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Specialist-led veterinary ophthalmology care is now available at The Pet Vet's Waltham Forest surgery, saving London-based pet owners the need to travel to Optivet's specialist hospital in Hampshire for advanced ophthalmology treatment.
The Pet Vet and Optivet will remain fully independent organisations, with Optivet delivering specialist ophthalmology services within The Pet Vet surgery.
Optivet London will be led by Dr Gemma Turner BSc DVM MANZCVS FANZCVS MRCVS, Specialist in Veterinary Ophthalmology, working in collaboration with The Pet Vet Waltham Forest Head Vet, Dr Katarina Krasna MVDr CertAVP MRCVS.
Optivet's services will cover a wide range of ocular conditions including distichia and ectopic cilia correction, entropion surgery, medial canthoplasty, superficial keratectomy, corneal crosslinking, cataract surgery, retinal reattachment surgery, enucleation and evisceration, orbitotomy procedures, and retrobulbar abscess management.
Optivet.com
Richard completed his specialist training at the Royal Veterinary College and remained there for a further year as a clinician before spending seven years gaining referral experience at a multi-disciplinary referral hospital in Surrey.
From the Sevenoaks hospital he provides ophthalmology services including cataract surgery, corneal ulcer management, treatment of feline corneal sequestra, tear film disorders such as keratoconjunctivitis sicca (KCS), and emergency ophthalmic cases.
South East Veterinary Referrals has installed a Zeiss operating microscope to support procedures including cataract removal, corneal ulcer repair and corneal transpositions.
Richard said: "Eye problems in dogs and cats can progress rapidly.
"Cataracts linked to diabetes, deep corneal ulcers, or trauma can threaten sight within days.
"Until now, many complex cases in Kent had to be referred many miles away.
"SEVR provides a seamless pathway for assessment and surgery, whilst ensuring pets return to their first referral vet for follow-up care when appropriate."
www.southeastvetreferrals.com
Phacoemulsification uses ultrasonic energy to emulsify and remove the cataract through small incisions on the eye, instead of requiring ophthalmologists to open 180 degrees of the eye.
It also allows for the placement of an artificial intraocular lens for the best possible visual outcome for patients.
This, says Chestergates, significantly reduces recovery time and complication rates compared to traditional methods.
Chestergates has invested over £130,000 in human-grade ophthalmic technology for its phacoemulsification patients, including an Alcon Centurion Vision System with Active Sentry Handpiece, a next-generation operating microscope, portable electroretinography (ReteVet), a Chromatic Pupillary Light Reflex (CPLR) tester and high-frequency ultrasound probes for ocular imaging.
Endika said: “Chestergates is one of the few specialist veterinary hospitals in the region to offer this new technique.
"It allows for safer, more precise removal of cataracts and placement of artificial intraocular lenses - restoring vision with minimal recovery time.
"We hope it will be of great benefit to pets suffering from cataracts across the region.”
Chestergates is offering fixed pricing for its new cataract surgery service using phacoemulsification.
The cost is £4,550 for one eye and £5,550 for both eyes, including all preoperative tests (electroretinography, gonioscopy, ultrasound, blood work), surgery, 24-hour hospitalisation, take-home medications, and 8 weeks of postoperative care.
In a survey conducted for the company last year, 31% of pet owners said they would wait 3 days or more before going to a vet if their pet's eye condition hadn’t improved.
The awareness week is designed to make owners more aware of their animals’ eye health, to help understand the signs and when to take action.
The campaign also offers support for veterinary practices to engage with their communities with educational displays and digital outreach.
Dr Emma Hancox, Technical Vet at Dômes Pharma said: “We know that pets often suffer in silence when it comes to eye issues, and it’s often hard for owners to recognise the signs.
“Through this campaign, we aim to equip veterinary professionals with the tools they need to educate pet owners and ultimately help to improve pet eye health across the country.”
Participating clinics can request display materials and shareable content for social media to drive engagement throughout the awareness week.
There is also a prize draw to win an ophthalmoscope for your practice.
https://domespharma.co.uk/national-pet-eye-health-awareness-week
Dogs with RVED develop retinal degeneration from around four years of age which, if untreated, leads to blindness.
In partnership with James Oliver, Head of Ophthalmology at DWR Veterinary Specialists (pictured), researchers set out to discover why some Cocker Spaniels have such low vitamin E levels in their blood, despite it being present at normal amounts in their diet
James helped to design the study, recruit cases and collect samples.
Cathryn Mellersh, Senior Research Associate at the Canine Genetics Centre, said: “The team strongly suspected a genetic cause and has been trying to discover the responsible gene for several years with the help of owners and vets, who have contributed DNA samples.
“Thanks to updated information on the canine genome, Katherine Stanbury, one of our research associates, found a mutation in the alpha tocopherol transfer protein gene which is causative of the disease.
“This gene is responsible for getting vitamin E into the blood stream.
"We now know that RVED is a recessive disease, meaning that affected dogs must have two copies of the faulty gene to develop low vitamin E levels and retinal degeneration.”
The team’s DNA test can be used by dog breeders to find out if dogs carry the gene mutation, so they can avoid matings which result in affected puppies being born.
Cathryn said: “This DNA test is a rare example of one which not only can be used to identify dogs that are carrying the mutation and thus reduce the frequency of the mutation in future generations, but also has the incredible benefit of providing a sight-saving treatment option for dogs with the disease.
“From the research we have done we estimate that there could be several hundred Cocker Spaniels alive today that have two copies of this mutation, whose eyesight could be saved by this test.”
A DNA test for the mutation that causes RVED is now available from Canine Genetics Testing, which operates alongside researchers from the Canine Genetics Centre.
www.cagt.co.uk.
The team’s RVED research can be viewed at https://academic.oup.com/g3journal/advance-article/doi/10.1093/g3journal/jkaf016/7985679?searchresult=1
The device emits low dose 265 nanometre (nm) ultraviolet C light at a targeted area.
In a 2022 in vitro / ex vivo study to evaluate the therapeutic potential of 265nm UVC for infectious keratitis1, UVC was found to inhibit all tested bacteria and fungi, including mixed culture and strains linked to antibiotic resistance.
In the study, no evidence of infection was found from 4 hours onwards, ulcers responded significantly in under 24 hours, and at the end point, those treated with UVC performed as as well as those treated with ciprofloxacin.
Photon Therapeutics says that in simple cases, one five-second treatment will suffice, but more complex cases can be re-treated after 24 hours.
Currently, there are two main barriers to the successful treatment of eye infections in dogs.
The first is the difficulty diagnosing the infection and identifying the right antimicrobial to use, highlighted by a 2017 study: Bacterial Isolates from Canine External Ocular Disease and their Antimicrobial Sensitivities 2.
The second is whether the owner is able or willing to administer a topical treatment.
Here the evidence suggests that even when treatment is possible, people do not comply with clinical advice anything like as much as they claim.
Photon Therapeutics points to what it says is the nearest study there is, in which carers of young children with uveitis did not give the correct treatment in 75% of cases3.
If the device is as effective as claimed, then both these issues simply evaporate.
PhotonUVC costs £4,995.
https://photon-therapeutics.com
VetNurse.co.uk product briefing: https://www.vetnurse.co.uk/nursing/m/veterinary-product-briefings/156724
References
PhotonUVC Vet is a non-contact treatment which emits low dose ultraviolet C light at a targeted area.
Photon Therapeutics says the device kills bacteria, viruses, fungi and other infecting organisms while being safe to host tissues.
Other claimed benefits of the device are that it avoids client compliance issues associated with eye-drops, it eliminates the need for antibiotic eye drops, and it is very simple to learn how to use.
The device costs £4,995.
To explain more about The PhotonUVC Vet, Dr. Simon Dean. MBChB, MSc, FRANZCO, FBCLA Chief Scientific Officer at Photon Therapeutics, and Dr. Mark Leddy BVSc, MBA, CEO, will be delivering a CPD presentation at the Exhibitor Showcase Theatre 3: "5 Amazing Seconds – A New Transformative Treatment for Corneal Infections", on Thursday 14th November at 3pm.
There is also a launch event reception at the stand from 16.15 to 18.15 on Thursday 14 November.
https://photon-therapeutics.com/
LacriProtect is designed to increase the depth of the tear film in the management of dry eye, during anaesthesia, or in case of irritation.
It contains a carbomer-based formula in individual, resealable single-use pipettes, so that each application is hygienic and free from cross-contamination.
This, says Samaxia, is particularly useful in clinical settings.
Lacri+ contains 0.4% cross-linked sodium hyaluronate and urea, and is designed to hydrate, lubricate and protect the ocular surface.
It comes in a multi-dispense bottle with a tip-seal mechanism and multilayer filtration to ensure sterility and give a shelf life of three months after opening.
https://www.samaxia.com
The materials include a social media toolkit and a board kit, both designed to encourage owner awareness and more frequent conversations on eye health.
There is also a new CPD module, focused on ophthalmology.
The company is running a webinar on 24th September which focuses on management of dry eye and corneal ulcers for brachycephalic dogs
Campaign materials & VPD module: https://www.tvm-uk.com/national-pet-eye-health-awareness-week
Webinar: https://thewebinarvet.com/webinars/take-a-closer-look-big-eyes-big-problems-ocular-issues-of-the-brachycephalic
The new product, which is for the management of any condition where eye health is supported by providing additional moisture or lubrication, is suitable for dogs, cats, horses, rabbits and other animals.
Oculeze contains glycerine (0.8%), Aloe vera, chamomile and propolis extract, the latter of which contains polyphenols which Millpledge says have been shown to support corneal health by multiple mechanisms of action including modulation of the tear film and a reduction in inflammation, apoptosis and oxidative stress1.
Millpledge says Oculeze lasts longer on the ocular surface than non-lipid lubricants2 because it evaporates more slowly3.
This prolonged action means fewer administrations, which should help client compliance.
Oculeze comes in two sizes - a 10 millilitre bottle and a pack of ten resealable 0.6 millilitre vials, suitable for short term use and travel.
The 10ml bottle includes a filter, preserving sterility for up to three months after opening.
Oculeze is available direct from Millpledge or from your usual wholesaler.
https://millpledge.com/shop/oculeze
sales@millpledge.com
Snowflake previously had a squamous cell carcinoma mass on the right lower eyelid, which was completely removed in 2018.
However, her owner noticed an abnormal growth in the left eye, and brought her back to the RVC.
On presentation, Snowflake was bright and in good body condition, weighing 71kg.
Both eyes were open and appeared comfortable and visual.
Ocular reflexes and responses were also present as expected and there was no evidence of recurrence of the squamous cell carcinoma on the lower right eyelid.
Snowflake was, however, diagnosed with mild cataracts in her right eye deemed unlikely to interfere with her vision.
In addition, the mass of her left third eyelid was nonpigmented and displayed a poorly defined mass-like lesion, with an irregular surface on the leading edge, appearing consistent with a squamous cell carcinoma.
The team, led by Dr Maria-Christine Fischer, Lecturer in Ophthalmology, Dr Sara Lawrence-Mills, Senior Clinical Training Fellow in Anaesthesia, and Dr Carolina Palacios Jimenez, Lecturer in Anaesthesia, decided to undertake surgery.
They removed the third eyelid under sedation and applied local anaesthetic blocks and topical tetracaine eye drops.
Cryotherapy was then applied to the wound edge as an adjunctive therapy.
The RVC says that to date, there are few publications detailing anaesthesia in reindeer and so this protocol was a novel approach to maintaining a safe level of sedation in a well-domesticated animal.
The College added that the use of these nerve blocks to facilitate ophthalmic surgery has not been reported before and is in the process of being published.
Snowflake’s third eyelid was submitted for histopathology, which confirmed the diagnosis of squamous cell carcinoma, which the team at the RVC was able to remove completely.
During the process, Snowflake’s daughter was with her so they both remained calm, and she has now made a full recovery and has enjoyed being reunited with her herd.
Maria-Christine said: “Snowflake had a cancerous mass on her third eye lid.
"Surgical removal of the third eyelid in a reindeer has not been reported before.
"We were pleased that we could perform the surgery with Snowflake under a standing sedation and with using local anaesthetics.
"As an ophthalmologist, I am committed to preserving vision so it’s rewarding that we were able to completely excise the tumour and did not have to remove the eyeball. It’s a very good outcome.
"I’m also pleased that Snowflake recovered quickly from the procedure, and we were able to share the protocol of the sedation and the local nerve blocks with other vets via a scientific publication.
"Sharing our knowledge will hopefully be beneficial for future ophthalmic surgeries in reindeer.”
* aka Mr Nick Dean.
The new Chestergates ophthalmology service will offer a wide range of treatments for eye conditions, including: cryotherapy, corrective lid surgery, rhytidectomy, nasal fold ablation, cherry eye and scrolled cartilage, keratotomy, keratectomy, pedicle conjunctival graft, corneo-conjunctival transposition, bioimplants for corneal reconstruction, glaucoma diagnosis and monitoring, management of dry eye (KCS) and neurological dry eye, retro-bulbar disease investigation and treatment, cataract assessment, and intracapsular lens extraction.
The service will be led by Chestergates Advanced Practitioner in Ophthalmology, Endika Garcia MRCVS DVM PGCertSAOphthal.
Endika graduated in 2016 from the University of Valencia, completed a rotating internship, then worked for a few years in different hospitals in Spain, before moving to the UK, enrolling on the BSAVA Certificate in Small Animal Ophthalmology and being awarded Advanced Practitioner status.
Endika will be supported by a 25 strong specialist nursing team, four nurse students, one lab technician, two sterile technicians and a team of receptionists and support colleagues.
Consultations and surgical procedures will be offered at Chestergates Veterinary Specialists on Mondays and Thursdays between 8am and 5pm.
https://chestergates.org.uk/referral-services
Remend Corneal Gel is used to aid the healing process of superficial corneal ulcers in dogs, cats and horses while Remend Dry Eye Lubricant Drops is designed to give long-lasting moisture and lubrication for dry eyes in dogs.
https://www.tvm-uk.com
To help veterinary practices engage with pet owners and help them understand the importance of eye health, TVM has produced a range of free educational materials including waiting room displays, informative web pages and social media packs.
The company has also published a page of information at www.tvm-uk.com/eyehealth – where pet owners can find out more about eye problems, how to spot them and learn what can be done about them.
Emma Hancox MRCVS, Veterinary Advisor at TVM said: "It can be easy for owners to miss the signs of problems with their pet’s eyes, but they can be extremely distressing for animals and be a sign of conditions ranging from cataracts and glaucoma through to conjunctivitis - all of which can be painful, and in the worst-case scenario, lead to blindness.
"We hope that National Pet Eye Health Awareness Week will help practices assist owners in understanding the importance of eye health and prevent more serious conditions occurring."
To request your board kit and pet owner leaflets, and download your free social media pack, visit www.tvm-uk.com/eyehealth or contact your Territory Manager.
Ceva says the aim of the course is to enable vet nurses to get the most out of their ocular exams and gain confidence in identifying ocular lesions associated with feline hypertension.
The course is presented by Dr Ben Blacklock BVSc (Hons), Dipl. ECVO, MRCVS, senior lecturer in veterinary ophthalmology at the University of Edinburgh.
It comprises of 10 short videos grouped into four sessions, along with a self-assessment quiz to consolidate learning for each module.
The course counts for a total of two hours’ CPD.
Course content includes: the patient/equipment set up and getting the most from an ophthalmoscope; determining what is normal and what is abnormal during ocular examinations; an overview of ocular pathologies associated with hypertension; avoiding common pitfalls and mistakes; and hints and tips on how to take photographs of the fundus on a mobile phone.
To register, visit www.veterinarywebinars.com/community/ceva.
The ophthalmology service, which offers cataract surgery, corrective eyelid surgery and corneal disease management amongst other things, is headed by RCVS and US Ophthalmology Specialist, James Histed (pictured right)
The hospital, which has doubled in size to 30,000ft², now has a purpose-built theatre complex, a new reception and waiting area, 12 additional consulting rooms and a new rehabilitation centre equipped with a water treadmill and a large arena for treatment and gait analysis.
It also has a new lecture theatre where SCVS can deliver its CPD programme and parent company IVC can deliver its intern and residency programme.
The company says that its redevelopment has focused on employee wellbeing, to which end there is a new staff area for the 200-strong team a place to gather, dine and relax.
Kennel space for staff dogs has also been increased to support SCVS’s ‘bring your dog to work’ policy.
The new hospital facility is fully operational and open 24/7 for referrals, supporting colleagues from surrounding vet practices.
www.scvetspecialists.co.uk
To help practices make the most of the week, TVM is providing waiting room displays, client leaflets, social media packs and online information to help educate pet owners on the symptoms of poor eye health.
The company will also be holding an webinar for vets and nurses which will be published during the week.
Will Peel, Product Manager at TVM said: "Eye problems in pets are common and brachycephalic breeds are particularly prone to them due to a number of compounding factors.
"They commonly suffer from corneal ulcers and are nearly four times more likely to develop dry eye than other breeds, so Pet Eye Health Awareness Week is focused on helping pet owners understand the issues, identify eye problems early and seek veterinary advice quickly".
www.tvm-uk.com/eyehealth
The new technique enables the surgeon to suspend a modified acrylic lens from a damaged capsule, which has historically not been possible.
Gary and Chris have published a paper analysing the results of the surgery in the Journal of Small Animal Practice: "Post-operative outcomes in canine eyes receiving a rhexis-fixated prosthetic intra-ocular lens: 30 cases (2014-2020)1"
Surgery was carried out in a total of 30 eyes using a modified acrylic IOL, where the lens capsule could not accommodate a conventional prosthetic endo-capsular IOL.
Over a follow-up period from three to 76 months, 26 of the 30 eyes remained visual.
Chris said: “It’s a novel technique for implanting a prosthetic lens into the eyes of patients who otherwise may have not been suitable for surgery, either saving or restoring their sight.
“Gary developed a method of modifying the lens to fit in the eye in dogs where the lens capsule is damaged.
For more information, visit www.veterinaryvision.co.uk.
Reference
James says he is sticking his neck out after seeing a significant increase in cases where dogs with diabetes are referred too late to save their sight.
He said: “If we are given the chance to assess a dog with diabetes as soon as cataracts develop then it is usually pretty straightforward to restore vision with a specialist operation.
“Often, diabetic dogs are referred to us too late because vets unwittingly delay referral while they enhance control of the diabetes.
“Unfortunately, this can mean it can become too late to perform sight-saving surgery and the dog may even have to have their eyes removed on welfare grounds.
“When cataract surgery wasn’t commonplace and as successful, maybe 20 years ago, there was more of a justification to delay surgery. But that isn’t necessary now with advances in veterinary care.
“It’s why it’s so important to improve education about this issue and raise more awareness of what can be done to both vets and dog owners alike.”
Corneal ulceration is a condition that affects up to 0.8% of cats and dogs in the UK1.
It can have a number of causes such as trauma, foreign bodies or underlying ocular pathology such as tear film insufficiency.
Helen Harrison MRCVS, Veterinary Advisor at TVM, said: "Keratomalacia, or corneal melting, may develop as a complication of an existing corneal ulcer due to the uncontrolled action of proteolytic enzymes.
"This can lead to corneal perforation and permanent loss of vision.
"Management of keratomalacia requires prompt and aggressive medical treatment to arrest corneal destruction.
"Anti-collagenases, anti-microbials and analgesia are the mainstay of medical therapy, with surgical intervention also indicated for cases requiring tectonic support.
"In addition, certain patients (such as brachycephalic breeds) are more at risk of keratomalacia occurring, therefore anti-collagenases should be considered pre-emptively as part of the treatment plan."
Stromease, which TVM says is the first and only licensed product of its type, contains the active ingredient N-acetylcysteine.
It does not require any prior preparation or special storage.
Presented in a 5ml bottle, Stromease has a three-year unopened shelf-life.
The licensed dose is two drops into the affected eye(s) 3-4 times daily.
Will Peel, TVM’s product manager said: "Traditionally vets have had to rely on ‘home-made’ anti-collagenase preparations which can be time-consuming to prepare, difficult to store correctly and inconvenient to use.
Stromease is a licensed, anti-collagenase treatment option for corneal ulcers dogs and cats, presented in a user-friendly format."
For more information visit: www.tvm-uk.com/cornealfocusrange or ask your territory manager.
Registration will start at 9am, with the first lecture from 10am.
As usual, abstracts will be presented during the day, and there's an exhibition to visit during breaks and lunch.
Hot ophthalmology topics such as rhytidectomy and facial reconstruction will be discussed, with lectures presented by renowned veterinary and human ophthalmologists.
The day will end with a Q&A session where all lecturers will take part.
There is a reduced price of £90 for vet nurses to attend.
For more information, visit https://bravo.org.uk
Led by the RVC’s VetCompass Programme, researchers say the study1 was the largest exploration of cherry eye in dogs in the world.
The research team followed the anonymised veterinary health records of 905,553 dogs for a year and identified that 0.20% (1,802 dogs) were affected by this condition.
Certain breeds showed showed significantly high proportions of dogs with cherry eye, including: Neapolitan Mastiffs (4.9%), English Bulldogs (4.8%), Lhasa Apsos (1.6%) and American Cocker Spaniels (1.5%).
Importantly, say the researchers, some popular designer breeds of flat-faced dogs were also hugely affected, such as the Puggle (Pug x Beagle) (2.1%) and Jug (Jack Russell Terrier x Pug) (1.2%), suggesting the recent craze for designer crossbreeds does not eliminate health issues associated with the parental pure breeds.
Overall, brachycephalic breeds had 6.9 times the risk of cherry eye compared with dogs with medium skull length, with the Neapolitan Mastiff at the top of the league table with a risk factor of x34.
Other findings from the study included:
Dr Dan O’Neill, Associate Professor in Companion Animal Epidemiology at the RVC and lead author of the paper, said: “Given that humans designed dog breeds in the first place, we all carry a heavy responsibility to constantly improve our designs to breed away from poor health for these dogs.
"The hugely increased risks of cherry eye in popular flat-faced breeds such as English Bulldogs suggests that we have some way to go before we can consider many flat-faced breeds as designed for optimal health.
"The findings from this study will hopefully help prospective owners make better informed choices when purchasing a dog. We urge all would-be dog owners to follow advice from the UK Brachycephalic Working Group to ‘stop and think before buying a flat-faced dog’.”
The strange phenomenon was spotted by Veterinary Vision's clinical director Chris Dixon when he examined Dachshund called Margo, which had been referred for the treatment of a corneal ulcer and fungal infection.
Chris said: “I was assessing Margo’s eye and was very surprised to see a face smiling back at me.
"It perhaps doesn't bear quite the same resemblance as the Turin Shroud. Still, I've never seen anything like it before.
"The good news is that it does not appear to have affected her vision at all.”
Apparently the smiling face is still there, even after Chris performed a corneal graft.
Chris added: "I think we can safely say that Margo is a very happy dog, both inside and out!"
Andra-Elena Enache and Savina Gogova join the head of service Richard Everson, an RCVS and European Recognised Specialist, to form one of the strongest ophthalmology teams in the UK.
Richard said: “It is fabulous that Andra and Savina were both successful in their specialist examinations.
“Of course, we already knew their expertise but passing the examination requires not just an unparalleled knowledge of their subject but also the constitution that allows them to prove their knowledge, skills and professionalism in the crucible of the examination environment.
“For both Andra and Savina to pass at the first time of asking is remarkable and just confirms their brilliance. It’s also a big boost for NDSR.
“Having three internationally-recognised specialists in ophthalmology in one hospital makes the service so much more resilient; for example, we will never have to close due to annual leave or lecturing commitments.
“This strength in depth means we really can offer the best possible service to our referring vets and poorly pets.”
For more information, visit: www.ndsr.co.uk.
In the study titled “Outcomes of treatments for keratomalacia in dogs and cats: a systematic review of the published literature including non-randomised controlled and non-controlled studies”, a systematic review of the current literature was undertaken to determine the evidence base for the various treatments of keratomalacia in dogs and cats.
The aim of the review was to assess the evidence base and identify recommended treatment(s) based on globe survival, visual outcome, and time to resolution (while maintaining a globe).
An online literature search found 18 relevant studies which were then reviewed and assigned a level of evidence base as described in the Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence Working Group.
Each study was assessed for type of study described (e.g. retrospective, prospective, controlled, random/non-random, cohort study, case series/study), the number of animals included, criteria for assessing outcome (e.g. vision, corneal clarity, anatomic repair) and duration of follow-up and time to resolution.
Systematic reviews of randomised trials, randomised trials or observational studies with dramatic effects would have provided the most reliable evidence on which to base recommendations for treatment(s) but none were available for inclusion.
Only one study was classified as level 3 evidence (non-randomised controlled trial) and considered the use of corneal cross-linking (CXL) in the treatment of keratomalacia.
Most studies were level four evidence reporting the outcome of a single treatment, with three prospective studies and seven retrospective studies.
The remaining seven studies were level five evidence (mechanism-based reasoning) and were considered not to provide good evidence for answering the particular study question.
The findings of the study suggest that the evidence for improved outcome of one proposed treatment over another proposed treatment for keratomalacia in dogs and/or cats is very weak.
A combination of treatments – both medical and surgical – may be the most appropriate depending on the individual case.
Studies utilising mechanism-based reasoning would suggest that medical treatment with anti-collagenase treatment is a minimum requirement for keratomalacia cases to prevent globe loss through perforation, with associated pain and suffering.
Nicola Di Girolamo, Editor of JSAP, said: “The findings of this study highlight once more the infrequency of randomised controlled trials in the veterinary literature, and the need for such studies to expand the evidence base in this field.
“Focussing on collecting available evidence in well-conducted systematic reviews is a critical step in order to improve accessibility of the literature for general practitioners and specialists alike.”
The full article can be found in the October issue of the Journal of Small Animal Practice and can be read online here: https://onlinelibrary.wiley.com/doi/10.1111/jsap.13326. It is open access and can be freely accessed by anyone.
Photo courtesy BSAVA