A Clinical Case from the Archives : 03/03/2007

Here’s a picture taken with my new Dioptrix Hawkeye photoslit-lamp! What do these signs in a Welsh Springer Spaniel suggest to you? What steps should be taken in diagnosis and treatment?

The episcleral engorgement, the perilimbal vascular fringe and the corneal oedema all spell glaucoma. The intraocular pressure was 68mmHg and 15mmHg in the fellow eye. Topical prostaglandin latanoprost reduced the pressure to 45mmHg in half an hour but not much lower unfortunately. The dog is blind in this eye but quite comfortable, so the key therapeutic step is prophylactic – Trusopt (dorzolamide) as an anti-glaucoma medication in the other eye to keep the pressure normal in this eye. Here’s a supplementary question – why do we get this corneal vascular fringe in acute glaucoma?

 

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