Uveitis questions

Ha. That made me laugh. I’m learning lots about autoimmune diseases and and currently throwing all the pro and pre biotics at him along with all the other $$ supplements to try to give him a boost. And the carrots from my garden for the vitamin A. He’s probably pissing away my retirement fund but I have to try!

My mare had a nonhealing corneal ulcer (catheter for 2+ weeks resolved that) and then was very sun sensitive, so the ophthalmologist suggested any of these masks: image
This was at the end of September and I ordered the Equivizor since it was the only thing in stock in her size (arab) - it is cheap and has buckles in addition to the velcro. I also ordered the more expensive option, but still only around $70, Equine Sun Visor that came in 6 weeks later being custom made for her. It is a heavier duty cashel type mask with the UV block around the eyes. She wears either with no issues now, even when riding.

I will add that she ended up having an issue with her other eye after her right eye ulcer healed that wasn’t getting better with triple antibiotic, so another trip back to New Bolton Center led to a diagnosis of an auto immune disease, immuno mediated keratitis, in both eyes. She will need anti inflammatory ointment for the rest of her life - 0.1% diclofenac is working for her pretty well. She is still getting terramycin in her left eye, it is an antibacterial with anti inflammatory properties as well.

If she doesn’t respond medically, there is surgery that is possible, where they cut away the diseased portion of her cornea, but hoping that she will respond medically so she doesn’t need to undergo surgery to both eyes. The disease can occur in a single eye, but as always, Ana does everything to the highest degree and is affected in both eyes. Also, the earlier it is caught, the better prognosis of eye sight remaining - so I suggest a visit to your local ophthalmologist, or internal medicine specialist at a minimum. It is my impression (from research) that general practice vets do not have the experience to diagnose this disease and time is critical.

Good luck.

If he’s really upset out it, can you get a catheter installed?

I’ve been able to do eye meds in one of mine recently by just putting her in cross ties and using my left arm (treating the left eye) over the left cross tie to help stabilize the head. Cross tie winds up in my left armpit, left hand manages the lids, right hand applies the meds. It’s kind of trappy, though. This one doesn’t mind, but it could certainly produce a big reaction on one that does. I do followup with handfuls of treats!

Yes, he did bring up the lavage system, but also said it would be expensive.

I’m changing up my treat game and so far it seems to be working. If I get the timing right and the tube in just the right place and so on, I can get the meds in. Fingers crossed it keeps working.

Just a quick update in case anyone else finds themselves in this position - the treats (so far) are doing the trick. apples or carrots. He gets one so he knows it’s game on. Then there’s a brief struggle, but some soft talk and gentle hands settles him and he lets me get it done. I treat immediately after. The treats were key - it’s like he knows what it means and puts it all together (stand still, get a treat).


My horse has insidious uveitis and requires daily topicals to manage (atropine and diclophenac) even though he hasn’t had a visible flare since February. He’s generally always been agreeable about treatment but I find he much prefers if I use my (clean) finger to apply the meds rather than using the tube directly into his eye. Treats always help too though! Hope your boy feels better soon, its a frustrating disease to deal with for sure!

Can you elaborate on the insidious uveitis? I’m currently treating for a corneal ulcer, so the uveitis had to go on the back burner.

I’m seeing all my plans slip away and it’s frustrating!

Sure! So Insidious Uveitis differs from ERU in that it never really clears up fully. With regular ERU the disease flares and requires treatment but then goes dormant for a period of time before flaring again. Insidious Uveitis never goes fully dormant but operates on a slow burn - there may be no outward systems but the inflammation stays active on a lower level in between larger flares so it requires continuous treatment. He gets Atropine and Diclophenac topically 1x/day and is on half a tab of Dex a day to manage which so far has kept him from having a visible flare since February. He wears a regular Cashel flymask when turned out but other than that we don’t do anything special to protect the eye. From my understanding, staying on the Atropine to keep the pupil dilated reduces the chance of scarring from the inflammation that can result in permanent vision loss, the other two help manage the inflammation. I inquired about removing the eye but was told that because he still has a good amount of vision, it was not advised.

I purchased this horse in November of last year and he showed no visible signs of having any issues in the eye - no cloudiness, no scarring, etc. that was visible to the naked eye. After a month or so I did feel in my gut that something was off with his vision but still no definitive signs. Occasionally (not always) he would trot right into a cross rail instead of popping over top and he was also fussy in the bridle, preferring to go around with his head cocked to one side and locking his neck if you tried to coax him into straightening out. He had been out of work for quite a while before I bought him so all of this could have just as easily been attributed to being green and out of shape, so initially I tried not to think too much about it and explored other avenues such as getting his teeth done, saddle fitted, bodywork, etc. Then about 3 months into owning him, we wormed him shortly after he had been vaccinated and that triggered a big flare that caused the eye to go completely blue. We luckily live in an area with a very good equine Ophthalmologist local to us so we were able to have her out right away. She was able to see with her tools that he had some scarring in the back of the eye which indicated this wasn’t his first flare. She rechecked him 2-3 times over the next month or so and through that was able to determine from the lack of progress in reducing the inflammation completely that he had Insidious Uveitis. I sent her photos of the eye (to see the level of pupil dilation) and updates for several months afterwards until he reached a point we felt like his treatment regimen was stable.

Worth noting that while I did not PPE this horse, she explained that even if I had this wouldn’t have been caught unless I had specifically had an Ophthalmologist do an additional exam. It was her opinion that a regular vet would not have caught it and that often cases like the ones my horse has are missed, resulting in a horse that quietly goes blind and often has issues that are misattributed to behavior. You know, in case you needed another nightmare scenario to worry about :slight_smile:

Also just want to add, that while I decided it was in my horses best interest not to jump he remains completely useable as a dressage/trail/flatwork mount. Other than some quirkiness in the bridle and an occasional spook if something appears quickly on his bad side, you would never know he has partial vision loss. Some of that can be attributed to temperament and the fact that hes probably lived with this for a while before I got him and is used to it, but horses are highly adaptable and often will adjust just fine if given the proper time and support.

Sorry to read about your saga with Uveitis.

Just a thought since you mentioned a flare up after deworming. Uveitis can be caused by Onchocerca parasites. I don’t know why Veterinarians do not treat for these in all uveitis cases which flare after an ivermectin or moxidectin based wormer is given? Especially since there is no viable testing and the adults can live inside horses for 10-15 years. These parasites are carried into horses via the bites of no see um gnats.

Double doses of Equimax repeated in two weeks targets the juveniles. Doxycycline targets the adults ( in humans). There have been lots of studies about this in humans. If you google, onchocerca river blindness or Onchocerca uveitis, you can read more.

Might be worth asking your Veterinarian. If that’s the cause you can treat it rather than symptoms.

Best wishes.

I could have typed this… practically the same, except he came with a (disclosed, no one was trying to hide anything) scar on his eye but it was fine for a long time. Until it wasn’t.

Luckily his temperament is second to none. He is literally the unicorn every re-rider goes looking for, so it makes it easier to deal with. I’m just concerned about pain. I need to figure out how to definitively know the pain is under control. Like right now it looks fine - no squinting, tearing, eyelashes are in the “right” position. But the ulcer isn’t fully healed and the edema isn’t fully cleared (fingers crossed it does). He’s getting the whole month of December off anyway, but I’ll worry in January when we start light riding again.

Anyway, appreciate all the replies. It really helps to have things to mull over.

Bumping this…just got the diagnosis today, seems my horse has uveitis, but couldn’t get any good diagnostics, because little idiot wouldn’t cooperate, first sedative didn’t touch him at all, second one, amped him up so we couldn’t get a really look.

Now waiting for a consult with an ophthalmologist…but feeling quite down…