Ocular conditions Flashcards
Define entropian
Eyelids roll inwards causing the eyelashes to irritate the eye
What are the clinical signs of entropian?
Excess tear production
Epiphora (overflow of tears down the face)
Conjunctivitis
Corneal ulceration
Why should an entropian animals eyes be assessed prior to pre-med?
ACP will make the eyelids droop
Describe surgery for entropian
Slivers of skin are removed to turn the eyelid out
More than one surgery may be required
Define ectropian
The eyelid is oversized and bags/ droops open exposing the conjunctiva
What are the clinical signs of ectropian?
Appearance
Conjunctivitis
Chronic keratitis (inflammation of the cornea)
Describe surgery for ectropian
As before the eye should be assessed prior to any pre-med being given
Slivers of skin are removed to ‘take up the slack’ of the eyelid
Describe post-op care for entropian and ectropian
Buster collar must be applied immediately on recovery
Use of cold compresses if indicated to reduce swelling
Describe distichiasis
A whole row of extra eyelashes inside the normal lashes
Describe ectopic cillia
One or two abnormally positioned eyelashes
What are the clinical signs of distichiasis and ectopic cillia?
Epiphora
Conjunctivitis
Blepharospasm (spasm of the eyelids, blinking lots)
Corneal ulcer
Chronic keratitis (corneal inflammation)
Describe surgery options for Distichiasis and Ectopic Cillia
Can simply pluck extra lashes away under sedation, but they will grow back
Electrolysis gives longer lasting results but again will grow back
Delicate surgery performed at referral centres to remove the eyelash roots
Cryotherapy can be used
Describe eyelid tumours
Marginal tumours are common in older dogs
Cause irritation by rubbing in the surface of the cornea
Removed by excising a wedge of the eyelid margin
Patient interference should be prevented immediately on recovery
Describe cataracts
Increase in the opacity of the fibres or capsule of the eye lens.
Primary or secondary condition
Can be left untreated or removed at referral centres
Describe cataracts surgery
Phacoemulsification technique is used
Needle vibrated by ultrasound and this breaks up the cataract
Particles are then aspirated
Alternatively the lens is removed
Describe ‘blue eye’
Older animals will have a ‘blue’ colour to the lens of their eyes
Occurs as a result of the aging process
Not a cataract the animal can still see
Senile nuclear sclerosis, a natural aging process
Describe first aid for a prolapsed eyeball
Prevent the eye from dehydrating
Use of saline, ophthalmic ointment or water soluble jelly to prevent this
Prevent the animal traumatising the eye
Describe surgery for a prolapsed eyeball
Lateral canthotomy is an incision at the lateral canthus to extend the eyelids
Eyelids sutured together for approx 2wks to prevent reoccurrence
Describe post-op management for a prolapsed eyeball
Buster collar to prevent self trauma post operatively
Describe corneal damage
Most common corneal damage is ulceration
Blepharospasm
Epiphora
Pain
Animal may rub at the eye
Describe treatment for corneal damage (ulcer)
Medical treatment in the form of regular eye drops and NSAID can normally heal an ulcer
Ulcer gently debrided using a cotton bud to remove any loose tissue
Describe a third eyelid flap
3rd eyelid pulled closed over the eye and sutured in place
Acts as a bandage and prevents the eyelid irritating the ulcer
Eye drops are still applied
Describe a conjunctival flap
A pedicle of conjunctivia is sutured to the cornea, covering the ulcer
Again acts as a bandage, but this method also supplies nutrition the ulcer to encourage healing
Describe a punctate ketatotomy
Sedation and local anaesthetic eye drops are required
Gently debride the ulcer
Ulcer being debrided with cotton buds
Sterile hypodermic needle is used to scratch grid lines on the surface of the damaged area
Stimulates healing in tissues that have become dormant
Describe enucleation
Enucleation is indicated if the eye is too damaged to save as a result of –
Gross trauma
Neoplasia – of the eye or behind the eye
Untreatable glaucoma
Irreducible prolapse
Cosmetic appearance is of a concern to many clients prior to this surgery
More time and reassurance may be needed prior to surgery to ‘council’ these clients
The animal will tolerate enucleation well and in some cases improves their quality of life
Describe surgery for enucleation
Many techniques are available
Commonly a Trans Palpebral Enucleation is performed
Eyelids are first sutured together using a continuous suture
Eye is then removed by dissection of the conjunctiva
Optic nerve and blood vessels are clamped and carefully ligated
An ‘emovet’ pad sometimes required - encourages haemorrhage to clot
Oculocardiac reflex can occur. A stimulus to the eye pressure, manipulation or traction gets transmitted to the vagal nerve and onto the heart.
Causes profound bradycardia, arrhythmias or asystole
Critical to monitor the heart very closely/continuously throughout the procedure
If any signs are noticed to a change in the heart the surgeon must be notified immediately so they can re consider their surgical technique
Describe post-op care for enucleation
Buster collar
Observation for haemorrhage
Describe cherry eye
Describes the protrusion of the tear gland associated with the 3rd eyelid
Occurs due to a weakness of the glands normal attachment
Describe surgery for cherry eye
Surgery involves replacing the gland into its normal position and suturing in place.
Better success with surgery if it is carried out as soon as possible
