Ophthalmology (Exam 1) Flashcards
How are MMPs involved in corneal ulceration?
Secreted by epithelial and stromal cells, also invading microorganisms
Involved in degradation of ECM and BM
What is neurotrophic keratitis?
How is it tx?
Corneal innervation dysfunction
Tx: abx (TS), serum, GFs, antivirals (if herpes)
How is a simple corneal ulcer treated?
T Abx (BNP, erythromycin, tobramycin) Atropine to stabilize vascular endothelium
How is a complicated (non-healing) corneal ulcer treated?
TS abx
Systemic antiinflammatory
Serum
*Refer
What are indolent ulcers?
How are they treated?
Superficial ulcer with redundant epithelium/nonadherence
Debride if superficial
Refer for diamond burr/grid
What happens if grids are used in cats?
Sequestrums
NEVER DO THIS
When is surgical therapy indicated in corneal ulcers?
Depth >2/3, melting, risk of rupture
What is a corneal sequestrum?
How is it treated?
Painful, brown pigmented plaque d/t degradation of collagen
Typically in cats
Medical if vascular
Surgery if avascular
What is pigmentary keratopathy?
How is it treated?
Progressive following injury to cornea
Lubrication
T steroid
Cyclosporine/tacrolimus
What is pannus?
How is it treated?
Chronic superficial keratitis with inflammatory basis
GSD, Greyhound
Lifelong tx required T steroid (weaned off) Cyclosporine/tacrolimus Avoid UV light
What is corneal dystrophy?
How is it treated?
Hyperlipidemia in the center of the cornea
Only painful in Shelties
Lubrication
Cyclosporine/tacrolimus
*NO STEROIDS
What is calcium keratopathy?
How is it treated?
Mineral accumulation in the center of the cornea
Med: Lubricant
T abx
EDTA
Sx: diamond burr / needle /TCA
conjunctival graft
What is florida keratopathy?
How it treated?
Round and white stromal opacities
No treatment required
What is eosinophilic keratitis?
How is it diagnosed?
How is it treated?
Eosinophilic white plaque lesion in cats, associated with FHV
Dx: cytology for eos
abx
T steroids
How is immune keratitis treated?
T steroids
Cyclosporine/tacrolimus
What is bullous keratopathy?
How is it treated?
Breakdown of endothelium resulting in profound edema
Cats only
T NaCl ointment
*TE flap (only time indicated!)
What are dermoids and choristomas?
How are they treated?
Congenital tumors involving lid, conjunctiva, and/or cornea
No tx needed
What is entropion?
How is it treated?
Inward rolling of lid margin
Surgery indicated
- Hotz-Celsus
- Temporary eyelid tacking
What is ectropion?
Eversion of eyelid margin
What is blepharitis?
How is it treated?
Inflammation of the eyelid
Most often allergic
Warm compresses
TS abx
Steroids if severe
What techniques are available for eyelid neoplasia?
Cryotherapy/laser ablation Wedge resection (20% of margin)
What is distichia?
How is it treated?
Cilia from meibomian glands
Lubrication (ointment)
Manual epilation (temporary)
Electrolysis
*Cryotherapy
What is KCS?
Deficiency of the aqueous portion of tear film
May be qualitative (mucin deficiency) or quantitative
What signalments are associated with KCS?
Yorkies, bulldogs, westies
Burmese cats
What etiology is most common in KCS?
Immune-mediated lacrimal gland adenitis
How is KCS diagnosed?
STT
How is KCS treated?
Replace tears
Stimulate tear production (cyclosporine/tacrolimus)
Add 2% pilocarpine if neurogenic
Abx and corticosteroids
What is the most common CS associated with imperforate puncta?
Epiphora (tear staining)
Conjunctivitis in cats… most likely dx?
Herpesvirus
How is herpesviral conjunctivitis treated?
T abx (tetracycline, erythromycin) Antivirals
*steroids CONTRA
How is chlamydia conjunctivitis treated?
Tetracycline topically
How does medial canthal pocket syndrome present?
How is it treated?
Dogs with large orbits
Nasal fornix is large, trapping debris –> conjunctivitis
CS: mucus at medial canthus in the morning
Tx: flush orbit and lubricate
What breed is associated with nodular granulomatous episcleritis?
How does it present and how is it treated?
Collies
CS: nodular nonpigmented mass from limbus or third eyelid
ST steroids
Azathioprine
Surgical excision +/- cryo
T/F: excising the TE in dogs may cause KCS
TRUE, NEVER DO IT
