Cloudy Eyes in Dogs? Cataracts Explained

Perhaps you’ve noticed that your curious and adventurous dog has started navigating the world more cautiously, especially in darker rooms or at night. Cataracts could be the cause of vision changes or cloudiness in your dog’s eyes. This guide includes everything you need to know about cataract surgery for dogs, including symptoms, what to expect from cataract surgery, and costs.

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Understanding cataracts in dogs

The eye's lens is a clear structure that rests just behind the pupil (dark center) and iris (colored ring) in a healthy dog's eye. The lens focuses light entering the eye through the pupil to create a clear image for the retina to detect.

A cataract is an opacity of the lens or the capsule that contains it. An opacity of the lens affects how much light can pass through the lens to the retina. Cataracts cause blurry vision, reduced nighttime vision, and sometimes blindness. Cataracts can occur in one or both eyes.

The age at which a dog develops cataracts depends on the underlying cause. Most cataracts in dogs have an underlying genetic component. Breeds with a higher prevalence of cataracts include smooth fox terriers, Havanese, Bichon frisés, Boston terriers, poodles, silky terriers, American cocker spaniels, and miniature schnauzers. The second most common cause of cataracts in dogs is diabetes. Injuries to the eye and infections can also cause cataracts.

Symptoms of cataracts in dogs

The two main symptoms of dog cataracts are changes to vision and a cloudy white pupil. Small or immature cataracts may not cause any noticeable change in your dog’s behavior.

Some cataracts cause inflammation in the front of the eye (anterior uveitis), which causes pain, eye redness, and excessive tear production. They can also cause glaucoma, with signs including eye pain, swelling of the eye, discharge from the eye, clouding of the cornea (clear outer layer of eye), and blindness. Symptoms of blindness in dogs include bumping into objects, clumsiness, easily startling, anxiousness, and difficulty finding specific objects.

If your dog has cataracts due to diabetes, you may also notice excessive urination, increased thirst, and weight loss.

Diagnosing cataracts in dogs

A veterinarian can diagnose canine cataracts before they're easily visible, determine if there's an underlying cause (like diabetes) that needs management, and create a treatment plan to slow progression. Your veterinarian can also differentiate cataracts from nuclear sclerosis, which is a normal aging change to the lens that causes a bluish haze in the pupil. You may be referred to a veterinary ophthalmologist for a discussion of surgical treatment.

Your veterinarian will diagnose the presence of cataracts with a simple eye examination. This involves shining a light into the eye and looking through a magnifying lens at the back of the eye. The veterinarian will also determine if your pet has any vision through the eye and test the pressures in the eyes to rule out glaucoma. Blood and urine may be collected to rule out diabetes.

You may be referred to a veterinary ophthalmologist for further characterization of the cataract. To examine the eye's overall health and determine the cataract stage, the ophthalmologist will dilate the pupil with specific eye drops (tropicamide). With the pupil dilated, a complete eye examination can be performed to determine how obstructed the view of the retina is. A slit lamp can be used to characterize the cataract fully.

Earlier detection of cataracts allows for intervention before the cataract progresses to cause pain, glaucoma (increased pressure in the eye), retinal detachment, or uveitis (inflammation in the eye). These conditions can result in complete vision loss and the need to remove the eye (enucleation) for pain management.

Stages of dog cataracts

Part of diagnosing cataracts includes determining the stage or maturity of the cataract. The stages of dog cataracts are based on the severity of the cataract and how much of the lens is affected during retinal examination. These stages include:

1. Incipient. Under 15% of the lens is affected. The dog will not have noticeable changes to vision.
2. Immature. Early immature cataracts affect 15–50% of the lens. Late immature cataracts affect 50–99% of the lens. Some of the lens's transparency has decreased, but the back of the dog's eye may still be partially visible on exam. The dog's vision will be blurry, but they will not be blind at this stage. Vision loss is usually mild to moderate. Surgery is generally recommended at this stage, mainly if the cataract is progressive.
3. Mature. 100% of the lens is affected. The eye is considered blind, though the dog may see shadows. Most dogs are still good surgical candidates at this stage, though the success rate will be lower than for immature cataracts.
4. Hypermature. The lens will begin to liquefy, and the cataract may have a sparkly appearance. Though some return of vision may initially occur as the lens liquefies and fades, the dog will develop severe inflammation in the eye (lens-induced uveitis). Surgery may still be recommended for a hypermature cataract, but the surgery is less likely to have a good outcome, and the risk of complications is higher.

Treatment options for dog cataracts

Treatment options for dog cataracts are selected based on the severity of the cataract, the patient's overall health, and owner finances.

• Monitoring. Early cataracts (incipient and early immature cataracts) usually don’t require surgery. Some of these cataracts won’t progress, but your veterinarian will recommend check-ins to ensure they’re stable.
• Medical management. While waiting for surgery, the dog may be managed with topical medications that dilate the eye and reduce inflammation. Glaucoma should be treated, as well. Long-term administration of anti-inflammatories may prevent secondary conditions like glaucoma, uveitis, or retinal detachment, but the cataract may still progress, leading to blindness.
• Cataract surgery. Cataract surgery is the primary treatment option for progressive immature, mature, or hypermature cataracts. It aims to restore vision and prevents secondary conditions like glaucoma or lens luxation (displacement of the lens within the eye).
• Enucleation. For pet owners who cannot afford specialty surgery, eye removal may result if cataracts progress to cause loss of vision and significant pain. While cataracts themselves are not painful, they can cause inflammation of the eye (uveitis) or glaucoma, which are painful conditions. Removing the eye will improve the quality of life of a dog that is already blind and painful when cataract surgery isn’t an option.

Cataract surgery for dogs: what to expect

Cataract surgery is performed by veterinary ophthalmologists at specialty clinics or universities.

Before surgery, the veterinarian will perform lab work — usually blood and urine testing — to ensure your pet is healthy enough for anesthesia. The ophthalmologist may also perform an eye ultrasound and/or an electroretinogram to ensure your pet is a good candidate for the surgery. Ultrasound will allow the ophthalmologist to see the structures behind the cataract to ensure they're normal. Electroretinograms test the retina to ensure it's still functional — this is how they ensure your dog can see if they perform surgery. If the retina is nonfunctional, the eye is blind already, and there is no need for specialty surgery.

If your pet already has another eye condition, like uveitis or glaucoma, these must be controlled prior to cataract surgery. Other considerations include your dog's overall life expectancy, the existence of other health conditions, and your dog's temperament. Your dog will require frequent eye drops. If they are aggressive or don't tolerate eye medications, they are at risk of having an unsuccessful post-op recovery period.

The surgery is performed under general anesthesia, so your pet won’t experience pain. The veterinarian performing the surgery will be using a surgical microscope. The current state-of-the-art procedure for cataracts is called phacoemulsification. A small incision is made in the eye, and a probe is inserted into the lens capsule. The lens is shattered with ultrasonic waves, and the probe removes the debris. After removing the lens, a fake lens (intraocular lens or IOL) is implanted. If an IOL is not implanted, the animal will still be visual, though they’ll be significantly far-sighted.

Some surgeons will perform surgery on both eyes at once, while others prefer to do one eye at a time.

Recovery after cataract surgery

In the immediate recovery period after surgery, your pet must be aggressively monitored for uveitis and glaucoma. Some surgeons will recommend hospitalization for 1–2 days after the procedure to monitor for complications. Your pet will have a recovery cone to prevent them from scratching or rubbing their eye(s).

The primary surgical complication to be aware of is uveitis. Because the surgery involves cutting into the eye and opening the lens capsule, all patients who receive this surgery will develop some degree of uveitis. Postoperative uveitis is treated aggressively with medications to reduce inflammation and dilate the eye. Some surgeons may preventatively put animals on medications that decrease pressure within the eye to prevent postoperative glaucoma. Most pets who receive this surgery will also receive antibiotics during recovery to prevent infection.

Some dogs can develop a condition called posterior capsule opacification (PCO) over time after lens implantation. Cells left behind within the capsule replicate and cause a thickening in the back of the capsule. Studies to reduce the development of this complication are underway.

Other risks include retinal detachment (causing blindness), bleeding within the eye, and surgical site infection.

You should expect your pet to require frequent rechecks, often every six months, for the rest of their life. You will also need to apply drops to the eyes 4 to 6 times per day during recovery, which is a significant time commitment. Some pets will remain on medications long-term to control inflammation and pressures in the eye.

Over 90% of patients who receive the surgery regain functional vision, and most pet owners are satisfied with the results. Long-term complications or poor outcomes are likely in pets whose owners do not bring them in for the necessary rechecks.

Cost of cataract surgery

Cataract surgery costs around $2,500–4,000 per eye. Pet insurance plans that cover accidents and illness, called comprehensive plans, are likely to cover your pet's cataract surgery as long as they didn't have changes to their eyes before signing up for insurance, which could cause cataracts to be considered a pre-existing condition. Cataracts due to diabetes may not be covered if your pet had diabetes before signing up for insurance. Some insurance plans may not cover cataracts in predisposed breeds. The potential development of cataracts is one reason to consider pet insurance for older dogs.

Cataract surgery is a safe and effective treatment that preserves vision for most dogs with cataracts that haven't caused secondary eye conditions like glaucoma. Early detection and treatment of cataracts increase the likelihood of success. If you think your dog may have cataracts, schedule an appointment with your veterinarian to discuss eye health and determine if cataract surgery is recommended.