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RUSVM SAM 2 > Conjunctiva > Flashcards

Conjunctiva Flashcards

1
Q

What cells make up the conjunctiva?

A

Epithelium
Goblet cells
Lymphoid tissue
Vasculature

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2
Q

How can you get a sample of conjunctiva for cytology?

A

Cotton swab, kimura spatula, back of scalpel blade

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3
Q

What do you see in the typical cytology of a dog with conjunctivitis ?

A

Epithelial cells and neutrophils

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4
Q

The mucous part of the tear film is produced by??

A

Globlet cells of the conjunctiva

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5
Q

Mucous provides a good media for bacterial growth and recruitment of white blood cells creating a ___________ discharge?

A

Mucopurulent

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6
Q

Mucopurulent discharge is most commonly found with what ocular disease?

A

Keratoconjunctivitis sicca

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7
Q

Where are conjunctival lymphoid follicles usually found?

A

Bulbar surface of the third eyelid

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8
Q

Enlarged lymphoid follicles on the injunctive indicates?

A

Non-specific antigenic stimulation

Likely a primary conjunctivitis

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9
Q

What are the two types of vessels in the conjunctiva ?

A

Conjunctival vessels — superficial small vessels

Episceral vessels — larger deeper vessels

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10
Q

Conjunctival hyperemia is secondary to?

A

Superficial irritation (eg conjunctivitis, superficial corneal ulcer, keratoconjunctivitis)

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11
Q

Episceral injection is usually secondary to?

A

Deeper inflammation or congestion

— large identifiable vessels that course perpendicular to the limbus

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12
Q

What are disorders of the canine conjunctiva?

A

KCS
Allergic conjunctivitis
Infectious conjunctivitis (adenovirus, herpesvirus, distemper)

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13
Q

Clinical signs of allergic conjunctivitis?

A 
Blepharospasm 
Epiphora 
Mucoid discharge 
Hyperemia 
Lymphoid follicles
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14
Q

Signalment associated with allergic conjunctivitis ?

A

Young atopic dogs

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15
Q

What are causes of viral conjunctivitis?

A

Adenovirus
Herpesvirus
Distemper

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16
Q

How can you make a diagnosis of primary conjunctivitis?

A

Compatible signalment (young dog with allergies)

Clinical signs (conjunctival pathology without keratitis or episceral/intraocular pathology)

Minimum data base in normal limits

17
Q

How do you treat a primary conjunctivitis?

A

Often self limiting

Irrigation with eyewash
Symptomatic used of topical anti-inflammatories

Treat underlying cause of atopy

  • avoid offending allergen/hyposensitization
  • symptomatic use of topical anti-inflammatories
18
Q

What topical anti-inflammatories are the mainstay for primary conjunctivitis?

A

Neomycin - polymixin- dexamethasone - steroid

Diclofenac -NSAID

Optimmune (cyclosporine) - Tcell inhibitor

19
Q

What are the most common causes of feline conjunctivitis?

A

Feline herpesvirus keratoconjunctivitis

Chlamydia conjunctivitis

Mycoplasma conjunctivitis

Calicivirus

20
Q

What are the 3 forms of FHV1 ?

A

Primary (young cats) - acute lysis

Latency

Recrudescence - lysis and disease

21
Q

What is the pathophysiology of herpesvirus?

A

Mucosal eatery followed by viral replication and systemic viremia

Incorporation into host DNA

Epithelial tropism — epithelial cytolysis
—> blepharospasm, epiphora, and mucoid discharge (concurrent URI)

Latency —> FHV invades sensory nerve endings of trigeminal nerve and travels to ganglion

Recuredescent —> reactivation of virus, usually be stress , Replication in sensory axon and migration back to epithelial tissues

22
Q

Clinical signs associated with FHV?

A

Blepharospasm, epiphora, mucoid discharge

Hyperemia

Conjunctival and possible corneal ulceration
Symblepharon (adhesion between conjuntiva and cornea)

23
Q

What stain can you use to determine conjunctival ulceration

A

Rose bengal stain

24
Q

What stain can you use to determine corneal ulceration?

A

Fluorescein stain

25
Q

What pattern of corneal ulceration if pathognomic for FHV infection?

A

Dendritic

26
Q

What occurs if two ulcerated surfaces (conjunctival and corneal) heal together?

A

Symblepharon

27
Q

What are possible tests to diagnose FHV?

A

Cytology — intranuclear inclusion bodies
Fluorescent antibody testing
PCR
Virus isolation

28
Q

Treatment of FHV?

A

Antiviral therapy

  • topical cidofovir
  • oral famciclovir
  • lysine ( substitutes for arginine and inhibits viral replication)

Supportive care
-erythromycin (topical)

29
Q

What is a common autoimmune sequela from FHV1 infection?

A

Feline eosinophilic keratoconjunctivitis

30
Q

Clinical signs of feline eosinophilic keratoconjunctivitis ?

A

Blepharospasm, epiphora, mucoid, or mucopurulent discharge, +/- corneal ulceration

Raised white or yellow corneal or conjunctival infiltrates

31
Q

T/F: finding a single eosinophil on cytology of the conjunctiva is diagnostic for feline eosinophilic keratoconjunctivitis

A

True

32
Q

Treatment for feline eosinophilic keratoconjunctivitis ?

A

Immunomodulation - topical cyclosporine

Anti-inflammatory —NSAIDS or steroids

Antiviral — cidofovir or famcyclovir

33
Q

What is a specific clinical sign for chlamydial conjunctivitis ?

A

Chemosis (conjunctival edema)

34
Q

T/F: chlamydial conjunctivitis causes corneal or conjunctival ulceration

A

False

35
Q

How can you confirm diagnosis of chlamydial conjunctivitis ?

A

Cytology — intracytoplasmic inclusion bodies

PCR, history, compatible clinical signs

36
Q

Treatment of chlamydial or mycoplasma conjunctivitis?

A

Topical

  • oxytetracycline (tetracyclines)
  • erythromycin (macrolides)

Oral
-doxycyline

37
Q

You do a cytology in a cat with blepharospasm, epiphora and mucoid discharge.
It shows numberous coccidia membrane associated bacterial illusions. What is this?

A

Mycoplasma associated conjunctivitis

38
Q

How is calicivirus differentated from herpesvirus?

A

Oral ulceration are pathognomic for calicivirus

39
Q

Treatment for calicivirus?

A

Erythromycin - topical

RUSVM SAM 2 (44 decks)

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