WHAT TO EXPECT DURING MY PET’S EYE EXAM: SMALL ANIMAL EDITION
WHAT TO EXPECT DURING MY PET’S EYE EXAM: SMALL ANIMAL EDITION
Elizabeth Lutz, DVM, MS, DACVO
As board-certified veterinary ophthalmologists, we are SO GRATEFUL that you have scheduled an appointment for your pet to be seen at one of our offices, and we know how much you love and care about your pet to have found your way to one of us!
If you have found your way to this article, and you believe that your beloved pet has an eye problem, please know that you can call to make an appointment with a veterinary ophthalmologist without a referral or recommendation from your primary care veterinarian, and even if you don’t have a primary care veterinarian at this time. Simply visit https://www.acvo.org/ophthalmologist-search to find an ophthalmologist near you who can help!
Here are some things that can help make your ophthalmology appointment flow more smoothly for both you and your pet:
· Make sure that a copy of your complete medical records have arrived at our office in advance.
· Bring a list of all medications, medical conditions, and surgeries for which your pet is receiving treatment.
· Bring ALL of your medications and supplements with you to your visit – it really does help us to see them!
· If your pet is anxious when at the veterinarian’s office, or is very painful, please do NOT hesitate to call ahead to discuss this. We often work with your family veterinarian to use calming and/or anti-anxiety medications to allow your pet to have a stress-free, pain-free examination.
Prior to meeting the ophthalmologist, you will often be greeted by a veterinary technician who has attended school to become licensed in the medical care of animals. Some veterinary technicians are even studying to become board-certified in veterinary ophthalmology! These technicians will ask questions for the ophthalmologist ahead of the exam, and perform basic diagnostic testing. You may have seen some of this diagnostic performed already at your primary care veterinarian’s office, and you may wonder why it is repeated again at our office. Measuring basic diagnostic parameters gives us a great deal of information about the health of an eye, and this information changes on a day to day, hour to hour basis (just like your own blood pressure or temperature can change from one doctor’s office to the next). No ophthalmologist (or veterinarian) will ever subject your pet to a test that is painful, harmful, or unnecessary.
The most basic diagnostic tests include:
1—Schirmer Tear Tests: Small pieces of white filter paper are placed inside of the lower eyelid to assess the resting volume of tear film that collects over 60 seconds. The normal value for this test varies by age, breed, and species.
2—Tear Film Breakup Time: Fluorescein stain is applied to the surface of the eye in order to assess the quality of the tear film – how thick the tear film is, how well it spreads across the cornea, and how long it lasts on the surface of the eye. The normal value for this test varies by skull shape.
3—Intraocular Pressure: A tonometer (handheld digital pen-like device) is used to screen for glaucoma and/or uveitis. The normal value for this test varies by age, breed, and skull shape.
4—Fluorescein Stain: This dye is applied to the surface of the eye to assess the integrity of the corneal and conjunctival surface, as well as the health of these tissues. It screens for corneal ulceration and abrasions, but it also evaluates the tear film health, and tear duct patency. There are many uses for this dye test.
Once initial diagnostics are collected, your veterinary technician may dilate your pet’s pupils (with a short-acting pupillary dilating agent that lasts for 4-6 hours). Did you know that without pupillary dilation, less than 30% of the lens, retina, and optic nerve can be examined? Pupillary dilation can take 10—15 minutes to occur. This is not uncomfortable, and does not cause sleepiness, feeling faint, or changes in heart rate as it can in humans. However, your pet should NOT drive you home following pupillary dilation. 😊
The veterinary ophthalmologist may examine your pet with one of several different non-invasive, non-painful tools. Topical numbing drops are always applied during diagnostic testing, and these drops last for 15 or more minutes (and are reapplied, as necessary). Examinations are always performed in the dark so that the pupil relaxes, so that we can see into the eye as much and as easily as possible. Our faces need to touch your pet’s face (most closely, their mouth), so it is very important that you let us know if your pet is nervous or needs to wear a muzzle. Believe it or not, most pets prefer to be examined without their owners in the exam room, which allows them to relax, and worry less about protecting you during the exam. (Many ophthalmologists will have chairs immediately outside the exam rooms for exactly this purpose.)
Once the lights are off, the white or blue device that every ophthalmologist holds in our hand to look at the eyes is called a slit lamp. This is a hand-held microscope that magnifies everything that we see by 16 times the size of normal. This is a handheld version of the big machine that humans place their chins into in order to have our eyes examined (but cannot produce a puff of air!). Animals and small children are not always able to sit still, and so, we have a hand-held slit lamp that is able move along with them.
The black headset that we place on top of our heads like a hat is a magnifying system that allows us to look inside of the eye, all the way back to the retina and the optic nerve. Most human ophthalmologists have this piece of equipment, as well! Some offices have this device connected to a monitor so that you will be able to see what we see on a television screen.
Every exam will be just a little bit different, depending upon what your pet needs, but we work as quickly and as gently as we can each time. Some of us will ask questions while the lights are off, and some of us will save all of our talking until the lights are back on. You should always leave our office with some instructions written down, and you should come to every appointment with questions written down to ask us, if you have any!
Most of us like to give your pet some treats at the end of (or even during) an exam, to help reward your pet for being patient and/or well-behaved, and to help them to understand that our office is a good, safe place to be. (This means that if your pet has dietary restrictions or a food allergy, it is a good idea to bring some treats of your own, or to let us know!)
It is incredibly important to us that you leave our office understanding what is going on with your pet, what your options are for making them better, and how we can help you. Always feel like you can ask questions, and make sure that you familiarize yourself with different members of the team, as everyone will be an important part of your support system. Remember that we love your pets, too, and are here to help!