Overview

• Infection of the conjunctiva and/or cornea before or just after the separation of the eyelids in the neonate.
• Occurs in puppies and kittens.
• Associated with Staphylococcus spp. or Streptococcus spp. in dogs and cats, and with herpesvirus in cats.
• Potentially vision threatening.
• Source of infection-believed to be from an intrauterine infection, a vaginal infection of the dam at the time of birth, or from a non-hygienic environment.

Signalment

• Affects all breeds of cats and dogs.
• Neonates before the time that the eyelids open (10–14 days postpartum).

Signs

• Upper and lower eyelid margins are fused (physiologic ankyloblepharon) and the lids bulge outward because of the accumulation of debris and discharge within the conjunctival sac.
• May note a mucous to mucopurulent discharge extruding through a patent opening at the medial canthus.
• Cornea and conjunctiva may be ulcerated.
• May note adhesions (symblepharon) of the conjunctiva to the cornea or to other areas of the conjunctiva (including that of the nictitans).
• Perforation of the cornea with iris prolapse and collapse of the globe is occasionally seen.

Causes & Risk Factors

• Intrauterine or vaginal infections in the dam near the time of birth.
• Unclean environment for the neonates.

Differential Diagnosis

Neonates with entropion in which the eyelids have already separated-mucous to mucopurulent discharge may be present; view of the cornea may be obscured; may have appearance of ankyloblepharon; differentiated by age (patients older than 10–14 days) and ability to separate the eyelids.

CBC/Biochemistry/Urinalysis

Normal unless there is a concurrent systemic infection.

Other Laboratory Tests

• Cultures of neonate's ocular discharge and/or dam's vaginal discharge-may help diagnose bacterial infection and guide antibacterial therapy.
• Cytology of the affected tissues-may help diagnose bacterial infection and guide antibacterial therapy.
• Immunofluorescent antibody or polymerase chain reaction tests (cats)-feline herpesvirus.

Imaging

N/A

Diagnostic Procedures

• Full physical examination of the dam and neonate.
• Fluorescein staining-corneal or conjunctival ulceration.

Drug(s)

• Broad-spectrum, topical antibiotics-e.g., neomycin/bacitracin/polymyxin B; applied 4 times daily for at least 1 week; antibiotic chosen on basis of bacterial culture and sensitivity, if available.
• Antiviral therapy in the case of herpesvirus infection in cats.

Contraindications/Possible Interactions

• Tetracycline-do not use in neonates because of the risk of affecting bone or teeth; topical ofloxacin or ciprofloxacin is drug of choice for Chlamydophila.
• Topical corticosteroids-contraindicated.

Patient Monitoring

• Warm compresses-may be necessary for a few days to keep the eyelids from readhering.
• Topical antibiotics-continued for a minimum of 7 days.
• Observe littermates that are not initially affected.
• Treat vaginal infections in the dam with appropriate medications.

Prevention/Avoidance

• Keep the external environment and the dam's nipples clean.
• Treat vaginal infection in the dam before delivery, if possible.

Possible Complications

• Severe keratitis with scarring and symblepharon.
• Rupture of the cornea with secondary phthisis; blindness may be irreversible.

Expected Course and Prognosis

Favorable with correct and timely diagnosis and treatment and if no major complications occur.