Serious eye problems in pets are a big challenge
As a vet, I have learned not to be squeamish. I need to be able to be calm and professional, whatever crisis happens to be in front of me. I am usually able to remain unfazed by the physical condition of my patients. A type of practical objectivity kicks in. I have to focus on what needs to be done to help the animal, rather than worrying about the awfulness of what's going on.
But there are two situations that I still find exceptionally challenging. The first one, which readers will be relieved to hear I am not going to discuss today, is when animals are brought to me with maggot infestations. That's a difficult topic, and maybe I will discuss that on another occasion.
The second situation that I find distressing is when there are serious eye problems. Whenever an animal is brought to me with severe issues affecting one or both eyes, I can't help imagining the painful and disabling aspects of their condition. Of course, I still get on with the job, doing my best to help the unfortunate creature, but I find these occasions quite disturbing. I'm very happy that we have an excellent local eye specialist, so that I can rapidly find the highest possible level of care to give such patients the optimal help they need.
There are two types of ultra-serious eye problems that can affect pets. It's important that owners realise that affected animals to see the vet as soon as possible for urgent help.
The first, most obvious and most distressing, is a problem known scientifically as "proptosis". In layman's terms, this is a prolapsed eyeball, and it is one of the most nightmarish traumas for pets, owners and vets. I see a couple of cases of this every year, and there are two common causes. First, after a road accident. Affected dogs and cats often have other head injuries, but the protruding eye is often the most obvious one. The second common cause is in certain flat faced breeds - like Pekingese and Pugs - who are involved in vigorous play or fights with other animals. Their eyeballs are less deep-set than in other breeds, and so they "pop out" very easily.
The principle of treatment of a prolapsed eyeball is simple: it needs to be placed back into its normal position as rapidly as possible. If an other finds a pet with this condition, they should use a moistened wad of clean fabric (e.g. a dish towel or a bundle of kitchen roll) to place over the displaced eye, holding it as close as possible to the face. The eye is so sensitive that it's easily damaged, and so it needs to be held gently and securely to protect it. The animal should be taken to the vet at once.
My job with such cases is to carry out immediate anaesthesia, and then to physically return the eyeball to its natural place in the eye socket. The eyelids are then sutured closed to hold it in place. Sometimes, this approach is successful: when the sutures are removed ten days later, the eye is back to normal. In other cases, the eye is too badly damaged, and it then needs to be surgically removed. A prolapsed eyeball is one of the most upsetting traumas to witness, and I hope that as few readers as possible ever need to do so.
The second type of serious eye problem is less dramatic: to the owner, it looks as if the animal simply has an extremely painful eye. Sometimes the eye is closed, and on other occasions it may be open, but it never looks "normal". Animals can't complain about pain, and they will often be just quiet and dull. Whenever a dog or cat has a change in behaviour like this, accompanied by an eye that doesn't look right, they need to be taken to the vet at once. Any delay will lead to a worse outcome, including the risk of blindness. Even though such cases look less dramatic than prolapsed eyeballs, I still find them upsetting: I can't help imagining the animal's pain.
There are two main types of painful eyes.
The most common is when there is laceration or other surface damage to the front of the eyeball, a problem known as corneal ulceration. The surface of the eye has many layers, like an onion, and after accidents (like cat scratches) and bashes (e.g. running through bushes) the front of the eye is easily damaged. If the injury to the front of the eye is deep enough, the fluid from the inside of the eyeball can start to leak out, creating an even bigger crisis. Again, some breeds (such as Boxers and Pugs) are more prone to this condition, because their eyes have a more bulgy appearance. With the prompt help of a vet, affected animals can be helped with pain relief, soothing drops and other medications to help the eye make a full recovery.
The second type of painful eye happens when the eyeball becomes abnormally swollen, a condition called glaucoma. Normally, the body keeps the pressure inside the eyeball stays at a steady, even level, like a balloon that stays permanently at the right state of inflation. Sometimes, for various complex medical reasons, the normal control mechanisms go wrong, and the pressure inside the eye goes up, like a balloon being over-inflated. This causes severe pain, and urgent veterinary help is needed to return the pressure to normal.
Serious eye problems can be challenging, but if those caring for the animal (owners and vets) are able to stay calm, sensible and efficient, a positive outcome can often be achieved.