What to expect during an eye exam.
When a veterinary ophthalmologist comes to your barn to examine your horse, you can expect a thorough, specialized assessment of your horse’s eyes, along with a detailed treatment plan tailored to any issues discovered. Veterinary ophthalmologists are specially trained to diagnose and treat eye conditions, so they bring expertise and tools beyond those of a general equine veterinarian.
Maintaining communication with other clinicians on the case is important in order to give a well-rounded evaluation and make the best plan forward. A discharge summary will be emailed to you and the primary care veterinarian, along with any laboratory tests. Text, phone call and email updates are welcomed to keep everyone informed.
Preparation Before the Exam
- History and Background: Be prepared to provide information on your horse’s medical history, any previous eye problems, and recent symptoms, such as squinting, tearing, or swelling around the eyes.
- Barn Setup: Make sure your horse’s stall or the examination area is clean, quiet, and can be darkened. Cross ties are often helpful but not necessary. An area such as a wash rack or isle often work well. A stall can also work if it is large enough.
- Lighting: Most of the ophthalmic exam is done using only the light of the specialized equipment. Overhead lighting should be able to be turned off. It is very helpful if barn doors and windows can be closed. We do have some black out curtains that can be hung over windows during the exam if needed.
- Horse Restraint: The vet will want the horse standing quietly, so consider having a trusted handler present.
- Sedation: In most cases, a mild sedative will be needed to allow for a thorough eye exam. Eyelid blocks will make the eyelids easier to open as well as numb the eye and surrounding tissue to make the exam more comfortable. This will all wear off in 20-30 minutes.
- For procedures that require heavy sedation having 3 or more straw bales around can help to steady the horse when stacked in front of them.
- After the exam: Your horse should be kept stalled with the food pulled until they are fully awake. They should be able to have food returned ~30-60 minutes.
Equipment and Tools Used in the Exam
- Slit Lamp Biomicroscope: This is used for a closer, magnified view of the eye’s anterior segment, which includes the cornea, iris, and lens.
- Fluorescein Stain: This orange dye highlights any corneal ulcers or abrasions, making damage to the eye surface easier to see.
- Tonometer: This measures intraocular pressure (IOP) to check for glaucoma, a common eye issue in horses that can lead to pain and vision loss if untreated.
- Ophthalmoscope: This device allows the veterinarian to examine the retina and other internal structures of the eye in detail.
Examination Steps
- External Examination: The vet will start by examining the eyelids, cornea, and other external structures for signs of swelling, discharge, or abnormalities.
- Evaluation of Eye Reflexes: They will test the horse’s response to light and other reflexes, which helps determine if the visual pathways and optic nerves are functioning correctly.
- Internal Examination: The ophthalmologist will use the ophthalmoscope and slit lamp to check internal structures like the iris, lens, and retina, assessing for cataracts, uveitis, and other internal eye conditions.
- Pressure Testing: The tonometer will be used to ensure normal eye pressure. Abnormal results may prompt the veterinarian to investigate further for conditions like glaucoma.
- Staining Test: If there’s any suspicion of corneal injury or ulceration, the vet will use fluorescein stain or rose bengal stain to identify scratches, ulcers, or other damage on the cornea.
- Photography: Photodocumentation of the eye will be performed to maintain accurate records and show you lesions that were identified.
Diagnosis and Discussion of Findings
- After the examination, the vet will discuss their findings with you. This may include explaining any conditions they’ve identified, potential causes, and possible outcomes.
- The vet may use diagrams or images to help explain complex eye structures or conditions, making it easier to understand the diagnosis and prognosis.
Treatment and Recommendations
- Discharge Summary: A full detailed discharge summary of the findings and recommendations will be emailed to you and your primary veterinarian within 24 hours of the exam.
- Treatment Plan: If treatment is needed, the vet will outline a plan. This could include topical or oral medications, surgical procedures, or changes to the horse’s environment to prevent further issues.
- Medication Instructions: If the horse needs medications, the ophthalmologist will give you instructions on administering them. Eye medications often need frequent application, so be ready to handle this part of aftercare.
- Follow-Up Care: Some eye conditions require regular monitoring. The ophthalmologist will let you know if and when they should return or if a local vet can help with follow-ups.
Tips for a Smooth Exam
- Keep the Horse Calm: Stress can make exams difficult, so consider using treats or calming aids if needed.
- Ask Questions: Don’t hesitate to ask about the diagnosis, treatment, or any unfamiliar terms the vet may use.
- Prepare for Possible Follow-Up Visits: Eye conditions often require monitoring, so ask about scheduling and signs to watch for between visits.
By understanding what to expect during an ophthalmology visit, you’ll be prepared to support your horse’s eye health and provide necessary care after the exam.