“Good morning, Dr Kraemer; My 1.5-year-old Fr. bulldog Jussi seems to be squinting a lot, and I’ve noticed some rt eye redness, puffiness, discoloration, painfully squinting and she is trying to rub it. Should I come to see you for that? What could be causing this, and what steps should I take for my bulldog’s eye discomfort? #BulldogHealth #EyeIssues 🐶👁️ #VeterinaryAdvice
Unlike many other breeds where trauma is the leading cause of corneal ulcers, this is not the case in bulldogs.
The elevated risk in bulldogs stems from their distinctive features, such as
- flattened skulls
- excess skin folds
- prominent bulging eyes
- insufficient tear production
- eyelid inward rotation
- Ingrown or abnormal eyelashes
These factors contribute to a significantly increased susceptibility to corneal ulcers compared to most other dog breeds.
Corneal Ulcer in Bulldogs and French Bulldogs: ANATOMY
Your bulldog’s cornea is the front part of the eye; it is transparent and acts like a windshield, covering the bulldog’s eye.
Its concave and clear nature makes it more noticeable when viewed from the side or in a profile position.
This is the area where we normally apply eye drops.
Bulldog CorneaL Health Impact on Eyesight:
The corneas facilitate light entry into the eye, guiding it through the inner eye chambers and lens.
This transparent structure enables the light to reach the back of the eye, where the retina and optic nerve are located, and where the light and nerves create an image.
The eye is the camera, the cornea is the lens and the film is the retina.
Just like scratches and “dirt spots” on a camera lens that can blur and reduce the quality of developed photos, scratches on the cornea and a decrease in transparency obstruct the passage of light.
If light cannot fully enter the eye, it will affect the sharpness of the image formed by the retina, directly impacting your bulldog’s eyesight.
BULLDOG CORNEA: 3 X LAYERS
The bulldog cornea is made from three specialized layers
- EPITHELIAL: the first layer, the outermost layer
- STROMAL: the second layer sandwiched in between the superficial epithelial and the posterior deep descement layer
- DESCEMET & ENDOTHLUM: the deepest, most posterior layer
BULLDOG TEAR PRODUCTION:
The bulldog cornea is bathed and “lubricated” with tears.
The tear film helps provide nutrients and oxygen to the cornea.
Corneal Ulcer in Bulldogs and French Bulldogs: TYPES
There are a few types of corneal ulcers, ranging from superficial and mild to deep and severe.
Bulldog Cornea EPITHELIAL ULCER
- It can be difficult to see with a naked eye and might require a stain for a diagnosis
- It is considered the least severe
- And typically responds promptly to appropriate treatment, resulting in quick healing.
The superficial corneal ulcer in bulldogs is the most prevalent type
Bulldog Cornea STROMAL ULCER
A bulldog stromal corneal ulcer is
- easier to see with the naked eye
- it’s usually cloudy-looking
Bulldog Cornea DESCEMET ULCER
Bulldog descemtocele ulcer is the
- most serious
- can melt and perforate
- challenging to treat
- duration to full healing is often much longer
A Descemtocele deep corneal ulcer has the potential to perforate, leading to permanent loss of sight in your bulldog thus require urgent care.
Corneal Ulcer in Bulldogs and French Bulldogs CAUSE
For most breeds, exterior trauma is the #1 cause; it is not so for bulldogs
In contrast to other breeds, the most common causes of bulldog corneal ulcers are due to the breed’s anatomical characteristics and structural defects:
Bulldog corneal ulcer: ENTROPION
The inversion of eyelids, caused by the abundance of facial skin folds, leads to the lid and eyelashes rubbing against the cornea, causing irritation and injury.
Bulldog corneal ulcer: DRY EYE
Bulldog dry eye (keratoconjunctivitis sicca KCS ) is a prevalent immune-mediated condition unique to the breed that impacts tear production.
The deficiency in tears deprives the cornea of vital nutrients, oxygen, and lubrication, leading to chronic corneal disease and ulceration.
Bulldog corneal ulcer: ABNORMAL EYELASHES
Irregular eyelashes that come into contact with the cornea can cause pain and an urge to rub, leading to direct and indirect injuries to the cornea.
Direct injuries happen when the eyelashes touch the cornea, while indirect injuries result from the rubbing and itching in response to the irritant.
Examples of abnormal eyelashes include:
- ectopic cilia
Bulldog corneal ulcer: TRAUMA
While less frequent, corneal ulcers may also arise from external traumatic incidents, such as:
- Running into a rose bush
- Cat Scratch
- A chemical injury, such as soap or shampoo
- Accidentally rubbing the eye due to allergies such as bulldog food allergy and atopic dermatitis
- Rubbing the eyes due to bulldog skinfold dermatitis
Bulldog corneal ulcer: CHERRY EYE
Cherry eye is common in French bulldog and English bulldog puppies.
A large, protruded cherry eye could rub the cornea and also impede tear production
Bulldog corneal ulcer: EXPOSURE KERATOPATHY
Injuries resulting from exposure are a consequence of the breed’s brachycephalic confirmation. The compressed skull affects the eye sockets, causing bulging eyes and an inability of the eyelids to fully close.
These bulging eyes, coupled with insufficient tear distribution, contribute to corneal exposure and issues with the tear film
Bulldog corneal ulcer: OTHER
CORNEAL ULCER: HORMONAL
Endocrines diseases such as
VIRAL & BACTERIA CORNEA ULCER
FACIAL NERVE PARALYSIS:
can contribute to dry eyes by disrupting the blinking mechanism, consequently affecting the spread of tear film.
Insufficient distribution of the tear film leads to dry eyes, and persistent dry eye conditions can result in corneal ulcers.
Corneal Ulcers in Bulldogs and French Bulldogs PRESENTATION
Depending on severity, your bulldog may exhibit a wide range of symptoms
Bulldog Cornea Ulcer: SEVERE PAIN
Pain is typically manifested by:
- Blinking & Squinting
- Tearing & Discharge
- Rubbing & Pawing
- Shut often swollen eyelids (closed eye)
- Other: change in appetite and other behavioral abnormalities associated with PAIN
Bulldog and French bulldog corneal ulcers can be very painful
Bulldog and French Bulldog Cornea Ulcer DISCOLORATION
- white patches
- opaque area
- vascular areas
- pigmented areas
Bulldog and French Bulldog Cornea Ulcer PUNCTURE
Visible “holes,” punctures and concave lesions are prone to infection and can rapidly deteriorate. It should always be regarded as an emergency.
Corneal Ulcer in Bulldogs and French Bulldogs: DIAGNOSIS
Visual examination and ophthalmoscopy exam:
Evidence of ocular discomfort, squinting, abnormal blinking,
ITCHING AND RUBBING
Evidence of skin irritation and redness that can trigger rubbing and pawing
Evidence of underlying traumatic causes, such as abnormally rotating eyelids.
It usually requires a magnifier and special bright lumination.
OTHER BULLDOG OCULAR DISEASES:
We are looking for evidence of ocular diseases such as glaucoma and uveitis, including ocular discoloration and bulging consistently.
The diagnosis will require tonometry (measurement of the intraocular pressure)
BULLDOG CORNEAL ULCER STAINING
Using a special corneal stain and ultraviolet light we can detect ulcers that might be difficult to deduct on an exam.
The fluorescein stain test is the most common bulldog cornea ulcer test performed
SCHIRMER TEAR TEST
A tear production test should be done on any bulldog presented with a cornea ulcer
CORNEA ULCER CULTURE & CYTOLOGY
A deep more advanced corneal ulcer or non-healing one will require a sample for culture and cytology.
Corneal Ulcer in Bulldogs and French Bulldogs TREATMENT
Treatment depends on the type of ulcer and the underlying cause
Bulldog Cornea Ulcer TOPICAL TREATMENT
1. TOPICAL ANTIBIOTIC:
ophthalmic antibacterial ointment or drops placed a few times daily
2. TOPICAL SPASM & PAIN RELIEF:
Ophthalmic atropine drops or ointment can help with ocular pain and discomfort
3. LUBRICATION AND TEAR PRODUCTION
Ophthalmic drops or ointment should be used for excessive exposure.
- hyaluronic acid
lifelong drops/ointment to help maintain adequate tear production
4. SERUM & PRP
Autologous serum eye drops and PRP (platelet-rich plasma) can also help heal some types of corneal ulcers
5. BULLY SKINFOLD ANTISEPTIC WIPES
It is important to recognize the cause and effect of itch, painful nasal or facial bulldog skinfold dermatitis, and bulldog corneal ulcers.
The proximity of the infected folds to the eyes means that an itch, pawing, or rubbing of the infected skinfold can lead to an accidentally injured cornea
Preventive care for your bulldog’s skinfold dermatitis can prevent a more serious and costly corneal injury.
Using Dr. Kraemer’s V4B Antiseptic Bully Skinfold XL wipes is the ideal preventive and maintenance therapeutic remedy for this common bulldog condition
6. SYSTEMIC RX
Pain Relief: Oral NSAID anti-inflammatory and pain relief analgesics might be needed, especially for bulldogs with deep stromal and descemetocele corneal ulcers
Antibiotics: oral antibiotics are not necessary for superficial ulcers but often are for deep stromal and/or descemetocele corneal ulcers
Corneal Ulcers in Bulldogs and French Bulldogs: SURGERY
Surgery might be necessary for indolent ulcers to help remove detached or poorly healing corneal epithelium
might be necessary for corneal descemetocele
Is urgently needed when the corneal ulcer is caused by your bulldog’s inward eyelid rotation
TEMPORARY ENTROPION SURGERY:
Bulldogs experiencing inwardly rotating eyelids (entropion) can find relief through this procedure. The surgery is also advantageous for eyelids experiencing spasms due to pain. Moreover, it serves as an emergency measure until a permanent entropion correction can be scheduled.
It is usually done with surgical staples
This procedure can be swiftly performed in an emergency setting within seconds and without anesthesia, or with mild sedation if necessary.
ABNORMAL EYELASH SURGERY:
To help remove an eyelash(s) that are growing in the wrong direction or inside the eyelid.
It is usually done with liquid nitrogen freezing (cryo freezing)
BULLDOG CHERRY EYE SURGERY:
Some protruding or “cherry” eyes can rub against the cornea, resulting in injury.
Bulldog cherry eye can also hinder tear production, leading to dry eyes and subsequently causing corneal ulcers.
Cherry eye surgical repair must preserve the gland; never allow the gland to be removed, as it is critical for tear production.
Bulldog and French Bulldog Corneal Ulcer TIPS & WARNINGS
PROTECTIVE GEAR TIP:
Place a buster collar to prevent any further injury
R/C EXAM TIP:
r/c exams are critical to confirm healing; they usually require a cornea-negative staining
A referral to a specialist might be required for a nonhealing corneal ulcer or a severe, deep, melting, or perforating one.
BULLDOG CORNEAL ULCER WARNINGS
Besides relieving the spasm, the atropine ophthalmic drops will also dilate your bulldog’s pupils. Therefore, it’s important to keep your bulldog away from direct, bright light.
Topical ophthalmic steroids are commonly employed for diverse ocular conditions. However, they should only be applied after the ulcer has healed.
It is crucial to NEVER use them on an active, live corneal ulcer, as they impede the healing process and may lead to serious complications.
If your bulldog exhibits worsened symptoms, such as squinting, blinking, or a discolored cornea, after using any topical ophthalmic containing a steroid (indicated by terms like “pred,” “dex,” or “hydro”), discontinue use immediately and seek veterinary attention as soon as possible.
Corneal ulcers constitute an emergency. If you observe your bulldog squinting or notice the cornea appearing discolored, vascular, or opaque, it is imperative to seek veterinary assistance promptly.
Member of this bulldog community prefer prevention over RX
*This guide was compiled courtesy of Dr. Kraemer, a “must-read” manual for any current or future bully owner