Ulcerative keratitis is a condition of ocular surface that needs prompt and appropriate treatment to minimize risk blindness. This study was to analyze clinical management of ulcerative keratitis in 860 dogs (910 eyes) presented to the Ophthalmology Clinic, Small Animal Teaching Hospital, Faculty of Veterinary Science, Chulalongkorn University, Thailand, from April 2012 to April 2014.

Shih Tzu was the major breed predisposing to ulcerative keratitis.

According to all eyes obtained in this study, ulcerative keratitis was classified into simple superficial ulcer (n = 243), complicated superficial ulcer (n = 307), deep ulcer (n = 181), descemetocele (n = 46) and perforated ulcer (n = 133).

Simple superficial ulcer could heal within seven days with administration of topical antibiotic. Of all complicated superficial ulcers, 75% of cases required medical treatment alone, while the rest underwent grid keratotomy together with third eyelid flap.

For deep ulcers, cases with a small lesion could successfully be treated with medications. Nictitating membrane flap was majorly selected for cases with large deep ulcers (46/53). Even though healing process was delayed up to a few weeks, results were promising.

Descemetocele (70%) and perforated ulcers (62%) treated with corneal suturing or corneal grafting, in association with nictitating membrane flap, showed better prognosis (regained vision) than cases treated with medication alone. Glaucoma was commonly observed among other surgical complications after a correction of descemetocele (8.6%) and perforated corneal ulcer (14.4%).

In conclusion, surgical correction is strongly recommended for cases with severe ulcerative keratitis. Not only to stimulate corneal healing but also a return of vision.