Treatment of corneal ulcers. When is surgery indicated?

Practical relevance: While corneal ulcers in cats frequently arise secondarily to feline herpesvirus (FHV-1) infection, and thus medical therapy is often indicated, other causes include trauma, eyelid abnormalities (agenesis, entropion, dermoids and neoplasia), tear film abnormalities and neurological deficiencies (trigeminal nerve paralysis or facial nerve paralysis). In some such cases, surgery is required. Treatment always needs to be tailored carefully according to the depth and progression of the ulcer, any concurrent ophthalmic disease, the patient's general health and demeanour, and owner compliance and financial circumstances. Patient group: All age groups and breeds can suffer with ulcerative keratitis although some breeds are over-represented for some types of corneal ulceration. Evidence base: The scientific literature on feline ulcerative keratitis is extensive. This article reviews the surgical indications for corneal ulceration in cats with reference to the current evidence base.