Conjunctivitis and KCS Flashcards
Describe the conjunctiva
Delicate membrane lining the eyelids and covering the eyeball
Deacribe medical canthal pocket syndrome
occurs in dolichocephalic breeds with naturally deep set eyes
mucus accumulates at medial canthus
no treatment indicated
List the clinical signs of acute conjunctivitis
hyperaemia (rednes)
chemosis (oedema)
swelling/ thickening
discharge
mild irritation/ blepharospasm
occasionally pruritis
List the clinical signs of chronic conjunctivitis
hyperpigmentation
thickening due to squamous metaplasia of epithelium
follicular hyperplasia
List some differentials for a purulent discharge in a eye
Bacterial conjunctivitis
Grass seed FB in conjunctiva
KCS (dry eye)
List some differentials for thich/ tenacious discharge in eye
KCS (dry eye )
List 2 possible differentials for haemorrhagic discharge in eye
trauma
coagulation problem
List 2 possible causes of serous (watery) discharge in eye
Increased lacrimation due to ocular pain
Tear overflow (‘epiphora’) due to reduced nasolacrimal drainage
what is the most common cause of canine infectious conjunctivitis
secondary bacterial infection
List 4 possible unlying causes for conjunctivitis
FBs
Adnexal disease- (disorders of the eyelids, tear drainage and orbital tissues)
Irritants- e.g. smoke, sand
Allergic e.g. atopic dermatitis
what is adnexal disease
disorders of the eyelids, tear drainage and orbital tissues.
What is entropion
inversion of the eyelid margin
Describe treatment for entropion
Hotz-celsus surgery: removal of elliptical piece of skin
what is ectropion
eversion/ outward turning of the eyelid margin
List 3 possible aetiologies of canine conjuctivitis
Infectious
non-infectious
secondary to adnexal disease or other ocular disease
describe how to treat eyelid masses
wedge resection
what is distichiasis
extra eyelashes emerge from the meibomian gland orifices
May cause irritation/conjunctivitis, but can be incidental – don’t always need treating
Describe how to treat distichiasis
only treat is causing problem
options= cryotherapy and electrolysis - referral
what are ectopic cilia
Arise from follicle inside/near meibomian gland – emerge through conjunctiva at right angles to cornea
always causes irritation +/- corneal ulcer - need treatment
describe how to treat ectopic cilia
surgical excision
Describe keratoconjunctivitis sicca
dry eye
Local immune-mediated destruction of lacrimal tissue: lacrimal gland and third eyelid (nictitans) gland
common cause of canine conjunctivitis
other then immune-mediated list 5 other possible causes of KCS in the dog
congenital
neurogenic
toxic
endocrine disease
iatrogenic
List the clinical signs of KCS
- Recurrent conjunctivitis that improves with any topical therapy as anything lubricates eye!
- Tacky mucoid-mucopurulent discharge stuck to ocular surface
- Blepharospasm
+/- Corneal ulceration
List 2 corneal changes that occur with chronic KCS
corneal vascularisation, fibrosis and pigmentation
reduced vision
Describe how to diagnose KCS
Schirmer tear test
10-15mm/min = borderline
<10mm/min= KCS
You are presented with a dog with recurrent conjunctivitis in both eyes. The right eye is shown below. Schirmer tear test readings are 13mm/min in the right eye and 9mm/min in the left eye.
What is the most likely diagnosis?
KCS in both eyes
Describe how to treat KCS (immune-mediated)
Tear substitutes
tear stimulant - cyclosporine
broad spec ABs to treat secondary infection
what is the most common cause of conjunctivitis in rabbits
Dacryocystitis
Underlying cause: overlong molar roots pressing on nasolacrimal duct
List 3 ocular conditions with which ‘red eye’ can be seen
uveitis
glaucoma
scleritis/ episcleritis
don’t assume it is just conjunctivitis
what is the most common cause of subconjunctival haemorrhage
due to blunt trauma
check for intraocular damage
other differentials: coagulopathies, systemic hypotension and vasculitis
What parts of the ophthalmic examination are most relevant in an animal presenting with conjunctivitis?
Hands off exam
Hands on exam
Schirmer tear test
Fluorescein stain- check for ulcer
General clinical exam including the skin
Describe how to treat canine conjunctivitis
treat/ remove underlying cause
Topical Ab therapy- fusidic acid OR chloramphenicol
describe the etiology of feline conjunctivitis
Infectious common
non-infectious- less common
extension from other ocular disease
conjunctival involvement in systemic disease
List the 2 most common causes of primary infectious conjunctivitis in cats
Chlamydophila felis (bacterium)
Feline herpesvirus-1 (FHV-1) (virus)
List the clinical signs of Chlamydophila felis
Unilateral conjunctivitis, becomes bilateral within a few days
Chemosis often marked, hyperaemia
No corneal signs
Absent or mild upper respiratory disease
Describe how to diagnose chlamydophila felis
clinical signs +/- conjunctival swab for PCR test
Describe how to treat C felis
Systemic treatment indicated as organism affects respiratory tract, GIT and reproductive tract as well as eye
Doxycycline antibiotic of choice
Treat in-contact animals
List the clinical signs of feline herpesvirus in kittens/ young cats
Bilateral conjunctivitis in conjunction with upper respiratory signs (cat flu)
+/- corneal ulceration
List the clinical signs of feline herpesvirus 1 in adult cats
Unilateral ocular discharge with mild conjunctivitis
History of previous upper respiratory infection
Wide range of other conditions, e.g. corneal ulceration, sequestrum, entropion, eosinophilic keratitis
Describe how to diagnose FHV-1
history and clinical signs
conjunctival swab for PCR- interpret carefully
Decsribe how to treat FHV-1
Nursing
broad spec Abs - topical unless resp involvement then use systemic
anti-virals
what are the form forms of conjunctiva
palpebral and bulbar
where does the conjunctiva attach
at the limbus and eyelid margins
describe the sensory innervation to the eye
opthalmic branch of the trigeminal nerve (CN5)
how can we tell episcleral congestion
will be larger thicker blood vessels- compared to conjunctival congestion only
