This big eyed, sweet dog (Bubbles) was rescued this week by Saving Grace Animal Society. He presented to us Central Vet Clinic on Monday completely blind. Despite his eyes being huge and bulgy, they were not painful for him. We all had ideas of what might be going on with this 6 month old pup but needed more information before we could make a diagnosis.
His physical exam and bloodwork were completely normal. Neurologically, he was normal except from having major deficits with his eyes. He was blind and did not blink when a hand was moved towards his eyes (no menace response), his dilated pupils did not change in response to light (pupillary light response), and his eyes were so large (buphthalmia) they no longer fit in his eye socket. The outside of the right eye had a healed corneal ulcer from chronic irritation. Looking at the back of the eye there was severe optic nerve damage and both lens were luxated (see picture). His eyes both produced a normal amount of tears and the pressures in the eyes were high normal.
We thought we were getting closer to a diagnosis but decided to contact a veterinary ophthalmologist to confirm our suspicions. The specialist told us he believed it was CONGENITAL GLAUCOMA and because of the severity of the disease he recommended removing both of the eyes (enucleation/ eviseration). Typically, pressures are increased with glaucoma; however, because this dog has been suffering with high eye pressures for so long it has caused other adverse conditions in the eyes that have resulted in normalized pressures.
Dr. Juli removed his eyes this afternoon and bubbles is doing wonderful! He will adjust quite well to having no eyes and will be at much less of a risk of adverse effects than if he kept his eyes.
CAUSES
-It can be inherited or genetic mutation that is present at birth
-It is considered a primary glaucoma in which there is malformation of the drainage inside the eyes leading to an increased pressure
CLINICAL SIGNS
Present very early in life and may include:
-Enlargement of globe (bupthalmia)
-Clouded eye(s) (corneal edema)
-Dilated pupil(s) (mydriasis) with sluggish or no response to light
-Blindeness or vision impairment
-Redness of eye(s) (episcleral injection)
-Scratches on eye(s) surface (ulcers)
-Evidence of painful eyes
-Luxation of lens
-Damage to optic nerve
-Retinal degeneration
DIAGNOSIS
-Clinical signs above
-Eye pressures are typically increased
TREATMENT
-Early diagnosis: combinations of eye drops to decrease pressures. Multiple rechecks are required to monitor the eyes and change medication as needed. This will require lifelong treatment and usually results in eye removal.
-Chronic disease: removal of the eyes to prevent secondary complications
PROGNOSIS
-Poor. Most cases eventually result in removal of the eyes in cases of congenital glaucoma.
Bubbles is such a sweet boy and is going to do amazing despite being blind. He deserves a chance for an amazing life and is up for adoption through Saving Grace Animal Society.
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