A 15-year-old, female spayed, mixed breed dog presented to the Cornell University Hospital for Animals (CUHA) Ophthalmology Service on 7/26/19 for treatment of glaucoma in her left eye. The patient had a 6-day history of an enlarged left eye with clear ocular discharge, squinting, corneal clouding and mild lethargy. She was seen by a primary care veterinarian and was prescribed dorzolamide ophthalmic drops and oral tramadol until she could have more definitive treatment performed by an ophthalmologist. On presentation, she was quiet but responsive and had blepharospasm of her left eye. On ophthalmic examination, the left eye had epiphora, corneal vascularization, diffuse corneal edema, buphthalmia, immature cataracts and an anterior lens luxation. The pupillary light reflex (PLR) was not visible due to corneal edema and there was no menace response nor dazzle reflex. The right eye had a normal PLR, an immature cataract and a positive menace response. The palpebral reflexes were present bilaterally. Schirmer tear test was 5mm/min in the right eye and 15mm/15sec in the left eye. There was no fluorescein stain uptake bilaterally. The intraocular pressure in her right eye was within normal limits at 5 mmHg; however, the intraocular pressure in her left eye was elevated at 51 mmHg. Overall, the patient was extremely uncomfortable and blind in the left eye with both an anterior lens luxation and glaucoma. As the left eye was blind, painful and had a very guarded prognosis for vision, it was elected to remove the affected eye.
This presentation will discuss the difficulties of determining the primary underlying cause of disease in an eye that has both glaucoma and an anterior lens luxation present.