Diagnosis of the Cloudy Eye

Question 1

Approach Diagnosis of the Cloudy Eye

Answer 1

Localize the lesion
Subjective/Objective qualifiers (uni-, bilateral, diffuse, focal, severe, mild)
Historical factors (onset rapid, gradual, progessive, waxing or waning)
Signalment (breed, age)
Symptoms/signs (ocular, non/ocular)

Question 2

4 causes of non-painful Corneal cloudiness

Answer 2

1. Edema
2. scar
3. lipid
4. mineral

Question 3

What can cause a PAINFUL, cloudy eye?

Answer 3

EDEMA

Question 4

Anterior chamber and aqueous flare

Answer 4

uveitis

Question 5

Anterior chamber and lipid flare

Answer 5

metabolic hyperlipidemia

Question 6

Corneal mineralization

Answer 6

• SPICULATED and scratchy; kind of chalky and white
• dense, moth-eaten
• cushing’s can cause similar to calcinosis cutis

NOT glittery or shiny

Question 7

Corneal mineralization causes

Answer 7

1. degeneration (ocular disease, age related)

2. metabolic (systmeic metabolic disease)

Question 8

Corneal lipid causes

Answer 8

1. lipid dystrophy (ovoid/circular – hereditary and bilateral)
2. lipid degeneration (irregular in shape – prior keratitis, infil. corneal dz, topical steroids, systemic metabolic dz)

Question 9

Corneal edema causes

Answer 9

1. ulceration/epithelial

2. endothelial dysfunction (anterior uveitis, glaucoma, endothelial degen., localized dysfunction

Question 10

Corneal edema

Answer 10

Cobblestone appearance or “ground glass” appearance
may notice the LIP of a SCCED
- starts laterally and marches across the cornea

Question 11

Corneal scar

Answer 11

• homogenous, and whispy

Prior ulcer/trauma
Chronic exposure (lagophthalmos, KCS)
Chronic abrasion (Entropion, distichiasis, Ectopic cilia)

Question 12

Corneal lipid

Answer 12

sparkly and glittery

Question 13

Difference between Lipid Flare and Aqueous Flare

Answer 13

Lipid is “milkier” in appearance and NOT painful and usually bilateral. Indicates lipemia

Aqueous flare is associated with uveitis would produce a ton of pain and discomfort if severe enough to appear as milky/white as lipid.

Question 14

Difference between sclerosis and cataract

Answer 14

• sclerosis will still see tapetum

- cataract will see white cataract

Question 15

Lens cloudiness

Answer 15

Sclerosis or Cataract

Question 16

Posterior segment cloudiness

Answer 16

vitreous (inflammation, hyalosis, synchesis scintillans)

retina (retinal detachment, may lose tapetal reflection)

Question 17

Acute corneal edema is more likely _____

Answer 17

Glaucoma or uveitis

Question 18

Progressive corneal edema is more likely _____

Answer 18

endothelial dystrophy/degeneration

Question 19

Edema associated with corneal endothelial dysfunction tends to be _______ in nature

Answer 19

DIFFUSE

Question 20

What is aqueous flare ?

Answer 20

increased protein in the anterior chamber and is related to breakdown of the blood aqueous barrier, caused by anterior uveitis