Equine Eye Infection Assessment Form
Complete this Equine Eye Infection Assessment Form to provide details about your horse’s eye infection concerns. This helps ensure a thorough evaluation and appropriate guidance.
Horse Name
*
Horse Age (in years)
*
Owner/Handler Name
*
Which eye is affected?
*
Left
Right
Both
How severe are the symptoms?
*
Mild
1
2
3
4
Severe
5
1 is Mild, 5 is Severe
How long have the symptoms been present?
*
Less than 24 hours
1-3 days
4-7 days
More than 1 week
Observed symptoms (select all that apply):
*
Redness
Swelling
Discharge
Squinting
Rubbing eye
Cloudiness
Other
Possible triggers or exposures
Recent dust exposure
New bedding or hay
Contact with other horses
Recent turnout or pasture change
None known
Other
What care or treatment has already been given?
How urgent do you feel the situation is?
*
Routine concern (can wait for next appointment)
Should be seen soon (within a few days)
Emergency (needs immediate attention)
Submit
Should be Empty: