Lucy, a 6 year old spayed female terrier mix, presented to the CARE Animal Emergency Service after an acute history of suffering a traumatic proptosis of her left eye. Although in Lucy's case the direct cause was unknown, a traumatic proptosis event may follow blunt trauma such as being hit by a car, or a fight with another animal. During trauma, the globe (eyeball) is luxated (dislocated) from the orbit, and eyelid spasms prevent its retraction - which was the case with Lucy. In most cases, there are consequences to the luxation of the globe such as secondary orbital hemorrhage and swelling that in turn displaces the globe further from the orbit. Prognosis of the eyeball depends on pupil size and reflexes, duration of exposure, other globe or orbital damage, breed and other systemic trauma. Approximately 40% of dogs can recover vision.
In Lucy's case, treatment was implemented by providing moisture to lubricate the exposed globe. General anesthesia followed by a temporary tarsorrhaphy was completed. A temporary tarsorrhaphy is a surgical procedure where the upper and lower eyelids are sewn together using one to three horizontal mattress sutures of non-absorbable material. The purpose of a tarrsorrhaphy is to provide protection to the ocular surface by reducing exposure and mechanical abrasion to the cornea while allowing the insulted area to heal.
Unfortunately, a persistent infection prevented clinical improvement and the tarsorrhaphy failed. Lucy's owners opted to remove the eyeball with a surgical procedure called an enucleation. The eyeball was then removed and the source of constant irritation and infection was then alleviated. Lucy went home with an Elizabethan collar (a cone of shame!) to make sure that the sutures that were placed would heal appropriately (it is very important to keep the Elizabethan collars on our animals after ocular surgery). Currently, Lucy is doing fantastic at home and adjusted well to her new look on life post-operatively.