October 17, 2013

My name is Dr. D and yesterday, I removed a cat’s eyeball. Gruesome to think about, I know. Fortunately, enucleations (eye removal surgeries) are rare, but we do perform them on occasion. Why on earth would we ever remove an animal’s eye? There is a short list of reasons, but all are compelling since they result in significant pain for Fluffy or Fido. By removing the eye, we remove the source of pain.

1.) Glaucoma: Glaucoma results from increased fluid accumulation and increased pressure within the globe. Glaucoma is known to be very painful, and it often cannot be successfully controlled with medication. Most of our canine patients with glaucoma lose vision in their eye(s) as a result of the disease, and they are in chronic pain. Thus, especially in refractory glaucoma cases, surgical removal of the affected eye or eyes is the humane treatment of choice.

2.)  Trauma: If an injury results in perforation or proptosis (extrusion) of the eye, enucleation is sometimes the only treatment.

3.) Ruptured corneal ulcers: Corneal ulcerations are one of the most common ocular disorders we diagnose. A variety of things can predispose our patients to corneal injuries: trauma, anatomy (think about our brachycephalic breeds such as boxers and bulldogs, with their prominent eyes), herpes viral infections in cats and untreated dry eye in dogs. Deep corneal ulcers, especially if not appropriately diagnosed and treated, can occasionally result in herniation of the internal ocular contents through the disrupted cornea. It’s gross to think about, but this is one of the most common reasons we have to perform enucleations (and why my recent kitty patient needed her eye removed.)

4.) Tumors: Intraocular tumors such as melanomas occur infrequently; these can sometimes cause glaucoma and almost always cause pain. Excision of the eye can relieve pain, and sometimes cure whatever cancer might be present.

The discussion about whether or not to remove an eye can be a difficult one. Understandably, owners have a tough time committing to this type of surgery. However, there is some good news here! In most cases, Fido (or Fluffy) has another healthy eye from which to see, and can function completely normally with one eye. (The reality is that when we suggest that an enucleation is necessary, the eye to be removed is often completely blind anyway.) This surgery, while causing temporary pain as Fluffy heals, can ultimately provide permanent relief from a chronically painful condition.

There are a lot of healthy, happy and otherwise completely normal one-eyed pets out there. Our own Dr. Rockwood has a one-eyed kitty at home! We certainly don’t take this type of surgery lightly, and recommend it only when necessary, but our dogs and cats tend to recover quickly and are pain-free soon after surgery! One-eyed (and no-eyed) quadrupeds are remarkably functional, happy and inspirational to us bipeds.