Proptosis is defined, as the forward displacement of the globe (eyeball) out of the socket, with the eyelids trapped behind the globe.
Proptosis is an ophthalmic emergency. Any suspected trauma to your pet’s eye warrants a visit to your veterinarian immediately.
Let us first have a look at the normal eye anatomy:
Proptosis is a condition more commonly seen in Brachycephalic breeds (dogs with prominent bulging eyes, short noses and shallow eye sockets). Pekingese, Pug, Boston terrier and Shihtzu are over represented.
Often the first thing noticed by owners is a very prominent eye where the eyelids are unable to blink over the eyeball (globe).
Other signs include:
Your pet will be assessed for any other injuries or possible complications; this is a very important step especially if the cause of the proptosis was an accidental hit by car. The patient must be stable before any surgery can be attempted.
The vet will then examine both eyes to assess the extent of injury.
The vet will look at the cornea (thin see-through layer) by staining it with fourecein to determine if there are any cuts or scratches on the surface of the eye (this stain changes color from orange to green if there are any cuts or scratches on the cornea). Then also the muscles, skin and nerves (optic nerve) attached to the eye will be examined
Based on the severity of the injury two treatment options exist, either replacement of the eye back into the socket or enucleation (surgical removal of the proptosed eye).
The prognosis for vision in the affected eye is always poor and is often dependant on the extent of the trauma to the eye and how soon treatment is started. Even if vision is lost, rapid response could aid in salvaging the eye for cosmetic reasons.
When the patient is stable enough they are placed under general anesthesia.
If the eye can be salvaged it is lubricated and placed back into the eye socket. Sometimes an incision is made on the outer edge of the eyelid to allow more space and make replacement of the eye easier. They eyelids are then stitched closed – this procedure is called a temporary tarsorrhaphy. Often times the vet will dispense eye drops that needs to be applied daily, this promotes healing of the cornea. The stitches are removed after two weeks and the function of the eye is reassessed to determine if the vision in the eye was affected or not.
If an enucleation is required, the globe is removed, blood vessels and nerves are tied-off and excessive tissue is also trimmed away. The eyelids are permanently stitched closed.
In both instances the patient is sent home with pain medication and an Elizabethan collar to prevent further trauma to the surgical site.
The thought of imagining a beloved pet with only one eye is very distressing and traumatic to owners, but most often these patients recover really quickly and do lead normal happy lives.
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