Koi with Popeye - Exophthalmos

The picture above shows a koi with Popeye or more properly know as Exophthalmia. It can look like air or fluid trapped inside or behind the eye causing it to bulge out of its socket. This koi shows similar symptoms to mine, with the koi's eyes only appearing affected. All the fish in this pond were similar but in less than a week they made a full recovery. The owner was unable to pinpoint an answer for the outbreak as water quality seemed good, other than it was a new pond and the fish were still suffering from stress. Given optimum conditions they improved on their own.

My koi in quarantine seems slightly better and has even started taking an interest in food again. So far the only treatment has been regular daily water changes of 10% and the addition of a very small amount of salt. The condition is still worrying but the improvement is encouraging. I am thinking of trying Kusuri-Sabbactisum to increase its immune system and kill any internal infection. Even with the best efforts and treatments Koi can still die. One of the problems with trying to diagnose fish diseases is that they often exhibit similar symptoms or secondary infections mask the underlying causes. This is a problem when looking for answers to Popeye.

Popeye or Exophthalamia is not a disease but rather a symptom of many possible causes. For this reason you can become confused by the varied and apparently contradictory advice. Make sure any treatment is the right for your fish before rushing to administer something which only makes the problems worse. The best course of action is to immediately provide your koi with the best conditions such as water quality and to lower stress. Get these right and you can then begin identifying what medications to use if any. Reading many books and websites, Popeye is associated with many diseases and I have found myself believing my koi has all of them. Some are very nasty diseases and are often a cure comes too late. The best advice is to look at the most common reasons and compare with your own koi's symptoms.

Here is a list of possible popeye causes or diseases seen together starting with the most common :

• Bad conditions eg. Lack of water changes or inefficient filtration, extreme PH levels and fluctuations or waste build up - bacteria levels can build up in fish waste and stress reduces koi immune system so they get the diseases listed below.
• Trauma -Usually caused by damage such as leaping out. Treatments including antibiotics but can affect filter bacteria. Kanamycin sulfate based antibiotics are absorbed through the skin but are best given in food.
• Bilateral Exophthalmia and Ascites (a swollen abdomen from fluid build up) is often seen in kidney disease - salt and anti internal bacteria treatment should help.
• Icthyophonus hoferi (fungal disease) symptoms as above.
• Vibrio (bacterial disease)symptoms as above usually with ulcers.
• Dropsy - Possibly the same problems as above with body swelling but very hard to treat once the scales start 'pineconing'. The eyes aren't always affected with Dropsy.
• Fish TB - Mycobacteria- Warning! Always wear gloves if you suspect this disease as it can pass to humans. This infection affects the koi's internal organs, often the gut causing similar osmotic imbalance and wasting. Some say not to treat this disease but antibiotics can be tried.
• SVC Spring Viremia of Carp- Luckily quite rare and a notifiable disease with all fish needing to be culled. Usually infected koi display similar symptoms like dropsy with haemorhaging.
• Gas Bubble Theory- Its possible that too much oxygen or nitrogen can bubble in the cells of a koi like a diver with the bends.
• Nutritional Deficiency- This is unlikely with modern koi food.

This is by no means every disease but hopefully helps point you in the right direction. Speak to an expert if not sure. Most trouble starts from the same route cause of stress from the koi's environment and the many diseases are similarly treated.