Enucleation Due to Eye Trauma or Disease in Dogs

Enucleation is a permanent treatment for many different eye diseases by the  removal of an affected eye. This course of action is used when there is  unmanageable pain resulting from either a disease in the eye or trauma to the eye. Though it is a very common surgery, it is only used as a last resort when other treatments have failed to save either the eye or the vision. Other treatments will always be attempted prior, as this procedure can cause anxiety and emotional upheaval in not just the dog, but the owner as well.

Enucleation is the surgical removal of the eyeball, edges of the eyelid (eyelid margin), third eyelid, and the conjunctiva when no other treatment has proven successful in saving the eye or vision as a result of many different eye diseases.

Enucleation is a treatment for conditions that a canine may suffer such as trauma, glaucoma, infection, and laceration. Below are listed just a few of the symptoms of one of the most common causes for enucleation. 

• Glaucoma 
• Different sized pupils
• Eye pain
• Bloodshot eyes
• Clouded eye
• Squinting and tearing
• Change in behavior and appetite
• Swollen eye
• Difficulty seeing 

 Types  

There are two types of common enucleation surgeries; subconjunctival, and transpalpebral. These are done under general anesthetic.

• Subconjunctival - This is where the eyeball is taken out first, then the edges of the eyelid, followed by the nictitating membrane (third eyelid), and ending with the removal of the conjunctiva. 
• Transpalpebral - The eyelids are stitched closed at the edge, followed with the removal of the eyelid margins, nictitating membrane, eyeball, and conjunctiva at the same time, as one. This type of surgery allows for the total removal of the conjunctiva.

• Glaucoma in the end stage
• Antibiotic resistant infections
• Cancer
• Birth defects in the eye
• Trauma to the eye
• Diseases of the tissues surrounding the eyeball
• Diseases that can potentially spread to other parts of the body
• Inflammation of the eye
• A blind and painful eye
• Eyes with corneal scarring from dry eye
• Eye tumors
• Damage to the eye that creates collected discharge in the conjunctival sac  
• Proptosis with the eye avulsed in more than three places

Keep track of your dog’s symptoms and note any changes to aid  your veterinarian in the correctly diagnosis of your dog. The veterinary team will determine the specific condition within your dog’s eye, and from there, diagnosis will determine whether enucleation will be necessary. The veterinarian may use tools in the ophthalmic examination to evaluate the health of your pet’s eye, in addition to verifying his vision capabilities. For conditions such as glaucoma, the veterinarian or referred ophthalmologist may perform a tonometry or a gonioscopy of the inner eye.

Other tests that may be done in order to determine if there are underlying illnesses that could be affecting your companion’s eye are complete blood count, serum biochemical test, urinalysis, EKG, and X-rays.

It is very for common for a treatment protocol to result in enucleation. This presents little risk to your dog’s overall health. This procedure actually very often provides much needed relief from pressure in your dog’s eye. 

In some cases of enucleation, a replicated eye made of plastic will be put into the eye socket of your dog prior to the finishing of stitching. This plastic orb keeps the facial skin from falling into the empty eye socket. The insertion of the plastic orb will only be done when there is no risk of an infection, and if no cancer was found in the eye socket. 

Your dog will be released with an E-Collar to prevent any rubbing or self-inflicted irritation to the surgical site and stitches. If an infection was found, your veterinarian will prescribe antibiotics, along with pain medication if needed. You should expect to see some swelling and bruising after the surgery, this is normal.

Your veterinarian may decide to keep your dog overnight in the hospital to monitor his condition more closely. Most dogs recover quickly and are back to normal activities within a 48 to 72 hour period, but it can take up to five days.  Your veterinarian can best advise you on the expected recovery time.

The veterinary team may suggest that if your dog is comfortable and permitting, you place warm wet compresses over his surgical site twice a day, for up to five minutes. Stitches will generally be removed within seven to ten days. Your dog may experience some bloody nasal discharge on the same side of his enucleation. This will generally clear up within two to four days. You will have a follow up appointment with your veterinarian about five days after surgery. This appointment is very important to keep. 

There is not any long-term pain from an enucleation, on the contrary, it is used to relieve pain and pressure and your dog will feel better afterward. In order to prevent a secondary infection, your veterinarian will most likely prescribe antibiotics, and it is very important to follow through to the end of the medication.