Successful management of a unilateral persistent epithelial defect secondary to meibomian gland dysfunction in an Irish Sports Horse using a multi-modal treatment plan

Abstract

A novel equine multi-modal protocol was implemented for management of unilateral equine dry eye disease and worsening persistent epithelial defects in a clinically well Irish Sports Horse. Utilising knowledge directly from human ophthalmic medicine for meibomian gland dysfunction, the meibomian glands were first mechanically debrided and expressed. Then a four-point treatment protocol was instigated. The protocol comprised hot compressing, artificial tears, autologous serum and a topical azithromycin regimen, resulting in a significant improvement in persistent epithelial defects and clinical signs. This case highlights the benefits of a treatment plan containing both non-pharmacological and pharmacological therapies targeting the lipid component of the tear film matrix in horses with dry eye disease.