Corneal necrosis and sequestration in the cat: a review and record of 100 cases

Long-term treatment outcomes and risk factors for recurrence in feline corneal sequestrum: 72 cases (2009-2017)

BACKGROUND

This study aimed to evaluate long-term treatment outcomes in feline corneal sequestrum (FCS), compare the recurrence rates between different surgical techniques, identify possible recurrence risk factors and monitor the development of FCS in the contralateral eye.

METHODS

The medical records of 72 cats (79 eyes) with FCS treated between 2009 and 2017 were retrospectively analysed.

RESULTS

The most commonly affected breeds were Persian, domestic shorthaired and Burmesecats. The mean age was 6.9 years. Sixty-five cats (90%) were affected unilaterally. Sixty-six eyes (83%) underwent surgery: keratectomy in 34 eyes (52%) and keratectomy followed by a graft procedure in 32 eyes (48%). Recurrence occurred in 13 out of 66 eyes (19%) at a median of 245 days after surgery. Skull conformation, location of the FCS, type of surgical procedure and concurrent ocular surgery did not significantly affect the recurrence rate. Eighteen cats (27%) developed FCS in the contralateral eye at a median of 635 days after surgery.

LIMITATIONS

Limitations are related to the retrospective nature of the study, the use of telephone follow-up for assessment of recurrence in some cats and the small number of cases.

CONCLUSIONS

Surgical excision had a successful outcome in most cases. The type of surgical procedure and skull conformation did not affect the recurrence rate. One-quarter of the cats developed FCS in the contralateral eye.

Epidemiology and clinical presentation of feline presumed hereditary or breed-related ocular diseases in France: retrospective study of 129 cats

OBJECTIVES

This study aimed to describe the epidemiology and clinical presentation of presumed hereditary or presumed breed-related ocular diseases in a population of cats in France.

METHODS

Medical records from between September 2013 and August 2017 were reviewed to identify cats with at least one presumed hereditary or breed-related ocular disease. Cats with concurrent, or a history of, ocular or systemic infectious diseases were excluded. Signalment, history and clinical findings were recorded.

RESULTS

Of the 1161 cats that presented to our institution during the study period, 129 were diagnosed with at least one presumed hereditary or presumed breed-related ocular disease (11.1%, 95% confidence interval [CI] 9.3-12.9). Five ocular abnormalities had a prevalence of >1%: entropion, corneal sequestration, persistent pupillary membrane, cataract and retinal dysplasia. The prevalence of entropion was 2.2% (95% CI 1.3-3.0), with Persians (P = 0.03), Maine Coons (P <0.01) and male cats (P <0.01) being over-represented. The prevalence of corneal sequestration was 2.4% (95% CI 1.5-3.3), with Persians (P <0.01) and Exotic Shorthairs (P = 0.02) being over-represented. Persistent pupillary membranes and cataracts had the same prevalence of 2.3% (95% CI 1.5-3.2), with no particular sex or breed significantly over-represented. Retinal dysplasia had a prevalence of 1.6% (95% CI 0.8-2.3) and Persian cats were over-represented (P = 0.04). Anterior segment dysgenesis had a low prevalence (0.9%, 95% CI 0.4-1.5), with all affected cats being domestic shorthairs and this breed therefore was over-represented (P = 0.04).

CONCLUSIONS AND RELEVANCE

In a French population of cats, presumed hereditary or breed-related ocular diseases accounted for 11.1% of all ocular diseases. Cataracts, corneal sequestration, persistent pupillary membrane, entropion and retinal dysplasia were the most common conditions. Statistical breed over-representation was observed for entropion, corneal sequestration and retinal dysplasia. We recommend that more systematic screening of feline species is conducted.

Genetic Aspects of Corneal Sequestra in a Population of Persian, Himalayan and Exotic Cats

Simple Summary

Corneal sequestrum is a common eye disease in Persian, Himalayan and exotic cats. It is a brown stain on the cornea that can be painful and often requires surgery for full recovery. The cause of this disease is unknown. One hypothesis is that genetic factors influence the disease, but there are no data to support this in the scientific literature. In this study, the influence of genetics on this disease was investigated on the basis of clinical and pedigree data from a cattery. Kittens of some dams in this cattery turned out to have a higher risk of corneal sequestra than kittens of other dams, indicating that genetics indeed play a role. The disease also has a high heritability, which implies that by selecting the right breeding animals, breeders can reduce the risk of corneal sequestra in the offspring. DNA analysis of some of the cats from the cattery could not link the disease to a specific region in the DNA, so it is possible that many different genes in different DNA regions are involved in the development of corneal sequestra.

Abstract

Corneal sequestra are ophthalmic lesions that are remarkably common in Persian, Himalayan and exotic cats. In this study, the genetic aspects of this disease were investigated in a population of cats originating from a single cattery. Odds ratios were calculated for parents with affected offspring. The heritability of (owner-reported) corneal sequestra was estimated with a Markov chain Monte Carlo procedure. Well-phenotyped cases and controls were used for a genome-wide association study. Data from 692 cats originating from the cattery, of which 61 were affected, were used. Cats from two specific mothers had significantly higher odds of developing corneal sequestra, but no significant effect of the fathers was found (after correction for the mothers). The heritability of corneal sequestra was estimated to be 0.96. A genome-wide association study with 14 cases and 10 controls did not reveal an associated chromosomal region. The large effect that genetic factors had on the development of corneal sequestra in this study suggests that selective breeding could be an effective way to reduce the prevalence of this condition in these cat breeds.

Autologous lamellar keratoplasty for the treatment of feline corneal sequestrum: A retrospective study of 35 eyes (2012-2020)

OBJECTIVE

To evaluate the use of autologous lamellar keratoplasty for the treatment of feline corneal sequestrum (FCS).

PROCEDURE

The medical records of cats diagnosed with FCS that underwent autologous lamellar keratoplasty between 2012 and 2020 with a minimum of 2 months of follow-up were reviewed. After keratectomy of FCS, a button adjacent to the corneal limbus was harvested on the same eye and sutured to the recipient bed. A nictitating membrane flap was left in place until the first recheck except for one patient. Postoperative treatment with topical and systemic antibiotics and systemic nonsteroidal anti-inflammatory medications was prescribed. Follow-up examinations were carried out 2 weeks, 1 month and 2 months post-operatively and consisted of a complete ophthalmic examination.

RESULTS

A total of 35 cats (35 eyes) were included. The median follow-up time was 3.2 months (range, 2-59 months). Brachycephalic cats were overrepresented (85.7%). The mean graft size was 6.5 mm (range, 6-9 mm). Minor complications consisting of melting and partial integration of the graft occurred in 2/35 eyes (5.7%). Recurrence was observed in 1/35 eyes (2.9%) and was managed by a superficial keratectomy. A good visual outcome was achieved in all eyes, and a faint or mild corneal opacification occurred in 15/35 (42.9%).

CONCLUSIONS

Autologous lamellar keratoplasty is an effective treatment for FCS, providing good tectonic support to the affected cornea and resulting in good visual and cosmetic outcomes. These results should be verified in future prospective studies that include a larger number of cases and longer-term follow-up.

Corneal sequestra in cats: 175 eyes from 172 cases (2000-2016)

OBJECTIVES

To report the clinical outcomes of different surgical treatments used to manage feline corneal sequestra in a large number of cases.

MATERIALS AND METHODS

Medical records of 172 cats affected by feline corneal sequestra and surgically managed by different techniques were retrospectively evaluated. Signalment, surgical technique, visual outcomes, postoperative corneal clarity and recurrence were evaluated.

RESULTS

One hundred and seventy-two cats (175 eyes) of different breeds, ages and sex were included in the retrospective case series. The Persian was the most represented breed (123/172; 71.5%), followed by Exotic Shorthair breed (21/172; 12.2%), Domestic shorthair breed (21/172; 12.2%) and a smaller group of other different breeds (7/172). Surgical management included a superficial (84/175 eyes) or deep (91/175 eyes) lamellar keratectomy in association with the following covering techniques (tectonic support and/or protective support): nictitans membrane flap (n=84), conjunctival pedicle graft (n=52), BioSISt graft (n=9), corneoconjunctival transposition (n=7), corneoconjunctival transposition+nictitans membrane flap (n=6), conjunctival free island graft (n=6), BioSISt+conjunctival pedicle graft (n=6), BioSISt+nictitans membrane flap (n=4) and bridge conjunctival graft (n=1). At the end of the retrospective case series, visus was present in all patients and no or mild corneal opacity was detected in 86% (151/175 eyes) of the patients. Sequestra recurred in 20 eyes (20/175; 11.4%) within 2 years.

CLINICAL SIGNIFICANCE

This paper describes the clinical outcomes of a large number of cases of feline corneal sequestra treated with varying surgical techniques and provides useful insight regarding the prognosis and outcomes of these techniques within feline ophthalmology.

Feline corneal sequestra: outcome of corneoconjunctival transposition in 97 cats (109 eyes)

Case series summary A retrospective study was undertaken to review outcomes of keratectomy and corneoconjunctival transposition in cats with superficial and deep corneal sequestra. Information including pertinent history, signalment, ophthalmological findings and postoperative outcome was collected from medical records. Follow-up was obtained by clinical examination, contact with the referring veterinarians and review of medical records or telephone contact with owners. Ninety-seven cats (109 eyes) were included from 2005-2015. The most commonly affected breeds included Persian, Burmese and Himalayan. The mean age at the time of surgery was 6.8 years (median 6.5 years; range 8.0 months-18.0 years). A corneal sequestrum in the contralateral eye was diagnosed in 28 cats (28.9%). Recurrent corneal sequestration was diagnosed in eight cats (nine eyes), with recurrence occurring a mean of 703 days after surgery (range 29-1750 days). Age, sex, breed, depth of sequestration and concurrent ocular disease in the contralateral eye were compared between cats with and without recurrence, with no risk factors for recurrence identified. Relevance and novel information Excellent surgical outcomes have previously been described in a series of 17 cats with superficial and mid-stromal corneal sequestra. This paper adds further information to the literature by describing a larger series of cats, with corneal sequestra affecting the full range of corneal thickness, and good long-term postoperative outcomes.

Aetiology of corneal ulcers assume FHV-1 unless proven otherwise

OVERVIEW

Feline ulcerative keratitis is a common presenting complaint and is frequently a sequela of feline herpesvirus 1 (FHV-1) infection; so much so, in fact, that it is fair to assume an FHV-1 aetiology until proven otherwise. Other potential causes of ulceration are trauma or underlying eyelid abnormalities (entropion, ectropion, agenesis, dermoids, neoplasia), lash abnormalities (ectopic cilia, trichiasis), tear film abnormalities or neurological deficiencies (trigeminal nerve paralysis, facial nerve paralysis).

CLINICAL CHALLENGES

The management of corneal ulceration in cats is frequently challenging, and treatment needs to be tailored carefully to the individual cat, its temperament, and the disease process present.

EVIDENCE BASE

The scientific literature on feline ulcerative keratitis is extensive, particularly that related to FHV-1 infection. The aim of this article is to review the aetiology and diagnosis of corneal ulceration in cats with particular reference to the evidence base available.

PATIENT GROUP

All age groups and breeds can suffer with ulcerative keratitis. Breed predispositions are present for some forms of corneal ulceration, and these are discussed.

Ultrastructural findings in feline corneal sequestra

OBJECTIVES

(1) To describe the ultrastructural features of corneal sequestra in cats; and (2) to enhance our understanding regarding the pathogenesis of feline corneal sequestration.

METHODS

Nine corneal sequestra were harvested via keratectomy from globes of nine cats. The sequestra were routinely fixed then postfixed for high resolution light and transmission electron microscopy (HR-LM and TEM, respectively). The tissues were embedded in Epon/Araldite. Sections of 0.5-microm thickness were cut and stained with 1% toluidine blue in 1% sodium tetraborate solution for HR-LM. Ultrathin sections were collected on copper grids and stained with uranyl acetate and Sato's lead stain for TEM. Ultrathin sections were examined and the images were captured on an Advantage HR CCD camera using a Hitachi 7500 electron microscope operated at 80 kV. Two healthy corneas from two cats were harvested immediately following euthanasia. These corneal tissues (control samples) were processed in the same manner as the corneal sequestra for HR-LM and TEM. A portion of each sequestrum was also submitted for polymerase chain reaction (PCR) testing for infectious agents including feline herpesvirus-1 (FHV-1), Toxoplasma gondii, Chlamydophila felis and Mycoplasma spp.

RESULTS

Ultrastructure of healthy corneal tissues revealed basal corneal epithelial cells aligned adjacent to a thin acellular layer similar to Bowman's layer with underlying tightly packed, regularly arranged, collagen fibrils oriented in different planes. Keratocytes were elongated and had long and irregularly shaped nuclei, and cytoplasm contained rough endoplasmic reticulum and abundant membrane-bound vesicles. In contrast, corneal sequestra contained varying amounts of an amorphous, electron-dense substance, continuous with intact basal epithelial basement membranes peripherally, and overlying corneal ulceration and loosely packed collagen fibrils. Remnants of necrotic keratocytes were seen in spaces between disarranged collagen layers. In all samples, occasional keratocytes exhibited morphology indicative of apoptosis including clumping and margination of chromatin, and shrunken cytoplasm. Varying degrees of inflammation were noted on HR-LM and TEM of affected corneas including peri- and intralesional neutrophils, lymphocytes, plasma cells, and macrophages. Corneal sequestra were FHV-1-positive (n = 3), FHV-1- and T. gondii-positive (n = 1), T. gondii-positive (n = 3), or negative for DNA of these infectious agents (n = 2) using PCR. All corneal sequestra were negative for DNA of Chlamydophila felis and Mycoplasma spp. using PCR.

CONCLUSIONS

Apoptosis may play a role in the pathogenesis of feline corneal sequestration independent of the presence of DNA of these infectious organisms. Prospective clinical studies are warranted to further understand the significance of T. gondii in relation to feline corneal sequestration.

Qualitative tear film and conjunctival goblet cell assessment of cats with corneal sequestra

OBJECTIVES

To evaluate the tear film qualitatively and conjunctival goblet cell numbers in cats with and without corneal sequestra. ANIMALS STUDIED AND PROCEDURES: This was a prospective evaluation of 11 cats with corneal sequestra and 14 control eyes that were either the contralateral normal eye when the sequestrum was unilateral or from control cats of similar age with no ocular disease. All cats in this study were examined by a veterinary ophthalmologist. The ophthalmic examinations included a neuro-ophthalmic evaluation, Schirmer tear tests, fluorescein staining, tear film break-up times, applanation tonometry, biomicroscopy, and indirect ophthalmoscopy. The palpebral conjunctiva at the dorsal nasal, ventral nasal, dorsal temporal and ventral temporal fornices were biopsied after topical anesthetic was applied to the cornea and conjunctiva. The conjunctival biopsies were fixed in formalin and sectioned routinely and stained with hematoxylin and eosin, and periodic acid-Schiff. These slides were examined by light microscopy by a blinded examiner. Goblet cell numbers were compared to conjunctival basal epithelial cell numbers by region. The goblet cell numbers by region from the eyes with sequestra was statistically compared to those from eyes without sequestra, with a student's paired t-test. Conjunctival swabs were collected from the cats with corneal sequestra and submitted for polymerase chain reaction for Herpes felis, Chlamydia psiitticia, and Mycoplasma felis. The corneal sequestra were removed by surgical keratectomy and fixed and stained routinely, and examined by light microscopy.

RESULTS

No neurologic abnormalities were detected in any of the cats. The Schirmer tear tests (eyes with sequestra 14+/-5.1 mm/min; normal eyes 15+/-6.8 mm/min) and intraocular pressures (eyes with sequestra 21+/-6.6; normal eyes 22+/-5.8) were within normal reference ranges for cats. Biomicroscopic examinations revealed varied sizes and depths of brown- and amber-colored corneal sequestra. No abnormalities were noted on indirect ophthalmoscopic examinations. The tear film break-up time was 21 s (+/-12) for the normal eyes (n=14) and 14 s (+/-13) in eyes with corneal sequestra (n=11). The average goblet/epithelial cell ratios by region for the normal eyes and the eyes with sequestra respectively were 0.66, 0.56 for the dorsal nasal fornix, 0.68, 0.57 for the ventral nasal fornix, 0.63, 0.48 for the temporal dorsal fornix, and 0.55, 0.49 for the temporal ventral fornix. There were no significant differences in tear film break-up times and goblet cell numbers in eyes with corneal sequestra and those without sequestra. Three conjunctival swabs from two of 11 cats with sequestra were positive with PCR for Herpes felis virus. These included one cat with bilateral sequestra and one cat with unilateral corneal sequestrum.

CONCLUSIONS

The pathogenesis of feline corneal sequestra does not appear to be linked primarily to abnormal goblet cell numbers, qualitative tear film abnormalities, and accelerated tear film break-up time.

Congenital and hereditary ocular abnormalities in cats

Congenital and inherited ocular diseases are reported less frequently in the cat than the dog. The 2 species also differ in their array of disorders, with familiar canine abnormalities like cataracts overshadowed by unique feline diseases such as eyelid agenesis and corneal sequestration. Organized according to the primary ocular structure affected and commingling congenital and inherited disorders in each section, the review begins with multiple ocular anomalies and their impact on globe-orbit relationship. Adnexal disorders include eyelid agenesis, entropion, dermoid, and nictitans gland protrusion. Corneal abnormalities range from the routine sequestrum and PPM-related opacity to those rare infiltrates accompanying inborn errors of metabolism. Brief descriptions of uveal anomalies, primary glaucoma, cataracts, and lens luxations follow. Retinal dysplasia and progressive retinal atrophy complete the summary. Suspicions of heritability are often based on small numbers of animals in sporadic reports of ocular disease, but the Persian, Burmese, and Siamese are among the breeds repeatedly linked with one or more of these disorders.

Feline Corneal Disease

The cornea is naturally transparent. Anything that interferes with the cornea's stromal architecture, contributes to blood vessel migration, increases corneal pigmentation, or predisposes to corneal edema, disrupts the corneas transparency and indicates corneal disease. The color, location, and shape and pattern of a corneal lesion can help in determining the underlying cause for the disease. Corneal disease is typically divided into congenital or acquired disorders. Congenital disorders, such as corneal dermoids are rare in cats, whereas acquired corneal disease associated with nonulcerative or ulcerative keratitis is common. Primary ocular disease, such as tear film instability, adenexal disease (medial canthal entropion, lagophthalmus, eyelid agenesis), and herpes keratitis are associated with the majority of acquired corneal disease in cats. Proliferative/eosinophilic keratitis, acute bullous keratopathy, and Florida keratopathy are common feline nonulcerative disorders. Nonprogressive ulcerative disease in cats, such as chronic corneal epithelial defects and corneal sequestration are more common than progressive corneal ulcerations.

Feline corneal sequestra: a review of 64 cases (80 eyes) from 1993 to 2000

Feline corneal sequestrum is a common condition of the feline cornea. The purpose of this study was to provide a detailed description of the clinical features of the condition including the response to different management options and to assess the rate of recurrence. The medical records of 64 cases (80 eyes) of feline corneal sequestra that presented to the Animal Health Trust from 1993 to 2000 were reviewed. Fifty-two cases were reviewed retrospectively; 12 cases were assessed prospectively between April and September 2000 as part of a separate study. The Persian was the most frequently encountered breed and the mean age of affected cats was 5.6 years. At initial presentation, sequestra were unilateral in 58 cats and bilateral in 6 cats, 5 of which were Persians. Ocular discomfort and ocular discharge were common presenting signs, occurring in 42 and 36 eyes, respectively. Seventy-four eyes were managed surgically with keratectomy only (n = 44) or keratectomy followed by a graft procedure (n = 30). Sequestra recurred in 16 eyes in the study. There was no significant difference in the rate of recurrence between eyes that received a graft procedure (n = 5) and eyes that did not (n = 11) (P = 0.56). Complications following transection of conjunctival pedicle grafts were observed. Brown to black discoloration of noncorneal tissue and therapeutic biomaterials was observed, including discoloration of both viable and apparently nonviable grafted conjunctival tissue, small intestinal submucosa graft material and bandage contact lenses.

Effects of bovine lactoferrin on in vitro replication of feline herpesvirus

OBJECTIVE

To investigate the effects of bovine lactoferrin on in vitro replication of feline herpes virus (FHV-1) and to determine at what points during viral replication these effects occur.

SAMPLE POPULATION

Cultured Crandell-Reese feline kidney (CRFK) cells and FHV-1 strain 727.

PROCEDURE

Five concentrations of bovine lactoferrin (0.5, 1, 2, 5, and 10 mg/mL) were added at one or more of three time points during conventional plaque reduction assays: (a) uninfected CRFK cells were incubated in lactoferrin-containing medium for 30 min prior to viral adsorption; (b) virus was suspended in lactoferrin-containing medium prior to and during adsorption, or (c) CRFK cells were incubated with lactoferrin-containing medium for 48 h following viral adsorption. Plaques were counted and antiviral effect expressed as percent inhibition relative to control medium that contained no lactoferrin.

RESULTS

Exposure of CRFK cells to lactoferrin prior to or during viral adsorption inhibited FHV-1 replication by 87-96% (mean: 91%). Application of lactoferrin following viral adsorption had no appreciable effect on FHV-1 replication. No additive or synergistic effects were noted when lactoferrin was added at multiple steps. These effects were similar at all concentrations of lactoferrin tested. Cytotoxic effects of lactoferrin on CRFK cells were not observed at any concentration tested.

CONCLUSIONS AND CLINICAL RELEVANCE

Bovine lactoferrin has a notable inhibitory effect on the in vitro replication of FHV-1 prior to and during, but not following viral adsorption. These findings strongly suggest that lactoferrin inhibits FHV-1 adsorption to the cell surface and/or penetration of the virus into the cell. Clinical effects of topical lactoferrin in acute or recrudescent herpetic episodes in cats warrant investigation.

Mineralized corneal sequestrum in a cat

An 8-month-old 3-kg (6.6-lb) sexually intact male cat was evaluated for chronic refractory keratitis and a corneal plaque that developed after treatment with a corticosteroid-containing ophthalmic preparation. Pertinent ophthalmic findings included blepharospasm, conjunctivitis, corneal vascularization, and a tan raised corneal plaque with a dense and gritty composition. Lamellar keratectomy was performed to excise the plaque. The cornea healed with mild scarring. Histologic examination revealed extensive coagulation necrosis and mineralization of the corneal stroma with increased inflammatory cells, blood vessels, and fibrosis, which is compatible with a diagnosis of mineralized corneal sequestrum. The history suggested chronic feline herpesvirus-1 (FHV-1)-induced keratoconjunctivitis as the underlying cause. Topical corticosteroid administration may have potentiated the preexisting corneal necrosis and initiated mineralization. To our knowledge, mineralization of a corneal sequestrum in a cat has not been reported in a clinical case but has been reported in cats experimentally infected with FHV-1.

Lamellar keratoplasty for the treatment of feline corneal sequestrum

A lamellar keratoplasty was used to treat corneal sequestrum in four Persian cats (six eyes). Following a superficial keratectomy, lamellar corneal allografts (feline corneal tissue) or heterografts (canine corneal tissue) which had been preserved at -20 degrees C were placed in the recipient cornea. All grafts became optically transparent within 2 months following surgery and no recurrences of the sequestrum have been noted during the follow-up period (4-30 months). We conclude that feline corneal sequestrum may be successfully treated with feline or canine donor corneal tissue using this technique.

Corneoconjunctival transposition for the treatment of feline corneal sequestra: a retrospective study of 17 cases (1990-1998)

OBJECTIVE

To describe and evaluate the use of corneoconjunctival transposition as a surgical treatment for corneal sequestra in cats.

ANIMALS STUDIED

Fifteen cats (17 eyes) of various breeds and ages with corneal sequestra treated surgically with corneoconjunctival transposition.

PROCEDURE

Retrospective medical records study.

RESULTS

Median age was 39 months. Eight patients were castrated males, five were spayed females, and two were intact females. The left eye was affected in eight cats, the right eye was affected in five cats, and both eyes were affected in two cats. Mean (+/- SD) sequestrum diameter was 4.4 +/- 2.4 mm (range 1-10 mm) and the sequestrum was located centrally in all cases. Sequestra occurred in the superficial stroma in 8/17 corneas, in the anterior one third of the stroma in 3/17 corneas, and in the middle one third of the stroma in 6/17 corneas. Median duration of clinical signs prior to presentation was 39 days (range 14-1095 days). Median time to healing, defined as the number of days from surgery to cessation of medical treatment, was 34 days (range 25-86 days). There were no recurrences and minimal scar formation.

CONCLUSIONS

Corneoconjunctival transposition is a valid procedure for surgical treatment of corneal sequestra in cats. The procedure results in excellent cosmesis and functional vision with no recurrences.

Hereditary and congenital ocular disease in the cat

The aim of this review of hereditary and congenital ocular disease in cats is to present an overview of the most common disorders seen in this species, the pathogenesis of the problems and wherever possible, how they are treated. Several defects are common in breeds such as the Persian, Himalayan and Burmese cats and affect the anterior segment of the eye. Examples are agenesis of the eyelids, dermoids, entropion and corneal sequestrum. Other problems such as cataracts, lens luxation and retinal dysplasia, cause problems of the intraocular structures, but are less common in cats compared to dogs. Finally, various parts of the retina and in some diseases other parts of the eye, are specifically affected by hereditary diseases. Examples of these are lysosomal storage disease, Chediak-Higashi syndrome and progressive rod cone degeneration and rod cone dysplasia. Research of the latter two hereditary diseases, both described in the Abyssinian breed of cat, have made affected individuals important animal models for research into comparable diseases of humans.

Surgery of the cornea

Corneal surgery is a common and essential part of veterinary ophthalmology and ranges from simple linear keratotomy for indolent ulcers to penetrating keratoplasty for restoration of optical clarity. Success in corneal surgery relies on an understanding of corneal anatomy, physiology and wound healing, meticulous attention to detail, microsurgical equipment and techniques, and use of appropriate preoperative, intraoperative, and postoperative medications. Surgical management of corneal disease is indicated for corneal ulceration, excision of a mass lesion, reconstructive procedures, therapeutic indications, optical restoration, and cosmetic purposes.