

Brachycephalic Syndrome

Short-nosed patients (brachycephalics) commonly deal with Brachycephalic Syndrome or changes to the eyes due to their conformation. These conformational changes include the following:

·       Shallow orbits (or sockets), causing extreme exposure of the eyeballs and predisposes proptosis*

·       Excessive eyelid length

·       Relatively poor blink reflex

·       Medial canthal entropion, ** causing irritation to the surface of the eye

*Proptosis is when the globe (eyeball) is pushed out of position
**Entropion is rolling inward of the eyelids causing the eyelid hairs to make contact with the cornea (surface of the eye)

All the above concerns could result in corneal scarring, pigmentation, and ulceration. The condition can be corrected with surgical techniques, such as a Medial Canthoplasty. This procedure removes a portion of the eyelids in the inner corner of the eye, where hairs are constantly rubbing on the surface. This removes the medial canthal entropion and shortens the eyelid length, aiding in better protection for the eye. Surgical correction also decreases corneal exposure and irritation, and promotes a healthy cornea long term.

Pigmentary Keratitis, or corneal scarring, can be a result of chronic exposure or irritation. If left untreated, the entire eye may be affected and cause blindness. Depending on progression, the inciting cause (entropion or exposure) may need to be address. Occasionally medical treatment with topical drops can slow progression, but should be discussed with an ophthalmologist.

Tear Staining. It's time to talk. It's me, not you.

Tear Staining can be frustrating.. Just ask Phil.

Phil's tearing is a combination of a few issues. First he has hairs at the corner of his eyes that are wicking tears onto the face. Secondly due to his conformation he has tight medial canthal ligaments which allow for the puncta (openings to the nasolacrimal system) to be tucked down and result in less tears going where they should and instead falling over the eyelid.

We need to address the cause of the tearing FIRST and then once this resolves, the tear staining will ALSO resolve. Antibiotics can improve the look of tear staining but long term antibiotics is not recommended for this. The tearing alone for Phil right now is not causing an issue such as dermatitis on the skin (but for some pet's it may).

Phil and his family have a few options:

 1. Flush nasolacrimal ducts alone and see the value of this alone (does tearing immediately improve?)

 2. Surgically address Phil's tearing by improving location of the puncta, freeze hairs at the medial caruncle, and flush the nasolacrimal ducts. Great prognosis!

 3. Ignore and tolerate the tearing/tear staining due to the mild affect on Phil. (It’s me, not you)

If you want to know what’s best for YOUR pets tear staining, please contact our office!

What is that black spot on my dogs eye?

Limbal melanocytomas are benign neoplasias that arise from a band of melanocytes along the limbus (margin of the cornea to sclera).  These occur in two age groups of dogs. In young dogs it manifests clinically with continued local growth and necessitates removal to prevent ongoing ocular involvement (which can result in loss of the eye due to growth and pain).  In older dogs (great than 8 years of age) it grows slower and can be observed for growth. Regardless of growth, these melanocytomeas do not spread to organs in the rest of the body.

 We offer several options for treatment include biopsy and cryotherapy, some available with just sedation! Call to schedule a new patient examination with Dr. Bliss and her team.

Photo:

Limbal Melanocytoma

Flamingo receives cataract surgery!

CENTRAL POINT, Oregon - A flamingo can see much better these days after her vision was restored in a very rare procedure.

Catalina is a Chilean flamingo who lives at Oregon's Wildlife Safari.

Employees noticed the 32-year-old bird began stumbling around at night and realized she wasn't able to see clearly.

They called in a veterinary ophthalmologist who looked straight into Catalina's tiny eyes and knew the little pink lady was suffering from cataracts.

Dr. Cassandra Bliss has performed eye surgery on plenty of animals, but never on a flamingo, and never on eyes so small.

In fact, Bliss says this is only the second time that a flamingo cataract operation has ever been performed in the U.S.

"It's rarely done in this species. In fact it's only been done one other time in New York. But never on the west coast," Bliss told KOBI.

"When you speak to any ophthalmologist we are already using micro-surgical tools. That being said we have different sizes and this is definitely going to be the smallest."

The minuscule surgery was a giant success!

Catalina will recover for two weeks before being placed back with her flock.

Chilean flamingos can live up to 65 years in captivity, which gives the flamingo many more years of eagle vision.

What is that brown spot on my cat's eye?? FELINE CORNEAL SEQUESTRUM

What is Corneal Sequestrum?
Feline corneal sequestrum is an unusual corneal disease unique to domestic cats. It refers to the development of an opaque, dark brown to black plaque on the cornea. This plaque is actually a dead piece of corneal tissue. Sequestra are usually oval to round; they vary in size, from very small to quite large, and can extend deep into the corneal tissue. Corneal sequestration can occur in cats of all ages and breeds.

Causes
The cause of feline sequestra is unclear. However, development of a sequestrum is often associated with corneal trauma, dry eye syndrome, abnormal eyelid conformation, and/or Feline Herpesvirus infection. Genetics and conformation may also be involved since there is a definite breed predisposition with Persian and Himalayan breeds being frequently affected.

Clinical Signs
Initial signs may be subtle and include signs of pain such as squinting, tearing, and elevation of the third eyelid. As the sequestrum develops the cornea turns from clear to brown or black.  Blood vessels may extend from the edge of the eye to the sequestrum.  In some cats the cornea surrounding the sequestrum can become infected or the sequestrum is so deep it may involve the entire thickness of the cornea. These cats are at risk of losing the eye.

Treatment
Since sequestra may be painful and can cause irreparable damage, surgical removal of the sequestrum is the treatment of choice. The surgical procedure to remove a sequestrum is called a lamellar keratectomy. This surgery is performed using an operating microscope, micro-surgical ophthalmic instruments, and with the patient under general anesthesia. A conjunctival grafting or corneal transplant may be recommended. Long term artificial tear supplementation in both eyes is recommended to prevent recurrence of the condition as well.

Prognosis
The prognosis for the eye to be free from pain and have normal clinical vision is good with surgery, especially if the sequestrum is removed at an early stage. However, sequestrum formation is the way an individual cat responds to corneal irritation, and additional episodes may occur in one or both eyes in the future. To help prevent any recurrences, notify your veterinarian or veterinary ophthalmologist immediately if any new eye injuries occur.  

Canine Superficial Keratitis (Pannus) and Plasmoma

This is an important disease that cause blindness without the appropriate treatment. Pictured is our patient, Maddie, who came in almost blind and then after only 2 weeks of treatment her eyes are already looking much better and she is catching a ball again!. Read more about this disease below.

What is Chronic Superficial Keratitis (CSK)?

CSK (also referred to as pannus or degenerative pannus)  is a slowly progressive disease of the canine cornea, characterized by pigmentation, vascularization, and opacification.  There is also a form of this disease which affects the third eyelid called plasmoma.  CSK is seen predominantly in the German shepherd dog and greyhound, but sporadic cases occur in other breeds as well.

Causes
The exact mechanism is unknown, but several factors are involved. The fact that certain breeds are more prone to the disease suggests a genetic predisposition. Ultraviolet (UV) radiation plays an important role as an inciting and propagating factor in the disease. In fact, dogs living at higher altitudes where exposure to UV light is greater are often more severely affected. Immunologic factors are also believed to be contributory. An allergic-type reaction to environmental allergens or against the cornea itself may be involved in the disease process.

Symptoms
The most common sign is infiltration of the cornea with blood vessels and pigment. This gives the eye a visible discoloration. The change normally begins at the outside or bottom of the cornea and moves inward. In some cases the pigment can be so severe that it leads to vision loss. Reddening, thickening, and pigment loss of the third eyelid characterize a subclass of CSK, called plasmoma. Plasmoma is often associated with mucoid discharge from the eye. 

Diagnosis
Clinical signs may be enough for diagnosis however it is necessary to rule out other diseases that can have a similar clinical appearance but markedly different treatment. In some cases it is necessary to perform cytology to confirm the diagnosis.

Treatment
A cure is not possible, but life-long medications and prevention of excessive exposure to UV light will prevent the disease from progressing. Common medications include eye drops that control the growth of blood vessels and pigment. These may be steroids or T-cell inhibitors or a combination of both.  Initially the drops may be used quite frequently but over time these can generally be decreased to only once or twice a day therapy. Dogs on long-term medications should be monitored to prevent secondary infections. In very severe cases surgery to decrease the scaring of the cornea may be needed in the initial stages of treatment.

Monitoring

The condition waxes and wanes throughout life, so periodic follow-up is indicated to ensure that your pet is on the most appropriate therapy. 

Canine Dry Eye is Serious... We Can Help!

We want to share a testimonial for a patient that had terrible dry eye.  Meet Chewy! His mom writes: "I truly don't know how to thank you, you are a blessing and I truly mean that. I know I say this every time I come in,it was those 4 simple words," you need a trainer"!!!!! I/we are forever grateful for you and what you do! I have traveled all over the country for the past 8 years since I rescued Chewy and we have seen many veterinarians, and an ophthalmologist in Rhode Island. I know that Grants Pass brought me back here for other things but I'm so fortunate that I found you. You have made my life and his life so much better, I don't have to worry about his eyes anymore which was a big stress!! I truly don't know what else to say but I feel like thank you just isn't enough, so when we leave either in November or February I think you need to pack up and come with us so you can take care of him. Haha Again thank you for you true dedication and compassion that you show to Chewy as well as others!"

What is KCS?
Keratoconjunctivitis sicca (KCS) or "dry eye" is a condition affecting many pets, most often older dogs. The absence of tears makes the cornea very susceptible to damage. Although it is seen in all breeds some are more prone to developing KCS than others.  These breeds include: the American Cocker Spaniel, Dachshund, English Bulldog, Lhasa Apso, Miniature Schnauzer, Pug, Shar Pei, Shih Tzu, West Highland White  Terrier, and the Yorkshire Terrier. In cats, the condition is most commonly initiated by feline herpesvirus infection. The condition is a result of decreased tear production and changes in the composition of the tear film. Tear film functions include providing oxygen and nutrition, removing waste products and debris, lubrication to the eyelids, maintaining a smooth optical surface, and providing antibacterial components. 

Causes
There are a number of potential causes of KCS; in most pets the cause is not determined. In dogs the disease is frequently inherited and presumed to be caused by an immune-mediated attack of the lacrimal (tear producing) gland, especially in those susceptible breeds mentioned earlier. Certain drugs, most notably the sulfa-containing medications, may cause KCS depending on the susceptibility of the pet. Neurologic conditions such as facial nerve damage can also result in KCS. Infection and
inflammation of the lacrimal gland may cause it to be temporarily or permanently destroyed. Viral infections known to cause damage include canine distemper and feline herpesvirus.

Clinical Signs

• Increased mucoid discharge
• Discomfort: squinting or pawing at the eyes
• Reddened conjunctiva
• Pigmentation, blood vessels, or a hazy, irregular appearance to the cornea
• Vision loss in severe cases
• Corneal ulceration which may be severe

 Diagnosis
Clinical signs are often suggestive of KCS, depending on the severity of the condition. Confirmation is achieved utilizing the Schirmer Tear Test, which uses a small strip of sterile filter paper to measure tear production. Normal tear production is generally considered to be between 15 and 25 mm in a minute. 

Treatment
The ultimate goal of therapy is the return of normal tear function. Frequent supplementation with a long-lasting artificial tear is necessary until tear production increases. Topical eye drops such as cyclosporine or tacrolimus are used to stimulate the lacrimal gland to produce tears. These drugs are very effective but are only helpful as long as they are being used. After the initial diagnosis of KCS, topical application of medications may be frequent, but the frequency is decreased as the pet begins to respondto treatment. Although the majority of KCS cases respond well by increasing tear production, the occasional case does not. In such cases frequent medical therapy in the form of an artificial tear every few hours is required on a life-long basis.  

Bliss Animal Eye Care - OPEN for BUSINESS

KOBI Covered our open house! Click the link below! Thanks to the City of Central Point Chamber of Commerce for helping us celebrate with a red ribbon cutting. 

https://kobi5.com/news/new-eye-care-clinic-for-creatures-25566/

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New Hospital!! Opening In April!

Please join us for the Open HOUSE

Referring Veterinarians & Staff are invited from 5-7pm April 12th 

Clients & the public are invited from 5-7 pm April 13th. 

Wildlife Images golden eagle gets cataract removed in Medford

By Vickie Aldous 
Mail Tribune

Dave Siddon waited anxiously as Phoenix the golden eagle was put under anesthesia and draped in cloths until only his eye and tail feathers were showing.

"It scares me to death," Siddon said of the cataract surgery the 35-year-old bird was about to undergo in Medford. "I love this bird so dang much. It's like he's my child."

Found by a logger on a remote road while still a fuzzy eaglet, Phoenix has called the Wildlife Images animal center outside Grants Pass his home for decades. He is too dependent on humans and deeply bonded with Siddon, the center's executive director, to be released into the wild.

Working in a darkened surgery suite at Southern Oregon Veterinary Specialty Center with a light illuminating Phoenix's eye, animal specialty ophthalmologist Dr. Cassandra Bliss began the delicate procedure of cutting into the eye to reach the clouded lens obscuring the eagle's vision.

Six months ago, Phoenix's vision began to deteriorate, and staff members at Wildlife Images noticed fogginess in one eye, Siddon said.

"It progressed much quicker than we expected," he said.

Without vision in his eye, Phoenix would have had trouble finding his food and landing on his perch. Eagles that can't see correctly have difficulty flying, Siddon said.

"They crash and burn, and their feathers break," he said.

Siddon said he couldn't stand by and watch the eagle's quality of life deteriorate.

The bird serves as an animal ambassador for Wildlife Images, educating the public about wildlife and appearing in films and on television. Phoenix also has a one-of-a-kind personality.

"He has the whole package," Siddon said. "He's very bright and adaptable. He's got a great attitude. I've worked with hundreds of eagles in my life, and we've formed a bond."

Phoenix is known to play favorites with his human handlers.

"An eagle's talons are as strong as a leopard's jaws. They can literally break bones," said Siddon, who dons a large protective glove so Phoenix can perch on his arm. "He doesn't clamp down on me. Some people he doesn't like, and he will go after them. There's a person he doesn't like at Wildlife Images, and he will clamp down on her glove."

As the surgery continued, onlookers went back and forth between watching the procedure through a window and getting a close-up view via a video monitor in a separate exam room.

Bliss removed the cataract from Phoenix's eye and inserted an artificial replacement lens donated by I-MED Animal Health, a Canadian company that was the first to develop replacement lenses for birds of prey.

She wrapped up the surgery by sewing Phoenix's eye with a curving needle, then went out to report the outcome of the surgery to Siddon.

"The surgery went great," Bliss announced.

There were a few hurdles to overcome, especially when Phoenix's eye wouldn't dilate as was needed for the surgery to proceed, but Bliss said she expected the eagle to recover well.

She said eagles and falcons can develop cataracts for a variety of reasons, including genetics, injury and age. With no known trauma to his eye and considering his age, Bliss said, Phoenix's cataract was likely age-related.

With his sight restored, Phoenix could live well into his 40s, according to Wildlife Images.

Bliss said sight is the most important sense for eagles. Their large eyes weigh more than their brains, and they have a mind-boggling one million photoreceptor cells per square millimeter in their retinas.

Soon after the surgery, Phoenix woke up and looked around. With Valium in his system to combat the stress of surgery, he left with his human companions for the trip back to Wildlife Images. Bliss will check on him as he recovers over the next two weeks.

She said performing the cataract surgery on Phoenix was a unique opportunity.

"I've done it on a penguin and hundreds of dogs and cats, but this is my first eagle," Bliss said.

Staff reporter Vickie Aldous can be reached at 541-776-4486 or valdous@mailtribune.com. Follow her at www.twitter.com/VickieAldous.