INFECTIOUS KERATITIS IN ANIMALS – MORE THAN JUST ANTIBIOTICS

to describe the treatment of infectious keratitis in veterinary ophthalmology

a veterinary clinic specialized in ophthalmology

a review of treatment options for infectious keratitis in animals 

Infectious keratitis is a common cause of blindness in animals. Causes can be viral, parasitic, fungal, and bacterial. Bacteria are the most common agent in dogs and cats, while fungal infections are often found in horses. Symptomatic treatment in all cases includes inhibition of matrix metalloproteinases as well as mechanical support for the cornea. Examples are topical application of serum, plasma, platelet rich plasma, EDTA solutions and amnion as well as systemic tetracyclines and corneal grafting and cross-linking procedures.  Etiologic treatment is aimed at eliminating the causative agent and includes topical and systemic antivirals and systemic antiparasitics. Fungal infections can be treated with systemic and topical antifungal medications, with intracorneal infections being especially effective. Photoactivated chromophore for infectious keratitis cross linking (PACK-CXL) using UV-A light is also an option. With increasing bacterial resistance to antibiotics, medical antibacterial medications are often not sufficient and their success depends on local antibacterial conditions. PACK-CXL is often effective, strengthening the collagen bonds in the stroma, therefore stopping corneal melting and killing bacteria. However, an effect is often not noticeable until after a few days. The use of UV-C, which can kill bacteria in seconds to minutes, has recently been described and is currently used as an adjunct treatment in our clinic. The instruments and treatment options used in veterinary medicine will be described.

Historically, antibiotics were the mainstay for treatment of infectious keratitis. With an increasing number of etiological agents and increasing bacterial resistance, adjunct treatment, e.g. with PACK-CXL and UV-C irradiation can be a useful addition to therapy.