Ophthalmic emergencies

Incidence of concurrent systemic injuries with traumatic proptosis and its effect on outcome - 100 dogs

Objective

To evaluate the incidence of concurrent systemic injuries in dogs with traumatic ocular proptosis and their effect on survival to discharge. Additionally, to evaluate for associations between the type of trauma, each presenting vital signs, minimum laboratory database findings including packed cell volume, total solids, plasma glucose and lactate concentrations, and the diagnosis of concurrent systemic injury and survival.

Design

Retrospective study between the years 2017 and 2022.

Setting

One university teaching hospital and one large, private practice.

Animals

One hundred dogs presenting to the hospital with a diagnosis of traumatic ocular proptosis.

Measurements and main results

Medical records were retrospectively reviewed; signalment, breed, sex, age, weight, date of presentation, type of trauma sustained, time from trauma to presentation, vitals on presentation, and minimum laboratory database findings including packed cell volume (PCV), total solids (TS), plasma glucose concentration, and plasma lactate concentration were recorded. A modified animal trauma triage (ATT) score was retrospectively calculated. A total of 17 dogs (17%) had concurrent systemic injury. Compared to dogs without systemic injuries, dogs with systemic injuries had a significantly lower body temperature [median 101.1F (38.3C) vs. 101.6F (38.6C); P = 0.008], significantly higher plasma glucose concentrations (125 mg/dL, 6.9 mmol/L vs. 112 mg/dL, 6.2 mmol/L; P = 0.012) and approaching statistical significance, lower PCV values (median 40 vs. 46%; P = 0.051).

Conclusions

Dogs presenting with traumatic ocular proptosis do present with concurrent systemic, non-ocular injuries; however, these concurrent injuries do not seem to be associated with survival to discharge.

Case Report: Surgical Treatment of Severe Facial Wounds and Proptosis in a Dog Due to a Traffic Accident

Although facial wounds caused by traffic accidents in dogs are common, the surgical management of severe facial injuries involving the soft tissue, bone, dentition, nose and orbit are challenging. A 2 year-old Korean Jindo dog was diagnosed with severe skin defects of the face and proptosis caused by a vehicular accident. Along the left lateral maxilla, severe injury involving the overlying skin and platysma muscle occurred, to the extent that the middle part of the sphincter colli profundus pars intermedia muscle was exposed. Repair surgeries of the skin defects and globe displacement were performed using a local subdermal plexus rotation flap and a partial transposition of the dorsal rectus muscle combined with small intestinal submucosa (SIS) instead of enucleation as the first attempt. SIS was used to sustain the torn medial region. In this case, the surgery resulted in good cosmetic and functional outcome in the dog, despite the atypical complexities upon presentation.

Clinical findings of traumatic proptosis in small-breed dogs and complications associated with globe replacement surgery

Background:

Proptosis is a serious traumatic disease commonly affecting small breed dogs and possibly causing loss of vision, with globe replacement surgery (GRS) being essential in most of the cases after stabilizing the patient’s condition.

Aim:

To determine the common dog breeds and clinical findings associated with traumatic proptosis and demonstrate the short-term complications following GRS.

Methods:

The study was performed on 15 client-owned small-breed dogs presented with unilateral traumatic proptosis. Dogs were examined at initial presentation to determine the concurrent abnormalities associated with globe prolapse. The globe was replaced within the orbit and avulsed extraocular muscles were identified and sutured. Endoscopic examination of the ocular fundus was achieved 1 and 3 weeks after GRS in one Pekingese diagnosed with glaucoma. Complications following GRS were recorded.

Results:

Pekingese (53.3%) and Griffon (26.7%) were the most affected dogs with proptosis in Egypt. Bruised, hyperemic and swollen conjunctiva and periorbital tissue, lateral globe retraction, cloudy cornea, and miosis were common clinical findings associated with proptosis. Exposure keratitis, keratoconjunctivitis sicca, and exotropia were identified in all 15 patients at presentation. Complications following GRS included phthisis bulbi (53.3%), strabismus (26.7%), and lateral exotropia (20%). Intraocular pressure was reduced to 22 mmHg 3 weeks after GRS in the only patient diagnosed with glaucoma, and endoscopic evidence of optic nerve cupping was identified.

Conclusion:

Clinical findings associated with proptosis at initial presentation may have influenced the outcome of GRS. Favorable prognosis may be given to patients with relatively high potential for vision at initial presentation and ≤2 extraocular muscle avulsions. Immediate surgical intervention following the occurrence of proptosis should be advised to achieve favorable disease prognosis.

Penetrating palpebral grass awn in a dog: Unusual case of a penetrating grass awn in an eyelid

An unusual case of a penetrating grass awn in an eyelid of a dog is reported. A 6-month-old mixed breed dog was referred to the Ophthalmology Unit of the Veterinary Teaching Hospital of Camerino University for anorexia, lethargy, left monolateral ocular swelling and pain to the left eye, present from 1 month. Ophthalmic examination of the left eye showed copious and purulent discharge, and ultrasonography revealed the presence of an abscess containing a grass foreign body. The grass awn was surgically removed. Three days after surgery, the dog showed a marked improvement, with a total resolution obtained in 7 days. To the authors' knowledge, penetrating foreign bodies such as the one of this paper have never been described before in literature.