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Equine Clinical Practice Exam 1 > Corneal Diseases > Flashcards

Corneal Diseases Flashcards

1
Q

Etiology of ulcerative keratitis?

A

Trauma
Foreign body
Exposure/Paralytic keratitis
EHV (uncommon to rare)
KCS (rare)

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2
Q

What are the categorizations of ulcers?

A

Superficial
Stromal
Descemetocele

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3
Q

How do we approach diagnosing an ulcer?

A

Eyelid block is required*
1. Check for underlying cause
2. Culture/Cytology
3. Fluoroscein stain

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4
Q

What criteria classify an ulcer as complicated?

A

Secondary infection
Stromal degredation
Iridocyclitis (uveitis)

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5
Q

What is a differentiating feature of a fungal ulcer?

A

“Mote” or clear zone at the periphery of the ulcer

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6
Q

Goals of therapy for corneal ulcers?

A
  1. Control & prevent corneal infection
  2. Inhibit corneal proteolysis
  3. Manage secondary uveitis
  4. Increase patient comfort
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7
Q

What are the different types of medical management for ulcerative keratitis?

A
  1. Topical antibacterials until healed
  2. Topical antifungals
  3. Topical atropine (if cycloplegia)
  4. Systemic NSAIDs
  5. Anti-proteases
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8
Q

What surgical procedures are indicated with ulcerative keratitis?

A
  1. Stromal antimicrobial injection
  2. Keratectomy (conjunctival flaps)
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9
Q

Clinical findings associated with corneal perforation?

A
  1. Iris prolapse/fibrin
  2. Corneal edema
  3. Hyphema/hypopyon
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10
Q

T/F: Corneal perforation is always surgical

A

TRUE

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11
Q

Corneal perforation prognosis is worsened by:

A

Blunt trauma etiology
Ulcerative etiology
Endophthalmitis
Severe hyphema
Lens rupture
Chronic rupture

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12
Q

Clinical findings associated with corneal abscesses?

A

Yellow-white stromal opacity
Severe ocular discomfort
Secondary uveitis

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13
Q

Management of corneal abscesses?

A
  1. Antimicrobials must penetrate corneal epithelium
  2. Manage secondary uveitis
  3. Must vascularize to resolve
    AVOID TOPICAL STEROIDS
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14
Q

What is the surgical treatment option for corneal abscess?

A

Excision with conjunctival flap; keratoplasty procedures

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15
Q

What is band keratopathy?

A

Corneal mineralization/calcification
Degenerative condition

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16
Q

Band keratopathy is often associated with:

A

Chronic uveitis (ERU)

17
Q

What are the 4 classifications of IMMK?

A

Epithelial
Superficial Stromal
Mid-Stromal
Endothelial

18
Q

What are the lesions typically seen with epithelial IMMK?

A

Multifocal punctate to coalescing non-ulcerated epithelial opacities
No vascularization/no discomfort

19
Q

What are the lesions typically seen with superficial stromal IMMK?

A

Stromal haze, vascularization, & cellular infiltrate (green/yellow appearance)

20
Q

What are the lesions typically seen with mid-stromal IMMK?

A

Stromal haze, vascularization, & cellular infiltrate (green/yellow appearance)

21
Q

What are the lesions typically seen with endothelial IMMK?

A

Severe regional or (more commonly) diffuse corneal edema

22
Q

Medical treatment for IMMK:

A
  1. Topical steroids and/or cyclosporine (lifelong tx)
23
Q

How does the classification of IMMK affect treatment?

A

Epithelial and stromal have some efficacy with topical steroids and cyclosporine;
mostly ineffective for endothelial IMMK

24
Q

Describe the surgical treatment of IMMK

A

Lesion excision for stromal forms can be curative
Cyclosporine implants
Photodynamic therapy

25
Q

What are the clinical findings associated with eosinophilic keratoconjunctivitis?

A

Ocular discomfort
Raised pink-white necrotic corneal plaque
Variable corneal ulceration

26
Q

What is the etiology of eosinophilic keratoconjunctivitis?

A

Immune-mediated
Allergy/hypersensitivity suspected

27
Q

How do you diagnose eosiniphilic keratoconjunctivitis?

A

Corneal cytology

28
Q

Treatment of eosiniphilic keratoconjunctivitis?

A

Topical corticosteroids
Systemic corticosteroids
Topical cyclosporine
Systemic antihistamines
Keratectomy

29
Q

Prognosis of eosiniphilic keratoconjunctivitis?

A

Generally good, recurrence rates unknown

30
Q

What is the etiology of corneoconjunctival SCC?

A

UV
Breed/Genetics
Viral (?)

31
Q

Clinical appearance of corneoconjunctival SCC?

A

Raised, fleshy, verrucous appearance
Lateral limbus
Stromal invasive form

32
Q

Treatment of SCC?

A

Surgical excision
CO2 laser ablation
Cryotherapy (adjunctive)
Radiation therapy (adjunctive)
Photodynamic therapy
Topical chemo (Mitomycin C, 5-fluorouracil)

33
Q

Prognosis for corneoconjunctival SCC:

A

-Good to excellent with appropriate treatment
-Early referral for surgical treatment ideal
-Loss of globe likely with delayed/absence of treatment
-Stromal invasive SCC has poorer prognosis

Equine Clinical Practice Exam 1 (10 decks)

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