A favourite ex-student of mine called me from South Africa yesterday about a horse with a problem eye – or should that be an eye problem?!
What is likely to be going on here, what ancilliary tests would be useful and what treatment should Dilly give?
This ground glass or cake frosting appearance spells fungal keratitis and the prognoais is not that good in my view. Diagnosis can be confirmed by cytology showing fungal hyphae as below and fungal culture and sensitivity is called for.
Tonometry would show a reduced intraocular pressure because of a secondary uveitis. Dennis Brooks and colleagues in Florida would probably suggest a full thickness keratoplasty, but a debridement and treatment with an antifungal such as itraconazole or natamicin might suffice.