Pie's face is slowly getting better - it's still swollen but everytime I see him it's not quite as bad. I'm continuing to ice it when I can - he's very good about letting me ice his face without him even being haltered, and he even let me run cold water on his cheek when I was hosing him off - I guess it felt good (I never spray my horses in the face or on the head when I'm hosing off - they don't like it and I can easily take a wet sponge and sponge their faces and around their ears).
Pie had a visit with the eye vet yesterday - more vets? he says - to check out his cyst and also evaluate him for any damage from Lyme. It was good that they made a barn visit - the other eye vet in our area doesn't and you have to trailer to them and we are at the moment trailerless.
He has no retinal or optic nerve damage from Lyme, which is very good news - another horse at our barn, who'd probably had Lyme for a long time before it was detected, has permanent eye damage from it. The cyst, although good sized, is on the lower, rather than upper, edge of his iris which means it interferes with his vision less than it could. His spookiness may just be adjusting to the changes in his vision due to the shadow cast by the cyst - the vet agreed he was one of the least nervous or spooky horses she'd looked at - he just stood there half asleep as she examined his eyes. He can clearly see, the question is how well - horses can't take eye tests.
So for now, we're watching things - if the cyst gets bigger or his spookiness worsens we can do the laser procedure, which simply deflates the cyst. The procedure can be done with standing sedation at the barn, and is fairly straightforward and low risk, although pricey. For now, I'll just keep working with him, including taking him on the trail some more - wearing my helmet (of course) and also a body protector, and not taking to the trail alone. We may also experiment with some things - the vet suggested trying some obstacles - rails, step up platforms, tarps, etc. - with one eye covered and then the other to see if that makes any difference. I can also play around with race horse blinkers, which could make things better or worse.
And then, later in the day, another vet stopped by to take his blood for two tests - a follow-up on the slightly elevated EPM titer he had a while ago - he was treated and we think he's fine now - as well as a Lyme retest since he's now 6 months out from the end of his treatement for Lyme. As usual, he was a saint for the vet. His personality has changed a lot since I got him - he started out being aloof and a bit remote, got very crabby and unhappy when he had Lyme, and now he's just plain sweet, sweet, sweet. Everyone who meets him comments on it. He loves to meet with new people - even vets - is interested and alert and just is a real doll. That's my Pie Pie!