Traumatic eye prolapse
by  Jeff Grognet, D.V.M., B.Sc.(Agr.)


This article was published in the August 2007 edition of Dogs In Canada.

If an eye is forced from its socket, the prolapsed state is called "proptosis." In a flat-faced dog such as a Pug, Shih Tzu or Pekingese, this is not an uncommon eye injury. It is, however, an emergency that needs immediate veterinary attention.

Most cases of proptosis occur as a direct result of head trauma. A blow to the skull or a bite from a larger dog can lever the eye out of its socket.

Occasionally, an owner will accidentally prolapse his dog's eye through excessive restraint to the head and neck that forcibly pulls the eyelids back. In this case, the eye can be returned to its normal position by pulling the eyelids from behind the eye to in front of it. This immediately allows the eyeball to fall back into place. Obviously, this correction must be done immediately.

If a dog's eyeball habitually prolapses, a simple surgery can be performed to correct the anatomical anomaly at the root of the problem. The eyelids are sewn partially closed so the opening becomes too small for the eyeball to fit through.

If your dog has a prolapsed eye that can't be easily returned to its socket, you must get him to your veterinarian as soon as possible. For the best results, the eye should be repositioned within 15 to 30 minutes.

If you want to give your dog's eye the best chance at survival, you'll need to perform some first aid before leaving for the hospital. Keep the eye moist with sterile saline, an eye irritating solution, or as a last resort, water (it's better than nothing). Moisten a pad and bandage it your dog's eye, or hold it in place with your hand. Keep your dog from rubbing by holding his paws or putting an Elizabethan collar on him.

When you arrive at the clinic, the veterinarian will determine whether your dog's pupil is responding to light (constricts). If this happens normally, nerve function is still present in the eye (a good sign). If his pupil is constricted (small), it also means the eye has nerve function (since the pupil goes small under painful conditions). If the pupil is dilated and non-reactive, the prognosis for future vision is much poorer. Only 20 per cent of dogs suffering from a prolapse eye regain some functional vision.

A prolapsed eye can be handled in one of two ways - the eyeball is either replaced or removed (enucleation). Unless the eye is severely damaged (nerves and muscles torn, or the eyeball ruptured), the eyeball should be returned to its socket and the eyelids temporarily sewn together to hold it in place.

If the eye is non-functional, immediate enucleation is indicated. The eyeball is removed and the eyelids stitched together permanently. An alternative is to replace the damage glove with a false eyeball (prosthesis). In the latter case, the eye looks almost normal.

A multi-published writer, Jeff Grognet, D.V.M., B.Sc.(Agr.), runs a veterinary practice in Qualicum Beach, B.C., along with his wife, Louise Janes, D.V.M.