Equine ulcerative keratitis with furrow: A review of the outcomes of 72 cases from 1987 to 2015.
Authors: Berkowski W M, Craft W F, Whitley R D, Brooks D E, Plummer C E
Journal: Equine veterinary journal
Summary
# Furrow-forming Keratitis: A 28-year Retrospective on Medical and Surgical Outcomes Furrow-forming ulcerative keratitis represents a serious corneal condition historically associated with poor prognosis, yet its aetiological drivers and treatment efficacy remain incompletely characterised in the equine literature. This retrospective analysis examined 72 cases presenting to the University of Florida between 1987 and 2015, with microbiological investigation identifying fungal infection in 27% of cases with confirmed diagnoses, mixed fungal-bacterial infection in 38%, and purely bacterial infection in 35%—highlighting that furrow formation cannot be assumed to indicate a single causative pathway. Medical management alone achieved visual success in 77% of eyes (20/26), whilst combined medical-surgical intervention improved outcomes to 87% (40/46), with 83% of all treated horses (60/72) retaining vision long-term; notably, only 17% of cases (12/72) failed treatment, with six requiring enucleation and six becoming phthisical. For practitioners encountering furrow-forming keratitis, these data suggest a considerably more optimistic prognosis than previously reported, though the 28-year study period means treatment protocols have evolved substantially and individual cases will vary in their response to current antimicrobial and surgical techniques. Definitive culture-based and PCR diagnostics should guide targeted therapy, with surgical intervention reserved for cases unresponsive to medical management, as the combination approach yields the strongest visual retention rates.
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Practical Takeaways
- •Furrow-forming ulcerative keratitis carries a much better prognosis than previously reported, with 83% achieving useful vision when treated appropriately
- •Combined medical and surgical treatment is significantly more effective (87% success) than medical therapy alone (77%), suggesting early surgical referral should be considered
- •Identify the infectious aetiology (fungal vs bacterial vs mixed) through cytology and culture, as this guides treatment protocols and affects clinical outcomes
Key Findings
- •83% of 72 horses with furrow-forming ulcerative keratitis achieved positive visual outcomes with medical or surgical treatment
- •Fungal keratitis accounted for 27% of cases with definitive diagnosis, mixed fungal-bacterial 38%, and bacterial 35%
- •Surgical intervention combined with medical therapy resulted in 87% positive visual outcome compared to 77% with medical therapy alone
- •17% of cases failed treatment, with 6 eyes requiring enucleation and 6 becoming phthisical