Zak is a young adult, neutered male Labrador retriever. Not much is known about him. He was found tied to the door of a veterinary clinic (a long way from here) one morning late in July. They neutered and vaccinated him and treated an irritated eye with topical medications. The new owner has had him for about 2 weeks. He has been generally doing well except for the left eye that has a large amount of discharge that has not changed much with the medications. He holds the eye open and does not paw at it. On physical examination he is a very nice and happy dog in good body condition. Except for the left eye he appears generally healthy. The left third eyelid seems very red and irritated, possibly even ulcerated on the outer surface. The eyeball is not significantly red or irritated. There is a large amount of mucopurulent discharge. The corneal surface does not have evidence of damage and the tear production is normal. The eyelids roll in a little but this resolves with some topical anesthetic application. Even with the topical anesthetic he will not allow a look behind the eyelids.
What is the next step? What are you suspicious of and checking for?
The next step is to sedate Zak and take a good look behind the eyelids. Foreign material must be high on the list of considerations given how long this has been going on. Significant trauma, abscess and tumor must also be considered. This has been going on long enough that this next step needs to be performed.
Zak was moderately sedated and topical anesthetic placed in the eye. Atraumatic forceps and cotton swabs were carefully used to lift the lids and examine the structures. Almost immediately the problem was seen to be in the third eyelid. A small black foreign body was present on the outer surface. Upon closer examination it was actually a little longer. Using forceps, an approximately 1.5cm thorn was pulled from the third eyelid.
The thorn had penetrated into the central portion of the third eyelid. As the eye was flushed it was discovered that the thorn completely pierced the third lid. Around this hole was a large amount of inflammation.
Ocular foreign bodies are relatively common in dogs, especially later in the year as there are many seeds around and hunters are more active. These foreign bodies can cause serious trauma to the eye.
One uncommon thing in this case was that Zak was holding the eye open normally and did not seem particularly bothered by it. Usually dogs will squint and rub at the eye.
Zak was treated with pain medications and both oral and topical antibiotics. He is now doing very well.