Corneal Ulcers (Ulcerative Keratitis) in Cats

Key Takeaways

Ulcerative keratitis is a type of inflammation of the cornea: the transparent surface of the eye. 

• A corneal ulcer is the loss of specific cells produced by the outermost layer of the cornea

• Signs of ulcerative keratitis include excessive squinting, cloudiness or reddening of the eye, rapid blinking, and increased tearing

• Injuries and feline herpesvirus infections are the most common causes of corneal ulcers

• Diagnosis involves ophthalmic examination, including fluorescent staining 

• Treatment and prognosis vary according to severity

• Small, superficial ulcers often heal within a week or less with only antibiotic eye drops and an e-collar to protect the eye

• More severe or chronic cases often require multiple surgical procedures and take a long time to heal

• Corneal ulcers are painful and can result in the loss of sight or necessitate surgical removal of the eye

A Closer Look: What is Corneal Ulcers in Cats?

Ulcerative keratitis is a painful condition that can potentially lead to blindness or loss of the eye. 

Rapid veterinary intervention is necessary to fully evaluate the severity of the ulcer, determine the treatment plan, and determine if any underlying conditions are present. 

Symptoms vary depending on the depth and size of the ulcer, as well as its cause. If an ulcer is not healing on its own, a more aggressive treatment plan is necessary.

Risk Factors

Stray cats are at higher risk of ulcerative keratitis because they often get into fights and the possibility of scratching the cornea is high. Feral cats are also less likely to be vaccinated against infectious diseases like herpesvirus and more likely to be exposed, so they’re at higher overall risk for corneal ulcers as a result. 

Corneal ulcer is a non life-threatening condition but requires prompt medical attention as the symptoms might become progressively more severe if ignored. Mild cases may heal quickly without treatment, but severe cases are difficult to treat and often require several surgeries.

Possible Causes

There are many potential causes of corneal eye ulcers. Corneal ulceration is usually caused by injury such as a cat scratch during a fight, dirt embedded in the eye, or a sharp foreign object coming in contact with the cornea.

Infection with feline herpesvirus is another common cause. 

Ulcerative keratitis can also be the result of a chemical burn caused by shampoos or other irritating chemicals.

It can also be an indicator of an endocrine disease such as diabetes mellitus or Cushing’s disease.

Keratoconjunctivitis sicca (KCS or “dry eye”) and eyelid/lash disorders like entropion, ectropion, and distichiasis may lead to corneal ulcers, but these conditions are rare in cats.

Main Symptoms

The primary symptoms of ulcerative keratitis  in cats include

• Excessive squinting (blepharospasm)

• Constant or excessive rubbing of the eye

• Rapid blinking

• Eye discharge

• Reddening of the eye

• Cloudiness of the cornea

Testing and Diagnosis

Ulcerative keratitis can often be managed by a primary care veterinarian. Referral to an ophthalmologist is not always necessary but it’s strongly suggested, especially for complicated cases. 

The diagnostic process involves a complete physical and ophthalmic examination, including blood testing to detect other associated conditions. Specific ophthalmologic tests include:

• Fluorescein dye is used to visualize the damaged corneal epithelium.

Other ophthalmologic tests include: 

• Schirmer tear test

• Blinking and reflex examination

• Analysis of samples from the cornea under the microscope

Steps to Recovery

Treatment depends on the severity of the ulcer and the underlying cause. Options range from antibiotic drops to surgery in more severe cases. Prognosis largely depends on the size and depth of the ulceration.

Mild cases, such as small, superficial ulceration, usually heal in about a week. Chronic ulcers are much more difficult to treat and may require several treatments or surgery and take weeks to heal. 

Frequent rechecks are recommended to evaluate the effectiveness treatment and determine if more aggressive therapy is needed.

Prevention

Home care to avoid recurrence during treatment includes lubricating ointments that prevent the eye from drying and cleaning eye drainage so it doesn’t accumulate on the face.

Preventive measures include keeping cats and kittens indoors and up to date on vaccinations, since most feline corneal ulcers are the result of feline herpesvirus and fighting.  

Using care with shampoos or any other chemicals that might damage the cornea also helps prevent ulcers.

Are Corneal Ulcers Common in Cats?

Ulcerative keratitis is common in cats.

Typical Treatment

• Antibiotic eye drops 

• Surgery

• Specific medications for the underlying cause

• Lubricating eye drops