Deep corneal ulcerations are treated the same way that superficial ulcerations are, yet these require close observation for progression or worsening of the ulcer.
Bacterial cultures of such ulcers are necessary to be certain that the antibiotics being used are effective against any organisms involved.
For deep ulcers that worsen or fail to respond to conventional treatment, additional procedures might be necessary to speed healing or to prevent the cornea from actually rupturing.
A favorite procedure among veterinarians consists of surgically freeing and extending a portion of the thin conjunctiva over the ulcer and actually tacking it down against the ulcer using suture material (conjunctival flap).
The flap of conjunctiva provides nutrition and speeds healing to the ulcer, and also allows any medications applied directly to the eye(s) to reach the ulcer without hindrance. Once healing has been accomplished, the flap is released, and excess conjunctival tissue is trimmed away from the healed surface.
Special contact lenses and/or corneal tissue adhesives can also be applied over the damaged surface of the cornea. These serve to protect it from further degradation and help promote rapid healing. For difficult ulcers, actual grafts using fresh or frozen corneal tissue may be required.