Eosinophilic keratitis in 46 eyes of 27 horses in the Mid‐Atlantic United States (2008–2012)

OBJECTIVE: To review the signalment, clinical characteristics, treatment, and outcome of equine EK cases in the Mid‐Atlantic United States; to evaluate the effects of topical or systemic corticosteroid treatment, oral cetirizine treatment and secondary corneal infection on disease duration; and to evaluate the association between corticosteroid and cetirizine treatment and likelihood of recurrence. ANIMALS: Twenty‐seven horses (47 eyes) diagnosed with EK from 2008 to 2012. PROCEDURE: Retrospective medical record review followed by phone interview to obtain recurrence data. RESULTS: Average age of affected horses was 8.2 years, SD 5.8 years. Eleven of 27 horses (41%) were diagnosed with EK in July. Twelve horses (44%) had been affected in previous years. Time to resolution averaged 3.7 months, SD 2.3 months. Ten horses (18 eyes) were treated with systemic dexamethasone, with a significantly shorter time to resolution, P = 0.03, averaging 2.23 months, SD 1.13 months, relative to horses not so treated, averaging 4.20 months, SD 1.47 months. Secondary infection led to a significant increase in time to resolution, P = 0.03, average 4.1 months, SD 1.7 months, relative to horses without secondary infection, average 3.0 months, SD 1.5 months. All eyes were visual at resolution. Horses treated with cetirizine were less likely to have recurrence during the follow‐up period (1/13, or 8%) relative to horses not so treated (8/14, or 57%). CONCLUSIONS: Eosinophilic keratitis has a seasonal occurrence in summer in the Mid‐Atlantic United States. Systemic but not topical corticosteroid treatment may decrease therapy duration. Treatment with cetirizine may be associated with a decreased risk of recurrence.