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CVSOH BVSc4 > Ophth - Conjunctiva, third eyelid, lacrimal system > Flashcards

Ophth - Conjunctiva, third eyelid, lacrimal system Flashcards

1
Q

What makes up the third eyelid?

A

T shaped hyaline cartilage

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2
Q

What is another name for the third eyelid?

A

Nictitating membrane

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3
Q

What make up the normal conjunctival microenvironment?

A

Gram positive aerobes - staph, bacillus, strep

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4
Q

What are some clinical signs associated with conjunctival diseases?

A

Hyperaemia, chemosis, exudation, follicular hyperplasia

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5
Q

What is hyperaemia?

A

Branching bright red vessels
Redness of the conjunctiva

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6
Q

What is chemosis of the eye?

A

Conjunctival oedema
More seen in cats

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7
Q

What is exudation of the eye?

A

Discharge - serous, mucoid or purulent

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8
Q

Where does follicular hyperplasia occur in the eye?

A

Inner aspect of the third eyelid
Upper fornix

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9
Q

What causes conjunctivitis?

A

Usually secondary - irritants, chemicals, drugs
Abnormal eyelid conformation
Aberrant hairs
Keratoconjunctivitis sicca
Trauma/Foreign body

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10
Q

What can cause primary conjunctivitis?

A

Follicular conjunctivitis
Juvenile conjunctivitis
Viruses - distemper, herpes, adenovirus
Parasites - thelazia, leishmania
Allergic conjunctivitis

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11
Q

How can you treat conjunctivitis?

A

Topical antibiotics - chloramphenicol
Topical anti-inflammatories - NSAIDs
Lubrication
Cleansing/warm compresses

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12
Q

What are some causes of third eyelid protrusion?

A

Enophthalmos/exophthalmos
Inflammation of third eyelid
Neoplasia of third eyelid
Horners syndrome
Scrolled cartilage of third eyelid
Prolapsed gland or third eyelid - cherry eye

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13
Q

What is cherry eye?

A

Red, homogenous mass arising from the bulbar aspect of the third eyelid due to prolapse of the third eyelid gland

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14
Q

How should you treat cherry eye?

A

DO NOT remove the gland - secondary keratoconjunctivitis sicca
Can use medical treatment to reduce inflammation but corrective surgery usually required

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15
Q

What is the corrective surgical technique for cherry eye surgery?

A

Modified Morgan pocket technique - bury the gland in conjunctival pocket

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16
Q

What is the prognosis of cherry eye surgery?

A

80% success rate

17
Q

What are the 3 layers that make up the composition of the pre-corneal tear film?

A

Deep mucin layer
Intermediate aqueous layer
Superficial lipid layer

18
Q

What is the function of the superficial lipid layer of the precorneal tear film?

A

Prevents evaporation of the tear film

19
Q

What two structures produce the aqueous layer of the precorneal tear film?

A

Orbital lacrimal gland (2/3)
The third eyelid gland (1/3)

20
Q

What produces the lipid portion of the precorneal tear film?

A

Meibomian glands

21
Q

What produces the mucous portion of the precorneal tear film?

A

Conjunctival goblet cells

22
Q

What is the name for the holes in the eyelid that the tears exit the eye through?

A

Puncta

23
Q

What are the tubes that transmit the tears to the nasolacrimal duct?

A

Canaliculi

24
Q

What is the function of the lipid layer of the tear film?

A

Prevents evaporation
Aids tear film distribution

25
Q

What is the function of the aqueous layer of the tear film?

A

Supplies corneal nutrition
Antibacterial properties
Removal and remodelling - proteases

26
Q

What is the function of the mucous layer of the tear film?

A

Lubrication
Refractive properties
Anchors aqueous layer to the cornea

27
Q

What is keratoconjunctivitis sicca (KCS)?

A

Dry eyes

28
Q

What are the clinical signs of KCS?

A

Strings of adherent mucus
Poor corneal clarity/shine
Low Shirmer tear test reading
Conjunctivitis
Ocular pain
Decreased vision
Corneal vascularisation

29
Q

What are the two different types of KCS?

A

Quantitative - amount of tears produced is reduced
Qualitative - poor quality of tears but amount is normal

30
Q

What causes the majority of quantitative KCS cases?

A

Immune mediated adenitis - immune system attacks the lacrimal gland

31
Q

What are some other causes of quantitative KCS?

A

Iatrogenic - anaesthetics, atropine, drug toxicity
Neurogenic - facial nerve, trigeminal nerve
Trauma to eyelids and third eyelid

32
Q

What can cause qualitative KCS?

A

Inflammation of the meibomian glands
Abnormal goblet cells

33
Q

How do you test for qualitative KCS?

A

Tear film break up time (can be subjective)
Add fluorescein into eye, then observe with a blue light and see if it breaks up

34
Q

How do you treat qualitative KCS?

A

Treat the identified cause
Frequent lubrication
Immunomodulation - topical cyclosporine, optimmune
Use antibiotics to treat secondary infections

35
Q

What are the signs of impaired drainage through the nasolacrimal duct?

A

Epiphora
Mucopurulent ocular or nasal discharge
Swelling in medial canthus
Conjunctivitis

36
Q

How do you test for impaired nasolacrimal drainage?

A

Jones test
Apply fluorescein to both eyes
Observe at nostrils - should normally emerge within 5 mins

CVSOH BVSc4 (86 decks)

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