Taken from http://www.vetinfo4cats.com/cateye.h...rneal%20Ulcers
Q: My cat has a corneal ulcer. How long will it take to heal?
A: Most of the time corneal ulcers heal with antibiotic eye drops within 3 to 5 days. If this problem has persisted longer than that, please let me know.
Mike Richards, DVM
Q: About my cat's eye ulcer --- As you have said, most corneal ulcers probably heal within 3 to 5 days with antibiotic treatment.....However, poor little Tigby is now into this for 18 days!!! My vet has chosen Neobacimyx QID, and atropine sulfate BID. He went in for a re-check, and had his sutures for the 3rd eyelid
removed.....he's doing better, but not that much. His eye is still very much dialated from the atropine (which I've stopped), and I'm still using the antibiotic on a QID basis. What else, if anything can I do to help him along....He's still having trouble with the eye, and I'm not altogether sure that this vet is doing all that can be done for Tigby. You mentioned something about more information about difficult ulcers.....it very much appears that this one is VERY DIFFICULT!!!!
Persistent corneal ulcers in cats are usually due to herpes virus. In these ulcers, antibiotic drops are not helpful except to prevent secondary bacterial infection. Atropine sometimes makes the eye feel a little better by relaxing the muscles that may spasm due to ocular pain but has no direct healing benefit that I am aware of.
It is necessary to use antiviral medications in some cats to get these ulcers to heal and it can be helpful to use l-lysine supplementation (this is a food supplement). Some ophthalmologists think that debriding the ulcer edges is helpful and there is some disagreement about what the best topical anti-viral ophthalmic preparation is.
I tend to refer these cases to a veterinary ophthalmologist in my area because this is an easy option for me, but it is possible for most general practices to write prescriptions for anti-viral eye drops or to use very dilute povidone iodine to treat these eyes. Interferon is reported to help sometimes (orally and/or topically) and oral acyclovir has been reported to help in severe cases.
There are cats who are treated with several anti-viral agents who do not respond to treatment. This can be a very frustrating disorder to treat.
Once in a while we see a case of eosinophilic keratitis in a cat that really looks like it has caused a corneal ulcer (or is a corneal ulcer). This is treated differently than persistent ulcers due to herpes virus. In these cats, corticosteroids are necessary to resolve the problem. It is obviously very important to distinguish between the two types of problems. Corneal scrapings submitted for cytologic exam by a pathologist is a good way to distinquish betweeeosinophilic keratitis and ulcers from herpes, if there is any question of this.
Lots of places in the country now have veterinary ophthalmologists on at least a visiting basis, so it may be worthwhile to ask your vet for a referral.
Good luck with this.
Mike Richards, DVM
Repeated corneal ulcers
Q: We have an Exotic Long Hair, five years old who now has had 3 episodes of corneal ulcers. No history of trauma has been noted. Each time the vet has treated him with Chloramphenicol eye drops, for secondary Infection. The ulcers are singular and sheet-like across the cornea and always unilateral. What could their origin be and is there anything we can do to prevent them? Thank you very much
A: By far the most common cause of recurrent or difficult to cure corneal ulcers in cats is chronic herpes virus infection.
It can be helpful to use l-lysine at 250 to 500mg/day to help control this problem. It can be purchased at health food type stores, usually.
If your vet knows a source of anti-viral eye drops (I think they are hard to get right now but haven't had to treat for this recently so I am not sure), they can be helpful, too.
It is possible to do punctate keratotomy surgery for stubborn ulcers in cats. This is a fairly simple procedure but if your vet hasn't done this before he or she may want to send you to a veterinary ophthalmologist for the procedure.
That may be a good idea, anyway, given the difficulty in clearing up this ulcer. These are frustrating and the ophthalmologist may not be able to help much more than your local vet but at least you'd get a second opinion.
Mike Richards, DVM