Lessons on eye trauma
Dear Dr. Forsythe: My daughter and son-in-law from Santa Monica recently celebrated their first wedding anniversary by taking a cruise to Hawaii, and I volunteered to house-sit their two-year-old Pekingese “Noodle.” On the first night after they departed, Noodle was out playing with some of the children from the street and when she came in one of her eye balls was sticking all the way out of its socket. I could not believe my eyes, it looked like something from a horror movie. I asked the kids if anyone had kicked her or poked at her, and they all said no. Naturally, I was panic stricken, but since Noodle seemed fine otherwise, I tried to soak it with a warm washcloth and hoped the swelling would go down with Benadryl. When it was no better after several hours, I took her to an emergency animal hospital, but the doctors gave me terrible news. They had to remove Noodles eye because it was blind by then, too many hours had passed since the eye came out of its socket. I went ahead and had them take care of her, but as you can imagine, it was not easy giving this news to my kids. I now have a daughter who is mad at me, a son-in-law who feels terrible, and I feel awful even though I paid over a thousand dollars for the vet care while they were gone. What do you think caused Noodle’s eye to come out like that, and what should I have done differently?
Sign me – Glad to be back in NorCal
Dear Glad: You poor thing, first let me extend a warm and loving hug through these pages to you because Noodle is not the only one who went through a trauma recently: YOU DID TOO!!!! Prolapsed globes (or “eyeballs”) are not only scary, but rather hideous and nerve-wracking to witness.
Usually dogs with short faces like Pugs, Pekingese, Lhasa Apsos and Shih Tzu are the breeds most likely to suffer a prolapsed globe. Most of the time this happens secondary to trauma – either a bonk to the face or excessive restraint or squeezing around the neck of a dog. When the eyeball pops out of its socket, the optic nerve is immediately stretched out beyond its capacity and it can only survive if the eyeball is pushed back manually in within about 20 to 30 minutes. After that, the nerve fibers begin to die and permanent blindness results. However, if the eyeball is pushed back in and held in place with a cool cloth and the pet is taken to a veterinarian for an operation called a tarsorrhaphy (sewing the eyelids shut with the eyeball inside) within a short amount of time, the eye can be saved. If corrected promptly, the optic nerve has time to rebound and the vision will not be lost. Two weeks after tarsorrhaphy, the sutures are removed and the eye is typically visual.
I realize that this mini lecture on treatment of a prolapsed eyeball is of little help to you now, but I did want to impress upon readers how this is an example of a problem that could have been fixed with immediate veterinary help. However, I’d also like to say that you seemed to have used the best common sense you could muster at the time to deal with the solution at hand. While I don’t usually advocate waiting a few hours when there is a problem related to an eye, you did make an effort to compress the eye and give something that would decrease what you thought was inflammation.
I think it was most gracious of you to house-sit for Noodle and pay for the surgery to have his eye removed when it was recommended. Seems to me that your daughter should be grateful for the help you gave and happy to have a mother who “takes one for the team.” I hope your daughter realizes that, although this incident with Noodle was tragic and challenging, she is very lucky to have you and she needs to give credit where credit is due. Perhaps you can share this column with her so she can see the bigger picture here and give you credit for all you did and all you went through in dealing with her little bubble-eyed baby. And if that doesn’t work, I could always go pay them a house call… – Dr. F
