Advancements in equine ophthalmic imaging enhance understanding of ocular and orbital anatomy and disease in standing sedated horses

OBJECTIVE: To review data on the advances in equine ophthalmic imaging that have been made during the past 5 years and highlight advantages of using multiple imaging modalities to improve clinical observational skills and improve diagnostic accuracy. METHODS: A literature review from 2019 through 2024 of equine ophthalmic digital photography, fundus photography, ocular and orbital ultrasonography (US), ultrasound biomicroscopy (UBM), confocal microscopy (CM), spectral domain optical coherence tomography (SD-OCT), radiography, CT, and MRI. RESULTS: Digital photography remains the cornerstone of equine ophthalmic imaging for documenting examination findings, sharing information with colleagues, and consulting with specialists. Digital images also allow for in-depth postexamination review and evaluation, often revealing subtleties that may have otherwise gone undetected during the ophthalmic examination. Advanced imaging modalities are being used more frequently in equine ophthalmology, especially those that can be used with the horses standing under sedation, including US, UBM, SD-OCT, CM, and CT. DISCUSSION:: Advances in equine ophthalmic imaging have led to many new clinical discoveries and to an increase in our knowledge of ocular anatomy and diseases in the horse. Many of these advanced diagnostic imaging modalities, such as MRI, CT, SD-OCT, and CM, are cost prohibitive and require substantial operator training to ensure proficiency. However, their availability in tertiary referral centers, such as veterinary teaching hospitals and large equine clinics/practices, is becoming more widespread. CONCLUSIONS: Advanced equine ophthalmic imaging data contributes substantially to our general understanding of clinical and applied anatomy and improves our understanding of the underlying pathogenesis associated with specific diseases.