Land of eyeballs: ophthalmology rotation

I was really surprised at how interesting I found my ophthalmology rotation. Two weeks of eyeballs should have been mostly boring and creepy, right? But it turned out to be rife with my favorite kind of veterinary ethical issue: how we breed dogs.

Take the several bulldogs we saw who had so many facial wrinkles that their skin was folded over their eyes and rubbed against their eyeballs. (They also had yeast infections in the depths of their wrinkles, but that was a problem for a different department.) These dogs required surgical intervention to cut off the worst of the wrinkles. If they did not receive the surgery, they would be extremely uncomfortable (they all came in with red, squinty eyes), and would eventually get corneal ulcers which would proceed to infections and possible removal of the eye in question.

We also saw a raft of brachycephalic (flat-faced) dogs whose faces were so flattened that their eyes bulged out. Some of them could not completely close their eyelids. Their eyes were at risk for damage just due to being so out there in the world and unprotected. In the opinion of the ophthalmologists, pug owners all need to be given special eye care instructions when they acquire their new dog.

I asked the owner of one of the dogs that required surgery about where he had gotten the dog. He replied that the dog came from a breeder. I suggested that he get in touch with the breeder to let her know about the necessary surgery, so that she could use that information to help her choose wisely which dogs to breed in the future, and try to avoid producing more puppies with the problem. He replied in surprise, “I thought this was just a breed-related problem.”

Yes, these are breed-related problems. But breed-related isn’t synonymous with inevitable. It doesn’t mean we can’t try to avoid them as we create more dogs of that breed. Veterinarians can and should be more clear with their clients about this. They don’t have to be confrontational to do it! They don’t have to imply that the client made a mistake by purchasing the dog. They can instead look to the future: here’s what we can do to make the breed better.