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RUSVM SAM II > Exophthalmos, Proptosis, Buphthalmos, Glaucoma > Flashcards

Exophthalmos, Proptosis, Buphthalmos, Glaucoma Flashcards

1
Q

What is the difference between Buphthalmos & Exophthalmos?

A

Buphthalmos=ENLARGED globe(from increased IOP)

Exophthalmos= NORMAL sized globe that PROTRUDEs

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2
Q

A dog comes in with the main complaint of “pawing” at its eye. On tonometry you find the IOP=28 mmHg. While the eye is firm it does retropulse.
What is your top ddx?

A

Bupthalmos from glaucoma

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3
Q

What are the 4 main things to consider when working up an exophthalmos case?

A
  • Signalment & history are critical clues
  • Complete PE
  • Ophthalmic exam
  • Oral exam
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4
Q

What surgery removes ONLY the globe?

A

Enucleation

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5
Q

What surgery removes the globe & orbital contents?

A

Exenteration

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6
Q

Swelling of the eyelid conjunctiva=

A

Chemosis

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7
Q

T/F: Orbital cellulitis due to Idiopathic inflammation causes only bilateral exopthalmos.

A

FALSE!

Idiopathic inflammation causes unilateral OR bilateral Orbital cellulitis

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8
Q

What is the main c/s & reason the owner would bring in an orbital cellulitis / retrobulbar abscess case?

A

“Red eye”-hyperemia

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9
Q

On US of the orbit of a dog that was brought in for “red eye” you find bilateral fluid pockets. What is your top ddx?

A

Bilateral=Orbital cellulitis

If it were unilateral think Retrobulbar abscess

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10
Q

What is the difference in treating exopthalmos from Orbital cellulitis vs. Retrobulbar abscess?

A

Orbital cellulitis- Steriods & Antibiotics

Retrobulbar abscess- Antibiotics only

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11
Q

A _______ may be placed on the lateral canthus of an exophthalmic eye if it protrudes so much the dog can’t blink.

A

Temporary tarsorrhapy

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12
Q

What age & type of dog does orbital cellulitis/retrobulbar abscesses affect?

A

Young(1-5 y/o)

Large breed

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13
Q

T/F: The oral exam of an orbital cellulitis case ma cause pain.

A

True

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14
Q

Waxing/waning “suprised” expression
NON-painful when mouth opened
Normal behavior
NON-hyperemic orbital tissue

A

Extraocular polymyositis

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15
Q

What is the treatment for Extraocular polymyositis?

A

Immunosuppressive corticosteroids-SLOW taper

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16
Q

What should you warn the owner of with extraocular polymyositis?

A

May relapse 1-2 times

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17
Q

What is the #1 cause of Anterior uveitis?

A

Infectious diseases

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18
Q 
What are the top ddx for Peripheral lymphadenopathy cases with the following signs?
Exophthalmos
Anterior uveitis
Ocular cloudiness
Fever
A

Lymphoma
Tick borne dz
Fungal dz
Protozoal dz

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19
Q

Extreme exophthalmos to the point that they can’t close their eyes=

A

Proptosis

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20
Q

What types of dogs are predisposed to proptosis?

A

Brachycephalics

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21
Q

Trauma cases of proptosis in cats and non-brachycephalic dogs have what kind of prognosis?

A

SEVERE & more guarded prognosis

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22
Q

What is the prognosis for vision of proptosed eyes?

A

Gaurded-poor

only 27% of proptosed canine retained vision

23
Q

What can be used to reduce proptosis?

A

Lateral canthotomy w/ temporary tarsorrhaphy

24
Q

What is the tx for a completely avulsed proptosed eye?

A

Enucleate

25
Q

Buphthalmos is cause by ______ or _______.

A

Chronic glaucoma or IO neoplasia

26
Q 
What is the top ddx for the following c/s?
Dilation of pupil
Corneal edema
Subluxation or luxation of lens
Vision loss
Buphthalmus
A

Chronic Glaucoma

27
Q

What is the difference between Acute & Chronic glaucoma?

A

Globe size

Acute: NOT enlarged
Chronic: Enlarged(bupthalmic)

28
Q

What is the name for the break in Descemet’s membrane found with chronic glaucoma cases?

A

Haab’s striae

29
Q

T/F: Acute glaucoma is unilateral.

A

True

30
Q

What are the two types of primary glaucoma & which is more common?

A

Narrow/closed angle=common
-abnormal iridocorneal angle

Open angle=less common
-Normal iridocorneal angle

31
Q

Which of the two types of primary glaucoma has Goniodysgenesis?

A

Narrow/closed angle

32
Q

What are the top breeds that have the two types of primary glaucoma?

A

Close angle:

  • Cocker
  • Basset
  • Chow
  • Shar pei
  • Boston
  • WFT

Open:
-Beagle

33
Q

What is the pathogenesis of glaucoma?

A

Aqueous humor can’t get out(obstruction)

Fluid build up–>Increased IOP, stretch of ocular structures & lens zonules–> vision loss, buphthalmus & subluxation/luxation of lens

34
Q

What are the 4 main causes of secondary glaucoma?

A

Uveitis
Lens diseases
IO neoplasia
Trauma

35
Q

What is the most common cause of glaucoma in cats?

A

Uveitis

36
Q

Glaucoma= IOP > ____

A

25 mmHg

37
Q

What are the 2 main treatment goals of acute primary glaucoma if vision is present & c/s

A

Decrease aqueous production

Increase outflow

38
Q

What can be used to decrease aqueous production for acute primary glaucoma if vision is present & c/s

A

IV-mannitol

Carbonic anhydrase inhibitors

39
Q

What are the oral vs. topical carbonic anhydrase inhibitors?

A

Oral:

  • Methazolamide( Neptazane, Glautabs)
  • Acetazolamide(Diamox)
  • Dichlophenamide

Topical:

  • Dorzolamide
  • Brinzolamide
40
Q

What can be used to increase aqueous outflow for acute primary glaucoma if vision is present & c/s

A

F2a prostaglandin analouge(“Prosts”: Travoprost–>miosis, inc. outflow

Beta blocker”-olol”: Timolol, Betaxolol–> dec AH production, inc. outflow

Parasymphathomimetics: Pilocarpine, Demecarium bromide–>miosis

41
Q

What should you warn the owner about about with the treatment of actue primary glaucoma

A

CONTRALATERAL EYE! Prophylactically treat w/:

Timolol, Dorzolamide, or Demercarium bromide forever

42
Q

What are the indications for salvage procedures?

A
  • Blind PAINFUL eye
  • Blind eye REQUIRING MEDS
  • IO tumor
  • Severe IO infection
  • Severe orbital disease resulting in globe damage
43
Q

What are the 3 salvage procedures?

A
  • Enucleation
  • Evisceration & intrascleral prothesis insertior
  • Pharmacologic ablation of the ciliary body
44
Q

What drug could be used for pharmacologic ablation of the ciliary body?

A

Gentamicin-vitreal injection

DNU in cats

45
Q

What might pharmacologic ablation of the ciliary body with a vitreal injection of Gentamicin?

A

Phthisis bulbi-“Phthisical eye”

-ie. shrunken, non-functional eye

46
Q

T/F: Medical management is normally enough to control glaucoma enough to maintain vision.

A

FALSE!!!

Medical management is RARELY enough to control glaucoma enough to maintain vision.

47
Q

What surgery is recommended for tx of acute glaucoma that’s regaining vision & has an IOP

A

Diode laser surgery

48
Q

What surgery is recommended for tx of acute glaucoma that’s regaining vision & has an IOP >20mmHg?

A

Ahmed shunt placement & Diode Laser

49
Q

What c/s should make you want to exam an eye immediately for actue glaucoma?

A

Red, cloudy, painful, or blind eye

50
Q

Buphthalmos indicates _____ & ______ procedures are likely needed.

A

Chronicity; Salvage

51
Q

How is Glaucoma diagnosed?

A

Tonometry: IOP >25 mmHg

Applanation or Rebound= ideal

52
Q

Glaucoma can be caused by an of the following EXCEPT:

A. IO neoplasia
B. Lens luxation
C, Uveitis
D. Abnormal iridocorneal angle
E. Optic nerve atrophy
A

E. Optic nerve atrophy

53
Q

Treatment of an acute glaucoma case will involve all of the following EXCEPT:

A. Atropine
B. Oral carbonic anhydrase inhibitor
C. Topical miotic
D. Mannitol
E. Topical carbonic anhydrase inhibitor
A

A. Atropine

RUSVM SAM II (4 decks)

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