Ophthalmology for Animals, Monterey
OFA Monterey is now Veterinary Eye Clinic of Monterey Bay. Our staff and location are the same at Ryan Ranch. Come see us.
We work with your primary veterinarian to provide specialized eye care for your pet.
Conditions We Treat
There are occasions when your veterinarian might suggest a referral to an eye specialist to better meet your pet’s needs. Veterinary specialists complete additional intensive training to become experts in their field. Dr. Elizabeth Curto is a specialist in Veterinary Ophthalmology and is highly trained and experienced to diagnose and treat all conditions affecting the eyes of animals. At VECMB, we work along with your primary veterinarian as a team to provide advanced and complete care for your pet. Below are just a few of the eye conditions we routinely treat.
A cataract refers to an opacity within the lens due to altered cellular metabolism. Cataracts can occur for multiple reasons including genetics, Diabetes mellitus, senility (old age), trauma, nutritional deficiency, electric shock, and more. Very small cataracts are insignificant in animals and will not cause a noticeable problem. However, as a cataract advances it has the potential to cause issues such as inflammation as the lens swells and the proteins leak into the eye (lens-induced uveitis), glaucoma (elevated eye pressure), retinal detachment, and blindness. The only way to restore vision in an eye that has become blind due to cataract is surgical removal of the lens. When evaluating the animal eye as a potential surgical candidate, the veterinary ophthalmologist will evaluate the status of the cataract and associated inflammation, the position of the lens, the status of the retina and cornea and the anatomy of the iridocorneal angle and vitreous.
Eyelid Masses and Growths
Eyelid growths can be common especially in older dogs. Eyelid masses usually enlarge with time resulting in structural and functional changes to the eyelids and irritation to the ocular surface (cornea). Most are benign, but in a small percentage of cases eyelid masses can be malignant and appropriate diagnosis can determine whether further systemic treatment is needed. Due to the potential for irritation, growth, and discomfort, surgical removal of eyelid masses is often indicated. Small masses can sometimes be removed with local anesthetic, while large masses require general anesthesia. After removal, eyelid masses should be submitted for biopsy in order to obtain a definitive diagnosis and to determine if additional therapy is necessary.
Corneal Endothelial Degeneration
Corneal Endothelial Degeneration (CED) is a degenerative condition in dogs that affects the clarity of the cornea. This age-related disease can result in blindness and severe ocular pain from secondary complications. The cornea is the clear window at the front of the eye. It is a very delicate structure which is less than a millimeter thick. Endothelial cells are located at the most inner layer of the cornea and contain tiny “pumps” that are responsible for maintaining a proper fluid balance in the corneal tissues. This function is critical to ensuring that the cornea remains transparent for vision. Unfortunately treatment options for CED are limited, but identification and appropriate diagnosis early in the course of the disease, and early medical or surgical intervention can help your pet avoid ocular discomfort and slow, delay, or reverse vision loss.
Corneal sequestrum typically appears as a tan to dark brown-black area of corneal discoloration due to corneal necrosis, and is frequently surrounded by inflammation and vascularization. The sequestrum is frequently observed with refractory (chronic or slow-healing) corneal ulcers. Contributing factors include breed predisposition (seen in Persian and Himalayan breeds more frequently), entropion (rolling in of the eyelid), and Feline Herpes Virus. Cats with corneal sequestrum should be evaluated for management by a board certified veterinary ophthalmologist. Several factors, including your pet’s general health, determine the treatment options for this condition. Some sequestrums are managed with medical therapies, but if significant discomfort to the pet is noted, surgical options are usually indicated.
A corneal ulcer is a wound on the surface of the eye. The damage would be similar to a scrape or cut on your skin resulting in an unprotected wound. Squinting, winking, redness, watering, discharge, cloudiness or a change in appearance can indicate that an ulcer is present. There are many causes of corneal ulcers. Damage to the cornea can occur due to external trauma, irritation from eyelashes or eyelid tumors, environmental irritants, abnormal eyelid anatomy or poor eyelid nerve function. Systemic disease and tear film abnormalities also can result in deterioration of the corneal health and integrity. Treatment depends on the cause and severity of the ulcer and may include medical therapy alone or medication combined with surgery.
Distichiasis is a condition in which abnormal hairs emerge from the openings (ducts) of glands (Meibomian glands) along the eyelid margin. These glands do not normally produce hairs. The abnormal hairs can rub on the surface of the eye and may cause irritation or corneal ulceration. The severity of the problem and the need for treatment vary from patient to patient. Although some patients live their entire lives without being bothered by their distichia, others require medical or surgical treatment to alleviate irritation caused by the hairs rubbing on the cornea.
Entropion is a condition that arises where the eyelid margins invert and hair or fur around the eyes contacts the corneal surface. Entropion causes discomfort due to the hair and/or lashes rubbing on the cornea. Pain, corneal ulcerations, perforations, and scarring can occur. It can be caused by genetic predisposition (especially in certain breeds), ocular discomfort, intraocular inflammation, systemic dermatologic conditions, infectious eyelid and conjunctival diseases, and scarring of the eyelids due to trauma or injury. Treatment often requires surgery to correct the eyelid position. Evaluation with a board certified veterinary ophthalmologist can assure that correct surgical timing and technique are utilized to provide your pet with optimum comfort and corneal health.
Equine Recurrent Uveitis
Equine recurrent uveitis (ERU), also known as “moon blindness” is the leading cause of blindness in horses. Equine Recurrent Uveitis is characterized by recurrent episodes of inflammation inside the eye, with periods of quiescence in between “flare- ups.” The frequency and severity of inflammatory episodes is variable between individual horses, but can become progressively worse and more frequent over time. Every episode of inflammation contributes to cumulative damage to the structures inside the eye responsible for vision, as well as cause discomfort for the horse. The cause of the inflammation is not always determined but should always be investigated. Signs can be subtle and include tearing, squinting, ocular discharge, rubbing, redness of the whites of the eye, or cloudiness. Treatment depends on the cause, duration and severity of disease. Medical therapy is aimed at quieting the immune response in the eye and addressing the underlying cause whenever possible.
Feline herpesvirus (FHV-1) is a highly contagious virus and one of the major causes of upper respiratory infections in cats. One of the many potential long-term sequela of exposure to this virus is damage to the ocular tissues. The feline herpesvirus can replicate within the conjunctival epithelia, upper respiratory tract epithelia, and neurosensory ganglia. Neuronal infection with FHV-1 establishes lifelong latency with intermittent re-activation and viral shedding. The primary source of kitten infection is from their mothers at birth or during the first few weeks of life, but it can also be easily spread between adult cats through sneezing, grooming or fighting. Active infection can cause sneezing, coughing, runny nose, squinting, eye swelling, tearing, discharge, or corneal ulceration. Treatment is generally supportive since the viral infection is self-limiting, unless secondary complications have developed, such as secondary bacterial infection, sequestrum, keratoconjunctivitis sicca, or eosinophilic keratitis.
Geriatric patients can require special care, but some “normal” aging changes occur in older animals. These changes may need to be differentiated from possible pathologic problems which may present in a similar manner. The most common change noted in older animals is lenticular sclerosis, or hardening of the lens. Often a hazy blue appearance to both eyes is noted and can appear similar to cataract, but lenticular sclerosis does not obstruct vision or cause any pain. Another frequent aging change is thinning and atrophy of the muscle responsible for iris constriction (iris atrophy). These animals may be sensitive to bright light but can otherwise see normally. Corneal degenerations can cause cloudiness and can sometimes be painful if associated corneal ulcerations or infections develop. A veterinary ophthalmologist can differentiate between benign age-related conditions and those that require treatment.
Golden Retriever Pigmentary Uveitis
Pigmentary Uveitis (PU), also known as Golden Retriever Pigmentary Uveitis (GRPU) or Pigmentary and Cystic Glaucoma (PCG) is a relatively common inherited disease of Golden Retrievers with severe, blinding and painful complications that may require surgery. Subtle signs of early disease, including mild redness, make it difficult to detect a problem at home until the disease is more advanced. There may be pigment dispersion inside the eye, uveal cysts, adhesions between the iris and lens, cloudiness, cataract, and eventually glaucoma. The disease usually presents when the pet is between 5-10 years of age. Treatment is challenging because the underlying cause is not well described, but topical anti-inflammatory therapy is the standard of care. If glaucoma has developed, additional anti-glaucoma medications are indicated. Unfortunately, about half of Golden Retrievers with GRPU develop blindness and glaucoma within about six to nine months following diagnosis.
Glaucoma is a painful disease in which the pressure inside the eye increases and causes damage to the structures responsible for vision. Elevated intraocular pressure results in clinical signs such as a cloudy eye, redness, squinting, poor appetite, decreased energy, or sleeping more than usual. The longer the pressure in the eye is elevated, the more damage occurs to the structures in the eye responsible for vision (especially the retina and optic nerve), eventually resulting in permanent blindness. Glaucoma can be either primary (genetic) or secondary caused by chronic inflammation, lens luxation, trauma, and intraocular tumors, all of which obstruct normal drainage of fluid from the eye through the iridocorneal angle. Treatment is aimed at maintaining the pressure in a comfortable range and limiting damage to the retina and optic nerve through medications, surgery, or both. Prognosis of an eye with glaucoma depends on early detection and the patient’s response to therapy.
Keratoconjunctivitis sicca (KCS) is a disease characterized by inflammation of the cornea and conjunctiva (pink tissue covering the whites of the eyes and the inside of the eyelids) secondary to inadequate tear production by the tear glands. This leads to a build up of debris and bacteria that are normally washed away by the tears and a thick mucous discharge forms. The disease is usually caused by inflammation of the lacrimal glands, but can also be caused by the toxic effect of certain drugs on the lacrimal glands or by lack of nerve innervation to the lacrimal glands. Redness, squinting or blinking, and discharge are early signs of disease and indicate irritation and discomfort due to inadequate tears. Treatment is aimed at promoting your pet’s tear production, reducing inflammation, and supplementing the inadequate tears through the use of topical eye drops and ointments.
The crystalline lens is normally a clear rounded structure suspended in the middle of the eye with the purpose of focusing an image onto the retina in the back of the eye. A luxation occurs when the fibers that hold the lens in place (called zonules) are weakened and break, and the lens subsequently shifts out of its normal position. Causes can include severe trauma, weakness of the zonules that is either inherited or secondary to chronic inflammation, or breakage due to stretching (usually because of glaucoma). When the lens falls forward, it will cause significant discomfort and is an emergency. When the lens falls backward, it is more benign and not uncomfortable for the animal. Common sequelae of lens luxation are glaucoma and retinal detachment. Treatment for lens luxation includes both medical and surgical options and depends upon chronicity, degree of pain, visual prognosis, and development of secondary complications.
Ocular trauma is almost always an emergency. Many structures of the eye and surrounding tissues can be involved including the cornea, sclera, lens, iris, retina, eyelids, and orbit. Common traumas include bite wounds, scratches, or a hard hit to the head. Some traumas require emergency surgery to preserve or restore vision and comfort, others can be managed with medications. Your veterinary ophthalmology care team can help discuss the specific condition affecting your pet, prognosis, and appropriate treatment options.
Pigmentary keratitis in the dog is due to pigment migration onto the cornea and is a frequent cause of blindness in the Pug, Shih Tzu and Pekingese breeds. The pigment is darkly colored, and as it progresses across the clear cornea it interferes with light entering the eye. Many owners are not aware of the problem until their pet becomes visually impaired. The cause is multifactorial and can include corneal irritation from abnormally placed lashes, medial entropion (eyelids rolling inward), shallow orbits, incomplete blinking, excessive eyelid length, nasal fold trichiasis, and “dry eye” (KCS). Treatment is directed at halting the progression of pigmentation through a combination of medical and surgical therapy, especially in advanced cases or younger dogs who are likely to become blinded by the disease in their lifetime.
Pannus / Chronic Superficial Keratitis
Pannus is the common term for Chronic Superficial Keratitis (CSK) and/or plasma cell infiltrate of the third eyelids. Pannus is an immune-mediated, inherited problem most frequently identified in Shepherd breeds and Greyhounds. However, other breeds and mixed breed dogs can also be affected. Pannus occurs when there is an immune response of the eye toward the clear cornea. It frequently starts as cloudiness, redness, and/or pigmentation at the ventrolateral (outer and lower) aspect of the eye and progresses across the cornea. Treatment is aimed at reducing the inappropriate inflammatory response in the eyes using anti-inflammatory and immune-modulating medications. There is no cure; treatment to control active disease must be continued for the life of the patient to minimize the blinding effects of corneal scarring.
Progressive Retinal Atrophy
Progressive Retinal Atrophy (PRA) is a degenerative disease of the retina that ultimately leads to loss of vision. The retina is the neurosensory structure in the back of the eye that transmits images to the brain. In one of the most common forms of PRA called prcd-PRA (progressive rod-cone degeneration), the rods degenerate first leading to a loss in night vision followed by the cones with a loss of day vision. PRA is an inherited disease observed in purebred dogs but may be seen in mixed breeds. Generally, there is no treatment for PRA. However, veterinary ophthalmologists are conducting research to find treatments for this disease. Fortunately, the condition is not painful. Animals adapt well to vision loss especially with help from their owners. Training techniques have been described. A veterinary ophthalmologist can discuss how you can help your animal adjust and even thrive with blindness.
Prolapsed Nictitans Gland
In animals, a gland located at the base of the third eyelid (nictitans) is responsible for making 33-66% of normal tears to keep the eye lubricated. When the attachments holding the gland in place are loose or weak, it can prolapse from behind the third eyelid and appear as a red or pink mass. This prolapsed tear gland is commonly referred to as “cherry eye”. The cause is most often genetic. Removal of the gland is never recommended since dogs these individuals are predisposed to developing Keratoconjunctivitis Sicca (dry eye) later in life. To correct prolapse, surgical replacement of the gland is necessary. Early replacement of the gland provides the best chance of normal tear gland function and anatomic appearance.
Proptosis describes a condition in which the globe protrudes from the orbit, the eyelids trap the globe from behind, and tissues swell profoundly, preventing it from returning to a normal position. Acute trauma is the most common cause, but the eyes of brachycephalic (short-faced) dogs can develop a proptosis with manual restraint or excessive leash-pulling alone. Proptosis is an emergent situation that usually requires immediate replacement of the globe under general anesthesia. Immediate triage care prior to surgery, including placing of an elizabethan collar, lubricating the exposed tissues, and administering appropriate pain management, provides the greatest chances of preserving vision and preventing the loss of the globe. Surgery usually requires placement of temporary sutures in the eyelids to protect the exposed globe tissues and allow orbital swelling to resolve. Eyelid sutures are left in place for a minimum of two to three weeks while the damaged tissues heal.
The retina is a very complex neurologic structure that normally lies flat against the back of the eye, collecting light impulses which are then transferred to the brain and interpreted as vision. If the retinal cells detach from their normal position, they cease to function appropriately and the patient becomes blind. Retinal detachment can be caused by severe trauma, tumors, fungal infections, inflammation, genetic predisposition, high blood pressure, complications from ocular surgery, or immune system dysfunction. Early detection, diagnosis, and treatment of retinal detachment is extremely important for your pet’s general health and prognosis for retention or return of vision. Depending on what caused the detachment and how long the retina has been detached, in some cases the retinas can be reattached (medically or surgically) and vision restored.
Sudden Acquired Retinal Degeneration Syndrome (SARDS) is a poorly understood condition that affects the function of the retinal tissues of the eye. Clinical symptoms of this condition are characterized by acute (sudden) onset of blindness and dilation of the pupils. Many dogs concurrently show systemic and behavioral changes such as panting, increased appetite, increased thirst and urination, and sudden gain in weight. The cause of SARDS is being investigated and is still unknown. Much clinical interest and research funding has been dedicated to finding answers about this condition. Therapies that target these disease pathways have been proposed to reverse or prevent further vision loss in SARDS-affected dogs, but many of these treatments are controversial and no specific therapy has been documented as reliably successful. Your veterinary ophthalmologist can discuss your pet’s specific situation with you and provide advice and tips on how to help adjust to the change in their lifestyle.
Uveitis is the term used for inflammation of the uveal tract of the eye (the iris, ciliary body, and choroid). The uveal tract is the middle layer of the eye and is rich in blood vessels, which makes it very susceptible to diseases present in other parts of the body. Animals with uveitis can show a number of different signs including squinting, watery discharge, light sensitivity, cloudiness or redness, or visual deficits. Many different conditions can cause uveitis in animals. In general, they can be categorized into four large groups: infection, neoplasia (cancer), trauma, and immune-mediated. In all cases of uveitis, it is important to try to determine the underlying cause so that it may be appropriately treated. Therapy is aimed at reducing the inflammation and targeting the underlying cause of illness. Without treatment, uveitis can cause devastating complications, permanent damage inside the eye, persistent discomfort and irreversible blindness.
We Are VECMB
We strive for a safe, comfortable, stress-free and professional environment for you and your pet. The well-being of our patients and clients is our top priority. We understand that illness creates worry and uncertainty. Our skilled and compassionate nursing staff and doctors are here to help!
Our pets are family. They give us meaning and comfort, fill our lives with love and laughter, and feed our souls. We are committed to enhancing the lives of our patients by relieving pain, minimizing stress, restoring and maintaining vision, and providing enduring comfort.
We utilize a collaborative approach working along with your primary veterinarian for complete, well-rounded care. We offer advanced, evidence-based specialty ophthalmology services with state-of-the-art techniques and equipment.
Elizabeth Curto, DVM
Diplomate of the American College
of Veterinary Ophthalmologists
Dr. Elizabeth Curto received her Bachelor of Science in Biology with Honors from Virginia Polytechnic Institute and State University and earned her Doctorate in Veterinary Medicine from the University of California, Davis. Following an internship in Littleton, Colorado and a research fellowship at the Ohio State University, she completed her residency in Comparative Ophthalmology at North Carolina State University and became a Diplomate of the American College of Veterinary Ophthalmologists. Dr. Curto is passionate about helping large and small animal patients of all species.
Rachel Rowen, DVM
Jenn has worked in the veterinary field for over 10 years, ranging from shelter medicine to general practice and ophthalmology. Jenn received an AA from Hartnell College and attended CSUMB. Jenn loves to travel in her RV with her kids, husband, and 3 dogs, as well as ride horses and spend time at the lake.
Registered Veterinary Technician
Sue worked at the Monterey Bay Aquarium with the Sea Otter Research and Conservation group for 13 years. She then was a volunteer supervisor and animal care technician at the UC Davis Oiled Wildlife Care Network, followed by 3 years as supervisor at the Monterey SPCA Wildlfe Center. She then floated between general practice, internal medicine and surgery at a busy practice in Santa Cruz prior to joining ophthalmology. Sue has an AS in Veterinary Technology from Hartnell Community College in Salinas, CA and BA in Environmental Studies from UC Santa Cruz. Sue is an avid hiker, mountain biker, trekker, marathon runner and scuba diver. She shares her home with an enthusiastic Beagle and a sweet Terrier mix.
Registered Veterinary Technician
Brooke has over 20 years of experience in different areas of the veterinary field including general practice, surgery, emergency, critical care and ophthalmology. Outside of work she enjoys music, art, skateboarding, pottery, and spending time with her family and English Bulldog.
Registered Veterinary Technician
Reyna was born and raised in Salinas and has always loved animals. She graduated from Hartnell College and completed the Animal Health program in 2010, then became a Registered Veterinary Technician. Reyna has worked in small animal general practice since graduating college, and started working with ophthalmology in 2018. She is bilingual and enjoys helping people learn and understand how to care for their pets. She has a merle chihuahua named Lucy who is the light of her life and spoiled as can be. Outside of work she loves to travel the world and learning about different cultures.
Haylie has been a Veterinary Receptionist for seven years, previously at a general practice veterinarian before joining the team at Ophthalmology for Animals and continuing with Veterinary Eye Clinic. Haylie grew up in Monterey County and has always had a love for animals. She grew up riding horses and spending summers at her family cabin in south Monterey County along with their family pets. She enjoys spending time outdoors with her chocolate lab and her cat.
Rachel Rowen, DVM
Dr. Rowen earned her veterinary degree from the University of California, Davis. Following an internship at the Ohio State University, she practiced general and emergency medicine and surgery in the Bay Area for 12 years. During this time, she pursued advanced training and became a Certified Canine Rehabilitation Therapist and a diplomate of the American Board of Veterinary Practitioners in canine and feline practice.
Originally from Hawaii, Dr. Rowen grew up in Northern California and is thrilled to be training in ophthalmology on the Central Coast. She has a strong interest in exotics and wildlife. Outside of work she enjoys hiking and spending time with her family, including her spunky Pomeranian, Puccini, and her snuggly but spirited cat, Bug.
Why utilize a veterinary specialist?
Just as in human medicine, veterinary medical specialists are a valuable resource in treating your pet. Your general practice veterinarian has excellent training in veterinary medicine and acts as a family practice physician to your pet. But just as with human medicine, there are occasions when your veterinarian might want assistance or suggest a referral to a specialist to better meet your pet’s needs. Specialists should be board certified by the appropriate national agency and are available in ophthalmology, internal medicine, surgery, pathology, oncology, radiology, cardiology, dermatology, and others. You should not feel shy about asking your general practice veterinarian for a referral to a specialist if you feel one might be helpful. Your veterinarian and the veterinary specialist will work together as a team to treat your pet.
What is a veterinary specialist in ophthalmology?
A specialist in veterinary ophthalmology has completed all phases of training through an approved American College of Veterinary Ophthalmologists (ACVO) residency and passed all written and practical examinations. After obtaining an undergraduate degree, a 4-year doctorate in veterinary medicine is completed. This is followed by a 1-year clinical rotating internship or at least 2 years of general practice work. A 3- or 4-year residency program in veterinary ophthalmology is then followed by a demanding specialty examination including both written and practical portions. Knowledge and skill gained through rigorous advanced training allow a specialist in veterinary ophthalmology to diagnose and treat eye disease in animals. Once training is complete and exams are passed, a specialist is referred to as a Diplomate of the American College of Veterinary Ophthalmologists. A veterinary specialist is required to maintain their skills through annual continuing education. You may find more information about veterinary ophthalmology at www.ACVO.org.
Is my pet too old for anesthesia?
Age is only one factor when evaluating an animal for anesthesia. Quality of anesthesia is a much more important factor to consider than age. However, age-related problems such as renal or heart problems are weighed heavily into the equation. Pre-operative screening should detect these patients. Appropriate drugs, cardiovascular support and very close monitoring with state-of-the-art equipment are necessary for a successful anesthetic event. At Veterinary Eye Clinic, many of our patients are geriatric and we are prepared to administer and monitor anesthesia safely to older patients.
Do you offer appointments for horses?
Yes! Dr. Curto is experienced in diagnosing and managing equine ocular diseases. Our office works closely with Steinbeck Country Equine Clinic and local equine veterinarians to provide comprehensive ophthalmic services. Because equine cases can be particularly complex, they often require a team effort along with your regular veterinarian. Equine examinations should be scheduled through your veterinarian when possible.
Are E-collars necessary?
Yes, the use of e-collars is often necessary to aid in the healing process of your pet’s ophthalmic problem. We understand that they are not always easy for you or your pet, but please remember that the e-collar is safeguarding the eyes and improves the chances of a successful outcome. It often takes a day or two for your pet to adjust to the collar, but they will in time.
If your pet won’t eat or drink you can try elevating the food and water bowls with a phone book, box or large overturned bowl. If your pet’s ears smell or you suspect an ear infection you may need to trim hair around the ears and keep the inside of the collar more dry. If your pet is head-shaking or the signs persist, please bring your pet in to see your veterinarian. Head shaking can be detrimental to any corneal or intraocular surgery. Animals occasionally will not urinate or defecate while wearing a collar. Just be patient. Give your pet 24-48 hours after surgery as they may be “empty” due to pre-anesthetic fasting or may be constipated due to certain perioperative medications. You can try adding canned pumpkin to the food and take your pet for frequent walks. If constipation persists, please call us.
If your pet won’t walk or move while wearing the e-collar, you can try offering treats to lure them over to you. Keep encouraging them and over time, your pet will get used to the e-collar.
Recovery visors and masks offered by Protective Pet Solutions can be helpful to protect the eyes of pets that struggle with the e-collar, especially for larger breeds. These items can be purchased directly from their website: www.protectivepetsolutions.com.
Do I need a referral from my veterinarian?
Veterinary Eye Clinic is a specialty practice. We work closely with referring veterinarians to help manage ophthalmic cases. We do not require, however, that you see your regular veterinarian prior to scheduling an appointment with us.