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Diseases of the Orbit of the Eye in Dogs

Exophthalmos, Enophthalmos, and Strabismus in Dogs

Exophthalmos, enophthalmos, and strabismus are all conditions that can lead to abnormal positioning of a dog’s eyeball.

Exophthalmos is characterized by the protrusion or bulging of the dog’s eyeball from its eye socket. This protrusion may result from a mass occupying space behind the eyeball. On the other hand, enophthalmos causes the eyeball to recede or sink into the skull. Lastly, strabismus refers to the condition where one or both of the dog’s eyes appear to be looking in a different direction, unable to focus together. This is often referred to as “crossed eyes.” These conditions can affect both dogs and cats.

Symptoms and Types

The symptoms associated with each of these conditions are as follows:

Exophthalmos:

  • Fever
  • General malaise
  • Swollen eyelid
  • Presence of “Cherry eye”
  • Loss of vision
  • Formation of pus pockets in or around the eye (orbital abscess)
  • Discharge from the eyes, which may be watery (serous) or a mixture of mucous and pus (mucopurulent)
  • Lagophthalmos (inability to completely close the eyelids)
  • Inflammation of the cornea (the transparent coating of the eye) or the surrounding tissue
  • Pain upon opening the mouth

Enophthalmos:

  • Entropion
  • Presence of “Cherry eye”
  • Atrophy of the muscle surrounding the eye (extraocular muscle atrophy)

Strabismus:

  • Deviation of one or both eyes from the normal position
  • Reduced functioning of the muscles surrounding the eye

Causes

Exophthalmos typically arises from a mass occupying space behind the eyeball. Strabismus, commonly known as “crossed eyes,” often results from an imbalance in the tone of extraocular (outside the eye) muscles. The Shar-pei breed is particularly prone to this eye condition.

Other contributing factors to these eye diseases may include:

Exophthalmos:

  • Hemorrhage within the eye
  • Formation of pus pockets within the eye
  • Bacterial or fungal inflammation of eye tissues
  • Inflammation or swelling of the mucous sac in the bony socket surrounding the eye
  • Inflammation in the muscles surrounding the eye(s)
  • Arteriovenous fistula formation (a rare condition where arteries connect with veins, forming an abnormal passage)

Enophthalmos:

  • Cancer
  • Dehydration affecting the water content within the eyeball
  • Drooping eyelid
  • Constricted pupils
  • Collapsed globe
  • Reduction in the volume of the eyeball, rendering it non-functional
  • Horner’s Syndrome (a condition involving nerve distribution loss to the eye and/or nerve supply reduction)

Strabismus:

  • Genetic predisposition
  • Limitation of eye muscle movement due to scar tissue (often from previous trauma or inflammation)
  • Abnormal crossing of visual fibers in the central nervous system

Diagnosis

To diagnose your dog’s condition, your veterinarian will require a detailed history of your pet’s health, including the onset of symptoms and any preceding incidents. A comprehensive physical examination will be conducted, focusing on the eyeballs, surrounding bone and muscle, and an assessment of your dog’s mouth for any abnormalities.

X-ray imaging of the skull will be recommended to precisely locate any growths, pockets of fluid, or abnormalities in the muscle or bone contributing to the abnormal positioning of the eyeball.

Additionally, your veterinarian may suggest basic blood tests such as a chemical blood profile, complete blood count, urinalysis, and electrolyte panel to rule out any underlying systemic diseases.

Treatment

Depending on the specific condition, treatment options may vary:

Eyeball out of socket:

  • Surgery is recommended, with potential complications such as excessively dry eyes (keratoconjunctivitis sicca).

Abscess or inflammation of the eyeball:

  • Surgical intervention to drain the abscess.
  • Collection of samples for bacterial culture and microscopic examination.
  • Hot packing may be employed.

Cancer of the eye:

  • Early surgical removal of the malignant mass or the entire eyeball is often necessary.
  • If suitable, chemotherapy or radiotherapy may be prescribed.
  • Without chemotherapy or radiotherapy, survival is typically limited to weeks to months, especially if it is metastasizing malignant cancer (spreading cancer). End-of-life care or euthanasia may be the only options.
  • Consultation with a veterinarian specializing in cancer may be required for specific care.

Zygomatic mucocele (a pocket of mucous in the bone surrounding the eyeball):

  • Treatment involves antibiotics and corticosteroids.
  • Surgery may be necessary in some cases.

Strabismus:

  • If strabismus is caused by a nerve disorder, the underlying cause will be treated.
  • Surgical correction of muscle abnormality or muscle-strengthening therapy may be recommended.

Living and Management

Your veterinarian will arrange follow-up appointments based on your dog’s specific diagnosis. For instance, if your pet is diagnosed with an eye infection, your veterinarian will likely schedule weekly examinations until the signs of the disease have resolved.

If you observe any recurrence of symptoms associated with these eye diseases, it is crucial to promptly contact your veterinarian to prevent potential permanent damage to the eye.

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