The first forty-eight hours

摘要

True ophthalmic emergencies, in which the failure to diagnose and treat within the first 24-48 hours would result in irreversible damage do exist. Cases occur in which the animal's discomfort should be relieved even though the disease is not a majorthreat to the eye. More cases exist in which the presenting signs of a disease not needing immediate attention are similar to a disease that does. Cases are also presented as an emergency that are really only the end result of a chronic problem. A change in the animal's environment ("acute" blindness), a change in ambient light (dilated pupil, cataract, increase eye shine), or a recent trip to the groomer (cloudy eye, red eye) may all result in "emergencies" or acute eye problems in the mind of the owner. It is the job of the emergency clinician and staff to identify the true emergencies then institute appropriate therapy. This presentation will discuss only the emergency condition. Diseases such as anterior uveitis, glaucoma, and corneal ulceration will be only discussed as they relate to emergency cases. Only the author's choice of treatment will be discussed, which is not to imply other approaches are without merit. Treatment will be described for the management of the case for the first 48 hoursand not the long term follow-up or sequela. Recommended therapy is made under the assumption that no contraindications exist due to systemic or life threatening concomitant conditions. The successful management of many cases assumes the clinician has theproper instrumentation such as surgical instruments and diagnostic equipment including magnification. The availability of suitable materials such as proper suture material is also assumed. Some ophthalmic emergencies are best referred to a veterinary ophthalmologist if one is available on an emergency basis. Most ophthalmic emergencies are presented for one or more of four conditions; known trauma, signs related to ophthalmic pain, redness, or acute blindness. Our discussion will proceed with these four classifications.