Keratitis / Corneal Inflammation

Keratitis, an inflammation of the cornea, is a common and often recurring condition in horses. In some patients, the disease cannot be adequately controlled with topical medication alone and may require intensive or surgical treatment.

Table of Contents:

Causes

The cornea is exposed daily to environmental irritants and microorganisms. If the natural protective barrier consisting of the tear film and corneal epithelium is disrupted, bacteria or fungi can penetrate deeper layers of the cornea.

Such disruption may be caused by trauma, foreign bodies, dry eye conditions or immune mediated processes. Once pathogens enter the cornea, infectious keratitis develops. Without prompt treatment, this can lead to painful corneal ulcers, impaired vision or, in severe cases, loss of the eye.

Depending on the severity and depth of the infection, intensive medical therapy may be sufficient. In deeper or progressive lesions, however, surgical intervention becomes necessary.

In this patient, keratitis was caused by a bacterial infection.

Bei diesem Patienten wurde die Keratitis durch Bakterien ausgelöst.

Symptoms

Corneal inflammation often develops suddenly and is typically painful for the affected horse. Common signs include:

  • Excessive tearing and nasal discharge
  • Squinting
  • Sensitivity to light
  • Swelling and redness of the conjunctiva
  • Cloudiness or a milky appearance of the cornea
  • In advanced cases, corneal ulcers, visible blood vessel ingrowth or scar formation

If keratitis is suspected, a veterinarian should be contacted as soon as possible. Early treatment significantly improves the chances of healing and visual preservation.

Course of Disease

Diagnosis

Diagnosis is based on a comprehensive ophthalmic examination. This typically includes:

  • Fluorescein staining of the cornea to identify defects or ulcers
  • Slit lamp examination to assess the cornea, iris and anterior chamber
  • Swabs or tissue samples to identify bacterial or fungal pathogens
  • Additional diagnostics such as ultrasound or intraocular pressure measurement when indicated

Further treatment decisions are always tailored to the individual findings.

Treatment

If the corneal infection is deep or if an ulcer has already formed, conservative treatment alone is often insufficient. In these cases, surgical removal of infected tissue is required.

  • Keratectomy
    Layer by layer removal of diseased corneal tissue.
  • Conjunctival graft or transposition
    Healthy conjunctival tissue is sutured into the defect area. This stabilizes the cornea and delivers blood supply, immune cells and healing factors directly to the site of infection.

During keratectomy, chronically affected corneal tissue is carefully lifted and removed using specialized instruments. This eliminates local antigens that may repeatedly trigger inflammation. Depending on the extent and location of the keratitis, a relatively large wound surface may result, and healing can take several weeks.

With an uncomplicated healing process, a calm, comfortable eye and good visual function can usually be achieved.

Prognosis

Prognosis depends strongly on several factors:

  • Type of pathogen, bacterial versus fungal
  • Depth and extent of the infection
  • The horse’s immune status and ocular reactivity
  • Timing and intensity of treatment

Fungal infections of the cornea are particularly challenging and prone to recurrence. Delayed treatment or untreated infections may result in permanent corneal scarring, loss of vision or loss of the eye.

Frequently Asked Questions (FAQ)

Is keratitis in horses an emergency?

Yes. Keratitis often develops rapidly and is extremely painful. Without prompt treatment, it can quickly progress to deep corneal ulcers, scarring or even loss of the eye.

How can infectious keratitis be recognised?

Common signs include excessive tearing, eyelid spasms, light sensitivity, conjunctival redness and a cloudy or milky appearance of the cornea. In advanced cases, corneal ulcers, vascular ingrowth or visible defects may be present.

When is surgery required for keratitis?

Surgical treatment is indicated when the infection penetrates deeply into the cornea or when a corneal ulcer has formed. Procedures such as keratectomy or conjunctival flap surgery help remove infected tissue, stabilise the cornea and support healing.

Keratitis, an inflammation of the cornea, is a common and often recurring condition in horses. In some patients, the disease cannot be adequately controlled with topical medication alone and may require intensive or surgical treatment.

Häufig gestellte Fragen

Is keratitis in horses an emergency?

Yes. Keratitis often develops rapidly and is extremely painful. Without prompt treatment, it can quickly progress to deep corneal ulcers, scarring or even loss of the eye.

How can infectious keratitis be recognised?

Common signs include excessive tearing, eyelid spasms, light sensitivity, conjunctival redness and a cloudy or milky appearance of the cornea. In advanced cases, corneal ulcers, vascular ingrowth or visible defects may be present.

When is surgery required for keratitis?

Surgical treatment is indicated when the infection penetrates deeply into the cornea or when a corneal ulcer has formed. Procedures such as keratectomy or conjunctival flap surgery help remove infected tissue, stabilise the cornea and support healing.

Make an Appointment

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 - 5946340
Opening Hours

Please note our separate visiting hours.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Besuchszeiten

Bitte vereinbaren Sie einen Besuchstermin im Voraus. Planen Sie etwa 1 Stunde ein und berühre bitte nur dein eigenes Pferd.

Monday – Friday
10:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Emergency Service – Open 24/7

Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.

Call us:
+49 4282 - 5946 340
Appointment Image

Make an Appointment

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 340
Opening Hours

Please note our separate visiting hours.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Besuchszeiten

Please schedule your visit in advance. Allow approximately 1 hour, and kindly only touch your own horse.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Emergency Service
Open 24/7

Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.

Call Us
+49 4282 - 5946 340
Appointment Image

Make an Appointment

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 340
Opening Hours

Please note our separate visiting hours.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Besuchszeiten

Bitte vereinbare einen Besuchstermin im Voraus. Plane  etwa 1 Stunde ein und berühre bitte nur dein eigenes Pferd.

Monday – Friday
10:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Emergency Service – Open 24/7

Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.

Call us:
+49 4282 - 5946 340
Appointment Image