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How will my horse respond or cope

with the loss of an eye?

Understandably this is a frequently asked

question and the answer is that they normally

cope and adjust very well. An eye is generally

removed because it is painful and ocular pain

can be particularly distressing. Once removed

the patient will normally, after a few days,

become more relaxed and begin to put on

condition due to the reduction of pain.

The surgical procedure

The surgery is normally undertaken under

general anaesthetic to make it easier for the

surgeon to operate. However, over recent

years, an increasing number of operations are

undertaken with the patient standing, under

heavy sedation with the use of nerve blocks

and local anaesthetic. This can be of benefit

to older, quieter patients where a general

anaesthetic can pose a greater risk.

The surgery can involve removal of the eyeball

or the eyeball and some of the surrounding

structures. Whichever technique is employed

will depend on the reason for removing the

eye. If removal of the eye is due to cancer as,

for example, the horse in

figures 1, 2 and 3


additional tissue from the eyelids will need to

be removed to provide an adequate margin to

ensure that all the diseased tissue is removed.

A prosthetic implant can be inserted in place

of the eye that is removed. This can provide

a more aesthetically pleasing appearance,

giving the impression that the horse has just

closed its eye or is winking at you! The

downsides of fitting a prosthetic eye are:


An increased chance of wound breakdown

due to a slightly increased risk of infection

being trapped during the operation or

rejection of the implant by the body’s

immune system.


Difficulties of placing an implant that is not

a perfect fit, either too big or too small. This

is because it is difficult to predict how the

tissue, within the eye socket, will ultimately

settle down after the operation.

The horses in

figures 4 and 5

show how the

horse will look a few months after enucleation

with and without a prosthetic eye.

Surgical feature:


Removal of an eye is called enucleation; it is usually a procedure of last

resort. Enucleation is undertaken when treatment for a disease has

been unsuccessful; for example, uncontrolled equine recurrent uveitis

(ERU) or where there is irreparable trauma. It is not a small procedure

for the horse, pony or donkey and it can be quite a daunting undertaking

for the owner to contemplate.

Veterinary Nurse

Dominic Alexander

XLEquine Practice

Belmont Veterinary





Dominic Alexander BVMS MRCVS,

Belmont Veterinary Centre

Figure 2: regional nerve blocks being


Figure 3: the eye removed and the socket

closed post surgery

Figure 4: enucleation without a prosthetic eye

Figure 5: enucleation with a prosthetic eye

Figure 1: cancer that has migrated from the

third eyelid into the eye