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Ross Vet Pathology 2 > Ocular > Flashcards

Ocular Flashcards

1
Q

What is the circulatory disorder present in this puppy?

A

Corneal edema

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2
Q

What are the three general causes of corneal opacity?

A

Injury to epithelium

Injury to endothelium

Keratitis (Conreal inflammation)

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3
Q

What is the consequence of injury to corneal epithelium?

A

Corneal ulceration

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4
Q

What the the possible causes of injury to corneal endothelium?

A

Corneal enothelial dystrophy

Increased IOP (Glaucoma)

Immune-mediated

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5
Q

What is the primary cause of keratitis?

A

Neovascularization with leaky vessels

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6
Q

What is the diagnosis?

How did you come to that conclusion?

A

Corneal ulceration

Uptake of the fluorescent stain

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7
Q

What is the diagnosis?

A

Kertitis - note the neovascularization from the limbus visible grossly over the iris

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8
Q

When you see corneal opacity that is due to endothelial injury, would you expect to see this unilaterally or bilaterally?

A

Bilateral in most cases

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9
Q

What is the primary differential in a young puppy with bilateral diffuse corneal edema?

What is the common name for this finding?

A

Previous acute infection with infectious canine hepatitis (Canine Adenovirus 1)

Blue eye

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10
Q

What is hyphema?

What is the source?

What are your two primary rule outs for why it is present?

A

Blood in the anterior chamber of the eye

Typically the uvea or the retina

Primary vascular lesion vs. disorder of hemostasis

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11
Q

What is a serious potential consequence of hyphema?

A

Can block ocular drainage causing increased IOP

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12
Q

What is seen in the photo below?

A

Retinal hypertensive vasculopathy

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13
Q

A 6 year old dog comes into your clinic and this is what you see. They are painful, epiphora is present.

What is morphologically wrong?

What is your primary differential diagnosis?

A

Cataracts

Glaucoma (increased IOP)

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14
Q

What is the cause of PRIMARY glaucoma?

What species is this common in?

A

Goniodysgenesis - a detectable malformation of the trabecular meshwork

Dogs

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15
Q

What the hell does this pink smash show us?

A

Goniodysgenesis

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16
Q

Which is more common, primary or secondary glaucoma?

A

Secondary

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17
Q

What is the cause of secondary glaucoma?

Give some examples.

A

Anything that obstructs the pupil or trabecular meshwork

Exudate (Endophthalmitis)

Lens luxation

Posterior synechia

Peripheral anterious synechia

Compression of the filtration angle

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18
Q

What are some consequences of glaucoma?

A

Buphthalmos (Bulging eyes)

Retinal degenration & atrophy

Optic disc cupping

Optic nerve atrophy (loss of ganglion cells)

Cataract

Lens luxation

Iris atrophy

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19
Q

What is the most common disease of the lens?

What is its pathologic process?

A

Cataract

Swelling/Degeneration of lenticular fibers

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20
Q

What is the MDx?

What is the cause?

A

Lenticular (nuclear) sclerosis

Senile change

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21
Q

What are the possible causes of retinal degeneration & atrophy?

A

Senile change

Inherited metabolic defect of photoreceptor cells (Progressive retinal atrophy / SARD)

Toxicity

Metabolic deficiencies - taurine, vit. A

Increased IOP

Retinal detachment

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22
Q

What are the causes of retinal detachment?

Which is the most common?

A

Choroiditis, retinitis

Hemorrhage

Neoplasm

Trauma

Most common - inflammation (choroiditis, retinitis)

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23
Q

When the retina detaches, which two layers are separated?

A

The neural and pigmented layers

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24
Q

What is the primary consequence of retinal detachment?

A

Retinal degeneration and atrophy

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25
Q

What are the gross features of conjuctivitis?

A

Hyperemia

Swelling/edema

Discharge

Chemosis

Pigmentation

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26
Q

What is chemosis?

A

Severe conjunctival edema

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27
Q

True or false - Hyperemia alone is enough to indicate conjunctivitis.

A

False

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28
Q

MDx?

A

Suppurative conjunctivitis

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29
Q

What are the three primary pathogenic causes of conjunctivitis in cats?

A

Herpesvirus (FHV-1)

Chlamydophilia felis

Mycoplasma felis - normal resident or secondary pathogen

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30
Q

How does the cornea respond to injury? (5 ways)

A

Edema

Epithelial regeneration

Neutrophil mediated stromal lysis

Neovascularization

Stromal fibrosis

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31
Q

If eroded, epithelial regeneration is very rapid. However, if ulcerated what must preceed epithelial regeneration?

A

Stromal repair

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32
Q

In the presence of chronic/persistent injury, what may occur in the cornea?

A

Cutaneous metaplasia

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33
Q

MDx?

A

Cutaneous metaplasia due to chronic corneal injury

34
Q

What are some possible etiologies of keratitis?

Give some examples of each.

A

Trauma

Bacterial (Pseudomonas aeruginosa/Moraxella bovis)

Chlamydia/Mycoplasma

Viruses (IBR, MCF, FHV-1)

Fungi (Aspergillosis, mucormycosis)

Drying and dessication (Keratoconjunctivitis sicca)

Idiopathic

35
Q

What does keratomalacia mean?

What is it?

What is the cause?

A

Melting ulcer

Necrosis of corneal epithelium and stroma

Usually rapdily progressing bacterial or fungal infection

36
Q

MDx?

What is that exactly?

Next step?

A

Descemetocele

Melting ulcer has melted down to the edothelium and is at risk for rupture of the globe

Emergency referral to specialist.

37
Q

What is phthisis bulbi?

A

End stage eye - shrunken/atrophic, scarred/fibrotic eye.

38
Q

What is corneal sequestrum and what is it frequently confused with?

A

Happens in cats mostly. Localized area of necrosis of the epithelium and anterior stroma from severe corneal injury.

Confused with Corneal pigmentation.

39
Q

What is the pathogenesis of KCS?

A

Immune-mediated (most commonly) or other injury to lacrimal glands –> decreased tears and/or change in composition of tears –> drying out of cornea/conjunctiva –> chronic irritation

40
Q

MDx?

A

Hypopion/Anterior uveitis

41
Q

What is anterior uveitis vs. posterior uveitis?

A

Anterior - iridis (iris) and cyclitis (ciliary body)

Posterior - choroiditis (choroid)

42
Q

What is endophthalmitis?

A

Inflammation of uvea, retina, and vitreous

43
Q

What is Panophthalmitis?

A

Endophthalmitis PLUS corneal and scleral inflammation

44
Q

What are the 3 general causes of uveitis?

Give some examples

A

Hypersensitivity - Feline idiopathic lymphoplasmacytic uveitis; Equine recurrent uveitis

Infectious - FIP; systemic mycoses; perforation corneal ulcers; penetrating injuries (secondary infections)

Lens induced - releasing proteins causing inflammation

45
Q

MDx?

A

Keratic precipitates and rubeosis iridis

46
Q

MDx?

A

Corneal ulcer, corneal edema, and hypopyon

47
Q

MDx

A

Posterior synechia

(And a cataract)

48
Q

What is the consequence of a Pre-iridal fibrovascular membrane?

A

PIFM –> Closed drainage –> Glaucoma

49
Q

What are some consequences of uveitis? (there is a lot)

A

Synechia (fibrous adhesions)

PIFM (Pre-iridal fibrovascular membrane)

Cataracts - inadequate aqueous flow or posterior synechia

Lens luxation

Glaucoma

Retinal detachment

Phthisis bulbi

50
Q

WTF is going on here?

A

Cataract with dyscoria

Dyscoria indicated by scalloped edge which is the iris is stick to the lens

51
Q

What are other names for Equine recurrent uveitis?

A

Periodic ophthalmia

MOON BLINDNESS

Iridocyclitis

52
Q

What is the most common cause of blindness in equids?

What is it caused by?

A

Moon Blindness or equine recurrent uveitis

Caused by hypersensitivity to previous systemic infection, particularly Leptospira interrogans

53
Q

What is lens-induced uveitis?

What are the two types?

Which is worse?

A

Inflammatory response to lens protein

Phacolytic - leakage of lens proteins from hypermature cataract

Phacoclastic - rupture of the lens

Phacoclastic is more severe

54
Q

What do you see here?

What is it indicative of?

A

Rubeosis

Anterior uveitis

55
Q

What are some major causes of retinitis?

A

Neurotropic viral infections (rabies, distemper)

Visceral larval migrans (Toxocara canis, Baylisascaris)

56
Q

What is a major cause of synophthalmos or cyclopia in lambs?

A

Veratrum californicum ingestion on day 14 of gestation

57
Q

What are three major causes of developmental anomalies?

A

Genetic defect

In utero infection - BVD, Bluetongue, border disease, akabane, panleukopenia, classical swine fever

In utero exposure to teratogens

58
Q

The fuck?

A

Lamb with inherited microphthamlia

59
Q

Dude, seriously, what the actual fuck is this?

How bad is it?

A

Corneal dermoid

Iz bad, requires surgical intervention

60
Q

What’s wrong with this?

A

Posterior lens luxation

61
Q

What’s this?

A

Anterior lens luxation

62
Q

How can lens luxation occur?

A

Trauma, inflammation (severe uveitis), glaucoma

63
Q

What is the pupillary membrane?

A

Vascular tunic which supplies the lens during early development, usually regresses with age

64
Q

What is this?

(No, not Eye of the Jew)

A

Persistent pupillary membrane

65
Q

What is this developmental anomaly?

A

Iris hypoplasia

66
Q

What is this weird shit?

A

Iris coloboma

67
Q

What is shown in the image below?

How can this happen?

A

Retinal dysplasia

A wide array of retinal injury to the embryonic eye (BVD, bluetongue, canine parvo), or as an inherited condition

68
Q

What cell type is proliferating?

Diagnosis?

A

Melanocytes

Iris melanoma

69
Q

What is the most common intra-ocular neoplasm?

Who does it happen most commonly in?

Benign or malignant?

How can you tell this is it?

A

Diffuse Iris melanoma

Most commonly in cats (esp. with yellow eyes)

Most are malignant (benign in dogs)

Raised lesions with a velvet looking surface on the iris, +/- distortion of the iris/pupil

70
Q

What are the most important prognostic indicators for melanocytic neoplasms?

A

Species and location

71
Q

In regards to canine melanomas of/around the eye, which are benign and which are malignant?

A

Haired skin of eyelid - Benign

Conjunctiva - malignant

72
Q

Ciliary (iridociliary) adenoma/carcinoma:

Who is it in?

Benign/Malignant?

Secondary concerns?

A

In dogs more than cats

Most are benign -behave benign even if histologically malignant

Secondary glaucoma, hyphema, retinal detachment

73
Q

Intraocular sarcoma-

Who gets it?

Benign/Malignant?

Pathogenesis?

A

Unique to cats (rare)

Malignant.

Arises after ocular trauma, probably derived from lenticular epithelium –> wide invasion throughout eye, including down optic nerve

Can have distance metastasis following enucleation

74
Q

What is the most common metastasis involving the eye, especially in cats?

What’s it look like?

A

Uveal lymphoma

Thickening/pallor of uvea; difficult to differentiate from uveitis

75
Q

What’s up with that right eye?

This is a chicken, what’s your diagnosis?

A

Ocular lymphoma

Marek’s disease (gray eye)

76
Q

What’s dis?

A

Meibomian (sebaceous) adenoma

77
Q

Diagnosis?

A

Corneal squamous cell carcinoma

78
Q

Dx?

Breed specific?

Associated with?

What’s another possible Ddx?

A

Corneal lipidosis

No, but breed predilections

Associated with hyperlipidemia

Ddx - early corneal (endothelial) dystrophy

79
Q

What are Florida Spots?

Who gets them?

A

Tropical Keratopathy

Cats

80
Q

How does corneal pigmentation occur?

A

Derived from entrapped uvea

Repsponse to injury

81
Q
A

Ross Vet Pathology 2 (3 decks)

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