Swelling above eye + cornea ulcer

[ratchet]

Guys, this sucks so much.
Our gelding was moved to a nice little barn about an hour away for two months of pro training (and lessons for both of us) since he has been sitting for two years, and we need help addressing his pull back issue. Barn is a little too far away for long term comfort but we love the trainer.

Prior to this, he had a cracked molar extracted — no infection, thankfully. Quick and uncomplicated. He also had the nasal strangles vaccine since he was
moving to a public barn and strangles can be a problem here.

The day before last, my trainer texted me saying the hollow space above his eye was a little swollen. Vet said likely a reaction to the block they used and to watch it and use a compress.

Then yesterday, I receive this picture:

Emergency vet is called and I cancel everything to drive down there. I arrive right as the vet is wrapping up…after sedation and a stain etc he has a large abrasion on his eye. He is started on banamine, eye drops and a lotion that is applied to the skin around his eye (I will get the names of the meds today when I go back down to check on him).

The swelling improved with a compress but as you can see from the below photos, it is still quite severe above that eye. Hot to the touch. Vet wasn’t sure that the facial swelling is directly related to the ulcer, and she took blood to look for possible systemic issues but since we didn’t get a call last night I am assuming nothing of note was found.

We are to medicate him frequently throughout the next few days and I am putting a UV protective fly mask on him today. She is calling back on Monday to reassess.

I feel terrible for my poor fellow. And of course, this happens right when we move him to a boarding facility. Does anyone have any ideas what the swelling might be? If it is not improved by Mon I believe we will haul him to the clinic for more evaluation. I am wondering if he smacked his head or something is bothering him there, and he worried at it and scratched his eye as a result.

Temp, appetite, personality, bowels all normal. Pics below are from during the vet’s visit.

[SLW]

Are you saying the cracked molar was extracted in the days prior to your horse leaving for the training barn? Was it an upper or lower molar?

Hard to know why all the excessive swelling related to the corneal ulcer and it would all be complete guesses on my part.

Do not skip giving the eye meds because corneal ulcers can south, quickly. Hope the swelling goes down each day and this resolves without any other complications.

[trubandloki]

I wonder if the corneal ulcer is because of what is causing the swelling, not the other way around. Whatever caused the swelling caused the horse to rub its face in an attempt to deal with it and while rubbing they accidentally caused the corneal ulcer.

[ratchet]

Yeah, it was an upper molar on the same side as this swelling. He was going to take it easy at the boarding barn for ~10 days until recheck. We decided to haul him down there immediately after the procedure since we had to borrow the trainer’s truck…it’s a small place and the horses are well looked after, so we weren’t anticipating any issues as far as recovery from the extraction was concerned. But then of course this happened.

He wore a flymask during the trip to protect his eyes.

Absolutely not skipping any treatments. He is tolerant so far with the application and fingers crossed it stays that way. I scared myself into insomnia researching eye injuries last night and we are all taking this seriously.

Hoping that the odd swelling is a bit reduced today, about to head out there again.

[ratchet]

Here is the state of the swelling as of this morning (we cleaned off the dirt):

[MsM]

My old horse had a habit of looking like a losing prizefighter. He seemed to use his head as a battering ram and smash into things. He scratched his cornea several times. Other times he bashed his face and the area around his eye swelled up but the cornea was fine.

Eventually the vet and I developed a system. If it didnt look too bad I would give banamine and use hot compresses. I could use the ophthalmic ointment (NOT the atropine) If it wasnt better in 12 hours, he would come out and stain. The horse lived in a flymask most of the time and that helped. He always recovered fine and had no long term issues.

Best of luck with your boy. I found the compresses helped a lot!

[ratchet]

Thank you for the optimism! It’s so hard with him being this far away. I had been hoping the swelling would’ve been at least a little reduced by now. Compresses help his eyelids but not the giant lump.

I am hopeful for tomorrow’s update.

[4horses]

Just be aware that uveitis can present like this- the eye itches due to the uveitis and the horse rubs it causing swelling or a corneal ulcer.

Also possible is the reverse sequence - horse bumps face and scratches eye on something which causes uveitis to develop.

Hopefully it’s just due to trauma and does not become recurrent uveitis, but that will be something to watch for moving forward.

As for corneal ulcers, they heal quickly with frequent eye ointment applications. Usually I treat 6x daily for the first 2 days, 3x daily after that. Usually they improve quickly in the first 48 hours. One of mine had a corneal abscess - not as bad as it sounds -and she recovered full vision. Although it was a full month of medication.

[ratchet]

Thank you!! I will ask about uveitis when I talk to the doc again tomorrow.

[Ghazzu]

Late to the party. It’s a bit of a chicken/egg situation here, but with the hx of local anesthesia and dentistry, I’m inclined to think that it may have started from the horse rubbing his head due to pain/irritation, and scratching the cornea that way.

4 horses’ mention of uveitis is also a possibility, and w/o the hx of the dentistry, that would have been closer to the top of my list.

[ratchet]

Thank you.

Trainer sent me some pics and says that the swelling is reduced today, is less hot/squishy, and his eye is less squinty, so I will take a small sigh of relief. I know we are not out of the woods yet, but I was wondering if maybe he had fractured his skull or was forming an abscess in there of some sort.

[OzarksRider]

@4horses

As for corneal ulcers, they heal quickly with frequent eye ointment applications.

Not always. One of my horses once had a corneal abrasion/ulcer that took two months to heal. It was never infected; it just took its sweet time to heal. For weeks it seemed like it wasn’t getting any better at all, then finally it started looking better and then suddenly it was healed. I was putting ointment in his eye 4x/day the whole time, and the vet came out every couple of weeks to stain the eye to see how it was doing. My horse’s eye now has a small scar, but it doesn’t interfere with his vision.

Ratchet, hopefully your horse’s ulcer will heal quickly, but if it’s slow to heal like my horse’s ulcer was it doesn’t necessarily mean anything is wrong. Just keep medicating it and get the vet out to monitor it.

[ratchet]

Yeah, nearly every account of an eye ulcer on the internet echoes your story, OR. Some of the more difficult cases seriously terrified me. I know a horse can adjust to blindness of varying sorts, but I’d rather not Rajah have to go through that.

So, while I’m happy that the swelling is dissipating, I’m still on edge.

[ratchet]

Monday update: still swollen, but reportedly down a little, and his eye seems brighter and less squinty. Vet did not call so we left a message with her.
I feel like there is more swelling than I would like to see at this stage…but we still don’t know what it is even from.

[4horses]

Yes that swelling is concerning. I’ve treated at least 7 corneal ulcers, 1 corneal abscess, and recurrent uveitis. I even had a horse that severely poked his eye and despite one week of care at the vet hospital, still lost the eye. None of the horses had swelling like that- swollen eyelids, yes, but not swelling that high up. It almost looks like he bumped his head.

I think I would consider some x rays to ensure there’s no fracture, or infection. It’s an odd presentation.

[ratchet]

Blah. Today’s pic and we are working to get ahold of the vet and determine the next plan of action. Agreed that we are going to push some sort of imaging at this point.

[Ghazzu]

I’m getting suspicious of an abscess or perhaps a hematoma.

[ThreeWishes]

Poor sweetheart. There is certainly something else going on than a poked eye. Best wishes in finding out.

[ratchet]

Soonest the vet can come back out is tomorrow afternoon. I think we are going to push for an x-ray or something of the sort, to know precisely what we are dealing with, and then take him back home. Once he heals…we will try this whole boarding/training thing again
She will also re-check his eye, which seems to be looking super good for being a newer abrasion. So, there’s that, at least.

[OzarksRider]

Ratchet, any update on your horse?