In our clinic, we diagnose, manage, and treat all types of ophthalmological problems. Our veterinarian Kristi Sisask specialises and has completed in-depth training in ophthalmology. 

A visit to an ophthalmologist usually starts with a conversation with the patient’s owner or handler to gather the necessary information on the medical history, and is followed by several diagnostic tests. First, the specialist will ask you several questions about the onset of the problem and its course. During ophthalmological examination, the condition of the patient’s eyes is evaluated. Several diagnostic procedures may be performed, e.g. damage to the cornea is controlled using fluorescein eye stain test, lacrimation and intra-ocular pressure are measured, internal structures of the eye are evaluated. Depending on the results, further diagnostic procedures may be prescribed and a treatment plan developed. 

Glaucoma is a serious eye disease, where intra-ocular pressure increase may result in irreversible loss of vision and eye pain. Therefore, early diagnosis and treatment are essential, as these can help delay loss of vision for as long as possible.  Tonometry or measurement of intra-ocular pressure is done using a special apparatus. In our clinic, we use Tonovet and Tonopen tonometers. The procedure is fast and well tolerated by the animal, the results are immediately available. 

Gonioscopy is a method used to diagnose primary glaucoma.  During the procedure, irridocorneal angle or the anatomical angle between the eye’s cornea and iris is examined. Thus, the canals along which the aqueous fluid is moving inside the eye are examined using special equipment. As a rule, light sedation is needed to perform the procedure. Your veterinarian evaluates the necessity of the procedure. 

During this procedure, the eye is examined using a special eye microscope (biomicroscope). This examination helps determine small defects, eyelash abnormalities (ectopic cilia, dischitia), foreign body, evaluate the condition of eye anterior chamber, iris, and lens.

Eye fundus is examined using an ophthalmoscope to eliminate fundus diseases. It may be necessary to dilate the pupils to perform ophthalmoscopy, and therefore, pupil dilating eye drops are administered 20 minutes before the procedure. 

Eye ultrasonography is used if, for a certain reason, it is impossible to perform ophthalmoscopy to evaluate internal structures, or if tumours are suspected in the eye or orbital cavity. During eye ultrasonography, internal structures of the eye are evaluated. Animal does not usually require any sedation for the procedure. However, anaesthetic is administered to the eye before the procedure to make it more comfortable. 

Healthy and appropriately structured eyelids are necessary for normal functioning of the eye. The condition of the eyelids has to be checked if the animal suffers from eye squinting, lacrimation, and inflammations. The eyelid may be turned inward (entropium), be drooping and rolled outward (ectropium), or several problems may exist at the same time. Eyelid disorders cause reoccurring eye infections, corneal damage, pain, and even vision loss. Such patients need eyelid correction surgery. In more complicated cases, several surgeries may be necessary. The procedures are performed under general anaesthesia. The surgery is followed by a 2–3-week long treatment. The extent of the surgery is determined during individual pre-surgery examination.

The third eyelid protects the eye from trauma, drying, excessive light and impurities. The third eyelid prolapse makes it more visible, more susceptible to infections, and more painful. The condition may develop due to nervous system or internal disease.  The exact reason is determined during clinical examination in the animal clinic. The third eyelid lacrimal gland prolapse develops in dogs and, less frequently, in cats. It mainly occurs at a young age. Some dog breeds are predisposed to lacrimal gland prolapse (English Bulldog, Cocker Spaniel, and Pomeranean) in one or both eyes. It is related to the weakness of the connective tissue holding lacrimal glands together. One of the signs of the third eyelid prolapse is a pink or reddish formation, similar to a berry (therefore, it is named “cherry eye”), in the inner corner of the eye (as seen in the picture). The prolapsed lacrimal gland is placed back and is fixed. 
Dogs of large breeds and less frequently cats may suffer from the third eyelid turn. In this case, the deformed part of the eyelid is removed to normalise the eyelid position.  
These procedures are performed under general anaesthesia.

They are followed by a 2–3-week long post-operative treatment.  

Cornea is the layer covering the front of the eye. Normal cornea has to be transparent and without any patches. Trauma, irritation, and bacterial infections may cause corneal ulceration. The treatment depends on the extent of the damage. It is frequently sufficient to administer medication directly into the eye, however, sometimes oral medication is also required. In case of more severe damage, when there is a risk of rupture or cornea penetrating ulcer, it may be necessary to suture it. Thus, the animal’s own conjunctival, corneal, or artificial corneal tissues are used. The procedures are performed under general anaesthesia. These are followed by a 3–9-week course of medication. 
In certain cat breeds, especially Persian cats and British Shorthairs, corneal dystrophy (necrosis, sequestrum) are common. The symptoms include eye squinting, lacrimation, and light or dark brown patches on the cornea. Grey-reddish infected area may develop around those patches. The exact cause of necrosis remains unknown. Herpes virus infection is suspected to be the initial cause of the disease. Additionally, certain breeds are predisposed to rolling of the eyelid, which may result the drying of the cornea and lead to the conditions described above. At the initial stage, necrosis and corneal infection are managed using eye drops.  However, this method may not always be successful, and then, necrotic tissue has to be surgically removed. The procedure is performed under general anaesthesia. It is followed by a 3–8-week course of medication.

In cases of reoccurring eye pain or irreversible loss of vision, e.g. as a result of glaucoma, it may be recommended to remove the eye and replace it with a prosthesis to alleviate pain and improve pet’s quality of life. 
Prosthetic eye is cosmetically more appealing and allows the animal to move and blink the eye. 
Intrascleral prosthesis is a black silicone ball of the size of the normal eye. The prosthesis is placed into the eye through the opening made in the sclera. Thus, eyelid, conjunctiva and cornea are preserved. The surgery is performed under general anaesthesia. It is followed by a 3–6-week course of anti-inflammatory medication. After the surgery, the eye has to adapt to the prosthesis, and therefore, it is normal if infection develops: cornea turns greyish-red, conjunctiva becomes swollen and reddens, the animal may squint the eye. All the symptoms gradually disappear. Finally, cornea will remain grey and afterwards turn brown, but reddening and pain will disappear.
This surgery is performed on cats, dogs, and horses.
Possible complications include rejection of the prosthesis, as well as chronic treatment resistant infection and pain. These complications are relatively rare. In case of complications, eye removal may be considered. 

Conditions requiring first aid:

•    Eye squinting for more than 2 hours
•    Wound in the eye area
•    Eye trauma caused by a cat 
•    Sudden eye increase
•    Falling out of the eyeball
•    Bleeding in the eye
•    Eyelid wound

Emergency care provision

First of all, it is necessary to contact your veterinarian or call our clinic to get consultation and advice. 
As a rule, any general veterinarian may provide ophthalmologic emergency care and, if necessary, further refer the patient to an ophthalmologist to perform more specific procedures.

Ophthalmologic emergency care at home

•    Contact your veterinarian to get recommendations and advice.
•    Rinse the eye with saline solution, special eye rinse, or clean tap water by putting 4–6 drops into the eye, gently swabbing with a cotton pad and removing crust around the eye.
•    Avoid any pressure to the eye.
•    Prevent the animal from rubbing and scratching the eye. Put on a collar if necessary. 
•    Do not administer any medication if not prescribed by the veterinarian.
•    Contact the veterinarian as soon as possible.