A second look
In addition to antibiotic eye drops, systemic antibiotics and a tetanus booster, Spark was started on intravenous Banamine along with a topical nonsteroidal medication and atropine applied directly to his injured eye every six hours. “Atropine helps reduce pain by preventing muscle spasm in the eye. It also dilates the pupil to prevent adhesions of the iris to the lens,” says Sandmeyer. “When an eye is full of inflammatory proteins and the iris is damaged, it can start to stick to the lens, which sits behind it. If you can keep the pupil from constricting you can prevent that. That’s one of the reasons it’s so important to get treatment right away for eye injuries: The longer inflammation goes unchecked, the more potentially permanent damage it will cause.”
After two days, the medications had resolved some of the inflammation in Spark’s eye and Sandmeyer could reevaluate the ocular exam. The eye was still too cloudy to see the internal structures adequately, however. Shining a light into the right eye caused both of Spark’s pupils to constrict---an indication that the retina was likely functioning. Next, Sandmeyer placed an ultrasound probe directly onto the eye to look for any abnormalities,
including foreign objects that might have been embedded in it. Everything looked normal.
“We also performed electroretinography, a test that measures the electrical response of cells in the retina,” says Sandmeyer. “Those results were normal as well.” All the structures that support vision appeared to be intact and functioning, and indeed, Spark’s prognosis for regaining vision was good.
Sandmeyer presented Spark’s owners with three treatment options. “We could have removed the eye entirely,” says Sandmeyer. “But that seemed a little extreme given that the potential for return of vision was possible.” Another option was to simply continue medicating the eye with topical medications hoping that the laceration would heal on its own---but the effect that the adhesion of the iris within the wound might have on the ability of it to heal and the future of Spark’s vision because of this were impossible to predict. The third option was surgery to remove the protruding iris and repair the laceration. This would most likely minimize scarring and produce the best outcome for Spark’s vision. The owners opted for surgery.