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Wednesday, August 4, 2010

Bye-Bye Eye

Most of the surgeries veterinarians perform are spays and neuters and are very routine.  But it's not uncommon to do more advanced and uncommon procedures.  Monday was one such surgery, as I removed a dog's eye, a surgery called "enucleation".

The dog is an old poodle who had a history of eye problems.  His left eye had been injured many years ago and was shrunken and useless.  His right eye had developed a cataract, so he was essentially blind.  Last week the right eye suddenly became worse and the eye protruded.  Apparently the globe (eyeball) had slightly popped out and the eyelids had slid behind it, trapping the eye in front of the lids.  Infection developed and this was extremely painful.  There was no saving the eye so the decision was made to remove it.

**WARNING!!!!!**  If you're squeamish don't scroll down through the rest of the blog.  I'm posting some pretty graphic images.


This is what the eye looked like just prior to surgery and after shaving and surgical prep.  He is already under anesthesia at this point.


The cloudiness of the eye is a combination of cataract and pus.  The dog was completely blind, so the eye was only causing discomfort.  There was also severe damage to the eye so there wouldn't have been any benefit to putting it back into position.  The surgery is actually not very difficult and can be done by most general practitioners.  It's simply a matter of carefully cutting the muscles and connective tissues, gently freeing the globe from its attachments.  After cutting the optic nerve at the back of the eye, the globe comes out easily.


The last photo is of the empty socket after the globe has been removed.  The third eyelid and tear gland are removed and then the edges of the eyelid are cut away.  The eyelids are sutured closed so that the socket and tissues are protected.  In some cases a false eye is placed in the socket, but most vets don't do this and it is purely for appearances with no medical benefit.  Here's a picture of the patient after the surgery was finished.


Dogs do quite well after the surgery and will go home with antibiotics and pain control.  Sutures will come out in 7-10 days and by then they are usually back to normal.  Since this kind of surgery is done because of severe damage to the eye, the dog is already blind prior to surgery, so removing the eye only improves their quality of life.

6 comments:

  1. My boy Rocky is almost blind. His site is comparable to that of governor Patterson of NY.

    He had dry eyes for a long time and when we adopted him at 6 years his eyes (pupils?) were almost black from the rubbing of his eyelids on the eyes.

    We use a mixture that our vet makes from a compound pharmacy for dry eyes and now Rocks eyes are about a 5.5 when they do a moisture test on his eyes.

    The damage has been done though and his sight is very limited.

    I wonder what life is like for blind dogs. Rock seems ok but I wonder how he deals with the loss of sight emotionally.

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  2. I remember the first time I did that - was so scared !
    In later years I removed an eye from a peke with glaucoma - and a couple of years later, also removed the second eye - the owner was struggling with daily meds and the dog was in pain - and already blind... the owner said the dog coped fine being blind, and the dogs fur hid both empty eye sockets.... but she did comment later it often used to give people a fright when they stroked the dog's head and the fur pulled back!!!
    -

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  3. thanx for the blog. I've had many special needs dogs for a while with varying levels of vision. Some people often ask why/why not just take the eyes out...I'll send them here.
    I currently have a blind dog micro-opthal...recently her upper eye lashes have started to point down and is irritating that area. I'm tempted to have this done because epilating doesn't seem to work for long and it appears painful to the dog. You mention that this is a relatively simple procedure that a GP can do. I have taken this dog to a vet opthal but he never mentioned this procedure only our GP did. Granted this dog has multiple issues (seizures, PDA, deaf) would you consider this procedure?

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  4. Anonymous, with microphthalamia the eye is already non-functional, so it serves no purpose in remaining in the head. Epilation of eyelashes is indeed temporary unless done with cryosurgery (which many ophthalmologists can perform). However, with a serious heart condition and seizures, anesthesia would be risky and may mean that the risk is too great for any benefit. Talk to your vet more about this as he/she knows the specifics of your dog's health. If they think it's safe, it is probably a good idea.

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  5. I just got 9 week old puppy that has lost her eye only empty socket sometime ago due to injury.I' m looking for advice on best way to care for it until I get her to the vet in a couple weeks. There is not any discharge or infection and she looks perfectly normal otherwise. Guess im just worried about it

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    Replies
    1. If the socket is open and the eyelids aren't sealed shut you need to get to a vet IMMEDIATELY. This kind of opening exposes the optic nerve which leads directly to the brain. If that nerve and the opening in the bone is exposed there is a significant risk of a serious infection. DO NOT wait a couple of weeks.

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