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Wednesday, November 4, 1998

LIVE: Veterinary Eye Doctor Seth A. Koch

Seth A. Koch, VMD file photo

Like physicians dispensing medical care for humans, veterinarians have increasingly moved toward specialization over the past 30 years. New developments in medical technology coupled with revolutionary advances in instrumentation and technique have encouraged veterinarians to specialize in everything from cardiology to orthopedics.

Seth A. Koch, VMD is a pioneer veterinary ophthalmologist, specializing in the medical and surgical treatment of acute and chronic eye problems in animals of almost every variety. A pioneer in his field, Koch opened the East Coast's first speciality veterinary practice in 1969 in suburban Virginia.

An adjunct clinical professor of ophthalmology at the University of Pennsylvania, Koch has treated a bestiary of exotic patients, including an African lion, a Komodo dragon, elephants and birds. He is a consultant to the Chesapeake Wildlife Foundation and the National Zoo, where he performed successful corneal surgery on Hsing-Hsing, the only panda housed in North America.

Dr. Koch is online live now to answer questions about your pet's eyes and animal eye care in general. You may submit your questions now or during his appearance.

Washington, D.C.: I have two English Cocker Spaniels who are 11 years old and I have seen a number of other English Cockers go blind when they grow older. Is there anything we can do to either prevent it or if not, what can be done to prepare for it?

Seth A. Koch: What you are describing to me is a disease called progressive retinal atrophy. It is common in the English cocker, and initially presents as loss of night vision. It usually occurs in middle age, and is inherited. So the reality is that you can't do anything about it except to be very selective as to where you get your dogs and the history of the line that you are electing to buy.

Arlington, Virginia: Dr. Koch:

My cat--about 7 years old--recently had her teeth cleaned and was given general anesthesia. After the procedure was completed, the vet noticed her left eye was irritated. Two weeks later, this problem has been diagnosed as Horner's Syndrome. Do you think there is a cause-effect relationship here? What sort of treatment do you recommend? Do you think the condition will ultimately clear up?

Thanks.

Seth A. Koch: It sounds like what youare describing to me as Horners syndrome could be cause and effect if the nerve that is compromised was damaged during the anesthetic protocol. The good news is that most Horners syndromes like this go away over a period of time, probably six to twelve weeks. And the other good news is that it doesn't affect vision--and you need not treat it. So hang loose and stop worrying.

Fairfax, VA: Should this dog be bred?
Found to have "PUNC.Posterior cortex/significance unkown" In Comments"Cataract is not typical of inhertance in this breed.
It is a 8 month old golden Retriever from 2 clear parents.
Thank you

Seth A. Koch: You sound like you're interested in breeding your dog from the point of view of creating another great line of goldens. And what you describe sounds like a CERF exam, and from what I read from your report, I would not be concerned about these findings. I see a lot of little punctate opacities in the lens of eyes that never change. So go ahead and get another great golden. Do you think I'm playing favorites? :)

Washington, DC: We adopted a dog that has only one eye. According to the shelter, when he was found on the side of the road his right eye was so mangled that it had to be removed. The scar has healed well and the fur has grown over it, and he seems to have made the adjustment well. But our vet said that because the shelter didn't have a prosthetic put into the socket before they sewed it up, he may have problems later on. What types of problems could develop, and is there anything we could now to head off any future complications? Our vet tends to be a bit of an alarmist, so I'd like to hear what you have to say.

Seth A. Koch: I don't think you have a thing to worry about except that your pup cosmetically probably would be shunned by the neighborhood poodle, but short of that don't worry.

Yukon Oklahoma: One of our younger dogs seems to have a sight problem. Is there a simple at home method to check for basic vision i.e.
near-far sightedness. Also can animal suffer from glaucoma? I have heard this is true.

Seth A. Koch: The easiest way to check your pup's vision is to put a maze up in your living room and watch how the pup maneuvers around the furniture. And if you really want to go hog wild, you can vary the intensity of the light and see how he does in dark and bright. Glaucoma, your other question, is worth a few hours of talk and is very common in the canine.

Alexandria, VA: Dr. Koch,
No question here, but just wanted to thank you for the wonderful work you did on my beautiful calico cat Buttons last summer. You removed a large tumor from behind her right eye. This, along with chemotherapy, gave her a brief, but sweet remission. While she lost her battle eventually, we are grateful for the time we had. Thanks for your your help. God bless you, Carol, George, and Buttons

Seth A. Koch: Thanks very much for your compliment. I'm glad that Buttons had a good few months, and it's nice to know that clients like you go the whole route.

Granville, Ohio: My niece's horse developed an infection in one eye that was not treated immediately. As a result, he has apparently lost viosion in that eye, which appears sunken now. Her vet said it had probably been a virus, but he couldn't tell at that time. Are there many such viruses/bacteria prevalent in the midwest? Is there any prevention other than quick intervention? My horses are with her horse, are they in danger of the virus?

Seth A. Koch: Horses are very prone to a particular inflammation called uveitis. It can be caused by a variety of disease entities. It's not so much midwest as any other areas of the U.S. And unless your niece's horses are deficient in terms of their immune status, I don't think you have much to worry about. If your horses eye continues to shrink, it may be appropiate to have it removed just so it doesn't act as a chronic source of discomfort.

McLean, VA: How well do dogs see at night?

Seth A. Koch: Generally, night vision is excellent in the dog unless their is indication of progressive retinal atrophy, which is inherited and we've already alluded to that in one of the previous questions.

Rockport, Maine: I am afraid that my 4 year old Golden retriever may have cataracts. apparently on of his sibs does, and larely we have noticed that he is hesitant to go down the stairs when the light is off, and he has walked into a closed door at the end of a dark hall. What should I expect to see if I take my office ophthalmascope home and take a look?? Thanks
D.S. Cole, M.D.

Seth A. Koch: What you're describing, as a number of other Web visitors have asked, is retinal atrophy with secondary cataracts. The disease in man equivalent to this disease is retinitis pigmentosa. There is no therapy for either disease. And much as I would like to fit your dog with low vision aids, it's reasonably impractical.

Woodbridge, VA: Recently my parents cat developed what their vet suspected was an eye tumor.
Please discuss eye tumors in felines and canines. How common is this disease? What preventive measures can be taken and what types of surgery is avaiable. Thank you.

Seth A. Koch: Tumors within the eye are different from tumors of the lid. I'm assuming from what you're saying that the kitty that you are describing has a tumor inside the eye. Most of those are melanomas which rarely cause a problem in terms of the whole body, and may or may not cause a problem with the eye specifically. My own cat has had an intraocular tumor for 12 years, still has his eye and still has vision. So if you were my client, I would advise in all liklihood to leave well enough alone.

Montgomery Village, MD: I sent in my question before ... about the poodle whose eyes have turned blue. But I have never used this kind of service before and I don'd know where to go for Dr. Koch's answer.

Seth A. Koch: Depending on where the blue is, it could be a change in the lens of the eye or the cornea. If it's the lens, and the dog is seeing, it's probably nuclear sclerosis, which is a normal aging process, and is not a cataract. If it's the cornea, then the front of the eye turns blue and that's called a corneal dystrophy, which doesn't remarkably interfere with vision, but looks funny.

Washington, D.C. : My dog (she's a mutt) has very strange eyes. They're blue and instead of a round little pupil, they have kind of fragmented black spots through the iris. As far as I can tell, her vision is perfect, but I'm wondering if there is some problem I should watch out for. She is about 3 years old.

Seth A. Koch: The blue color that you describe is not unusual depending on the coat color of your dog, and if she has some Australian shepherd in her or similar breed, she would have light colored eyes. The fragmented black spots are probably pigment, but that's one that I would certainly want to see before I go any further.

McLean, VA: Dr. Koch:

My cat has a bad eye (looks like a cataract) that she has had ever since I adopted her from the Humane Society about 3 years ago. My vet has expressed some concern that there could be future complications, e.g., her eye could become cancerous. Do you think this is a valid concern, and are there any measures I can take now to prevent it (my cat is about 6 or 7 years old)?

Seth A. Koch: I'm not concerned. Certainly I would not expect a cataractous eye to become cancerous. It could develop glaucoma at a later date, but certainly not cancer.

Beltsville, MD: Do you recommend any special care to prevent blindness in aging dogs?

Seth A. Koch: There is no way to prevent blindness in any species. However, being aware of any clinical signs of eye disease--be it redness, irritation, discharge--should immediately raise a red flag and you should consult your regular veterinarian, or go directly to an ophthalmologist.

Rockville Maryland: My 10 year old female dog has developed a milky film over her eyes. My vet said that its normal and nothing to worry about. Is that true?

Also, how well do dogs see in low light evironments like a dark room. Should we leave a light on for her?

Seth A. Koch: Your doctor is correct, however, be aware that if we all lived long enough, our dense lenses would become cataracts. She shouldn't need a night light unless she is suffering from retinal degeneration.

Washington, DC:
Is it true that some breeds of dog, e.g., cocker spaniels, tend to have eye and ear problems more than others? If so, why and are there any preventative measures that can be takened to reduce future eye and ear problems in the breed.

Seth A. Koch: Cockers are very prone to cataracts and glaucoma. Cockers are one of the top ten breeds that I see. Ear problems are rampant in the cocker and you should probably talk to your regular veterinarian about their care.

Montgomery Village MD: I have a standard poodle, nine and a half years old. He seems to see well, but in the past couple of years his eyes have turned blue. He has always been troubled by mattercollecting in the corners of his eyes. I clean them out with tissues. I plan to take him to an opthalmologist, but I would like your opinion on his condition. Thank you

Seth A. Koch: The blueness is sclerosis, the matter collection, if it's silvery-gray, represents mucous and that's extremely common at this time of the year. I have it also. If it's yellowish-green, then it represents infectious disease and it should be reckoned with.

washingtonpost.com: We have a half hour remaining with Seth A. Koch. You may continue submitting questions.

cOLLEGE pARK, md: I have a terrible time getting my dog to keep her head in the car when the windows are down. I've heard that this is bad for a dog's eyes and for the mucuous membranes of their noses. Is there anything that can be done preventatively for her eyes -- goggles sound funny, but who knows? Any suggestions besides keeping the windows closed?

Seth A. Koch: My sugestion in all these cases with dogs and windows is to crack the window enough so that the pup can get her nose out and not her eyes. Imagine you driving at 60 mph without eye protection in your convertible--with no front windows.

d.c.: My 14and 1/2 yr.old ,otherwise
very healthy Lhasa Apso, has reduced near vision and slightly cloudy lens of both eyes, suggestive of cataracts. Assuming that is the diagnosis,is that type of surgery fequently performed on dogs? Or maybe we should just count are blessings and not intervene.
Thanks, Marlene

Seth A. Koch: Cataract surgery in the dog is about 90 to 95 percent successful to restore vision in a previously blind animal. The most important thing is to determine if the retina--the seeing portion of the eye--is working before considering cataract surgery. All it takes is a little bit of time and a little bit of money and lastly, as far as I'm concerned, age is never a disease--otherwise I'd be long gone.

washington, dc: I am worried about my 2 year old cat's right eye which seems a little cloudy sometimes. It is difficult to tell if it is really cloudy or if it simply his eyes reflecting light in a strange way. I think the eye is a little weepy, also. Is there a simple way to tell if there is a problem before I take him to the vet? He is due for his shots soon, so I don't want to make more trips to the vet than absolutely necessary...but I will go if there is a danger.

Seth A. Koch: The problem with kitty cats and weepy eyes is the possibility of infectious diseases. The cloudiness that you describe concerns me, and I would suggest to you that you do in fact take him to your doc. And if he or she is at all concerned, they will probably recommend that you see a specialist.

Chantilly, va: I had anEnglish Bulldog (was 12 when she passed) as a child, and am planning on getting another. My concern is that on several occasions she had to have surgery because she had scratched her cornea. Is there anything I can do to prevent this?

Seth A. Koch: English bulldogs have multiple ocular problems because of their facial structure, most commonly lid and cornea. When and if you get an English bulldog, you should probably have him or her closely evaluated. The greatest thing about English bulldogs is that they are so ugly they are cute.

Leesburg, VA: I have a five-year-old mixed breed female dog that has dry eye in both eyes. Under the care of a veterinarian, we have tried a variety of medications and solutions to treat the problem, all of which have been unsuccessful. She is now scheduled for surgery to correct the problem by rerouting saliva ducts from her mouth to her eyes. Could you tell me how successful this type of surgery is and what problems we may encounter by having the surgery?

Seth A. Koch: What you're describing is a parotid duct transpostion and if it's not an ophthalmologist doing it or a good surgeon who has done lots of these, be careful. The medication that you described works 70 percent of the time. The other 30 percent require surgical correction. Ninety to 95 percent of the time, the PDT is very effective and allows you to avoid constant ocular therapy.

Bossier City LA.: Doc , my Lab tends to have crud building up in the corner of one eye. It appears to be like the sleep humans develop in thier eyes. Should this be a concern or a normal accurance?

Seth A. Koch: Sounds like conjunctivitis or a blocked tear duct, and since you're from Louisiana, you may be hunting your dog and getting foreign bodies in his eyes. I certainly would have him looked at.

Baltimore, MD: My cat often has a black piece of goop near the tear duct in each eye. Should I wipe this off or let her remove it? It never seems to bother her much.

Seth A. Koch: This is very common, especially in the short-nosed cats. As long as it's not bothering the kitty, I'd just keep his eye cleaned.

New York, NY: My cat has had a small black patch (she is orange) on her chin that is very bumpy and feels like a scab. I have asked my vet about this and he said it was "kitty acne," but why would this persist for years and in the same place? I do not think he was right in his diagnosis. What else could it be?

Seth A. Koch: Sounds like your veterinarian is correct. This is not uncommon and often occurs in the eye as tiny white spots all over the cornea. It's probably from all that smog on the East Side. I used to live there.

Sterling, Virginia: My two year old Sheltie has never been able to catch soft toys and food tidbits very well. Can our vet tell if she has a near/far vision impairment?

Seth A. Koch: Your veterinarian will not be able to tell, and I'm not so sure I could either. But I would want to make sure that your pup doesn't have any retinal degeneration, which is not uncommon in young shelties.

Billings Montana: A few months ago our tomcat, Sylvester, had something wrong
with his eyes that caused the inner eyelid to partially cover the eye. In all, it lasted over a period of 2 months and also spread to Tabby, female cat, but not as noticeably or as long. They also seemed to be depressed during this time. Is this an eye disease or some other illness and what caused it. I looked on the internet for answers but could never be sure what this was. Dial a Vet suggested it was an infection. They are now over this but I still wonder what it was and if it was an infection, could it be passed on to us humans.

Seth A. Koch: Sounds like an entity called haws, which nobody has an answer to. Except that it goes away the same way it came, so just be thankful that it went away.

Auburn,AL: My 12-yr-old cockapoo has diabetes, glaucoma, and cataracts. He still sees light, but nothing else. I have taken him to the Auburn Univ. clinic, but they can't help him. I took him to a specialist in Birmingham who said she would remove the cataracts but that there was a good chance he would have lots of problems afterwards. Now I am taking him to a homeopathic vet. What can I do to control the glaucoma so that he can be operated on? He's using Trusopt, Xalatan, and Vitamin C drops and his diabetes is under control. We are following Pitcairn's diet.I don't know how to get into an on-line discussion, so can you please e-mail me the answer? I will take him to you if you can help. Allison Orr roorr@auburn.campus.mci.net

Seth A. Koch: Tough question. Easy answer: There is no glaucoma control. It's a surgical problem in my opinion. You're spending lots of bucks for the drugs you're using, and probably getting nowhere. Operate the pup, get him out of discomfort, and accept the fact that you're not going to restore vision because of the glaucoma--not because of the cataracts. And I hear this in the cocker all the time.

Reston, Virgina: I have a 22 year-old Hanoverian gelding that was diagnosed with equine periodic opthalmia ("moon blindness")about 4 years ago after a particularly severe bout. It had occured previously to that time very sporadically, and my vet had not labeled it as moon blindness; but during that occurrence made the diagnosis, and it has been reocurring on a more frequent basis (every 2-3 months); cloudiness, puffiness and watering, photophobia, etc. He is on a regular regimen of aspirin powder, and each flare-up is treated aggresively with antibiotic drops and/or ointments. I do not detect any vision impairment that I have noticed, and his other (left) eye has never shown any signs of affliction. What is the prognosis for this condition and is there any treatment that should be considered other than what's being done now?

Seth A. Koch: As I alluded to before, this represents chronic uveitis, which is difficult to keep under control. It sounds like you're doing everything right. The only thing I would do differently is use cortisone topically if there are no signs of corneal ulcers. Good luck, it's a bad disease to deal with.

Parksley, VA: I have a Cocker Spaniel with a cataract (eye problem). She is blind in one eye and the other one is beginning to cloud. Can these be removed? She has had cancer; is 10 years old; and does not go anywhere outside without a leash so my veternarian said he did not advise operating and he does not do this operation.

Seth A. Koch: I disagree with your doc. No dog is too old. The risks are minimal. The success rate is high--if the retina is okay. I suggest you get an ophthalmologist's opinion. There are a number of us throughout the Maryland-Virginia area.

Lancaster, Pennsylvania: My 10 year old Rottweiler has a small sack tumor on the upper eyelid which does not seem to interfer with the the cornea. It does drain on occasion and will fill with blood within a few weeks. I cleanse the area regularly with a swab dampened with a solution of water and hydrogen proxide. Am I doing a disfavor to my dog by maintaining this growth, or should I have it removed which I believe involves full sedation. Thank you.

Seth A. Koch: Stop using the hydrogen peroxide. It will cause corneal irritation if you get it in the eye. Why not just have the mass removed once and for all? Jerry Glickstein, VMD comes to the Lancaster area periodically. Check with your veterinarian to find out when and where.

Springfield, VA: Dr. Koch,
My 2-yr old cat suffers from seasonal air-borne allergies. Sometimes his eyes discharge mucous & the whites get red. He is receiving shots but not on a regular basis, as there's concern about long-term side effects. My question is this: is there anything I can put in his eyes to relieve the redness & discharge (e.g. Visine or a kitty-equivalent)?
Thank you.

Seth A. Koch: You are one of four or five guests asking about allergies. When we can solve mine, then we'll probably be able to solve yours. My best suggestion is to keep the eyes cleansed and use one of the anti-allergics, which are mast cell inhibitors, which seem to help and keep things under control--but never cured until you find the specific allergy. Good luck.

San Antonio, Texas: What are Y tips? If they were opaque on a 4 yr. old, is this a inheritable condition that I should be concerned with? Will it CERF?

Seth A. Koch: Y tips are normal and are part of the embryonic structure of the lens. On some occasion they become slightly opaque, but visually they mean nothing. And depending on the breed, could or could not be potentially certified. Most of the time, I make very little of them.

washingtonpost.com: We are out of time. Many thanks to Seth Koch for his visit today. Dr. Koch would be happy to answer further questions by writing him at his office at 8023 Piney Branch Road, Silver Spring, MD 20910. And as long as you are patient, he'll get back to you.

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