Ophthalmology

Diagnostics We Use/Services We Provide

Diagnostics

At CARE ophthalmology, we use state-of-the-art equipment to perform a complete ophthalmic exam for your pet. Some of the equipment used during the exam might include:

• Slit lamp biomicroscopy – Slit lamp examination of the eye allows a magnified, high-resolution view of the anterior structures of the eye (e.g. eyelids, cornea, anterior chamber, iris, pupil, lens) to look for any abnormalities.
• Indirect ophthalmoscopy – This technique allows a detailed view of the back of the eye, including the vitreous, retina, and optic nerve. This allows us to examine the structures that are most important for vision.
• Tonometry – Tonometry is a way to measure the pressure inside of the eye. This is commonly performed to check for the serious disease of glaucoma that can lead to blindness.
• Schirmer Tear Test – Dry eye is a very common condition in dogs that can lead to pain, corneal ulceration, and ultimately vision loss. Schirmer tear tests are performed to check for dry eye.
• Fluorescein stain – A corneal ulcer is a serious and painful condition of the eye that requires immediate attention. Fluorescein stain is used to help diagnose a corneal ulcer so we can begin treatment.

At a specialty facility such as CARE, we have access to many modern diagnostics that can be performed with intricate/complicated ophthalmology cases. Some of these diagnostics include:

• Ocular ultrasound – When the back of the eye is difficult to assess, ocular ultrasound can be used to examine the vitreous, retina, and optic nerve to evaluate these structures for disease.
• Electroretinogram (ERG) – ERG testing assesses retinal health in cases when the retina cannot be seen, such as when cataracts block our view (especially before cataract surgery to ensure the retina is functioning properly). We use it also to distinguish cases of blindness caused by an issue in the eyes from blindness caused by an issue in the brain.
• CT Scan Imaging – In tissues behind and around the eye where we cannot see clearly with simple X-ray, we commonly perform a CT scan to evaluate the soft tissue fully.
• Chest X-rays, abdominal ultrasound and bloodwork – Some systemic diseases will first present in the eyes. In these cases, a systemic workup to look for the underlying issue in the body may be necessary. Such workups may include bloodwork, chest X-rays and abdominal ultrasound.

Services

Procedures and surgeries offered within the ophthalmology service at CARE include:

• Phacoemulsification – Phacoemulsification uses ultrasound waves to break up the cloudy cataract for removal so an artificial lens can be placed. The procedure is painless and can restore great vision to our patients.
• Laser and valve procedures for glaucoma – We use a new technology known as Endolaser Cyclophotocoagulation that involves precise, accurate lasering of the cells responsible for causing the high pressure in the eye. In many cases, we will combine this laser procedure with a drainage valve procedure (gonioimplant) to facilitate drainage of fluid from the eye to lower the pressure. The combination of these two surgeries has been shown to be the best option to control the pressure long term and preserve vision/comfort. See the FAQ below for further information.
• Laser and surgical removal of eyelid tumors – These tumors will cause swelling/bleeding and may cause a corneal ulcer from constant rubbing.
• Correction of eyelid abnormalities – We treat issues such as entropion (inward rolling of the eyelid), dermoids (abnormal growth of haired skin on the cornea/eyelid) or eyelid agenesis (where a portion of the eyelid never developed at birth).
• Permanent correction of eyelash and abnormal hair growths – Surgery or alternative methods (e.g., cryotherapy) are commonly used to preserve the eyelid and eyes while permanently resolving the painful hairs.
• Resolution of non-healing corneal ulcers – Non-healing ulcers, also known as Spontaneous Chronic Corneal Epithelial Defects (SCCED), “boxer ulcers” or “indolent ulcers” are seen daily at CARE. Intervention can relieve the risk of developing an infection, losing vision or potentially losing the eye.
• Correction of cherry eye conditions – A prolapsed gland of the third eyelid (also known as a “cherry eye”) can lead to chronic irritation, inflammation, dry eye, and vision loss over time. Surgery carries a very high rate of success and patients generally go home the same day as if nothing happened!
• Blind/painful eyes – Our primary goal at CARE is to save/restore vision if possible. When blindness does occur, our main focus is comfort. See our FAQ below for options for addressing corneal ulcerations/perforations, glaucoma, cancer in the eye etc. in our blind patients.