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Glaucoma is one of the most common vision threatening diseases in dogs. Increased intraocular pressure (IOP) is identified as the main risk factor in optic nerve damage, resulting visual field loss and blindness. In the dog, the IOP increases because the outflow of fluid from the anterior chamber is either reduced or absent. The fluid in the eye (aqueous humor) is produced by the ciliary body which is located behind the iris. Fluid exits the eye mainly by the iridocorneal angle. The iridocorneal angle (drainage angle) is located at the junction of the iris and the cornea. In a normal eye, the production of fluid and the drainage of fluid are equal to maintain a fairly constant IOP. When production remains constant and drainage is decreased, the IOP rises.
Glaucoma is a progressive disease which means it gets worse over time. When uncontrolled, glaucoma not only leads to blindness, but it is also painful. Therapy is aimed at saving vision for as long as possible, reducing IOP's rapidly and safely, and relieving the associated pain. The therapeutic plan for your pet will be based on type of glaucoma (primary or secondary).
Primary glaucomas are those associated with an abnormal anatomy of the iridocorneal angle. Primary open angle glaucoma is common in people, yet rare in dogs. This type is mainly seen in Beagles. Closed or narrow angle glaucoma is very common in dogs. This type occurs in many breeds including but not limited to Cocker Spaniels, Basset Hounds, Miniature Poodles, Boston Terriers, Dalmations, and Arctic breeds. Both types of primary glaucoma are incurable but can be managed for variable periods of time with medical and surgical therapy. Primary glaucoma is an inheritable disease and will likely affect both eyes.
Secondary glaucomas are those that occur following another disease such as trauma, inflammation, hemorrhage, or a tumor inside the eye. These glaucomas can often be treated and vision saved if the underlying cause can be identified and corrected. Treatment will also need to address the secondary glaucoma.
After establishing a diagnosis of glaucoma, therapy depends of whether or not there is still potential for vision. Topical therapies (eye drops) may be used alone or in combination with IV mannitol and/ or surgeries.
If your pet has a blind eye, therapy is directed at maintaining long term comfort. Evisceration with intrascleral prosthesis, enucleation with or without an intraorbital prosthesis, and pharmacologic ablation of the ciliary body are treatment options. These are not procedures used on potentially sighted eyes.