Corneal lacerations can result from similar causes as penetrating foreign bodies except the object is not retained. For example, cat claw injuries and metallic objects are common causes of full-thickness lacerations in small animals and horses, respectively. Clinical signs and diagnostic testing are similar to those for a penetrating intraocular injury; it is particularly critical to assess the lens for concurrent involvement. Prognosis depends on size and position of the corneal laceration as well as involvement of the iris, lens, and/or sclera with concurrent iris prolapse, with lens injury and/or scleral involvement tending to have a poorer prognosis.
A dorsal, perilimbal corneal laceration with iris prolapse and mild reflex uveitis of short duration, with a favorable prognosis if primary surgical closure is performed.
Courtesy of Dr. K. Gelatt.
Large, ventral corneal laceration with intraocular hemorrhage and retinal detachment (by B-scan ultrasonography) would not result in restoration of vision even if repaired; enucleation should be considered in cases such as these with a grave prognosis for vision and comfort.
Courtesy of Dr. K. Gelatt.
A large, full-thickness corneal laceration with moderate edema is observed in the central cornea of the right eye of a cat.
Courtesy of UC Davis Comparative Ophthalmology Service.
A large, full-thickness corneal laceration with moderate perilesional edema in the central cornea of the right eye of a cat has been surgically repaired with 9-0 vicryl using simple, interrupted sutures and an overlying simple, continuous suture pattern.
Courtesy of UC Davis Comparative Ophthalmology Service.
In patients with vision, the corneal laceration is apposed with simple interrupted 7-0 to 9-0 absorbable sutures; a continuous suture line may be placed for additional stability. To provide additional protection and support, the sutured laceration may be covered with a bulbar conjunctival graft and/or partial temporary tarsorrhaphy. If the patient is blind, enucleation should be considered, although some owners may elect for surgical repair for cosmetic purposes.
Postoperative therapy to control the secondary iridocyclitis consists of topical and systemic antibiotics, systemic NSAIDs, and mydriatics. Postoperative therapy is similar to that of penetrating intraocular foreign bodies and includes topical and systemic antibiotics to prevent infectious keratitis or endophthalmitis, respectively, as well as systemic anti-inflammatories and topical mydriatics to address the reflex anterior uveitis.
Postoperative complications include:
variable and often dense corneal scarring
cataract formation with posterior synechiae
secondary glaucoma
phthisis bulbi
bacterial keratitis or endophthalmitis
For More Information
Also see pet health content regarding corneal injuries in animals.