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Y4 - Small Animals > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

What is distichiasis?

A

Hairs growing in an abnormal site
from the tarsal/Meibomian glands within the tarsal plate and emerging at the lid margin

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2
Q

What is treatment of distichiasis?

A
  • Plucking = regrow
  • Electrolysis
  • Tarsoconjunctival resection
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3
Q

What solution should be used for the eye?

A
  • Povidone iodine antiseptic solution
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4
Q

What is ectopic (conjunctival) cilia?

A
  • Emerge from the conjunctival surface and impinge directly on the eye
  • Much more sporadic and far less common than distichiasis
  • Far more painful - can cause shallow ulcers
  • Alert - young dog (especially bulldogs) with a severely painful eye, possible shallow ulcer and no obvious cause
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5
Q

How are ectopic cilia treated?

A
  • Easy to deal with = cut out (scalpel / biopsy punch)
    -go deep enough
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6
Q

What is entropion? What can it cause?

A
  • In rolling of lid margin = skin hairs impinge on eye
  • Can cause corneal damage (masses of corneal granulation tissue)
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7
Q

What is treatment of entropion?
What are consequences of treatment?

A
  • Skin + muscle excision to pull eye margin out
    -Hotz-Celsus procedure
  • Tx can lead to minor post-op ectropion = not a problem
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8
Q

What breeds are predisposed to bad entropion at young age?
What should be done?

A
  • Shar-pei - most need skin + muscle excision on all 4 eyelids eventually
  • Tx = do not excise as they will grow
    -temporarily ‘tacking’ is advised until mature
    -suture good temporarily but cut in + migrate
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9
Q

What breed of dogs have medial entropion with trichiasis?

A
  • Pugs
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10
Q

What breed get upper lid trichiasis syndrome?
Tx?

A
  • Middle aged cocker spaniel upper eyelid syndrome
  • Tx = Stades procedure
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11
Q

What is the most common eyelid tumour in dogs?

A
  • Sebaceous adenoma / epithelioma
    -arises from tarsal gland
    -benign
    -require full thickness excision
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12
Q

What is the function of the third eyelid?

A
  • Secretory - 30% of aqueous tears
  • Surface protection
  • Tear film distribution
  • Immunological
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13
Q

What is cherry eye?

A
  • Prolapse of the nictitans gland
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14
Q

How can you manage cherry eye?

A
  • Burying but preserving gland =
    -preserves function
    -expensive
    -can fail
  • Excision of gland
    -cheap + guarantee
    -30% of aqueous tear capacity lost
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15
Q

When would you excise the third eyelid?

A
  • Only if neoplasia
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16
Q

What is non-specific ocnjunctivitis?
Tx?

A
  • diffuse redness without corneal, pupillary light reflex
    or vision defects
  • Tx - Fusidic acid (only for STAPHs)
  • Tx = Clinagel = Gentamicin (gram +ve & -ve)
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17
Q

Other than conjunctivitis what else can cause red eye?

A
  • Corneal ulcer or trauma
  • Glaucoma
  • Dislocated lens
  • Uveitis
  • Dry eye
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18
Q

What produces portions of the tear film?

A
  • Lipid = tarsal gland
  • Aqueous = lacrimal + nictitans glands
  • Mucus = conjunctival goblet cells
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19
Q

What are causes of dry eye in the dog?

A
  • Immune-mediated inflammation of the glands with secondary loss of function
  • Neurological (“Dry eye – Dry Nose” syndrome)
  • Sulphonamides / salazopyrin
  • Distemper
  • Chronic lid abnormalities
  • Endocrine abnormalities contributory (hypothyroidism/diabetes)
20
Q

What are clinical signs of dry eye?

A
  • Chronic conjunctivitis
  • Dull appearance to the ocular surface
  • Mucopurulent discharge - tenacious and adherent
  • Discomfort
  • Corneal ulceration (variable)
  • Corneal vascularisation and pigmentation
21
Q

How can you quantify dry eye with tear production?

A
  • 15mm = minimum
  • 10-15mm = moderate dry eye
  • <10mm = moderate to severe dry eye
22
Q

What is medical management of dry eye?

A
  • Tear stimulants - cyclosporin (optimmune), Tacrolimus
  • Tear film replacements - carbomer gel
23
Q

How can lacrimal drainage be monitored?

A
  • Fluorescein drainage test =
    -apply fluorescein with 2 drops of saline
    -should see stain coming out of nose in 3-4minutes or less
24
Q

What is a corneal ulcer?

A
  • Full thickness defect in epithelium
    -causes pain + potential for progression
25
Q

what are the 4 layers of the cornea?

A
  • Epithelium
  • Stroma
  • Descemet’s membrane
  • Endothelium
26
Q

What is the stroma susceptible to? what is this referred as?

A
  • Enzymatic digestion =
    -proteolysis
    -keratomalacia
    -collagenolysis
    -melting
27
Q

What can cause release of proteolytic enzymes?

A
  • Bacteria - pseudomonas, B haemolytic streps
  • Inflammatory cells
  • Corneal cells
  • Unexplained / sterile
28
Q

What are signs of corneal perfortation?

A
  • Sudden pain
  • Convex protrusion of brown / black tissue with overlying fibrinous material
  • Blood from eye
29
Q

How does fluorescein work?

A
  • Orange dye, turns green in alkaline conditions
  • lipophobic = runs off intact epithelium
  • hydrophilic = adheres to exposed stroma
  • shows better with blue light
  • Must flush with saline after exposure to eliminate false positives
  • If depression and clear area in deep ulcer = not good + won’t stain as down to descemet’s membrane
30
Q

What are primary causes of corneal ulceration?

A
  • Factors causing direct mechanical damage
    -eyelids, trauma, foreign bodies
  • Factors contributing to an unhealthy superficial environment
    -dry eye, poor blink
  • Inherent corneal defects - indolent (boxer) ulcer
  • Multifactorial - brachycephalics
31
Q

What are non-specific medical therapy for corneal ulcers?

A
  • Broad spec AB = gentamycin, ciprofloxacin, chloramphenicol + fluoroquinolone
  • Lubricant frequently
  • Atropine
  • Acetylcysteine - for melting ulcers (anti-collagenase)
32
Q

What are reconstruction techniques for corneal ulcers?

A
  • Conjunctival pedicle graft
  • Corneo-conjunctival transposition
33
Q

What are indolent ‘boxer’ ulcers?

A
  • Superficial chronic cornea epithelial damage (SCCED)
  • epithelial only - not a concavity/crater
  • mild oedema and loose under-run edges
  • breed helpful - boxers, corgis, Staffies
  • stain well with fluorescein
  • vascularisation varies from none to extreme
  • THEY DON’T HEAL - surgery
34
Q

What are the 2 types of corneal foreign bodies?

A
  • Adhere to surface
    -flat/shallow curvature, little penetration, can be wiped out
  • Intracorneal (usually thorns)
    -easier with reasonable protrusion
    -needle for removal
35
Q

What animals are more prone to pigmentary keratitis?

A
  • Brachycephalics
36
Q

What breeds tend to get dermoids? (hair growing on eye)

A
  • French bulldogs
37
Q

What are pannus? breed predisposed? Tx?

A
  • Inflammatory + vascular tissue advances across the cornea always from the ventrolateral direction
  • GSD
  • Topical cyclosporine / tacrolimus / topical steroids
38
Q

What does the uvea consist of?

A
  • Iris
  • Ciliary body
  • Choroid
39
Q

What are causes of anterior uveitis?

A
  • Spontaneous/idiopathic/immune-mediated
  • Deep and/or infected ulcers
  • Corneal trauma/laceration
  • Remote sites of infection inc. pyometra
  • Post intraocular surgery
  • Specific intraocular infections
40
Q

How do you treat uveitis?

A
  • Mydriatics = relieve pain, reduce risk of adhesions
  • Topical steroids +/or NSAIDs
    • oral steroids / NSAIDs
41
Q

What is glaucoma? Causes?

A
  • Abnormal rise in intraocular pressure
    -always a problem of aqueous flow or drainage not over-production
42
Q

Why is glaucoma serious?

A
  • Painful
  • Rapidly destroys retina + optic nerves
  • Main cause of eye removal
43
Q

What can cause secondary glaucoma?

A
  • Uncontrolled inflammation
  • Tumours
  • Trauma
  • Anterior lens luxation
  • Perforations
  • Severe intraocular haemorrhage
  • Chronic retinal detachment
  • Intraocular surgery
44
Q

What are signs of acute glaucoma?

A
  • Red eye
  • Pain & lethargy
  • Steamy cornea
  • Non-responsive pupil
  • Blindness
  • Globe hard but normal size
45
Q

What is tonometry / gonioscopy?

A
  • Tonometry = measure of intraocular pressure
  • Gonioscopy = assess drainage angle
46
Q

What is topical treatment for glaucoma?

A
  • Trusopt, azopt - topical carbonic anhydrase inhibitors
  • Prostaglandin analogues - Xalatan
  • Also prophylactic treatment of ‘good eye’
47
Q
A

Y4 - Small Animals (105 decks)

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