Traumatic deviation of the globe is an acute event most commonly seen in the more prominent eye dogs such as Boston terriers, shih tzus, pekingese, pugs and less frequently in collie type breeds. In the acute phase, the eye is propelled forward, extending out of the orbital socket to varying degrees. The globe may be “outside” the palpebral fissure (eyelids). The appearance can be understandably quite devastating to the owners.
THERAPY
In the acute case, the dog is presented to the veterinarians’ office at which point they would normally be anesthetized and the globe manually positioned back into the orbital socket. This is not always possible. Back in the orbital socket the lids normally will be sutured partially shut to help protect the globe (eyeball) from reoccurring proptosis. In most cases the optic nerve is so damaged from this acute trauma that vision is very rarely saved even in an acute case. There are exceptions. Time is extremely important.
When the proptosis occurs, frequently there is damage to the extra ocular muscles that hold the globe in its normal position and allow it to move. This results in a forward and lateral deviation of the globe even after the globe is put back into the orbit surgically. This is what is termed a deviated globe.
In some cases the deviation will in a matter of days to 2-3 weeks return to a more normal position. In cases where the deviation is severe, cosmetic and functional exposure problems with corneal laceration, inflammation, etc. can be very significant. The deviated globe can be surgically corrected with a procedure that involves a positioning of a nylon pulley/sling, that when tightened, pulls the globe back into a more normal position. This procedure normally needs to be performed within the first 2-3 weeks but this is also variable. Again, most of these eyes are not visual but regaining a cosmetic, non irritated eye in a normal position is quite helpful.