Superficial ulcers usually heal in less than a week. Deep ulcers and descemetoceles may require corneal suturing, conjunctival grafts or conjunctival flaps, soft contact lenses, or corneal transplant. Topical corticosteroids and anesthetics should not be used on any type of corneal ulcer because they prevent healing and will often make them worse. Bioscaffold
A new bioscaffold developed by TR BioSurgical is being evaluated for refractory corneal ulcers in dogs. The study is being conducted by board certified veterinary ophthalmologists and has shown promise in healing refractory ulcers that have failed conventional treatment . Refractory corneal ulcers
Refractory corneal ulcers are superficial ulcers that heal poorly and tend to recur. They are also known as indolent ulcers or Boxer ulcers. They are believed to be caused by a defect in the basement membrane and a lack of hemidesmosomal attachments. They are recognized by undermined epithelium that surrounds the ulcer and easily peels back. Refractory corneal ulcers are most commonly seen in middle aged or older dogs and often occur in the other eye later. They are similar to Cogans cystic dystrophy in humans. Commonly affected breeds
Alaskan Malamute
American Cocker Spaniel
Boston Terrier
Boxer
Brussels Griffon
Cairn Terrier
Chesapeake Bay Retriever
Chihuahua
Chinese Shar Pei
Dachshund
Bulldog
English Springer Spaniel
German Shepherd Dog
Golden Retriever
Irish Setter
Japanese Chin
Lhasa Apso
Maltese
Pekingese
Poodle
Pug
Rottweiler
Samoyed
Shih Tzu
Silky Terrier
Weimaraner
Welsh Corgi
Welsh Springer Spaniel
West Highland White Terrier
Wirehaired Fox Terrier

Treatment
Refractory corneal ulcers can take a long time to heal, sometimes months. Topical antibiotics are used continually to prevent infection. Pain medications are given as needed. Loose epithelium is removed with a dry cotton swab under topical anesthesia.
Progressive scoliosis can generally be managed with standard instrumentation and fusion techniques. Surgical management in the craniofacial skeleton is complicated by frequent post-operative FD regrowth, and should focus on correction of functional deformities. Prophylactic optic nerve decompression increases the risk of vision loss and is contraindicated.Managing endocrinopathies is a critical component of management in FD. All patients with fibrous dysplasia should be evaluated and treated for endocrine diseases associated with McCune–Albright syndrome. In particular untreated growth hormone excess may worsen craniofacial fibrous dysplasia and increase the risk of blindness. Untreated hypophosphatemia increases bone pain and risk of fractures. See also
Cherubism
Dysplasia
McCune–Albright syndrome

References
Further reading
GeneReviews entry for Fibrous Dysplasia/McCune-Albright Syndrome


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