Placement and Management of Ocular Lavage Systems

Some conditions commonly found in equine ophthalmology such as deep ulcers, melting ulcers, calcified keratopathies or severe cases of uveitis require very frequent medical therapy. In addition horses with painful eyes may become very difficult or even dangerous to treat with topical medication. Ocular lavage systems should be employed in these situations to allow appropriate treatment of the ocular surface. Two main types of systems are described: nasolacrimal or subpalpebral. The subpalpebral systems are easier to apply and maintain and they are the most commonly used. They consist of a piece of silicone tubing with a single hole and footplate positioned in the superior or inferior palpebral fornix and that allows remote medication without direct interference with the eyelids or globe. A number of commercial systems are available in a variety of shapes, diameters and lengths.

For their placement the horse should be adequately sedated and topical anaesthetic applied to the ocular surface. Eyelid akinesia and analgesia should be provided with the appropriate regional nerve block. [...]