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Wednesday, June 12, 2013

Removing Both Eyes

Today's post is about a Siberian husky named Diesel.  He's a sweet six-year old boy that first began having problems in late 2012.  At first there was just some inflammation noted in his eyes, which we treated and it seemed like everything was okay.  Two months later, in December, he came in for more eye problems.  It didn't take long to determine that his eyes were painful and his eye pressure was very elevated.  A rather simple diagnosis:  glaucoma.  In his case there was still some inflammation within the eye (uveitis for the medically-minded) and I suspected that the glaucoma happened secondary to the first problem.  Whatever the cause, it needed to be treated and quickly.

I sent him to a local veterinary ophthalmologist the next day and she began treatment with multiple medications.  Over the next several months we slowly got his glaucoma under control with a few setbacks here and there.  The owners hated having do use 4-5 different eye drops every day, but they were willing to do so if it helped him.  Unfortunately he stopped responding as well, which brought us to May.

He made another visit to the specialist a couple of weeks ago and it was determined that his left eye had lost all vision and the right eye had only minimal vision along with a displaced lens.  The left eye was not salvageable, and the best thing to do was to remove it.  However, the right eye was mostly blind and the ophthalmologist gave it a guarded prognosis at best.  He could only see shadows to a certain degree and there was a high likelihood that the "good" eye would fail at some point in the future.

This situation led to a discussion between me and the client.  It was obvious that we needed to remove one eye.  But there was a strong justification for going ahead and removing the other one at the same time.  Both eyes were causing pain and discomfort.  He also did not like the multiple medications used to even somewhat control the glaucoma.  This was a lot of hassle, time, and expense for something that wasn't completely helping the problem.  We began to talk about doing a bilateral enucleation (fancy medical words for "removing both eyes") since there was a good chance that in six to twelve months we'd have to remove the other one anyway.

This was not an easy decision and I'm sure it sounds radical to many readers.  But in circumstances like Diesel the eyes are more of a problem than a benefit.  Neither of them was functioning well and he was effectively 80% or more blind already.  We think about it in our own terms and can't imagine not having our eyes.  Even if we were blind, removing such an important organ makes us cringe.  But with Diesel removing the eyes would be helping his comfort in the long run, and given that he is only six years old he still has a lot of life left in him.  The client thought long and hard and finally decided to go ahead with the surgery.

Here he is before the surgery.  You can tell that he is squinting his eyes more than a normal dog would, and that's due to the pain from glaucoma.

Here is a close-up of the left eye.  It's a little difficult to tell from this photo, but the eye is very cloudy and the pupil is dilated.

I've performed enucleations before, but this is the first time I've removed both eyes on the same pet.  As far as the technical aspects of the surgery, it went very well and without any complications.  In this kind of surgery we remove the eye, muscles, and tear gland (along with the associated third eyelid membrane).  We cut the edges of the eyelid and then sew them together so that there is no longer an opening.  Some specialists may place an artificial eye in the socket just to maintain a more normal, rounded appearance, but this is purely cosmetic and doesn't affect the surgical outcome.  It's also something I don't do.

Here he is immediately post-operatively.

The initial recovery period was a bit rough, despite extensive pain medications.  But he started coming around and relaxing.  My entire staff kept talking to him and when they were available would open his cage and pet him.

By the end of the day he was ready to go home.  He even wagged his tail as we walked him out to his owners!

I have known other dogs who have had double enucleations.  They actually do very well and learn to cope well with their new life and lack of vision.  They can still have a great quality of life and be very happy.  While I only recommend doing this radical of a procedure in extreme circumstances I also feel that this is not unfair to the pet and really is helping them.

Diesel and his people will have an adjustment period.  He will have to learn to get around without any sight or light at all.  The owners will have to learn to be patient and not move furniture around a lot.  But once he heals from the surgery he will be pain-free and will no longer have to deal with the hassles of eye drops.  We anticipate continuing to see him for many years to come.


  1. I remember the first time I did this. Well, removed a second eye when one had already been removed earlier. Glaucoma - same reasoning. He was in pain. Mine was a Pekinese and afterwards, the owner was thrilled to be free of the meds and pain for him.... his hair covered the sockets beautifully. Later, she said it made her laugh when people stroked him and smoothed back his fringe and realised he had no eyes - they knew he was blind, but were shocked at the nothingness.
    Strange really - but would recommend it to anyone who has a much loved dog with this condition.

  2. Awww. As the proud parent of a born-blind dog, I know they cope a lot better than we do.

  3. Wow, what an interesting case. We just finished with ophthalmology this semester, so it's nice to read this and understand the background. Hope Diesel is doing fine.

  4. This was a pretty interesting story, it makes me cringe so bad thinking of cutting out something's eyes.

  5. I just dropped my foster dog, Micah, off at the vet's this morning and she will be having both eyes removed. This article made me a little more comfortable in what to expect. This poor girl is also deaf but I know she's a fighter and will make it through this.

  6. Day two. He is more bruised and swollen today. It looks worse than yesterday. He went outside and knew where to find the steps to come in. His cone keeps getting stuck on things. He doesn't feel good. He'll get through this. Today I was able to get him to eat chicken so I didn't have to squish the pill, add broth, then use the eye dropper to get it in him. I'm so glad to see him eat..

  7. Our little lhasa tiggy had one eye removed last week after she got ulcers in both eyes. We are treating the other with drops, desperately trying to save it, but it's not looking good today. She's not opening it much at all. Very worried that the other will have to be removed next week.


  8. dog Gigi is only 6yrs just went through surgery in December had an eye removal has adapted well full of energy. However, this past week i noticed her other eye a bit swollen took her to the vet and looks like she got glaucoma on this eye as well and will also need surgery. The news was very hard but she is so young reading this article is very comforting to know that she will be able to adapt. Thank you

    Joanna Avila

  9. I have a 10 year old cocker spaniel who just had her remaining eye removed in February. She also suffered from glaucoma. she had the 1st eye removed in May. drops helped the Remaining eye but sadly they stopped working. We are now 3 months out and she really fascinated us how quickly she adapted. We joke we would still be in the fetal position feeling sorry for ourselves but this girl had no fear. She uses our doggy door, jumps on the couch, and still uses the doggy stairs to our bed. After shes been soundly sleeping and wakes up she has a tendency to bump into things but normally she runs out the dog door without an issue and uses the 2 stairs to the yard happily. We did put textured mats at the top of the 2 stairs outside. We also used runners to the doggy door ext. She also has a couple scents we use to let her know where she is. I must admit we were terrified and overwhelmed with the thought of having that 2cnd eye removed but truly she is finally pain free and has adapted very well already! Thank you for your article it is hard to find info on this subject.

  10. That's really reassuring rescueme as my 12 year old Shar Pei bitch is having her remaining eye removed in two days. I feel really bad, but even with her eye meds, she sometimes awakens in the morning completely blind. It's only after her remaining eye is bombarded with drops for an hour or so that some degree of sight returns. Her cornea has become really cloudy, even when her eye pressure comes right down it stays that way. I'm sure she only has partial sight remaining, but it's gotten to the point that her appetite is suffering. She can't tell me that it hurts so the only way to be sure is to remove the eye. I'm sure she'll adapt in time as she's very headstrong. I just want her remaining years to be comfortable and pain free.

    1. Phil, I still see this patient regularly, three years later. He is one of the happiest and most well-behaved pets that we see and has made the adjustment to having no eyes extremely well. Every time I see him he is still wagging his tail and eager to give kisses. If her eye is bothering her and is essentially mostly non-functional, you will see a big improvement in her energy and attitude once it is removed. Best of luck to you and her!

  11. My 8 year aussie is having both eyes removed as I type this. He has been seeing an eye specialist for almost five years. Started with cataracts in both eyes and detached retinal in one which was probably due to abuse. Testing showed he was not a good candidate for cataract removal and was already blind in both eyes. Fast forward to today, after developing glaucoma in one eye and successfully getting pressure down with additional multiple drops we decided to have have both eyes removed. At least all his trips to specialist will come to an end as well as all of the drops. We will no longer have to worry about how the sun and snow affects his eyes. I will miss seeing his eyes but know he will be more comfortable.

  12. Hi, glad I found this tonight. My foster failure wirehaired dachshund, about 10-12 years old, had both eyes removed today. He's been ours for 3 years and has been mostly blind for all of that time. About a year ago the glaucoma stopped responding to the various drops and he lost his vision. The eyes had to come out because of the pain. He hates the cone and I can't get him to take any food that I can sneak a pill into, but reading these stories gives me hope that we too will get to the other side of this journey. Blessings to all of you who love your pets enough to go through this with them .

  13. I have a 15 year old rat terrier mix. In November of 2016, I had to have her eye removed due to retinal was beyond saving at that point. She's been fine for the last 6 months, and then within the span of the last 3 days, she's lost her vision in her remaining eye. It's starting to swell, and show the same signs as what had happened to her first eye. The vet in my city recommended I go to an eye specialist, but the nearest one is over an hour's drive away, and the initial consultation is $234, which I don't just have laying around. I feel helpless right now. I feel helpless right now. I want to save what little vision she did have before this (I was told she has cataracts before all of this began)...but I know the longer I wait, the least likely that will happen. And if it was just her losing her vision, I know she would adjust... But because of the pressure building up in her eye, I know she's in I said, just feeling helpless right now. Looking for advice. She's old, she can't really hear very well anymore either, and now she's in pain and can't see...but I love her so much...and the fact that I don't have money to help her asap is killing me inside...


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