Ocular proptosis is the forward displacement of the globe (eyeball), typically beyond the eyelids . As you can imagine, it can look like a scene from a Halloween movie.
In dogs, proptosis usually results from blunt trauma. However, in certain breeds, proptosis can occur if the facial skin is accidentally pulled too hard. Brachiocephalic breeds, such as Pugs, Pekingese, Shih Tzu, and Lhasa Apso, are predisposed to proptosis due to their shallow orbits.
Ocular proptosis is easy to recognize. It basically looks like the eyeball has popped out of the socket. The conjunctiva can also become swollen and injected. Since the eyelids are unable to close over the proptosed globe, the conjunctiva and cornea will dry out and appear leathery. Left untreated, the cornea can even rupture.
Proptosis is an eye emergency. Animals with a proptotic eye should be taken immediately to a veterinarian. If the globe is still intact, the treatment is surgery to reposition the globe into the orbit. The best chance for salvaging the eye and preserving vision is to perform surgery to reposition the globe as quickly as possible.
Unfortunately, if extensive damage has already occurred to the extraocular muscles or the globe, the eye may not be salvageable and may need to be removed. Proptosis can also damage the optic nerve resulting in irreversible vision loss even if the globe is salvaged.
Ultimately, the treating veterinarian will need to:
- Assess the damage
- Check for signs of optic nerve injury
- Determine if the eye is salvageable
If the eye is salvageable, the patient will need to undergo surgery to reposition the globe. If not, the eye will need to be removed (enucleation). While awaiting the definitive treatment, the animal needs to be treated with adequate pain medications since proptosis is a very painful condition.
Although proptosis is a serious medical emergency that I frequently encounter, it does not have to end in tragedy. Last week a stray dog was brought in to the animal shelter after a dog fight. He had been attacked by a large dog and had bite wounds to the face and a proptosed eye. Fortunately, he was brought in promptly and the globe remained intact and did not appear to have optic nerve damage. The dog immediately underwent surgery to reposition the globe into the orbit. Since he received medical care promptly, he had a complete recovery. The take home point is that proptosis is an ocular emergency and requires immediate treatment.
If you have any questions or concerns, you should always visit or call your veterinarian they are your best resource to ensure the health and well-being of your pets.