Equine eye docs help horse regain sight

Willy, a 3-year-old quarter horse, has a goofy personality and loves to spend time with his many chicken friends at owner Mariah Kauffman’s home in Snyder County, Pennsylvania.

Soon after Willy joined their family, however, Kauffman noticed that every once in a while, his eyes would cloud over, then appear clear the next day. “He started bumping into things and getting cuts on his face,” Kauffman said. “He would run into the fence and spooked easily.”

That’s when she decided to call Willy’s veterinarian, Dr. Jacqueline Rapp of Susquehanna Valley Veterinary.

Rapp quickly referred Willy to the Cornell Equine Hospital for specialty care from Dr. Kelly Knickelbein, assistant clinical professor, alongside ophthalmology residents Dr. Irini Lamkin and Dr. Brittany Schlesener.

The Cornell team diagnosed him with equine recurrent uveitis (ERU), a common but harmful complex autoimmune disease among horses, with both genetic and environmental factors.

“This disease is particularly devastating as many horses do not show outward signs of a problem, so it can go unrecognized for long periods and loss of vision may be the first thing that is noticed,” Knickelbein said.

“Willy is my daughter’s first horse, and we were upset when we heard the news that Willy may lose his sight,” Kauffman said. “There were a lot of sleepless nights. We prayed for him to overcome his eye problems and maintain eye function.”

Horses suffering from ERU may experience eye pain, swollen eyelids, excessive tearing or a cloudy appearance to one or both eyes. In some cases, uveitis may not lead to obvious outward clinical signs until the disease is more advanced. Veterinarians will look for signs of haziness of the ocular fluids, as well as changes to the iris, lens and retina. ERU often results in loss of vision and may require an eye to be removed. The disease is most common in Appaloosas and warmblood breeds, though it can affect any horse breed as well as mules and donkeys.

Knickelbein, Lamkin and Schlesener found that Willy was able to see from his right eye but only had light perception in the left. He had severe inflammation in both eyes, in addition to changes to his irises, lenses and retinas. They tested his ocular fluid and blood to look for evidence of infectious agents associated with ERU, and treated him with topical steroids and atropine – a topical pain medication that also dilates the pupil – as well as an oral anti-inflammatory drug. He also received intraocular injections of an antibiotic, thought to break the cycle of recurrent or persistent intraocular inflammation.

Willy responded well to his treatment plan. “At his most recent recheck evaluation, he had no active inflammation inside either eye and seemed to be very comfortable,” Knickelbein said. “In addition, we were very happy that he regained functional vision in his left eye.”

Many horses with visual impairment or complete blindness can have an excellent quality of life, and some may be suitable for continued use as riding horses, depending on their discipline, level of training, the level of a rider’s training and the duration of the partnership. Veterinary professionals generally recommend that visually impaired or blind horses only be handled and ridden by adults fully informed about the impairment, and who are willing to accept the risks.

Thus far, Willy has made the journey to Cornell four times, with another recheck planned this summer.

“He has a wonderful experience each time, and he always loves rolling in Cornell’s fresh bedding after his check-ups,” Kauffman said.

Although Willy is still visually impaired, Kauffman reports he’s doing well and is back to his silly self.

“He is such a loving and goofy horse,” Kauffman said. “He can chase the chickens, and loves to throw around his ball in the pasture. Although he’s had his ups and downs, he is such a remarkable horse.”

The ophthalmologists at Cornell plan to recheck his eyes every few months; in the meantime, he receives a topical medication to limit inflammation, and the Kauffmans are diligent about monitoring for changes – key to helping Willy maintain visual and comfortable eyes, Knickelbein said. “Even minor changes to the eyes should prompt an immediate exam by your veterinarian,” she said.

“Willy was a champ through it all. We couldn’t be any happier with all the care he has received,” Kauffman said. “If it wasn’t for Cornell, he would most likely be blind in both eyes by now.”

Melanie Greaver Cordova is assistant director of communications in the College of Veterinary Medicine.

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