Blind painful eye: enucleation or intrascleral prosthesis
9-year-old Siberian Husky with end-stage glaucoma in the left eye: blind, buphthalmic and painful despite medical treatment. The owner asks about a more cosmetic option than enucleation.
Which of these situations contraindicates an intrascleral prosthesis and requires enucleation instead?
chevron_right Show answer and explanation
A. The eye being buphthalmic
Buphthalmos is not a contraindication: evisceration and prosthesis are adapted to the globe size, which often shrinks afterwards.
B. The glaucoma being primary
End-stage primary glaucoma is precisely the most common indication for an intrascleral prosthesis.
C. The dog being over 8 years old
Age is not a contraindication if general health allows anaesthesia.
D. Suspected intraocular neoplasia or infection, or corneal disease such as dry eye or ulcers
Correct. The prosthesis preserves the sclera and cornea, so it cannot remove a tumour or infection, and a diseased cornea may ulcerate and extrude the implant. In those cases the eye is enucleated and the globe sent for histopathology.
lightbulb Key takeaway
A blind, painful eye should not be kept on indefinite medical treatment. Before an intrascleral prosthesis, rule out neoplasia (ocular ultrasound) and measure the Schirmer tear test. In cats enucleation is preferred because of the risk of post-traumatic ocular sarcoma.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.