Ok, enough already! I get it, we live here for a reason, get to enjoy all the seasons and the diversity they bring to our lives. I like to ski, go sledding with my kids, build the occasional snowman. I have lived in more temporate and more severe climates so I have a nice barometer on weather variation and I do love the activities that each season allows. But I think we all agree….enough of the white stuff already! We have got nowhere to put it!
In all seriousness, we are trying our best, like most businesses, to keep ourselves open and available through all the inclement weather while trying to keep you, your pets and ourselves safe on the roads coming and going to the clinic. We have bulldozed as much snow as we can to keep the parking lot safe only to have the recent ice put a nice layer over the top of what remains. So be careful as we sand and salt and take your time if you are coming in to see us. Everyone has been very patient being seen earlier or later than their scheduled appointment times as scheduling itself is a challenge. We will try our best to be here and ready for you!
A number of different ocular diseases will present with a “white spot on the eye” with or without associated redness, irritation or discharge. Since there is some much white on the ground, let’s talk about what can be white on your pet’s eye.
Corneal Dystrophy
A corneal dystrophy by definition is a deposit of lipid on or in the cornea that is usually bilateral (both eyes), symmetrical, non-inflammatory, unassociated with systemic disease and genetic in basis. We see this on a regular basis and is the most common diagnosis associated with the “white spot on the eye” complaint. There are a number of different breeds that develop this abnormality that have some science to support that it is genetic in basis and I am sure there are others where we presume this is the case by the appearance. Common breeds noted in this practice include the Cavalier King Charles Spaniel, Golden Retriever, Husky, Cocker Spaniel and many others. If we rule out any other reason for cholesterol deposition on the cornea, we default to this diagnosis based on appearance and history. Typically, dystrophic areas may get bigger or more dense, can occasionally fade, and usually create no observable vision compromise to the dog. All in all, this is not a serious issue for your dog. A typical appearance would be like this:
Cornea dystrophy in a 3 year old German Shepherd
Corneal Degeneration
Lipid and mineral can be deposited into the cornea as a response to local irritation, old aging change, post-inflammatory change, secondary to elevation of blood fats and other entities that change the metabolism of the corneal tissue. This may occur in either or both eyes and may or may not have a vascular response associated with the deposition. These are classified as degenerations and may warrant intervention to stablize the region and prevent ulceration or extensive vascularization. Old age degeneration is not uncommon, especially in dogs with exposed eyeballs where protection is not optimal. Mineral binders may help smooth the area as the irregular surface can cause discomfort. In a severe form, sometimes the mineral is sloughed off and a deep hole in the cornea is created that necessitates surgery to prevent the eye from rupturing.
Corneal degeneration: note the blood vessels to the mineral
Eosinophilic keratitis
This is an odd but interesting disease of the cat. The eosinophil is a type of white blood cell that we see elevated in diseases where allergy or parasites are the primary concern. Cats have a series of diseases, primarily in the skin, where the eosinophil accumulates and creates lesions. In the eye, we can see something similar where the conjunctiva or cornea, the surface tissues of the eye, become inflamed and accumulate white plaques usually associated with vessels. The surface is usually not ulcerated so discomfort is not a feature. Herpes, the most common cause of surface disease in the cat, may be concurrent or it may be its own entity. This disease is usually responsive to antiinflammatory medication and is typically controlled, not cured. The white does go away!
Eosinophilic plaques and vessels
Cataracts
Cataracts are opacities of the lens that can be very small and difficult to observe or involve the entire lens and make the pupil appear white. When the lenses are extensively involved, vision compromise may be a feature if both eyes are affected. The color of the iris will be visible around the cataract and the central region is opaque and white. I have a posting concerning all the details of cataracts and cataract surgery on this site if you think your dog has this problem or are being referred for cataract evaluation. Here is a picture of a dog with signficant cataracts.
Dense resorbing cataract in a dog
Lipid flare
Animals will commonly get inflammation inside the eye called uveitis. Uveitis is a symptom of many problems from simple trauma to cancer. Infectious diseases like the tick-bourne entities in the Northeast or fungal disease in the Midwest can manifest themselves as uveitis with a red eye and protein and/or cellular debris suspended within the fluid that bathes the front of the eye. If your pet has uveitis for any reason and also has high levels of triglycerides or cholesterol in their blood stream, these fats can leak into the eye while it is inflamed. When that occurs, presto, you have a white eye that can look pretty scary. This is not too common, but we will see it usually on an emergency basis since it happens rapidly. Often the referral is for cataracts but compare this photo with the last one. You cannot see the brown iris clearly because the fluid in front of it is opaque, not the lens behind it.
Lipid flare in a dog with high blood cholesterol
There are certainly other lesions that can present as white in and around the eye. As I look out the window and see the snow piling up, I figure I have plenty of white to go around for a few more months. I even had to dig out Otto, our official greeter, so he wouldn’t get rolled by the plows! Good thing his eyes still look good….well, maybe!
Otto at the entrance to the AEC!