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Ophthalmology > Eyelids and conjunctiva > Flashcards

Eyelids and conjunctiva Flashcards

1
Q

Purpose of the upper and lower eyelids as well as the third eyelid. (7)

A
  • for maintaining ocular-surface health
  • physically protect the eye from insult
  • distributes the mucinous tear film
  • remove debris from the surface of eye during blinking
  • contributes constituents to the tears
  • film from the goblet cells within the palpebral conjunctiva meibomian glands (same as tarsal glands)
  • assists in pumping tears along the nasolacrimal duct during blinking

Deviation from normal anatomy can cause irritation and inflammation. In cases of blepharospasm, epiphora, conjunctivitis, corneal ulcer/pigmentation; eyelid anomalys should be excluded.

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2
Q
A
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3
Q
A

Macroblepharon/
macropalpebral fissure/
„diamond eye“

  • Abnormally large/long palpebral fissures
  • Drooping of the lateral +/- medial part of upper eyelids
  • Inversion of lateral +/- medial part of lower eyelid
  • Lower part of conjunctiva is too open
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4
Q
A

Also has ectropion.

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5
Q
A
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6
Q

Treatment of entropion.

A
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7
Q

Tx of medial lower eye lid entropion.

A

Typical to brachys.

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8
Q

medial canthal syndrome in
brachycephalic dogs

A

Chronic corneal and conjunctival irritation in dogs is often caused by anatomic eyelid abnormalities, particularly in brachycephalic and shallow-orbit breeds. may cause pigmentary keratitis, epiphora, and occasionally ulcers.

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9
Q
A

Medial canthoplasty

e.g. for medial lower eye lid entropion or cases of macroblepharon

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10
Q

In cases of blepharospasm, epiphora,
conjunctivitis, corneal ulcer/pigmentation, you must exclude:

A

ectopic cilia

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11
Q

Describe eyelid neoplasias in dogs and cats.

A

Most canine eyelid neoplasms are benign.
- Meibomian (tarsal) gland adenoma or papilloma
- Histiocytoma
- Epithelioma

Less common but more malignant in cats:
- Squamous cell carcinoma
- Meibomian gland adenocarcinoma
- Melanoma
- Mast cell tumor
- Basal cell tumor

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12
Q

identify these changes

A
  1. Meibomian (tarsal) gland adenoma
  2. papilloma
  3. melanoma
  • Eyelid tumors cause eye irritation
  • Should be surgically excised.
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13
Q

Eyelid Histiocytomas are usually seen in …

A

in young dogs.

Spontaneous regression is typical over
weeks to month.

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14
Q
A

squamous cell carcinomas

  • Have Erosions, ulceration
  • Typical patient is a white outdor cat or light horses, cattle.
  • Wide surgical resection needed, cryotherapy, radiotherapy too.
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15
Q
A

Mast cell tumor

May have Erosions, ulceration.

Require Wide surgical resection, cryotherapy,
radiotherapy.

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16
Q

What secures the gland of the Third Eyelid or nictitans membrane in place?

A

fascial retinaculum secures the gland.

The 3rd eyelid includes a T shaped cartilage structure inside it.

Lymphoid follicles are normal under the bulbar surface,

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17
Q

Function of the Third eyelid. (3)

A
  • Distribution of the precorneal tear film
  • Protection of the cornea
  • The Gland produces tears (in dogs ca 35-50% of
    tears) and immunoglobulins for the tear film.
18
Q

Diseases of third eyelid. (6)

A
  • Protrusion of the gland of the third eyelid
  • Eversion or scrolling of third eyelid (rolls up)
  • Protrusion of the third eyelid
  • Inflammation
  • Wounds
  • Neoplasia
19
Q

Protrusion of the gland of the third eyelid,
cherry eye, is seen in…

A
  • Young dogs
  • Common in Cocker Spaniels and brachycephalics
  • Sometimes in cats (persian)
  • Many breeds that are predisposed to Cherry Eyes
    also have Keratoconjunctivitis sicca or „dry eye”.
20
Q

Tx of cherry eye.

A

Protrusion of the gland of the third eyelid,
cherry eye needs surgical replacement (pocket technique) of the prolapsed gland.

21
Q
A

Eversion or scrolling of third eyelid which is a 3rd eyelid pathology/disease.

Seen in large breeds (St. Bernards, Great Danes)
* In period of growth
* Uni- or bilateral
* Has been suggested to have a hereditary basis.

22
Q

Tx of Eversion or scrolling of third eyelid.

A

Surgery involves removing the scroll part of the cartilage, and then the conjunctival wound can be left open without suturing.

23
Q

This Inflammation - conjunctivitis is caused by

A

macroblepharon

24
Q

Explain plasmoma.

A

Plasmoma is another word for pannus which is an immune-mediated condition affecting the eyes.

Its a form of chronic superficial keratitis (CSK), where plasma cells infiltrate the conjunctiva, especially the nictitating membrane.

Pannus is an abnormal layer of fibrovascular tissue or granulation tissue. Common sites for pannus formation include over the cornea.

This leads to thickening, depigmentation, and inflammation, often causing discomfort and vision issues.

It is believed to have a genetic predisposition and is more common in German Shepherds.

Treatment typically involves immunosuppressive therapy, such as corticosteroids, cyclosporine, tacrolimus (topical) to control inflammation.

25
Follicullar inflammation as part of conjunctivitis caused by allergy or eyelid problem.
26
Whats this
Protrusion of the third eyelid in this case caused by inflammation in root of upper PM4/M1or intraorbital inflammation/osteomyelitis and neoplasia.
27
Conjunctiva is offically defined as a
Mobile mucous membrane covering the inner surface of the eyelids (palpebral conjunctiva), third eyelid and anterior part of globe (bulbar conjunctiva) up until the limbus. Consists of a non-keratinized columnar epithelium and goblet cells. Goblet cells produce mucus and Conjunctival mucus is a part of tears.
28
Normal conjunctiva: the blood vessels of bulbar conjunctiva are highly mobile with the conjunctiva.
29
1. Palpebral conjunctiva 2. Conjunctival sac 3,4. third eyelid conjunctiva 5. Bulbar conjunctiva
30
Conjunctivitis can include: (6)
* Edema * Hyperemia * Mucoid or mucopurulent discharge * Follicles (not always) (bottom left pic) * Itchy eye/pruritus * Chemosis (more in cats)
31
Chemosis is a Very strong swelling of the conjunctiva. * usually in cats * The conjunctiva protrudes from under the eyelid margin. * Can be caused by Acute inflammation, irritation, allergic reactions. * causes in dog and cats are different * Bacterial conjunctivitis is secondary. * Try to find and treat the primary cause!
32
Conjunctivitis in dogs is frequently caused by: (8)
* Entropion, ectropion, ectopic cilia, macroblepharon * Keratoconjunctivitis sicca /dry eye syndrome * Atopy/allergy * Trauma * Immune-mediated +/- sec bact inf
33
Keratoconjunctivitis sicca / KCS
34
Conjunctivitis in cats is frequently caused by: (8)
* Feline Herpesvirus Infection (FHV-1) * Chlamydophila Felis Infection * Feline Calicivirus Infection (FCV) +/-Mycoplasma spp * Trauma * Entropion * Allergy * Immune-mediated +/- sec bact infection
35
Virus that causes conjunctivitis in dogs.
danine distemper virus (CDV), currently known as Canine morbillivirus, belongs to the Paramyxoviridae family, genus Morbillivirus also causes resp. signs ## Footnote canine adenovirus type 1, infectious hepatitis, can cause blue eye
36
Conjunctivitis in cats, most common cause:
Feline Herpesvirus Infection + secondary bacterial infection can be unilateral!
37
Conjunctivitis in neonatal kittens is often:
Ophthalmia Neonatorum * Infection and inflammation of the conjunctiva usually before the eyelids are even open. * Prevents the normal opening of the eyelids and the normal development of the eye. * Can cause symblepharon. Most often caused by: Herpes and/or Calicivirus infection.
38
Symblepharon =
an adhesion between the bulbar or palpebral conjunctiva, cornea, and third eyelid.
39
How do you tell feline chlamydia infection from herpes virus infection? (Chlamydia pictured)
both cause conjunctivitis and respiratory symptoms in cats. herpes is more likely to have nasal involvement (sneezing, discharge) as it is epitheliotropic, vs chlamydia doesn't mess much with the nose. herpes tends to cause corneal ulcers whilst chlamydia does not. chlamydia imroves with AB but herpes is a virus so it does not. chlamydia does not become latent, herpes does.
40
The tx of conjunctivitis depends on? Describe the tx. (8)
the cause. * Correction of primary cause if possible (e.g. entropion, ectopic cilia). * Cleaning the eye with special comercial solution or NaCl 0,9%. * Topical broad- spectrum AB * Systemic antibiotics if conjunctivitis is associated with blepharitis, systemic bacterial infection (e.g. Chlamydophila felis in cats). * Prevent self-trauma with Elizabethan collar. * Systemic or topical antiviral therapy if possible (FHV) * Systemic or topical steroid therapy only if it is an accurate diagnosis of allergy or immune-mediated inflammation. * Specific topical treatment may be life-long (e.g. KCS, immune–mediated inflammation).
41
Kittens open their yes by what day?
no later than 14 days old

Ophthalmology (7 decks)

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