Adnexa & Nasolacrimal Diseases

Question 1

Functions of the eyelid:

Answer 1

1. Protection (blinking)
2. Entrap & remove foreign material
3. Distribution of tears
4. Production of glandular secretions (meibomian glands) contributing to tear film

Question 2

Describe entropion and which eyelid does it typically affect?

Answer 2

Inversion of the eyelid margin causing hair to contact the cornea
-Lower eyelid

Question 3

What are the temporary and permanent corrections of entropion?

Answer 3

Temporary: Temp eyelid tacking sutures
Permanent: Hotz-Celcus procedure

Question 3

What is one of the most common neonatal ocular abnormalities in foals? What is it associated with?

Answer 3

Entropion
Associated with dehydration, neonatal maladjustment

Question 3

Causes of eyelid lacerations:

Answer 3

Blunt trauma
Direct contact with sharp objects
Ripping of eyelid

Question 4

Goals of treatment of eyelid lacerations include:

Answer 4

Prompt intervention; achieve functional and cosmetic eyelid

Question 5

When repairing an eyelid laceration, sutures must:

Answer 5

NOT penetrate through palpebral conjunctival surface

Question 6

Complications of improper eyelid laceration repair:

Answer 6

-Corneal ulcer due to suture rub
-Poor tear film retention or dispersion leading to chronic keratitis

Question 7

Causes of facial paresis/paralysis:

Answer 7

-Trauma
-Inflammation of inner ear, guttural pouch, salivary gland
-Fracture of stylohyoid bone, petrous temporal bone, or ramus of mandible

Question 8

Treatment for facial paralysis:

Answer 8

1. Topical lubricant 4-6 times daily
2. Topical management of corneal ulcer
3. Partial temprary tarsorrhaphy
4. Manage underlying conditions

Question 9

Prognosis of facial paralysis:

Answer 9

Traumatic cases resolve 3-4 weeks, prognosis declines significantly after this

Question 10

Define conjunctivitis:

Answer 10

Infalmmation of palpebral and/or bulbar conjunctiva

Question 11

Conjunctivitis is usually a:

Answer 11

SECONDARY ISSUE
to corneal disease, uveitis, etc.

Question 12

Diagnosis of conjunctivitis:

Answer 12

Cytology +/- culture

Question 13

The most common neoplasm of the horse is:

Answer 13

Sarcoid

Question 14

Prognosis of sarcoids in horses:

Answer 14

Metastasis rare
Recurrence common

Question 15

Three methods of sarcoid treatment:

Answer 15

1. Surgical excision (high recurrence rate with excision alone)
2. Chemotherapy
3. Immunotherapy - Immunocidin best option out there now

Question 16

What is the most common neoplasm of the equine eye and adnexa?

Answer 16

Squamous Cell Carcinoma
*Second most common tumor overall

Question 17

SCC metastisizes to:

Answer 17

Lymph nodes, salivary glands, olfactory region, lungs

Question 18

SCC is most commonly seen in:

Answer 18

Draft breeds, Appaloosas, Paints, and any breed with color dilution
Light hair & minimal skin pigmentation
Increased sunlight exposure

Question 19

SCC recurrence is about _____% with excision alone

Answer 19

50-60%

Question 20

Adjunctive therapy to SCC with excision:

Answer 20

Cryosurgery
Radiation
Hyperthermia
Immunotherapy
Chemotherapy
Photodynamic therapy

Question 21

What is the prognosis for equine adnexal SCC?

Answer 21

Varies widely, but more guarded than corneoconjunctival SCC

Question 22

Most common nasolacrimal congenital abnormality:

Answer 22

Imperforate nasal punctum

Question 23

Clinical sign of imperforate nasal punctum?

Answer 23

Severe epiphora
Becomes mucopurulent d/t secondary bacterial overgrowth

Question 24

Diagnosis of Imperforate nasal punctum?

Answer 24

-Inability to flush nasolacrimal duct
-Punctum not visible
-Contrast radiography
-Culture/susceptibilty

Question 25

Treatment of imperforate nasal punctum:

Answer 25

1. Pass catheter and cut conjunctiva to create nasal ostium
2. Prevent re-obstruction (suture catheter in place for 4-6 weeks)
3. Treat secondary infections

Question 26

Term for severe epiphora due to secondary bacterial overgrowth:

Answer 26

Dacryocystitis