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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7746
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hello, So I have pretty much thrown my hands in the air with

Resolved Question:

Hello,
So I have pretty much thrown my hands in the air with my dogs eye issue. She has always had big pupils but recently I have noticed her squinting when outside or even looking outside through a window. It got worse last week when I noticed green gunk coming from both of her eyes and both eyes were bloodshot as well. I took her to my work, thank god I work at a vet, and they ran many tests on her. Tear tests came out normal. Stain tests indicated that she had scars (from years ago when my cat wacked her in the face) that had nothing to do with her issues now and they don't bother her anyways, so no cataracs. The vet did notice that her pupils are abnormally dilated and it seems that she is almost blind in her left eye, but can see fine in her right. Now here comes the odd part, the pressure test indicated that her eyes were reading 8 and 9. The vet explained that this is odd because her symptoms, without the pressure test, are indicating glaucoma because of the dilation, BUT because of her eye pressure it is indicating uvetis or similar diseases. The vet was puzzled because she had dilation with soft eyes.

I've tried calling eye specialists, for both humans and animals, googling, Wed MDing, asking friends and family and no one has given me any answers. Can anyone help me here?

I should add that my vet prescribed 2 different medications for my dog. First a gel, Neomycin/PolymyxinB Sulfates & Dexamethasone Drops, to be applied 3 times a day for 5 days then 2 times until "recheck". Second a drop, Flurbiprofen Sodium, to be applied once a day 10minutes after the gel has been applied.

Since on the medications, the redness has gone away and the green gunk is gone however her eyes are still dilated and still having sensitivity to light. HELP!
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Rick replied 2 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Thank you for that excellent history.

Dr. Rick :

First off I would put the drops in five minutes before the gel. It is good that the gunk and redness have gone away but, as I'm sure you have already surmised, this therapy is not really getting at the underlying pathology.

Dr. Rick :

Lets take some of possible conditions one at a time. There is more to glaucoma then elevated pressure. It is possible that your dog has had glaucmoma for quite some time now and has reached a "burned out" stage where the pressure is now low because the eye is so damaged. Another possibility is that the measurements obtained were in error.

Dr. Rick :

Another possibility is optic nerve damage along with damage to the nerves that cause the pupil to constrict, say from infection, trauma, tumors, inflammation, systemic disease. This could, possibly cause the sever loss of vision combined with the dilated (?fixed and non reactive???) pupils.

Dr. Rick :

My screen shows you are in the chat room. Are you at your computer?

Dr. Rick :

Intraocular inflammation (Uveitis) could explain the loss of vision, the red eyes and the dilated pupil (from the inflammation "sticking" the pupil open)......

Customer:

Yes I am, sorry just reading what you are saying. Like I said before I have had noticed in the past that her pupils were dilated but with no other issues until recently with the light sensitivity.

Dr. Rick :

Uveitis sure would explain a lot of her findings and symptoms. However, the only way to really know what is going on would be for your dog to have a complete eye exam by a veterinary ophthalmologist. I know they can be hard to find but I would expect that most veterinary teaching programs would have one and I know that there are veterinary eye docs in private practice, mostly in very large cities and, of course, California.....

Dr. Rick :

I am encouraged that she has shown improvement in her redness and "gunk". Have you noticed any improvement in her light sensitivity with the current therapy?

Customer:

Yes me too, actually looking at her now all redness is gone so that I am happy about.. however, she still has that light sensitivity to the outside sun. She is fine indoors and with lower lighting. Both are still dilated... I may add that the vet said her right eye seems to be fine, besides the dilation and light sensitivity, while her left is almost completely blind now.

Dr. Rick :

One other thing? How old is your dog and what breed?

Customer:

She is 11, so an "elderly" dog.. and she is a mix, Black lab and Whippet.

Dr. Rick :

Was the vet able to look inside your dog's eyes with the "eye thing" (direct ophthalmoscope) they always buy to hang on the exam room wall?

Customer:

Yup, she even said that she could see right to the back of her eye.

Dr. Rick :

ok, that is good. Well, at this point it sounds like she is more comfortable even if she is still having problems with outdoor lighting. If I was in your shoes (and I

Dr. Rick :

've had a number of old dogs in my life....have 3 right now, plus horses, plus cats, plus daughters :) I'd have to ask myself how much I wanted to put my dog through to come up with a diagnosis that may be either 1. not able to be treated at this point. 2. Is painful to treat or 3. Would cost more then a years worth of mortgage payments.

Dr. Rick :

If you wanted to go full court press on this one then I recommend an complete eye exam by a veterinary ophthalmologist at a University teaching Veterinary hospital.

Dr. Rick :

I took my horse to The Univ. of Mn vet school when I was a teenager when he tried to cut of his leg with barb wire so I know exactly what you are going through....been there and done that.

Customer:

That is why I came here! HAHA! I have been already referred to 4 different doctors the past week and it's driving me mad! I pay for visits that all just come out with the same answer. My work vet did say that it wasn't urgent, as it does seem she has had this issue for quite sometime without me even noticing it until it got bad. I would like to help my dog though, at least be able to save her right eye.

Customer:

I live in the Boston area.. I know there's got to be someone around here that can help me out.

Dr. Rick :

I know exactly what you are saying.....Actually, I was an Animal Health Tech when I was in HS and college.....only went to medical school 'cuz my girlfriend transferred to a college that didn't have a vet school lol!

Dr. Rick :

There has to be an excellent veterinary teaching program somewhere close to you.......

Dr. Rick :

I'm sorry I couldn't do more then give you a run down of possible diagnosis and options, but hopefully I've been of some service.

Dr. Rick :

On the positive side you sure are going above and beyond the call of duty for your friend...and already she is feeling better.

Customer:

Yes and thank you so much, all of the different eye diseases make a little more sense to me. There seems to be so many, haha. I do have one last question, if I was to go in the deep end and eventually find an eye specialist, do you know what kinds of tests they would do on her? Money really isn't an issue...yet.. I would hate to see her go blind.

Dr. Rick :

They would first sedate her so that they could examine her with a human slit lamp that is specially set up for animals (I've seen pictures of the setup at meetings....), Then they would use special lenses to look at her retina, optic nerve, maybe her outflow channels (gonioscopy) and lens (cataracts). They may also do special tests with special drops to see how the nerves/muscles that open and close the iris are functioning.

Dr. Rick :

In humans and ERG (tests function of retina ) and EOG (tests function of eye and brain connection), angiogram, MRI, artery ultrasound, blood tests may also be done. I'm not sure if they do this in animals.

Customer:

Okay, well those don't sound too horrifying. As long as they don't cut her eyes apart to tell me that she was born with it and they can't do anything, lol. I can handle a few bloodtests or eye proding but please don't cut her eye up and say "oops" to me. (;

Dr. Rick :

I know the Texas A&M and Univ. of Wisconsin, Madison have some of the worlds best veterinary teaching programs.....I'd as your boss (she's a vet, right?) for some recommendations on where to go

Dr. Rick :

No. Don't think any cutting will be involved :)

Dr. Rick :

Although you know how us surgeons are....we LOVE to cut LOL!

Customer:

LOL That is so, soooo true! (; Thanks again for your time, hopefully I will find out what is wrong with her. Who knows maybe she'll be on The Today Show and all you eye specialists will have a new disease to read about HAHA

Dr. Rick :

Sounds like a plan! Have a good evening. And if you do find out what is going on please drop me a line on this thread. I'd love to hear how things turn out. Goodnight.

Dr. Rick :

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Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7746
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 2 years ago.
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Expert:  Dr. Rick replied 2 years ago.
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