Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Specialty Medicine (Ophthalmology, Oncology, Dermatology) > Ophthalmology > Flashcards

Ophthalmology Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

Why doesn’t a deep corneal ulcer take up stain?

A

Descemet’s membrane is lipophilic and stain is hydrophilic so if you get all the way to Descemet’s membrane then ulcer will be stain negative, also epithelium will not take up stain

In a normal, more superficial eye ulcer, the stroma will be exposed bc the epithelial layer is eroded which is hydrophilic and does take up stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What filter do we use to check for Fluorescein stain uptake?

A

Cobalt blue filter- stain uptake will be where there is exposed stroma (which is hydrophilic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Superficial corneal ulcers

A

only the epithelium is affected with the anterior stroma being exposed, if not resolved in 7 days, it is considered non healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tx for non-healing corneal ulcers

A

e collar, atropine 1-2 times a day, NSAIDs-systemic, topical abx, recheck in 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are some anti-protease (enzyme breaking down protein and peptides) medications for ulcer tx?

A

Doxycycline, EDTA, homologous serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the STT levels for KCS (early, mild, severe KCS)

A

> 15 mm/min= normal production
11-14 mm/min= early or subclinical KCS
6-10 mm/min= mild to moderate
< 5 mm/min= severe KCS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

KCS tx

A

cyclosporine, tacrolimus for tear stimulation (an immunosuppressant) and refresh eye drops and avoid atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Exposure keratitis

A

lack of eyelids, poorly reconstructed eyelid injury or wedge resection can cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are macropalpebral fissures?

A

common in pugs, shih tzu’s, pekingese
Shallow orbit and prominent globe causing increased sclera to show and leads to corneal exposure and patient may have poor corneal sensitivity so less blinking or incomplete blinking

TX is canthoplasty where a small amount of the medial lid margin is removed and closes the eyelid down more so there is more complete blinking

basically, excessively wide eyelids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is SCEEDS?

A

Spontaneous chronic corneal epithelial defect and is an epithelial defect that has not healed for the past 7 days and has fuzzy borders of the stain uptake, loose epith. edges, and epith. may be thickened around the ulcer

Tx is diamond burr, debridement with cotton tip applicator, or grid or multiple punctate keratotomy (DOGS ONLY!), or superficial keratectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why do we not do grid keratotomies on cats?

A

May predispose them to sequestrum formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

feline herpesvirus changes to the eye that can sometimes occur-

A

dendritic ulcers branching, corneal sequestrum (stromal collagen degradation- has other causes, too!!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the primary purpose of the lens?

A

focus light to the retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Degree of opacity with different types of cataracts

A

asses in a dark room with dilated examination using Tropicamide 1%

Incipient is less than 15%
Immature is 15-99%
mature is 100%
Hypermature is with breakdown/resorption occurring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the only proven way to resolve cataracts?

A

Surgery (Phacoemulsification, extracapsular lengs extraction, intracapsular extraction) and do Lanosterol drops to reduce the lens opacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is lens-induced uveitis??

How do you tx it?

A

Breakdown of the blood-ocular barrier, can occur at any stage of cataract development, usually has decreased IOP, aqueous flare, keratic precipitates

TX with topical prednisone acetate or use Neopoly Dex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the tx choices for phacolytic (meaning the lens boarder are in tact but fluid is leaking around it) lens-induced uveitis?

A

Topical and oral NSAIDs, atropine unless secondary glaucoma is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Anterior vs posterior lens luxation

A

Anterior is displacement of the lens in front of the iris in the anterior chamber
Posterior is displacement of the lens into the vitreous chamber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is gold standard sx procedure of lens luxation???

A

Intracapsular lens extraction– removal of the lens within its capsule but beware of retinal detachment or glaucoma post-op

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Feline calicivirus overview notes-

A

a single stranded RNA virus, infection is most common in young shelter cats, chronic or intermittent shredders are common, incubation period is 2-14 days before symptoms occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CS of feline calicivirus

A

URI, oral mucosal ulcerations, mild to severe conjunctivitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Diagnosis of feline calicivirus and TX

A

virus isolation, PCR, samples should include oropharynx and eye; TX is Tobramycin (abx) and anti-viral drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what feline virus can live undetected in ocular tissue (the cornea)??

A

Feline herpes virus type 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Feline herpesvirus CS

A

URI, nasal/ocular discharge, chemosis/hyperemia, conjunctivitis, keratitis, classic ocular lesion being dendritic ulcers
conjunctival cytology shows inclusion bodies and cellular infiltrates (neutrophils)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is eosinophilic keratitis?

A

Suspected to be immune mediated, it is white/pink raised tissue extending across the cornea, may cause vision loss and some discomfort
ddx- will see eosinophils on cytology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Tx of eosinophilic keratitis

A

topical steroid, optimmune, megesterol acetate which is a synthetic progestin, systemic NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Feline corneal sequestrum

A

predisposing factors include steroids, chronic irritation, ulcers, etc. and can be painful and can increased in depth and size.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are some antivirals to use with feline herpesvirus?

A

Cidofovir, famciclovir, l-lysine, and reduce stressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

FIV review

A

lentivirus, transmission via saliva/bites, can also have in-utero and post-partum infections via milk, predisposed are older males outdoor with hx of fighting and has FeLV infection

30
Q

CS of FIV–

A

chronic anterior uveitis, conjunctivitis, secondary glaucoma, ocular LSA can also occur

31
Q

What are the 3 subgroups of FeLV?

A

FeLV A: only subgroup that is infectious
FeLV B: assoc. with lymphoma and neuropathy
FeLV C: assoc. with non-regenerative anemia

32
Q

CS of FeLV

A

LSA, can affect uveal tract, conjunctiva, and/or the orbit and retinal hemorrhages associated with severe anemia

33
Q

Tx of p with FeLV

A

topical steroids, enucleation if blind and painful eye/uncontrolled glaucoma, and systemic chemo/radiation for ocular LSA

34
Q

What are the tx options in cats with glaucoma???

A

Dorzolamide or Timolol

Avoid using a prostaglandin analog like Latanoprost, bc that is for primary glaucoma and cats do not usually get primary glaucoma unlike in dogs where it is hereditary; cats usually get glaucoma secondary to uveitis or another form of trauma

35
Q

FIP CS of the eye

A

anterior uveitis, other non specific findings of the eye, usually assoc. with the DRY form of FIP

36
Q

What is gold standard diagnosis of FIP

A

Biopsy with immunohistochemistry staining of Feline coronavirus in macrophages of affected tissues.

37
Q

Tx of uveitis assoc. with FIP in cats

A

Atropine, oral NSAIDs (pred or onsior but NOT TOGETHER!!!)

38
Q

What is the most common virus in cats that is assoc. with ocular manifestations?

A

Feline herpes virus

39
Q

Cats with ____ should be tested for viral agents that can cause inflammation to the eye

A

uveitis

40
Q

Visual pathway review notes

A

light hits the retina and photoreceptors convert to electrical impulse, then goes to ganglion layers to the optic nerve. The tapetum also gives photoreceptors more light inflow

41
Q

What are the tests to run for a neuro-ophthalmic examination?

A

Menace response and maze test, pupillary light reflex (PLR), dazzle reflex, oculocephalic reflex

42
Q

PLR or dazzle reflexes tests do not test for ___

A

vision

43
Q

Menace response notes:

Afferent nerve, efferent nerve, CN to open or close eyes

A

Stimulus is motion toward the eye
receptor is the retina
afferent is optic nerve (CN II) TOO SEE
efferent is facial nerve (CN VII) TO BLINK
response positive is p blinking

CN 3 oculomotor nerve to open eyes, CN 7 facial nerve to close the eyes

44
Q

how to do the Menace response test

A

cover opposite eye while doing the test, do not cause wind or touch hair, it is not present in p less than 4 months old since it is a learned response

45
Q

PLR pathway notes

Stimuli, afferent, efferent, effector, response notes

A

Stimulus is light
receptor is retina
afferent is optic nerve (CN II)
efferent is oculomotor nerve (CN III)
effeCTOR is the iris sphincter muscle
Response is pupillary constriction

46
Q

what is direct vs indirect PLR

A

direct is observe eye being illuminated and indirect PLR is occurring when the opposite eye is illuminated

direct PLR should be slightly stronger than indirect PLR

47
Q

does PLR mean there is vision?

A

Not necessarily, PLR can be present in p that have no vision from a cortical disease
andddd eyes with NEG PLR can have vision

48
Q

Dazzle reflex notes

A

Stimulus is bright light
receptor is the retina
afferent is optic nerve (CN II)
interneuron is CNS/subcortical
efferent is orbicularis ocular muscle
response is a blink

49
Q

Oculocephalic reflex notes

Afferent, efferent notes

A

stimulus is head motion,”doll eye motion”
receptor is semicircular canal
afferent is vestibulocochlear nerve (CN VIII)
efferent oculomotor/trochlear/abducens nerves (CN III/IV/VI)

50
Q

emmetropia definition

A

normally focused vision, light accurately focused on the retina

51
Q

myopia

A

nearsidedness
light focused in front of the retina

52
Q

Hyperopia

A

farsidedness
rays of light focused behind the retina

53
Q

What is an astigmatism?

A

Optical irregularities, imperfections in the refractive media where light is not focused in a uniform manner (like in p with corneal disease, cataracts, corneal tears, etc. etc)

54
Q

Progressive retinal atrophy (PRA) in dogs

A

inherited retinal photoreceptor degeneration, progressive loss of night vision followed by day vision later on and rods are affected first and then the cones

may have reduced to absent PLRs, tapetal hyper-reflectivity, retinal vessels attenuation and optic nerve atrophy

55
Q

Diagnosis and TX of PRA in dogs

A

Hx, eye exam, electroretinography, testing for genetic mutation through UC Davis

Tx - none available at this time

56
Q

PRA in cats

A

rare in cats but has two forms:
Rod-cone dysplasia- in kittens
Rod-cone degeneration- older cats and slower loss of vision

57
Q

Optic neuritis

A

inflammation of the optic n. and is a clinical symptoms from another disease process, usually is bilateral

will be blind with pupils dilated, causes are basically anything, and diagnosis is CS, ERG, and MRI. Tx depends on underlying cause and prognosis for vision is guarded to poor

58
Q

Optic nerve atrophy

A

optic nerve loses myelin and appears grey to white in color, usually from secondary eye disease

59
Q

Sudden acquired retinal degeneration syndrome (SARDS)

A

sudden vision loss, variable degree of PLR, initial absence of eye lesions, usually middle aged female obese dogs

59
Q

Tx for SARDS

A

none at this time, unknown cause.

60
Q

Chorioretinitis causes

A

Distemper, fungus, autoimmune in dogs
Cats- FIP, FeLV, toxoplasmosis, fugus
Horses- ERU

61
Q

What are the two types of retinal detachement

A

non-rhegmatogenous- bullous retinal detachment, no retinal tear, commonly seen w infectious diseases

Rhegmatogenous- a hole or tear in the retina, shih tzu’s can commonly get this

62
Q

What is this disease of the eye:
Acute blindness of a cat (can also occur in dogs but more common in cats) with dilated pupils, retinal hemorrhages (maybe even detachment)?

A

Hypertensive retinopathy

TX is correct underlying cause and systemic and topical steroids bc uveitis and calcium channel blockers!!!

63
Q

What happens to cats if you baytril (enrofloxacin) to cats

A

dose related retinal drug toxicity, DO NOT give more than 5mg/kg/day!!!!!
causes retinal toxicity in cats

64
Q

how do use of mouth gags in cats affect the eye?

A

may lead to retinal ischemia in cats due to impairment of bf through the maxillary artery

65
Q

In cats, taurine def. can cause what in cats???

A

severe retinal degeneration and irreversible blindness in cats

66
Q

What do we give dry eye P?

A

Tacrolimus, artificial tears (Dr. Betbeze’s favorite is hyaluronic acid for the eyes like Ocunovis), and/or cyclosporin

67
Q

is tacrolimus the same as cyclosporin aka optimmune?

A

Nope

68
Q

Something that looks like cataract in a dog with cloudy aqueous and is not a cataract bc you cannot even see the iris so you know it is in the anterior portion of the eye. What is the Tx?

A

Lipid within the cornea and blood vessels are inflamed and can be very sudden onset, usually patient presents blind, usually concurrent with endocrine disease (hypothyroidism, Cushings, diabetes, Schnauzers), may or may not be bilateral, and usually fed a high fat diet

Tx- tx underlying cause and improve the diet
Use lipid lowering medications with help of internist clinicians, once Tx these cases can improve a lot fast. Also tx the eye because lipids are leaking out due to inflammation in the eye, can use steroid to decrease inflammation

69
Q

even a really mild looking ulcer in a _____ can progress very fast because they have the right environment for progression

A

Diabetic patient

Specialty Medicine (Ophthalmology, Oncology, Dermatology) (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions