Trying to save a horses eye…

Inspecting the equine eye

Today’s Diary Entry is sponsored by Chart Stables

So this morning at around 6am I got a sms for emergency surgery in the equine clinic, as always there was no indication of just what the surgery was going to be. Jumping out of bed I did an hours reading before then heading down to clinic so that I could be in on the pre-op. Heading into stables i found our equine surgeon talking with our ophthalmologist so realized it was eye related. I then found the patient, a foal that had sustained trauma to its right eye hiding in a stable behind mom.

Now i am not sure if i have written about foals before so I will include a few notes here. When working with foals you tend to also have to deal with mom, this can make it interesting as sometimes mom is not so keen on you touching her baby. Also adding another horse into a procedure just automatically doubles the danger. However to get the foal to go somewhere normally if you take mom the foal will follow, downside here though is that if mum gets nervous or scared then the foal will as well.

Because of this it is sometimes chosen to also sedate mom. So after mom leading the foal onto the scales to get the weight, and then the preparation of drugs it was time for the surgery. Now mom led the foal into the operating theatre, and the foal was positioned so that she would be able to have a controlled fall on the operating table. She was then given anesthetic drugs and carefully positioned onto the surgery table. Careful attention was given to mom during this time to ensure that mom did not freak out when her foal fell onto the table. Mom was then moved back to the stables whilst surgical prep started.

The area around the eye was cleaned and shaved whilst the anesthetic team monitored the foal and the ophthalmologist scrubbed and then prepared her instrument tray for the surgery. Something really important is balanced anesthetic and in this case it was also decided to use local nerve blocks around the eye to reduce the amount of general anesthetic needed. At this point it was uncertain whether the surgery would be to repair the eyeball or to remove it. The first thing the ophthalmologist did was to clean and examine the eye, unfortunately in this case the damaged was too severe and so the decision was taken to remove the eye.

Now this is a relatively simple procedure with several different techniques possible to achieve the goal of removing the eye. In this case because of the trauma what is called a transconjunctival approach was selected. This is where the conjunctive tissue (this is the tissue inside the eyelids) that surrounds the eyeball is cut to release the eyeball from the socket before the nerve and blood vessels are then cut. On this occasion the vessels were not ligated but compression used to achieve hemostasis by filling the empty socket with gauze to apply pressure until the bleeding stopped. A surgical drain was then placed to allow any fluid to drain from the wound. The eyelids were then trimmed to remove the eyelashes before these were sutured shut.

The foal was then taken to recovery. Now this is also different as we do not leave a foal to recover alone but support the recovery with the foal being restrained on the ground until the drugs wear off. Once the foal is reasonably awake we then help the foal to stand and support them until they can stand alone. After this mom is then brought back to be with the foal as this helps reduces stress in the foal.