Content continues after advertisement

Proptosis Reduction

Caryn E. Plummer, DVM, DACVO, University of Florida


|September 2013|Peer Reviewed

Sign in to Print/View PDF

Figure 1 (above). Proptosis in an Australian shepherd puppy.

Proptosis of the globe (Figure 1) is a true ocular emergency. The eyelids become trapped behind the equator of the globe, usually from trauma. The eyelid margins are seldom visible, and the patient is unable to blink and protect the cornea. Treatment delay and resultant elongated globe exposure can increase the likelihood of corneal ulceration, retrobulbar edema, and hemorrhage, raising the risk for blindness from globe perforation or optic nerve damage.

Related Article: The Concept of Corneal Protection

The force necessary to proptose a globe varies with orbital anatomy. Proptosis occurs more easily in brachycephalic breeds (both canine and feline) than in mesocephalic or dolichocephalic breeds, improving the odds for sight and globe retention in the former. The prognosis for vision is generally guarded to poor, but prompt treatment may save the globe. Enucleation may be best if the globe is ruptured or ≥2 extraocular muscles or the optic nerve is avulsed. If the status of the eye and muscles cannot be determined, proptosis should be reduced and a temporary tarsorrhaphy placed. The globe can be removed later if necessary, but it cannot be replaced.

Following surgery, the eye should be monitored for signs of keratoconjunctivitis sicca, a common sequela that requires frequent, diligent, and long-term medical therapy even if the globe has been rendered nonvisual. If owners are unwilling or unable to provide long-term care following resolution of proptosis, enucleation at initial presentation may be warranted.

Related Article: Exophthalmos in a Dog

What You Will Need:

  • Small scissors (Stevens tenotomy, strabismus, Mayo, or Metzenbaum)
  • Needle drivers
  • Small forceps (Bishop-Harmon, toothed)
  • Nonabsorbable suture (4-0, nylon or silk; 3-0 to 4-0 for dogs with thick eyelid margins [eg, English bulldogs])
  • Stents (pieces of wide rubber band material or IV tubing or buttons)
  • Topical ophthalmic antibiotic or lubricating ointment

Related Article: Corneal Cytology & Culture Collection

CARYN E. PLUMMER, DVM, DACVO, is on the faculty at University of Florida, where she completed her DVM and a residency in comparative ophthalmology. She completed her internship at Michigan State University. Her research interests include corneal disease and glaucoma. Dr. Plummer coordinates ophthalmic surgery laboratories at the NAVC Conference and has participated in the NAVC equine ophthalmology in-depth seminar and laboratories.


For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

All Clinician's Brief content is reviewed for accuracy at the time of publication. Previously published content may not reflect recent developments in research and practice.

Material from Clinician's Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us.


Clinician's Brief:
The Podcast
Listen as host Alyssa Watson, DVM, talks with the authors of your favorite Clinician’s Brief articles. Dig deeper and explore the conversations behind the content here.
Clinician's Brief provides relevant diagnostic and treatment information for small animal practitioners. It has been ranked the #1 most essential publication by small animal veterinarians for 9 years.*

*2007-2017 PERQ and Essential Media Studies

© 2023 Educational Concepts, L.L.C. dba Brief Media ™ All Rights Reserved. Terms & Conditions | DMCA Copyright | Privacy Policy | Acceptable Use Policy