Enucleation, or the removal of the entire eyeball, is a common and important surgery performed by veterinary ophthalmologists.
When a dog’s eye is irreparably damaged or causing significant pain that cannot be managed with medication, enucleation becomes a serious consideration for improving the animal’s quality of life.
Below, we will explore the reasons for recommending canine enucleation, some alternative surgical techniques, the specific steps involved in a subconjunctival enucleation procedure, and the crucial elements of post-operative care.
When is enucleation necessary?
Veterinarians usually perform enucleation when the eye is beyond saving and is causing significant pain. If a dog has lost vision and pain relief is the primary goal, enucleation may be the best option.
Some specific reasons for enucleation include:
- end-stage glaucoma
- serious cuts or tears to the cornea or sclera
- shrunken or collapsed eyes
- unresponsive and painful dry eye
- severe proptosis (eye displacement)
- intraocular tumors that are getting worse
- unresponsive uveitis that has caused blindness
Severe panophthalmitis (inflammation inside and outside the eye) or a retrobulbar abscess (infection behind the eye) might also require enucleation, or even exenteration (removal of all the tissue in the eye socket).
Are there other surgical options?
Enucleation is frequently necessary, but vets may recommend other procedures in some situations.
Evisceration removes the inside of the eye, but leaves the white part (the sclera) intact. Sometimes, vets will insert an artificial eye (called an intrascleral prosthesis) after evisceration to improve the dog’s appearance.
For severe infections, abscesses, or extensive tumors, vets might recommend removing all of the contents of the eye socket (exenteration).
Subconjunctival enucleation: a step-by-step guide
Here’s an overview of the procedure, according to the Today’s Veterinary Practice journal.
Pre-operative preparation
First, your dog will need to be placed under general anesthesia, and the surgical site must be thoroughly cleaned and prepped. The veterinary surgical team may use a vacuum pack to make sure your dog’s head stays in the correct position during the procedure.
Surgical procedure
The veterinary surgeon will make an incision through the conjunctiva, all the way around the cornea. Next, the extraocular muscles will be isolated, ligated, and transected. The optic nerve will be clamped and then transected. Bleeding will be controlled with a diluted epinephrine solution. Finally, the globe of the eye will be carefully removed.
Closure
The Tenon’s capsule and conjunctiva are closed in separate layers using absorbable sutures. The veterinary surgeon may place a subcutaneous layer to relieve tension on the incision. The skin will be closed with sutures selected based on your dog’s size.
Postoperative Care and Potential Complications
It’s important to manage pain after an enucleation. Your vet will likely prescribe pain medication for 3-5 days after the procedure.
They may also prescribe antibiotics to prevent infection.
To keep your dog from scratching or rubbing at the surgical site, use an Elizabethan collar.
Keep a close eye out for bleeding after the surgery. If it occurs, apply a bandage to the area.
Your vet will want to recheck your dog 5-6 days after surgery and remove sutures after 12-14 days.
Possible complications include bleeding, infection, and wound breakdown (dehiscence).
Make sure you understand what the area will look like after the surgery and what complications to watch for.
In Closing
Enucleation is a good surgical choice when a dog’s eye is causing pain or is too damaged to repair.
To ensure the best possible outcome, the vet must use careful surgical techniques and provide detailed aftercare instructions.
It’s also important to explain the procedure, what to expect afterward, and any possible problems to the dog’s owners.
By understanding when enucleation is the right choice, how to perform the surgery, and how to manage the aftercare, veterinary professionals can provide the best care for dogs needing this procedure.