Contralateral blindness following enucleation

RE: Contralateral blindness following enucleation

John Flynn — Sat, 16 Apr 2016 22:12:43 GMT

[quote user="David Mills"]

What I'm asking is whether people have had vision return in these eyes i.e. is this permanent or will there be some (potentially) reversible inflammatory component. Currently on preds and analgesia, no response to former in last 24h.

If return of sight is a possibility, what sort of time frame? And full return or still partially blind?

[/quote]

I've only had one post-op blindness in cat and that was after a limb amputation if I remember correctly - regained sight within a week.

As you don't know for certain that is traction on optic nerve as cause (however likely that may seem), I'd most likely give benefit of doubt and give 3 weeks to see if sight regained (and if not how well adapted to acute blindness) before condemning - I probably wouldn't give great odds in this case, though sometimes giving poor odds becomes a self-fulfilling prophesy [case's with X do not do well based on small poorly-representative case series or limited previous experience of grossly similar presentation with limited diagnostic refinement, therefore we euthanse them, our experience (or future studies) then reflects the invariably poor outcome of such cases that we see...]

RE: Contralateral blindness following enucleation

Rob Loxley — Fri, 15 Apr 2016 11:11:34 GMT

[quote user="David Mills"]What I'm asking is whether people have had vision return in these eyes[/quote]

We used to have one such cat on the books (the old boss's cat!) which stayed blind in the other eye

RE: Contralateral blindness following enucleation

Robert Lowe — Mon, 04 Apr 2016 11:42:27 GMT

[quote user="Francisco Gomez"]

[quote user="Robert Lowe"]

However it is also possible this is a hypoxic blindness following anaesthesia and vision may be restored over the week following anaesthesia.

[/quote]

Hi Rob, would you also favour NSAIDs over steroids in this case?

[/quote]

Not sure either will make a difference but would probably go with steroid over NSAID

RE: Contralateral blindness following enucleation

Francisco Gomez — Mon, 04 Apr 2016 10:24:06 GMT

[quote user="Robert Lowe"]

However it is also possible this is a hypoxic blindness following anaesthesia and vision may be restored over the week following anaesthesia.

[/quote]

Hi Rob, would you also favour NSAIDs over steroids in this case?

RE: Contralateral blindness following enucleation

Robert Lowe — Mon, 04 Apr 2016 10:04:28 GMT

The case series published by the AHT showed no restoration of vision when the blindness was due to traction on the optic nerve.

Contralateral optic neuropathy and retinopathy associated with visual and afferent pupillomotor dysfunction following enucleation in six cats. http://www.ncbi.nlm.nih.gov/pubmed/24131747

However it is also possible this is a hypoxic blindness following anaesthesia and vision may be restored over the week following anaesthesia.

Rob

RE: Contralateral blindness following enucleation

Martin Atkinson — Fri, 01 Apr 2016 12:10:20 GMT

Its never happened to me either but it is a known complication. Although it may now be water under the bridge it is important not to put any traction on the optic nerve - there is no need even to try and ligate it. I guess it depends whether there is just inflammation to the optic chiasm or it is permanently damaged - only time will tell but I wouldn't give up on it yet. Maybe someone like Rob Lowe will be along soon with a more informed opinion.

RE: Contralateral blindness following enucleation

Francisco Gomez — Fri, 01 Apr 2016 11:31:16 GMT

If youre looking for healing, use NSAIDs instead?

RE: Contralateral blindness following enucleation

Francisco Gomez — Fri, 01 Apr 2016 11:28:45 GMT

Excessive traction during enucleation can damage chiasm, if this is the case I'd guess is neurological thus blindness is likely to b a permanent thing. I would personally wait until the enucleatoon site heals (10days?) and support w antiinflammarories tho. If sight not returned by then Id guess its likely to be permanent.