Time and money are generally the two leading challenges. Treatment can require that medication be delivered to the eye every hour around the clock for days. Many owners are unable or available to do this. This necessitates that a horse be admitted to the hospital where medication can be delivered around the clock. As the medicating intervals become less intensive horses are sent home to finish up treatment.
As you can imagine an extended stay in the hospital, medications, and follow-up visits can become very costly, especially if the horse is not covered by insurance. This is the second challenge. In some cases treating the eye is not a financial option and eye removal is the only alternative. Enucleation (eye removal) can, in some dramatic cases, be fraction of the cost of treating a serious well-established corneal ulcer.
If an eye has to be removed take solace in the fact that most horses continue on with life as usual. They are not affected in ways owners often worry they will. Remember, horses are prey and they fear movement. Any movement to a horse could be a predator. This is why horses have developed with eyes set wide on their heads giving them great peripheral vision. They are not frightened of what they don’t see! This is why carriage horses where blinders. Unlike people, horses don’t suffer emotional trauma and tend to continue about their business with little interruption. This is the good news, however we want to save every eye we can and early treatment is key.