Services
Services
Animal Eye Center is a referral veterinary hospital whose practice is limited to diseases and surgery of the eye. Our goal is to provide the most advanced medical and surgical care available for our patients. Animal Eye Center has been serving the Sacramento and Sierra Nevada Foothill community since 1993.
Animal Eye Center (AEC) offers state of the art medical diagnostics and surgical procedures including cataract removal by phacoemulsification with intraocular lens implantation. AEC’s surgical facility is one of the few in Northern California equipped to perform Ahmed Gonioimplant and Endolaser Cyclophotocoagulation (ECP) surgeries for treatment of glaucoma.
What is a board certified veterinary ophthalmologist?
The doctors at Animal Eye Center have completed a three-year residency program in veterinary ophthalmology that has been sanctioned by the American College of Veterinary Ophthalmologists (ACVO). In addition, they have completed a rigorous written and practical certification examination to become a Diplomate of the ACVO.
Should your pet see a veterinary ophthalmologist?
Recent advances in diagnostic techniques and the development of sophisticated ophthalmic instrumentation for treating animal eye disease have increased the need for specialized care. Your primary care veterinarian may refer your pet for specialized diagnostics, advanced surgical procedures or a second opinion. In this case we will work closely with your referring veterinarian to facilitate diagnosis and treatment for your pet. In addition, clients may individually seek out advanced ophthalmic care for their pets with chronic or acute eye problems.
Conditions that may benefit from referral to a veterinary ophthalmologist include:
- Cataracts
- Glaucoma
- Eye trauma
- Uveitis (eye inflammation)
- Vision loss
- Keratoconjunctivitis sicca (dry eye)
- Ocular tumors
- Corneal ulcers
- Retinal disease
- Lens luxations
- Eyelid disorders (entropion, distichia)
Cataracts and Cataract Surgery
What is a cataract?
A cataract refers to an opacity of the lens. The lens is suspended behind the pupil opening in the eye and focuses light onto the retina. The lens opacity or cataract may be small and not affect vision or it can involve the entire lens resulting in complete blindness. Cataracts can start out as a small opacity and progress to a complete cataract. Animals can be born with cataracts (congenital) or they can develop them secondary to a genetic defect (inherited), old age (senile) or a metabolic defect (diabetic). Some cataracts develop secondary to chronic inflammation in the eye or they can occur after a severe trauma to the eye.
Currently, there is no medical treatment available to slow or prevent the formation of cataracts. Cataracts can cause severe inflammation in the eye. Treatment with anti-inflammatory drops will help prevent secondary glaucoma and improve the successful outcome of cataract surgery. If your pet has cataracts and its eyes are bloodshot you need to start therapy at once regardless of whether you want to pursue surgery to remove the cataracts. Surgical removal of the cataracts is the only treatment available to restore vision.
Is my pet a candidate for cataract surgery?
All pets with cataracts should have an evaluation with a Veterinary Ophthalmologist. There are a number of causes of cataracts including congenital, inherited, senile, diabetic, traumatic, chronic inflammation, lens subluxation, and retinal degeneration. Diagnostic tests will be performed to determine the cause of the cataracts. The longer the cataract has been present in the eye, the more inflammatory damage it can cause. Prompt referral to a Veterinary Ophthalmologist when a cataract is diagnosed is recommended even if you do not want to pursue cataract surgery for your pet. Glaucoma or increased pressure in the eye is a common complication when a cataract is present for an extended period of time. Medical therapy can alleviate pain and inflammation in the eye and lessen the need for removal of the blind eye.
Prompt referral for patients considering cataract removal will hasten treatment and increase the success rate of the cataract surgery. Examination of patients before the cataracts cause complete vision loss results in a better surgical outcome. All diabetic patients should have an ophthalmic examination as soon as the diabetes is diagnosed. Diabetic cataracts can advance rapidly and cause severe inflammation in the eye. Before undergoing cataract surgery, your pet will have a complete ophthalmic examination and a series of tests to determine if it is a good candidate for surgery. These diagnostic tests include intraocular pressure readings, gonioscopic and ultrasonic examinations, an electroretinogram (ERG), blood pressure measurement and complete blood analysis. These tests are preformed within two to three weeks of the scheduled surgery date to determine if your pet is a good candidate for cataract removal.
How is cataract surgery performed and what is the aftercare?
Cataracts are removed in most cases by phacoemulsification surgery. This involves the ultrasonic breakdown of the lens material and its aspiration out of the eye. If the lens capsule is stable an intraocular lens (IOL) will be implanted in the eye to improve immediate post-operative and near vision. The decision to insert an IOL is at the discretion of the surgeon. The surgery is performed with the patient positioned under an operating microscope using delicate instruments and state of the art phacoemulsification equipment. The patients are monitored closely under anesthesia by a veterinary technician. The surgery takes 60 to 90 minutes per eye. Patients go home the day of surgery and are re-evaluated the next morning. They will wear an Elizabethan collar for 10 to 14 days to prevent them from rubbing or bumping their eyes. Patients require medication with eye drops four to six times daily as well as oral medications once to twice daily. Frequent re-examinations are required for the first three weeks then every three months for the first year followed by yearly rechecks. Strict patient compliance concerning post-operative therapy and re-examination is imperative for long-term maintenance of vision. Cataract removal surgery is successful in 97% of cases. However, complications including retinal detachment, chronic inflammation, glaucoma, intraocular bleeding and vision loss can occur.
Glaucoma: Medical and Surgical Treatments
What is glaucoma?
Glaucoma is an increased fluid pressure in the eye. Normal intraocular pressures (IOP) are below 25 mmHg. When IOP increases over 40 mmHg, severe damage to the retina and optic nerve occurs, and the eye can lose vision within 24 hours. Eyes have a continual production and drainage of fluid or aqueous humor within the eye. Glaucoma occurs as an inherited defect of the drainage angle where the aqueous humor flows out of the eye. The fluid pressure within the eye increases rapidly if there is an acute blockage. Glaucoma can also occur secondary to blockage of aqueous flow within the eye due to inflammation, intraocular tumors or lens luxations. Acute glaucoma will cause the eye to be bloodshot and cloudy in appearance. The pupil may be dilated and the eye is painful, causing the pet to squint. Vision loss from the eye occurs when the intraocular pressure (IOP) is higher than 40 mmHg. If your pet has any of these symptoms, seek treatment immediately.
Medical treatment for glaucoma
Medical therapy for glaucoma includes IV or oral medication to reduce the pressure in the eye quickly in hopes of restoring vision. A combination of drugs that open the drainage angle and reduce production of aqueous humor are then used to try to keep the pressure in normal range. Some animals will respond to medical therapy for a period of time but eventually medical therapy fails. Surgical treatment may be recommended for animals with potential to retain vision.
Surgical treatment for glaucoma
There are two primary surgical treatments for glaucoma in patients who have not lost their vision. The first surgery involves placing a gonioimplant in the eye to drain aqueous humor out of the eye and into the subconjunctival space. The Ahmed valve device has a small silicon tube that is placed in the anterior chamber of the eye allowing aqueous humor to exit the eye through a valve and across a plate that is sutured to the eye under the conjunctival tissue. These valves can keep the pressure in the eye below 12 mmHg for a period of time ranging from weeks to over a year. They eventually fail due to the formation of scar tissue over the implant. When this occurs, it is recommended to proceed with a second surgery to reduce aqueous production in the eye.
Endolaser cyclophotocoagulation (ECP) combined with phacoemulsification of the lens and an intraocular lens implant surgery can be 80% effective in long-term management of glaucoma. When successful it can also decrease or eliminate use of most of the costly glaucoma medications. The endolaser procedure destroys the majority of the tissue that produces the aqueous humor thus decreasing the amount of fluid that has to exit the eye. In some animals the aqueous producing tissue can regenerate causing the IOP to increase again over time and additional endolaser therapy is needed. ECP can also be used prophylactically on animals undergoing cataract surgery that are at risk of developing glaucoma secondary to abnormal drainage angles. Not all animals are good candidates for these procedures and your veterinary ophthalmologist can best determine which pets will benefit from surgical therapy. Possible complications of the surgeries are intraocular bleeding, inflammation, infection, retinal detachment and ineffective control of IOP resulting in vision loss. However, even with the possible complications, ECP surgery is currently the best long-term treatment choice for sighted glaucomatous eyes.
For chronic glaucomatous eyes that are blind and painful, enucleation and orbital prosthesis surgery is recommended. Pharmacologic destruction of aqueous production with an intravitreous injection is also a surgical procedure that can reduce IOP and alleviate pain in glaucomatous eyes.