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SS - Exam 3 > Disorders Of Anterior Uvea 2 > Flashcards

Disorders Of Anterior Uvea 2 Flashcards

1
Q

Uveitis

A

Inflammation to any aspect of the uveal tract
• Anterior uveitis - iris + ciliary body
• Posterior uveitis - choroid
• Panuveitis - all three portions

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2
Q

Ocular signs of uveitis

A

Blepharospasm - squinting
• Episcleral injection,
• Ciliary flush
• Corneal edema
• Miosis
• Synechiae
• Aqueous flare
• Hyphema
• Hypopyon
• Keratic precipitates
• Rubiosis iridis
• Hypotony

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3
Q

Episceral injection

A

Congestion of the vessels

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4
Q

Ciliary flush

A

360 degree corneal vascularization
Red appearence around eye, vessels are usually deep, brush like appearence
- indicative of intra ocular disease**

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5
Q

Corneal edema

A

Fluid build up within stromal layer
Blue eye appearence

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6
Q

Miosis

A

Pupillary constriction

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7
Q

Synechiae

A

Adherence of iris to cornea (anterior) or lens (posterior)
Anterior is Common w full thickness perforation of cornea
Posterior is common in uveitis

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8
Q

Aqueous flare

A

Release of protein into the aqueous humor - breakdown of blood aqueous barrier
Leads to cloudy & protrusion of anterior chamber

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9
Q

Lipemic aqueous

A

Unique manifestation of uveitis - presence of lipids

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10
Q

Keratic precipitates

A

Accumulation of inflammatory cells that adhere to corneal endothelium (inner layer)
Common in cats

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11
Q

Hypopyon

A

Accumulation of inflammatory cells (pus) in the anterior chamber -

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12
Q

Hyphema

A

Accumulation of blood in the eye - any chamber but in the eye

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13
Q

Rubeosis iridis

A

Red iris - congestion of iridal vasculature

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14
Q

Hypotony

A

Low Intraocular pressure

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15
Q

Uveitis complications

A

Synechiae - adhesion of lens and iris
• Glaucoma
• Iris bombe
• Cataract -
• Lens instability - break down of zonular fibers
• Retinal detachment
• Phthisis bulbi
List builds /can progress from one disease to the next on the list

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16
Q

Mechanism 1 of uveitis to glaucoma

A

Obstruction of the angle by inflammatory debris

17
Q

Mechanism 2 of uveitis to glaucoma

A

Formation of Pre-iridal fibrovascular membnrane, lead by inflammatory cells. Drainage is compromised

18
Q

Mechanism 3 of uveitis to glaucoma

A

Iris Bombe + peripheral anterior synechiae
Accumulation of aqueous humor behind iris due to blocked drainage in eye

19
Q

Causes of uveitis

A

Primary ocular disease
Idiopathic
Trauma
Ocular manifestations of systemic diseases

20
Q

Primary ocular disease

A

Cataract
Lens rupture
Corneal ulcer

21
Q

Ocular manifestations of systemic diseases

A

Infectious
Metabolic
Immune-mediated
Neoplasia

22
Q

What percentage of dogs and cats are idiopathic?

A

Dogs - 47%
Cats - 70%

23
Q

Lens induced uveitis

A

Phacolytic Uveitis - Soluble lens protein leaks through an intact lens capsule (cataract) Phacoclastic uveitis - Sudden exposure of intact lens protein (lens capsule tear - trauma)

24
Q

Common causes of uveitis in dogs

A

Infectious
Lens induced uveitis - 2 types
Reflex uveitis - Corneal/ scleral diseases
Metabolic - Hyperlipidemia
Breed specific

25
Q

Common causes of uveitis in cats

A

Infectious - Viral (FeLV, FIP, FIV, FHV-1), Bacterial (Bartonella), Fungal (Histoplasma, Blastomyces, Coccidioides), Protozoal (Toxoplasma)
• Metabolic - Systemic hypertension
• Neoplastic - Lymphoma - most common metastatic

26
Q

Common causes of uveitis for horses

A

Trauma
• Reflex uveitis - Stromal abscess
• Equine Recurrence Uveitis (ERU)
• Systemic disease - Sepsis in foals, EIA , Potomac Horse Fever etc

27
Q

Equine recurrence uveitis

A

Most common cause of blindness in horses - suspect immune mediated cause

28
Q

Classifications for ERU

A

Classic - active bouts w quiet periods
Insidious - on going/low grade
Posterior - only choroid affected

29
Q

Breeds common w ERU

A

Appaloosa, draft, warm blood, Icelandic horses

30
Q

treatment for ERU

A

Supportive, surgical - implant, vitrectomy, Intravitreal infection

31
Q

DX uveitis

A

History - Vaccination, Life style (indoor/outdoor/travel), Acute/chronic, Previous meds
• Physical Exam - Ophthalmic Exam
• Minimum data base
• CBC, chemistry panel, UA

32
Q

Specific DX for uveitis

A

Initial serology
• Canine: fungal, tick titers, toxoplasmosis
• Feline: fungal, FeLV, FIV, FIP, toxoplasmosis
• Thoracic radiographs and abdominal ultrasound- fungal/neoplasia is suspected
• Ocular ultrasound: ONLY if you cannot see past the iris and lens
• Additional systemic testing as indicated by species/patient clinical signs/geographic area

33
Q

TX goals for uveitis

A

Prevent sequalae
• Eliminate intraocular inflammation
• Stabilize and restore blood - aqueous barrier
• Treat underlying cause when possible!!! Supportive

34
Q

Treating uveitis

A

Topical anti-inflammatories
• Corticosteroids - Prednisolone acetate, Dexamethasone
• Non-steroidal anti-inflammatories - Diclofenac, Flurbiprofen, Ketorolac
• Systemic anti-inflammatories
• Corticosteroids - Prednisone • Non-steroidal anti-inflammatories

35
Q

Topical atropine

A

Most efficient pain management for the eye
Mydriatic (synechia), Cycloplegic (analgesia)
• Stabilize blood-aqueous barrier
• Systemic therapy if indicated
• Antimicrobials
• Antifungals

36
Q

Contradictions for atropine

A

Contraindications
• Lens instability
• Glaucoma
• Dry eye • Parasympatholytic - decrease STT
• Bitter taste (CATS)

37
Q

Contractions for topical & systemic steroids

A

Topical
• Potentiate infection - melting ulcer
• Decrease would healing
• Corneal degeneration - consider switching to a topical NSAID long-term
• Systemic
• Depends on underlying disease
• Rule out infectious causes!

SS - Exam 3 (28 decks)

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