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Rolo, an 8 year old Pug, presented for assessment of a deep corneal ulcer affecting his right eye. Brachycephalic breeds often present with deep ulcers ranging from mid-stromal to descemetoceles. When a case presents with a deep ulcer, it is important to establish if there are any causative factors preventing healing or causing the ulcer to become deeper. Ectopic cilia, distichia, nasal fold trichaisis, entropion or lagophthalmos can all be causes that prevent ulcer healing, especially in brachycephalic breeds.  



On examination, it was clear that Rolo’s nasal fold was a factor in the ulcer not healing so a decision was made to perform a corneal conjunctival transposition graft to repair the corneal ulcer and to also remove his large nasal fold at the same time.






Nasal Fold Resection

Nasal fold resection is often required in brachycephalic breeds. The hairs on the nasal fold can rub the corneal surface and although they are not often the cause of ulceration, they can be a factor in ulcers not healing or can cause chronic changes to the cornea like hyperpigmentation. Corneal-conjunctival transposition grafts lend themselves well to ulcers like Rolo’s, as they bring corneal vessels into the area of ulceration and quickly support healing.

Rolo has been now been discharged and is a lot more comfortable than before his surgery. Even without the corneal issues, removal of nasal folds can really improve a patient’s quality of  life.   

As an advanced practitioner in ophthalmology, Jess can perform surgery on the surface of the eye using an operating microscope. This allows her to repair deep ulcers which could lead to eye rupture and removal if left untreated. Corneal grafts can be tricky surgeries and require dedication from owners to apply eye drops frequently afterwards.  

The procedure went well, and Rolo was signed off four weeks later. His family report that he seems a lot more comfortable without his nasal fold and we think he looks much more handsome!  


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