Just Ask the Expert: Premature eyelid opening in a kitten
Dr. Gionfriddo welcomes ophthalmology questions from veterinarians and veterinary technicians.
Q. A few weeks ago, an approximately 5-day-old kitten was presented to my clinic. The kitten had a mild ocular discharge and signs of an upper respiratory infection. The kitten's eyes were still closed. I wiped off the ocular discharge and treated for URI. Another doctor opened the cat's eyes during the appointment.
A week later, the cat was presented for evaluation of severe chemosis and was treated with erythromycin ophthalmic ointment. All other signs had improved. Last week, I saw the cat again—no menace response. I could not examine the fundus. Both eyes had corneal edema and neovascularization and, in the center of each eye, a round, raised, pink, fleshy mass.I referred the case to an ophthalmologist. I won't see the cat again because I am moving and starting a new job, but I've always been curious about this case. At what age do cats open their eyes? And do you think that opening the eyes prematurely had anything to do with what the cat is experiencing now?
A. Kittens are altricial animals, and their eyelids do not open until about 10 to 14 days after birth. The condition you describe in this kitten is called neonatal conjunctivitis; the most common cause of this condition is herpesvirus infection, which is contracted from the queen. There then can be a secondary bacterial infection, which causes a buildup of purulent discharge beneath the eyelids and, if untreated, can lead to severe corneal infection, scarring (the red, fleshy mass of granulation tissue you describe), and even ocular perforation. The fact that the kitten did not respond to a menace could be that it is truly blind from the corneal disease or that it is still too young to respond well.
The treatment for this condition is to immediately open the eyelids to let the purulent material drain off the surface of the cornea, clean the eyes well, and then apply topical antibiotics three or four times daily. So it is the infection, and not premature eyelid opening, that can cause blindness.
Juliet R. Gionfriddo, DVM, MS, DACVO