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The anatomy of the dog’s eye is like that of the human, and so it is no surprise that they can have the same kinds of eye problems. When it comes to cataracts, there are many similarities between the two species, including treatment and surgical intervention.
There are many small parts of the eye that allow dogs (and us) to be able to see. The lens is a small round object inside of the eye that focuses light onto the retina or the back of the eye. This is how images are generated. The lens needs to be crystal-clear in order to allow light to pass through it. A cataract occurs when there is an opacity in the lens that blocks the light and thereby obscures vision. This opacity can be very small and maybe not affect vision very much, or it can take up the entire lens and cause blindness.
Cataracts occur when there is damage to the cells and/or protein fibers that make up the lens. The most common cause of cataracts is when they are inherited genetically. Some of the most common breeds that can develop hereditary cataracts are Labrador Retrievers, Boston Terriers, Cocker Spaniels, French Poodles,1 Siberian Huskies, and Yorkshire Terriers2. The second most common cause of cataracts is diabetes mellitus. This is because high levels of sugar in the blood can alter the way that lens cells function, and it causes cataracts to develop very quickly. Other causes of cataracts include physical trauma to the lens and UV-ray damage from chronic exposure to sunlight.
Cataracts can sometimes form spontaneously in older pets. Cataracts are not 100% preventable, but steps can be taken to make sure that the risk is lessened. Many veterinary ophthalmologists provide Eye Certification Programs for breeding dogs1, and exposure to sunlight can either be avoided or mitigated with the use of special goggles that dogs can wear outdoors.
Not all cataracts require surgery. Very small cataracts, or incipient cataracts, are difficult to find without magnification. They take up less than 15% of the lens and so they may not affect vision as much as an immature cataract (more than 15% of the lens is affected but the retina is still visible) or a mature cataract, which takes up the entire lens1. Cataracts can greatly impair vision and can cause inflammation within the eye that can progress to glaucoma, which can be painful. Sometimes medicated anti-inflammatory eye drops can help cataract sufferers, but with advanced cataracts, surgical removal is recommended.
Ophthalmologists need to check if the dog’s retina is healthy in order to determine if they will be a good candidate for cataract surgery. This kind of surgery will not restore vision if the retina is damaged. Two kinds of tests are performed: an eye ultrasound exam and an electroretinogram (ERG), which looks at the electrical activity of the retina, like how an EKG looks at the electrical activity of the heart.
Cataract surgery for dogs is performed under general anesthesia because the eye needs to perfectly still for the procedure. A small incision is made into the eye, and then an ultrasonic handpiece is inserted into the incision. The handpiece is roughly the size of a ballpoint pen. It is used to break the cataract into pieces and then remove them from inside of the eye. This technique is called phacoemulsification.
Once the cataract fragments are removed, an artificial lens is then implanted inside of the eye and the incision is sutured closed. Cataract surgery is often performed on an outpatient basis, and so it is likely that the patient will go home on the same day. Most cataract surgeries have a 95% success rate, and the majority have their vision restored almost immediately3.
Because of the need for specialized equipment and general anesthesia, cataract surgery can be costly. On average, it can cost anywhere from $2700 to $4000 and will need to be performed by a veterinary ophthalmologist3. Post-operative medications and follow-up visits to the ophthalmologist should also be considered.
For the first couple of weeks, cataract surgery patients will need eye drops up to four times a day. They will require periodic follow-ups with the ophthalmologist as well. Most ophthalmologists will want to recheck their patients the next day. After that, rechecks are scheduled at one week, two weeks, one month, two months, and then every six months for life3.
Complications are rare but must also be considered. Inflammation in the eye or uveitis can happen to patients with cataracts, regardless of whether surgery is performed. Acute uveitis can be painful and can result in chronic uveitis if left untreated. Glaucoma, or increased pressure inside of the eye, can also occur regardless of whether surgery is performed. Patients without surgery are 20% more likely to develop glaucoma and patients with surgery only carry a 5% risk3.
CBD may be able to help with some of the pains associated after surgery as well as any anxiety that is present in the dog. It also has many health benefits to dogs.
Glaucoma can ultimately cause vision loss. Retinal detachment is infrequent but, if present, can cause cataract surgery patents to lose their eyesight. Infection is very rare but can cause problems with healing, and so it is important to prevent patients from itching their eyes after surgery and to use all medications as directed especially antibiotics. Scar tissue can develop around the intraocular lens implant and can act like a “second” cataract and cause slightly decreased vision over time. However, this does not mean that the cataract has returned. Once a cataract is surgically removed, it cannot come back again.
Whether they happen gradually or quickly, cataracts can be an alarming finding on a physical exam. They can be hereditary or possibly suggest an underlying cause. Cataracts can affect your dog’s vision to varying degrees and can also be painful. If you think your dog is beginning to develop a cataract in one or both of his eyes, then talk with your veterinarian about the next steps to ensure that your dog is comfortable and has a good quality of life.
Dr. Erica Irish
Erica has worked in the veterinary field since 2006, starting out as a veterinary technician before graduating from the UF College of Veterinary Medicine in 2013. As a general practitioner in an animal hospital, she has many interests and is especially interested in dermatology, cardiology, internal and integrative medicine.
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