OPHTHALMOLOGY
• Medical management of associated symptoms such
as uveitis or glaucoma
• The eye is painful, however the patient is not a surgi-
cal candidate
Enucleate if:
• Causing ocular discomfort from e.g. uveitis or glau-
coma
OCULAR NEOPLASIA (Fig 3 & 4)
Fig. 1. Severe proptosis in a cat as a result of being hit by a car
Enucleate if:
• Two or more extraocular muscles are damaged
• Mydriatic pupil which has a poor or no DPR and a
poor CPR from the other eye
• Globe has severe hyphaema, glaucoma or is perfo-
rated
ANTERIOR LENS LUXATION (Fig 2)
Salvage if:
• Can refer to a Veterinary Ophthalmologist for emer-
gency surgery [intracapsular lens extraction]
• Acute onset
• Can start on anti-glaucoma eyedrops immediately
Enucleate if:
• Intraocular pressures remain high despite treatment
• Surgery not an option
Sacrifice if:
• You have a very high suspicion of a cat with intraoc-
ular melanoma - these tumoUrs in cats have a high
metastatic rate. Beware though as nevi and freck-
les can appear on the iris and are not melanomas.
Melanomas tend to appear raised and increase in
size so monitoring monthly is essential. A slit lamp
biomicroscopy examination would be considered
essential to look for more subtle features that could
suggest neoplasia and hasten the decision for enu-
cleation. Advice to owners would be to take sequen-
tial photos to monitor progression if detected early.
Salvage if:
• Dogs with intraocular melanomas have a low meta-
static rate, however owners need to be made aware
of the risks either way.
Enucleate if:
• A retrobulbar tumor is diagnosed and access cannot
be done via an orbitot omy. Most orbital tumours are
removed with sacrificing the globe.
• Intraocular tumours causing uveitis, glaucoma or hy-
phaema [eg: ciliary body adenocarcinoma]
Exenterate if:
• Neoplasia involves the globe, conjunctiva and/or
periorbita. The globe will need to be sacrificed in or-
der to excise the lesion and close the incision.
Fig. 2. Anterior lens luxation in a cat
BLINDNESS
Salvage if:
• If acute onset. Such cases may be optic neuritis and
often can regain vision
• The eye is non-painful
Fig. 3. Squamous Cell Carcinoma on the eyelids of a sheep.
Issue 03 | JUNE 2017 | 29