"Is the right sunken
eyeball present since puppyhood?" I asked the lady owner
who showed me a bottle of eyedrops prescribed by Vet 1.
No other medication was given by Vet 1 who diagnosed eye
infection and advised review if the eye condition did
not improve.
Case of the Golden Retriever with a twitching eye
Golden Retriever, Male, 8 years. Weight below normal.
Complaint: Fits 2 days ago. I advised bringing the dog
to the Surgery rather than a house-call which would
waste money as the dog needed more detailed examination.
History: Right eye is smaller than left eye. Vet 1
prescribed eye drops.
Right eye: Drooping eyelid, retracted eyeball, twitching
uncontrollably as if blinking at me when reviewed.
Occasional twitching (videoed by Nicole).
3rd eyelid covered the right eyeball partially since it
has sunken in.
Hospitalised. Blood and urine tests are minimum tests
done.
Lumbar puncture for cerebrospinal fluid analysis, MRI
scan of the brain are not done at this stage to lower
vet costs.
OCULOMOTOR NERVE is the 3rd cranial nerve. It innervates
the muscles co controlling eye movements, the upper
eyelid muscle and the muscles controlling pupil
constriction.
In this dog, the Oculomotor nerve and its branches had
been damaged or inflamed causing the eyeball to sink
inwards, the eyelid to droop. However, since the dog
suffered from fits, the lesion is likely to be inside
the brain e.g. brain tumour or aneurysm near the
Oculomotor nerve or inflammation.
Blood test - high serum urea
Urine test - proteinuria
Brain scan and lumbar puncture are costly options which
need to be discussed with the owner.
Other contributing causes Trigeminal neuralgia involving only the ophthalmic
nerve? The trigeminal nerve has 3 branches - ophthalmic
nerve, maxillary nerve and mandibular nerve. There does
not appear to be facial spasm or dropped jaw and so, the
maxillary and mandibular nerves are not involved. The
ophthalmic nerve may be involved.
Diagnosis
Brain scan and lumbar puncture are needed for a
definitive diagnosis of acquired Oculomotor nerve palsy
in this dog but it is costly.
Treatment
Anti-fits and review. The dog can eat and drink and has
no more fits when on anti-fit medication. Steroids were
not prescribed. To review.
TOA
PAYOH VETS
