Cognition & Senses 2: Conjunctiva Flashcards
= what is the CONJUNCTIVA?
what is the difference between PALPEBRAL and BULBAR CONJUNCTIVA?
= the PINK MUCOUS MEMBRANE that LINES UNDERSIDE of UPPER & LOWER EYELID and the THIRD EYELID
PALPEBRAL conjunctiva = part of conjunctiva FACING THE LID
BULBAR conjunctiva = part of conjunctiva FACING THE GLOBE/EYE
what are 2 reasons we can see the eyes looking RED?
- CONJUNCTIVAL HYPEREMIA
- EPISCLERAL VESSELS become ENGORGED due to GLAUCOMA
CHEMOSIS definition
EDEMA of the CONJUNCTIVA
what are the 2 MOST COMMON causes of CONJUNCTIVITIS in CATS? (what is this OVERALL category?)
what about in DOGS? what is the MOST COMMON CAUSE of CONJUNCTIVITIS?
CONJUNCTIVITIS in CATS is usually INFECTIOUS
1. CHLAMYODPHILA FELIS
2. HERPESVIRUS
CONJUNCTIVITIS in DOGS is usually NON-INFECTIOUS = most commonly KCS
what is the MUCIN LAYER?
how is this mucin produced?
= the INNER LAYER of the TRILAMINAR TEAR FILM that acts as a MUCIN LAYER to KEEP FILM ADHERED TO CORNEA
mucin is produced by GOBLET CELLS in the CONJUNCTIVA
three ways how we DIAGNOSE conjunctivitis?
- PE findings
- CYTOLOGY
- BIOPSY (snipped after TOPICAL ANESTHETIC)
can we do a CULTURE to DIAGNOSE CONJUNCTIVITIS? why or why not?
there’s FEW ORGANISMS in the eye that COULD CAUSE IT, so if you DO A CULTURE you’ll FIND ORGANISMS THAT MIGHT NOT BE PATHOLOGIC
ID LESION (2)
- CONJUNCTIVAL HYPEREMIA
- CHEMOSIS (conjunctival edema)
what are 4 common DDxs for FELINE CONJUNCTIVITIS?
- FHV-1
- CHLAMYDOPHILA/CHLAMYDIA
- CALICIVIRUS
- +/- MYCOPLASMA
why can it be hard to DIAGNOSE FHV-1 if we suspect it in a cat with FELINE CONJUNCTIVITIS?
MANY cats are EXPOSED TO FHV-1 at some point in their life, so ON PCR even on the EYE it COULD COME UP FALSELY POSITIVE
if a cat comes in with FELINE CONJUNCTIVITIS, which of the COMMON DDxs would we suspect if we also see…
- CHEMOSIS?
- CONJUNCTIVAL HYPEREMIA & OCULAR DISCHARGE
- KERATITIS
- ORAL ULCERATION & PTYALISM
- CHEMOSIS = suspect CHLAMYDIA
- CONJUNCTIVAL HYPEREMIA & OCULAR DISCHARGE = FHV-1
- KERATITIS = FHV-1
- ORAL ULCERATION & PTYALISM = CALICIVIRUS
MYCOPLASMA & FELINE CONJUNCTIVITIS…
why is this a +/- DDx?
tx?
+/- because MOST CATS HAVE MYCOPLASMA, and UNSURE IF IT’S CAUSING CONJUNCTIVITIS
tx is SAME AS CHLAMYDIA
CHLAMYDOPHILA/CHLAMYDIA FELIS…
unilateral vs. bilateral? (hint: give a range)
4 clinical signs? which is a PROMINENT feature for this dz?
this disease is USUALLY ___-____
3 diagnostics?
treatment? (2, one is +/-)
can start as UNILATERAL but usually BILATERAL WITHIN 7-10 DAYS
4 clinical signs?
1. MILD RHINITIS
2. FEVER
3. LYMPHADENOPATHY
4. CHEMOSIS –> prominent
this disease is USUALLY SELF-LIMITING
diagnostics?
1. clinical signs/history of EXPOSURE
2. CYTOLOGY
3. PCR
treatment?
1. TETRACYCLINE (oral doxy is common)
2. +/- TOPICAL ANTIBIOTIC
ID LESION & suspected DZ
LESION = CHEMOSIS (edema of CONJUNCTIVA)
DZ = CHLAMYDIA FELIS
FELINE VIRAL CONJUNCTIVITIS…
most commonly caused by WHAT?
3 clinical signs?
after a cat is infected, HOW LONG does infection last? (2, hint: one is a range)
most commonly caused by FHV-1
3 clinical signs?
1. CONJUNCTIVAL HYPEREMIA
2. OCULAR DISCHARGE
3. KERATITIS
after a cat is infected…
1. establishes LIFELONG LATENT or CARRIER STATE
2. PRIMARY DZ usually SELF-LIMITING in 1-3 WEEKS
3 common causes of CANINE CONJUNCTIVITIS?
what is are 2 UNCOMMON?
common causes?
1. KCS
2. JUVENILE FOLLICULITIS (young dogs have ENLARGED FOLLICLES
3. IMMUNE-MEDIATED
what are 2 UNCOMMON? = VIRAL or BACTERIALLY caused
DERMOID definition
painful?
tx? (2 options)
= ABNORMAL TISSUE on the SURFACE OF THE EYE (could be on CONJUNCTIVA or CORNEA)
often NON-PAINFUL
tx? –> only if it BOTHERS ANIMAL, then…
1. CONJUNCTIVECTOMY
2. KERATECTOMY
ID LESION
DERMOID
ID LESION
CONJUNCTIVAL NEOPLASIA
CONJUNCTIVAL NEOPLASIA…
signalment? (1)
if it’s SMALL, tx?
commonality?
signalment = OLDER PATIENTS
if it’s SMALL, can use TOPICAL ANESTHETIC to SNIP IT OFF EYE SURFACE
commonality = RARE
THIRD EYELID GLAND PROLAPSE…
“aka?”
= definition?
what 3 breeds are predisposed?
why is SURGICAL tx recommended? (2)
what does it mean if this gland is PIGMENTED?
aka “CHERRY EYE”
= TURNING OUT of the THIRD EYELID GLAND due to LYMPHOID HYPERPLASIA
what 3 breeds?
1. ENGLISH BULLDOG
2. BOSTON TERRIER
3. COCKER SPANIEL
why is SURGICAL tx recommended?
1. it can INTERFERE with ability to CLOSE EYES (LAGOPHTHALMOS)
2. could DECREASE TEAR PRODUCTION and cause KCS
if gland is PIGMENTED, it means that the issue is CHRONIC
MORGAN POCKET technique
this is used to treat WHAT?
steps? (3)
at the end, MAKE SURE TO…
the BEGINNING & ENDING KNOT should be on the ___ side of the eye BECAUSE…
used to treat THIRD EYELID GLAND PROLAPSE (cherry eye)
steps?
1. grab LEADING MARGIN of THIRD EYELID & PULL IT OUT, then FOLD IT DOWN
2. make 2 CURVILINEAR INCISIONS
3. close DISTAL SIDES OF INCISIONS to make a POCKET via CONTINUOUS suture
at the end, MAKE SURE TO LEAVE BOTH ENDS A LITTLE OPEN so that WHEN GLAND IS NO LONGER INFLAMED, we DO NOT WANT TO MAKE A CYST & allow for DRAINAGE
the BEGINNING & ENDING KNOT should be on the PALPEBRAL side of the eye BECAUSE we DO NOT WANT TO SCRATCH CORNEA
ANCHORING..
used to treat WHAT?
2 steps?
disadvantages? (2)
used to treat THIRD EYELID GLAND PROLAPSE (cherry eye)
steps?
1. ENCIRCLE gland with SUTURE
2. using NONABSORBABLE SUTURE, make INCISION ON FACE and ANCHOR IT TO ORBIT’S PERIOSTEUM or RECTUS MUSCLE
disadvantages?
1. THIRD EYELID CANNOT MOVE
2. can PERFORATE THE GLOBE if ANCHORED TO RECTUS MUSCLE
SIGNALMENT for THIRD EYELID PROLAPSE? two things, three examples for second
- YOUNG DOGS
- BREEDS = BRACHYCEPHALIC, cocker spaniels/beagles too, GIANT BREED DOGS
SCROLLED THIRD EYELID CARTILAGE
= what is it?
what is often present CONCURRENTLY?
treatment? (overall, 3 steps but 2 has 2 options)
= in GIANT BREED DOGS, there’s SO MUCH LAXITY that T-SHAPED CARTILAGE in THIRD EYELID will FLOP OVER
THIRD EYELID PROLAPSE/CHERRY EYE often present CONCURRENTLY
treatment? = SURGERY
1. 2 point fixation of THIRD EYELID, PULL OUT & FOLD OVER
2. make 2 INCISIONS in CONJUNCTIVA to CUT OUT CARTILAGE
2. could also CAUTERIZE IT
PLASMOMA..
= definition
treatment? (2 options)
= CONSTELLATION of LYMPHOID FOLLICLES on the INSIDE OF THIRD EYELID
treatment?
1. TOPICAL ANTI-INFLAMMATORY like NEOPOLYDEX
2. or IMMUNOSUPPRESSIVE tx
ID DZ
PLASMOMA
THIRD EYELID NEOPLASIA…
commonality?
prognosis?
2 most common in DOGS?
3 most common in CATS?
why can this be hard to diagnose?
commonality = RARE
prognosis = POOR to GRAVE
DOGS?
1. HSA
2. ADENOCARCINOMA (glandular tumor)
CATS?
1. SCC
2. FIBROSARCOMA
3. LYMPHOSARCOMA
hard to diagnose because THIRD EYELID USUALLY HIDDEN, so BY THE TIME IT’S BIG ENOUGH FOR US TO SEE then IT’S LIKELY ADVANCED DZ
ID LESION
THIRD EYELID NEOPLASIA
the THIRD EYELID LACRIMAL GLAND produces WHAT % of ___ tears?
so, if we needed to remove it then…
produces 20-30% OF AQUEOUS TEARS
so, if we needed to remove it, then HIGH RISK OF KCS
how do we VISUALIZE the THIRD EYELID during an exam?
put TOPICAL ANESTHETIC ON THE EYE & RETROPULSE THE GLOBE DIRECTLY to bring it up
