Okay, thank you so much for your additional answers. That helps me out.
I have some big concerns about your dog's eye based on what you have described. I have a couple of thoughts as to what type of issue could be occurring.
It sounds like the treatments you are using for your dog's eye are the typical treatments for a corneal ulcer or uveitis (inflammation of the uveal part of the eye, which are some of the internal structures): antibiotic ointment, atropine (which dilates the eye and helps alleviate pain) and pain relief medication (Rimadyl). These are all good treatments, but if your dog had corneal ulcers or uveitis alone I would expect that you would be seeing a much better response by now. If the corneal is white, certainly that indicates fluid and inflammation in the cornea, which is not the only problem with your dog's eye based on what you are describing.
Here is a general article on eye pain with a lot of differnt conditions mentioned:
What concerns me even more with your dog is that the eyeball itself looks enlarged as well as the the tissue around the area. The 2 underlying conditions I would be most concerned about are:
1) Glaucoma: This disease is caused by an increase in pressure in the eye, which can have a number of underlying causes. The eyeball itself will look larger, and with time the eye is quite painful, red and bloodshot, and the cornea can turn bluish or white due to the intense inflammation. Eyes with glaucoma can easily go blind so it is very important to get it under control if possible. This condition is diagnosed by checking the eye pressures. It can be treated with a variety of medications. If it cannot be well controlled or is too advanced, the eye may have to be removed to alleviate the pain for the dog. Here is an article on glaucoma:
2) The other possibility would be retrobulbar abscess, which simply means an infection behind the eye. I am quite suspicious of this possibility as well as your dog has some consistent signs. The eyeball itself may appear enlarged because it is often pushed forward with all the swelling around it. The tissue around the eye becomes very swollen and painful, like you mention. This is not usually the case with glaucoma. The dog may have trouble chewing because it is painful to chew. This is because the infection is behind the eye area and close to the "hinge" (temporomandibular joint) of the jaw and that area can also be tender. These infections are common in dogs as they can chew on material and get a piece wedged up through the oral tissue way back in the upper part of the mouth and up behind the eye area, or a puncture wound in this area which introduces bacteria. These are tricky to diagnose as you may see nothing unusual actually in the mouth. The dog has to be sedated and the area behind the upper jaw explored. When this area is opened there may be drainage of pus and you know you have found the problem!
Here is an article on this condition:
Of course I cannot diagnose your dog online, and if I was to look at her eye I may be thinking something different. But based on your description, and the fact she is not responding well to routine treatments, these are the conditions I would want to check into. She should have a full eye exam, if not from your vet, someone else---to have the eye pressures checked (if not already done), and possible sedation and oral exploratory to see if there could be an infection behind this eye. Certainly other diagnostics may also be needed.
I hope this provides some guidance. Let me know if you have any more concerns. I will be signing off soon for the night, but will check in in the morning! Thank you, XXXXX XXXXX hope you and your dog get the answers needed! Blessings, Dr. Marcia