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Enucleation in Cats
Written By hannah hollinger
Published: 01/05/2017Updated: 11/19/2021
Veterinary reviewed by Dr. Linda Simon, MVB MRCVS
What is Enucleation?
Enucleation is the surgical removal of the eye. Enucleation surgery is an irreversible and permanent solution for various eye disorders. Enucleation in cats is performed when all other medical options have proven ineffective in order to alleviate pain and give the feline a better quality of life. Enucleation surgery is performed by a veterinary ophthalmologist.
The veterinary ophthalmologist can approach enucleation surgery in two ways; transconjunctival or transpalpebral. The transconjunctival approach to enucleation has the advantage of reducing orbital tissue loss, subsequent orbital sinking, less hemorrhaging and a faster procedure time overall. In a transconjunctival surgery, the veterinarian ophthalmologist will only remove a portion of the eye’s orbit. With the transpalpebral approach, the entire eye globe is removed including the elements within the conjunctival sac (nictitating membrane, conjunctiva, eyelids). The veterinary eye specialist may choose to take the transpalpebral approach if the eye is unsalvageable.
Enucleation Procedure in Cats
The patient’s vital signs are taken before pre-anesthetic drugs are administered. General anesthesia is started after sedation is achieved through injectable tablet induction. The fur surrounding the affected eye is shaved to the midline. The upper eyelashes are trimmed with fine scissors and douched with ointment to prevent lashes from falling into the eye’s orbit. Tape is applied directly to the skin to remove fine hairs.
- The periocular skin, corneal surface and the conjunctival fornix is prepared with a 1:50 povidone-iodine solution.
- The patient’s head is placed in lateral or semi dorsal recumbency with the palpebral fissures aligned parallel to the floor.
- The endotracheal tube is reinforced to avoid anesthetic complications.
- The eyelids may be sutured shut if the globe is infected. Any suture material may be used, as the sutures begin from one corner of the eyelid to the other, close to the meibomian glands.
- A No. 5 scalpel blade is used to cut around the eye. 5 mm thick elliptical incisions will be made away from the eyelid margins, joining the incisions at the lateral and medial canthus.
- An Allis tissue forceps or towel clamp will be used to grasp the incised eyelid margins.
- Blunt dissections will be made using a Metzenbaum scissor, alternating from side to side until approaching the sclera.
- Using a No.15 scalpel blade, the medial and lateral canthal ligaments are transected.
- Hemorrhaging is controlled and the orbital rim is identified.
- The posterior ciliary arteries and optic nerve are clamped, or ligated. These structures are severed through use of a curved Metzenbaum scissor.
- A plane of dissection is made using Metzenbaum scissors to release the globe from the orbital tissues that remain in the orbital rim.
- The dissected globe is removed and handed off to a veterinary technician to prepare for histological laboratory submission. (Important for detecting life-threatening disease).
- The veterinary ophthalmologist will return to the orbital opening, dissecting the periocular tissue from the sclera.
- The eye socket will be packed with gauze, applying light pressure for 5+ minutes to encourage a clot to form. Excessive bleeding may be ligated and synthetic hemostasis products may be applied to halt unsourced bleeding.
- A sterile silicone orbital prosthesis will be placed in the orbit. The veterinarian will trim the prosthetic to size. (only used in non-neoplastic or infectious conditions)
- Using 3-0 or 4-0 monofilament polyglyconate synthetic, absorbent sutures, the orbit will be closed with a minimum of three layers. The last layers of sutures will be using a 3-0 absorbable braided or monofilament type.
Efficacy of Enucleation in Cats
Enucleation surgery is a permanent solution for unresponsive eye conditions. Removing the painful, infected, necrotic, damaged, or cancerous eye completely will ideally eliminate the problem, as well as preventing the condition from spreading.
Enucleation Recovery in Cats
The surgical site will be protected following surgery, as the feline will be sent home with an Elizabethan collar to wear at home until healing is complete. Mild swelling, inflammation and bruising around the suture site are to be expected. Blood may drip from the nose occasionally as the tear ducts are connected to the inner nostrils. Any epistaxis (bloody nose) will diminish approximately two to four days post-op. Careful monitoring is essential following surgery, as trauma to the suture site can cause adverse effects. Sutures are typically removed about seven to 10 days post-op, however, the feline’s whiskers will not regrow for six to eight weeks. Cats without whiskers are prone to becoming imbalanced and must be monitored to stay protected.
Cost of Enucleation in Cats
An enucleation surgery for a feline can cost approximately $600 to $1,000. Preoperative and postoperative care should be taken into consideration for the total price.
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Cat Enucleation Considerations
Removal of one eye can be a concern to cat owners, as partial vision will be lost. The majority of felines respond very well to partial blindness and resume regular activities quickly.
Enucleation Prevention in Cats
Enucleation surgery is often used for feline eye conditions that have unknown causes and prevention is not always possible. Preventing eye trauma is important and seeking veterinary attention immediately when a problem is noted will be a step in the right direction.
Enucleation Questions and Advice from Veterinary Professionals
American Shorthair
Shelter Cat
5 Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
None
Hi! I visited a shelter and saw an adult cat that had recently had enucleation surgery. She was struggling with her balance, but that is expected with the loss of an eye. I am considering adopting, so I was wondering what further medical attention the cat may need and what I should be prepared for in terms of assisting her with recovery.
Thank you
Jan. 28, 2018
Answered by Dr. Michele K. DVM
0 Recommendations
Thank you for your email. It is very nice of you to consider giving this cat a home. Animals do quite well after the loss of an eye, and there is very little aftercare once the surgery site is healed. She would need to be an indoor cat as her defenses to threats are reduced, but otherwise should require the same care that any other cat would need. I hope that she is able to find a home with you!
Jan. 28, 2018
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Domestic shorthair
Asher
1 Year
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Eye Bleeding
Eye Bulging
Eye Clouding
Hi. I recently had a foster cat in my home with my own. They did not get along and the foster cat had scratched my cat’s eye. His eye had immediately turned white and infected. I know it most likely needs removed and I’m not sure what the cost may be. He doesn’t seem to be in pain at all and it doesn’t bother him.
Jan. 1, 2018
Answered by Dr. Michele K. DVM
0 Recommendations
Thank you for your question. Asher needs to see a veterinarian to have the eye assessed and see if it is treatable or does need to be removed; I can't tell without seeing it. The cost of the surgery varies by veterinarian, and by the area where you live, so they will be able to give you an estimate for cost if that needs to happen, as well. I hope that Asher is okay.
Jan. 1, 2018
My feline eye specialist here in New York just quoted me $2,300.00 for a 20 minute enucleation procedure............. :(
Jan. 10, 2018
Judith M.
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domestic medium hair
Babette
2 Years
0 found this helpful
0 found this helpful
My pet has the following symptoms:
Blindness
I adopted a cat last week who was described as partially blind. Per the shelter's advice, I took her to the vet opthomologist to just see what was going on with her eyes. She has noticeable cataracts in both eyes. The vet said she was unresponsive to light in both eyes and subsequently fully blind. Her right eye registered pressure at 3x the desired pressure. The vet said she does not seem to be exhibiting any pain symptoms related. They tried drops but it was unsuccessful in relieving the pressure. They sedated her and drained the eye for a temporary fix. The vet suggested removal of the right eye. I am worried about putting her through surgery. I want to make sure she has the best quality of life. I would like to hope that this would prevent any future procedures that she would need to manage the glaucoma, but I worry that the surgery will have lots of complications and complicated after care. She is two years old and I am wondering how she managed this for 2 years and now all of a sudden she needs eye removal ASAP. I am wondering what to do for my little love bug.
Nov. 19, 2017
0 Recommendations
Glaucoma is something that may develop for various reasons in an eye with the majority of cases having glaucoma affect the second eye after a year or so; you should follow the instructions from the Ophthalmologist as they will have evaluated all the options and would be in a better position to advise you about the eye. The removal of the eye is a straightforward operation and will prevent pain or discomfort developing in the eye. Regards Dr Callum Turner DVM
Nov. 19, 2017
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Bengal
Dutchess
2.5 years
3 found this helpful
3 found this helpful
My pet has the following symptoms:
Discharge From The Eye
I recently adopted a cat with no right eye, there is an occasional slight discharge from the eye socket. When I adopted her, I was told the missing eye was a birth defect. Should I have the eye sewn up to prevent any foreign items or bacteria from entering the socket?
Nov. 12, 2017
3 Recommendations
If the eye socket is open you should have that taken care of by a Veterinarian to ensure that the socket is closed and to prevent any secondary infections or foreign bodies as well as eliminating any discharge. Regards Dr Callum Turner DVM
Nov. 12, 2017
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