Refractory superficial corneal ulcers are common in middle-aged and older canine patients. Referred to as boxer ulcers, indolent ulcers, or recurrent epithelial erosions, this refractory lesion is characterized by a chronic epithelial defect that persists despite conventional medical therapy. Affected dogs are typically over 5 years of age but may be of any breed or either sex. Boxers, poodles, golden retrievers, corgis, and dachshunds are commonly affected breeds seen in our practice. Decreased hemidesmosome numbers and abnormalities in the basement membrane of affected dogs prevent epithelial-to-stromal attachment. Ultrastructural abnormalities observed in the basement membrane of Boxers suggest that an epithelial dystrophy is responsible in that breed. Studies in other canine breeds also have identified changes in biochemical composition of the basement membrane that could inhibit normal binding and function. When treated conventionally, erosions will persist for extended periods. In previousreports, healing times ranged from 14 to 180 days, in contrast to the 5 to 7 days expected for healing of a simple superficial ulcer. Perhaps the most important part of recurrent erosion management is to prepare owners for a lengthy treatment regimen!
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