What are Enophthalmos?
Enophthalmos in dogs, or Horner’s syndrome, is due to abnormalities within the sympathetic nerves in the eyes and also within the muscles of the face. Enophthalmos is when the eyeball is further back in position than normal within the eye orbit. This is due to possible bone changes within the orbit in comparison to the orbital fat and eyeball. It is also due to possible function loss of the muscle around the orbit, or orbitalis muscle. This syndrome also has the characteristic of a “third eyelid” occurring as well.
The orbit is the socket within the skull that contains the eye and surrounding appendages. In enophthalmos, the sympathetic nerve pathways have been damaged due to trauma, a wound,
disease of the discs within the back, a middle-ear condition, or a tumor. Enophthalmos is considered to be a condition known without cause, or idiopathic. This syndrome can appear without warning and quite suddenly. The affected dog may have symptoms beforehand, such as drooling and having a difficult time chewing on the side of the mouth that is affected by the sympathetic nerves of the eye area and nearby facial area.
Enophthalmos in dogs is a condition in which the eye, within the cavity, is dispositioned. Typically, enophthalmos presents itself with the eyeball of the dog being positioned further back within the socket than normal.
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Symptoms of Enophthalmos in Dogs
Enophthalmos, or Horner's syndrome, is a neurological disorder which is quite common among dogs. The symptoms may suddenly occur, and include:
- Droopy eyelid
- Constricted pupil
- A “sunken” eye
- A noticeable third eyelid that is raised and bright red
One of the causes of enophthalmos can be due to specific types of parasites or fungi that may enter into the orbital region of the eye. They may enter through the nasal cavity and sinuses. Such parasites include:
- Cryptococcus neoformans
- Blastomyces dermatitidis
- Coccidioides immitis
Causes of Enophthalmos in Dogs
Orbital disease, or enophthalmos, in dogs can be caused by a variety of specific disorders. Causes of this condition are determined by a veterinarian through physical examinations, lab work, and thorough assessment of the orbital cavity of the affected eye of the dog. Causes of enophthalmos in dogs include:
- Vascular abnormalities
- Parasites and fungi
- Foreign bodies
- Bite wound
- Disc conditions of the back
- Middle ear infection
Diagnosis of Enophthalmos in Dogs
If your dog is showing symptoms of enophthalmos, make an appointment with your veterinarian. Once you have arrived at the veterinarian’s office, your veterinarian will begin by performing a complete physical examination of your dog. He will check your dog’s vital signs, perform bloodwork, and a urinalysis. These tests will check for any underlying conditions that may be causing his enophthalmos. Your veterinarian will also examine your dog’s affected eye and will order a sonogram, or ultrasonogram, to be performed. This will allow the veterinarian to take a closer look at what could be causing the abnormal orbital space. An ultrasonogram will make it clear to the veterinarian if your dog has a fluid substance within the area or a solid mass. He may also perform an aspiration to sample either the fluid or the mass, if either is present. The medical professional may also perform an MRI to further examine the soft tissue.
The veterinarian may also perform any other neurological and ophthalmologic tests to further investigate the orbital abnormality. If the veterinarian suspects disc disease that is affecting the nerves, he will perform tests to decipher the extent of the nerve damage within the upper back.
One common ophthalmologic test which may be performed is testing the response of the pupils. The medical professional will topically apply adrenergics, typically of epinephrine, to both of your dog’s eyes to check the dilation response of the pupils. Within the normal pupil, the veterinarian will expect no abnormal response; however, in the affected pupil, there may be a dilation in which the veterinarian will be able to conclude as to the type of lesion affecting your dog’s eye and causing the syndrome.
Treatment of Enophthalmos in Dogs
Enophthalmos in dogs is caused by a variety of underlying conditions. Treatment will vary depending on precisely what has caused enophthalmos in your dog. Treatment methods may include:
If your dog’s condition was caused by an infection that developed within the orbital eye cavity, the veterinarian will prescribe specific antibiotics to get rid of the infection. The antibiotics may be topical, oral, or both, depending on the specific infection your dog has been diagnosed with.
If your dog has an abscess or cyst that has caused his enophthalmos, the veterinarian may perform a procedure to drain it. This procedure may be performed within one day, or your dog may have to stay overnight in order to be sure the drainage is successful and that he begins to heal properly. This will be followed by giving him specific medications, such as antibiotics, for him to take after the minor surgical procedure.
If your dog has a fungal infection which has caused his orbital abnormality, the veterinarian will prescribe antifungal medications to treat the specific fungus that has invaded the orbital cavity. Your dog will need to take these medications either orally or topically, or both.
Removal of Foreign Object
If your dog has a foreign object in the eye, your veterinarian may have to do a small surgical procedure to remove it. Foreign objects within the eye may be able to be removed without any surgical intervention, as well. If your dog needs a surgical procedure, this may include an overnight stay and be followed up with antibiotics to prevent any infection from occurring.
Recovery of Enophthalmos in Dogs
An Elizabethan collar (cone) may need to be worn by your dog until his eye heals, and it is highly recommended that it stays on him the whole time he is recovering. This will prevent your dog from pawing at his eye and further irritating it, thus preventing the treatment from being effective.
Typically, enophthalmos can be successfully treated and the eye will successfully heal in time. Your dog may be put on prescription medications that you may need to give him at home. Your veterinarian will give you specific instructions on how to administer any medications to your dog. The medications may be in the form of eye drops, eye gel, or in pill form. Be sure your dog takes the medication regularly and until the medication runs out.
In terms of enophthalmos caused by intervertebral disc disease, your veterinarian will recommend physical therapy to treat the nerve damage. He may also give you medications for this as well, or possibly at-home treatments that you can do with your dog.
The recovery and management of your dog’s enophthalmos solely depends on the cause of the syndrome to begin with. Rest assured, this condition is treatable, and with your help and with following the veterinarian’s instruction for aftercare, your dog should recover in time. Your veterinarian will want to see your dog for future visits to be sure he is recovering in a timely manner and making progress with his underlying condition. If you see any new symptoms develop, do not hesitate to contact your veterinarian in between follow-up visits.