Excess Blood Cells in the Eye in Dogs

Excess blood cells diffuse into the eye as a result of a breakdown in the aqueous-blood barriers that normally keep them out. Most commonly this is due to uveitis, an eye infection which includes the iris, ciliary body, and sometimes the choroid as well. Severe, recurrent infections can be difficult to treat and may lead to a more complete breakdown of the eye barriers.  When this happens, white blood or lipid cells can infiltrate the anterior chamber of the eye. White blood cells create a white or yellow opaque area, either in one spot or across the whole eye. This condition is called hypopyon and it is often a sign of a severe eye infection. Lipid cells may also enter if the dog has high levels of fat or cholesterol in his blood. These cells cause a white discoloration that is cloudy rather than opaque. Both conditions are treatable, but they should be checked out immediately since serious complications can lead to vision loss or blindness.

When inflammation destroys natural eye barriers, blood cells can infiltrate the visible part of a dog’s eye and create discoloration. White blood cells which have entered the anterior chamber of the eye are called hypopyon, while similar looking fat cells are referred to as a lipid flare. Both these conditions can create a white discoloration, but hypopyon is usually more opaque.

Take your dog to the veterinarian as soon as you see signs of an eye infection. Sudden and drastic color changes should be treated as an emergency. These are some of the symptoms to look for:

• Cloudy or milky appearance to the eyes
• Opaque yellow or whitish appearance
• Particles or floaters in the eye
• Vision loss
• Eye pain
• Sensitivity to light

Types 

These are the most common conditions related to excess blood cells in the eye:

• Hypopyon – white blood immune system cells in the eye as a result of infection.
• Lipid flare – lipid cells in the eye as a result of excess fat and cholesterol in the blood. This is often combined with infection, but it may also indicate hyperlipidemia, a serious metabolic disorder.
• Aqueous flare – protein molecules in the eye, the most common symptom of uveitis. The molecules are visible as suspended particles in the eye. Aqueous flare can resemble a lipid flare, but is less white in appearance. This condition can also occur along with hypopyon.

Uveitis – this is the most common cause of excess blood cells in the eye. Uveitis can be related to a number of conditions:

• Infection (bacterial, viral, or parasitic)
• Trauma
• Auto-immune condition
• Diabetes
• High blood pressure
• Metabolic abnormality
• Idiopathic

Hyperlipidemia – a metabolic disorder which affects the breakdown of fats. It can occur by itself or in combination with another condition such as diabetes or hypothyroid. It can have serious side effects, including blindness.

Tumors or corneal disease in the eye

Excess blood cells are usually visible without a microscope. To the untrained eye hypopyon, lipid flare, and aqueous flare might look similar, however, a veterinarian will usually be able to tell them apart. The veterinarian will examine your dog’s eyes with an ophthalmoscope and check eye pressure as this can sometimes be affected by uveitis. Unless there is an obvious local cause such as trauma or corneal damage, bloodwork and urine tests will also be done. These will often indicate the underlying cause of uveitis and will also show abnormalities if hyperlipidemia is present.

The veterinarian will want to know your dog’s complete medical history. Any known conditions like diabetes or high blood pressure can be very important, as well as recent injuries. Additional symptoms not related to the eyes could help to determine the underlying cause.

Treating the immediate infection can usually clear the eyes quickly. Several medications can be used to treat uveitis including corticosteroid drops and non-steroid anti-inflammatory drops. These will be administered a number of times daily until symptoms taper off.

Systemic medication will also usually be prescribed to treat the underlying cause. Bacterial infections may require an antibiotic. Parasite or viral infections could require other treatment. Ingested steroids will often be given for autoimmune responses. Medication may also be aimed at better controlling diabetes and stabilizing high-blood pressure.

Hyperlipidemia will sometimes be treated with changes in diet and fish oil supplements. There is believed to be a genetic component to this condition (especially among Miniature Schnauzers), so diet change may reduce the symptoms, but doesn’t completely reverse the problem. Lipid flare usually clears up quickly with treatment, but if it is related to hyperlipidemia it may be recurrent. If symptoms reappear, it’s best to return to the vet for treatment as soon as possible.

The prognosis for recovery from either of these conditions is somewhat guarded, even though it is relatively easy to treat the symptoms. Many types of uveitis clear up with treatment and do not return; however more severe infections that lead to hypopyon are also often the ones that can be troublesome. If your dog has recurrent infections, you will need to return often for examination and treatment. Even if there are not more infections, it’s as well to return for check-ups. Serious uveitis infections increase the chance of glaucoma, so the veterinarian should monitor the pressure in your dog’s eyes closely.

If a metabolic disorder is causing a lipid flare in your dog, this will likely need to be managed. Some conditions are mild while others can create very severe symptoms. Discuss a long term treatment plan with the veterinarian based on the severity of your dog’s symptoms.