Star Gazing
Star was a tidy bay Thoroughbred, just 3 years old when Teresa Scott brought him to Snow Angel Ranch. He showed promise as a fancy hunter with his supple handling, smooth way of going and aptitude in schooling over a low jump now and then. Teresa buys hunter/jumper prospects to train, an investment and a hobby. In warm weather, she conditions the horses on the gravel roads that lead to Devil Mountain Trail and along the Chris Mountain Loop.

The horses of Snow Angel Ranch live at 7300 feet elevation among century-old Ponderosa and Aspen. They commune with the elk and deer every morning, and at night they have a crystalline view of myriad galaxies twinkling in the black sky. In the winter, the ranch is only accessible by snowmobile, and Teresa and her husband Robert make sure they have put up plenty of hay, filled the grain bin (and the freezers), stockpiled wood, and winterized the historic cabin that they call home. The horses have good food and shelter, and space to play in the snow. When Teresa wasn’t working Star, he was turned out on several acres of forest pasture with Zena, a forest wise thoroughbred mare, and they ran, reared, dodged, and played through the fall and the winter.

In the spring, another young thoroughbred off the track who had wintered at the ranch was added to the pasture and the play got more rambunctious. One day in the midst of a mock battle, Star reared and dodged the wrong way trying to avoid the snapping teeth of his buddy. He impaled his right eye on a stout broken branch of a pine tree. The branch ruptured the eyeball and, along with aqueous fluid, the iris prolapsed and the eyeball collapsed. The branch had punched on up through the upper lid.

Teresa called our office. My husband and partner, Dr. Jim Latham, made the long drive on gravel roads to Snow Angel Ranch, fording spring-fed Devil Creek. He examined Star under sedative and confirmed the loss of the eye and fracture of the bony orbit. He removed a splinter of wood embedded in a wound above the eye. He was concerned about future migration of sequestra, devitalized bone fragments. Plans were made to remove the damaged eyeball once local inflammation and infection were under control. Jim prescribed Bute for pain relief, trimethoprim-sulfa as antibiotic and local eye ointment after gentle cleaning.

Slim never did have as good a tan as the other horses.
One month later I traveled with Jim to Snow Angel Ranch. Under general anesthesia, Jim debrided the wound above the eye and removed small bone fragments that were free in the tissues. We enucleated the right eye using a transpalpebral approach—an incision about 1/4 inch behind the eyelid margins, removing conjunctiva, the globe, and the third eyelid, and clamping and ligating the optic nerve and associated blood vessels. We inserted a round, sterile silicone intraorbital implant, more than an inch and a half in diameter, to reduce the orbital defect cosmetically and to avoid a skin dimple that would collect dirt, oils and debris requiring daily cleaning. We sutured the eyelids closed over the implant. Star now appeared to have a permanent wink.

Implants are not used in situations where cancer or infection may be present in the orbit, but where cosmetics are more important—a stallion or a valuable show horse, the eyeball only may be removed, preserving the eyelids and tissues around the eye including the ocular muscles and the tear glands. An intrascleral silicone prosthesis, a fake eyeball, may then be placed in the defect. Normal eyelid and eyeball movements and tearing remain and the prosthesis may be painted to approximate the normal appearance of the horse’s eye.

Star recovered well and seemed comfortable with his prosthesis. He adjusted immediately to one-sided vision. His increased awareness of sound and touch seem to reassure him and he does not shy from people or objects that approach his blind side. Throughout it all, Star retained his confident good nature and remained the alpha horse in his pasture. He continues to train not only on high country trail rides but in the ring; at liberty, on line, or under saddle, working well in both directions and once again showing form over low jumps. Star’s prosthetic eyeball implant give roundness to the site of injury, and his permanent wink adds a touch of humor to his friendly face. This young horse still looks forward to his future.

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