Blindness from untreated eye infections

Eye infections are a treatable condition in cats; however, severe eye infections and eye infections which are left untreated can cause permanent blindness in cats. As well as the risk of blindness, eye infections cause extreme discomfort and pain. It is therefore extremely important that cats with eye infections are given veterinary attention.

Conjunctivitis is the most commonly diagnosed eye infection in cats. This is where the infection leads to inflammation of the conjunctiva – the pink membrane that lines the inner surface of the eyelids and the outer surface of the eyeball (see picture). Left untreated, conjunctivitis can lead to eye damage, vision loss and blindness.

Eye infections can be caused by injuries to the eye, or foreign objects in the eye (eg, dirt, sand). Newborn kittens may develop eye infections due to vaginal infections of the mother at the time of birth, as well as being born into an unsanitary environment.

Viral or bacterial diseases can also lead to eye infections. Feline calicivirus is a highly contagious virus that is a cause of ‘cat flu’, and can lead to conjunctivitis in cats. Likewise, feline herpesvirus is also a highly contagious virus that can lead to conjunctivitis, as well as (less commonly), keratitis, which is the inflammation of the cornea (the transparent front part of the eye). Damage to the cornea as a result of keratitis can lead to blindness. Feline chlamydophilosisis a bacterial cause of conjunctivitis. Other viral infections, such as feline immunodeficiency virus, feline leukaemia virus, and feline infectious peritonitis, can lead to uveitis (inflammation of the uvea, the middle area of the eye including the iris), which can also result in blindness.

Signs of an eye infection

Ocular discharge (discharge from the eyes) ranging in colour from clear to green-yellow, which may dry to form a crust

Excessive production of tears

Swelling of the eye

Red swollen conjunctiva

Clouding of the cornea

Squinting – due to discomfort, but severe inflammation can also cause scarring and fusion of the eyelids to the eye, especially in kittens

Rubbing due to discomfort

Treatment

Eye infections are often treated with eye drops or ointment and usually respond well to treatment. Seek veterinary advice as soon as possible when any ocular changes are noted, to avoid further pain and reduce the risk of blindness occurring.

Sudden onset blindness

Sudden onset blindness in cats can be a very worrying and confusing disease.

For the affected cat they can become extremely disorientated and may behave in a strange and unusual way. They may wander apparently aimlessly, may bump into things, and may become distressed. One of the difficulties is that it may not necessarily be obvious to an owner that the cat has become blind and it may only be when your cat is examined by a vet that you will know why they have started to behave strangely.

One of the signs that may be noticed though is that the pupils (the dark central part of the eye) usually become very dilated if a cat becomes blind.

Causes of blindness in cats

There are many potential causes of blindness in the cat – some will cause a gradual slow deterioration in vision, and in these cases, cats often learn to adapt to their reduced sight remarkably well showing few, if any, signs that they have any difficulty. However, if the blindness develops very rapidly then there is no chance for the cat to adapt and he or she will be very disorientated and confused. Some of the causes of sudden onset blindness include:

Optic neuritis

This is a condition where the optic nerves (the nerves that carry the visual information to the brain) become inflamed and as a result no longer function, causing blindness. This is a rare disease in cats.

Hypertension (high blood pressure)

Hypertension is an important disease in cats and one of the most common causes of acute onset blindness. With high blood pressure, damage can occur to small blood vessels in the back of the eye that can lead to bleeding, or fluid leaking out of the vessels. This may in turn cause the retina (the layer of light-sensitive cells that line the back of the eye and enable us to see) to become detached. If the retina is detached it can no longer function and blindness will occur. In some cats, high blood pressure may also cause some bleeding towards the front of the eye which can be easily seen.

Diseases of the brain

Because the visual signals pass through the optic nerves to the brain and are processed within the brain, if there are diseases affecting the brain (such as infections, inflammatory conditions or tumours) this can potentially lead to blindness.

Retinal degeneration

Just as with humans, cats can suffer from degeneration of the layer of light-sensitive cells at the back of the eye (the retina) which is responsible for vision. When this occurs it is often a slow process, which allows cats time to adjust to their reduced vision. However, on rare occasions, this can be sudden in onset.

Diagnosis

Your vet will first want to confirm or establish that blindness is the cause of your cat’s clinical signs. This is usually very straightforward and involves some simple examination techniques.

Once blindness is confirmed, because there are a number of potential underlying causes, careful further evaluation will be required. Investigations will include:

Careful examination of the eye – many causes of blindness may be evident through careful examination of the eye with an ophthalmoscope (the instrument a vet or doctor uses to examine structures within the eye).

– many causes of blindness may be evident through careful examination of the eye with an ophthalmoscope (the instrument a vet or doctor uses to examine structures within the eye). Measurement of blood pressure – as hypertension is one of the common causes of blindness, your vet will want to measure your cat’s blood pressure. This is easier than it sounds, and as in humans is usually done by wrapping a cuff around a leg which is inflated and deflated while blood flow is detected through a vessel below the cuff.

– as hypertension is one of the common causes of blindness, your vet will want to measure your cat’s blood pressure. This is easier than it sounds, and as in humans is usually done by wrapping a cuff around a leg which is inflated and deflated while blood flow is detected through a vessel below the cuff. Routine blood and urine tests – these will usually be done to help detect underlying diseases. For example, chronic kidney disease (kidney failure) is a common cause of high blood pressure in cats.

– these will usually be done to help detect underlying diseases. For example, chronic kidney disease (kidney failure) is a common cause of high blood pressure in cats. Brain scans – in some cases, especially if disease of the brain is suspected, your vet may suggest a brain scan is done (an MRI or CT scan). It is possible that your vet will refer you to a special clinic for this.

Treatment and prognosis

The treatment for acute onset blindness will vary according to the underlying cause, but may often involve use of medications (eg, tablets to reduce blood pressure or relieve inflammation). In some cases the underlying cause of the blindness will be reversible and normal vision may return. However, in other cases, even if the underlying cause is resolved, the damage to the sight may be permanent and there may be no change or improvement in the cat’s vision.

Adjusting to loss of sight

Even if vision does not return, cats are actually very good at adjusting to loss of sight. They compensate remarkably well by using their senses of hearing, smell and touch (using their whiskers to prevent bumping into objects). However, sudden loss of sight is obviously initially very distressing for a cat. They may bump into objects in the house or garden or become withdrawn and only go where they feel very safe.

Caring for a blind cat has challenges. Affected cats will adjust well but certain changes will make their lives a lot happier. Furniture should be kept in the same position and resources (food, water, litter trays) made easily accessible. Care should be taken to avoid noisy approaches and any children should be told to move slowly, quietly and be careful not to frighten the cat who cannot see them coming.

Blind cats may be able to go outside, but only into an enclosed garden as they may otherwise lose their way or be vulnerable to attack by other cats or dogs. Over time, and with a constant environment that does not change, most blind cats will adapt extremely well and live a very happy life.