Eyes are beautiful, truly unique, and colorful. Unfortunately, accidents involving the eyes happen. One of the more common mishaps is proptosis of an eye. This week I’m sharing information about this unique problem to help raise awareness. I hope you find the post insightful and helpful. Happy reading!

Proptosis – What is it?

Proptosis is the term used to describe a scenario in which the eyeball moves forward beyond the borders of the eye socket and eyelids. In fact, the eyelids get stuck behind the globe, thus preventing the eyeball from returning to its normal position. The abnormally exposed eye subsequently becomes inflamed and dry, often resulting in ulcers of the cornea.

Proptosis of the eye is most commonly caused by trauma, most commonly motor vehicle accidents, animal fights, choking accidents, and aggressive scruffing. Small brachycephalic (flat-faced) dogs are over-represented since they have naturally prominent eyes. There is no age or sex predilection.

Proptosis – What does it look like?

As mentioned earlier, the globe extends forward beyond the borders of the eye socket. The conjunctiva is typically reddened and swollen. Blood may be present in the anterior chamber of the eye (the area between cornea and the iris). The cornea may be discolored, and the muscles that control eye movement are often torn.

Proptosis – How is it diagnosed?

Diagnosis of eye proptosis is straightforward and based on the appearance of the globe protruding out of the eye socket. Given proptosis is often the result of trauma, a veterinarian will perform a thorough physical examination in an attempt to identify other injuries. Blood and urine, as well as diagnostic imaging tests, may be recommended to evaluate the health of major organ systems.

Proptosis – How is it treated?

Proptosis of the eye is considered a surgical emergency. Given this condition is typically the result of a traumatic accident, patients must be appropriately stabilized prior to anesthesia, potentially necessitating a delay of surgery. The severity of the proptosis and the length of time to surgery dictates the type of surgical intervention. Those without severe injuries may be treated by a veterinarian replacing the eye in the socket. The doctor temporarily closes the eyelids via a procedure called a temporary tarsorrhaphy and prescribes ophthalmic antibiotics and multimodal pain medications. See the video below to watch this procedure.

A veterinarian will often treat severely damaged eyes (or patients for whom surgery had to be delayed due to a need for stabilization) via surgical removal of the globe (called enucleation). The eye and orbit tissues are removed, and the eyelids are permanently sewn closed. Prognosis for vision is always poor. Patients who have surgery within a couple of hours of the accident have the best chance for having their vision saved.

The take-away message about proptosis in dogs…

Proptosis of the eye is a common ophthalmic injury most often due to a traumatic accident. Although prognosis for vision is always poor, stabilization and timely surgery are the best strategies for potentially saving vision.

To find a board-certified veterinary ophthalmologist, please visit the American College of Veterinary Ophthalmologists.

Wishing you wet-nosed kisses,

CriticalCareDVM