Cornea Flashcards
1
Q
cornea (rankin)
Pannus
A
- Chronic superficial keratitis
- Most common
- German Shepherds
- Greyhounds
- Dobermans
- Pigment and vascularization
- Starts laterally
- Higher altitudes
- Bilateral disease
- NONPAINFUL!!!!!!
- Atypical pannus
- Third eyelid
- Depigmented and follicles
2
Q
cornea (rankin)
Pannus Treatment
A
- Life long treatment!!!!
- Treat aggressively initially then taper
- Topical steroids
- Prednisolone acetate 1%
- Neopolydex (0.1% dexamethasone)
- 3-4 times daily
- Topical cyclosporine A or tacrolimus
- 1or 2% CsA from licensed compounding pharmacy
- 0.2% CsA Optimmune ®
- 0.02% 0.03% tacrolimus from licensed compounding pharmacy
- BID
- Taper medications
- Control with CSA or tacrolimus
3
Q
Pigmentary Keratitis
A
- PUGS!!!!
- 82.4%
- Nonpainful
- Blinding
- Starts medially
- Multifactorial
- Exposure
- Medial entropion
- Trichiasis
4
Q
Treatment of Pigmentary Keratitis
A
- Surgical
- Medial canthoplasty
- Medical therapy
- Mild cases
- Topical cyclosporine or tacrolimus (SID to BID)
- Avoid topical steroids in PUGS!!!
5
Q
Corneal Dystrophy
A
- Opacity
- Axial or paraxial
- Inherited, bilateral
- Relatively common
- Nonpainful
- Lipid deposition
- No treatment
6
Q
Corneal Endothelial Dystrophy
A
- Corneal edema
- Inherited
- Boston Terriers, Boxers, Dachshunds, Poodles, and Chihuahuas
- Generally young dogs
- Treatment:
- NaCl ointment 5% T-QID
- Muro128
- Topical antibiotics for ulcers
- Referral surgical procedures
- NaCl ointment 5% T-QID
7
Q
Corneal Endothelial Degeneration
A
- Corneal edema
- Bulla formation
- Recurrent ulcerations
- Old dog disease
- Treatment
- NaCl ointment 5% T-QID
- Muro 128
- Topical antibiotics for ulcers
- Referral surgical procedures
- NaCl ointment 5% T-QID
8
Q
Corneal Foreign Body
A
rare in cats
9
Q
cornea (rankin)
Corneal Ulcers
- Clinical signs
A
- Blepharospasm
- Rubbing
- Epiphora
- Elevated third eyelid
- “Red
- Reflex uveitis
- Miosis , aqueous flare, hypopyon, fibrin, photophobia
10
Q
cornea (rankin)
Diagnosis of Corneal Ulcer
A
- Examine eyelids and conjunctiva
- Palpebral reflex
- STT
- Fluorescein staining
- Examine posterior TEL
- Cytology
- Culture and sensitivity
11
Q
cornea (rankin)
Corneal Ulcer
- superficial vs deep
A
- Corneal blood vessels
- 3-5 days to begin to grow
- ~1mm/day
- Is it superficial or deep?
12
Q
cornea (rankin)
Infected Corneal Ulcer Signs
A
- Depth
- Corneal malacia
- Cellular infiltrate
- Pain
- Purulent ocular discharge
- Hypopyon
13
Q
Has the ulcer perforated?
A
- Perforation site will be “bulging”
- Sealed with
- Fibrin
- Blood
- Iris
- Hyphema
- Shallow anterior chamber
- Restrain patient “VERY GENTLY”
14
Q
Causes of ulcers
A
- Trauma
- KCS
- Eyelash disorders (ectopic cilia/rarely distichiasis)
- Eyelid disorders (entropion)
- Exposure (lubricate under general anesthesia!!!)
- Foreign body
- Infectious causes (herpesvirus and Moraxella Bovis
15
Q
cornea (rankin)
How am I going to manage the ulcer?
A
- If greater than 50% depth or severe infection:
- Surgical therapy recommended: Conjunctival graft, corneoconjunctival transposition, corneal transplant, amnionic memebrane graft referral