Osbourne's New Eye

by Mary Ann Maier in consultation with John Sapienza, DVM
and Jennifer Saver, DVM

September 12, 2002 was supposed to be a happy day for Osbourne. He was going to leave the shelter for his new adoptive home to start a whole new life. But as soon as I saw him that morning, I knew something was very wrong. There was a strange white spot right in the middle of his left eye. I knew it had not been there when I visited him at the shelter last week, and I also knew he couldn’t go anywhere until he saw a vet. After a quick phone call to his adopter, off we went to see Dr. Jennifer Saver.

Dr. John Sapienza and Osbourne
size each other up.

Upon examining Osbourne’s eye, Dr. Saver suggested we run a blood titer* to test him for E. cuniculi (a protozoan parasite that can cause signs ranging from head tilt, to incoordination, to paralysis, to blindness). She then referred Ozzie to a specialist: veterinary ophthalmologist Dr. John Sapienza at Long Island Veterinary Specialists.

In a pitch black room, wearing an indirect ophthalmoscope (headpiece with a specially focused light), Dr. Sapienza examined Ozzie’s eye. He explained that the white spot was a granuloma — a growth resulting from an inflammatory process in the body. But what he told me next made my heart sink: this growth was probably the result of infection by E. cuniculi. “This white spot is ruptured lens tissue. It’s called ‘phacoclastic uveitis’ and we’re seeing more and more rabbits with this condition,” said Dr. Sapienza. “Sometimes it is treated with topical antibiotics or steroids. However, I usually recommend surgery.” Surgery?! Yes, he explained, the damaged tissue has to be removed, and one way to do this is to remove the eye. Squeamish at the thought, I shuddered.

But Dr. Sapienza offered me an alternative. He proposed giving Osbourne a prosthetic eye. Visions of Peter Falk and Sammy Davis Junior filled my mind. “l can open the eye between the cornea and the sclera, remove the tissue within, and insert a gel-like substance, much like a rubber ball, in its place,” he said. Dr. Sapienza performs this procedure several times a week on dogs with glaucoma, and has used it with rabbits as well. The benefits are obvious: an almost-normal looking, blinking eye, symmetry of the face, overall aesthetics. And he pointed out an additional benefit: The procedure itself does not require cutting anywhere near the venous sinus — a large network of blood vessels behind the eye which, if nicked or punctured, can result in massive blood loss and possible death. As Dr. Sapienza put it, “You could end up losing the bunny for an eye problem.” That was enough for me: I decided on the prosthetic eye. In preparation for the surgery, Dr. Sapienza sent us home with a topical antibiotic to be applied until the surgery was
performed.

Meanwhile, the titer test came back positive for E. cuniculi, adding support to Dr. Sapienza’s opinion as to the cause of the problem. Dr. Saver prescribed oxibendazole, which, like albendazole and fenbendazole, is used to treat suspected E. cuniculi infection.

Osbourne was an amazingly good sport about it all, and accepted both his daily eye medication and daily oxibendazole without a fuss. However, in spite of the medications, the white spot continued to grow rapidly, finally overtaking most of the surface of his eye. As instructed, I watched for any indication of pain from glaucoma (a condition secondary to the inflammation), but Ozzie showed no signs of discomfort.

Finally, the day of the surgery arrived. The procedure itself took less than half an hour, and the veterinary technician on the phone reported that all had gone well. Happy and optimistic, I went to pick up Ozzie, never thinking to prepare myself for his appearance. What a shock. First, half his face had been shaved. (It’s quite a revelation to see how small our rabbits’ skulls are — those irresistible cheeks are mostly fur!) Second, he had a black eye worthy of a prize fighter, with swelling that made me wonder if Dr. Sapienza had put in too big a prosthesis. Third, his eyelids were partially sewn shut with a little device called a “stent” to ensure good blinking (according to Dr. Sapienza, Oz was a “crummy blinker”).

I was to administer drops and apply warm compresses several times daily. But Ozzie seemed not to mind at all, and even leaned into the compress, showing me how good it felt. Within days the swelling was down, the eye was opening a bit, and tufts of fur were growing back. Things were looking so good to me that at first I didn’t realize the cornea was getting infected. Dr. Saver noticed, however, and sent Oz and me back to Dr. Sapienza. He had never seen post-operative cornea irritation in any of his cases before, and he increased Ozzie’s antibiotics to fight it. Dr. Saver suggested we also use blood serum in Oz’s eye to speed healing. It’s a ghoulish-sounding procedure: a small amount of blood is taken from a healthy rabbit and processed to separate the serum from the other components. The serum is then used as eye drops, and put directly into the patient’s eye. Serum only keeps for a few days, so it was a good thing I have a house full of healthy rabbits to serve as blood donors!

Author's Note: Within a few months of his surgery, Oz was adopted by Lauren Spooner, in whose loving home he lives happily with galpal Greta.

The infection finally under control, Osbourne’s eye started to look almost normal. The stent was removed, and, as expected, the eyeball became red for a time, indicating the cornea was becoming revascularized, with fresh blood supply bringing healing. It then seemed to have settled in to a blue/gray color. More important, all signs of infection had disappeared. When friends asked if Oz was back to normal, I told them that he was never not normal; throughout his entire ordeal he never showed signs of discomfort, never missed a meal. Even now, when I squirt a bit of lubricant into his eye (he needs this daily—he’s still a crummy blinker!), he acts as if I’m patting him.

Would I do it again? Probably. The post-op infection scared me, and the need for frequent medicating was taxing on my schedule. But the excellent surgical and veterinary care available to Osbourne, and the relative safety of the prosthesis surgery as opposed to enucleation were big considerations. And, of course, the ever-unflappable Osbourne was able to keep his dashing good looks

BACK TO INDEX (From 2003 NYC Metro Rabbit News)


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