Ophthalmic Therapeutics

Ophthalmic drug delivery in horses poses unique challenges due to anatomical and physiological barriers, including the cornea, blood-aqueous barrier, and blood-retinal barrier. The success of topical, intracorneal, periocular, intraocular, systemic, and implant-based therapies depends on tissue condition, drug properties, and delivery. Topical application remains the primary route of delivery, with ointments and solutions tailored for corneal and anterior segment disease. Subpalpebral lavage systems improve compliance for frequent dosing. Intracorneal and periocular injections bypass epithelial barriers, achieving higher local concentrations, while systemic administration is reserved for posterior segment or orbital disorders. Implants and membrane-based systems provide sustained drug release and represent a promising area for innovation, though safety and duration need further study. Drug selection should be based on etiology and consider bioavailability, pharmacokinetics, and adverse effects. Future research focuses on advanced delivery technologies, improved precision, and strategies to enhance equine ocular health and preserve vision.