A variety of cacti thrive in Arizona, the most common of which are the prickly pear, cholla, saguaro, hedgehog cactus, barrel cactus and button cactus. The bristles and spines covering these cacti, especially the prickly pear and cholla are a frequent source of injuries in dogs’ and cats’ eyes.
At Eye Care for Animals, we often treat patients who present with spines impaled in or around the eye. Very often, these spines have penetrated the surface of the eye, reaching intraocular tissue, such as the iris or even the lens. In a few of our patients, we have seen spines that were completely embedded within the anterior chamber of the eye.
Corneal ulcers, including those caused by foreign bodies can lead to corneal scarring, corneal vascularization and ocular infections, which affect the internal and/or external areas of the eye (intraocular/extraocular infections) as well as secondary complications as discussed in the section titled “Treatment”.
Treatment
Our goal in treating cactus-related eye injuries is to ensure the health of patients’ eyes and promote patients’ comfort.
Cactus spines are commonly embedded in conjunctival and corneal surfaces. Spines embedded in the conjunctival surface cause severe irritation and can damage surrounding ocular tissue. Thus, these spines must be removed. If the spine leaves a large defect in the cornea, reconstructive surgery or direct suturing of the corneal tissue may be necessary.
In contrast, patients often tolerate microspines that are embedded in the cornea and consequently, such spines might not need to be removed. We often find tiny spines embedded within the cornea as an incidental finding in patients that present for evaluations of other ocular conditions.
Large cactus spines that penetrate the cornea and reach the iris or lens must be treated like punctures, which can cause both corneal and intraocular complications. We begin treatment by removing the cactus spine, after which we often seal the puncture with sutures or a conjunctival graft to promote rapid healing. The vast majority of these procedures are performed with the patient under general anesthesia while the surgeon employs the operating microscope. We control the resulting inflammation of intraocular structures with anti-inflammatories. We also use topical antibacterial drugs to prevent the secondary bacterial and fungal infections to which cactus spines can give rise.
We often treat a small penetrating injury to the lens with medical treatment, which may adequately control intraocular inflammation in these cases. However, in cases of large lens lacerations we may have to surgically remove the lens. The extent of damage will determine if an artificial lens can be placed. We remove the lens only when we cannot otherwise control intraocular inflammation.
Although not all foreign body eye injury or corneal ulcer patients require surgical intervention, the owners of those that do need surgery should be aware of potential complications. Any surgical procedure can introduce complications, including potential anesthetic risks. Surgical procedures that involve the cornea seldom give rise to complications, which occur in less than 5% of these cases. Nevertheless, potential complications include, but are not limited to, inflammation of the pink tissue (conjunctivitis); break down of the tissue or suture (wound dehiscence/graft retraction/rejection); infections at the surgical site, which may extend to other internal and/or external areas of the eye (intraocular/extraocular infections); corneal ulcerations (superficial to deep); migration of further foreign bodies; corneal scarring, vascularization, or mineralization; ocular rupture, secondary to ulceration; inflammation inside the eye (uveitis), secondary to infection or ulceration; high pressure within the eye (glaucoma), secondary to uveitis; retinal detachment or degeneration, secondary to uveitis or infection; ocular or orbital pain, secondary to uveitis, glaucoma or infection; eyelid rubbing; bleeding inside the eye (hyphema), secondary to uveitis or infection; tearing (epiphora); and/or lens luxation, secondary to uveitis, glaucoma or infection. Some of these complications can lead to blindness.
If you have any questions regarding Cactus-Related Eye Injuries or other Foreign Bodies, please call us at Eye Care for Animals.
