Prognosis and impact of equine recurrent uveitis.
Authors: Gerding J C, Gilger B C
Journal: Equine veterinary journal
Summary
Equine recurrent uveitis represents one of the most consequential causes of vision loss in horses, yet its broader impact on affected animals and their owners has been poorly quantified. Gerding and Gilger conducted a retrospective review of 224 horses (338 eyes) presenting to North Carolina State University between 1999 and 2014, coupled with owner questionnaires, to characterise both the disease trajectory and real-world consequences of ERU. The findings were sobering: nearly half the horses (46.9%) developed blindness in the affected eye despite treatment, 12.1% required enucleation, and leptospirosis serology (particularly *Leptospira pomona*) proved positive in 45.5% of tested cases; functionally, 29.4% of horses never returned to work and a further 31.4% could only manage reduced activity, whilst the disease triggered euthanasia in 14.9% and ownership changes in 19.1% of cases. For equine practitioners, these data underscore that ERU management extends well beyond ophthalmology—the progressive nature of the condition and its profound economic and performance implications demand proactive leptospirosis screening, honest owner counselling regarding realistic prognoses, and integrated planning for horses' alternative futures, particularly given the documented monetary devaluation across the cohort.
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Practical Takeaways
- •ERU carries a guarded prognosis with nearly half of affected horses becoming blind; early detection and aggressive treatment are critical to preserving vision and function
- •Leptospirosis serology should be routinely obtained in ERU cases as it is positive in approximately 45% of horses and may guide treatment decisions
- •Owners should be counselled about realistic expectations: one-third of horses lose function entirely, and approximately 15% are euthanised due to progressive disease and associated costs
Key Findings
- •28.4% of ERU eyes were blind and 11.2% had glaucoma at initial evaluation, with Appaloosas overrepresented at 24.1% of cases
- •Leptospirosis serology was positive in 45.5% of 88 tested horses, with L. pomona being the most frequently isolated serovar
- •46.9% of horses were reported blind in affected eye(s) by owners, and 12.1% of eyes resulted in globe loss
- •29.4% of horses did not return to previous role and 14.9% were euthanised as a direct result of ERU, with 31.4% performing at reduced level