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Medicine I > Feline Opthamology > Flashcards

Feline Opthamology Flashcards

1
Q

What is eyelid agenesis?

A
  • Absence of a portion of the eyelid
    • Sequalae - secondary trichiasis and exposure keratoconjunctivitis
    • Most common in cats and horses
      • cats - upper temporal eyelid
        • commonly associated w/ other ocular abnormalities, PPM, retinal dysplasia, cataracts)
      • Horses - upper nasal eyelid
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2
Q

What is the treatment for eyelid agenesis?

A

surgical relocation of other skin

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3
Q

What is Corneal Sequestrum?

A
  • Area of corneal degeneration w/ amber to brown discoloration
  • Usually in the central/paracentral cornea
  • Variable vascularization
  • Variable ocular pain
  • Unique to cats
    • more common in Persians, Himalayans
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4
Q

What is the treatment for Corneal Sequestrum?

A
  • Surgical removal:
    • keratectomy +/- conjunctival graft
    • cornealconjunctival transposition
    • cyanoacrylate glue
    • lamellar or penetrating corneal transplant
  • Recurrence is always possible!
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5
Q

What is Eosinophilic Conjunctivitis/Keratoconjunctivitis?

A
  • Proliferative, white to pink, irregular, vascularized lesion
  • Commonly originates from the nasal or temporal limbus
  • Conjunctiva may be affected
  • More often unilateral
  • Variable ocular discomfort
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6
Q

How is Eosinophilic conjunctivitis/keratoconjunctivitis diagnosed?

A
  • Eosinophils on cytology
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7
Q

What is the treatment for Eosinophilic Conjunctivitis/Keratoconjunctivitis?

A
  • Topical
    • Prednisolone acetate 0.1% TID to QID
    • Dexamethasone 0.1% TID to QID
    • Optimmune 0.2% cyclosporine BID
    • Cyclosporine 1 or 2% BID
    • Tacrolimus 0.02 or 0.03% BID
    • Topical megestrol acetate TID
  • Systemic
    • Prednisolone
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8
Q

What is the Prognosis for Eosinophilic Keratitis?

A
  • Usually favorable
  • Treatment may be long term
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9
Q

What do corneal ulcers from Feline Herpesvirus 1 look like?

A
  • Geographic
  • Dendritic
  • Stromal keratitis
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10
Q

How is FHV-1 diagnosed?

A
  • Clinical Signs
  • Conjunctival cytology
    • intranuclear inclusions, neutrophils
  • PCR - sensitive and specific
  • IFA - insensitive
    • fluorescein stain may cause false positive
  • Serology (serum neutralization titer - insensitive
  • Virus isolation
    • Definitive dx for acute infection
    • Insensitive for chronic infection
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11
Q

What is the treatment for Feline Herpesvirus?

A
  • Topical Treatment - Prevent bacterial infection
    • Cidofovir 0.5% solution
      • compounding pharmacy
      • 2 times daily
    • Idoxuridine 0.1% solution
      • Compounding pharmacy
      • 4-6x daily
    • Trifluridine 1% solution
      • Viroptic and generic
      • Refrigerated
      • Topically irritating
  • Systemic Treatment
    • Famciclovir
      • 250 mg or 125 mg tablets
      • 30-40 mg/kg BID to TID PO
    • Lysine
      • 250 mg PO BID kittens
      • 500 mg PO BID cats
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12
Q

Why should valacyclovir be avoided in cats?

A

potential for fatal hepatic and renal necrosis

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13
Q

what are possible eye complications of FHV-1?

A
  • Globe rupture
  • Symblepharon
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14
Q

Is Glaucoma common in cats?

A
  • Primary glaucoma is very, very rare
  • Secondary glaucoma
    • Uveitis
    • Intraocular neoplasia
    • Feline aqueous misdirection syndrome
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15
Q

What is the treatment for glaucoma in cats?

A
  • Topical carbonic anhydrase inhibitors (Dorzolamide 2%)
  • Beta blockers (0.25%)
  • Latanoprost ineffective in cats
  • Do not use oral carbonic anhydrase inhibitors
    • more sensitive to adverse effects
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16
Q

What is Feline Aqueous Humor Misdirection Syndrome

A
  • Generally in older cats
  • Aqueous Humor shunted into the vitreous
    • shifts lens and iris anteriorly
  • Results in Anisocoria and Shallow anterior chamber
  • IOP often not elevated initially
17
Q

What is the treatment for Feline Aqueous Humor Misdirection Syndrome?

A
  • Topical Carbonic anhydrase inhibitors BID to TID
  • Monitor IOP q1-3 months (both eyes)
  • Refer for surgery if unresponsive to medications
18
Q

Do cataracts occur in cats?

A
  • Primary inherited cataracts are rare
  • Most are secondary:
    • Anterior uveitis
    • Trauma
    • Lens luxation
19
Q

What is Hypertensive Retinopathy?

A
  • Generally in older cats (>10yrs)
  • Present with dilated pupils or vision loss
  • Causes:
    • hyphema
    • Vitreal hemorrhage
    • Retinal hemorrhages
    • Retinal detachment
    • Retinal vessel tortuosity
20
Q

What is the etiology of Hypertensive Retinopathy

A
  • Idiopathic - 20%
  • Chronic Kidney Disease 19 - 65%
  • Hyperthyroidism 10 - 20%
  • Others:
    • Diabetes mellitus
    • Primary aldosteronism
    • Pheochromocytoma
    • Chronic anemia
21
Q

how is hypertensive retinopathy diagnosed?

A
  • Systolic blood pressure
    • >160 mmHg
  • CBC/Chemistry Panel/UA/T4
22
Q

What is the treatment for Hypertensive Retinopathy

A
  • Treat underlying condition
  • Antihypertensive medication
    • Amlodipine
      • 0.18 - 0.22 mg/kg PO SID
      • 0.625 mg PO SID
  • Goal BP < 150 mmHg
23
Q

Why should Enrofloxacin be avoided in cats?

A
  • Can cause acute retinal degeneration
    • may occur even at recommended dose (2.5mg/kg BID)
      • especially in cats with impaired drug metabolism (renal/hepatic disease)
      • IV administration may increase risk of retinal toxicity
  • Most cases of blindness is permanent
  • Only use if there is no alternative
    • use at lowest dose for the shortest amount of time
24
Q

Are other fluoroquinolones safe to use in cats?

A
  • Consider that all fluoroquinolones may have the potential to induce ocular lesions in cats
    • all should be used with caution
25
Q

Why should Polymyxin B be avoided in cats?

A
  • linked to anaphylaxis and death
    • usually topical ophthalmic products
26
Q

What is a Diffuse Iris Melanoma

A
  • Most common feline primary intraocular tumor
  • Malignant melanocytic neoplasm
  • Slow, progressive, often multifocal areas of pigmentation of the iris
  • Secondary glaucoma from involvement of the iridocorneal angle
27
Q

How can Diffuse Iris Melanoma (DIM) be distinguished from Iris Nevus?

A
  • Iris Nevus (think of it like a freckle of the Iris - benign)
  • Histopathology
    • DIM:
      • Progressive growth
      • Raised, velvety surface
      • Exfoliating cells in the anterior chamber
      • Involvement of the iridocorneal angle
      • Secondary glaucoma
28
Q

What is the prognosis of DIM?

A
  • Metastasis to the Liver and Lungs
    • late in the disease
  • Prognosis - related to location in the iris
    • Confinement to the iris - better prognosis
    • Involvement of the iridocorneal angle - poor prognosis
29
Q

What are the treatment options for DIM?

A
  • Monitor for progression
    • Photos of drawings in the medical record
    • Recheck at 2-4 month intervals
  • Possible Laser ablation
  • Enucleation:
    • only if metastasis is not present

Medicine I (43 decks)

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