Immune Mediated Keratitis (IMMK) is a chronic corneal disease in horses that has been diagnosed with increasing frequency in recent years. It is one of the most important causes of recurrent corneal disease and can significantly impair vision in the affected eye.
IMMK is an inflammatory condition of the cornea that is not caused by infectious agents such as bacteria or fungi. Instead, it results from a misdirected immune response in which the horse’s own immune system attacks corneal structures, leading to persistent inflammation.
The exact triggers of IMMK are not yet fully understood. It is believed that an exaggerated immune response to otherwise harmless structures or to previous corneal injury initiates the disease process.
Genetic predisposition, ultraviolet light exposure and dysregulation of the immune system are also considered contributing factors. In many cases, IMMK develops without a clearly identifiable external trigger.
Clinical signs of IMMK may develop gradually or appear in recurrent flare ups.
Typical symptoms include:
Because the disease is not always associated with severe pain, it is often recognized late by owners.
IMMK usually follows a chronic and recurrent course. Without treatment, progressive scarring of the cornea may occur, leading to permanent visual impairment. In advanced cases, complete blindness of the affected eye is possible.
Periods of apparent improvement are common, but inflammation often returns if the underlying immune response is not adequately controlled.
Diagnosis is based on a thorough ophthalmic examination. Typical diagnostic steps include:
Differentiating IMMK from bacterial or fungal keratitis is essential, as treatment strategies differ fundamentally.
Treatment of immune mediated keratitis aims to control the inappropriate inflammatory response, reduce flare ups and preserve corneal clarity and vision. Before starting therapy, infectious causes must be reliably ruled out, as immunosuppressive treatment would significantly worsen bacterial or fungal keratitis.
Therapy is usually topical and tailored to the activity and severity of the disease.
Typical components include
Depending on clinical findings, anti inflammatory eye drops or ointments are used. Immune modulating agents are commonly applied to suppress the abnormal immune response of the cornea and to reduce the risk of recurrence. Treatment often extends over several weeks to months and is tapered gradually based on response.
Tear substitutes and corneal protective products help stabilise the ocular surface and support healing. In horses with marked light sensitivity or irritation, additional protective management measures may be recommended to reduce environmental stress on the eye.
IMMK typically follows a chronic, relapsing course. Regular ophthalmic re examinations are essential to assess corneal clarity, vascularisation, inflammatory activity and intraocular pressure, allowing timely adjustment of medication.
If a corneal ulcer develops or there is suspicion of bacterial or fungal involvement, treatment priorities change. Intensive local anti infectious therapy and corneal protection become essential. Immune suppressive medications are only reintroduced once infection has been safely excluded or controlled.
In advanced or therapy resistant cases, surgical intervention may be considered to stabilise the cornea or protect deeper ocular structures. The indication depends on lesion depth, scarring and the risk of further complications.
Immune Mediated Keratitis is a serious but treatable ocular disease in horses. Prognosis depends largely on early diagnosis, consistent treatment and long term disease management.
When therapy is initiated early and adjusted appropriately, progression of corneal scarring and vision loss can often be slowed or prevented. At the first signs of corneal clouding or increased tearing, prompt evaluation by a veterinarian or an equine clinic with ophthalmologic expertise is strongly recommended.
Typical signs include a white or bluish corneal haze, blood vessel ingrowth, increased tearing and recurrent flare ups. Pain may be mild, so the condition is often noticed late.
IMMK is non infectious but can look similar to bacterial or fungal keratitis. Treatment is fundamentally different. Incorrect therapy may worsen the condition, so infection must be reliably excluded.
IMMK ist meist chronisch und neigt zu Rückfällen. Mit früher Diagnose, konsequenter Therapie und regelmäßigen Kontrollen lässt sich die Entzündung oft gut kontrollieren und das Sehvermögen bestmöglich erhalten.
Immune Mediated Keratitis (IMMK) is a chronic corneal disease in horses that has been diagnosed with increasing frequency in recent years. It is one of the most important causes of recurrent corneal disease and can significantly impair vision in the affected eye.
IMMK is an inflammatory condition of the cornea that is not caused by infectious agents such as bacteria or fungi. Instead, it results from a misdirected immune response in which the horse’s own immune system attacks corneal structures, leading to persistent inflammation.
Typical signs include a white or bluish corneal haze, blood vessel ingrowth, increased tearing and recurrent flare ups. Pain may be mild, so the condition is often noticed late.
IMMK is non infectious but can look similar to bacterial or fungal keratitis. Treatment is fundamentally different. Incorrect therapy may worsen the condition, so infection must be reliably excluded.
IMMK ist meist chronisch und neigt zu Rückfällen. Mit früher Diagnose, konsequenter Therapie und regelmäßigen Kontrollen lässt sich die Entzündung oft gut kontrollieren und das Sehvermögen bestmöglich erhalten.
We kindly ask you to schedule appointments by phone. This way, we can plan the best treatment for your horse individually and directly.
+49 4282 - 5946340Please note our separate visiting hours.
Bitte vereinbaren Sie einen Besuchstermin im Voraus. Planen Sie etwa 1 Stunde ein und berühre bitte nur dein eigenes Pferd.
Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.
We kindly ask you to schedule appointments by phone. This way, we can plan the best treatment for your horse individually and directly.
+49 4282 - 5946 340Please note our separate visiting hours.
Please schedule your visit in advance. Allow approximately 1 hour, and kindly only touch your own horse.
Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.
We kindly ask you to schedule appointments by phone. This way, we can plan the best treatment for your horse individually and directly.
+49 4282 - 5946 340Please note our separate visiting hours.
Bitte vereinbare einen Besuchstermin im Voraus. Plane etwa 1 Stunde ein und berühre bitte nur dein eigenes Pferd.
Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.
