Healthy Pets

Eye Disorders

posted: 05/15/12
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Dog's eyes can be so expressive, showing excitement, sadness, apprehension... When there are disorders of the eyes, the dog not only has impaired sight, but impaired ability to communicate. Any disease of the eye should be considered serious and treated promptly under your veterinarian's supervision.

Tear Stains

On many lightcolored dogs, especially miniature and toy breeds, we may see a brown or pink stain on the skin and hair below the inside corner of the eye. We can also see these tear stains in cats, most commonly in Persians. In both dogs and cats, this is a common cosmetic problem caused by an overflow of tears onto the cheeks. The color change of the hair and skin occurs when the normal bacteria on the hair and skin react with the clear tears.

In normal animals, tears are constantly produced and drain out through small ducts in the eyelids. The ducts empty into the nose. (That's why your nose runs when you cry.) In animals with blocked ducts, the tears overflow the lids and run down the face.

There are several causes of the overflow of tears. Miniature breeds and Persians often have more prominent eyes. This stretches the eyelid and may cut off the drainage system. This is the most common cause and there is little we can do to correct it. Some animals are born with an abnormal drainage system that may or may not be surgically correctable. Sometimes the eyelids turn inward and block the drainage. This is also surgically correctable.

Hair can act like a wick, drawing the tears out of the eye. This can be corrected by removing the offending hair. In some cases, tear overflow may be due to excessive tear formation caused by irritation of the eye by a particle of something in the eye, an allergy, or an abnormal eyelid or eyelash which turns inward and rubs against the surface of the eye. Inflammation or ulcers of the surface of the eye (cornea), or inflammation of the duct system is also a cause. These conditions, which are often painful, need to be seen immediately by your veterinarian.

Since the tear accumulation on the facial hair can also lead to matting of the hair, skin irritation and possible infection, you must keep this area clean. Trimming the hair below the eye will help. Clean the area and remove any accumulated material or crusts. If a skin lesion is seen, clip the hair closer, and after cleaning the area it may help to apply an antibiotic ointment; it is best to use an ophthalmic (eye) antibiotic ointment on skin this close to the eye. If the lesion is large, deep, or ulcerated, or if you have any question about the severity of the lesion, you should see your veterinarian. More severe cases may require oral antibiotics and other treatment measures.

There are products available which are used to remove the brown stain from the hair. These products can be irritating to the eye. They should NOT be used directly in the eye. If necessary, to protect the eye, apply an ophthalmic ointment to the eye prior to using these products.

To help maintain healthy eyes in your pet, check the eyes on a regular basis, keep the area around them clean, and when in the car, roll the window high enough to prevent your pet from getting his head out of the window. Because your pet's eyes are so important, consult your veterinarian if you suspect any type of eye infection or problem.

Strabismus is a term used to describe the abnormal positioning or direction of the eyeball. Normally, the eyeball is held in place and moves from side to side and top to bottom under the influence of small muscles which attach directly to the eyeball. Occasionally one muscle may be longer or stronger than the muscle located on the opposite side. This causes the eyeball to veer off in an abnormal direction. One or both eyes may be affected. If both eyes deviate towards the nose, the pet is referred to as cross-eyed. This is common in Siamese cats and is called medial or convergent strabismus. The eyeballs may deviate away from the nose, just the opposite of being cross-eyed, and this is called divergent strabismus. This is common in Boston Terriers and is inherited in this breed.

Strabismus can also occur as a result of injury to some of the nerves going to the eye muscles. In addition, it may be seen if the dog has a disease of the vestibular system. The vestibular system is part of the ear and is what helps the dog (and us) keep our balance. If the vestibular system is not functioning normally, the dog may feel as though he is spinning, and his eyes will move abnormally to try to adjust to that.

If it is an inherited condition, no treatment is recommended as the abnormality is generally a cosmetic problem which does not affect the quality of life. If it is inherited, the breeding of affected individuals is not recommended.

For animals with injury to or disease of the nerves or the vestibular system, the underlying cause needs to be found and treated. Sometimes anti-inflammatory medications are helpful.

Retinal Dysplasia

Retinal dysplasia refers to a disorder in which the cells and layer of retinal tissue did not develop properly. Usually first noticeable in puppies about six weeks of age, the retina will appear to be layers of folded tissue rather than flat. This can only be seen with the aid of an ophthalmoscope. Various forms of retinal dysplasia are found in many breeds including English Springer Spaniels, Labrador Retrievers, Sealyham Terriers, Beddington Terriers, Doberman Pinschers, Cocker Spaniels, Rottweilers, Yorkies and Old English Sheepdogs. Retinal dysplasia, however, is not limited to these breeds. It is considered an inherited trait.

Some dogs have no symptoms and can only be identified with an ophthalmic examination. More severely affected puppies may be partially or totally blind. Retinal dysplasia generally results in inadequate vision and can lead to blindness. There is no treatment for retinal dysplasia.

Persistent Pupillary Membrane

A persistent pupillary membrane results from an abnormality relating to fetal development. As the eye of the normal fetus develops, there are some blood vessels within the eye that are present only in the early stages of development. These vessels normally lose function and deteriorate. Occasionally, however, the deterioration is incomplete, and small strands of abnormal tissue are left within the eye chambers. These fibrous strands may actually crisscross the eye chambers and attach to the lens and/or cornea. A corneal opacity may be seen. There is no treatment and the condition may be inherited in Basenjis.

The eyeball is comprised of several structures including the cornea, iris, lens, chambers, and the retina. The eyeball is located within the bony socket of the head and is partially protected by the three eyelids.

Microphthalmia is a condition in which the eyeball is smaller than normal. Usually the internal structures of the eyeball are abnormal as well. Microphthalmia is inherited in Australian Shepherds, Great Danes, Beagles, Collies, Borzoi, Dobermans, Sealyham Terriers, Bedlington Terriers, Portuguese Water Dogs, Shelties, Akitas, Miniature Schnauzers, Labrador Retrievers, Dachshunds and Cavalier King Cocker Spaniels.

Microphthalmia can also occur in newborns whose mothers received certain medications during pregancy.

The eyeball will appear smaller than normal for the breed. Signs of visual impairment will also be noticed. Many dogs become visually impaired or completely blind. There is no treatment, and affected individuals should not be bred.

Heterochromia

Heterochromia is a term used to describe variations in the color of the iris, the colored portion of the eye. "Heterochromia" is used to describe a multi-colored iris within the same eye, or two eyes with distinctly different colored irises. This condition can occur in dogs and cats. Individuals with irises of different colors are common in many dog breeds including Siberian Huskies, Great Danes, Dalmatians, and Malamutes. Vision is completely normal in these individuals and heterochromia is not considered a medical problem but rather a normal variation in eye color.

Hepatitis Blue Eye

'Blue eye' is a term used to describe cloudy corneas as a result of an adenovirus type 1 infection. Adenovirus type 1 is a severe viral disease affecting dogs of all ages. Usually the liver is affected, hence the name hepatitis, but occasionally the eye is also involved, hence the term 'Hepatitis Blue Eye.'

What are the symptoms?

About 10 days after exposure to the virus, the corneas appear blue or very hazy. Most patients squint and the eye may tear excessively. Puppies are more commonly involved than adults. Signs such as lethargy, poor appetite, nausea, jaundice (a yellowing of the skin, eyes and membranes), bloating or even death may be noted if the liver is severely affected by the adenovirus infection. Sometimes the vaccination for hepatitis could actually cause the blue eye, hence the popular name 'blue eye reaction.' This reaction is seldom seen with modern vaccines.

Once the patient's body fights off the viral infection, the eyes will clear. Several weeks may be required for the eyes to become normal again. In severe cases involving the liver, death can result. Fortunately, excellent and safe vaccines for adenovirus type 1 are available and usually administered yearly to prevent this disease. In animals not protected, life-saving treatments may be needed, including hospitalization and intravenous fluids.

Cataracts are one of the most common problems affecting the eyes of the dog. There are many different forms and causes of cataract formation. They affect all breeds and ages of dogs but certain types show up more commonly in certain breeds. Despite the fact that they are very common there is still a lot that we don't know about canine cataracts. The only current treatment option is surgery but with correct patient selection the outcome is very good. This article will explain some of the different forms of cataracts including their age of onset and their treatment options.

What are cataracts?

The word cataract literally means 'to break down'. This breakdown refers to the disruption of the normal arrangement of the lens fibers or its capsule. This disruption results in the loss of transparency and the resultant reduction in vision. Cataracts often appear to have a white or crushed ice appearance and are found in the lens of the eye.

Nuclear sclerosis

I often get people that bring an older dog into the clinic complaining of cataract formation in their dog's eyes. The vast majority of the time the dog does not have cataracts but has the much more common condition known as nuclear sclerosis. Nuclear sclerosis is a normal change that occurs in the lens of older dogs. Nuclear sclerosis appears as a slight graying of the lens. It usually occurs in both eyes at the same time and occurs in most dogs over six years of age. The loss of transparency occurs because of compression of the linear fibers in the lens. The condition does not significantly affect the vision of the dog and treatment is not recommended.

How do cataracts form?

Despite the fact that there are several different forms and causes of cataracts, they all develop in a similar fashion. The normal lens is maintained in a dehydrated state. It consists of 66% water and 33% protein. There is a complicated sodium water pump system in the lens that keeps this water/protein balance in check. When the biomechanical system in the lens is damaged, this pump system begins to fail and extra water moves into the lens. In addition, the percentage of insoluble protein increases. These changes result in the loss of transparency and cataract formation.

Age of onset

The age at which a dog develops cataracts is very important in classifying the type of cataract. The age of onset is particularly important for determining if the cataracts are the result of a hereditary trait in certain breeds of dogs.

Congenital Cataracts: These are cataracts that are present at birth. These cataracts usually occur in both eyes. Despite the fact that the animal is born with them they are not necessarily inherited. Infections or toxins may cause the formation of these cataracts while the puppies are still in utero. Primary congenital cataracts such as those found in miniature schnauzers are, however, inherited.

Developmental (Early Onset) Cataracts: Developmental cataracts are those that develop early on in life. As with congenital cataracts they may be inherited or caused by outside sources such as trauma, diabetes mellitus, infection, or toxicity. Inherited cataracts at this age are more common in several breeds including afghan hounds and standard poodles.

Senile (Late Onset) Cataracts: The cataracts that occur in dogs over 6 years of age are called senile cataracts. They occur much less frequently in dogs than in humans. Nuclear sclerosis, which is not considered to be a medical problem, is often confused with cataracts at this age.

Inherited cataracts

Inherited cataracts in the dog may occur independently or in association with other ocular disease. The breeds that appear to develop inherited cataracts along with their age of onset are listed below. If a dog is diagnosed with inherited cataracts, the dog should obviously not be used for breeding because of the likelihood of perpetuating the disease in the offspring. The most common metabolic disorder resulting in cataract formation in the dog is diabetes mellitus. If diabetic dogs are followed for a year or more, almost all of them would develop cataracts. In diabetic dogs the glucose concentrations in the lens increases. The extra glucose is converted into sorbitol, which causes an increase in the influx of water to the lens. The increase in water causes a breakdown of the lens fibers and a resulting cataract. Cataracts in diabetic dogs can develop extremely rapidly if the dog is not regulated. They generally affect both eyes. Surgical removal of the lens can be successfully performed in the diabetic dog if the animal has been regulated successfully for at least three months.

Trauma

Trauma from an automobile accident, or penetration of a thorn, shotgun pellet or other object may damage the lens and a cataract may develop. These types of cataracts usually only occur in one eye and can be treated successfully with surgical removal.

Treatment

Treatment for canine cataracts consists of surgical removal of the lens. There is currently no good non-surgical treatment for this condition. With the increase in veterinary surgical skill and equipment, the surgical procedure to remove the problem lens is becoming increasingly more common. There are several different techniques used to remove the affected lens including; the removal of the entire lens and surrounding capsule, the removal of the lens leaving the surrounding capsule, phacoemulsification of the lens, and aspiration and dessication of the lens. All of these techniques can offer excellent results. For a successful outcome the affected animal must undergo a thorough examination to determine if it is a good surgical candidate. Diabetic animals that are not regulated, aggressive animals that are difficult to treat daily, or animals in poor or failing health, are not good surgical candidates. If you suspect your dog is developing cataracts then you should work closely with a veterinary ophthalmologist to take the best and most effective course of treatment for the dog.

Corneal dystrophy is an inherited condition resulting in corneal opacities in both eyes. They are usually symmetrical being in similar locations in each eye. The opaque areas generally contain fatty deposits. Most dogs with corneal dystrophy are six months of age and older. Different types of corneal dystrophies are seen based on the location of the fatty deposits within the cornea. Breeds most affected appear to be Airedale Terriers and Shetland Sheepdogs.

The symptoms are opaque (whitish) areas located within the normally clear cornea. In more severe cases the entire cornea may appear hazy or bluish. Many lesions are progressive, starting out small and eventually occupying most of the corneal surface. Vision may become much impaired with ulcerations of the cornea developing over the areas with fatty deposits. There currently is no effective treatment for corneal dystrophy.

Dermoid Masses

A dermoid is a growth on the cornea or conjunctiva which consists of a mass of tissue containing fat, glandular tissue, hair follicles and hair. Dermoids are congenital and can affect young puppies. Dermoids can be described as an abnormal mass with hair on an inappropriate area of the eye is the symptom. The dermoid may be located on the eyelid margins or directly on the eyeball itself, usually on the cornea.

The mass, depending on its location, can be a source of severe ocular pain. If on the lid margins it prevents the normal blinking reflex and therefore proper eye lubrication. The hairs can cause severe irritation and possible ulceration of the cornea. Dermoids located on the cornea are a physical barrier preventing normal vision. Surgery is the treatment of choice to manage dermoids. The dermoid mass is dissected from the normal eye tissue. Those located on the cornea present the greatest challenge but the outcome is generally favorable.

Keratoconjunctivitis Sicca (Dry Eye)

Keratoconjunctivitis sicca (KCS) is the technical term for a condition also known as 'dry eye.' Inadequate tear production is the cause. This may be due to injuries to the tear glands, such as infections or trauma. The nerves of these glands may also become damaged. Eye infections and reactions to drugs such as sulfonamides can impair the nerves and/or the glands. Some cases are also the result of the gland of the third eyelid being surgically removed by mistake. Many cases have no known cause; the glands simply cease to function at their normal levels.

The eyes typically develop a thick, yellowish discharge. Infections are common as the lack of the bactericidal tears allows bacterial organisms to overgrow on the eye. Additionally, inadequate lubrication allows dust, pollen, etc., to accumulate. As a result the eyes lose their ability to flush away foreign particles and protect themselves from bacteria. To confirm a case of dry eye, a measurement of tear production is performed. Veterinarians use a small piece of absorbent material called a Schirmer tear test strip. This small strip is placed in the eye. Over a period of usually one minute, the tears soak and migrate up the strip. The wet area of the strip is then measured and compared to normal values. If inadequate tear production if found, then dry eye is diagnosed.

Left untreated, the patient will suffer painful and chronic eye infections. Repeated irritation of the cornea results in severe scarring which will become apparent. Corneal ulceration may develop, and will lead to blindness. If the cause can be identified, treatment should be aimed at eliminating it. An evaluation to determine infection should be performed. A thorough history may reveal past infections that could have damaged the tear glands or their nerves. If the patient is receiving sulfa drugs, they should be stopped at once. From our clinical experience, it is very rare that the cause can be identified, in which case therapy is aimed at replacing tears rather than correcting the cause.

Artifical tear solutions available for humans and sold in pharmacies can be used in canines. Depending on the severity, these drops are placed in the eyes at regular intervals throughout the day. These artifical tears provide the needed lubrication and flushing for the corneas. Antibiotic preparations are often used simultaneously to provide protection from bacterial organisms. Recently drugs such as Cyclosporine have been utilized to actually stimulate more tear production. The use of Cyclosporine has been quite successful in the management of this disorder.

In very severe cases, a surgery can be performed which transplants a salivary duct into the upper eyelid area. Saliva then drains into the eye, providing lubrication. This procedure is rarely used, but is an option.

Collie Eye Anomaly (Scleral Ectasia Syndrome)

Collie eye anomaly, also known as scleral ectasia syndrome and collie ectasia syndrome, is an inherited condition in which certain tissues in the eye of the fetus did not transform normally, resulting in various eye abnormalities. Originally discovered in the Collie breed, Collie eye anomaly also affects other breeds including Australian Sheepdogs, Border Collies and Shetland Sheepdogs. In the Shetland Sheepdogs the condition is commonly referred to as 'Sheltie eye'. Collie eye and Sheltie eye are inherited, and as many as 90 percent of all Collies in the United States are said to be affected to some degree.

In this condition areas of tissue in the fetus did not transform as they should have. In severe cases, vision may be greatly impaired, however, in most instances, the lesions can only be identified by an exam with an ophthalmoscope. Collie eye anomaly is a condition which includes several eye defects. A dog with Collie eye anomaly may have a detached retina, optic nerve abnormalities and/or a loss of retinal cells.

Vision is always impaired, but the extent depends on the severity of the defects. It is inherited and should be selected against in any breeding program. Exams and certification by a veterinary ophthalmologist should be conducted in all animals of affected breeds who may be used for breeding. These exams can be done as early as 6-8 weeks of age. There is no treatment to eliminate Collie eye anomaly. Breeders typically select against this condition by having puppies examined at a very young age (six weeks), then periodically afterwards. Veterinarians can detect lesions early on in cases of which the retina has not developed correctly or lacks normal pigmentation. Small lesions, however, may become pigmented with age. Breeders refer to puppies with disappearing lesions as 'go-normals.' Despite the term 'go-normal,' these puppies are not normal and should not be bred.

Progressive retinal atrophy or degeneration (PRA or PRD) is the name for several diseases that are progressive and lead to blindness. First recognized at the beginning of the 20th century in Gordon Setters, this inherited condition has been documented in over 100 breeds, and mixed breed animals as well. PRA is not very common in cats.

Anatomy of the eye

The eye is a very delicate, yet surprisingly durable organ. It consists of several layers. The cornea is a transparent layer that covers the front of the eye. The iris is the colored part of the eye and it is responsible for letting in more or less light. The lens gathers and 'bends' light in order to focus it on the retina. In between the cornea and lens is an area of fluid which bathes the lens and helps it focus. The retina lines the inside of the eye and converts light into signals which travel down the optic nerve to the brain. A large area between the lens and the retina contains a jelly-like fluid called 'vitreous.' The vitreous gives the eye its form and shape, provides nutrients, and removes waste products.

The retina is the structure affected in PRA. This important part of the eye receives the light gathered and focused by the other eye structures. It takes the light and essentially converts it into electrical nerve signals that the brain, via the optic nerve, interprets as vision. The retina contains photoreceptors, called rods and cones, which help the animal see in darkness (rods) and see certain colors (cones). There are multiple forms of PRA which differ in the age of onset and rate of progression of the disease. Some breeds experience an earlier onset than others; other breeds do not develop PRA until later in life.

Normally, the photoreceptors in the retinas develop after birth to about 8 weeks of age. The retinas of dogs with PRA either have arrested development (retinal dysplasia) or early degeneration of the photoreceptors. Retinal dysplastic dogs are usually affected within two months of birth and may be completely blind by one year. Dogs with retinal degeneration are affected from one year to eight years of age and the symptoms progress slowly.

PRA worsens over time. The affected animal experiences night blindness initially because the rods are affected first. The condition progresses to failed daytime vision.

What are the signs of PRA?

Signs may vary depending on the type of PRA and its rate of progression. PRA is non painful and outward appearance of the eye is often normal, i.e.; no redness, excess tearing, or squinting. Owners may notice a change in personality of their dog such as a reluctance to go down stairs or down a dark hallway. This is characteristic of night blindness, in which vision may appear to improve during the daytime. As the disease progresses, owners can observe a dilation of the pupils and the reflection of light from the back of the eye. If the blindness is progressing slowly, the owner may not notice any signs until the dog is in unfamiliar surroundings and the lack of vision is more apparent. In some animals, the lens of the eyes may become opaque or cloudy.

Depending on the form of PRA, characteristic changes in the retina and other parts of the eye may be observed through an ophthalmic examination by a veterinary opthalmologist. More sophisticated tests such as electroretinography may also be used. Both tests are painless and the animal does not have to be anesthetized. If no abnormalities are found during the exam by a board certified veterinary ophthalmologist, the dog can be certified free of heritable eye disease through the Canine Eye Registration Foundation (CERF).

Unfortunately, there is no treatment for PRA, nor a way to slow the progression of the disease. Animals with PRA usually become blind. Dogs are remarkably adaptable to progressive blindness, and can often seem to perform normally in their customary environments. Evidence of the blindness is more pronounced if the furniture is rearranged or the animals are in unfamiliar surroundings. PRA has been shown to have a genetic component. Puppies from parents who have no history of the disease and have been certified free of PRA will have less risk of developing the disease. Affected animals should not be bred and should be spayed or neutered. The littermates or parents of animals with PRA should also not be bred. If your dog develops PRA, notify the breeder, if possible.

In the last several years, DNA is being used to identify which genes are responsible for PRA. In one form of PRA called 'rod cone dysplasia 1' (rcd1), which affects Irish Setters, the gene mutation has been identified.

Dog Breeds Most Commonly Affected by PRA, and/or Have DNA Testing Available:

  • American Cocker Spaniel
  • Briard*
  • Cardigan Welsh Corgi*
  • Chesapeake Bay Retriever*
  • Collie*
  • Dachshunds
  • Doberman Pinschers
  • English Cocker Spaniel*
  • Irish Setter*
  • Labrador Retriever*
  • Miniature Schnauzer*
  • Norwegian Elkhound
  • Poodle
  • Portuguese Water Dog*
  • Siberian Husky*
  • Samoyed*

* Indicates DNA test available

Progressive rod-cone degeneration (prcd) is the most widespread form of PRA and affects many breeds including Poodles, American and English Cocker Spaniels, Labrador Retrievers, and Portuguese Water Dogs. Prcd starts with night blindness and progresses to total blindness at 3 to 5 years of age. The late onset of clinical signs in prcd is particularly devastating to breeding programs because many dogs have already been bred prior to the onset of symptoms. Thus, the development of a genetic test for this disease which could identify both affected animals and those that just carry the gene would be particularly useful. The researchers at the James A. Baker Institute have found a set of genetic markers that usually indicate the presence of the gene mutation that causes prcd in English Cockers, Labrador Retrievers, Chesapeake Bay Retrievers, and Portuguese Water Dogs. Although the exact gene mutation that causes prcd has not been found, every dog that is affected with prcd has two copies of the genetic marker and every dog that does not have the marker is clear of prcd. Unfortunately, this test for the genetic marker is not as accurate in diagnosing prcd as it would be if the actual gene mutation was found. This is because dogs that are not affected by prcd may still have the genetic marker present and have false positive test results. Thus dogs that are positive for the gene marker may be either false positives or may be carriers of the disease or may actually have the disease. The marker test may be done at a very early age, so potential breeding animals may be selected when they are still puppies.

The medical term for cherry eye is nictitans gland prolapse or prolapse of the gland of the third eyelid. Unlike people, dogs have a 'third eyelid' that contains a tear gland and is located in the corner of each eye. Under normal circumstances this gland is not visible and aids in the production of tears. For some reason, which is not completely understood, the gland of the third eyelid prolapses or comes out of its normal position and swells creating the condition known as cherry eye.

What dogs are likely to get cherry eye?

Any dog can develop cherry eye but there are several breeds that appear to have a higher incidence of developing it in both eyes. They are the Beagle, Bloodhound, Boston Terrier, Bulldog, Bull Terrier, Lhasa Apso, St. Bernard, and Sharpei. Dogs can acquire this condition at any age and it affects males and females equally.

What causes it?

The exact cause is not known, but it is strongly suspected that it is due to a weakness of the connective tissue that attaches the gland to the surrounding structures of the eye. The weakness of the connective tissue allows the gland to prolapse. Once the gland prolapses and is exposed to the dry air and irritants, it can become infected and or begin to swell. The gland often becomes irritated, red and swollen. There is sometimes a mucous discharge and if the animals rubs or scratches at it they can traumatize the gland further or possibly create an ulcer on the surface of the eye.

What is the treatment?

The treatment is very straightforward and consists of surgically repositioning the gland. Topical or injectable treatments of antibiotics and steroids are rarely effective in reducing the gland and allowing for correction without surgery. Because the exposed gland is at greater risk for further trauma or infection, prompt surgical replacement is the best choice.

At one time it was popular to surgically remove the gland as a way to correct this condition. While this procedure is often effective, it can create many problems later in the animals life. The gland of the third eyelid is very important for the production of tears. Without the tears produced by the third eyelid many dogs could suffer from the condition known as dry eye. Dry eye or keratoconjunctivitis sicca (KCS) is a serious condition that results from the decreased production of tears. When the third eyelid gland is removed we are greatly increasing the chances for the development of this condition. The much better and preferred surgical option is to surgically tack the gland back into place with a suture that attaches the gland to the deeper structures of the eye socket. Most of these surgeries are performed quickly and have very few complications and allow the gland to return to normal function. After the surgery some animals may need to be placed on antibiotic ointment for a few days.

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