Just a little eye redness winds up being something rare but treatable.

By: Dr. Alexis Gullett from Animal Medical Center.

Cookie is a 9-year-old male neutered Bichon Frise who presented with a 1-month history of a slightly red eye. He is up-to-date on all vaccines and parasite testing and prevention, and has no pertinent medical history. The owner had been monitoring his eyes at home and had noted no pain, discharge, or irritation besides a very slight reddening, especially in the medial canthus (inside "corner") of the eye. There was no history of trauma or infection, and after using a special eye stain no cuts or ulcers were noted. He was started on topical antibiotics three times a day and a recheck was scheduled for 2 weeks. At this recheck, there was no improvement to the redness, and a very small slightly raised bump was noted on the sclera (white) of the eye at that medial canthus. At this point, the owner elected to go to a veterinary ophthalmologist (eye specialist) for further testing.

At the specialist, his eye was again tested for ulcers and none were found. His pressures were checked and were normal, eliminating glaucoma at this point. His tear production was tested and found to be normal as well. Two special pieces of equipment called a slit lamp and an ophthalmoscope were used to look all throughout the eye to be sure the retina and cornea were normal, that the vessels and nerves were normal, and that no masses or tumors were inside the eye that hadn't been located on the first two exams. Only the small bump in the medial canthus was noted. At this point, it was determined that Cookie had a disease called Nodular Granulomatous Episcleritis, or NGEK.


NGEK is an immune-mediated disease that affects the sclera, cornea, and nictitans. For some unknown reason, the sclera becomes inflamed and will form thick nodules on the surface. This was the bump that was in Cookie's eye. It is not infectious or contagious, since it is the animal's own body attacking the surface of the eye causing this inflammation. Nor is it painful. However, left untreated it can advance into the cornea, leaving crystalline deposits and edema (inflammation) in that portion of the eye as well. For that reason, treatment is important. As it is an immune-mediated disease, treatment consists of drugs known as immune-modulators. Some doctors choose to use topicals alone and some use oral medications alone, but most choose to use a combination of the two. Cookie was placed on Pred acetate drops four times daily and azathioprine (Imuran) orally once daily for a week, then every other day until his recheck one month later. At that recheck, it was determined that his lesions were under control and his eye drops were tapered. At his check-in phone call one month later, the owner noted that the lesions were starting to creep back into his eye, and he was again placed on drops four times daily and continued the oral medication every other day. At this time his lesions are controlled but he is closely monitored for flare-ups. There is no cure for this disease, but with vigilant monitoring the lesions can be controlled and a regular lifespan with no restrictions is expected.

Many owners see a red eye in their pet and think allergies or infection, and often choose to wait it out. However, there are many other processes that can cause these very basic and similar symptoms. Some, like cancer and retinal problems, are things that no owner ever wants to hear. Some, like infections or cuts, can be treated and cured. And some, like NGEK, are neither life-threatening nor curable, but are manageable with proper and vigilant care. The eyes are a very important and vital part of our pets. Any changes noticed, including but not limited to redness, swelling, discharge, or itching, warrant a visit to your pet's veterinarian. Even something as simple as a small amount of redness could indicate a beginning disease process and truly isn't something you should just keep an eye on.