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

Abstract

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.

Surgical correction as treatment of proptosis of eyeball: Case report

“…Portanto, é esperado que um trauma causado por acidente automobilístico traga injúrias mais severas especialmente quando acomete regiões de tecidos delicados como a face (Kim et al, 2020). Ressalta-se que após um trauma grave, onde há rompimento do nervo óptico com grande perfuração do globo ocular, hifema difuso e ruptura de três ou mais músculos extra-oculares o prognostico é ruim (Ali & Mostafa, 2019;Cho, 2008).…”

“…O prognóstico é favorável quando o trauma é recente, o animal revelar resposta visual, mantiver os reflexos fotopupilares direto e consensuais presentes e apresentar exame de fundo de olho normal (Cho, 2008). No caso em questão, todos esses parâmetros estavam dentro da normalidade, de modo que corrobora com os dados da literatura de que esses critérios podem ser utilizados como fatores prognósticos favoráveis à recuperação visual do olho acometido (Ali & Mostafa, 2019;Cho, 2008;Fossum, 2014).…”

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

“…Ocular misalignment can occur due to orbital fracture, nerve damage, or muscular damage (8)(9)(10). Although anatomical restoration has been performed in humans, strabismus with ocular misalignment has been difficult to correct in dogs because of anatomical and technical limitations (11). If the eye and the extraocular muscles are intact, globe replacement with tarsorrhaphy should be performed.…”

“…Ocular misalignment, such as strabismus or proptosis after trauma, may develop from orbital fracture, muscular damage, and/or nerve injury (9,10). In dogs, acquired proptosis with damage of MRM may develop from proptosis secondary to blunt head trauma (11). It is a common sequela resulting from avulsion of the MRM, which is the shortest of the four rectus muscles in dogs and can reduce the vitality of the globe and cause loss of vision (13).…”

“…It is a common sequela resulting from avulsion of the MRM, which is the shortest of the four rectus muscles in dogs and can reduce the vitality of the globe and cause loss of vision (13). Proptosis is an acute emergency condition, and immediate intervention is essential after the patient is stabilized (7,11). Temporary tarsorrhaphy with globe reduction and enucleation are two treatment options.…”