The veterinary ophthalmologists Marta Leiva and Maria Teresa Peña, ECVO graduates, responsible for the Ophthalmology Service of the Hospital Clínic Veterinari of the UAB and professors in the Department of Medicine and Surgery of Small Animals of the Universitat Autònoma de Barcelona are the directors and heads of the course.
Last Saturday, March the 12th was World’s Glaucoma Day. Did you know that Glaucoma is one of the main causes of blindness in dogs? In order to increase the awareness and knowledge of this disease that is one of the most common ocular emergencies in the small animal practice, we’ll explain the key points of the pathology.
Glaucoma is a chronic neurodegenerative disease of the Optic Nerve and retina. It is characterized by an alteration in the balance between the production and the output of the aqueous humor, leading to its accumulation inside the eye and thus, an increase of the intraocular pressure (IOP). The consequences of the IOP increase are the progressive damage of the retinal Ganglion Cells leading to their apoptosis and the neuritis of the Optic Nerve that may lead to the loss of the patient's vision. The patient's prognosis is usually reserved, with most of them losing both eyes sight progressively and even in some cases, leaving the veterinarian with no other solution but the enucleation of the affected eye/s.
Glaucoma can be classified in the following different ways:
According to their evolution, we can classify them as acute or chronic.
Depending on the cause, we can differentiate them between:
Primary: usually linked to hereditary factors. It is the most common in dogs.
Secondary to other intraocular pathologies. Most common in cats.
Depending on the morphology of the iridocorneal angle, they might be of:
Open angle: it is the most common in humans. There are some predisposed breeds, such as Beagle or Norweigan Elkhound.
Closed angle: It is the most common kind in dogs. Some predisposed breeds are American and English Cocker Spaniel, Basset Hound, Chihuahua, Great Dane, Labrador Retriever, Chow-Chow, Shar-pei, etc. just as we already informed you some time ago in our social networks (Linkedin, Instagram).
In the most initial phases when the IOP is lightly elevated, the symptoms usually go unnoticed by the owners, but they will progress until the IOP is markedly elevated and in that moment the patient will present all or some of the following symptoms: severe pain, reddened eyes, photophobia (intolerance to light), epiphora (excessive and constant tearing), mydriasis (pupil dilation), etc.
To reach its diagnosis the veterinarians will have to look at the patient’s clinical history, perform a general and ophthalmological examination, measurement of IOP by tonometry (there is a variety of different ones in the market) and evaluate the morphology of the iridocorneal angle with gonioscopy. In some cases, other techniques such as high-resolution ultrasound may also be performed.
Various types of treatments, both medical (topical or systemic) and surgical (such as the different techniques of laser cyclodestructive surgery) can be used to try to reduce the IOP. Another key asset in the treatment of glaucoma to try to delay as much as possible the loss of the patient's vision, either in both eyes in early diagnosis or at least one of the two, when the vision has already been lost in one, will be the supplementation with nutraceuticals such as Glauco, rich in B group vitamins and other antioxidant and neuroprotective substances such as Ginkgo Biloba or wild blueberry, to help reduce the progression of the disease and then, protect the retina and the Optic Nerve from damaging free radicals due to increased oxidative stress and increase blood flow to the Optic Nerve.
In conclusion, the more information and knowledge we have about glaucoma and the earlier it is diagnosed, and the vision of both or at least one of the two eyes is preserved, the greater the opportunity for the treatment options to be more effective, reducing then the damage to the retina and Optic Nerve and improving the dog’s quality of life.