rabbits eye problem

Question
My boyfriend got us a bunny rabbit about 4 months ago. The bunny is now about 5 and a half months old. About a month ago while my boyfriend was holding him the bunny jumped out off his hold and while we managed to caught him before he hit the floor I saw that he had knocked his head on the side of a box. A few days after that we noticed that his left eye was swollen and looking cloudy so I took him to the vet. The vet did some tests on him and said that he had an ulcer on his cornea and glaucoma. He was prescribed an antibiotic,a pain relief, an eye ointment and Trusopt to treat glaucoma. Everything was looking good in the first week the bunny's eye was responding well to medication but the week after his condition would flared up again so I took him back to the vet and we decided to keep going with the medication and see how it went. Now 2 weeks after, his ulcer is healed but the result is still the same his eye would respond to the eye drops (less swollen and clearer eye) but a few days later his eye would swell up and gone cloudy again. It has been like this on and off. I'm planning to take him to the vet again this week but wondering if you can give any advice or suggestion?
The vet said that she would like to check the eye IOP level again but I'm very worry about putting the bunny on anesthetic again.
Also another thing I noticed with the bunny is that almost every day he would tilt his head back and open his mouth a few times like yawning but he would also squeeze his tummy in and out. I always wonder what it means?

Many thanks
Kat


Answer
Hi Kat....Very interesting.  I have a couple of questions that I need answered so I hopefully can give you a good response.  Specifically what drugs were used...especially the ointment. What is your rabbit's weight?

Has the eye been restained since the original diagnosis?  If not, I would certainly stain that eye again to see what is going on with the cornea.  If there is still damage, I would take a look under the eyelid for any debris or even an eyelash.  If that is clear, we have had success using a drug called Acetylsystine.  I have repaired some significant ulcer damage in both domestic and wild rabbits using this drug.  I use this drug in conjunction with normal optic abx (w/o steroids) and appropriate pain meds.  I have never had to sedate a rabbit to get an eye pressure...but if your rabbit is jumpy, I can see it.  And honestly, I have never seen such a young rabbit with glaucoma unless there is an underlying problem.  Do you know what the pressure was in each eye?

There is one fly in the ointment that might be a bit "out there" but should be considered. That is the tilting back of the head with the mouth open.  That is usually an indication of an airway constriction or possibly a dental concern.  While it would be rare for such a young rabbit to have dental issues, it is possible.  The pre-molar and molar roots of the upper arcade of teeth are quite long.  There are some cases that the root can elongate and affect the respiratory system or the eyes.  Some of these conditions can result in an abscess inside the skull.  This will initially present as a cloudy eye with increased pressure.  If it is an infection and it is not addressed, the affected eye(s) will start to bulge and will usually start having a discharge as the issue progresses.  This condition is known as Exophthalmos.  While this condition is very unlikely, with the problem returning after intial treatment, if nothing is found during the stain, it is certainly something that should be considered.  Diagnosis of dental issues can only be properly attained by taking radiographs of the jaw....just a visual won't do.

Please let me know the specific drugs that were used.