Ocular proptosis is one of the most important ophthalmological emergencies in the canine species. It consists of the forward displacement of the eyeball, which occurs as a result of a trauma that causes the eye to exit its orbit. Although it can appear in any breed, it is especially common in brachycephalic dogs.
If you want to know more information about ocular proptosis in dogs, its treatment, causes and recovery join us in the following article on our site, in which we will also talk about symptoms and diagnosis.
What is ocular proptosis?
Proptosis or anterior dislocation of the eyeball consists of the eyeball coming out of the orbit as a result of trauma. Immediately after the eyeball moves out of its usual position in the orbital space, the eyelids close, thus preventing the eye from returning to its seat.
As a consequence, the following events occur:
- Venous return is impaired, causing conjunctival congestion.
- The cornea dries out and severe ulcers (exposure keratitis) occur.
- Associated uveitis occurs.
- The extraocular muscles may rupture, resulting in a subconjunctival hemorrhage.
- The optic nerve may be affected, by the trauma itself or by the inflammation that is generated, producing blindness.
It is important to note that ocular proptosis is always an ophthalmological emergency that requires immediate medical and surgical treatment to reduce the risk of irreversible loss of vision. Even in cases where vision cannot be recovered, prompt and correct treatment will preserve the eyeball and maintain the aesthetics of the animal.
Causes of ocular proptosis in dogs
Ocular proptosis in dogs occurs as a result of traumatisms that cause the eyeball to come out of its orbit. These injuries include:
- Blows to the skull
- Rundowns
- Fighting or biting
- Falls, etc.
This is a process that occurs more frequently in dogs of brachycephalic breeds (flat) due to their large eyeballs, flattened orbits and very wide palpebral openings. In non-brachycephalic breeds, the trauma required to produce proptosis is much greater.
Symptoms of Ocular Proptosis in Dogs
The clinical signs that can be observed in the prolapsed eyeball are:
- Edema and swelling of the eyelids.
- Desiccated cornea.
- Corneal ulcers.
- Chemosis: edema in the conjunctiva that covers the eyeball.
- Subconjunctival hemorrhage.
- Hyphema: presence of blood in the anterior chamber.
- Miosis (contraction of the pupil) or mydriasis (dilation of the pupil).
Diagnosis of Ocular Proptosis in Dogs
The diagnosis of canine ocular proptosis should include the following items:
- Ophthalmological examination: a systematic examination of all ocular structures should be performed to assess the functionality of the eye and thus be able to guide treatment and issue a forecast.
- Skull X-ray: when it occurs as a result of trauma, it is important to perform a head X-ray to rule out possible skull fractures. In addition, it is especially relevant to know if there is a fracture at the level of the orbit, since in this case it will not be possible to reposition the eyeball in its place.
- General examination: the patient's general condition must be assessed and any systemic alteration caused by the trauma that could compromise the patient's life should be ruled out. animal.
Treatment of ocular proptosis in dogs
As we have already mentioned in previous sections, ocular proptosis is an ophthalmological emergency that requires immediate treatment to avoid irreversible loss of vision or, at least, to avoid enucleation (removal of the eyeball). That is why it is important to act as quickly as possible.
Caregivers who detect or suspect possible ocular proptosis in their dog should Protect the eye to prevent it from drying out and further damageTo do this, moisten some gauze with serum or water and place them on the prolapsed eyeball.
Next, you should go to an emergency veterinary center. There, the veterinary team will be in charge of establishing an initial treatment to prevent the process from worsening.
Medical therapy of ocular proptosis includes:
- Continuously irrigate the cornea with saline solution and keep it moist and protected with cold compresses.
- Administer corticosteroids intravenously to reduce inflammation
- Dehydrate the vitreous to make the eyeball softer and easier to reinsert into the orbital space
- If the prolapse is partial, the animal can be sedated and try to re-introduce the eyeball manually (without forcing it in any case). However, in most cases it does not usually work and it is necessary to resort to surgical treatment.
The surgical treatment involves repositioning the eyeball in the orbit under general anesthesia. Once reintroduced, the upper eyelid must be sutured to the lower one (tarsorrhaphy or blepharorrhaphy) to keep the eye closed for 15-20 days, since otherwise, the eye would immediately prolapse again as a result of the inflammation.
However, in some cases it is not possible to preserve the eyeball and it is necessary to perform an enucleation (removal of the eyeball). Generally, enucleation is recommended in the following cases:
- Tear of more than 2 extraocular muscles.
- Optic nerve avulsion (partial or complete section of the nerve).
- Corneal or scleral rupture.
- Hyphema.
- Severe sequelae 20 days after tarsorrhaphy.
Recovery from ocular proptosis in dogs
During recovery or after surgery, treatment should be instituted to combat inflammation and prevent infection:
- Apply local cold immediately after surgery.
- Administer systemic anti-inflammatories (corticosteroids or NSAIDs): during 7-10 days to reduce intraocular, eyelid and optic nerve inflammation. It is not recommended to administer them by ophthalmic route (in eye drops) since the cornea may be inflamed.
- Administer systemic and/or topical antibiotics.
The tarsorrhaphy or blepharorrhaphy should be maintained between 15-20 days. After that time, the stitches should be removed and possible sequelae in the affected eye should be evaluated.
Sequelae of ocular proptosis in dogs
Canine ocular proptosis can cause a series of consequences, depending on the severity of the process and the haste with which it is acted. Specifically, the possible sequelae that may occur in the affected eye are:
- Blindness.
- Squint.
- Corneal ulcers.
- Keratoconjunctivitis sicca.
- Exposure keratitis.
- Glaucoma.
- Ptisis bulbi: atrophy of the eyeball.
Prognosis of Ocular Proptosis in Dogs
The prognosis for vision preservation is Reserved to Severe, since most prolapsed eyes experience irreversible blindness due to optic nerve damage or intraocular damage. In fact, only of dislocated eyes retain vision
However, while every effort should be made to preserve vision, it should be noted that dogs can adapt to one-eyed vision without drastically affecting their quality of vision. life.
