1. Flashcards
What is the normal eye p?
15 - 25 Hgmm.
Schirmer time in a normal dog test.
1 min.
Which sp has multi- line eyelash?
Dog.
Which is the most important examining technique?
Flourescein staining +Opthalmoscope.
In which sp is glaucoma a frequent hereditary disease?
Dog.
What does symblepharon mean?
- Adhesion of conjunctiva on itself/ on the cornea.
- Typically found in young cats with viral conjunctivitis (FHV).
In which sp is cataract inheritible?
Dogs.
What doesn’t have a role in the amt of aq humour?
Light reflection of tapetum + non- tapetal fundus.
What can be a reason for lens surgery?
Ant lens luxation, Cataract.
Co blue light?
Provides a suitable means of exciting Na fluorescein ( orange dye) for examination of ocular surface integrity.
What doesn’t cause glaucoma?
Post lens luxation.
What you do ø do before taking sample for bacteriology?
Do local anesthesia.
How to treat cataract?
Surgery is the only way.
When can you see a “ cresecent moon”?
At lens subluxation.
Symptoms of Horner’s syndrome?
- 3rd eyelid prolaps.
- Myosis, Enophtalmos.
- Narrowing of palpebral fissure.
- Peripheral vasodilatation may occur causing increased facial warmth, best observed in ipsilat ear.
- Golden retriever- idiopathic.
- Other causes- trauma, otitis, tumour.
What is true for sub- conjunctival inj in Eq?
- Local supf anest.
- Full anest.
- Max 3 ml.
??
What grows together when there is post synechia?
The iris adheres to lens.
What are the consequences of chronic inflammation in Eq?
- Chronic uveitis.
- Corneal endothelial degeneration/ dystrophy.
> corneal vascularization/ precipitates. - Lens luxation, subluxation.
> vitreal opacities.
> focal chorioretinitis, retinal detachment.
Definition of glaucoma:
Disturbance in the drainage of aq, which can elevate IOP.
How to examine the retina detachment in the most precise way?
By monocular indirect ophthalmoscope–> greater field of view.
What is true for direct ophthalmoscope?
Monocular.
Sus has ø light reflecting layer/ tapetum
T.
How descemetocele is stained by fluorescence?
Fluorescence adheres only to the walls of ulcer, the central floor of the ulcer appears black.
What is phacoemulsification?
A modern cataract surgery in which the eye’s int lens is emulsified with an ultrasonic handpiece + aspirated from the eye.
What doesn’t get damaged in glaucoma/ ø in this way.
Destroy all intraocular structures: cornea, lens, sclera, ant uvea, vitreous, retina ONH.
Statements of sub- palpebral drains.
Continuous eye drops in horse, tarsorrhaphy.
Jone’s test?
Fluorescein staining for corneal integrity and it appears at the nares within 1- 10 minutes in ipsilateral nose.
Components of uvea?
Iris, corpus cilliare + choroid.
Purkinje’s images?
On the lens/opacity on the lens.
Connection of retina?
At 2 sites: behind the ciliary body- parts plana, + near optic n head.
What do ciliary bodies do?
Produce aq fluid.
Normal p in the ant chamber?
15 - 25 mmHg.
Which n blocks do you use for the subpalpebral drainage?
Auricopalpebral + frontal n block.
Why do you perform a subpalpebral drainage?
Continuous eye drops in Eq.
How long can the drain stay?
3 - 4 wks.
Nasolacrimal drainage used?
Only when you can’t use subpalpebral?
Why do you use a 3rd eyelid flap?
For protection + healing, only small animals?
How long can the 3rd eyelid flap stay on?
2 wks?
What is a tarsorraphy?
Suturing eyelids together.
What is the lat canthotomy?
Cutting the lat canthus.
When is lat canthotomy used?
Porobtosis, ocular trauma + release of IOP?
Contraindication of lat canthotomy?
Globe rupture?
Stay sutures of globe?
Into sclera, ø penetrating–> gives support for surgery, 3+ 9 o’clock?
Neuromuscular blockers used?
Atracurium/ Pancuronium 0.2 mg/kg- paralyse breath for 30 mins?
Human ophthalmological sutures?
10/0 + 11/0 non absorbable atraumatic nylon?
Veterinary ophthalmologic sutures?
6 - 8/0 monofilamentous/ polyfilamentous ABs, atraumatic?
Cannula for inj of fluid?
30G?
Extraoccular tampon?
Cotton?
Intraocular tampon?
Cellulose?
Viscoelastic material?
Methycellulose injected into the ant chamber to replace the aq humor.
What is the fundus?
Visible background of the eye seen through dilated pupil.
How to dilate the pupil?
- 1 dp of tropicamide, wait for 20 mins.
- It should last for 4 - 6 hrs.
When do you ø perform this examination? IOP
Glaucoma/ lens luxation?
Direct ophthalmoscope?
Lens + light together is the best- slit lamp.
Diopter for fundus?
Tapetal fundus.
Role of tape fundus?
Reflective tissue ( ø pigments), amplify light ( ø in Sus + humans).
What is ø true about tapetum?
Located between the chorioid + retina vent on the globe.
Which sp have tapetum fibrosum?
Herbivores.
Which sp have tapetum cellulosum?
Car.
Who has stars of Winslow in the fundus?
Eq.
What is the Progressive Retinal Atrophy Syndrome ( PRA)?
- Pigmented change in the tapetal fundus with attenuation of vasculature + atrophy of the optic dic + V.
- Prone in middle aged labradors.
- The retina absorbs less light + therefore there is more light being reflected.
What is seen in PRA?
Very reflective tapetum, atrophy of v + pale optic n. head.
What is seen in the collie eye anomaly ( CEA)/ Retinal dysplasia ( RD)?
?
How is the CEA seen on an ophthalmoscope?
Folds seen are epsilon- like stripes.
Reasons for retinal haemorrhage?
Cat with hypertension, ethylene glycol toxicosis + Erlichiosis.
Retinal detachment?
Separation of inner layer of retina from the choroid plexus- holes in the retina.
Solution?
pH 3.5- 10.5, should be sterile, pH + temp stabile.
Suspension?
Drug is included in small particles, the tear dissolves the particles, it has long contact time, absorption in form of solution: prolonged contact time.
Ointment?
pH + temp is ø important, oil/ H2O base, disadvantages: inhibit corneal wound healing.
Absorption after topical administration?
Mostly washed out, absorption by the conjunctival capillaries/ penetration to the cornea- lipid best.
Subconjunctival inj?
Corticosteroids mostly, max 1 ml in the dors palpebra.
Retrobulbar inj?
Lower lat quadrant into the retrobulbar space, anesthetic for eye removal in cow, Ab in small animal.
Intravitreal inj?
- At lat canthus, quadrant, with 2- 3 mm from limbus, the needle is inserted intoo the vitreous.
- Gentamycin inj in glaucoma.
Systemic inj?
Only if inflammed, Ab/ hyperosmotics are the most common.
Mydriasis?
Sympathetic innervation m. dilator pupillae, glandula lacrimalis.
Miosis?
Parasympathetic innervation- M. Sphincter pupilla, M. Ciliaris + glandular lacrimalis.
What is ø a topical treatment?
Subconjunctival/ installation.
When doing bacterial sampling?
Take sample before anaesthesia.
What do you do immediately with a Eq that has pink eyes?
Fluorescin test.
Which is false for 3rd eyelid?
Well muscled in large + small animals, covered both sides by conjunctiva, position supported by the globe?
What is mydriasis?
Pupil dilation.
What effect do Parasympatholytics have on eye?
- They inhibit the pupil sphincter m + ciliary m. function.
- Mydriasis with cycleopegia.
What are solutions?
ø easily infected.
Fluorescein stain?
Hydrophilic + stains exposed stroma.
The tear test?
Is done without anaesthesia?
What do you ø use for melting ulcers?
Supf keratectomy/ pedicle Graft transplantation/ Free island transplantation?
What do you do with descemetocele?
It requires surgical intervention.
What is Ankyloblepharon?
Inability to close the lids/ lid margins partial/ total closure.
How to treat blepharospasm in Eq?
Frontal n. block/ auriculopalpebral n. block/ tropicamide solution.
What are the indications for vitrectomy in a Eq?
Recurrent uveitis?
Effectiveness of Atropine to keep the pupil dilated gives us information about?
The severity of uveitis.
When are glucucorticoids contraindicated?
If fluorescin stains the cornea.
What is blepharitis?
Inflammation of eyelids.
What are the glds of eyelid?
Zeis, Mill, Meibomian/ Tarsal.
What is Chemosis?
Oedematic swelling of the conjunctiva.
What are the borders of the eye chamber?
Iris, pupil + cornea.
What is the dazzle reflex?
Subcortical reflex.
Which animals have cilia on the lower eyelid?
None?
The shape of pupil in herbivores?
Horizontal elliptical.
What is false about ointments?
Can be used intraocularly.
Johnes test?
The appearance of something at the nostril?
Most important drain.outflow in Eq?
Uveo- scleral route?
What is ectropion?
- Eversion, turning of eyelid, always the lower eyelid is affected.
- Etiology: developmental/ structual, acquired/ cicatrical, intermittent.
What is ø a CS of acute uveitis?
Mydriasis.
Rose Bengal:
- ( Hydrophilic red stain).
- Stains the degenrated, necrotic cells + the mucus in brillant red.
Which one is false when examining the fundus?
Examiner needs to sit.
Adjustments needed for direct + indirect opthalmoscope?
Direct: form - 3 to + 20?
There is a strong connection between the post lens + ant surface of vitrous body in animals?
True.
Cataract surgery, which one has the post lens capsule intact?
ECE- Extracapsular lens extraction.
Is Phaco ICE/ ECE?
ECE.
ERU in Eq, what can it lead to?
In influx of inflammatory cells into the eye + hypersensitivity of the uvea.
About aq humor + what does ø have an effect on it’s production?
..
Entropion is never?
Intermittent.
When is it appropriate to take bacterial sample?
Before topical anaesthesia.
3rd eyelid is well developed in SA?
ø true?
What do parasympatholytics do?
They block function of M. sphincter pupillae + M. ciliaris causing mydriasis with cyclopegia.
Which route is ø topical treatment?
Subconjunctival, retrobulbar, intravitreal inj.
Fluorescent dye?
Hydrophilic, stains exposed stroma green.
How do you perform Schirmer’s tear test?
Fold strip at the mark + place in the lower conjunctival sac for 1 mn.
Which drugs ø to use in cases of KCS?
Hyaluronic acid.
Chemosis?
- Swelling/ oedema of the conjunctiva.
- Sign of conjunctivitis.
Cherry eye syndrome.
- Defect, laxity in the retinaculum that binds the gl + the nicitans to the periorbita–> protrusion of 3rd eyelid gl.
- In dog, breed and age predisposition.
- Surgical treatment, replacement of prolapsed gl.
Entropion + Ectropion.
- Entropion = inward of the eyelid margin.
- Ectropion= eversion, turning out of the eyelid.
Solutions, Suspensions + Ointments.
- All used topically.
- Solution:
> pH 3.5 - 10.5.
> pH + temp –> determine stability.
> should be sterile. - Suspension:
> Drug is included in small paticles.
> Tear dissolves the particles -> absorption in the form of solution, prolonged contact time. - Ointment:
> Oil/ H2O based.
> pH + temp is ø as important in the stability.
> Inhibit the corneal wound healing.
Topical treatment.
By using solutions, suspensions, + ointments.
Trichiasis.
- Cilia arising from normally located follicles, are pointed in abnormal direction.
- Ectopia ciliae: Additional ciliae originating from abnormally located follicles.
Extirpation vs Evisceration.
- Extirpation: Complete excision/ surgical destruction of a body part.
- Evisceration: The removal of the eye’s contents, leaving the scleral shell + extraocular m intact.
Jone’s test.
- To see if the lacrimal duct is obstructed/ ø.
- Method: Put Fluorescein in the conjunctiva + wait a few mins.
- +ve: Dye is detected in the nostril of the same side of the eye in question –> lacrimal gl is working fine + is ø obstructed.
- -ve: Dyes is ø detected in the nostril of the same side fo the eye in question –> a partial/ complete obstruction/ failure of the lacrimal gl.
Abnormalities regarding the hair??
- The eyelids can have deformities which can cause hair to be in const contact with the cornea, causing irritation + excessive lacrimation + may lead to corneal vascularization + corneal ulceration.
- Deformities:
> Prominent nasal fold in brachycephalic breeds.
> Disorders of the ciliae.
• Distichiasis.
• Trichiasis.
• Ectopia ciliae.
> Entropion.
> Ectropion.
> Hordeolum.
> Blepharitis.
> Traumas.
Dazzle reflex.
Type of reflex blink where the eyelids involuntarily blink in response to a sudden bright light.
Properties of Atropine.
- Mydriactic–> dilates pupil.
> Min adhesions( synechiae).
> May ø be able to break down synechiae in chronic cases.
> Keep the pupil dilated gives us information about how severe an uveitis case is –> the longer the pupil is dilated, the milder the uveitis case.
> Eyes with a brown iris stay dilated longer than eyes with a blue iris. - Cycloplegic –> relaxes the ciliary m.
> Relieve ciliary m pain.
> Pain relief. - Stabilises blood aq barrier.
Contraindications of corticosteroids.
Corneal ulcers –> make sure eye is fluorescein -ve.
ø eyelashes on lower lid.
Abscence of ciliae in lower eyelid is physiological in cat, Eq, cow.
Shape of pupil.
- Eq, cow, Sus –> horizontal elliptical.
- Dog –> rounded.
Cat –> perpendicular rhomboid.
Draining tracts of the Eq eye??
Eye has the iridocorneal angle for the drainage of the aq humour.
What is used to decrease blepharospasm in eq?
Merck: Auriculopalpebral n block.
What is done 1st to diagnose Descemetocele?
Fluorescein stain.
What is ankyloblepharon?
Fusion of part/ all of the eyelid margins.
What is the main indication for pars plana virectomy in Eq?
Eq recurrent uveitis.
Detected painful red eye in Eq: What do you do 1st?
Stain with fluorescein.
What is ø a topical treatment?
Subconjunctival inj.
When do we do bacterial sampling?
Before topical anaesthesia.
The 3rd eyelid: which is false?
It is well muscled both in large + small animals.
What is mydriasis?
Pupil dilation.
What effect do Parasympatheticolytics have on the eye?
They block the function of the M. splinter pupillae + M. ciliaris–> mydriasis with cyclopegia.
What are solutions?
ø easily infected?
Fluorescein stain?
Is hydrophilic + stains exposed stroma.
The tear test.
Is done without anesthesia.
What do you ø use for melting ulcers?
Supf keratectomy.
Jone’s test:
Fluorescence stain appear at nares after 1- 10 mins.
Components of uvea:
- Vascular layer.
a. Ant uvea- Iris + cilia.
b. Post uvea- Choroid.
Connection of retina:
Pars plana- joins the retina- Ora ciliaris retinae.
What does the ciliary body do?
Produces aq humour, accomodation, lens zonules.
Normal p in ant chamber:
12 - 22 mmHg.
What n blocks for sub- palpebral drainage?
Auriculopalpebral n block + Supra- orbital n block.
Why sub- palpebral drainage?
Eq sub- palpebral lavage- continuous eyedrops in Eq.
How long can drain stay?
SPL system can remain in place for 2 - 6 wks/ more, if it is ø damaged + kept clean.
Nasal lacrimal drainage:
Only when cannot use sub- palpebral?
Why 3rd eyelid flap?
- Protection + healing, only in SA.
- SA- Indolent supf corneal ulcer, deep corneal ulcer- 3rd eyelid flap as a supportive technique, post- op management.
- IBo keratoconjunctivitis ‘ pink eye’- Tarsorrhaphy +/ or 3rd eyelid flap in severe cases.
How long can 3rd eyelid flap stay?
2 wks?
What is tarsorrhaphy?
Suturing eyelids together.
What is lat canthotomy?
Multi- purpose general intervention in eye surgery- release increased orbital p.
Contraindication of lat canthotomy:
Globe rupture.
Stay suture of globe:
Into sclera, ø penetrating - support for surgery, 3 + 9 o’clock?
Neuro- muscular blockers used:
Atracurium + Pancoronium.
Human opthalmology sutures
10/0, 11/0, non- absorbable, atraumatic nylon.
Vet opthalmology sutures:
6 -8/0 mono- filamentous/ polyfilamentous, absorbable, atraumatic.
Cannula for inj of air:
27 G.
Cannula for inj of fluid:
30 G.
Extra- ocular tampon:
Cotton.
Intra- ocular tampon:
Cellulose?
Visco- elastic material:
Methyl- cellulose inj into ant chamber to replace aq humour.
What is the fundus?
- Every structure which can be seen on the ocular background.
- Visible background of eye, seen through dilated pupil.
How to dilate pupil:
- Mydriasis= Dilation of pupil.
- 1 drp of Tropicamide, wait for 20 mins, last for 4 - 6 hr.
When ø to dilate:
Glaucoma/ Lens luxation?
Direct ophthalmoscope:
- Mono- ocular- Lens system with changeable diopter- Changeable illumination light- High mag X15, small field of view- Erected picture.
- Lens + light together.
Diopter for fundus:
- 1-3?
Dors 1/2 of fundus:
Tapetal.
Role of tapetal fundus:
Reflective tissue, amplify light, ø in Sus nor humans.
Who have tapetum fibrosum?
Cows, sheep, goats, Eq.
Who have tapetum cellulosum?
Car, rodents, cetecea.
Who has stars of Winslow in the fundus?
Eq.
What is Progressive retinal atrophy syndrome ( PRA)?
Pigmented change in tapetal fundus w attenuation of vasculature + atrophy of optic disc, middle aged labrador.
What is seen in PRA?
Disorder of fundus, very reflective tapetum, atrophy of v, pale optic n head.
What is collie ey anomaly ( CEA)/ retinal dysplasia ( RD)?
Scleral actasia= Sclera protrude into eye around optic n head.
How is CEA seen with ophthalmoscope?
Folds seen as epsilon- like stripes.
Reason for retinal hemorrhages:
Tumor, conjunctivitis, traumatic injury, uveitis with infective systemic disease.
Retinal detachment:
- Separation of inner layer of retina from choroid- Holes in retina.
- Due to tumors, uveitis.
Solution:
pH 3.5 - 10.5, sterile, pH + temp = determine the stability.
Suspension:
Drug in small particle–> Tears dissolve the particles–> Absorption in the form of solution: Prolonged contact time.
Ointment:
- Oil/ H2O- based, pH + temp are ø so important in the stability.
- Disadvantage: Inhibits corneal wound heal.
Absorption of topical administration:
- Drops, ointment, sub- palpebral + naso- lacrimal methods.
- After administration, either washed out by tears/ absorption by the conjunctival capillaries/ penetration into the cornea.
- Lipid soluble drugs–> Easy, trans- cellular absorption.
- H2O soluble drugs–> Poor, inter- cellular absorption.
Sub- conjunctival inj:
- Cornea- conjunctiva barrier is bypassed.
- High drug conc in the ant segment.
- After topical anesthesia, fine needle used.
- Mild hemorrhage.
- Mydriasis, Abs, corticosteroids.
- Max 1ml in dors palpebral.
Retrobulbar inj:
- High drug conc in the orbit + the post segment.
- SA –> general anesthetics–> Ab.
- Cow –> local anesthetics for extirpation.
- Needle is inserted at the lower- lat quadrant into the retro- bulbar space.
> IOP may increase afer administration.
Intra- vitreal inj:
- At lat canthus, with 2- 3 mm from limbus the needle is inserted into the vitreous.
- Ab under general anesthesia.
- Gentamycin in glaucoma.
Systemic inj:
Only if inflammation, ab/ hyper- osmotics.
Mydriasis- Sympathetic innervation:
M. dilator pupillae, glandula lacrimalis.
Tropicamide:
- Mydriatic, poor analgesic.
- Fast acting, effective mydriatic, poor cycloplegic.
- Ideal for induction of diagnostic mydriasis.
- ø side effects.
Miosis- Parasympathetic innervation:
M. sphincter pupilla, M. ciliaris, glandula lacrimalis.
Pilocarpine:
Miosis, help decrease IOP.
What is the job of uvea?
Prevent leakage of protein to the eye, vascular part of bulbus.
What is the job of iris?
- Separates the ant + post chambers.
- Regulates
What is the job of corpus ciliare?
Produce aq humour + accomodation.
What is corpora nigra?
Aid in control of bright light entering hrough constricted pupil, only herbivores.
What part of ciliary body joins retina?
Pars plana- joins the retina- Ora ciliaris retiane.
How many layers in choroid?
Histologically has 4 layers.
Which spp does choroid supply entire retina?
Eq.
Where is tapetum lucidum?
At the dors fundus btw retina + choroid.
Most common tumor in uvea:
- Melanoma esp in grey Eq.
What is corectopia?
Abnormal location of pupil.
Ant uveitis:
- Changes of aq humor- Hyphemia.
- Kerati precipitates KPs.
- Iridocyclitis –> inflammation of iris + ciliary body.
Post uveitis:
Choroiditis –> inflammation of chorois, retina often affected as well.
Most common reason for uveitis in SA:
Idiopathic + autoimmune.
Signs of acute uveitis:
Decreased IOP, miosis, aq flare, inflammatory deposits, corneal oedema.
Ant synechia:
Iris adhere to cornea.
Post synechia:
Iris adhere to lens.
IOP in chronic uveitis:
Up/ down ( eye atrophy)?
Eq corneal ulcer pathogens:
Strep, Staph, P aerugnosa, fungi, aspergillosis, fusarium?
CS of melting ulcer:
Severe pain, purulent discharge, diffuse corneal oedema, greyish- white gelatin- like material at the base + edge of ulcer, hypopyon, 2º uveitis.
Surgery for Eq corneal ulcer:
Pedicle conjunctival graft transposition, direct suturing of the cornea.
Corneal stromal abscess with fluorescein:
-ve?
Surgery for stromal abscess:
Cornea transplant surgery- Keratoplasty.
Long term consequence of Eq uveitis:
Cataract, lens luxation, blindness.
Cause of Eq uveitis:
Idiopathic, auto- immune, with infective systemic disease, with non- infectice systemic disease, trauma, reflex uveitis, toxic, lens induced, uveo- dermatological, ERU.
Conseauence of Eq uveitis:
Proteins, fibrocytes in aq humor + vitreous body?
CS of acute Eq uveitis:
Aq flare, inflammatory deposits, miosis, decreased IOP.
CS of chronic Eq uveitis:
Corneal endothelial degeneration/ dystrophy, lens luxation/ sub- luxation.
Surgery for Eq uveitis:
Pars plana vitrectomy in the comfortable period?
Treatment for Eq uveitis:
Topical anti- inflammatory, mydriatics + cycloplegics, topical anti- inflammatory.
Glaucoma:
Pathological cond with increased IOP, resulting in destruction of ocular structures function.
How does aq drain?
Shlemm’s canal in iridocorneal angle + oveoscleral route.
Reason for glaucoma:
Decreased angle of pectinate lig, / defect in draining - Rare in cat.
What is gonioscopy?
Special lens _ optical instrument to examine ant chamber _ determine ocular motility + rotation.
What does increased IOP do?
Destroy all ocular structures.
What is goniodysgenesis?
Abnormal development of the iridocorneal angle- familial in cocker spaniel + basset hound.
Hereditary open angle glaucoma:
Beagle + poodle, sec obstructed angle- uveitis?
2º closed glaucoma:
Pupillary block, w/ pupillary block?
CS of acute glaucoma:
IOP ? 25 mmHg, ø PLR.
CS of chronic glaucoma:
IOP increased/ normal, vascularization, pigmentation, Descemet’s streaks, vision disturbance, iris + disc atrophy, bupthalmus.
Therapy of glaucoma:
- Medical- Carbonic anhydrase inhibitor, ß- blocker, hyper- osmotics, prostaglandins.
- Surgical- Intra- ocular surgery, cyclo- destructive methods.
Intraocular surgery for glaucoma:
Cyclodialysis, intra- capsular lens extraction ICE of luxated lens, corneoscleral trepanation, drainage implant.
What does cyclo- destructive surgery mean:
Decrease aq production.
How to do cyclophotocoagulation?
Trans- scleral laser cyclophotocoagulation- Iris- oculight diode laser equipment- Decreases aq production.
What is TSCP?
Trans- Scleral cyclophotocoagulation at 35 sites, 3 mm behind limbus.
What is the pt of intra- ocular surgery?
Improve drainage of the aq.
Regeneration of ant ep of lens?
Limited regeneration.
Function of ant epi?
- Produces the lens cells.
- Actively transports nutritives from the aq
What is hordeolum?
- Externum –> Purulent inflammation of a lash follicle + Associated gl of Zeis.
- Int –> Purulent inflammation of a tarsal gl.
- Stap aureus.
What is chalazion?
Cyst of tarsal gl.
What is ectropion?
Eversion of eyelid, always loxer lid is affected.
What breed is ectropion normal?
May have genetic basic, breed related –> St Bernard, Spaniel, Bloodhound, Mastiff.
Acquired/ Cicatrical ectropion:
- Trauma to the lids + healing without treatment –> formation of cicatrix –> Fibrosis + contraction of the tissues –> Ectropion.
- Fibrosis _ contraction may be associated to periocular surgery + chronic inflammatory proc –> Ectropion.
- Eq.
What is intermittent ectropion?
- In larger hunting breeds of dog.
- Lids are normal in the morning, ectopion occurs in the night.
Treatment of intermittent ectopion?
Nothing, surgery contraindicated.
Surgery of ectropion:
- Surgery is indicated –> IF there are 2º signs/ if desired by owner.
- Remove triangle in lat part of eyelid, modified Kuhnt- Szymanowski method.
What to evaluate in traumatic eyelid injury?
Cond of globe + lacrimal punctae.
What is blepharitis?
Inflammatory cond of eyelids.
Site of immune- mediated disease- ex pemphigus?
Mucocutaneus junction?
Layers of conjunctiva?
- 3 layers.
- PTF, ep, substantia propria.
Ciliary v when injected?
Dark red, brush like, short + straight, v at the limbus affected, topical adrenalin has ø effect.
Conjunctival v when injected?
Bright red, branch- like + tortuous, v in the fornix affected, v are mobile with the conjunctiva, adrenaline has good effect.
What is conjunctival dermoid?
Skin tissue in conjunctiva- ectopy.
Why conjunctival cyst?
Obstruction of duct of the conjunctical gl, ectopic glandularly tissue.
What is symblepharon?
Adhesions of any portion of the conjunctiva to itself/ to the cornea.
Why symblepharon?
Young cats with viral conjunctivits- FeHV.
Ab for conjunctivitis?
Neomycin + gentamycin.
Conjunctival tumor in cattle?
Squamous cell carcinoma, hemangioma, hemangiosarcoma.
Conjunctival tumor in dogs?
Papilloma.
What is chemosis?
Swelling of conjunctiva.
What determines position of 3rd eyelid?
Partially determined by sympathetics tone.
What is the T- shaped cartilage?
Cartilaginous skeleton at base of 3rd eyelid gl.
What does gl of 3rd eyelid do?
Seromucoid; prod of 30 - 50% of PTF + in dog 1/3 of tear prod.
What is Harders’ gl + who has it?
Deep portion of 3rd eyelid gl in Sus + rodent.
Tear prod?
Gl of 3rd eyelid, tear gl, accessory tear gl.
What is cherry eye syndrome?
Protrusion of 3rd eyelid gl, mostly dogs.
Treat of cherry eye?
Surgery.
Protrusion of T- shaped cartilage?
Eq + dog, developmental abnormality, rare in LA, ø 2º inflammation, ø discharge/ hyperemia.
What is Horner’s syndrome?
Sympathetic denervation causing prolapse of 3rd eyelid, enophtalmus, ptosis, myosis, in dog + cat + Eq/.
What is consequence of myositis eosinophilica?
3rd eyelid prolapse + eno-/ exophtalmus.
What does tetanus cause?
Bilat eversion of 3rd eyelid.
Layers of cornea?
- PRF.
- Ep.
- Stroma.
- Descement membrane.
- endothelium.
Which part of cornea has elastic collagen fibres?
Descement membrane.
How are the collagen fibres arranged?
Parallel layers.
Where do fluid accumulate in case of corneal oedema?
Stroma.
Reason for corneal oedema?
Glaucoma, inflammation, endothelium dystrophy.
Where does vascularization come from?
Deep, supf / mixed- conjunctiva.
What is ø a topical treatment?
Subconjunctival inj/ instillation.
When doing bact sampling?
Take sample before topical anesthesia/ after anesthesia.
What do you do immediately w/ Eq w/ pink eyes?
Fluorescens test.
For the 3rd eyelid, which is false?
Well muscled in large + small animals.
Mydriasis?
Pupil dialtion.
What effect do parasympatheticolytics have on the eye?
They block function of M. sphincter pupillae + M. ciliaris –> mydriasis with cyclopegia.
What are solution?
ø easily inf?
Fluorescent stain?
Hydrophilic + stains exposed stroma/ hydrophobic + stains stroma.
ø use for melting ulcers?
Supf keratectomy.
What do you do with descemetocele?
Require surgical intervention, special staining by fluorescein, medical treat contraindicated.
How to treat blepharospasm in Eq?
Auriculopalpebral n block.
What are indication for vitrectomy in Eq?
Recurrent uveitis.
Use of atropine?
Analgesia in ciliary body, mydriatic/
When is glucocorticoids contraindicated?
If fluoresceine stains the cornea?
What are the gl of the eyelid?
Tarsal gl?
What is chemosis?
Oedematic swelling of conjunctiva.
What are the borders of the ant eye- chamber?
Iris, pupil + cornea.
What is dazzle reflex?
Subcortical reflex.
Which animal has cilia on lower eyelid?
Dog.
Shape of pupil?
- Herbivore + Sus: horizontal, elliptical.
- dog: rounded.
- Cat: perpendicular rhomboid.
What is false about ointment?
Intraocular use.
Most important outflow/ drain of aq in Eq?
Uveo- scleral route.
What is ectropion?
Eversion + outward turning of eyelid w/ imperfect of eyelid.
What is ø CS of acute uveitis?
Mydriasis.
Extirpation/ evisceration?
- Extirpation: removal of globe transconjunctival.
Trichiasis?
Cilia arise from normal located follicles, pointed in abnormal direction.
How to diagnose descemetocele?
Bottom of ulcer is formed by protruded Descement membrane, blackish + shining, mucopurulent discharge, pain, special staining by fluorescein + 2º uveitis.
Which equipment do you need for microsurgery?
Hand- held microsurgery instruments, magnifier, operation microscope.
What can ø entropion be?
Intermittent.
What is ø typical?
Subconjunctival inj.
What is ø microsurgery?
Eyelids.
What belongs to microsurgery?
Lacrimal punctas, corneal- conjunctiva, intraocular interventions.
Preparation + isolation for general eye surgery?
Trimming/ shaving with betadine soap, disinfection of fornix + lid marginds with betadine 1: 10, disinfect lids + periocular areas with cc betadine, isolation textiles.
Which is ø a general intervention in eye surgery?
Tarsorrapy, 3rd eyelid flap, approach 3rd eyelid, med canthotomy, stay sutures in globe.
Hypopyon:
Pus in ant chamber.
Hyphema:
Blood in ant chamber.
What is mydriasis?
Pupil dilation.
What are solutions?
- Should be sterile.
- pH 3.5 - 10.5.
- pH + temp determine stability.
Fluorescein stain.
Hydrophilic + stains exposed stroma bright green.
What is Ankyloblepharon?
Lid margins partially/ totally closed.
What’s the job of the uvea?
- Prevent leakage of proteins to the eye.
- Vascular part of the bulbus.
What is the job of iris?
Regulate amt of light.
What is corpora nigra?
Aif in control of light entering through constricted pupil - only in herbivores.
What part of ciliary body joins the retina?
Pars plana.
How many layers in choroid?
4.
Which sp does choroid supply entire retina?
Eq.
Most common tumour in uvea?
Melanoma in the iris.
What is corectopia?
Abnormal location of pupil.
Ant uveitis?
Iritis, cyclitis.
Post uveitis.
Choroiditis.
Most common reason for uveitis in SA?
Idiopathic + autoimmune.
Signs of acute uveitis?
Decreased IOP, miosis, cornea oedema.
Ant synechia?
Iris adhere to lens.
Post synechia?
Iris adhere to lens.
IOP in chronic uveitis.
Decerased.
Eq corneal ulcer pathogens.
- Strep, Staph, P aeruginosa.
- Fungi: aspergillus, Fusarium.
CS of melting ulcer?
Pain, Ant uveitis, corneal oedema, Hydropyon.
Surgery for Eq corneal ulcer?
Grid keratectomy, debridement keratomy, pedicle conj flap.
Corneal stromal abscess with fluorescein?
-ve.
Surgery for stromal abscee?
Cornea transplant- Keratoplasty.
Long term consequence of Eq uveitis?
Cataract, lens luxation, blindness.
Cause of Eq uveitis?
Leptospira, Borrelia, Riboflavin def, hereditary, autoimmune.
Consequences of Eq uveitis?
Proteins, fibrocytes in aq humor + vitreous body.
CS of acute Eq uveitis?
Enophtalmus epuphora, ciliary inj in cornea, hypopyon, opacity.
CS of chronic EQ uveitis?
Permanet corneal opacity, cataract, 2– glaucoma, choroiditis, bulbi atrophy= end stage.
Surgery for Eq uveitis?
Pars plan vitrectomy in the comfortable period.
Treatment for Eq uveitis?
Local cortiscosteroids, atropine, cyclosporin, topical + systemic NSAID.
Glaucoma ?
Pathological cond with increased IOP.
How does aq drain?
Schlemm’s canal in iridocorneal angle + uveoscleral route.
Reason for glaucoma?
Decreased angle of pectinate lig/ defect draining.
What is goniodysgenesis?
Abnormal development of the iridocorneal angle- familial in C. spaniel, Basset hound.
Hereditary open angle glaucoma?
- Beagle + poodle.
- 2º- obstruction of angle uveitis.
2º closed glaucoma?
Can be with/ without pupillary block.
CS of acute glaucoma?
IOP> 25 mmHg, opacity, mydriasis, ø PLR.
CS of chronic glaucoma.
May be normal IOP, vascualrzation, pigmentation, descmet’s streaks in cornea, iris + optic disc atrophy, buphtalmos, blindness.
Therapy for glaucoma?
Carbonic anhydrase inhibitor, ß- blocker, myotics, hyperosmotics, PG.
Intraocular surgery for glaucoma?
Cyclodialysis, intracapsular lens extraction.
What does cyclodestructive surgery mean?
Decrease aq production.
How to do cyclophotocoagulation?
Transscleral laser cyclophotocoagulation- destroy ciliary p.
What is TSCP?
Transcleral laser cyclophotocoagulation at 35 sites, 3 mm behind limbus.
What’s the pt of intraocular surgery?
Improve drainage.
Regeneration of ant ep of lens?
Limited.
Function of ant ep?
Transport glucose from aq, produce lens cells.
What is hordeolum?
Inflammation of sebaceous gl of eyelids, Microabscesses.
What is hordeolum externum?
Purulent inflammation of lash follicle + zeis gl.
What is hordeolum int?
Purulent inflammation of lash follicle + meibomian ( tarsal ) gl.
Site of immune mediated diseases?
Mucocutaneous junction.
Lab test for blepharitis?
Cotton swab, skin scraping, biopsy.
What is important when applying clotrimazole _ amitraz?
ø corneal drug contact.
Most common eyelid tumours?
Adenoma, sarcoma melanoma, papilloma.
How much of eyelid can be removed?
1/4 of it with V- shaped incision.
What is conjunctiva?
Well vascularized MM.
Which gl produce PTF?
Lacrimal gl of 3rd eyelid, tarsal gl, globlet cells in conjunctiva.
Ciliary v?
Dark red, v at limbus, adrenaline has ø effect.
Conjunctival v?
Bright red, v in fornix, adrenaline has good effect.
What is conjunctival dermoid?
Skin tissue in conjunctiva, inherited in Herefords.
Why conjunctival cyst?
Obstruction of duct of conjunctival gl, ectopic glandular tissue.
What is symblepharon?
Adhesions of conjunctiva on itself/ on the cornea.
Why symblepharon?
Young cats with viral conjunctivitis- FEHV.
Ab for conjunctivitis?
Neomycin + gentamycin.
Conjunctival tumours in cattle?
SCC, hemangioma/ sarcoma.
Conjunctical tumours in dogs?
Papilloma virus, SCC.
What is chemosis?
Swelling of conjunctiva.
What determines position of 3rd eyelid?
Sympathetic tone.
What is the T- shaped cartilage?
Cartilaginous skeleton at base of 3rd eyelid gl.
Treatment of cherry eye syndrome?
Replace gl with Morgan’s technique, don’t cut off —-> KCS.
Protrusion of T- shaped cartilage?
Eq + dog, developmental problem, rare in LA; ø 2º inflammation, ø discharge/ hyperaemia.
What is Horner’s syndrome?
Sympathetic denervation causing prolapse of 3rd eyelid, enopthalmus, ptosis, miosis in dog, cat + Eq.
What is consequence of myositis eosinophilica?
3rd eyelid prolapse + eno/ exophtalmus.
What does tetany cause?
Bilat eversion of 3rd eyelid.
Layers of cornea?
PTF, Ep,stroma, descemet’s membrane, endothelium.
Which part of cornea has elastic collagen fibres?
Descemet’s membrane.
How are collagen fibres arranged?
Parallel layers.
Where do fluid accumulate in case of corneal oedema?
In the stroma.
Reasons for corneal odema?
Glaucoma, inflammation, endothelial dystrophy.
Where does vasculatisation come from?
Deep- ciliary, supf conjunctiva.
What is ø a topical treatment?
Subconjunctival/ retrobulbar/ intravitreal inj/ systemic.
When to do bacterial sample?
Before topical anaesthesia.
Parasympatholytic effect on eye:
Mydriasis with Cyclopegia.
Solutions:
pH 3 - 10/ buffer/ pH + temp determines stability/ should be sterile.
Fluorescin:
Hydrophilic, stains the stroma won’t stain the descements memebrane/ ep cells as they are hydrophopic.
Grid keratotomy:
Only in non- melting ulcers.
What to do with descemetocele:
Emergency intervention, eliminate the cause, ø medical therapy- surgery- free island graft in SA, pedicle graft LA + direct suture the cornea.
Indication for vitrectomy in Eq
ERU?
Atropin
ø a diagnostic mydriatic, but for therapy.
When are glucocorticoids/ corticosteroids contraindicated?
With corneal ulcer + +ve fluorescein test.
Borders of ant chamber:Dazzle reflex:
is elicited by sudden stimulation of eye with an extremely bright/ shiny light.
Most important drainage if aq in Eq:
Uveo- scleral.
CS of acute uveitis:
miosis: swollen + injected iris, pain, photophobia, cornea oedema, dec IOP.
CS of chronic uveitis:
Ant synechia- Iris adheres to cornea, Post synechia- iris adheres to the lens, Decrease IOP= eye atrophy, increase IOP= glaucoma.