A Clinical Case from the Archives : 18/06/2005

This 6 year old Jack Russell terrier is presented for a non-ocular complain but, being a budding ophthalmologist you are drawn more to the blueish tinge in its cornea than its anal gland that need squeeezing (not an unreasonable diversion from such a task in my view at least!) Why is the cornea thus coloured, what is the diagnosis here and what would you do?

The diagnosis is lens luxation, inherited and relatively common in this breed. The edge of the lens can be seen, showing it to be in the anterior chamber, although there is no aphakic crescent as seen in this cat. The cat had an intraocular pressure of 38mmHg while the dog has a pressure of 18mmHg when you measured it at least. The corneal oedema (for that is what the blue tinge is) is most likely caused by the lens abutting on the corneal endothelium and probably not from glaucoma while the cat certainly has glaucoma. While lens removal is the standard treatment for lens luxation, both thee animal present somewhat of a problem. Is the cat’s lens luxation the cause of the glaucoma or the other way round? As we don’t see primary glaucoma in cats, that probebly is the case and lendectomy is called for. The dog presents rather a difficult problem. Although lens removal is what the books recommend, the owner says the eye has been like that for the last year, the dog’s vision is normal and she asks what is to be gained by operating. While one can say that future glaucoma will be avoided, I think the best thing is to refer the dog on to a specialist to discuss the condition and its treatment with the owner!

 

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