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Cool Case Friday: What Happens When You Can't Save an Eye?

Hello Everyone! Today’s cool case might not be for the squeamish at heart. There are some pictures in today’s post that may not be suitable for all readers and especially small children. Today’s subject is ENUCLEATIONS. What are those? That is removal of an eye due to trauma, infection, or inflammation.


Let’s jump right in. Mimosa (name changed for privacy) was another animal that came over to my Animal Hospital from the local animal shelter. This tiny kitten had a HUGE eye. I believe that eyes are one of the most important things on our body. We only get two of them, they play a huge part in how we perceive the world, and are necessary for depth perception, safety, and for creating bonds with others. I always do my best to help pets keep both of their eyes. Sometimes, however, that just is not possible, and enucleation is our only option.


What are some of the reasons we may need to remove an animal’s eye? The most common is TRAUMA. Most of the eyes I have removed during my career have been on small dogs that were bitten in the face by bigger dogs. If the bite happens at just the right place, it will push the eye out of the socket. I’ve received many frantic phone calls from owners of small dogs (typically pugs, cavaliers, etc) with an eye pushed out of the socket. Sometimes it is possible to save these eyes. If they bring the dog in fast enough, keep the eye lubricated until they come in, and there wasn’t extensive damage to the surrounding musculature or too much “pull” on the optic nerve, I can surgically place the eye back in the socket and sometimes pets will regain most of their vision in the eye. This is quite the process with suturing the lids close together over the eye, an e-collar for weeks, eye lubrication, and some finger crossing, but I’ve had great results!


Next we think about INFLAMMATORY causes for enucleation. These are typically older dogs with glaucoma. Yep, the same ocular disease that humans get. When the pressure inside the eye increases to dangerous levels due to increased fluid production or decreased fluid drainage in the eye, blindness can occur within 24 hours and sometimes is not reversible. The pain of glaucoma is severe, and if we cannot bring the pressure back down to normal and restore vision, sometimes enucleation is our only option.


Finally, let’s bring Mimosa back into this discussion. Another reason for considering enucleation is INFECTION. The cornea (clear part of the eye over the pupil) is very thin, and as little kittens are playing or fighting, those razor sharp little claws may puncture the eye. Cat claws are full of bacteria, and if that bacteria gets into the globe of the eye due to puncture, the bacteria will multiply leading to an abscess within the globe of the eye. Most times enucleation is our only option, and was definitely the case for little Mimosa.


We took all 3 pounds of her to surgery that day. Removing an eye is a very intricate process. We want to remove all of the diseased tissue, while not putting too much pressure at the back of the diseased eye. This is so we can maintain vision in the “good” eye. The optic nerves cross behind the eyes, and if one is pulled on too hard, it can damage the opposite eye. After removal of the eye, the lids are sutured together. As you can see in her post-surgical picture, there is still a lot of inflammation present and extra skin due to stretching with all of the inflammation. This will all change as the area heals over the next two weeks.


In these final pictures of Mimosa a few months after surgery, you can see just how nicely the incision has healed, how the hair has regrown and how happy she looks. She was adopted by one of my technicians and came back to see me on a yearly basis for vaccines, etc.

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