Eben’s Eye
By Dr. Daniel A. Liebsch

Equine veterinarians encounter a variety of eye cases throughout the year; the most common conditions treated are corneal ulcers, uveitis, soft tissue trauma, and neoplasia (cancer). Due to the delicate nature of the eye and associated tissues, many of these patients are seen on an emergency basis. Early detection (through regular checkups and diligence by horse owners) can prevent further tissue damage that may ultimately lead to blindness. Despite the severity of many of these conditions, the appropriate treatment coupled with medical advancements can yield a good prognosis. 

Eben is an 8 yr. old Clydesdale gelding who is used mainly as a cart horse for special events such as parades and weddings. His owner first noticed a growth on the soft tissue of the eye approximately 4-6 months prior to the exam, however there was no sign of discomfort such as squinting, tearing, or photophobia (light sensitivity).  It wasn’t until a thorough ocular exam was performed that the extent of the mass was appreciated; otherwise Eben was a normal, healthy horse. The mass was originating from the limbus (the junction of the sclera and cornea) and measured approximately 2cm x 1cm.  The surface of the mass was irregular and there was no evidence of discharge suggesting infection or a foreign body such as a splinter or grass awn.   Due to Eben’s breed, the location of the mass, and its notable growth over the past couple of months, the main differential at this time was squamous cell carcinoma.  His owners agreed to pursue further diagnostics to get a definitive diagnosis and to ensure that appropriate therapy was initiated.  A biopsy of the mass was performed and the tissue sample was submitted to a laboratory for evaluation yielding a diagnosis of squamous cell carcinoma.  With that diagnosis, a treatment plan was formulated.  The owners were committed to saving the eye and were wishing for a cosmetic result.  Eben was sedated and prepared for surgical removal of the mass. 

Eben stood perfectly while the cancerous mass removed.  The mass was delicately removed and Eben recovered quietly in his stall.  He was treated with topical antibiotics to treat any corneal ulcers that may have developed during surgery.   Topical antibiotics and systemic anti-inflammatory drugs were administered for 5 days.  When it was determined that the cornea was happy and healthy, a chemotherapy eye drop was started as an adjunctive therapy.   The drops were administered twice daily for a total of 45 days. Eben was rechecked at 30 days and 60 days post surgery. Examination of the original site revealed complete resolution of mass. At last check, Eben was doing excellent with no reappearance of the squamous cell carcinoma.

Squamous cell carcinoma is a very common cancer on or around the eye. Appaloosas, paints, and draft horses are all more likely to develop these cancerous masses. Squamous cell carcinoma typically starts as reddened areas which often progress to ulcerative, proliferative masses. Horses with no pigmentation around their eyes are more likely to develop squamous cell carcinomas and warrant more diligent eye care.  There are a variety of treatment options for squamous cell carcinomas depending on the location, size, etc.  However, it is paramount that therapy be initiated early in the course of disease in an effort to give the patient the best curative chance. 

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