Ocular Challenges: Common Eye Related Ailments and their Impacts

Really, the goal is just to use our stories to bring veterinary medicine to life for the pet caretakers of the world.

And we're doing it because we believe that educating these caretakers is the most powerful thing that we can do to improve the life quality of all of the pets that we love. Music. Hello, welcome back to Vet Tales. This is Dr. Natalie Key. This is Dr. Jessica Estep. Yeah, it's been a minute. Since Dr. Estep's been on a podcast, I'm very excited to get her out of surgery and into the podcast room. Yeah, I think it's been since we built this building. Yeah, I mean, here, yeah, it's been a minute.

I also, so Dr. Estep does a lot of surgery, but she also is the one we reach out to when we get stumped for behavioral stuff and eye problems.

We've talked a little bit about eyes on podcasts before, especially one on blindness. But it's been a long time since we've really gone into just generalized ocular diseases and so I thought maybe you could walk us through some of the more common things we see and also some of the fun weird stuff we see. For sure. I mean we see eyes almost every day there's something new with an eye whether it's a dog or a cat or even sometimes those exotic pets but Not if I can help it.

Yeah. I'll get Dr. Damon on that. And really I think most commonly what we see is ulcers. Yeah. So an ulcer on the eye usually is on the cornea. So the clear part of the eye where you can see the color and look into the eye and they'll get a scratch, an abrasion, you know, for whatever reason. Usually it's trauma. Yeah. And then that becomes painful. And then you get a whole lot of other symptoms from that, just from that one scratch.

Yeah. Yeah. I mean, the trauma can be, you know, like playing too rough or running outside and getting a grasp, you know, some kind of grass scratching you or whatever. But sometimes their face, like I had a cat today actually that had just been itchy on its ear, scratching its face, and it actually scratched its own eye. And they can be scary because they can really get nasty. I mean, I've seen animals lose their eyes because of an unaddressed corneal ulcer.

Yeah. Yeah, and they happen quickly and then they deteriorate quickly. And so they're usually something you want to get in as soon as possible. I did have a case a month ago where I'd had it for a month already. And we're still trying to treat it. Yeah, they can last forever. Especially the really, I find like the really superficial ones. And they'll just drag on and don't heal well. Yep, yep. And that's exactly what happened with this one.

The dog had the ulcer for about a month and wasn't healing. So it came to us. And I almost had it healed completely. And then she hid it again.

And re-scraped it well and that's the number one thing they taught us in vet school with ulcers was make sure they wear cones because that's the reason why they fail the number one reason they fail to heal is because the animal keeps re-traumatizing it yeah uh because it hurts and so what do we all do when something hurts we rub it yeah um but when you rub the surface of your eyeball it's not good for your eyeball yeah so so ulcers why they while they're very common.

And it's like, oh, it's a scratch, you know, like no big deal. They can actually be a really serious issue.

Yes. And, you know, just because they start superficial doesn't mean they can't get deeper, especially if they hit it or scratch at it. Or if it gets a nasty infection there. The melting corneas. Oh, those are so cool. Yeah, they are. They call them melting corneas because it literally looks like the cornea is melting like wax. It's awful. It's gross. And just so we're all clear, the cornea is the clear part of the front of your eyeball.

So just just a little eye anatomy it's difficult for us to describe that well on a podcast but it's like think about when you look at a cat's eye sideways you see that big like snow globe projection on the front that's just totally clear that front of that snow globe is the cornea yeah yep it's just that clear layer trying to protect the eye and if it melts or gets deeper it can even turn into a desmetaceal is what it's called where it's really deep and it's a high risk of rupturing the

eyeball yes because they will actually rupture yeah which just means the eyeball goo leaks out sorry yeah for the gross description that's exactly what happens yeah and often not always but nearly always that results in what we call enucleation or removal of the eye yeah so bummer it does suck when it gets so yeah when you see any eye problem take it very seriously very quickly yes yeah and not not just for that reason ulcers can also inflammation on the outside of the eye,

whether it's ulcers or not really allergies, but conjunctivitis, if something's causing inflammation to the white part of your eye, that can go to the inside of your eye.

Uveitis which is inflammation of the uvea which is kind of like your iris the color of your eye, and that is extremely painful which I can say for first-hand experience because you've had it yeah uveitis it was horrible yeah but so ulcers or conjunctivitis can cause inflammation inside the eye and things become a lot more serious yeah that way absolutely and then you can also get the inflammation of the tissue around the globe of the eye, which is like if you lift,

lower your eyelid down and look like if you're looking for an eyelash and there's something, that pink stuff, that's the conjunctiva. And you can get conjunctivitis as well. So you've got conjunctivitis, uveitis. All the itises. All the itises. Itis is just fancy for inflammation. And so you can get all kinds of inflammatory responses. Yeah. Which is the next thing on your list, actually, is the conjunctivitis? Yeah. So when you say conjunctivitis, I think to most people, they think pink eye.

Oh, right. They do. Because I've had pink eye a lot. I had a lot of eye problems when I was younger. Which is how you got passionate about the field, right? Yeah. Yeah. A lot of experience. So eyeballs, I think, are really cool because of all the problems I have with mine.

But you think pink eye in people, which is typically bacterial and can be contagious, but that's not usually what we see in dogs and cats and you can get conjunctivitis for numerous reasons really yeah just like allergies or like like if there's fire burning maybe like smoke irritation. There's a foreign body a foreign body herpes virus in cats oh yeah that's a common one yeah they get it all the stinking time, And it's really hard to get rid of. Yeah, yeah. But yeah, so all that tissue

can get super inflamed and irritated. Which can make them scratch their eye. And then you get an ulcer. You get an ulcer. So much fun. Yeah. Just enjoy the eyeballs. It's such a tiny little spot on the body that causes so much problem. So many. Our ophthalmologist used to call that, you know, people say the eyes are like the window to the soul.

And she was like, they're actually just like the window to the body, too. because like so many systemic diseases will manifest in the eye. And actually, you know, in my last Western, when I went to CE in Western, I attended an ocular lesion for systemic diseases and for cats. And I was like, wow, there's so much that can be found just looking in the eye. I know. Well, and you had that, I think I'm skipping off of our list a little bit,

but you had that husky that you found a systemic disease from the eye. Yeah. Rare. This husky had something called uveodermatologic syndrome. Oh, that's fun. UVD. Only case I've ever seen. Have you seen one? No, I have not. It's pretty rare. Huskies are the most common, huskies and malamides. But it's basically an autoimmune disease where the body attacks both the skin and the eyeball, most commonly the uvea, causing uveitis.

And I had a case and I saw the dog and thought, well, if this doesn't look like UVD, I don't know what does. Poster child. Yeah. And so that dog actually ended up having one of her eyeballs removed because the inflammation in her eye was so severe. Wow. But she went to an internist as well, and they got a lot settled out there. Hopefully get to save the other eye. Yeah, that's the goal. And keep her own immunosuppressants probably for life, right? Yes, yes.

Nuts. Do you want to walk us through some other autoimmune eye diseases? Yeah, so another one I also recently saw that I haven't had a case of yet was PANIS, which is chronic superficial keratitis. Which is where it can kind of present like an ulcer because people, you can actually just see it looking at the eye standing from a distance. It's where decornea, a clear snowblow that we're talking about, develops what we call granulation tissue or inflammatory tissue. It's like pink, fluffy, thick.

Yeah, and it can go over the entire eyeball. Yeah. But it's not actually painful per se.

It doesn't we don't typically see all the tearing and all the redness and the squinting that we see as ulcers or uveitis but it can obviously cause widespread inflammation eventually and blindness as well yeah just from like literally like pulling a curtain across the front of the eyeball yeah so that's it's thick it is it's like it and i've seen some ulcers try to heal with graham tissue so it can look really similar but a lot of times it's the signalment of the of the

patient so like a lot of times it's like a german shepherd which that dog was yeah all i think of all my panis cases they've all been shepherds yeah but maybe one it's just kind of a mixed breed but anyway and a lot of times it'll be on both eyes and there's and they're the big distinction is they're not painful whereas most ulcer patients will be yeah yeah and that was actually how i figured out this panis the dog came to me for a lesion on

one eye and you were standing in the room and the owner said oh he has one on his other eye as well and I said okay.

What are the chances you get two ulcers yeah yeah he responded to treatment as well so that's kind of the two I've seen recently pretty close together and one that's not really autoimmune but you saw yeah was that yeah I had a cat and I thought well again I thought it was a granulation over an ulcer because that's what it looked like this big, fluffy tissue over the a certain little triangular section of the cornea and the cat was super.

Fractious so he was not having it yeah no touchy he said and so the first time we just tried to do the exam like from afar and tried some medicine the owner was really successful in getting medication in and it wasn't getting better but he had no other symptoms he didn't really seem painful. So I was like, we're going to have to sedate him and do like a proper exam. And so we sedate him and you walk by. And I'm like, hey, Dr. Issa, what do you think about that? Yeah.

I think that's eosinophilic keratitis. And I was like, yeah. So I was thinking too. But sure enough, so we did a little bit of digging on it and everything checked out perfectly. And then we changed the medication as indicated because these dogs are cats in this case. and you're putting them on medication with a steroid in it, which you cannot do if they have an ulcer. Right. It's a totally different medication plan. And then poof, the eye was great.

It's awesome. Yeah. You saved its little pink eye. Yeah. And we always avoid steroids when it comes to eye stuff off the bat because if they have an ulcer and you give them a steroid, topically, not orally, but a topical steroid, it'll make it significantly worse. Yeah. Your ulcer will go from kind of bad to really bad in a hurry.

Very quickly so so yeah if you ever like are asking your veterinarian can you just please refill my steroid eye cream from when they had allergies last year and the vet is like no i really need to see it first it's because when they have the allergies they can add you know rub their face get an ulcer that they didn't have last time and if we just refill that we could.

Definitely make the dog's eye worse yeah and so we tip it or cat so typically we recommend at the beginning of each episode to make sure there's not a scratch which we do with the corneal stains yeah yeah so just put a little fluorescent dye in the eye and look to see if it sticks to any ulcers yeah which is really fascinating it is i like doing it i mean yeah it's so rewarding when you see it you're like it's like it looks like highlighter yellow stuck to the bad tissue on the eye and a

really really vibrant color and you can show the owner and see like this is how big it is and then when we come back we recheck it and see is it smaller bigger and they and they can see it yeah and children love it yeah it's love seeing the green yeah yeah children and doctors alike yeah all find it very entertaining so anyway so yeah so the we switched the cat with the eosinophil keratitis to a steroid and poof a lot better

yeah so much better so okay so that was kind of autoimmune things except for the one right above it on your list about that one yeah Dry eye. Dry eye. Or keratoconjunctivitis cica. Yeah. That's the one. It's exactly what it sounds like. Dry eye. Dry eye. Yeah, the little tear duct just quits doing its thing because the autoimmune or the immune system is attacking her on the tear duct. It causes inflammation, decreases tear production.

And then the biofilm on the eye that's necessary to protect the eye is insufficient. And so the eye gets dry, as the disease indicates. And you'll see this like really sticky and mucousy tear gick, like eye boogers. It's really gross. Yeah, and the eye just looks dry, like matted, like a matte paint, if you will. Not matted hair, but like a matte paint, just dull. And then they're just wildly susceptible to ulcers because the cornea is not protected by that lubrication.

Yep, and that's either from their hair or if they're rubbing at it because it's mutated, all of the above. And most commonly, we see it as an autoimmune disease and we treat it with drugs for that. Very rarely, I haven't had a case, a neurologic case, but... I've had a couple, but there is, yeah, so there are some that require a totally different treatment plan because instead of it being like a local duct issue, it's like a nerve function issue.

So you have to actually, a lot of times we treat those with oral medication. Right. Instead of the topicals like we will with the normal KCS. Right, that we normally see, yeah. We see those all the time, especially in the more bulgy-eyed dogs. Yeah, Shih Tzus. Pugs, Maltese, Boston, Bulldogs, all the time. And you may hear us, like, you may notice over the course of this, like, whatever long minute podcast, we go, and then you wind up with an ulcer at the end of all of these disease processes.

So be patient with your veterinarian. If your dog has or cat has an ulcer, they may have to deal with the ulcer before they can get back to what the original problem was.

Right like another great example on our list is the cherry eyes entropion and ectropion yeah these all potentially lead to ulcers yeah so do we want to break those down yeah so cherry eye entropion and ectropion are all kind of like confirmation yeah issues of the eye if you at all yeah it's like the structures surrounding the eye not the globe itself yeah and i had a cherry eye case today Cherry eye in and of itself doesn't necessarily cause a problem.

What that is, is that tear gland that's in your eye. You may see your dog or cat has a third eyelid and it will raise up and down sometimes. They have a gland in there and it can prolapse out. It can basically just pop right up on the eye. It's like you flip the purse inside out. Yeah. And it doesn't cause any functional problems, really, unless it gets irritated and then they scratch it and then they get an ulcer.

And there is a surgery you can do to correct that. We most commonly see it in Bulldogs, my Bostons. But entropion or ectropion are more of the eyelids themselves because, you know, the eyelashes on the inside of like we do on their eyelids. And entropion is where the eyelid rolls in and those eyelashes rub and stab at the cornea which causes an ulcer. An ulcer! And ectropion is where it's the reverse where the eyelid rolls out and these are both because there's generally too much skin.

Yeah so think about like a bloodhound or bass hound with the big saggy eyes and they'll have these little pouches then that are catching debris. And then when they close their eyes, the debris is what's rubbing against the cornea, as opposed to with the entropion where the eyelashes rolling in and rubbing. So either way, you're getting friction on the cornea of things that aren't supposed to touch it. Yeah. And then you get ulcers. And then you get ulcers.

And so those, to correct those, we don't often correct them in puppies. Yeah. Because they have so much crowing to do. We wait until they're usually about a year old.

But there are surgeries you can do to correct that as well and it's what we call tacking which is taking some of that extra tissue out to make the eyelid sit where it's supposed to sit yeah facelift yeah just yeah a little bit of plastic surgery a little nip and tuck yeah exactly yeah cures what ails you yeah so it's it's interesting to kind of watch some of those dogs as they go through the maturation process they will sometimes autocorrect on those but if they

haven't by the time they're a year and it's causing irritation like surgery will save you so much headache it's a very simple procedure and it will fix it to the point where you're not constantly chasing conjunctivitis and ulcers for that dog's whole life yeah and when i see some of these cases with entropion or kcs or ulcers dogs that have had chronic eye problems and we're not sure of the cause

because maybe it's the first time we're seeing it or it just started there are a lot of diagnostics we.

And it's not always straightforward because maybe their eye looks like that because they found an ulcer for three months or maybe they have dry eye and you can't tell or is it just that their eyelids rolling in. And so sometimes we'll have to do several diagnostics to test for each one of these things, treat and redo diagnostics again. Once you've gotten it, it's like kind of unraveling the yarn. You got to get you got to fix the primary issue before you can see what's happening.

Underneath yeah or like the shih tzus that get the eyelash ectopic cilia they get the eyelash that's growing on the inside of their eyelid like rude because you can't see it no you have to sedate them to flip the eye so it's like you get a shih tzu with an eye problem and you're like well you're a shih tzu of course you have an eye problem no worries and you treat it and they're like well let's make sure it's not dry it's not dry and you're feeling pretty good about yourself and then

it comes back and you're like what is happening yeah and until you sedate the patient and flip that eyelid you can't tell that they have these little eyelashes that are growing on the wrong side of their eyelash or their eyelids and they're tiny they're so tiny it's the tiniest little so it's not like some obvious glaring big long beautiful eyelash it's just this little tiny pokey hair yeah and yes those are the things that you just like it's a process eyes are a process It is.

And so we often just have to do diagnostics over and over, and it can be frustrating. One of the first things I tell my clients is like, you're going to get real sick of seeing me. Yep. I apologize in advance for how many times you're going to see me before this isn't a problem for you anymore. But we just can't take those chances because they can change so rapidly. Yeah, definitely. So many changes in a short amount of time. Yeah.

I mean, yeah, it's, you know, days can go from pretty much normal to going to lose the eyeball yes so anyway yay gloom and doom sorry you're not gonna lose your eyeball it's gonna be fine yeah but you got it all right what else you got on your list here i think kind of two that sort of go together cataracts and glaucoma yeah they don't always go together lens like we get to the lens and lens luxations yeah so glaucoma can be caused by a lot of reasons many many

many reasons so many uveitis can cause glaucoma cataracts can cause glaucoma lens luxations and spin caused glaucoma. Glaucoma really just means increased intraocular pressure. So basically the way the eye wall works is you have. Just like everything else in our body, there's this constant cycling of fluid. So the fluid in your eye right now is constantly being drained and refilled, like a pool filter, if you will.

So for some reason with glaucoma, that balance is upset where you have more being put in than what is getting out and recycled for some reason or another. And there are many reasons, but all of them cause too much fluid in the eye. And so it causes this pressure, which is really, really painful. It can actually visually change the size of the globe. Like you can look at a dog and be like, whoa, that eye is big. Yeah. And then they can get secondary uveitis from the glaucoma, or it could be the

uveitis that cause the glaucoma. So much fun. But anyway, so that's what glaucoma is, is this buildup of pressure. And so all these diseases that Dr. Esep is going to tell us about are all causing that fluid balance to be offset. Yeah. And most of the time, you know, what you do to treat glaucoma is give them medications to help decrease the pressure of the inside of the eye, whether that's decreasing production or helping it clear the fluid more.

But certain cases, like lens luxations, which we're about to talk about, are just severe inflammation in the eye causing synecchia, where that iris, the color part of your eye, sticks to your lens, and then you just literally cannot move the fluid in the path it needs to go. Sometimes you can't fix guacama, and you just have to take the eye.

Especially in the hereditary congenital primary glaucomas like that just you can keep them at bay for a while or if you have a full lens luxation and you don't get it fixed I mean it's just there are times where ultimately removal of the eye is the kindest thing because the pet can't see out of it anyway at that point and then once they can't see out of it all it's doing is causing chronic pain and you're trying to give all of these eye medications all the

time which eventually the patient gets resentful of. Right. And so sometimes it's best to just remove the eye if you get to that point. And I've had people say after we've taken. Removed an eye after glaucoma, after we take the eye out, that their dog's an entirely new dog. Well, yeah, because their chronic pain went away. It's like, you think about having the worst headache of your life all day, every day, and then not.

Yeah. So it sounds sometimes weird, like we just want to take the eyeball out, but it's really... Yeah. Dogs don't feel sorry for themselves. Cats don't feel sorry for themselves. They don't know that they're like, look different, or they don't care that they look different.

And if the eye was non-visual to them anyway all you did was make their day better you're right make me feel better which is ultimately at the end of the day the the goal yeah help them feel better so when it comes to cataracts i don't think i've ever seen a cataract in a cat huh and they're it's really mostly a dog now that you're saying that i i think inflammation chronic kebiitis can cause it if cats get cataracts it's always secondary to inflammation yeah it's

some kind of traumatic incident yeah It's not really something that they get, and I don't think I've ever seen one. But dogs typically get cataracts, like people can. A lot of times it's from diabetes. Yeah. And that's, in school they told us it was the most common thing to cause cataracts, but I feel like I've seen a lot of cataracts now that are not associated with.

I guess maybe what they're trying to say is like cataracts will just happen in dogs with age and time, But if there's going to be a primary cause of just an acute onset cataract, it will be diabetes, yes. And if it, you know, if it feels like suddenly their eye just, they developed a cataract, you know, blood breaks never a bad thing to check to make sure we don't have diabetes. But if we are diabetic and one eye develops cataracts, the other eye will most certainly develop a cataract.

You know, and even if you have your diabetic patient well regulated, they'll sometimes just get cataracts. But you can get those lenses replaced and get your vision back in those patients. I've had several diabetic patients that have had cataract surgery, and it's done really well. Yeah. There's a couple of places near us that will do that, the surgeries and restore vision, because cataracts do cause blindness.

Yes. It's the same thing like we were talking about with the panace, where you've got this granulation tissue over the eye. Except for in cataracts, it's inside the lens.

It just it gets so cellularly dense or there's so much density in the cataract that you can't see through it it's just like trying to look through like frosted shower glass yeah but then like maybe more and more and more layers of it over time depending on how bad it gets they will become completely blind because they just physically can't see through that lens which is you know what sits in the middle of your eye which because a lot of times i i have clients that will have a corneal edema

case, so the surface of the snow globe gets blurry, hazy, and they'll think it's a cataract, or vice versa. The cataract is happening behind the pupil. Yeah, behind the colored part of your eye. Yes. Yeah, so when you would look at someone's pupil and see black, now you're going to see white or some variation of gray or blue instead of seeing black at the center of the colored part of their eye. And that's where a cataract lives.

And so you have to get behind the iris, correct the lens, and then you can restore vision. Yeah. And there's not really a way to predict on how a cataract will develop because you basically have immature cataracts, mature cataracts, or hypermature cataracts. And they're not truly blind, they say, until it's a mature cataract. It's just 100% of length. Just density. Yeah, density. However, at some point with an immature cataract, they also just can't see well.

So it's hard to say, oh, he's going to go blind in one month or he's going to go in a year. You can't really predict that. And they may never progress past a certain point. Yeah, some of them will just get a little bit changed. And the other thing that, too, can look a lot like it is lens thickening or lenticular sclerosis, but they are actually different. And lenticular sclerosis does not progress to blindness, but it can impact things like seeing in the dark and depth perception.

I kind of think, I think of it, I like to do analogies, and in my mind, it's like when we start needing bifocals. Yeah. Yeah. It's just a normal age change to the eye that won't cause blindness, but causes vision change. And when you look at the pet that has that, you'll see this kind of like, especially when the light's in their eye, you'll see this blueness that you didn't used to see where it used to just be black.

And people will think it's a cataract, but cataracts are much whiter and much denser. Yeah. Yeah. Difficult to tell apart, though, I think, without an ophthalmoscope. I would say you usually have to use that just to even see. But I've had a lot of, I think he's getting a cataract. I'm like, oh, good news. It's only lens exposure. Yeah. But the lens, cataracts can also cause uveitis because it's just not how it should be.

So it can cause inflammation, which can then cause glaucoma, which can then cause a lot of problems.

So as you can see, everything is kind of connected in the eye. Yeah. I mean, I suppose it is in the body as well. But it's just like when you have this tiny little organ, it's easier to see the connection really quickly. Yeah, yeah. And then another thing the lens can do is luxate and move either forward or backwards. Yeah, basically the lens is suspended in the eye by these little spindle fibers. And if they break loose, then it's like literally it's like I think of it like a gong.

You know, like how a gong is being suspended. it's like the gong thing broke loose and it just goes and falls forward or backwards yeah or can move around in the eye yeah if it's super luxated yeah and it's also you can't see like they can't see with that yeah they can't focus focus anything yeah and can get glaucoma and it's very painful but they can be corrected if you go very quickly to an ophthalmologist for surgical correction in some cases? In some cases, it's an emergency.

So if it, if, you know... For the vision. The dog won't die. Yeah, yeah. Just urgent that we help the eyeball. For vision. Yeah. Best case scenario if a lens luxates is that it falls backwards into the eye versus forward, past your iris, past your people. And that's because if it falls forward, it can cause glaucoma. Yeah. We are back here again, but... It can cause glaucoma very quickly, and it can be an emergency for the eyeball itself.

And so there are surgeries you can do to correct that. But I had a case recently where a lens luxeated backwards or posteriorly, and what we do for that is we just constrict the pupil. So you give topical eye medications to make the pupil constricted. That way it can't fall forward. And it stays back in this little, thick little chamber. Doesn't cause any problems back there.

And dogs stay pretty comfortable that way. it would be different if we were asking the patient to have a dilated eye every day because it would be very difficult for their like sun like brightness regulation i think it would be uncomfortable but when you're asking the people to stay small the dog can't focus anyway because the lens isn't in place and so you're keeping them comfortable the eye is viable it doesn't

cause them any pain and it's not not a terrible long-term plan and it can happen for numerous.

Reasons like uveitis or tumors or in jack russells it can just congenitally yeah I have seen that a few times yeah so I haven't seen a lot I've seen maybe three or four since yeah I was practicing well yeah I wouldn't I mean I mean I don't think I've seen more than three or four in in 15 years yeah of the jack russells oh no I just overall oh Lynn's locations yeah I don't think I've seen even a jack russell oh yeah give it a minute I've been on the planet now that i've

said it yeah right it's coming for you yeah so lens luxations just you know i don't know how would you even know that i guess they would like if you're the owner you're just like my dog can't see so most commonly they say they noticed a color change like the light looking different yeah if it fell backwards if it fell forward they're like there's something inside my dog's eye yeah it's so weird because it's right there yeah it was they in the lens looks like a little clear jelly disk. Yeah.

Yeah. I don't know. It feels like it too. Yeah. Touch once. Yeah. Not that we're sitting over here just opening up eyeballs, but from vet school. Yeah. Yeah. So usually it's very obvious if it's in the front of the eye. You see it immediately. They may not notice if it's in the back of the eye for a little while. Yeah. Yeah. But sometimes it'll find that moon. Yes. If it just kind of falls down, you get that crescent moon. Look at the top.

Yeah. And so they can tell that something looks odd there. Yeah. You guys are going to have to Google Images so you can see what we're seeing in our minds. We put dog after it. Yeah, unless you want to see a person, but we try to not. I try not to. We don't do the human medicine so much.

Okay, let's talk about, let's go into like tumors or cancer. Yeah, most commonly... If I'm worried about cancer, it's for the cat, because I see more iris color changes in cats than I do dogs. That's not related to another thing like uveitis. But as cats get older, sometimes they, you know, most cats have yellow eyes for the most part. Some variation of gold, green, yeah. And they'll get like a brown spot on one of their irises. It may never change or it might rapidly develop.

And so our main concern there is melanoma.

Perhaps they can get iris melanoma it may not be melanoma it may be the benign version of that i'm feeling you're i can't remember either but and even like or if you have the blue-eyed dogs their iris the blue will just kind of like float away and then you're just literally just seeing the iris or the pupil without having the pigmentation yeah over the top of the iris yeah and so it will be a black spot but it's actually just the absence of color so much as having the color turning black.

Right. If that makes sense. It just lost all color. Right, because our iris color is just pigmentation over the top. And underneath there, it's the same color from everybody. So when we see them, I find it's difficult when you see iris color changes with no obvious cause because one of your concerns is cancer. But the only way to diagnose that is to take the eyeball out and send it out. Which is, yeah, not a decision you want to make unless you're pretty darn sure. Yeah.

Unless you actively see a tumor in the eye, which is rare. Which, I mean, and I've seen them, like, where the iris, it'll look... Because, you know, normally you're looking across the cross-section of an eye and it's very flat and smooth. But you'll get this mountain range effect where it's like lobbing and like undulating. You'll see, I don't know how to describe it. It becomes very three-dimensional. And you're like, oh, that is absolutely never good.

Yeah. I've had a couple of squamous cell carcinomas in the eye, a lymphoma in the eye, and then fungal is always an option too, especially in lymphoma. For sure. But usually you'll find the fungal infection back of the retina. Right. But when you see the undulating, like, mountainy range on the top of a cat iris, like, I just call it because I've never been wrong on that. Yeah. I mean, maybe treat it for uveitis for a week or two, but it's like it looks so distinct.

Once you start getting that 3D topography that you're seeing, yeah. But when it's early on, you're like, this could just be a pigment change to the eye.

It could be something more sinister. the only way to tell us to take the eyeball out which I haven't had had to do that just yet but it's it's a big risk to take for something that might not I mean a huge pro-con list right like if it's cancer you need that eye out right now right if it's not cancer you don't need that eye out right now yeah yeah so that was definitely a hard one and cats I feel like get a lot of change to their irises

yeah so so true especially if they get some renal disease or things like that Yeah. And then there's like a lot of just changes you see to the eye that are completely harmless. Like the calcification on the corneas and cavaliers. So you get these little white specks in there. It's a congenital change. We see it a lot with the breed. It is absolutely harmless. It means nothing. And that can be a mineral deposit. That can be lipid deposits.

Yeah. We were reading about the corneal dystrophy, which I've already forgotten about. Yeah. So corneal dystrophy is just where I actually had a recent case like this. Oh, yeah. That's right. You're telling me that? It's where a fluid will build up in the eye, which actually my family's personal dog had corneal edema that had to be treated. But sometimes they can form cysts that can rupture, become an ulcer, be very painful. Oh, great. So we're back to ulcer. Yes. Okay.

Yes. And so this dog would get literally these cysts on the cornea that would rupture. They look like little bubbles? Yeah. Yeah. Like his eye was going to boil? Yeah. Like you got a blister. Well, I don't love that. Yeah. Okay. They treated it. It came really quickly. I've been seeing this dog for two years now, frequently. And she was fine. And then out of the blue, just got it. And she went to an ophthalmologist and they've been treating it very well, but...

The cornea can do a lot, and especially in Boston's, they're known to get corneal edema. Yeah. As they get older, which my family's dog was a lab. He had it. But corneal dystrophy, I think, is some component of that where there's abnormality to the cornea. Yeah, it does say it's genetic, though, but that if it's not causing a problem, like, leave it alone. Yeah.

Interesting. I mean, the eyeball is just full of fun little surprises, and we really didn't even talk about retinas today. No. You know, someday maybe we'll do a podcast on just the retina, Yeah. Which is the thing at the back of the eyeball that has all the information gathering things in it. Yeah. And must be attached or it doesn't work. Yeah. It's like its own organ inside the organ. Yeah. It's a busy little guy. It does a lot for us. So it really does. Without your retina, you can't see.

No, no. So anyway, or at least your brain won't know that you saw it. Yeah. So anyway. Okay. Well, so that was a very long podcast about a lot of like little eye things that are just just And we just scratched the surface, no pun intended. Yeah, we just gave a tiny ulcer. It was just a tiny little ulcer on the topic of eye diseases. So maybe next time we'll do cornea melting versions of all these. We'll see. Oh, yeah. Anyway, okay, hopefully we did not go on too long for your attention span.

But if you have questions about these, let us know. Happy to go over those anytime. Oh, I was going to ask you three questions because that's going to be the new thing. The first question is, what should clients do with the information that we've given them today? Oh, that's a good one. So really, we look at our animals a lot, but eye changes can be really subtle until they're not. So I'd say just make sure you're looking at your kid's eyes frequently enough just to make sure.

And if there is an eye problem, it needs to be seen immediately.

Yeah. All eye concerns are potential emergencies. Okay. The second question I feel like is this particular podcast isn't going to apply very well, but I'm going to ask you anyway. Who exactly of the veterinary patients does this apply to? All of them. Anybody with an eyeball. Anyone that has an eyeball. Yeah, I did not pro Dr. Issa for this. I heard this third question.

You may have to Google an answer. If you had to list out one or two potential resources where clients or podcast listeners could go to for more information about ophthalmology and veterinary medicine, where could they go? So. Besides chat GPT. Yeah. Usually if I'm looking up eyeball stuff online that's not like veterinary specific I'm going to BCA's website. Oh yeah BCA has really great client education. It's veterinary. What does BCA stand for?

It's a vet clinic. Yeah. They're a big corporate vet clinic and they have a lot of good client education. And they just have individual documents over each disease that is excellent for client education. So I usually just if I'm trying to find a client education document, those are perfect. So the VCA's websites. That's a really good idea. Yeah. Lots of breakdown at the client level for all kinds of eye disease. So yay. Thanks, VCA, for being a resource for us. Really helpful.

Honestly, I really appreciate that. Okay, guys, that's all we have for today. I hope you have a wonderful rest of your week. Until next time. Music.