Conjunctiva Flashcards
1
Q
What are the differential diagnoses for Red eye?
A
- Conjunctival hyperemia
- extensive branching
- Extraocular disease
- Episcleral injection
- Radial pattern from limbus
- Dark red
- Intraocular disease
- Subconjunctival hemorrhage
- Diffuse red
- Trauma/bleeding disorder
2
Q
What types of ocular Discharge are there
A
- Serous
- Mucoid
- Mucopurulent
3
Q
What diagnostic tests can be done for “Red Eye”
A
- Fluorescein stain
- Schirmer tear test
- Intraocular pressure
- +/- Conjunctival cytology
- +/- Aerobic culture and sensitivity
4
Q
What is Ophthalmia Neonatorum? treatment?
A
- Infection prior to separation
- Puppies - bacterial
- Kittens - viral (FHV-1) or Chlamydia
- Treatment:
- Separate eyelids
- Flush with sterile saline
- Puppies - broad spectrum antibiotic ointment - BNP (Bacitracin/Neomycin/Polymyxin B)
- Kittens - Tetracycline ointment (Terramycin®)
- Treat 4 - 6 times daily
5
Q
What are possible sequelae of Ophthalmia Neonatorum?
A
- Symblepharon
- bulbar and palpebral conjunctiva form an abnormal adhesion to one another
- Corneal perforation
- Corneal scar formation
- Blindness
6
Q
What is Canine Conjunctivitis?
A
- Rarely infectious
- Usually secondary to other abnormalities
- Entropion, ectropion, trichiasis, eyelid tumors…..
- Tear film abnormalities - keratoconjunctivitis sicca (KCS)
- Irritants - chemicals, dust, smoke….
- Bacteria can frequently be cultured at low numbers from normal conjunctiva
- Staphylococcus, Streptococcus, Cornyebacterium, Bacillus spp.
7
Q
What is the treatment for Canine Conjunctivitis?
A
- Treat underlying cause
- Broad spectrum topical antibiotics QID
- Topical corticosteroids (hydrocortisone)
- must be fluorescein negative
- If no response - re-evaluate diagnosis
8
Q
What is Follicular Conjunctivitis
A
- Typically seen in young dogs
- Lymphoid follicles bulbar surface of the nictitans
- Etiology - immune mediated, allergic, chronic irritation….
- Treatment: topical steroids +/- topical antihistamines (olopatadine)
9
Q
What is Feline Conjunctivitis?
A
- Usually Infectious
- Feline herpesvirus 1 (FHV-1)
- Chlamydia
- Mycoplasma
- Calicivirus
- Eosinophilic conjunctivitis
10
Q
What is Feline Herpesvirus 1?
A
- Most common cause of feline conjunctivitis
- Seroprevalance up to 97% of cats
- >80% of cats that recover are carriers
- ~½ shed under normal conditions
- Latency occurs in trigeminal ganglion
- Short-lived in the environment (<18hr)
- Virus is inactivated by most disinfectants
- Sneezing carries the virus ~14ft
- Severe cases can result in Corneal Ulcers/Keratitis
11
Q
How is FHV-1 treated
A
- Most recover in 10-21 days
- treat ones with moderate to severe conjunctivitis or corneal disease
- Topical antiviral medications
- Cidofovir 0.5% solution BID
- Idoxuridine 0.1% solution 4-8x daily
- Trifluridine 1% solution 4-8x daily
- keep refrigerated
- topically irritating
- Systemic antiviral medications
- Famciclovir 30-40mg/kg B-TID PO
- Oral lysine
- 250mg PO BID kittens
- 500 mg PO BID cats
- Decrease stress
12
Q
How is FHV-1 diagnosed?
A
- Clinical signs
- conjunctivitis, ocular discharge, nasal discharge, sneezing
- Conjunctival cytology
- Intranuclear inclusions, PMNs (WBC)
- PCR - sensitive and specific
- IFA - insensitive
- Fluorescein may cause false+
- Serology (serum neutralization titer) - insensitive
- Virus Isolation
- definitive dx for acute infection
- insensitive for chronic infections
13
Q
What are the common sequela to FHV-1
A
- Recurrence
- Corneal disease/ulceration/perforation
- Chronic epiphora
- Symblepharon
14
Q
What isChlamydia felis
A
- Gram negative, obligate intercellular bacterium
- Causes Upper Respiratory infection in young cats
- Chemosis begins unilaterally then bilateral
- Follicles develop w/ chronicity
15
Q
How is a Chlamydia felis infections diagnosed?
A
- Cytology
- Intracytoplasmic inclusion bodies
- Days 3-14
- PCR
18
Q
How are Mycoplasma ocular infections diagnosed?
A
- Cytology: small cytoplasmic basophilic inclusion bodies
- Culture in specific media
- PCR test for M. felis
