Ocular Surface Disease of

Rabbits
Kathleen M. Bedard, DVM

KEYWORDS
 Rabbit  Cornea  Conjunctiva  Dacryocystitis  Surface disease

KEY POINTS
 The prominent, laterally placed eyes of the rabbit predispose it to surface injury.
 The tortuous path of the nasolacrimal duct makes the rabbit prone to obstruction and sub-
sequent inflammation and infection.
 Conjunctivitis is a common problem in the rabbit and can be due to both infectious and
noninfectious (husbandry-related) causes.
 Corneal ulceration in the rabbit can be managed similarly to ulceration in canine and feline
species.

INTRODUCTION

The domestic rabbit (Oryctolagus cuniculus) continues to grow in popularity as a com-

panion animal and thus is encountered with increasing frequency by the veterinarian in
private practice. Ocular problems have been reported in both populations of research
and pet animals and can greatly affect quality of life and welfare. One study of 1000 pet
rabbits in the United Kingdom found 26% to have ocular lesions, with 2.5% suffering
from corneal lesions and another 3.5% afflicted with dacryocystitis.1 Understanding
the unique attributes of the rabbit eye and the diseases that commonly affect the
eye is important to being able to treat these animals effectively. This review focuses
on diseases that affect the surface of the eye, namely corneal and adnexal disease.

ANATOMY

The first detailed text describing the anatomy of the rabbit was published in 1954 by
Prince.1 Rabbits have prominent, laterally placed eyes to help facilitate nearly 360 of
visualization of their environment. While enabling rabbits to better keep a look out for
predators, the prominence and position of the eye leaves it exposed and subject to

Disclosure Statement: The authors have nothing to disclose.

Comparative Ophthalmology, University of Georgia, 2200 College Station Road, Athens, GA
30202, USA
E-mail address: kmbedard@uga.edu

Vet Clin Exot Anim 22 (2019) 1–14

https://doi.org/10.1016/j.cvex.2018.08.003 vetexotic.theclinics.com
1094-9194/19/ª 2018 Elsevier Inc. All rights reserved.
2 Bedard

trauma. In addition, the corneal surface is large compared with the size of the eye it-
self, predisposing the rabbit to ulceration.1–4
The rabbit has a unique nasolacrimal system in that there is only one slitlike inferior
punctum, located deep within the inferior medial fornix, and no lacrimal sac.3–5 In addi-
tion to these unique attributes, the rabbit nasolacrimal system follows a particularly
tortuous route through the nasal ostium with 2 sharp diversions and areas of narrow-
ing. This tortuous route makes them highly susceptible to developing obstructions of
the duct. Finally, the nasolacrimal duct passes very close to the molar and incisor
tooth roots and can easily be affected by dental disease.
The rabbit third eyelid contains no muscles, but instead is passively drawn across
the eye by the action of the retractor oculi muscle, which can advance the third eyelid
more than two-thirds of the way across the ocular surface.4
The rabbit has a circular pupil and, in nonalbino species, a highly pigmented iris.
Rabbits have a very complex vascular anatomy with a large retrobulbar venous
plexus. They also boast an impressive collection of tear glands, which occupy a large
portion of the retrobulbar space. Finally, rabbits have a merangiotic fundus, meaning
that retinal vessels extend from the optic disc along with myelinated nerve fibers
to course horizontally across the back of the eye. Their visual streak is located par-
allel and inferior to the retinal vessels and myelin, supplied solely by the choroidal
vasculature.1,4,5

BLEPHARITIS

Blepharitis can be caused by a variety of infectious, inflammatory, and neoplastic

causes (Fig. 1). Diagnostic workup should include cytology, culture, and/or biopsy if
indicated. One of the most common causes of infectious blepharitis in the rabbit is
infection with Treponema cuniculi. Infection with T cuniculi is thought to be transmitted
to neonates by the genitally infected dam.6 Experimentally, rabbits of infected dams
birthed via hysterectomy failed to develop spirochaetosis, whereas rabbits born
from infected dams developed infection regardless of whether or not they were nursed
from the infected dams or were fostered with noninfected dams. The diagnosis is best
made by identifying the spirochete organism on conjunctival cytology. Treatment in-
volves 3 injections of penicillin G at 40,000 IU/kg given 1 week apart. Care must be

Fig. 1. Blepharitis and chronic keratitis.

 Ocular Surface Disease of Rabbits 3

used when administering systemic antibiotics to rabbits because fatal dysbiosis has
been reported.7
Other differentials for rabbit blepharitis include myxomatosis (described further un-
der conjunctivitis), staphylococcal infection, and squamous cell carcinoma.

NASOLACRIMAL DISEASE

Disease of the nasolacrimal duct is one of the most frequently reported ocular dis-
eases in rabbits. In a clinical study of 344 rabbits at the University of California, Davis
found that 10% of all disease presentations were ocular related and of those, 73% had
clinical signs of dacryocystitis.8 Another study of pet rabbits in 2006 found that 7 out of
the 102 rabbits examined had a history of dacryocystitis.9 Prevalence of dacryocystitis
in pet rabbits in the United Kingdom has been reported to be as high as 3.5%.1
Dacryocystitis, or inflammation of the lacrimal sac, is diagnosed when purulent ma-
terial can be expressed from the nasolacrimal puncta on placing pressure on the skin
beneath the medial canthus.8,10 However, the normal tear secretion from the gland of
the third eyelid can seem milky in appearance and should therefore not be mistaken
for infection.11 In severe cases of dacryocystitis, the lacrimal gland can actually be
visually distended with pus.10 Other concurrent clinical findings can include conjunc-
tivitis, corneal edema, and keratitis (presumably related to the presence of chronic pu-
rulent discharge on the cornea) (Fig. 2).
As mentioned earlier, the unique anatomy of the rabbit likely contributes the fre-
quency of nasolacrimal duct disorders. The pathway is quite tortuous and the duct
must narrow as it passes through the lacrimal to frontal bone and again at the base
of the maxillary incisor (Fig. 3).11 Inflammation of the nasolacrimal duct is known to
cause alteration of the tear film, which becomes viscous and gritty and can block
the duct at its 2 narrowest points. In addition, the duct passes quite close to both
molar and incisor tooth roots.1,3,4 Any elongation of the incisor tooth root can result
in subsequent functional obstruction of the duct, and tooth root abscessation can
extend locally to affect the duct as well. Blockage of the duct and stasis of the muco-
purulent discharge can then lead to secondary bacterial infection.12 In a retrospective
study of 28 rabbits with dacryocystitis, 50% of cases had underlying dental disease,10

Fig. 2. Dacryocystitis and concurrent superficial corneal ulceration. (Courtesy of Mary

Landis, VMD, MA; Whitehall PA.)
4 Bedard

Lacrimal
Lacrimal Lacrimal gland
sac puncta
Incisor
bend
Retro-orbital
Nasal lobe
meatus

Proximal
Orbital lobe
maxillary
bend
Infraorbital of
the accessory
lacrimal gland

Fig. 3. Rabbit nasolacrimal duct anatomy.

making thorough oral examinations paramount in the diagnosis of nasolacrimal

disease.
Primary bacterial dacryocystitis has been reported, and historically it has been most
attributed to infections with Pasteurella sp.11 More recent investigations have found a
plethora of other bacterial agents such as Staphylococcus sp, Moraxella sp, Oligella
urethralis, Pseudomonas, and Streptococcus viridans. However, these bacterial iso-
lates have been found on both healthy and diseased patients, so careful interpretation
of bacteriological sampling results is important.
Clinical workup of dacryocystitis should include microbiological sampling via culture
and cytology of ocular discharge, Jones test, flushing of the nasolacrimal duct, com-
plete oral examination, and skull or dental radiographs if indicated. Advanced imaging
via computed tomography or dacryocystorhinography may also be indicated to iden-
tify the site of obstruction if present.
Treatment of dacryocystitis can be protracted and quite frustrating. A retrospective
analysis of 28 cases of dacryocystitis in rabbits reported 5.8 weeks as the mean dura-
tion of therapy, although rabbits in this study whose disease was cured tended to have
a shorter course of treatment.10 Topical antibiotic therapy is often the first choice of
treatment, although many rabbits will require systemic antibiotic therapy as
well. Oral antiinflammatory agents are often indicated to help with pain and inflamma-
tion. Nasolacrimal flushing is also a mainstay of treatment, either with sterile saline, an-
tibiotics, acetylcysteine, or some combination of these.10 Those rabbits with
underlying malocclusion or other dental disease should be treated for such if the asso-
ciated nasolacrimal duct inflammation is to be resolved. Many cases will not resolve
regardless of how aggressive the therapy instituted. One of the few studies looking
at outcome of dacryocystitis cases indicates that the longer the treatment course,
the poorer the outcome. In addition, those rabbits placed on systemic antibiotic ther-
apy (presumably because of more severe disease) also had poorer outcomes.10
Finally, although congenital nasolacrimal duct obstruction in the rabbit has not been
reported in the literature, rabbits have been used in studies investigating treatment of
this condition because their nasolacrimal duct is structurally and histologically similar
to that of people. In a study by Goldstein and colleagues13 in 2006, balloon dacryo-
plasty with inflation up to 3 mm in infant New Zealand White rabbits did not induce sig-
nificant inflammation or crush injury to the nasolacrimal duct. Results of this study
indicate that balloon dacryoplasty could be used safely to treat congenital nasolacri-
mal duct obstruction if identified in a clinical setting.
 Ocular Surface Disease of Rabbits 5

NASOLACRIMAL FLUSHING

When approaching diagnostic and or therapeutic flushing of the nasolacrimal duct in

cases of dacryocystitis, it is important to remember that the duct will be irritated and
fragile.11 Using rigid metal cannulas is therefore discouraged, because these can
potentially perforate through the wall of the duct. Instead, soft Teflon catheters
(27G) are preferred and should be introduced into the nasolacrimal puncta carefully
to avoid causing trauma (Fig. 4). Rupture of the lacrimal sac can occur and can be
identified by progressive exophthalmos when instilling irrigation fluid through the cath-
eter, which then enters the periorbital tissue through the rent. The cornea can also
easily become scratched or ulcerated during this process, so care should be taken
to avoid contacting the cornea if possible.11
Flushing can be accomplished in the awake animal, but sedation is recommended
to reduce stress in the patient and increase compliance. When flushing both eyes, a
new catheter should be used for each to avoid spreading of infectious organisms.
The lacrimal punctum is located deep within the ventromedial fornix of the lower
eyelid. Gentle pressure can be applied to evert the lower eyelid, causing the lips of
the puncta to pouch outward, allowing easy cannulation. Once the nasolacrimal punc-
tum has been carefully catheterized, warm sterile saline or water in a 3 mL syringe can
be attached to the hub and used to flush the duct. Flush can be pushed in short gentle
bursts as the cannula is gently moved back and forth to try and unblock the duct. Daily
or multiple flushes per week are often required to clear serious infections.

KERATOCONJUNCTIVITIS SICCA

Rabbits have 5 different tear glands that contribute to the precorneal ocular tear film:
the Harderian, nictitating, lacrimal, infraorbital, and extraorbital glands.1,3,5,14 These
glands occupy a large portion of the retrobulbar space and thus disease affecting
anyone of them can lead to exophthalmos. As with canine patients, rabbits can

Fig. 4. Nasolacimral duct flush in a rabbit with dacryocystitis.

6 Bedard

experience prolapse of the nictitating gland requiring surgical replacement via similar
methods to improve cosmesis and avoid the development of clinical dry eye (Fig. 5).4
The tear film in the rabbit is remarkably stable, which is likely why rabbits can have
such a low blink rate of 3 to 4 times per hour without any associated corneal drying.15
The normal tear osmolarity in the rabbit is between 300 and 305 mOsm/L,16 and
normal tear film breakup time has been determined to be around 20 seconds.17
Traditionally, clinical measurement of tear production in our domestic species is
accomplished through the Schirmer tear test (STT). Measurements of normal tear pro-
duction in rabbits using this method have been reported as anywhere from 5.2 to
7.6 mm/min.18–20 Because using STT strips in smaller rabbit breeds with compara-
tively smaller eye size can be irritating and potentially damaging to the ocular surface,
alternative tear testing to the STT has been investigated. Phenol red thread testing is
better suited to measuring tear production in smaller eyes and in animals with lower
tear production.20 The test involves using a special cotton thread impregnated with
phenol red, a pH-sensitive indicator that changes color from yellow to red when
wetted with tears. A thread 70 mm long is crimped at one end and then placed in
the ventral conjunctival fornix for 15 seconds, and the wetted length is then measured
in millimeters.21 Mean reported tear production measurements in New Zealand White
rabbits using the phenol red thread test was 20.88 mm per 15 seconds with a range
from 15 to 27 mm per 15 seconds.20
Paper point tear testing (PPTT) in rabbits is another alternative to traditional STT
strips and like the phenol red thread test, avoids the ocular irritation and difficulty of
inserting the large STT strip into conjunctival fornix of young dwarf breeds. Tear pro-
duction in rabbits as measured by PPTT was reported to be 13.8  1.5 mm/min. In-
vestigators noted discomfort, restlessness, and a desire to try and remove the strip
when using the traditional STT testing but failed to note any such behavior with the
PPTT.18
No matter the method used to measure tear production, it is important to remember
that tear production can vary between rabbit breeds, although the differences noted
have still been within the calculated range for what is considered normal.22
Although clinical cases of keratoconjunctivitis sicca in the rabbit are rare, the rabbit
has been used frequently as a model for human dry eye disease. In experimental set-
tings, clinical dry eye in rabbits has been simulated via multiple different methods,

Fig. 5. Prolapsed Harderian gland. (Courtesy of John Sapienza, DVM, DACVO; Plainview NY.)
 Ocular Surface Disease of Rabbits 7

including giving lymphocytes sensitized to lacrimal antigens or following intralacrimal

injections of concanavalin A.23,24 Following induction of disease, the rabbit is then
often used to determine the efficacy of different tear stimulants and antiinflammatories
for the amelioration of clinical signs. Based on studies such as these, we know that
rabbits will respond to topical treatment with 0.05% cyclosporine A after several
weeks25 and will also benefit from treatment with topical dexamethasone.24 These
findings indicate that traditional treatment of dry eye disease in other species can
be successfully applied to the rabbit, should the rare clinical case of dry eye disease
be presented.
Although spontaneously occurring dry eye disease is rare in the domestic rabbit, iat-
rogenic dry eye has been documented in rabbits experimentally treated with
trimethoprim-sulfamethoxazole (TMS). Rabbits treated with 40 mg/kg of TMS by
mouth twice daily demonstrated a drop in tear production by about 50% at the end
of the 2-week study period.26 Therefore, as with canine patients, rabbits treated
with oral TMS should be monitored closely for any decrease in tear production.

CONJUNCTIVITIS

Conjunctivitis is a frequently encountered problem of domestic rabbits. As with other

species, underlying causes of conjunctival inflammation can be mechanical (hay dust
or other irritants), infectious (bacterial, fungal, viral, etc.), immune mediated (kerato-
conjunctivitis sicca), or neoplastic.
Noninfectious conjunctivitis has been documented before in research colonies
where rabbits developed severe, chronic, and purulent conjunctivitis. Microbiological
testing failed to identify a causative agent for the clinical signs, and treatment with
topical neomycin and hydrocortisone failed to improve discomfort and irritation. It
was only when hay was moved from an overhead rack to a bundle on the floor of
the cage, thereby reducing the amount of atmospheric hay dust, that the rabbits
improved.27 Keeping this laboratory case example in mind, it is important to investi-
gate any husbandry problems that might be contributing to ocular irritation in patients.
Bedding and hay should be examined for quality in cases of conjunctivitis, as well as
how the hay is offered.28
Most cases of bacterial conjunctivitis were historically thought to be due to infec-
tions with Pasteurella multocida.29 More recent studies have revealed a greater
number of potential causative organisms. To interpret microbiological testing re-
sults in cases of conjunctivitis, it is important to understand the normal conjunctival
flora of the rabbit. A study by Cooper and colleagues30 in 2001 investigated the
normal flora of 70 healthy domestic rabbits. They found deoxyribonuclease-
negative Staphylococcus species to be the most frequently cultured bacteria, fol-
lowed by Micrococcus species and Bacillus species. A few rabbits also grew Sto-
matococcus, Neisseria spp, Pasteurella spp, Corynebacterium spp, Streptococcus
spp, and Moraxella spp.30 Note that Pasteurella, previously thought to be the main
causative agent of bacterial conjunctivitis, was found in the flora of clinically normal
rabbits. And although Staphylococcus spp is considered a normal commensal or-
ganism, there are reports of this organism causing clinical disease.31 Therefore,
whenever any bacteria are found on culture or cytology, it is important to interpret
results in light of clinical findings. Furthermore, when commensal organisms are
thought to contribute to disease, it is important to look for breaches in normal
host defenses, which may set up for opportunistic infection such as mechanical
irritation (trichiasis, foreign body, entropion), tear film deficiencies, and or
immunodeficiency.
8 Bedard

Treatment of conjunctivitis should be aimed at addressing the underlying cause. If

bacteria are thought to be the underlying cause of infection, appropriate antimicrobial
therapy should be selected based on sensitivity. In cases of Pasteurella infection,
topical chloramphenicol, ciprofloxacin, and or gentamicin 4 times daily combined
with systemic broad spectrum antibiotic therapy (enrofloxacin, 10 mg/kg, twice daily)
has been successful.5 Autogenous vaccines have been used in the past for treatment
of Staphylococcal conjunctivitis with initial success; however, permanent resolution
was not achieved until appropriate antibiotic therapy was instituted.32
Viral causes of conjunctivitis must also be considered when approaching rabbits
with clinical disease. Specifically, myxoma virus is known to cause inflammatory
and edematous lesions of the eyelids and conjunctiva. The acute form will often
lead to death before ocular signs can occur, or conjunctival hyperemia may be the
only sign before death.1,4,33 With the subacute form, conjunctival hyperemia will prog-
ress to chemosis with copious ocular exudate. Edematous and often exudative lesions
around face and anogenital area are pathognomonic for the disease. Furthermore,
cases of myxomatosis involve profound immunosuppression and often subsequent
multifocal infection with commensal organisms33 such as Pasteurella, Pseudomonas,
and/or Staphylococcus. Virus isolation can be accomplished 5 days postinfection and
the diagnosis made based on clinical signs and the characteristic finding of intracyto-
plasmic inclusion bodies in mucosal scrapings or histopathologic samples.34 Specific
treatment is not available and the prognosis is poor.5

CONJUNCTIVAL OVERGROWTH

Conjunctival overgrowth has been described by many names, including ankyloble-

pharon, pseudopterygium, conjunctival stricture, epicorneal membranous occlusion,
circumferential epicorneal membranous occlusion, and or conjunctival centripetaliza-
tion.1,3,35,36 The syndrome is unique to rabbits and involves growth of a fold of
conjunctival tissue arising from the limbus of the eye and extending 360 toward the
axial cornea (Fig. 6). Unlike pterygium in humans, this conjunctival fold is nonadherent
to the peripheral cornea and may appear as a narrow annulus or an extensive sheet
that covers nearly the entire corneal surface.37 The syndrome is nonpainful but can
be difficult to correct, because surgical removal of the aberrant tissue is not definitive
and regrowth will occur within a matter of weeks to months. Histopathology of the
aberrant tissue reveals normal conjunctival epithelium and focal excess of conjunctival
collagen. The condition seems to be overrepresented in young male dwarf rabbits.22

Fig. 6. Conjunctival overgrowth. (Courtesy of John Sapienza, DVM, DACVO; Plainview NY.)
 Ocular Surface Disease of Rabbits 9

A surgical technique has been described, which involves making centrifugal cuts
into the conjunctival fold up to the limbus and lid margin. A horizontal mattress suture
of 7-0 polypropylene is then made by passing the needle through the eyelid transpal-
pebrally and through the central rim of the conjunctival fold to manually retract the fold.
Rabbits should then be treated with topical steroid ointment and the sutures left in
place until they drop out. When using this method, no reoccurrence was noted in pa-
tients for 5 to 72 months of follow-up time.35
An alternative surgical technique was performed on a 10-month old dwarf rabbit
who failed the abovementioned procedure 3 weeks postoperatively. This technique
involved resecting the conjunctival membrane to the limbus and then inverting the
cut edges to just behind the limbus using a Lambert suture of 6-0 polyglactin 910.
The rabbit was treated with topical steroid and cyclosporine following surgery and
no evidence of recurrence was noted during the follow-up period.36

KERATITIS

The rabbit is prone to several diseases of the corneal surface; however, traumatic
injury is thought to be the most common cause.3 Trauma can be the result of irritants
from bedding or hay particles or fighting with other animals. Rabbits can also
develop ulcers from underlying conditions such as entropion, distichiasis, or trichi-
asis. Such causes for ulceration should be investigated and treated appropriately
with surgery.3 Exposure keratitis can occur following anesthesia, with facial nerve pa-
ralysis, or with severe retrobulbar disease leading to exophthalmos and an inability to
blink. Conditions such as persistent blepharitis and dacryocystitis can also lead to
corneal ulceration, although these ulcers are typically ventral in location and super-
ficial (Fig. 7).1
Superficial corneal ulceration can be managed with topical antimicrobial agents
(neomycin-bacitracin-polymyxin B ophthalmic ointment 4 times daily) and topical
cycloplegic medications to address painful ciliary muscle spasm and miosis.5 With
the latter, it is important to remember that rabbits have endogenous atropinase, which
will affect the potency of cycloplegic medications. As with management of corneal ul-
ceration in other species, cytology and culture can be useful in identifying concurrent
microbial infection and help to recommend targeted therapy, especially if keratomala-
cia is present (Fig. 8). Although rare, there has been a report of keratomycosis in a pet
rabbit.38 After culturing Aspergillus fumigatus, the infection was successfully treated
with topical terbinafine ointment.

Fig. 7. Superficial corneal ulceration with concurrent conjunctivitis. (Courtesy of John

Sapienza, DVM, DACVO; Plainview NY.)
10 Bedard

Fig. 8. Deep melting corneal ulcer. (Courtesy of Gerlinde Janssens, DVM; Hemiksem, Belgium)

Rabbits can also develop indolent ulcers, such as those seen in boxer dogs and
corgis, with a characteristic nonadherent epithelial lip. Similarly, treatment of these ul-
cers requires debridement. Should simple debridement with a cotton-tipped appli-
cator fail to produce resolution, further treatment with a grid keratotomy or anterior
stromal puncture can be performed.39,40 Placement of bandage contact lenses has
also been shown to be effective in management of this disease by improving comfort
level and encouraging healing.3
Although ulcerative keratitis is a commonly encountered problem in the rabbit,
they are also known to develop noninfectious keratopathies. Distinguishing these
conditions from infectious, nonulcerative keratitis has important prognosis and
treatment considerations (Fig. 9). Lipid keratopathy is an infrequent condition
that has mainly been reported in research conditions and manifests as multifocal
to coalescing white refractile opacities within the cornea (Fig. 10). This

Fig. 9. Chronic keratitis with corneal scarring. (Courtesy of Stacy Peterson, DVM, DACVO;
Albuquerque NM.)
 Ocular Surface Disease of Rabbits 11

Fig. 10. Corneal lipid keratopathy. (Courtesy of Sinisa Grozdanic, DVM, PhD, DACVO;
Hiawatha IA.)

condition has been reported in rabbits fed cholesterol-rich diets41,42 and in rabbits
fed a 10% fishmeal maintenance diet.43 Outside of the realm of research, a case
of lipid keratopathy was reported in a pet rabbit fed a predominately milk-based
diet.44 Whatever the underlying dietary cause, these lipid deposits are thought
to be the result of increased uptake of low-density lipoproteins and cholesterol
esters within the stromal keratocytes. These keratocytes become overwhelmed
with the amount of intracellular lipid, resulting in cell death and causing the
lipid and proteinaceous debris to become liberated into the corneal stroma.
This debris is then phagocytosed by macrophages.45 This process occurs in
Watanabe rabbits with heritable hyperlipidemia, which have an inherited deficiency
of low-density lipoprotein receptors.41,46 Correction of the diet can help to
alleviate or decrease progression of disease, and superficial keratectomy can be
used to remove affected corneal tissue if extensive and visually impairing. This
condition is otherwise nonpainful and often not significantly visually impairing if
mild.
Corneal dystrophy has also been reported in the rabbit. Two distinct conditions
have been described. The first condition appears as a unilateral, raised opaque pe-
ripheral membrane. Histologically, this condition involves areas of epithelial thinning
adjacent to areas of epithelial cell hyperplasia.47 With the other form, rabbits will
have unilateral or bilateral focal, linear, or curvilinear opacities within the superficial
layers of the cornea. This particular form has been seen in the American Dutch belted
rabbit.48 The underlying cause of these dystrophies has not been elucidated, but they
do not seem to be painful and only become problematic if severe enough to become
visually impairing.
Inflammatory keratitis has been reported in rabbits as well. Eosinophilic keratitis has
been described in 2 rabbits and, similar to this disease in horses and cats, appeared
as a raised, white to yellow plaque involving both the bulbar and palpebral conjunctiva,
as well as the corneal surface.49 Marked granulation tissue was present on the corneal
surface, and cytology identified numerous clusters of polymorphonuclear cells with
obvious intracytoplasmic eosinophilic granules. Treatment with topical neomycin-
polymyxin B-dexamethasone solution 4 times daily affected resolution of clinical dis-
ease; cyclosporine treatment did not seem to be effective in managing disease long
term.
12 Bedard

SUMMARY

In summary, the domestic rabbit is prone to many of the same ocular surface diseases
commonly encountered in our canine and feline domestic species, with a few excep-
tions. Care should always be taken to obtain a thorough history of the rabbit environ-
ment and diet at home, to determine any possible association with ocular pathology.
Additionally, a complete oral examination should be performed in any case of unex-
plained, persistent ocular discharge and periocular inflammation. Ulcers are a
frequently encountered problem in the rabbit and treatment is very similar to that of
ulcers in canine patients. Provided the general practioner is familiar with a few nu-
ances of treatment and anatomical considerations, success in treating ocular disease
in the rabbit is fairly straight forward and achievable.

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