Corneal Ulcer

Question 1

What is an ulcer

Answer 1

Loss of epithelium +/- stroma, descemet membrane

Question 2

fluorescein dye is absorbed by what layer of the cornea?

Answer 2

stroma - hydrophilic

Question 3

descemetocele

Answer 3

all layeres of cornea missing except descemet membrane

descemet membrane does not stain

Question 4

what is a corneal facet

Answer 4

healed stromal ulcer with intact epithelium

Question 5

how long does neovascularization take

Answer 5

3-5 days

Question 6

how much does vessels grow in the cornea per day

Answer 6

1mm/day

Question 7

what causes reflex uveitis

Answer 7

initiated by pain and inflammation associated with corneal ulcer

Question 8

what do you see with reflex uveitis

Answer 8

corneal ulceration
miosis
flare & cells

Question 9

C/S of corneal ulcer

Answer 9

corneal edema
pain
neovascularization
corneal pigment
loose epithelium
discharge
cellular infiltrate
malacia
conjunctival hyperemia
reflex uveitis - flare and miosis
fibrosis

Question 10

what do you often see with corneal ulcers in cats

Answer 10

sequestration

Question 11

what are the characteristics of an uncomplicated ulcer

Answer 11

superficial
no loss of stroma - (no indent & normal curvature)
not infected

Question 12

how long does it take a uncomplicated ulcer to heal

Answer 12

5-7 days

Question 13

characteristics of complicated ulcer

Answer 13

infected
stroma involvement (indent)

Question 14

causes of complicated ulcer

Answer 14

lagophthalmos
facial nerve paralysis
trichiasis
distichia
ectopic cilia 
entropion
FB
KCS

Question 15

how do you treat an uncomplicated ulcer?

Answer 15

topical antibiotic 3-4 times a day

Question 16

how often do you give topical antibiotics on a uncomplicated ulcer

Answer 16

3-4 times a day

Question 17

how do you treat an uncomplicated ulcer in a horse

Answer 17

topical antibiotic and SSD - must always cover fungal in horses

Question 18

when do you recheck an uncomplicated ulcer

Answer 18

1 week

Question 19

what medications do you normally use for complicated ulcer

Answer 19

Anticollagenase (serum)
2 topical antibiotics
Atropine
Systemic NSAID

Question 20

if you see neutrophils in the cytology what treatment should you do

Answer 20

serum

Question 21

how often should you use serum in a complicated ulcer

Answer 21

6-8 times a day

Question 22

how often do you want to give topical antibiotics in a complicated ulcer

Answer 22

6-8 times a day

Question 23

if you see rods/psuedamonus what antibiotic should you use

Answer 23

ofloxacin or ciprofloxacin

gram -, some gram +

Question 24

if you see cocci/staph strep would antibiotic should you use

Answer 24

neopolybac
(broad spectrum)
cefazolin (gram +)

Question 25

if the ulcer is melting what medication can you add to the treatment

Answer 25

cefazolin

Question 26

what are the anticollagense options

Answer 26

serum
edta
tetracycline
N-acetyl-cyseine

Question 27

antifungal medication for horses

Answer 27

SSD

Vorconizole

Question 28

when do you want to recheck a complicated ulcer

Answer 28

2-3 days

Question 29

at what depth of corneal loss do you go to surgery

Answer 29

50-60%

Question 30

how do you treat a indolent ulcer

Answer 30

debride with q-tip
grid keratotomy (25 g needle)
diamond burr keratectomy

Question 31

what is a surgery option for complex ulcers

Answer 31

conjunctival grafts

Question 32

what are the benefits of conjunctival grafts

Answer 32

tectonic support

blood supply