Examining and Medicating the Eyes of a Cat

This information is not meant to be a substitute for veterinary care. Always follow the instructions provided by your veterinarian.

In the photographs below, unless otherwise noted, the cat is facing with his nose pointing to your left. Variations on these instructions exist.
Some cats will happily sit in your lap or on a table while you medicate their eyes but many require some form of restraint. See the section on restraining a cat for some suggestions.
Anatomy of the normal eye

To hold your cat in your lap to place eye medications, drape your left forearm across the cat's body to keep him/her in your lap. Hold the head with your left hand using your left thumb to pull down the lower eyelid. Hold the medication in your right hand, balancing the heel of your right hand on the cat's head.

To examine the eyes, the head is cupped between both hands with one thumb on the upper eyelid and the other thumb on the lower eyelid.

 

To see the parts of the eye beneath the upper eyelid, pull the upper eyelid up with your thumb which will open the eye widely. The white part of the eye is the sclera. The sclera is normally glistening white and has small, thin red blood vessels on its surface.  Abnormal findings on the sclera include: large, engorged blood vessels bruises may indicate a local injury or a problem with the clotting system yellow discoloration of the sclera which indicates jaundice.

If you stretch the lid further you will see a pink tissue which is the conjunctiva. In health, the conjunctiva are about the same shade of pink as the gums.

Abnormal findings on the conjunctiva include:

• pale pink may indicate anemia
• yellow discoloration indicates jaundice
• bruises may indicate a local injury or a problem with the clotting system

Looking through the pupil, you look through the lens which is clear and you may see a very bright colorful structure which is the retina. When you photograph a pet and see "red eyes", you are seeing light shining off the retina.  The iris can be one of several different colors and some cats have 2 different color irises. Some, but not all cats with blue eyes are deaf.
Abnormal findings on the iris include:

• ragged edges, although this can occur with aging and is called iris atrophy
• growths on the iris
• black spots on the iris
• blood spots on the iris

The pupil is the black spot in the center of the eye. Cat pupils are oval compared to dog pupils that are round. The pupils should be the same size and should constrict to a slit when a bright light is shined in the eye. The pupil is a hole in the center of the iris. The lens is behind the pupil but is not seen when healthy as it is clear.
Abnormal findings in the pupil include:

• blue discoloration of the pupil is a color change in the lens, indicating cataracts or an aging change called nuclear sclerosis
• different sized pupils which is called anisocoria
• ragged edges, although this can occur with aging 

Use your lower thumb to pull down the lower eye lid. The third eye lid, also called the nictitating membrane, will protrude over the bottom inner corner of the eye. In the pictures above, notice that the third eyelid also protrudes when you pull up the upper eyelid. The 3rd eyelid is usually a pale pink or white color and has thin blood vessels on its surface. When you pull the lower lid down it pulls way from the eyeball creating a pouch that is lined by pink conjunctiva. This pouch is where eye medications are placed.

Abnormalities of the conjunctiva and 3rd eyelid include:

• yellow discoloration in patients with jaundice
• discharge may accumulate in this pocket 

Eye medications are either drops or ointments. Ointments stay in the eye longer than drops so are usually applied less often. Your veterinarian will prescribe specific medications for specific conditions.

Cradle the head in one hand, usually the left hand if you are right-handed. Use the thumb of the hand holding the head to pull down the lower eye lid to create a pouch.  Hold the ointment tube in your right hand, with the tip a few millimeters away from the eye, not touching the eye, squeeze a small ribbon of ointment into the pouch.

To distribute the ointment across the eye...

...massage the ointment across the surface of the eye with eyelids closed.

Eye drops are also placed in the pouch created when you pull down the lower eyelid. Hold the head and pull down the lower eyelid as described for placing ointments in the eye. Drop the prescribed number of drops into the pouch without the tip of the bottle touching the eye. Eye drops disperse across the surface of the eye rapidly and do not need to be rubbed across the eye by massaging.

Depending upon the size of the cat's head and your hands, you may rest the middle finger or heal of the hand holding the bottle or tube on the cat's head to keep your hand more steady and reduce the risk of poking the cat in the eye with the bottle or tube.