Running head: GLAUCOMA 1

Glaucoma

Elyssa Schwarz

VET 121a

Dr. Laurie Wright

August 10, 2016

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Glaucoma

Glaucoma is a very serious eye disease that affects many different animals, including

dogs, cats, and horses. However, some breeds are more susceptible than others. In dogs, breeds

such as the American Cocker Spaniel, Basset Hound, Chow Chow, Akita, Chinese Shar-Pei,

Norwegian Elkhound, and Samoyed often are affected. (Gelatt, 2013). Even with treatment, this

disease can have devastating effects on the animal.

Discussion

Glaucoma is a disease that causes the pressure in the animals eye to increase. This is

caused when the amount of aqueous fluid entering the eye exceeds the amount that is leaving.

This can lead to permanent vision damage and is deemed a true emergency (Summers, 2014).

In many animals, such as the dog breeds listed above, the disease is an inherited, or primary,

condition that affects both eyes. It can also occur as a secondary disease as a result of the animal

having inflammation, trauma, or tumors on its eye. The prognosis is considered guarded, with

the best results occurring if the disease is caught early on and treated properly. (Cornell

University, n.d.). However, the disease is progressive and will require lifelong treatment

(Summers, 2014).

History

When an animal has glaucoma, there can be multiple indications that they are sick.

Owners may notice that their dog has a lot of eye pain as the dog may turn away from them when

they try to touch the side of his head. There also can be a watery discharge from the eye along

with swelling and bulging of the eyeball. The sclera, the white part of the eye, may turn red, and

the cornea may turn a blue color and become cloudy. (VCA, n.d.). Also, blindness can result if

the disease is not treated immediately. If the pressure is not brought down quickly, the chronic
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blind eye will be unresponsive to treatment, and we can only try to make the animal comfortable.

(Summers, 2014).

In order to detect glaucoma early on, tonometry should be performed annually on dogs

that are at a high genetic risk. (Gelatt, 2014). As a result of the disease complications, the animal

will often experience a lens displacement, pain-induced behavioral changes, and prolonged

increase in intraocular pressure (Gelatt, 2014). Owners are warned to bring their pet in for an

exam as soon as they notice their pet has a red, swollen, and painful eye. If they dont their

animal may become permanently blind. (Summers, 2014).

Diagnostic Workup

Glaucoma is diagnosed by tonometry, which is using a tono-pen or a Schiotz tonometer

to measure the intraocular pressure of the eye. We can also use ophthalmoscopy or gonioscopy to

diagnose the disease. Gonioscopy detects outflow changes as the disease progresses, and tells us

the best treatment to use. (Gelatt, 2014). With the tono-pen, the intraocular pressure will be

higher than 30 mm Hg, when normal pressure in dogs and cats is 12 to 22 mm Hg. We can also

diagnose an animal with glaucoma by taking all the clinical signs into consideration, and by

ruling out lens luxation. (Summers, 2014).

Physical Exam

In an animal that has glaucoma, the clinical signs will be noted in the physical exam, but

there will also be other symptoms the owners dont notice that vet techs have to find. These

symptoms are usually divided into acute and chronic symptoms. Acute symptoms can have an

intraocular pressure of over 60 mm Hg, and can cause blindness within a few hours. Some of the

other acute symptoms are ocular pain, vascular congestion, corneal edema, and dilated and
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unresponsive pupils. The chronic symptoms usually appear more gradually, and can include an

enlarged globe, corneal striae, optic disk cupping, ocular pain, and blindness. (Summers, 2014).

When the animal is examined, the we see the intraocular pressure numbers, and this is a

large indication that the animal has glaucoma. We also will notice the red, swollen, and painful

eye(s) and possibly blindness. Blindness is not always obvious without the physical exam,

especially if an animal is only blind in one eye.

Treatment

The treatment is usually both medical and surgical. Drugs are given to control the

pressure, and surgery is usually performed to reduce pressure, and make the animal more

comfortable. (Cornell, n.d.). For acute glaucoma, the animal is usually treated with analgesic

drugs which control the pain and discomfort (VCA, n.d.). A few drugs that are used are:

Lantanoprost, IV mannitol, Oral dichlorphenamide, Topical pilocarpine, or Timolol (Summers,

2014). The surgical procedures that are usually performed include transscleral cryosurgery and

laser cyclophotocoagulation. However, these procedures often cause permanent blindness in the

animal. Another alternative, although expensive, is a procedure that increases the aqueous fluid

outflow. (Summers, 2014).

Treatments for chronic glaucoma are usually aimed to relieve the pain from blind eyes.

These treatments include enucleation, intraocular evisceration with an implant, and ciliary

ablation using gentamicin intravitreal injection. Enucleation is the removal of the affected eye.

This will relieve the severe pain that results from glaucoma, and will greatly improve the

animals quality of life, (Summers, 2014).

Glaucoma clearly is a very serious disease. Owners need to be aware of how their pets

eyes look, so that they are able to detect changes that may be serious. If left untreated, glaucoma
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is very painful, and the animal may become permanently blind. We need to make sure we are

paying attention, so that we can catch this serious disease in the early stages, when treatment is

the most successful.

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References

College of Veterinary Medicine - Cornell University. (n.d.). Retrieved August 9, 2016, from

http://www.vet.cornell.edu/hospital/Services/Companion/Ophthalmology/conditions/

Gelatt, K. N. (2014, June). Glaucoma. Merck Veterinary Manual. Retrieved from

http://www.merckvetmanual.com/mvm/eye_and_ear/ophthalmology/glaucoma.html?qt=g

laucoma&alt=sh

Glaucoma in Dogs. (n.d.). Retrieved August 9, 2016, from

http://www.vcahospitals.com/main/pet-health-information/article/animal-

health/glaucoma-in-dogs/767

Summers, A. (2014). Common Diseases of Companion Animals (3rd ed., pp. 83-84). N.p.:

Elsevier.