bunny eyes infection

Question
QUESTION: Dear Dana,
I have a 1yr6month old bunny girl. About 6month ago, i discovered that there is a white spot on my bunny's left eye. As a result, I brought my bunny to the Vet, and the Vet said there is no scar on the eye and concluded that there is only fat/lipid accumulated in the eye, no infection was diagnosed.  At the time, no medication was given to my bunny.
However, recently, I have discovered that the white spot on the eye got bigger and there's even 'blood-like' cluttered around the white spot. I brought my bunny to an vet. eye specialist, and my bunny was diagnosed with a very bad infection. The vet gave my bunny eyedrops to prevent the infection to get worse, and suggested me to do an eye-ball removal for my bunny.
I was heart broken to hear all these, while not knowing what decision I should make regarding this surgery. Should I let my bunny to accept the eye-ball removal surgery??? Is there any risk associated with this surgery?? Is surgery going to heal my bunny at all? Will she be happy without one of her eyeballs??
I am very depressed and feel helpless right now given that I don't have much knowledge about this. Would you please help me to answer the questions and give me suggestions??

THank you very very much!

ANSWER: Dear Sandy,

If this is an infection *inside* the eyeball, then removal of the eye might indeed be the kindest option.  And a one-eyed bunny can be very happy and fine (we've had several).  However, from your description, this doesn't sound to be the problem (and remember: I can't see the bunny so I am not the one to decide what the problem is.  If you can send a clear, close-up picture, I will be better able to help you.).

What you describe sounds as if it may be a corneal ulcer, and if there is vascularization (formation of small blood vessels) around the lesion, it is healing.  At this point, I would NOT have the eye removed.  We have had rabbits with horrible corneal ulcers make complete recovery with proper medication and patience.

Our veterinary ophthalmologist prescribes the following for corneal ulcers:  (1) gentocin ophthalmic drops, (2) ciprofloxacin or ofloxacin ophthalmic drops, (3) miconazole cream (same as what is prescribed over-the-counter for vaginal yeast infections, (4) atropine ophthalmic drops (to temporarily paralyze the muscles in the eye, relieving pain.

Bunny can also get metacam for pain relief.  When we have used this treatment, the eye begins to improve within a week, and complete healing (you will see blood vessels grow over the cornea and begin to "feed" the injury, healing it) has been effected within a few weeks with constant treatment, three times a day.

I have had less experienced vets tell me that a rabbit's eye needed to be removed, but then when I used the treatment prescribed by Dr. Karpinski (as described above), the bunny healed beautifully.  I would consider the enucleation (eye removal) ONLY after trying the drops for a few weeks, to see if it will heal if properly treated.  I am betting it will, even if there is a scar remaining on the cornea after the ulcer has healed.

I hope this helps.

Dana

---------- FOLLOW-UP ----------


Bunny's Eye   QUESTION: Hi Dana,

Thank you very much for your reply to my question! I really appreciated it! However, unfortunately, an ulcer may not be the case here because I have brought my bunny to her family vet and an optical specialist to do a check. They used a florescent gel to test if there are any scratched or damages to the eye lens, but found nothing and hence concluded that the chance of an ulcer is very low. The specialist commented that my bunny's iris is in odd shape right now due to the infection, and that the wronged iris has caused her eye pressure to be very low. We gave her anti-viral eye drops for a month, the infection has seem to slowed down, but the specialist said the infection will be on-going process if the iris remains in odd shape. He also commented that a cataract is present, however by removing it, the surgery itself may lead to even more problems in the future. So he recommended to have her eye ball removed to rid of the cataract, wronged iris, and the infection completely. I am really helpless right now, I have no one to ask for opinion. So I am sincerely begging you to help me with some advice. I really don't want to see my bunny loose one eye. Do you think removing the eye is appropriate/needed?  The specialist also mentioned that there is some degree of risk in this surgery because there is a main blood vessel behind a bunny's eye. Would you recommend doing this surgery? Will my bunny's life change dramatically after the surgery? I am really afraid and concerned. Your help is highly appreciated! Thank you in advance!

Answer
Dear Sandy,

Is the bunny exhibiting any signs of pain from the eye?  Is there still active infection in the eye?  If there is no longer an active bacterial infection, and no evidence that a molar root problem could cause it to recur, I am not sure I would go for the surgery.   It really depends on whether the eye is causing her pain or not.

If the eye appears to be painful (squinting, eye running), then the enucleation (eye removal) should be considered as a last resort.  But it is very important that the vet realize that nicking the large, venous sinus behind the eye--while it will cause a lot of bleeding--is NOT a death sentence!  Our own vet accidentally nicked one while removing an eye, and found that pressure on the sinus stopped the bleeding.  But it is truly better not to nick that delicate sinus, as it can cause tremendous bleeding, and an inexperienced vet could have a disaster.  

If the eye is pretty much just blind with a cataract, and has no active infection or pain, then I'm not sure why you'd want to remove it (except that the surgery could be quite lucrative for the vet...).

If it ain't broke, don't fix it.  It's all about PAIN and the possibility of future infection.  I can't address these issues, since I can't see the bunny.  But these are questions you can politely ask the vet.  If the eye is no longer infected and is not causing pain, then I would see no good reason to remove it.

Dana