Veterinary Ophthalmology is a highly developed science. Yet, there are only a few hundred veterinary ophthalmologists in the US in contrast to tens of thousands of human ophthalmologists. Until now, Hawaii has only one board certified ophthalmologist to see to the needs of hundreds of thousands of pets. The veterinarians at Gentle Vets have pursued extensive further education in veterinary eye care to make advanced eye care readily available. We have developed extensive experience with the eyes, especially the lids, the cornea and the anterior chamber as well as in glaucoma therapy.

Veterinary eye care specialists divide the eye into sections for diagnosis and therapy, although all are inter-related. The most common problems with the eye are corneal abrasions and ulcerations. The treatment may include special medications for the cornea or surgery. There are two common surgeries, depending on the depth and character of the lesion. Both are designed to protect the cornea while it heals. These are membrana nictitans or third eyelid flaps and conjunctival flaps. The third eyelid flap is relatively easy to perform and results in reasonable protection of the cornea but does not offer blood supply as does a conjunctival flap. The conjunctival flap is much more difficult to perform but offers excellent blood supply as well as protection of deeper and potentially penetrating ulcers. This surgery must be performed with the use of magnification, either loupes or a special operating microscope since the suture material is 1/3 the thickness of human hair and is almost invisible to the naked eye. Special medicated contact lenses can also be used. Many times surgery can be avoided through the intensive use of special medications.

Another common problem is dry eye or keratitis sicca. Unfortunately this problem, caused by lack of production of sufficient tears, is usually permanent although there are some medications and surgery that can significantly improve the outlook. In addition to medical therapy we can perform a surgery to provide “tears” to the eye by trans-positioning the salivary duct. Every time your pet thinks about food, his eyes will get a refreshing bath of saliva to keep the cornea healthy! We have had excellent success in improving many eyes suffering from this condition. A newer surgery, transplantation of cheek tissue to the conjunctive, learned from the leading ophthalmologist in Japan, may be even more effective than parotid duct transplantation.

The next deeper layer is the anterior chamber and iris or uvea. This is where glaucoma usually gets started. The eye is constantly producing and draining fluid. If the drainage stops or there is too much fluid produced, the eye swells and the pressure rises. This can quickly lead to retinal detachment, optic nerve degeneration, blindness and the loss of the eye. Glaucoma is a critical eye emergency with a very guarded prognosis. Therapy needs to be started immediately -NOW – if it a good outcome is desired. Since we at Gentle Vets see emergencies 24/7, we can get started on saving your pets eyes immediately. The main sign of this disease is very red eyes, or perhaps bulging of the eyes. Although all dogs and cats can get glaucoma, certain breeds such as samoyeds, beagles, bassetts and cocker spaniels are pre-disposed to this condition and should have their intra-ocular pressure routinely examined. If you suspect your pet has glaucoma, please call to let us know you are coming – today, now! We will work hard to save the eyes. We will start by measuring the pressure in the eyes to confirm the diagnosis. Then we will begin intensive therapy to save the eye.

Behind the iris is the lens. Many older dogs have a whitish haze to their lens called nuclear sclerosis. Many times this is just old-age hardening of the lens. This is due to the same process that happens to people as they age and need reading glasses. Sometimes, however, the whitish change of the lenses is due to cataract formation. Many times cataracts form secondary to metabolic diseases such as diabetes so it is important for us to run checks on your pet’s general health to find any of these underlying causes. A thorough examination with special equipment such as a Finoff transilluminator or a slit lamp will help define the exact problem with the lens. Just as in humans, cataracts can often, though not always, be corrected. The lens is carefully removed with the use of special equipment and often replaced with an artificial lens.

Your pet could possibly be returned to perfect vision. The surgery is not without complications and it is essential that your pet tolerate eye and other medications as these will be necessary for a successful outcome.

Retinal surgery is the most difficult of eye surgeries. Retinas can sometimes be re-attached with special laser surgery. The use of these surgeries is quite limited although there have been some success stories.

If the eye is lost to vision, we can sometimes maintain the cosmetic appearance through the use of intra-ocular implants. These allow the eye to remain completely normal in appearance. If that is not possible, orbital prosthesis allow removal of the eye without having a sunken appearance and maintaining reasonable cosmetic appearance. One good thing in pets that lose an eye is that since they depend so much on smell and sound, it is often not possible to even detect that a pet is actually blind. We have one feline patient that lost both eyes while young due to a Herpes infection. George is absolutely blind as he has no eyes. Yet he runs around the house jumping onto countertops and cutting around corners chasing and playing with his housemates. Interestingly George has huge ears, possibly developed since he lost his eyes while very young. Although we can often achieve excellent success in saving eyes and vision, it is good to know that pets can do pretty well without eyes.

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