Case 29

 A 6-year-old female spayed Cocker Spaniel is brought in for an emergency visit. The owner reports that the dog woke up this morning with a very red, cloudy right eye (OD). The dog is keeping the eye shut, is refusing to eat, and seems lethargic and painful. The owner does not know of any trauma. The left eye (OS) appears normal.

Physical Exam:

  • T: 102.6°F

  • P: 130 bpm

  • R: Panting

  • MM: pink/moist

  • CRT <2 sec

The dog is visibly depressed and in pain, resenting any handling of her head. The ophthalmic exam of the right eye (OD) reveals severe blepharospasm. When the eyelids are opened, there is marked episcleral injection (intense redness of the "white" of the eye) and diffuse, steamy-looking corneal edema. The pupil is mydriatic (dilated) and unresponsive to a bright light source. A menace response is absent in the right eye. The left eye (OS) appears normal on gross examination.

CBC and Biochemistry:

  • All values are within the reference range.

Urinalysis:

  • Not performed at presentation.

What will be your tentative and differential diagnosis? What further diagnostic test(s) you will perform to confirm your diagnosis? What will be your treatment plan(s)?

Solution to Case 29 will be posted on Aug 29

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