Case Study 18

J547x517-17020

Bubba, a 6 yo Chihuahua, presented to you for a red and “bulgy” eye. You note exophthalmia and a corneal ulcer, which you suspect developed secondary to exposure, since he does not seem able to completely close this eye. You prescribe treatment for the ulcer, but also recommend imaging of the orbit. The owner followed your suggestion, opting for MRI and this is one of many diagnostic views obtained.

  1. What do you see?
  2. What is a likely diagnosis (broad category)?
  3. Can you suggest a treatment plan?

 

 

  1. What do you see? There is a large soft tissue mass in the retrobulbar space of Bubba’s affected eye.  It is causing anterior protrusion of the globe (exophthalmia) and is compressing the posterior sclera.
  2. What is a likely diagnosis (broad category)? The appearance of the mass in this view is unfortunately highly suggestive of a neoplasm.
  3. Can you suggest a treatment plan? Though this should be confirmed by clinical exam, it is highly likely that this eye is already irreversibly blind, due to direct involvement of the optic nerve or compression of it. Therefore, sacrificing the globe along with the eye is appropriate as a means of palliation or perhaps achieving a cure. However, it should be noted that most tumors of the retrobulbar space of dogs (and cats) are malignant. Submission of either a preoperative biopsy or the surgically removed tissues is always indicated. For owners who are inclined, the cooperation of an oncologist to perform appropriate adjunctive therapy (usually radiation) is usually indicated to improve prognosis.