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equine Ophtho junior > Equine Ophtho exam > Flashcards

Equine Ophtho exam Flashcards

1
Q

Three basic layers of eye

A
  1. Outer coat (fibrous tunic)
    - cornea and sclera
  2. Middle layer (uvea)
    - choroid, ciliary body, iris
  3. central layer (nervous coat)
    - retina and optic nerve
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2
Q

Choroid (4)

A
  1. located in posterior one half of eye (between outer sclera and retina)
  2. provides nourishment to retina
  3. modifies internal light reflection and scatter
  4. heavily pigmented or reflective
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3
Q

Ciliary body (3)

A
  1. Production and outflow of aqueous humor through anterior segment
  2. Base for lenticular zonules
  3. muscles alter zonules to change lens shape
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4
Q

Iris (2)

A
  1. Extends from ciliary body to anterior surface of lens

2. Changes shape of pupil

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5
Q

2 ophthalmic dzs in horses

A
  1. Ulcers

2. Everything else

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6
Q

Basic equipment (6)

A
  1. Pen/paper
  2. Eyeballs (mine)
  3. Drugs
  4. Dark room
  5. Bright light source (transilluminator)
  6. Magnification (Ophthalmoscope/jewelers loops)
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7
Q

Diagnostic tools (8)

A
  1. Culturettes
  2. Schirmers tear test strips
  3. Rose Bengal stain/or green stuff
  4. Fluorescein stain
  5. Topical anesthetic (Propericaine/Tetracaine)
  6. Blades, glass slides
  7. Catheter and syringe
  8. Tonometer - In an ideal world
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8
Q

Therapeutic equipment (6)

A
  1. Subpalpebral lavage
  2. Syringes and needles
  3. Hard cup hood (Jorgenson eye saver cup)
  4. Fly mask
  5. Soft contact lens
  6. Drugs
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9
Q

How they see (4)

A
  1. Cornea lightly bends light
  2. Iris is the shutter
  3. Lens is fine focus (limited accommodation in horses)
  4. Retina - photo transduction
  5. No reds, better color percept in dim light than humans
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10
Q

Critical aspects of equine vision (3)

A
  1. Wide panoramic view
    - 65 deg binocular (we have 120 deg)
    - 146 deg uniocular (we have 35 deg)
    - 3 deg blind spot behind (we have 170 deg)
  2. Good vision in low light
  3. Motion detection
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11
Q

Equine acuity

A

20/33 - 20/60

-if horse has 20/50 and I have 20/20 horse needs to be at 20 feet to see what I can see at 50 feet

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12
Q

vision testing (2)

A
  1. Can test if completely blind

2. Cannot test vision objectively

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13
Q

Menace (5)

A
  1. Crude test
  2. Positive or negative (not degree vision)
  3. Positive = 20/20000
  4. Learned resp
  5. Subject and situation
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14
Q

Assessment limited to…. (3)

A
  1. Eye has dz/abnormality
  2. Visual deficit is present
  3. Major/vs minor - affecting behavior and safety
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15
Q

Reflexes/responses (5)

A
  1. Menace - Foals older than 9 days (learned)
  2. PLRs - present at birth (subcortical)
  3. Dazzle - present at birth (subcortical)
  4. Palpebral
  5. Corneal
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16
Q

PLR evaluates (5)

A
  1. Retina
  2. Optic nerve
  3. Midbrain
  4. Parasypathetic fibers of Oculomotor n.
  5. Iris musculature
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17
Q

Optic pathway (5)

A
  1. Optic nerve ->
  2. Optic chiasm (crossing over) ->
    - lateral geniculate nucleus (stops)
    - Pretectal nucleus -> central decussation or PS nuc CN III
  3. Parasympathetic nucleus of CN III (Edinger Westphal nucleus) ->
  4. Oculomotor nerve CN III ->
  5. CIliary ganglia -> retina
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18
Q

PLR helpful in …

A

Prognosticating - Trauma and Ulcers

  1. Direct
  2. Consensual
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19
Q

Visual with normal PLRs

A

YAY! You’re good to go

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20
Q

Visual with absent PLRs (3)

A
  1. Efferent problem (CN III or iris sphincter)
  2. Mechanical problem
  3. Drugs (Atropine)
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21
Q

Blind with normal PLRs (2)

A
  1. Something obscuring vision (cataract)

2. Cortical dz (behind reflex arc)

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22
Q

Blind with absent PLRs

A

99/100 retina or optic nerve prob

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23
Q

Example eye exam approach (8)

A
  1. Orbit
  2. Adnexa
  3. Tear film
  4. Cornea
  5. anterior chamber
  6. Uvea
  7. lens
  8. posterior seg
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24
Q

External eye exam (3)

A
  1. HX!!!!!!!!
  2. Menace, discomfort, d/c
  3. symmetry - orbit, globe position, eyelids/lashes, nictitans
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25
Q

Ptosis (2)

A

Droopy lid

  1. facial n. paralysis
  2. horner’s syndrome
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26
Q

Horners (5)

A 
Interruption sympathetic nerve supply to eye
1. Sweating/ptosis
Variable
2. enophthalmos, 
3. TE prolapse
4. miosis, 
5. +/-inc lacrimation...?!?!
27
Q

Exam before sedation: Globe position/size (5)

A
  1. Enopthalmos
  2. Exophthalmos
  3. Microphthalmos
  4. Phthisis bulbi - shrunken, non-functional eye
  5. Buphthalmos -GLAUCOMA
28
Q

Exam before sedation: Orbit/Adnexa (2)

A
  1. Position/symmetry

2. Palpation/Retropulsion

29
Q

Sedation drugs (4)

A
  1. Xylazine
  2. Detomidine
  3. Butorphanol - head bobs
  4. Romifidine
30
Q

How to: Regional anesth (2)

A
  1. 25 guage needle

2. Lidocaine, Carbocaine, Bupivicaine

31
Q

Motor blocks (3)

A
  1. Facilitate exam
  2. Facilitate procedure
  3. Akinesia: CN 7-Auriculopalpebral
32
Q

Sensory blocks (2)

A
  1. Facilitates procedures

2. Sensory Analgesia: CN 5 - frontal/supraorbital, line

33
Q

Tear film (2)

A
  1. STT - Quatitative/Not a linear/ <10mm/min = deficiency

2. TBUT - Qualitative/Rose Bengal/green stuff < 10s = deficiency

34
Q

Cornea exam (6)

A
  1. Clarity
  2. Color
  3. Infiltrates
  4. Integrity/defects
  5. Presence/absence vessels
  6. Thickness
35
Q

Corneal Culture (5)

A

Aerobic/fungal

  1. Culture PRIOR to putting stuff in
  2. Ulcers with depth
  3. Cellular infiltrate
  4. Collagenolysis - melting
  5. Severe edema
36
Q

Cytology (4)

A
  1. Gram stain, Wright-Giemsa, Diff-Quick
  2. Bacteria, fungus
  3. Inflammatory cells, neoplastic cells
  4. Topical anesth, brush/blunt end of scalpel, edge of lesion
37
Q

Indications to stain (4)

A
  1. Redness
  2. Pain
  3. Cloudiness
  4. Prior systemic/topical steroid use - FUNGUS
38
Q

Fluorescein uses (4)

A
  1. Corneal ulcers
  2. TBUT
  3. Seidel’s test - aqueous leakage
  4. Jone’s test - NL patency (>10 min abnormal)
39
Q

Rose Bengal stains (3)

A
  1. devitalized cells
  2. healthy cells not covered by tear film
  3. NOT diagnostic for fungal infection - confirm with cytology or culture
40
Q

Anterior segment eval

A
  1. Bright light source and slit lamp (if poss)
  2. AC
  3. Iris
41
Q

Aneterior chamber eval (6)

A
  1. clarity
  2. depth
  3. mass lesions
  4. hyphema - pooling of blood
  5. hypopyon - WBCs
  6. aqueous flare (ant uveitis) - inc protein and WBCs
42
Q

Irirs eval (6)

A
  1. Color/color changes
  2. Position
  3. Neovascularization
  4. Pupil size
  5. Infiltrates
  6. Mass lesions
43
Q

Miosis (2)

A
  1. Hallmark CS of anterior uveitis

2. Primary vs Secondary

44
Q

Mydriasis (3)

A
  1. Drug induced vs pathologic
  2. Glaucoma
  3. Retinal dz
45
Q

Dyscoria (3)

A
  1. Synechia
  2. Uveitis
  3. Mass lesions
46
Q

Lens eval (4)

A
  1. Need darkness
  2. Transilluminate, retroilluminate
  3. Clarity vs opacity - nuclear sclerosis or cataract
  4. Position - subluxations or luxations
47
Q

Iridocorneal angle

A
  1. Open meshwork thru which AqH flows
  2. Grossly visible in horses
  3. Changes from inflammation, inc IOP
48
Q

IOP

A
  1. Tonopen vs tonovet
  2. Use topical anesthetic and don’t dilate yet
  3. Head above heart
  4. 16-30 mmHg is normal (higher than dogs)
49
Q

Posterior segment of the eye

A
  1. May need to dilate pupil
  2. Direct ophthalmoscope/indirect/panoptic
  3. US
  4. Electroretinography
  5. MRI
50
Q

Pharmacologic mydriasis (3)

A
  1. 1% Tropicamide - onset 10-20 min/duration 4-6 hours
  2. 1% Atropine - onset depends/duration up to 14 days
  3. 2.5% Phenylephrine
51
Q

Vitreous (4)

A
  1. If normal not visualized ush
  2. Congenital abnormalities
    - persistnd hyaloid artery/remnant
  3. Acquired opacities
    - transudates/exudates
    - Hemorrhage
    - Asteroid hyalosis - age related
  4. Degeneration
52
Q

Direct Ophthalmoscopy (3)

A
  1. Ophthalmoscope
  2. Small field - 10-15x magnified
  3. Upright and real image
53
Q

Indirect Ophthalmoscopy (3)

A
  1. Transilluminator plus dioptic thing
  2. Large field - 2-4x magnified
  3. Upside down, backwards virtual image
54
Q

Panoptic

A
  1. Weird machine thing
  2. Large field - 2-4x magnified
  3. Upside down, backwards, virtual image
55
Q

Settings on direct ophthalmoscope (6)

A
  1. Light - spot size to ‘just’ fill pupil aperture
  2. Slit - determ depression/elevation
  3. Red-free (green) - observe opt nerve fiber layer and diff hemorrhage from pigment
  4. Zero setting - observe fundus
  5. Positive (green or black) - anterior
  6. Negative - depression (back of eye)
56
Q

Fundic exam (Retina) (7)

A
  1. Position/integrity
  2. anatomy
  3. color
  4. inflammatory lesions (active vs inactive)
  5. Hemorrhages
  6. Detachments
  7. Tears
57
Q

Fundic exam (Optic disk) (4)

A
  1. Size
  2. Shape
  3. Color
  4. Elevation/depression
58
Q

Fundic exam (Vasculature) (4)

A
  1. presence/absence
  2. Number
  3. Color
  4. Tortuosity or attenuation
59
Q

Tapetum resides in

A

superior choroid

60
Q

Tapetum

A
  1. Ush blue or green or yellow or absent
61
Q

Non tapetum

A
  1. black to brown

2. various degrees of chorioretinal hypoplasia

62
Q

Optic disk (5)

A
  1. round to oval
  2. salmon to pink
  3. Myelin ush doesn’t extend beyond ON
  4. Located in nontapetal fundus
  5. Vasculature visible on disc periphery
63
Q

US findings (7)

A
  1. Anterior seg mass
  2. Cataract
  3. Lens lux/capsule rupture
  4. Vitreal debris/hemorrhage
  5. Post segment mass
  6. Retinal detach
  7. Retrobulbar lesion
64
Q

Rentinal vasculature pattern

A

Paurangiotic

equine Ophtho junior (14 decks)

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