Aqueous humor is the liquid that surrounds and cushions the eyes. Glaucoma occurs when intraocular pressure (pressure inside the eye) from this liquid rises above normal levels. If left untreated, glaucoma can permanently damage your dog's eye. With prompt diagnosis, your vet has several treatments available to manage glaucoma and avert permanent eye damage and blindness.
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Medical Treatments
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Medical management of glaucoma isn't usually successful in dogs in the long-term. It is typically used only short-term in order to reduce eye pressure and for pain relief by increasing drainage of the aqueous humor. If surgery isn't an option, your vet will sometimes agree to lifetime treatments that consist of oral and intraocular medications to control eye pressure and reduce fluid accumulation. Your vet will sometimes administer an intravitreal injection of Gentamicin to kill some of the cells to reduce pressure.
Surgical Treatments
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Surgery is usually the most effective treatment for glaucoma. Cyclophotocoagulation uses a laser to destroy some cells to reduce pressure. Gonioimplantation inserts a surgical shunt into the anterior chamber of the eye to drain out excess fluid. Animals often require additional surgeries with both procedures. Your dog will probably be put on oral or topical medication to help control eye pressures after the surgery, and will likely continue to need those for life.
Enucleation
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If the glaucoma is discovered too late, or if the medical and surgical interventions are ineffective, your vet will probably suggest removal of the eye. Enucleation is where the entire eye is taken out and the eyelids are sutured closed. By the time this becomes an option, the dog will have already lost all vision in the eye, and the swollen eye will need to be removed for pain management.
Prosthetic
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Removing the eye will leave the dog looking abnormal, but there are cosmetic options that can help. If you prefer--and can afford it--a veterinarian surgeon can remove the eye (enucleation) and replace it with a prosthetic eye. Depending on the type of prosthetic, it will either prevent the dog's eye from appearing sunken in, or it will look and move like an actual eye, though the dog will have no vision.
Herbs
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For dogs who are on lifelong management for glaucoma, either following early diagnosis or surgery, some herbs can help to manage aqueous humor production and keep eye pressures lowered. These herbs can be used in conjunction with veterinarian-prescribed medications. Bilberry nourishes the inner eye and increases the flow of oxygen. Blueberry is an acceptable alternative if you can't find bilberry. Gingko biloba increases the flow of blood and improves circulation. It is often used in conjunction with bilberry (or blueberry). All the supplements are available in tinctures or capsules, and can be added to your dog's food or favorite treat. Some dogs will eat fresh bilberries or blueberries without you needing to disguise them in some manner.
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