Ophthalmology team treat cat’s congenital eye problem with human sub-dermal lip filler

The Ophthalmology team at Davies Veterinary Specialists has saved a young cat from chronic debilitating eye pain and corneal damage by using human sub-dermal lip filler.

Nala, a young domestic shorthaired cat was born with a congenitally under-developed upper eyelid margin of her right eye. The condition, called eyelid coloboma (or eyelid agenesis) is the most common congenital eyelid abnormality in cats. The extent of the defect can vary from a small missing section of the eyelid margin to the complete absence of the whole upper eyelid.  As the upper eyelid is abnormal and cannot function properly this can lead to corneal exposure and trichiasis (contact of facial hairs against the corneal surface). This in turn can result in chronic discomfort and potentially cause severe damage to the cornea due to ulceration and scarring.

Nala was in considerable discomfort with her right eye tightly closed, when she was assessed by Rachel Lockhart, one of the ophthalmology clinicians at Davies.  Rachel explained that given the amount of discomfort Nala was in, some form of surgical correction was indicated.

Recognised surgical options for this condition include various techniques aimed at reconstructing the upper eyelid by transposing portions of the lower eyelid or even the upper lip into the defect.  However, these surgeries can be quite extensive, and often need to be staged over multiple operations. Before committing Nala and her owners to extensive surgery Rachel also discussed an alternative option – that of sub-dermal sodium hyaluronate filler injections, the best-known version of which is human lip-filler.

By injecting the filler just under the skin surrounding the defect it is possible to realign the skin hairs and divert them away from the eye. This can be done under sedation, so avoiding full general anaesthesia.

“The filler is broken down by the body and the effect is technically only temporary,” explained Rachel. “But it may persist for many months in some individuals so it can afford a good level of comfort for a considerable time.  Eventually, Nala may need definitive surgery but for the time being the filler is keeping her eye comfortable.”

Nala’s eye pre-injection

Nala’s eye post-injection

Nala’s owner Lucy Peacock can’t believe the transformation: “Nala was clearly suffering and really struggled to keep her eye open – it was devastating to see her looking so dejected. We were really worried about the potential damage that was being caused to her sight in the long term, but after just a small and unobtrusive procedure, she is like a different kitten!

“Rachel was so helpful in talking us through our potential options and making recommendations for what was best for Nala. We felt really at ease with the whole process, and whilst we are fully aware that Nala may need surgery in the future, we are just happy to see her back to her mischievous, adorable self for the time being. I can’t thank Rachel enough.”

Nala post-treatment

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