Eye Help: infection, blocked lacrimal duct? *up close pics*

[Daybreaker]

*Sigh* This poor little dude, he can't catch a break. He came to me with an RI (which was cleared, he hasn't shown any signs of RI in about three months since stopping Baytril treatment) and now it looks like he has an eye infection. I'd like some input on what I can do for him; it looks like he's getting fluid over his eye and I'm not sure if it's do to an infection from him rubbing on something or a blocked lacrimal duct? He's been acting normal, eating fine every 5 days on rat pups f/t, on paper towel substrate with a water bowl and two little paper hides, and in QT.

Does it look like I caught it early? Can I do anything for him to relieve some of the mild swelling (warm compress maybe)?
If it's a blocked duct is there a way to see by opening up his mouth? I'll admit I'm not exactly sure where the duct is in the mouth.
If a blocked duct is it the norm to have the blockage removed then give eye drops?

Pics of the "bad" eye:









Pics of his "good" eye (he's always had that white line behind the eye, I never thought it to be detrimental. If you have input on that please LMK, he's never had stuck eye caps with me):






Any input/suggestions would be wonderful before contacting my vet, I've never dealt with any eye issues so I'm open to learn.
Angelica

[dr del]

Hi,

When did he last shed?

And the white line on the toher eye is nothing to worry about - it is the white of their eyes is all.


dr del

[Daybreaker]

Hi,

When did he last shed?

And the white line on the toher eye is nothing to worry about - it is the white of their eyes is all.


dr del

I didn't write down the exact date, but within the last two weeks. Fairly recently; he's been eating spot on every 5 days so he's been shedding pretty consistently.

Good to hear about the white line, I've never noticed it on any of my other snakes so wasn't sure how common it was.

[Daybreaker]

Decided to feed him last night since it will be ~2 days until any vet visit, and he ate fine and didn't act any differently. Any other input?

[itchmynipple]

slow shed?

[skirtinthedirt]

You won't be able to see a blocked lacrimal duct unless it is severely infected because they are so tiny.

Depending on what is causing the blockage (I don't know if that's what it is but it looks like a very good possibility), you may or may not be able to fix it. If there has been trauma (from substrate, etc), often scar tissue will cause a permanent blockage. If there is infection, antibiotics might help.

It doesn't look infected at the moment, but may become that way. You will need to monitor him closely and watch for that eye to get cloudier and milkier. If it stays clear and he's comfortable, eating, etc, a blocked lacrimal duct can be managed, but in instances where infections and discomfort arise, surgical intervention is sometimes necessary, and the eye can become compromised.

Another cause for this appearance is corneal edema (fluid buildup inside the tissues of the cornea itself), which can result from an injury, ulcer, uveitis (inflammation inside the eye), and rarely autoimmune disease.

Any of these things can cause damage to or compromise an eye. If this doesn't resolve I'd take him to your vet if possible. What would be great would be to find a veterinary ophthalmologist that would see a reptile. That would be the best way to get an accurate diagnosis and treatment options.

[Daybreaker]

Thank you for the input!

slow shed?

When I had him out he didn't see any signs of going into shed; I'm not sure if a snake can even go into blue with one eye milky and one normal?

You won't be able to see a blocked lacrimal duct unless it is severely infected because they are so tiny.

Depending on what is causing the blockage (I don't know if that's what it is but it looks like a very good possibility), you may or may not be able to fix it. If there has been trauma (from substrate, etc), often scar tissue will cause a permanent blockage. If there is infection, antibiotics might help.

It doesn't look infected at the moment, but may become that way. You will need to monitor him closely and watch for that eye to get cloudier and milkier. If it stays clear and he's comfortable, eating, etc, a blocked lacrimal duct can be managed, but in instances where infections and discomfort arise, surgical intervention is sometimes necessary, and the eye can become compromised.

Another cause for this appearance is corneal edema (fluid buildup inside the tissues of the cornea itself), which can result from an injury, ulcer, uveitis (inflammation inside the eye), and rarely autoimmune disease.

Any of these things can cause damage to or compromise an eye. If this doesn't resolve I'd take him to your vet if possible. What would be great would be to find a veterinary ophthalmologist that would see a reptile. That would be the best way to get an accurate diagnosis and treatment options.

Thanks you for the information! Would a warm compress be an idea to see if it helps at all or should I not even mess with that eye and just monitor him?

If it is a blocked duct does the face sometimes swell as well as the eye?

If it is inflammation inside the eye or from an exterior injury (he's on paper towels with a plastic crock water bowl and paper hides, I don't see anything sharp inside his tub) is antibiotics the usual route to take (injectable or eye drops maybe)? What are some medications that are prescribed?

[skirtinthedirt]

Compresses might help a lot actually. Not just the eye but that whole side of his face. If there is infection, inflammation, the compresses may help loosen things up. Take a peek in his mouth if you can Stomatitis can cause blocked lacrimal ducts. Sometimes their whole face will swell, depending on the cause of the blockage, but not always. This condition is more serious in snakes than mammals because of the spectacles. Tears that don't drain out of the lacrimal system of a dog or cat just spill onto the face. In a snake, the tears get caught behind the spectacle, which can damage the eye. Generally what happens (from my understanding) is that the eye looks swollen like that and when the eye gets overfull the tears can leak out or get diffused into surrounding tissues.

An injury would be treated with antibiotics. Inflammation is treated with anti-inflammatories (steroids). Usual method is drops or ointment. It's important to determine if there is an ulcer present before starting anti-inflammatories because treating an eye with steroids that also has an ulcer can impeded the healing of the ulcer and predispose it to infection.

I still think a diagnosis by a vet would be optimal. One cheap OTC med you can try is a human eye ointment called Muro 128. This is a salt solution. It will not harm you guy in any way, no matter what is wrong, but if he does have excess fluid either from tears or edema this ointment (I'd get the ointment instead of drops) might help draw some of that fluid out (because the tears/edema is attracted to the salt in the ointment). Might is the operative word. We see boston terriers at my work all the time with a condition called "bullous keratopathy" which basically means that fluid builds up in between the layers of the cornea. This isn't a problem in and of itself, but the little fluid pockets (called bullae) frequently burst, which causes a corneal ulcer. We recommend the Muro 128 as a long-term med to help draw the excess fluid out of the cornea. It's worth a try IMO, and like I said, will not hurt anything or interfere with any future medical therapy initiated.