Eye Ulcers (Corneal Ulcers) in Dogs: Signs, Treatment and Healing

Signs of an Eye Ulcer in Dogs

• Squinting, blinking a lot or holding the eye closed^2,4
• Watery eye or discharge^3,4
• Red eye⁴
• Rubbing or pawing at the eye^2,4
• A cloudy or hazy area on the eye, or a visible pit^2,4
• Avoiding bright light⁴

Small ulcers are often invisible without a special dye, so a squinting dog should be checked even if the eye looks normal.^3,2

What Causes Corneal Ulcers?

• Injury, the most common cause: scratches from cats, plants or play, rubbing, grass seeds or grit^2,3,4
• Chemicals such as shampoo²
• Eyelid and eyelash problems, including inward-rolling eyelids (entropion) and extra lashes^2,8
• Dry eye (KCS)^2,9
• Infection, which more often develops after an ulcer forms^3,2
• Hormone diseases such as hypothyroidism, Cushing's disease and diabetes, which can contribute to dry eye and slow healing^2,9

Breeds at Higher Risk

In the UK study, Pugs had 19 times the odds of crossbred dogs, Boxers 12 times and Shih Tzus 10 times. Bulldogs and Cavalier King Charles Spaniels were also at higher risk.¹ Flat-faced breeds have prominent eyes, often can't fully close their eyelids, and may have nasal folds or hairs that rub the eye.^5,7

Types of Corneal Ulcer

• Superficial ulcers affect only the outer layer and usually heal quickly.^10,2
• Deep ulcers go into the thicker middle layer of the cornea. They are more serious and often need surgery.^10,3
• Melting ulcers occur when enzymes from bacteria and the eye itself dissolve the cornea, which looks soft and gray. They can deepen very quickly and are an emergency.^10,11,6
• Descemetoceles are ulcers that reach the innermost layer of the cornea. If that layer ruptures, the eye can collapse.^2,10
• Indolent ulcers (also called SCCEDs or "Boxer ulcers") are shallow ulcers that won't heal because the surface layer can't stick down properly. They mostly affect middle-aged and older dogs, especially Boxers, but any breed can get them.^10,12,13

How Vets Treat Corneal Ulcers

Your vet will put a drop of fluorescein dye in the eye. It turns green where the cornea is damaged.² Treatment then depends on the type of ulcer:^2,10

• Antibiotic drops or ointment to prevent or treat infection^2,10
• Pain relief: atropine drops to ease painful eye spasm, and pain medicine by mouth^2,10
• A cone (E-collar), which is essential to stop rubbing^2,4
• Treating the cause, such as removing a foreign body, correcting eyelids or lashes, or treating dry eye. Unless the cause is fixed, ulcers often don't heal.^10,2
• Serum drops (made from blood) for melting ulcers, to block the enzymes that dissolve the cornea^11,10
• Surgery for deep, melting or perforated ulcers, usually a graft from the eye's own tissue, often done by a veterinary ophthalmologist. In a large specialist series, one graft technique saved vision in about 97% of 418 eyes, with poorer results when the eye had already ruptured.^10,6,14

Treating Indolent (Non-Healing) Ulcers

Antibiotics alone don't heal indolent ulcers. The loose surface layer needs to be removed so new cells can attach.^13,12,10 Options include:

• Debridement with a cotton swab, which heals about half of cases by itself^13,15
• Diamond burr debridement or grid keratotomy, usually done with numbing drops, sometimes with light sedation. These heal most ulcers within 2 to 3 weeks; some dogs need the procedure repeated.^16,17,12,13
• A bandage contact lens, which speeds healing^18,12
• Superficial keratectomy, surgery under general anesthesia with a success rate of 95% or more, for ulcers that don't respond^17,19

Indolent ulcers can come back in the same or the other eye.^12,20

What Not to Use

• Any drop or ointment containing a steroid (dexamethasone, prednisolone, hydrocortisone and others), including antibiotic-steroid combinations such as Neo-Poly-Dex, TobraDex or "HC" ointments. Steroids can make an ulcer melt and deepen. Check the label or ask your vet.^21,2
• Anti-inflammatory (NSAID) eye drops, which can also worsen ulcers. Pain medicine by mouth from your vet is fine.^21,12
• Leftover or human eye drops, including redness relievers such as Visine.^22,23
• Numbing drops for repeated use at home; they damage the cornea.²

How Long Does It Take to Heal, and Signs of Healing

Most uncomplicated ulcers heal within about a week, often in 3 to 5 days.^2,3 An ulcer that hasn't healed in 7 to 10 days should be rechecked for an indolent ulcer or another cause.^13,16 Indolent ulcers often take 2 to 3 weeks after treatment.^16,20

Signs an ulcer is healing: your dog squints less and opens the eye more, and the eye looks clearer. Red streaks of new blood vessels growing toward the ulcer can be a normal part of healing; your vet will check whether they're expected. Only a repeat stain test shows that the ulcer has fully closed, so keep your recheck appointments.^24,2,10

Signs it's getting worse: more squinting or pain, a growing cloudy or white area, a soft or gray-looking spot, or a deepening crater. Call your vet right away.^2,6

See dog eye infections for other causes of a sore eye.

Frequently Asked Questions

Can a dog's eye ulcer heal on its own?

Very small scratches sometimes heal, but you can't tell at home how deep an ulcer is or whether it's infected. Ulcers can worsen quickly, so a dog that's squinting needs a vet exam and treatment.

How can I treat my dog's eye ulcer at home?

Give the medicines your vet prescribes exactly as directed and keep the cone on. Don't use steroid drops, human eye drops or home remedies.

How long does a corneal ulcer take to heal in a dog?

Most simple ulcers heal within about a week. Indolent ulcers often take 2 to 3 weeks after treatment.

How do I know if my dog's eye ulcer is healing?

Your dog squints less, the eye looks clearer, and your vet's stain test no longer turns green.

Is an eye ulcer painful for dogs?

Yes. Ulcers are painful, which is why dogs squint and rub. Your vet can prescribe pain relief.

Can a dog lose an eye from an ulcer?

Yes, if an ulcer becomes infected, melts or ruptures and isn't treated in time. Prompt treatment gives the best chance of saving the eye.

Why won't my dog's ulcer heal?

It may be an indolent ulcer, or something such as dry eye, an eyelash or eyelid problem, or a foreign body is keeping it open. Ask your vet about debridement or referral to an ophthalmologist.