咨询描述：我家猫上周发现右眼的右上方有一点点浅浅的白膜，一开始以为只是发炎，就每天正常用**眼净清洗，上了一点***眼膏，上周日发现没有好转，白膜变白了而且还有一个小点，就开始每天2到4次**洗眼睛，***滴眼液，***眼膏。怀疑是角膜溃疡，我拍了图，昨天开始加了一个***眼用凝胶，用药次数也加大到一天5到6次，麻烦医生看看，是角膜炎还是角膜溃疡，目前用药是否需要更换或者增加，是否是外伤导致的
——
猫咪背景情况：已经4岁的猫咪了，疫苗齐全，没有接触外面的猫，目前没有病毒导致角膜溃疡的症状。它从小由于脸略微凹陷，鼻泪管有点堵，所以眼睛一直有泪痕问题，基本都是每天用**洗眼睛，最近工作太忙了可能有时候就疏忽了。
回复总结：针对猫咪角膜溃疡的症状，用药治疗方面建议给猫咪使用抗生素滴眼液和眼膏，同时还需要配合使用角膜修复的眼药。注意，所有的眼药都要间隔5分钟使用。如果条件允许，建议最好带猫咪去专业的宠物医院，可以用金刚砂针给猫咪把角膜磨一磨，能促进猫咪角膜的恢复。
问题大致一样，细节不同？
郭秋萍
执业兽医师
根据您讲到的小麦情况，我初步判断有角膜溃疡，但仅仅根据目前信息，还不能做出进一步的判断。我还有几个问题需要向你核实一下：
1. 你检查一下，他的眼睛发白部位是在眼球的表面还是在眼球里面？
2. 另外你拍的照片是今天的照片吗？他刚开始发病的时候的照片有没有？可以上传过来我对比看一下吗？
3. 他自己有没有抓或者是挠？另外家里有几只动物呀，有没有打过架？
4. 他目前精神食欲大小便情况怎么样？
以上这些情况您仔细回忆后详细的描述给我，对我给宝贝目前情况做判断以及制定治疗方案有非常大的帮助，感谢您的配合。另外，把您家爱宠的信息补充完整，特别是『年龄、体重』，待会儿咱们沟通后如果涉及用药建议，方便为宝贝开具处方。
1.是在眼球表面
2.刚发病的图没有拍过，就是那种半透明的小小的看起来很薄的薄膜，是没有白点或者别的什么的
3.图片是今天的图片。之前都没拍，小麦平时就懒懒的喜欢躺着，所以精神不太好观察呢，但是没有蔫蔫的表现，食欲正常，便便也还好
4.它平时在家和另外一只猫也就是追追跑跑，不真的打架，互相挠也就是很短挠一两下，闹着玩的不严重那种
5.小麦很爱干净，非常喜欢自己洗脸，我从上周日怀疑它溃疡之后就给戴了圈圈
——
备注：它这次溃疡的是右眼，它左眼在10天前 大概这个时间，我发现内眼角外有一点伤口，伤口像泪痕没及时清理，堆积导致的那种，我上了***眼膏，两三天就好了，后来过了大概一两天我发现右眼的问题，上周日开始新增了****滴眼液的时候，我也会减量给左眼也滴一些，滴了两天后，左眼开始有白色絮状物排出，昨天左眼就已经基本不排什么絮状物了，只有极少量絮状物，到今天就基本没有了
郭秋萍
执业兽医师
那从你给的信息，你家猫咪现在就是典型的角膜溃疡，他的眼角膜发白是因为出现的水肿。
而且从这个形态来看，他这个多半是慢性角膜溃疡。恢复的话，估计需要一两个月的时间。不排除是因为猫咪之间玩闹误伤的，也有可能是眼睛里进入了什么液体或刺激物导致。
治疗的话最好是配合自体血清一起使用。另外你你手里的抗生素滴眼液和眼膏都可以使用。再加上角膜修复的眼药。
根据猫咪的情况，我给它开个处方。处方里面的1.干细胞滴眼液，修复角膜，一天6次，一次1滴，连用14天。
2. ***滴眼液，滋润角膜，一天6次，一次1滴，连用14天。
加上你手里自己已经有的****滴眼液，***眼膏，还有***，这些所有的眼药都要间隔5分钟使用。
好的，谢谢医生
就是你从图片看的话，它的情况严重吗？有没有恶化的趋势呀，溃疡损伤大吗？
如果我持续这样用药，如果多久没有明显好转我需要送它去医院呢？
慢性的是不是就是大概一到两个月持续用药才会呢？另外就是您开的药建议用14天，用满14天之后，我应该评估哪些情况来决定是否继续用药或者停药呀？
郭秋萍
执业兽医师
他现在的情况属于中等严重吧。溃疡面还是比较大，但是至于有没有恶化，我本身也才第一次看，没有对比就不知道了……
你像这样的要最少要半个月才能看出来有没有什么变化，而且角膜上越是有血管爬行就越说明恢复的好。如果滴药期间没有任何变化超过一个星期，那你就需要去医院再次检查一下。
是的，慢性的最少要一两个月才能恢复，而且像他这种情况，正常来说每两个星期你都需要去医院重新评估一下，可能需要调整用药，以及重新制定用药方案。最好是去比较专业的眼科医院，这样他还可以用金刚砂针给他把角膜磨一磨，这样能促进他的角膜的恢复。
最好是14天之后你再重新评估之后再说停药或者是继续用药。
医生您好，我还想问一下，因为给小麦用***8效果没有什么明显效果，是否可以换成****或者****滴眼液，还需要额外口服消炎药吗
郭秋萍
执业兽医师
可以换成其他的抗生素类的滴眼液，****这样的也可以，不需要给他单独口服消炎药，因为角膜上面，口服药物能达到的药效非常渺茫。
医生建议及处方根据当前病情给出，仅适用于本次问诊
蘑菇宠医处方笺
用法用量需根据患宠的年龄、体重等信息开具，此处方暂不展示
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