Lecture 11 2/21/25 Flashcards
What are the differential etiologies for uveitis?
-infection
-lens-induced
-secondary to corneal ulceration
-neoplasia
-trauma
-uveodermatologic syndrome
-cardiovascular
-idiopathic
Which infections can cause anterior uveitis?
-blasto
-histo
-other fungi
-prototheca
-pyometra
-brucella
-septicemia
-tooth root abscess
-heartworm
-rickettsia
-RMSF
-toxoplasmosis
-ICH
What are the diagnostics and treatment for infections causing anterior uveitis?
diagnostics:
-appropriate tests for locale
-clinical and physical findings
treatment:
-general therapy for uveitis
-specific treatment for underlying disease
-NO systemic steroids for systemic infectious dz
What is lens-induced uveitis?
-local immune-mediated cause of anterior uveitis that occurs when cataracts develop to hypermaturity phase
-lens proteins liquefy and leak from lens capsule
What are the diagnostics and treatment for lens-induced uveitis?
diagnostics:
-presence of cataracts + anterior uveitis signs
treatment:
-general uveitis therapy
-cataract surgery once uveitis is under control
-removal of lens if cataract results from trauma with puncture to capsule
What is secondary uveitis?
spread of inflammation from sclera or cornea, often secondary to ulcerative keratitis
Which neoplasms can cause anterior uveitis?
-lymphosarcoma
-melanoma
-ciliary body adenoma
-multiple myeloma
How is anterior uveitis-causing neoplasia diagnosed and treated?
diagnostics:
-complete physical exam
-chest rads
-ocular exam
treatment:
-enucleation of eye for localized neoplasm
-appropriate cancer treatment if systemic dz
How does blunt trauma cause anterior uveitis?
causes inflammation inside the eye via complex acoustic interface mechanism
How does penetrating trauma cause anterior uveitis?
results in direct damage to anterior uveal structures
How is trauma-induced anterior uveitis diagnosed and treated?
diagnostics:
-history
-physical exam
-fluorescein stain
treatment:
-general AU therapy if no corneal ulcer
-topical antibiotic therapy for ulcers
-low dose systemic pred. or topical nonsteroidal for severe uveitis
What is uveodermatologic syndrome?
autoimmune disease against melanocytes seen in the uvea and the skin
How is uveodermatologic syndrome diagnosed and treated?
diagnostics:
-depigmentation of skin and nose in addition to uveitis and chorioretinitis
-may see depigmentation spots on retina
treatment:
-immunosuppressive steroid doses; systemic
-general uveitis therapy
What is the prognosis for uveodermatologic syndrome?
-poor prognosis for vision due to development of secondary glaucoma and/or retinal detachment
-blindness often occurs despite aggressive treatment
How is systemic hypertension diagnosed and treated?
diagnostics:
-BP measurement with blood work and urinalysis
treatment:
enalapril or amlodipine
What are the characteristics of idiopathic uveitis?
-common in cats
-not common in dogs; cause typically found if work-up persued
What is pigmentary and cystic glaucoma of golden retrievers?
ocular syndrome that occurs in goldens and appears to be inflammatory but is not
What are the clinical signs and pathophysiology of pigmentary and cystic glaucoma of golden retrievers?
-radial pigment seen on anterior lens capsule
-thin walled cysts extend from ciliary body
-secondary glaucoma eventually develops
-can see mild flare in some cases
How is pigmentary and cystic glaucoma of golden retrievers diagnosed and treated?
diagnostics:
-clinical signs
-signalment
treatment:
-glaucoma treatment once developed
-topical NSAIDs and steroids; discontinue if no response
What is hyphema?
blood in the anterior chamber
What are the complications of hyphema?
-synechia
-cataracts
-secondary glaucoma
-retinal detachment
-phthisis bulbi/eye shrinks down and is not visual
What are the etiologies for hyphema?
-trauma
-intraocular neoplasia
-blood dyscrasias (abnormal/altered states)
-clotting abnormalities
-circulatory disorders
-infectious dz
-retinal detachment
-any disease that causes uveitis
What are the diagnostics for hyphema?
-history and physical exam
-CBC/chem
-chest rads
-blood pressure
-coag. panel
-titers
-ocular ultrasound
What can be seen on ocular ultrasound?
-masses
-retinal detachments
-lens luxations
What are the treatment steps for hyphema?
-find and treat underlying cause
-topical prednisolone
-possible tropicamide
-monitor for secondary glaucoma; treat if it develops
What is the prognosis for hyphema?
-localized hemorrhage to anterior chamber has good prognosis
-hemorrhage present in the vitreous chamber and/or secondary retinal detachment have poor prognosis
What is iris atrophy?
irregular pupillary margin with a moth-eaten appearance to the iris due to senile change; may cause decreased PLRs
What is the treatment for iris atrophy?
none indicated
What are the differential etiologies for iris masses?
-iris cysts
-iris nevi
-uveal melanoma
What are iris cysts?
spherical, hollow cysts that may be free-floating or attached to the pupillary margin; originate from iris or ciliary body epithelium
What is the treatment for iris cysts?
-none necessary
-can be aspirated if they interfere with vision
What is iris nevis?
darkly pigmented focal lesion on iris face
What is the treatment for iris nevis?
-none necessary
-monitor; can be pre-neoplastic
What are uveal tumors?
-tumors arising from iris or ciliary body
-commonly melanoma, ciliary body adenoma, or ciliary body adenocarcinoma
-rarely metastasize
What is the appearance of uveal tumors?
-cannot be transilluminated
-not free-floating
-not spherical
What is the treatment for uveal tumors?
-typically enucleation
-may respond to laser therapy
-can watch melanomas and act if they begin to grow rapidly/cause issues
