Retrobulbar Abscess in Cats

The retrobulbar space is the area just behind the eye. Although uncommon, an abscess or pocket of infection/pus can develop behind the eye, which is referred to as a retrobulbar abscess. This is usually associated with inflammation and infection of the tissues behind the eye. When this infection becomes localized in one area, an abscess can form.

This infection can develop as the result of an infection of the mouth, teeth, eye or sinuses; the migration of foreign material; or from systemic infections. It can occur in cats of any age or sex. When related to the migration of foreign material, retrobulbar abscessation is more common during periods of prolonged drought. During these times, plant material is drier, sharper, and more brittle, and can more readily migrate through the tissues of the mouth into the space behind the eye.

For most cases of retrobulbar abscessation, only one eye is involved and the cat responds well to treatment. Many cats improve in 48 to 72 hours with appropriate early treatment of the condition.

What to Watch For

Signs of retrobulbar abscessation usually occur suddenly and include:

Bulging of the eye
Swelling of tissues surrounding the eye
Prolapse of the third eyelid partially over the cornea
Pain upon opening the mouth
Not eating (due to pain)
Crying when chewing
Lethargy
Fever

Diagnosis of Retrobulbar Abscess in Cats

A thorough eye exam is performed, which includes fluorescein staining of the cornea to check for ulceration, as well as measurement of the pressure within the eye. Attempts may be made to examine the mouth, but this may be too painful for your pet and may have to be performed under sedation.

Often, physical examination is all that is needed to diagnose retrobulbar abscessation. In some cases, additional diagnostics may be required and may include:

Complete blood count
Biochemical profile
Urinalysis
Ultrasound of the eye and the tissues behind the eye
X-rays of the mouth/teeth

Treatment of Retrobulbar Abscess in Cats

Treatment is aimed at eliminating the infection and allowing drainage of any pus from behind the eye. In mild cases, antibiotics are usually started both orally and topically. Many of these cases respond and improve in 48 to 72 hours. If the signs are severe or worsen, a surgical procedure may performed that involves opening the area behind the eye to allow the pus to drain. This is accomplished by making an incision in the roof of the mouth behind the last upper molar tooth. General anesthesia is needed for this procedure.

Home Care and Prevention

If your pet is painful or has a bulging eye, a veterinary examination is recommended immediately. Once a retrobulbar abscess is diagnosed and treatment has been started, all medications must be continued at home exactly as prescribed. Such medications may include topical antibiotics or lubricants, and oral antibiotics. You may be asked to apply warm, wet compresses to the eye three to four times per day for several days to reduce swelling. Offer soft foods to help your pet eat until the swelling and pain have diminished.

To reduce the risk of retrobulbar abscessation, try to prevent your pet from ingesting foreign material, particularly plants. Prompt treatment of infections can also help reduce the risk of developing a retrobulbar abscess.