Diagnosis and Surgico-Therapeutic Management of Anterior Segmental Ocular Affections in Dog

Introduction

Dogs were the earliest domesticated animals and have evolved from hunting companions to valued protectors and emotional companions of humans. Vision plays a crucial role in their interaction with the environment and with humans, influencing behaviour, navigation, social communication, and survival. Any impairment in vision can significantly affect a dog's behaviour and quality of life, often resulting in hesitation, collision with objects, and difficulty adapting to unfamiliar surroundings. Therefore, maintenance of ocular health is essential for the well-being of dogs. The eye is a highly specialized sensory organ often compared to a biological camera because of the coordinated functioning of its components that enable vision. Light enters through the pupil, is focused by the lens on to the retina, and the resulting impulses are transmitted to the brain through the optic nerve to produce visual perception. Even minor disturbances in ocular homeostasis caused by trauma, infections, metabolic disorders, or systemic diseases can adversely affect ocular function (Scountzou, 2003) [16] .

Ocular disorders form an important component of small animal clinical practice, and studies on these conditions provide valuable information regarding their prevalence and distribution among different breeds, ages, and sexes. In dogs, the globe is particularly susceptible to trauma due to the incomplete bony orbit (Magrane, 1971) [10] , and ocular injuries may accompany generalized trauma and remain unnoticed during initial clinical examination (Bachrach, 1992) [1] . Early diagnosis and appropriate management are therefore essential to prevent permanent vision loss. Anterior segmental ocular affections involve structures such as the eyelids, third eyelid, conjunctiva, sclera, cornea, anterior chamber, and iris. These conditions may require medical or surgical intervention depending on severity. Disorders such as proptosis, eyelid tumours, eyelid lacerations, cherry eye, and deep corneal ulcers often require surgical correction, whereas conditions like conjunctivitis, corneal opacity, superficial ulcers, and keratitis are commonly managed medically. Accurate diagnosis based on careful ophthalmic examination is critical, as empirical treatment without proper diagnosis may lead to poor therapeutic outcomes (Mould, 1993) [12] . Inadequate diagnosis and treatment may also result in chronic ocular conditions that persist throughout the animal's life. Advances in veterinary ophthalmology have improved the diagnosis and management of ocular disorders in dogs through the use of specialized diagnostic tests such as ophthalmoscopy, slit-lamp biomicroscopy, tonometry, ocular ultrasonography, Schirmer's tear test, fluorescein dye test, and neuro-ophthalmic reflex evaluations. These techniques enable accurate assessment of ocular health and facilitate appropriate medical and surgical interventions. In view of the increasing importance of ocular health in companion animals and the need for effective diagnostic and therapeutic approaches, the present study entitled "Diagnosis and Surgico-Therapeutic Management of Anterior Segmental Ocular Affections in Dogs" was undertaken to evaluate various anterior segment ocular disorders in dogs using standard diagnostic procedures and to assess appropriate medical and surgical management strategies with the following objectives:

Objectives of the study 1. To determine the incidence of anterior segmental ocular affections in dogs. 2. To standardize the diagnostic and surgico-therapeutic approach for their effective management.

Materials and Methods

The study was conducted at the Department of Veterinary

Physiological assessment

Physiological parameters including rectal temperature (°F), conjunctival mucous membrane colour, and heart rate (beats/min) were recorded on the 0 th day and subsequently on the 3 rd and 7 th day during the study period.

Anamnesis

Detailed case histories were recorded for all 36 dogs, including breed, age, sex, laterality of involvement, clinical signs, and any previous treatment undertaken. Information regarding onset and progression of ocular signs was obtained from the owners to aid in diagnosis and therapeutic planning.

Clinical evaluation A. Ophthalmic Examination

A detailed ophthalmic examination was performed in all selected cases to confirm the diagnosis. Complete history including signalment, duration of illness, clinical signs, and previous treatment was recorded. Examination was conducted in a well-illuminated room using direct and indirect ophthalmoscopy. Neuro-ophthalmic assessment was performed, and only cases without neurological deficits were included in the study.

B. Gross examination

Both eyes and periocular regions were examined by visual inspection and palpation. The eyelids, conjunctiva, adnexa, and globe were evaluated for vision status, signs of pain, irritation, swelling, discoloration, and ocular discharge. Vision was assessed behaviorally through obstacle avoidance and menace response. Ocular pain and irritation were identified by blepharospasm, photophobia, lacrimation, and pawing at the eyes. Swelling was graded as mild, moderate, or severe.

Corneal color and transparency were noted, and discharge was classified as serous, mucoid, purulent, or hemorrhagic.

C. Neuro-Ophthalmic Examination

Neuro-ophthalmic examination was performed to rule out neurological causes of visual impairment following standard procedures (Maggs, 2008) [9] . The menace reflex was assessed by making a sudden threatening hand gesture toward each eye separately without creating sound or air currents, and the blink response was recorded (Fig. 1). The pupillary light reflex (PLR) was evaluated using a focused beam of light from a pen torch to observe direct and consensual pupillary constriction.

The palpebral reflex was tested by gently tapping the medial canthus and noting eyelid closure (Fig. 2). The dazzle (photic blink) reflex was examined by directing a bright light into the eye and observing the blink response. Functional vision was assessed using the maze/obstacle test, in which the animal's ability to navigate around obstacles was observed and recorded (Fig. 3). Responses in all tests were graded as positive, sluggish, or negative.

D. Special Diagnostic Tests

Special diagnostic tests were performed on the day of presentation and during follow-up as required. The schirmer tear test (STT) was performed by placing a sterile tear strip in the lower conjunctival fornix for one minute, and tear production was recorded in mm/min and interpreted as normal, mild, moderate, or severe keratoconjunctivitis sicca, while values above normal indicated epiphora (Fig. 5). The fluorescein dye test was conducted by applying a moistened fluorescein sodium strip to the conjunctiva to detect corneal epithelial defects; retention of dye indicated corneal ulceration (Fig. 6). The rose bengal test was performed by applying a pre-wetted Rose Bengal strip to assess devitalized epithelial cells and tear film instability, where reddishpink staining indicated ocular surface damage. Tonometry was carried out using applanation tonometry (Tono-Pen) after topical anesthesia to measure intraocular pressure (IOP) for the diagnosis of conditions such as glaucoma.

E. Haematological and biochemical investigation

Haematological parameters including haemoglobin (Hb), total erythrocyte count (TEC), total leucocyte count (TLC), and packed cell volume (PCV) were evaluated on the 0 th , 3 rd , and 7 th day to assess systemic involvement and therapeutic response. Serum biochemical analysis was performed by estimating mean blood glucose (mg/dl) levels at similar intervals to monitor metabolic status and systemic response during treatment.

F. Microbiological Examination and Antibiotic Sensitivity Test

Microbiological examination was conducted in selected cases to identify causative organisms and determine antimicrobial sensitivity.

Conjunctival swabs were aseptically collected from the lower conjunctival sac and subjected to microbial isolation and culture sensitivity testing to guide appropriate antibiotics therapy (Fig. 4).

G. Anaesthesia and Preparation of Animal

All dogs were premedicated with atropine sulphate (0.02 mg/kg SC), followed by intramuscular administration of xylazine (1 mg/kg) and butorphanol (0.2 mg/kg) for sedation. An intravenous catheter was secured, and crystalloid fluids (normal saline or Ringer's lactate) were administered at 10 ml/kg/hour during surgery. Anaesthetic induction was achieved using midazolam (0.2 mg/kg IV) and propofol (4 mg/kg IV), followed by endotracheal intubation. Anaesthesia was maintained with propofol (4 mg/kg IV). Topical ocular analgesia was provided using 0.5% proparacaine hydrochloride. Anaesthetic depth and vital parameters were monitored at 5-minute intervals throughout the procedure. Dogs were positioned in lateral recumbency with the affected eye uppermost and the head supported. The periocular hair was clipped, the area aseptically prepared with povidoneiodine, and the conjunctival sac cleansed with diluted povidone-iodine followed by saline rinse. The site was then draped with a sterile ophthalmic drape to prevent contamination.

H. Surgico-therapeutic approach applied for various ocular affections: Depending upon the type of affection suitable therapeutic and surgical protocol under general anesthesia will be followed.

Statistical Analysis

The data recorded at scheduled intervals (0 th , 3 rd , and 7 th day) for 36 cases were analyzed using standard statistical procedures as described by Snedecor and Cochran (1994).

Results and Discussion

The study on anterior segmental ocular affections in dogs was conducted at the Veterinary Clinical Complex, PGIVAS, Akola, from February 2025 to January 2026. Of 928 canine surgical cases, 36 dogs with anterior segmental ocular disorders were selected for detailed evaluation. Cases underwent systematic ophthalmic examination and were managed medically or surgically as indicated. Incidence, clinical findings, and therapeutic outcomes were analyzed and compared with existing literature. [11] .Fluorescein dye test was positive in four cases confirming corneal ulceration, and applanation tonometry detected elevated intraocular pressure (35 mmHg) in one case confirming glaucoma and aiding therapeutic monitoring (Thompson-Hom and Gerding., 2012) [18] .

Anamnesis

Microbiological Examination and Antibiotic Sensitivity Test

Conjunctival swabs collected from five cases of corneal ulcer and purulent conjunctivitis prior to topical medication revealed bacterial growth in three cases. Staphylococcus aureus was the predominant isolate, followed by Escherichia coli and Streptococcus spp., which are commonly reported pathogens in canine corneal infections. Antimicrobial susceptibility testing showed high sensitivity to moxifloxacin, gentamicin, and tobramycin, with gentamicin demonstrating consistent efficacy against both staphylococcal and streptococcal isolates (Ollivier, 2003) [13] . Gentamicin showed consistent efficacy against both staphylococcal and streptococcal isolates, aligning with findings of Deepika et al.

Haematological and biochemical investigation

Haematological parameters (Hb, TEC, TLC, and PCV) recorded on days 0 th , 3 rd and 7 th remained within normal physiological limits with no significant variations, indicating minimal systemic involvement in anterior segmental ocular affections, similar to the findings of Aaditya (2021). Serum glucose levels were also within normal limits in most cases, except for transient hyperglycaemia observed in the glaucoma case, which normalized following therapy, suggesting that these ocular disorders are primarily localized and have little effect on systemic haematological or biochemical status, although glucose monitoring remains clinically relevant (Lee et al., 2022) [8] .

Clinical application of the surgico-therapeutic approaches employed for the management of various ocular affections in dog.

The present study demonstrated that appropriate surgicotherapeutic interventions can effectively restore ocular health and preserve vision in most anterior segmental ocular affections in dogs. Surgical correction proved particularly beneficial in structural disorders of the eyelids and adnexa. Cherry eye was successfully managed in the majority of cases using Morgan's conjunctival pocket technique, which allowed gland preservation and prevented postoperative keratoconjunctivitis sicca, while recurrent cases were effectively treated by gland excision (Gupta et al., 2016) [6] , (Fig. 8). Similarly, entropion was corrected using the modified Hotz-Celsus technique, resulting in complete restoration of eyelid conformation without recurrence or complications (Fossum, 2019) [3] . Traumatic ocular conditions required prompt surgical decision-making depending on globe viability. In proptosis cases, eyes with irreversible damage were treated by enucleation, whereas a viable globe was successfully repositioned with temporary tarsorrhaphy, emphasizing that early surgical intervention plays a critical role in determining prognosis and visual preservation (Kumar et al., 2015) [7] , (Fig. 9). Surgical management also proved effective in localized eyelid conditions such as eyelid laceration and eyelid growth, where blepharoplasty with primary suturing or excision restored eyelid integrity and function with uneventful healing (Gelatt., 2011) [4] . Corneal disorders were primarily managed through a combination of medical and supportive therapies. Superficial corneal ulcers responded well to topical antimicrobial and anti-inflammatory treatment, whereas deep ulcers required surgical support using a third eyelid flap with temporary tarsorrhaphy to promote corneal healing and prevent further damage (Maggs et al., 2008) [9] . Corneal opacity was successfully managed using a sequential conservative protocol including topical antibiotics, NSAIDs, hypertonic saline, lubricants, and corticosteroids after epithelial healing, which resulted in gradual improvement in corneal transparency (Ramani et al., 2013) [15] . Inflammatory and allergic ocular conditions were effectively treated with appropriate medical therapy. Periocular allergic dermatitis and allergic conjunctivitis responded favorably to topical antihistamines and lubricating tear substitutes, while purulent conjunctivitis showed complete recovery following topical antibiotic therapy based on antimicrobial sensitivity testing (Gerding et al., 1988) [5] . Blepharitis associated with ectoparasitic infestation responded well to eyelid cleansing, topical medications, and ivermectin therapy, confirming the importance of addressing the underlying cause (Gelatt, 2011) [4] . Similarly, chemosis, being a superficial conjunctival condition, resolved successfully with topical antimicrobial therapy. Certain intraocular conditions required targeted medical management to control inflammation and maintain ocular function. Hyphema was managed conservatively with topical corticosteroids and atropine sulphate, resulting in gradual clearance of intraocular hemorrhage and preservation of vision (Tuntivanich, 2007) [19] . Hypopyon associated with anterior uveitis responded well to topical antibiotics, antiinflammatory therapy, and cycloplegics, preventing further complications (Maggs et al., 2008) [9] . In the case of glaucoma, elevated intraocular pressure was effectively controlled using a combination of systemic acetazolamide and topical timolol and dorzolamide, which reduced pain and improved corneal clarity (Plummer et al., 2013) [14] . Advanced ocular pathology such as ocular lymphoma required definitive surgical intervention. In the present study, a case of advanced ocular lymphoma with globe autolysis was successfully managed by transpalpebral enucleation with exenteration, and histopathological examination confirmed the diagnosis (Fig. 10). This hihlights the importance of surgical removal in advanced neoplastic conditions where visual function is already compromised (Maggs et al., 2008) [9] . Diagnosis of ocular lymphoma is confirmed by histopathological examination, which reveals neoplastic lymphoid cell infiltration and tissueg architecture distortion. Further confirmation is achieved using immunohistochemistry (IHC), where B-cell markers such as CD79a show strong cytoplasmic positivity, establishing the lymphoid cells' origin. The characteristic staining pattern helps differentiate B-cell lymphoma from other ocular neoplasms (Fig. 11 &12). Overall, the findings of the present study indicate that early diagnosis, appropriate surgical correction, and targeted medical therapy are essential for the successful management of ocular affections in dogs. The combined surgicotherapeutic approach not only alleviated clinical signs but also ensured preservation of ocular function and favorable prognosis in the majority of cases.

Acknowledgement

AcknowledgementThe authors express their sincere gratitude to the faculty members of the Department of Veterinary Surgery and Radiology and to the Dean of the Post Graduate Institute of Veterinary and Animal Sciences (PGIVAS), Akola, for providing the necessary facilities and support to carry out this research work successfully.

References

1. Bachrach A Jr. Ocular emergencies. In: Kaplan PM, editor. Veterinary Emergency and Critical Care Medicine. Vol 1. St. Louis: Mosby Publishing; 1992. p. 273-282.
2. Deepika A, et al. Antibiotic sensitivity and cultural pattern of bacteria in deep corneal ulcers in dogs. Pharma Innovation Journal. 2022;11:1178-1180.
3. Fossum TW. Small Animal Surgery. 5th ed. St. Louis: Elsevier; 2019. p. 279.
4. Gelatt KN, Brooks DE. Surgery of the cornea and sclera. In: Veterinary Ophthalmic Surgery. Philadelphia: Elsevier Saunders; 2011. p. 191-236.
5. Gerding PA, McLaughlin SA, Troop MW. Pathogenic bacteria and fungi associated with external ocular diseases in dogs: 131 cases (1981-1986). J Am Vet Med Assoc. 1988;193(2):242-244.
6. Gupta AK, et al. Management of cherry eye using different surgical techniques: A study of 10 dogs. Intas Polivet. 2016;17(2):411-414.
7. Kumar A, et al. Surgical management of traumatic proptosis in dogs: A report of five cases. Indian J Vet Surg. 2022;43(2):279-280.
8. Lee E, et al. Quantification of tear glucose levels and their correlation with blood glucose levels in dogs. Vet Med Sci. 2022;8(4):1816-1824.
9. Maggs DJ, Miller PE, Ofri R, editors. Slatter's Fundamentals of Veterinary Ophthalmology. 4th ed. St. Louis: Saunders Elsevier; 2008.
10. Magrane WG. Canine Ophthalmology. 2nd ed. Philadelphia: Lea and Febiger; 1971.
11. Morreale RJ. Corneal diagnostic procedures. Clin Tech Small Anim Pract. 2003;18(3):145-151.
12. Mould J. Conditions of the orbit and globe. In: PetersenJones SM, Crispin SM, editors. Manual of Small Animal Ophthalmology. 3rd ed. Gloucester: British Small Animal Veterinary Association; 1993. p. 45.
13. Ollivier FJ. Bacterial corneal diseases in dogs and cats. Clin Tech Small Anim Pract. 2003;18(3):193-198.
14. Plummer CE, et al. Intranictitans tacking for replacement of prolapsed gland of the third eyelid in dogs. Vet Ophthalmol. 2008;11(4):228-233.
15. Ramani C, et al. Surgical bacteriology and grading of corneal ulcers in dogs: A retrospective study in 24 dogs. Indian J Canine Pract. 2013;5(1):136-138.
16. Scountzou E. Ophthalmic examination in dogs and cats. Part II. J Hellenic Vet Med Soc. 2003;54(4):329-334.
17. Singh AV. Surgico-therapeutic management of ocular affections in dogs. Nagpur: Maharashtra Animal and Fishery Sciences University; 2021.
18. Thompson-Hom AL, Gerding PA. Evaluation of intraocular pressure using rebound and applanation tonometers in dogs. Am J Vet Res. 2012;73(5):709-713.
19. Tuntivanich N. Ophthalmology snapshot. Thai J Vet Med. 2007;37(4):51-52.