Conjunctiva Flashcards
conjunctiva (rankin)
Red Eye
- Conjunctival hyperemia
- Extensive branching
- Extraocular disease
- Episcleral Injection
- Radial pattern from limbus
- Dark red
- Intraocular disease
- Subconjunctival hemorrhage
- Difuse red
- Trauma/bleeding disorder
Ocular Discharge
- Serous
- Viral (FHV 1)
- Epiphora
- Mucoid
- KCS (dry eye disease)
- Mucopurulent
- Bacterial infection
conjunctiva (rankin)
Diagnostic Tests for “Red Eye”
- Fluorescein stain
- Schirmer tear test
- don’t do for deep ulcer
- Intraocular pressure
- don’t do for deep ulcer
- +/- Conjunctival cytology
- +/- Aerobic culture and sensitivity
Ophthalmia Neonatorum
- Infection prior to lid 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
- Sequelae
- Symblepharon (conjunctiva stuck to more conjunctiva, or conjunctiva to cornea), corneal perforation, corneal scar formation, blindness…
conjunctiva (rankin)
Canine Conjunctivitis
- 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 , and Bacillus spp.
conjunctiva (rankin)
Treatment of Canine Conjunctivitis
- Treat the underlying cause
- Broad spectrum topical antibiotic QID
- Topical corticosteroids (hydrocortisone)
- Fluorescein negative!!!
- If no response to therapy
- Re-evaluate diagnosis
conjunctiva (rankin)
Follicular Conjunctivitis
- Typically seen in young dogs
- Lymphoid follicles bulbar surface of the nictitans
- Etiology-immune mediated, allergic, chronic irritation….
- Treatment-topical steroids +/- topical antihistamines (olopatadine)
conjunctiva (rankin)
Feline Conjunctivitis
- Usually infectious!!!
- Do NOT use topical steroids!
- Feline herpesvirus 1 FHV-1
- Chlamydia
- Mycoplasma
- Calicivirus
- Eosinophilic conjunctivitis
conjunctiva (rankin)
Feline Herpesvirus 1 FHV-1
- Most common cause of feline conjunctivitis
- Seroprevalance up to 97% of cats
- >80% of cats that recover are carriers
- Approximately ½ of the carriers shed under normal conditions
- Corneal ulcers/keratitis
- Latency occurs in trigeminal ganglion
- URI
- Kittens most susceptible
- Short lived in the environment <18hrs
- Virus is inactivated by most disinfectants
- Sneezing carriers the virus approximately 4 feet
DON’T USE TOPICAL STEROIDS IN CATS
conjunctiva (rankin)
FHV-1 Diagnostics
- Clinical signs!!!!
- Conjunctival cytology
- Intranuclear inclusions, PMNs
- PCR - sensitive and specific
- IFA - insensitive
- Fluor. stain may cause false +
- Serology (serum neutralization titer) insensitive
- Virus isolation
- Definitive dx for acute infection
- Insensitive for chronic infection
conjunctiva (rankin)
FHV-1
- time to recover
- when to treat
- Most recover in 10-21 days
- Which cases should you treat?
- Moderate to severe conjunctivitis
- Corneal disease
conjunctiva (rankin)
Treatment of FHV-1
- Topical and systemic antiviral medications
- Oral lysine
- Decrease stress
conjunctiva (rankin)
Antiviral Topical Treatment
- Cidofovir 0.5% solution
- Compounding pharmacy
- 2 times daily
- Idoxuridine 0.1% solution
- Compounding pharmacy
- 4-8 times daily
- Trifluridine 1% solution
- Refrigerated
- Topically irritating
- 4-8 times daily
conjunctiva (rankin)
Antiviral Systemic Treatment
- Famciclovir
- 250 mg tablets ( Famvir ®)
- 30-40 mg/kg B-TID po
- NOT the same as valacyclovir!
- Lysine
- 250 mg po BID kittens
- 500 mg po BID cats
- Give with food
conjunctiva (rankin)
Antiviral Therapy for FHV-1
Continue therapy for at least 1 week after resolution of clinical signs