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
What are the gross features of conjuctivitis?
Hyperemia Swelling/edema Discharge Chemosis Pigmentation
26
What is chemosis?
Severe conjunctival edema
27
True or false - Hyperemia alone is enough to indicate conjunctivitis.
False
28
MDx?
Suppurative conjunctivitis
29
What are the three primary pathogenic causes of conjunctivitis in cats?
Herpesvirus (FHV-1) Chlamydophilia felis Mycoplasma felis - normal resident or secondary pathogen
30
How does the cornea respond to injury? (5 ways)
Edema Epithelial regeneration Neutrophil mediated stromal lysis Neovascularization Stromal fibrosis
31
If eroded, epithelial regeneration is very rapid. However, if ulcerated what must preceed epithelial regeneration?
Stromal repair
32
In the presence of chronic/persistent injury, what may occur in the cornea?
Cutaneous metaplasia
33
MDx?
Cutaneous metaplasia due to chronic corneal injury
34
What are some possible etiologies of keratitis? Give some examples of each.
Trauma Bacterial (Pseudomonas aeruginosa/Moraxella bovis) Chlamydia/Mycoplasma Viruses (IBR, MCF, FHV-1) Fungi (Aspergillosis, mucormycosis) Drying and dessication (Keratoconjunctivitis sicca) Idiopathic
35
What does keratomalacia mean? What is it? What is the cause?
Melting ulcer Necrosis of corneal epithelium and stroma Usually rapdily progressing bacterial or fungal infection
36
MDx? What is that exactly? Next step?
Descemetocele Melting ulcer has melted down to the edothelium and is at risk for rupture of the globe Emergency referral to specialist.
37
What is phthisis bulbi?
End stage eye - shrunken/atrophic, scarred/fibrotic eye.
38
What is corneal sequestrum and what is it frequently confused with?
Happens in cats mostly. Localized area of necrosis of the epithelium and anterior stroma from severe corneal injury. Confused with Corneal pigmentation.
39
What is the pathogenesis of KCS?
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
MDx?
Hypopion/Anterior uveitis
41
What is anterior uveitis vs. posterior uveitis?
Anterior - iridis (iris) and cyclitis (ciliary body) Posterior - choroiditis (choroid)
42
What is endophthalmitis?
Inflammation of uvea, retina, and vitreous
43
What is Panophthalmitis?
Endophthalmitis PLUS corneal and scleral inflammation
44
What are the 3 general causes of uveitis? Give some examples
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
MDx?
Keratic precipitates and rubeosis iridis
46
MDx?
Corneal ulcer, corneal edema, and hypopyon
47
MDx
Posterior synechia | (And a cataract)
48
What is the consequence of a Pre-iridal fibrovascular membrane?
PIFM --\> Closed drainage --\> Glaucoma
49
What are some consequences of uveitis? (there is a lot)
Synechia (fibrous adhesions) PIFM (Pre-iridal fibrovascular membrane) Cataracts - inadequate aqueous flow or posterior synechia Lens luxation Glaucoma Retinal detachment Phthisis bulbi
50
WTF is going on here?
Cataract with dyscoria Dyscoria indicated by scalloped edge which is the iris is stick to the lens
51
What are other names for Equine recurrent uveitis?
Periodic ophthalmia MOON BLINDNESS Iridocyclitis
52
What is the most common cause of blindness in equids? What is it caused by?
Moon Blindness or equine recurrent uveitis Caused by hypersensitivity to previous systemic infection, particularly Leptospira interrogans
53
What is lens-induced uveitis? What are the two types? Which is worse?
Inflammatory response to lens protein Phacolytic - leakage of lens proteins from hypermature cataract Phacoclastic - rupture of the lens Phacoclastic is more severe
54
What do you see here? What is it indicative of?
Rubeosis Anterior uveitis
55
What are some major causes of retinitis?
Neurotropic viral infections (rabies, distemper) Visceral larval migrans (Toxocara canis, Baylisascaris)
56
What is a major cause of synophthalmos or cyclopia in lambs?
Veratrum californicum ingestion on day 14 of gestation
57
What are three major causes of developmental anomalies?
Genetic defect In utero infection - BVD, Bluetongue, border disease, akabane, panleukopenia, classical swine fever In utero exposure to teratogens
58
The fuck?
Lamb with inherited microphthamlia
59
Dude, seriously, what the actual fuck is this? How bad is it?
Corneal dermoid Iz bad, requires surgical intervention
60
What's wrong with this?
Posterior lens luxation
61
What's this?
Anterior lens luxation
62
How can lens luxation occur?
Trauma, inflammation (severe uveitis), glaucoma
63
What is the pupillary membrane?
Vascular tunic which supplies the lens during early development, usually regresses with age
64
What is this? | (No, not Eye of the Jew)
Persistent pupillary membrane
65
What is this developmental anomaly?
Iris hypoplasia
66
What is this weird shit?
Iris coloboma
67
What is shown in the image below? How can this happen?
Retinal dysplasia A wide array of retinal injury to the embryonic eye (BVD, bluetongue, canine parvo), or as an inherited condition
68
What cell type is proliferating? Diagnosis?
Melanocytes Iris melanoma
69
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?
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
What are the most important prognostic indicators for melanocytic neoplasms?
Species and location
71
In regards to canine melanomas of/around the eye, which are benign and which are malignant?
Haired skin of eyelid - Benign Conjunctiva - malignant
72
Ciliary (iridociliary) adenoma/carcinoma: Who is it in? Benign/Malignant? Secondary concerns?
In dogs more than cats Most are benign -behave benign even if histologically malignant Secondary glaucoma, hyphema, retinal detachment
73
Intraocular sarcoma- Who gets it? Benign/Malignant? Pathogenesis?
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
What is the most common metastasis involving the eye, especially in cats? What's it look like?
Uveal lymphoma Thickening/pallor of uvea; difficult to differentiate from uveitis
75
What's up with that right eye? This is a chicken, what's your diagnosis?
Ocular lymphoma Marek's disease (gray eye)
76
What's dis?
Meibomian (sebaceous) adenoma
77
Diagnosis?
Corneal squamous cell carcinoma
78
Dx? Breed specific? Associated with? What's another possible Ddx?
Corneal lipidosis No, but breed predilections Associated with hyperlipidemia Ddx - early corneal (endothelial) dystrophy
79
What are Florida Spots? Who gets them?
Tropical Keratopathy Cats
80
How does corneal pigmentation occur?
Derived from entrapped uvea Repsponse to injury
81