Retrobulbuar disease
Retrobular disease encompasses any disease process occuring behind the eye. Usually the eye itself is normal and visual.
Clinical signs
Causes
Diagnostic tests
It is difficult to diagnose retrobulbar disease because you cannot see behind the eye. Often multiple modes of imaging are used.
Emergency Treatment
If the cornea is at risk of damage because the eye is pushed out, we need to stabilise this urgently. A short acting anaesthetic can be done and sutures placed in the eyelids to close the eyelids down and protect the cornea. Given the patient is already under anaesthetic, we can use this opportunity to ultrasound behind the eye and attempt to take a sample.
Medical therapy
If the cornea is not at risk of exposure some patients may benefit from a medication trial. In this situation we can use broad spectrum antibiotics and anti-inflammatory medications for 7-10 days to see if the eye improves. If there is no improvement we need to investigate further.
Should you have any questions or concerns please contact us on 03 9545 0103.
Retrobular disease encompasses any disease process occuring behind the eye. Usually the eye itself is normal and visual.
Clinical signs
- Prominent eye – the eye gets pushed outwards and turned on an angle
- Difficulty in closing the eyelids – resulting in the cornea drying out
- Pain – on opening the mouth, commonly associated with an abscess
- Discharge – watery to mucky due to inflammation
- Third eyelid elevated – caused by pressure from behind the eye
Causes
- Bacterial infection or abscessation – foreign bodies in young animals and dental disease in older animals
- Fungal infection behind the eye – not common
- Extraocular myositis in dogs
- Tumours behind the eye – more common in older patients.
- Haemorrhage behind the eye – trauma or dental extraction
- Cellulitis – inflammation behind the eye
Diagnostic tests
It is difficult to diagnose retrobulbar disease because you cannot see behind the eye. Often multiple modes of imaging are used.
- Ultrasound +/- fine needle aspirate or biopsy under general anaesthesia
- X-ray of the head +/- x-rays of the chest and abdomen
- CT scan of the head
- MRI scan of the head
- Surgical exploration of the orbit (behind the eye)
Emergency Treatment
If the cornea is at risk of damage because the eye is pushed out, we need to stabilise this urgently. A short acting anaesthetic can be done and sutures placed in the eyelids to close the eyelids down and protect the cornea. Given the patient is already under anaesthetic, we can use this opportunity to ultrasound behind the eye and attempt to take a sample.
Medical therapy
If the cornea is not at risk of exposure some patients may benefit from a medication trial. In this situation we can use broad spectrum antibiotics and anti-inflammatory medications for 7-10 days to see if the eye improves. If there is no improvement we need to investigate further.
Should you have any questions or concerns please contact us on 03 9545 0103.
