rabbit glaucoma

Question
Hello, I just wanted to run my situation by you and see what you think is the best approach.. I have an almost 1 year old lop rabbit.  In august he started with this blood spot in his eye, a month or so later it spread and then a white chunk developed.  I took him to a vet who said it was a hyphema most likely from bumping his eye somehow and to keep an eye on it. I did, it didnt get better, it got worse.. its now covering his whole eye and it is bulging.. so I took him to a specialist yesterday who did all sorts of tests and said he has glaucoma and a cataract and the white chunks are actually his lens. (not sure why he develoepd this.. I'm going to get a blood test for encephalzoin?? I think that is what its called )  His IOP is 40-50 (his other eye is normal)  The doctor recommends removing the eye, which of course devestated me, but I dont want my baby to be in any pain.  He seems 'normal' just a little quieter, doesnt run around as much.. but does occasionally do his bunny hop, and chatters his teeth like crazy when i pet his ears.  Basically they gave me timolol and antibiotic ointment for his eye, and they said I could proceed with surgery right away or try the drops for a month and retest the pressure, but I was just looking to see what you think I should do? I dont want to put him through another month of agony if I dont have to, I just didnt realize this was causing him so much pain... but at the same time, he doesnt seem to be in pain to me, and I dont want to jump the gun adn possibly risk his life with surgery if I dont have to.. not to mention the bill for it, which really is the least of my concerns.. but still would rather not spend the money if I can help it.  He's a young guy.. is it possible to keep him on drops for the rest of his life or should I just go ahead with the surgery? Am I doing more damage by letting the eye stay in? And, if his eye is removed, should he proceed to be a normal bunny minus 1 eye or will his life expectancy change? Thanks, Jenn

Answer
Dear Jenn,

Rabbits are notorious for hiding their pain, which is natural since they evolved as prey animals who would be rapidly picked off by predators if they readily showed signs of weakness.  An eye with an IOP that high is painful, and if the lens is ruptured, this is a major problem.  A ruptured lens is, unfortunately, a nidus for constant inflammation and pain.

If this were my bunny, I would opt for enucleation of the eye while he is young and healthy.  It's a little sad, but the eye is already blind, and there is absolutely no sense in keeping an eye that will be painful all his life if he can't even see out of it.  

As long as the veterinary ophthalmologist is experienced with rabbits and knows that there is a *large* and rather fragile venous sinus right behind the eyeball (so that s/he will be sure not to nick it during surgery and cause excessive bleeding), things should be okay.  No surgery is 100% risk free, but an eye like this is going to be a terrible problem.

I hope his other eye is fine.  If he has such bad glaucoma in one, then you might want to ask the vet if the other one should probably also be treated with timolol (and whatever other drugs the ophthalmologist deems necessary) to prevent the same thing from happening there.  

If the vet thinks E. cuniculi is to blame for this, then you can't start him on Panacur (fenbendazole) too soon to prevent further damage to the other eye (not to mention his kidneys and central nervous system).  It won't hurt, and it might help.

I hope this helps you make a decision.  I'm sorry it's not going to be a very easy one, either way.  :(  But I hope that your boy will be fine soon, and back to his old, dancing self.  I think the best way to ensure that is by getting rid of the painful, useless eye, if that's what the vet ophthalmologist recommends.

Sending healing thoughts...

Dana