Lecture 7: Ocular Pathology Flashcards
Identify 1-2
- Eyelid
- Conjunctiva
what is the function of eyelid
1st line defense and forms protective barrier
what type of epithelium lines eyelid
stratified squamous epithelium
from eye- identify 1 and what is function
Meibomian glands- produce secretions that lubricate eyes
what is blepharitis
inflammation of eyelid
what is blepharedema
Edema of eyelid
what wrong
cherry eye/ prolapse of third eyelid
what breeds are predisposed to cherry eye and what causes it
bulldogs
Due to increased laxity of CT anchoring 3rd eyelid to periorbital tissue
what is likely dx for this benign tumor on dog eyelid
meibomian gland adenoma
what is likely dx for this tumor on cow eyelid. What other species commonly gets this
Squamous cell carcinoma
Cats
what is the conjunctiva
mucous membranes that line the front of eyes (bulbar) and insides of eyelids (palpebral) and terminate at the corneal limbus
identify 1-3
- bulbar conjunctiva
- Lacrimal gland
- Palpebral conjunctiva
What is conjunctivitis and what is it secondary to
inflammation of conjunctiva, secondary to infection or allergies
what are some common etiologies of conjunctivitis
herpesvirus, chlamydophila, mycoplasma
what is chemosis
edema of conjunctiva
What is the most common neoplasms of the conjunctiva
- Melanocytic tumors
- Hemangiomas/ hemagiosarcoma
tumor of conjunctiva- what is dx
Melanocytic tumor
what wrong
chemosis
what is the junction between cornea and sclera
limbus
identify 1-3
- Cornea
- Limbus
- Sclera
what features of the cornea allow for transparency
- No keratinized non pigmented epithelium
- Low cell density
- A vascular
what is the most common mechanism of injury to cornea
external injury (trauma, extension of eyelid/conjunctiva, chemical injury)
what is this called?
Cow has retrobulbar neoplasm caused by a retrovirus. What retrovirus, what neoplasm
exophthalmosis- protrusion of eye
Virus: BLV
Neoplasia: B cell lymphoma
what are the 4 ways the cornea responds to injury
- Ulceration
- Neovascularization
- Hyperpigmentation
- Inflammation- keratitis
what is the risk associated with neovascularization of cornea
corneal edema—> blue eye
what wrong
corneal edema
How does the cornea respond to injury that is shallow, mild and sterile
epithelial regeneration
how does the cornea respond to injury that is deep, infected, chronic
stromal fibrosis
horse eye- what is wrong
Keratomalacia- melting ulcer
what wrong and what layer is the damage down to in eye
Descemetocele leading to iris prolapse
Down to descemets membrane
What part of the eye has smooth muscle allowing for dilation/constriction—> controls diameter of pupil
iris
identify 1-2
- Iris leaflet
- Ciliary body
what structure makes aqueous (vitreous) humor
Ciliary body
describe the normal flow and drainage of aqueous humor
- Starts at ciliary body
- Moves to anterior chamber
- Drains out iridocorneal/filtration angle
identify 1-3
- Ciliary body
- Iridocorneal/ filtration angle
- Anterior chamber
increased intraocular pressure results in ___
glacuoma
what structure is between sclera and retina
choroid
what is the function of the choroid
provide nutrients to retina (capillaries)
identify 1-2
- Retina
- Choroid
identify 1-3
- Retina
- Choroid
- Sclera
what structure contains tapetum lucidum
choroid
what is the most common source of injury to uvea
hematogeous
what is uveitis
inflammation of uvea
what are some common causes of uveitis
- Infectious: bacterial, fungal, nematode migration, viral
- Immune mediated
- Trauma
- Reflex uveitis- secondary to corneal injury
what are some consequences of uveitis that effect the cornea
- Neovascularization
- Endothelia is
- Edema-blue eye
identify the changes to the cornea due to uveitis
left: neovascularization
Middle: endothelitis
Right: edema- blue eye
what are some possible causes of edema/blue eye
- FIP
- Canine adenovirus 1
- Malignant catarrhal fever
what are the consequences of uveitis on the iris
- Fibrovascular membrane forms
- Leading to synechiae
- Leading to iris bombe
what is synechiae
Fibrinous—> fibrous adhesion between iris and lens (posterior synechiae) or iris and cornea (anterior synechiae)
synechiae can lead to iris bombe- what is that
anterior bowing of the iris due to increase pressure in [posterior chamber because of bilateral posterior synechiae
fibrovascular membrane, synechiae, and iris bombe all lead to __ and why
glaucoma because block aqueous flow out of filtration angle—> increase IOP—> secondary glaucoma
what can occur secondary to glaucoma/ decreased nutrition/ inflammatory mediators
cataracts
what causes retinal detachment
- Uveitis
- Increased vascular permeability within choroid
- Effusion of fluid and cells into subretinal space
- Retinal detachment
what is the result of chronic retinal detachment
fibrinous exudate—> fibrovascular tissue
what wrong
Hyphema- hemorrhage in anterior chamber
what wrong
Phthisis bulbi- nonfunctional shrunken disorganized globe
what are two developmental diseases of the uvea
- Failure of formation: aplasia or hypoplasia or iris, choroid
- Goniodysgenesis: altered formation of filtration angle__> glaucoma
which normal vs abnormal and what wrong
Left: normal
Right: goniodysgenesis: closed filtration angle
Systemic fungal, algal and parasitic diseases of the uvea cause what type of inflammation
pyogranulomatous endophthalmitis
what are some examples of systemic fungal, algal and parasitic diseases of the uvea
blastomycosis, cryptococcus, coccidiodomycosis, histoplasmosis, protothecam leishmania
What stain is this
Grocott’s methanamine silver stain
what is the pathogenesis of phacolytic uveitis
cataract—> lysis and leakage of lens proteins—> mild anterior uveitis
what is the pathogenesis of phacoclastic uveitis
cataract—> lens rupture with release of large amounts of lens protein—> foreign body type rxn—> severe lens-centric granulomatous endophthalmitis
what is lens septic implantation syndrome and what is a common cause
traumatic rupture of the lens and bacteria
Cause: cat scratch
histo of lens, what is wrong, identify issues 1-3.
Phacoclastic uveitis
1. Inflammation
2. Lens proteins
3. Ruptured lens
what is the most common primary uveal neoplasia in dogs
canine anterior uveal melanocytoma
t or F: canine anterior uveal melanoctyoma is benign
true
what is the clinical presentation of feline diffuse iris melanoma
unilateral coalescing hyperpigmentation of iris that slowly progresses to iris thickening and secondary glaucoma
t or f: feline diffuse iris melanoma is benign
false- malignant
Eye of dog- what wrong
Canine anterior uveal melanocytoma
eye of cat what wrong
iris melanoma
what is an iridocilary (epithelial) primary uveal tumor
well differentiated papillary adenoma to solid carcinomas that rise from neurectoderm of posterior iris or ciliary body
dog eye what wrong
Iridociliary (epithelial) tumor
what are the 3 chambers of the eye
anterior, posterior, vitreous
what part of the eye is this histo from. Which side is anterior vs posterior
lens
Left: anterior
Right: posterior
the lens is dependent on ___for nutrition and removal of waste. Anything that disrupts that will result in ___
aqueous humor, cataract
what are some common mechanisms of injury to lens
- Trauma
- Primary or secondary glaucoma
- Nutritional: decrease aqueous humor (secondary to glaucoma)
- Metabolic- DM
how does the lens respond to injury
forms cataract
what is a cataract
lens is opaque resulting in obstructed view
what is a differential for cataract and how is it different
lenticular sclerosis- hardening of lens that does not disrupt vision
what wrong
Anterior and posterior luxation of lens
what are 2 sequela of lens luxation
cataracts, glaucoma
What is primary lens luxation
occurs without any known trauma, often result of insufficient zonular formation (zonular ligament dysplasia)
what breed is primary lens luxation most common in
terrier breeds
what is secondary lens luxation
blunt trauma that causes allusion of the zonules or excess stretching of the zonules
__% of diabetes develop rapid progressing bilateral cataracts
70%
What is the pathogenesis of developing cataracts in a diabetic patient
high levels of glucose within aqueous diffuse into lens—> activating sorbitol pathway—> sorbitol accumulates in the lens causing osmotic swelling
what portion of the eye is classified as neurosensory tissue held to the retinal pigmented epithelium by physical forces including presence of aqueous humor
retina
what supplies retina with blood
retinal and chorodial vessels
what are the most common mechanisms of injury to the retina
- Glaucoma causing destruction and atrophy of inner retina
- Inflammation, infection, vascular disease, trauma—> retinal detachment
- Endophthalmitis extending to cause retinitis
- Photoreceptor degeneration (inherited> toxic)
Systemic hypertension is an important cause of ___in dogs and cats
hypertensive Retinopathy
what are the clinical signs of hypertensive retinopathy
intraocular hemorrhage, retinal hemorrhage and edema, retinal separation, retinal degeneration
from cat eye who was hyperthyroid- what changes are seen
Ateriolar walls thickened by amorphous lamellar eosinophilic material.
Intraocular hemorrhage (right)
Hyperthyroidism (increase BP)—> hypertensive retinopathy
What are some causes of glaucoma
- Removal of aqueous humor
- Sustained increase amount of intraocular aqueous humor
- Stretching of ocular globe
- Damage to ocular structures, especially retina and optic disc
- Loss of vision/blindness
what is buphthalmos
atrophy/stretching of most structures in eye
what is primary glaucoma
occurring without any known acquired intraocular disease, resulting from developmental errors
what are some causes of primary glaucoma
- Goniodysgenesis: abnormal and incomplete development of the iridocorneal angle (dogs)
- Open angle glaucoma- dysfunction of an anatomically correct iridocorneal angle (cats, dogs, horses)
which is more common secondary or primary glaucoma
secondary
What is secondary glaucoma
acquired obstruction of aqueous humor outflow/ iridocorneal angle
what are some causes of secondary glaucoma
neoplasia, hemorrhage, fibrin, inflammation, pre-iridium fibrovascular membrane, pupillary block (synechiae, lens luxation)
What wrong
anophthalmia- no detectable globe development
what wrong
microphthalmia- small, disorganized globe in normal sized orbit
what causes microphthalmia
exogenous injury (in utero, trauma, ischemia, infection) rather than primary maldevelopment
what is pathogenesis of cyclopia
ewes grazing pastures with veratrum californicum on day 14 gestation give birth to lambs with this malformation
what wrong and pathogenesis
Coloboma (aka collie eye anomaly)
Defect in closure of optic fissure—> prevents local formation of choroid and sclera—> outpouching of the caudal eye— retina may grow outward through defect
What wrong and pathogenesis
Equine keratomycosis
Corneal wounds> opportunistic infection by fungi (aspergillus)
What predisposes horses to equine keratomycosis
use of topical antibiotics and corticosteroids
what wrong and pathogenesis
Equine recurrent uveitis (aka moon blindness)
Recurrent bouts of uveitis—> fibrovascular membrane, synechiae, cataract—> pthisis bulbi
what is the most common cause of equine glaucoma and blindness
equine recurrent uveitis
what is the cause of equine recurrent uveitis
immune mediated dz possibly instigated by leptospiria
cow eye- what wrong and what cause
Infectious bovine keratoconjunctivitis caused by moraxella Bovis
cow eye- what wrong and what cause
Bovine malignant catarrhal fever (OVH2) associated uveitis
Vasculitis—> corneal edema
dog eye- what wrong and what cause
chronic superficial keratitis
Immune mediated and genetic predisposition (GSD)
what wrong and what cause/ pathogenesis
uveodermatological syndrome
Immune mediated granulomatous inflammation targeting protein of melanin synthesis
Facial dermal depigmentation/ulcerations and severe bilateral uveitis—> retinal separation and glaucoma
what breeds are predisposed to uveodermatological syndrome
akitas, huskies, samoyeds, aussies
cat eye- what wrong and what cause
Dendritic ulcers —> feline herpetic keratitis caused by FHV-1
in cats, what does enrofloxacin and fluoroquinolones cause
photoreceptor degeneration
cat eye- what wrong and what is it characterized by. What cause
eosinophilic keratitis
Cause: idiopathic
Characterized by granular, white to pink proliferative plaque
cat eye what wrong and what cause
feline primary ocular sarcoma
Cause: trauma