Corneal sequestrum in the Persian cat: diagnosis and treatment
6-year-old Persian cat with blepharospasm, epiphora and a dark brown, almost black plaque in the centre of the left cornea, surrounded by vessels. Two months ago a chronic ulcer was treated with grid keratotomy.
What is the most appropriate treatment?
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A. Topical antibiotic and always wait for the plaque to slough on its own
Some sequestra slough, but this can take months, cause chronic pain and progress deeper. In a painful, vascularised eye removal is indicated.
B. Topical corticosteroid to reduce inflammation and pigment
It does not dissolve the necrotic tissue, may reactivate herpesvirus and is contraindicated if there is ulceration around it.
C. Lamellar keratectomy to remove all the necrotic tissue, with a graft if the bed is deep, and assess the role of herpesvirus and corneal exposure
Correct. A sequestrum is stromal necrosis with amber to black pigment. Removing it completely relieves pain; if little stroma remains it is reinforced with a graft. It can recur if predisposing factors persist.
D. Repeat grid keratotomy to stimulate epithelialisation over the plaque
Keratotomy in the cat is precisely one of the triggers for sequestrum; repeating it would make things worse.
lightbulb Key takeaway
Corneal sequestrum: amber, brown or black plaque in brachycephalic cats (Persian, Himalayan, Exotic) and also Birman and mixed breeds. Factors: chronic ulceration, herpesvirus, exposure, entropion and keratotomy. That is why you should never perform keratotomy in cats.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.