Eye Proptosis in Dogs

Dog breeds that have prominent protruding eyes with short muzzles and noses are more prone to eye proptosis. A brachycephalic dog is the medical term for dogs with a flat and wide skull shape.  Common brachycephalic dog breeds, which are prone to eye proptosis, include the Pekingese, Pug, Boston Terrier, Chihuahua, Lhasa Apso, French Bulldog and Shih-Tzu. 

If your dog’s eye is displaced he must be seen by a veterinarian as soon as possible.  There are animal emergency hospitals, which are open 24/7.  It is important to remain calm.  The eye dries quickly so it is recommended that you place sterile gauze with a saline solution over the eye.  Contact lens solution may be used as a saline solution.  It is a good idea to call the veterinarian’s office or clinic beforehand and let them know you are coming in with an emergency situation. This way they will be ready for your dog.  

Please be aware that your companion is in a lot of pain and may not act as he usually does.  Pain, stress and fear can make any dog behave in an unpredictable manner.  To transport a small dog, it is recommended that you use his carrier.  This way he is in a safe and confined space.  When transporting an immobile, injured larger dog, a throw rug, beach towel, blanket, or a plank can be used as a stretcher.  Try to keep movement to a minimum to prevent further damage.

The eyeball (globe) and its supporting muscles and ligaments are situated within the eye socket (orbit).  Eye proptosis in dogs is when the globe is removed partially or entirely out of its orbit.

Symptoms of eye proptosis may include:

• Eye is bulging or hanging out of the orbit
• The eye is bloody
• Tissue around the eye is red and inflamed
• Severed/torn muscles and or eye ligaments 
• Cloudy cornea
• Inability to blink 
• Constricted pupils
• Dogs that have experienced trauma (for example hit by a vehicle) may have other intensive injuries. The dog may go into shock.

Eyes proptosis may be caused by:

• Dogfight
• Dog was hit with a blunt object
• Hit by a motorized  vehicle
• Dog accidently hits head against an object
• Falls or stumbles, which can cause head injuries
• Choking, caused by the misuse of a choker collar

If you are taking your dog to an emergency clinic where he has never been seen, it is important to let them know if the dog is on any current medications or if he has any medical conditions (diabetes, allergies, epilepsy, and pseudohemophilia).  Dogs that have experienced major trauma will need to be stabilized and assessed before evaluating the eye injury.  The veterinarian team will start an IV to administer fluids, analgesics, and other needed medications.  

The veterinarian may want the patient to have skull x-rays and chest x-rays.  A complete blood count and a serum chemistry panel may be suggested.  These blood tests can help evaluate the condition of the dog (low blood count, organ function).  If the dog has lost a lot of blood, a blood transfusion may be needed.  Once the dog is stable the veterinarian will perform an ophthalmic examination. The injured eye will be lubricated and moistened with antibiotic ointment to help prevent further damage to the cornea.

If the patient has more than three extraocular torn muscles, optic nerve damage, a detached retina or if the eyeball is ruptured; globe replacement will not be attempted.  The veterinarian will recommend enucleation of the eye. After the removal of the eyeball, the edges of the eyelids are sutured together.  

If the veterinarian feels that there is a chance of retaining the patient’s vision he may suggest re-attaching the globe and performing a temporary tarsorrhaphy. The eyelids of the eye are partially sutured together for 2-3 weeks. This procedure is done to protect the cornea. Enucleation of the eye and temporary tarsorrhaphy are both performed under general anesthesia.

Patients that undergo an enucleation of the eye have a good prognosis. The veterinarian will prescribe pain medication and antibiotics. Follow-up visits will be required to monitor your pet’s progress. An E-collar will need to be worn for approximately 10-14 days.  The veterinarian will provide you with post-operative instructions.

Dogs that undergo a temporary tarsorrhaphy will be prescribed topical and oral antibiotics, atropine, and anti-inflammatory and pain medication. An E-collar will help prevent self-trauma.

Only 20-40% of dogs that have the reattachment of the eyeball regain their vision. Additionally, there are possible complications, which may occur after the surgery (blindness, glaucoma, corneal ulceration, and keratitis). Follow-up visits will be required to monitor the patient’s progress and to determine if there are any complications.