Examination of the eye: restraint and analgesia

The aim of the ophthalmic examination is to complete a thorough assessment of the eye without exacerbating any existing issues in a safe and controlled fashion. Using the following guide this should be achievable even for the most fragile eye.

Sedation and restraint

A quiet environment will make a significant difference to the ability to perform an examination effectively and a complete examination can be performed without the need for sedation. However, in a fractious horse with a painful eye or if additional diagnostic techniques such as conjunctival biopsy are to be performed then sedation is likely to be helpful. It is a personal choice in terms of sedation and there are no specific drugs or combinations that have any obvious advantage in relation to ophthalmic examination. The aim of the sedation is to achieve a relaxation of the patient without causing significant head droop or ataxia as this can make the examination more challenging. The use of a twitch is again a personal preference but it may interfere with examination as the operator is also closer to the head. Stocks are often poorly suited to ophthalmic examination as their design usually places an upright in the location that you might wish to stand in to perform the examination. Head position once sedation has been performed has an effect on intraocular pressure so tonometry should be done with the head held up in its normal resting position. […]