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eye shit (103 cards)

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1
Q

Identify the lens zonules and ciliary body in a eye ?

A
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2
Q

Identify the tapetum, choroid, retina and sclera in the eyeball ?

A

Globe

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3
Q

Describe the anatomy of the orbit in a dog or cat ?

A

The Orbit

The bony socket of the skull in which the eye and its adnexa live
- composed of seven skull bones and an orbital ligament
- it is incomplete in small animals - which makes it subject to trauma
- contains a foramina (Cranial nerve; optic nerve 2, occulomotor three, trochlear four, trigeminal nerve five, and the abducens 6).
- contains the globe and extraocular muscles

Orbital cone
- extraocular muscles+ blood vessels + nerves

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4
Q

Describe the indications and contraindications for the use of atropine in eye treatments ?

A

Atropine

Indication
- causes dilation of the pupil (Mydriasis)
- blocks iris sphincter and prevents ciliary spasm to relieve pain
- this enables a Vet to carry out an eye exam or surgery

Contraindications
- decreases tear production (never use with dry eye or glycoma)
- increases intraocular pressure
- may cause colic in horses or hypersalivation in cats.

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5
Q

Describe the Iridocorneal angle ?

A

Iridocorneal angle
- located between the cornea and iris
- structure responsible for the outflow of aqueous humour from the anterior chamber

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6
Q

What is abnormal about this eye ?
What leads to this abnormality ?

A
  1. Dermoid; patch of skin on the surface of the globe
  2. Failure of ectoderm modification from skin to corneal epithelium.
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7
Q
  1. What is abnormal about the eye ?
  2. What leads to this type of abnormality ?
A
  1. Persistant papillary membrane
  2. This is a developmental disorder; of the iris and retina
    - foetal blood vessel remnants
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8
Q

What tests could you use to assess vision ?

A

Vision assessment

  • Menace (learnt so must be >12weeks in puppy and kitten).
  • tracking of a cotton ball
  • tracking a spot of light
  • obstacle course
  • visual placement response
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9
Q

Identify this condition and its potential causes ?

A

Enophthalmos
A sunken globe with protrusion of the third eyelid.

Causes of Enophthalmos
1. Dehydration and severe cachexia
2. Loss of orbital fat (old age)
3. Ocular pain (retractor bulbi)
4. Loss of muscle mass associated with myopathy
5. periorbital fractures or trauma

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10
Q

Describe two clinical signs of orbital disease ?

A

Enophthalmos and
Exophthalmos

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11
Q

Identify; 6 CS of exophthalmos

Identify this condition and describe its clinical signs ?

A

Exophthalmos
This is protrusion of the globe and third eyelid.

Clinical signs
- decreased retropulsion
- eyeball deviation (strabismus).
- pain - evident when jaw opened by practitioner + temporomandibular area
- periorbital swelling
- third eyelid protrusion
- exposed cornea (exposure keratitis

To confirm suspicion based upon clinical signs
- use a dorsal view
- PLR function is lost

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12
Q

There are four main causes of exophthalmos ?

Identify the most common causes of Exophthalmos ?

A

The common causes of Exophthalmos
**
1. Inflammatory**
- orbital (retrobulbar), abscess, cellulitis
- masticatory or extraocular myositis
2. Neoplasia
- primary or secondary from adjacent areas of metastases
3. Trauma
- ocular proptosis, orbital fracture or orbital haematoma
4. Cystic disease

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13
Q
  1. Identify this condition how you could confirm your suspicsion ?
  2. Describe its potential causes ?
A
  1. Buphthalmos
    This is enlargement of the eyeball itself.
    - to differentiate buphthalmos from other conditions
    - assess eye size by corneal horizontal diameter
  2. Common causes of Buphthalmos
    - chronic glycoma
    - big blind globe
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14
Q

Identify this condition and its potential causes ?

A

Microphthalmos

This is a congenitally small globe
- can confirm the condition through horizontal measurement of the cornea.

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15
Q

Describe;
1. presentation of an orbital abscess ? and
2. common causes of orbital abscess ?

A

Orbital abscess

1. Presentation;
- exophthalmos
- rapid onset
- usually young dogs
- pain at the orbit when opening jaw, may see swelling, rarely pus

2. Causes
- FB entry via the conjunctiva, eyelid or soft palate
- infection - extension from sinuses, tooth abscess, lacrimal gland or zygomatic salivary gland
- rarely neoplasia necrosis.

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16
Q

Describe treatment options for an orbital abscess ?

A

Treatment orbital abscess

  1. Systemic antibiotics (with anaerobic cover) 3 wks
  2. Systemic NSAIDS or steroids
  3. Protect the cornea with lubricants (artificial tears
  4. Extract tooth if the root is diseases
  5. Punture and drain orbit if swelling observed (CS)
  6. You must reassess for response to therapy.
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17
Q

Describe the common presentation and treatment for orbital neoplasia ?

A

Orbital neoplasia
( dogs 80% primary, cats mostly secondary 70%)
**
Presentation**
- 90% of cases are malignant
- slow onset
- older animals
- usually not painful
- assess for other signs (especially in the cat).

Treatment
- exenteration complete removal of the globe and its surrounding structures.
- chemo and radiation.

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18
Q

How does being brachycephalic affect ocular proptosis ?

A

Brachycephalic ocular proptosis (medical emergency)

Brachycephalics are prone to eye proptosis
The eye sits on the face - at risk of protosis with very litle trauma - but has a better prognosis than other breeds.
- shallow orbit
- macroblepharon (exposed globes).
- lagophthalmos (incomplete eyelid closure)
- also increased risk of corneal disease and ocular proptosis.

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19
Q

Describe modified BAT in a cat ?

A
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20
Q

Describe the tube shift rule ?

A

Tube shift rule

The distal root of PM4 can superimpose with the 1st molar root.
- tube shift rule take - take xray perpendicular to the tooth.

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21
Q

Describe the Chevron effect ?

A

Chevron effect

Usually observed in the mandibular first molar, or canine
blood supply and nerves entering the tooth (40-50 neurovascular bundles) soft tissue

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22
Q

Describe the various treatment options for ocular proptosis >

A

Ocular proptosis is a medical emergency
(treatment depends upon the degree of protosis.
- keep eye moist
- stabilise patient.

Healthy eye - +PLR
- general anaesthetic and prep eye
- cut lateral canthus and retract eyelid margins
- TOPICAL ATROPINE + antibiotics
- push globe back while retracting eyelids
- temporarry tarsorrhapy for two weeks
- systemic antiinflammatories

Poor long term eye prognosis -ve PLR
- eye enucleation (dry eye / corneal disease)
- suture eyelids together or Alice tissue forceps
- cut around closed eyelids with a scapel
- blunt dissect with scissors the underlying tissues to margin
- cut optic nerve (inject bupivacaine + compression)
- use a 2-3 layer closure

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23
Q

Identify this disorder and its cause ?

A

Developmental condition = Simple entropion (more common).

The basic problem is the lid is too long
- rolled in lid margins (irritation as hair may contact cornea)
- may observe excessive lacrimation
- usually occurs on the lower lid
- corneal irritation and pain
- Blepharospasm

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24
Q

Describe the treatment for entropion at different ages ?

A

Treatment for entropion
(rolling in of eyelids more common then ectropion).

< 2weeks
- the eyelids may self correct monitor with development

< 6 months
- temporary tacking with vertical mattress sutures (2.0-4.0)
- the head will not mature in size until 6-12 months of age, so allow dog to grow into wrinkles and self correction to occur.
- may need repeat tacking until six months of age.

**>6 months of age HOTZ Celsus **
- roll out the eye and measure (wet area rolled out is approximately how much you cut)
- cut cresent shaped skin adjacent to entropion (width 4-6mm)

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25
What is this condition and its cause ?
Ectropion developmental condition Basically the lid is too long - dose not cause as much irritation as entropion - turned out lid margin, usually lower lid - chronic corneal irritation
26
Identify this condition and its causes ?
**Trichiasis** - developmental condition Normal lid hairs growing in an abnormal direction and contacting the globe. - long and curly hair (poodle) - nasal / facial folds (some brachycephalics) - extra folds
27
Identify this condition and its cause ?
**Distichiasis ** (developmental condition) An extra row of eyelashes - soft cilia (cocker spaniel, poodle) - bristly cilia (staffie, mastiff) Can undertake a surgery for correction under magnification. - pluck (may be used to assess if clinical signs resolve before complete anaesthetic). - electrocautery - cryosurgery
28
Identify this condition and describe its causes ?
Ectopic cilia (developmental condition) Abnormal hairs erupting through the conjunctival lid surface - classic in young dogs (severe pain) - must be treated and removed
29
Identify this condition and describe its causes ?
Blepharitis (inflammation of the eyelids) General blepharitis - many causes similar to dermatitis - Malasezzia, demodex Local blepharitis - meibomitis or style - inflammation or infection of eyelid glands.
30
identify this condition and its cause ?
Meibomian adenoma (neoplastic condition) Meibomian gland (sebaceous gland of the eye) = produces oils for the surface of the cornea. - nodules protruding from the eyelid margin - common tumour of older dogs - treatment is via surgical removal - benign Remove via wedge resection
31
Identify this condition and its causes ?
Neoplasm of the lid Potentially - squamous cell carcinoma - carcinoma - locally invasive and matastasize late. Treatment Wedge resection - cut out wedge with scissors or scapel - can remove upto 1/3 of eye lid with no problems - use meibomian gland openings as land marks - ensure mirror image - figure 8 suture pattern.
32
Identify this disease and describe its clinical signs ?
Horners syndrome Denervation of the sympathetic nervous system (3 stage pathway to the brain). The four cardinal signs of Horner's syndrome 1. Miosis 2. Enophthalmos 3. third eyelid protrusion 4. ptosis (drooping upper eyelid), narrow palpebral fissure.
33
Identify this condition and describe the potential clinical signs ?
Conjunctivitis Conjunctivitis is inflammation of the conjunctiva. Clinical signs - superficial and thin branching blood vessels - hyperaemic (increase blood flow / dilated blood vessels) - oedematous conjuntiva - ocular discharge (seroud muco purulent)
34
How can deep and superficial deep bulbar blood vessels be used to distinguish between diseases ?
Dorsal conjunctival vrs bulbar blood vessels Superficial = conjuntival " think conjunctiviti" Deep = episcleral think glycoma or uveitis blinding and painful
35
What are the common causes of conjunctivitis in the dog ?
Dogs conjunctivitis Primary infections are uncommon in the dog. Secondary gram +ves - dry eye is the most common in the dog - local irritation (common bilateral) - FB and trauma - eyelid abnormalities - allergic conjunctivitis Schirmer tear test - normal
36
What are the most common causes of conjunctivitis in the cat ?
Feline Conjuntivitis (Infectious) - FHV1 - Calicivirus - Chlamydia - Mycoplasma - bacterial - allergic - environmental causes.
37
What could result in elevation of the third eyelid ?
Elevation of the third eyelid Occurs with retraction of the globe into the orbit (pulled into the socket) - some dog breeds may retract for discomfort - cats Horners syndrome
38
Identify this condition and its causes ?
Cherry eye This is a prolapse (lacrimal gland of the third eyelid) - requires surgery for correction - common small dog breeds (brachy, burmese cats) Use a Morgan pocket technique - orbital anchoring
39
40
Identify this abnormality and its cause ?
Dacryocystitits This is infection of the lacrimal sac. - pus discharge - yet globe appears healthy
41
What is the name of this condition and what secondary disease may result ? What simple diagnostic aids will help in assessment of this eye ?
Q1. Entropion - which could lead to corneal ulceration Q2 Topical anaesthesia Fluorescein stain
42
What is the treatment for this condition ?
Q1. Entropion corrective surgery with lid roll out and shortening.
43
Identify the five layers of the cornea ?
The five layers of the cornea 1. Tear film 2. Corneal epithelium 3. Corneal stroma 4. Descements membrane 5. Endothelium (mesoderm)
44
Identify this condition of the cornea and its potential causes ?
Corneal Oedema Corneal overhydration - this leads to increased collagen fibre spacing which interfers with light transmission - appears stippled blue/grey - opacity / cloudiness - in health the collagen spacing is very specific and results in minimal scattering of light - when spacing increases through increased water content there is a increased scattering of light. Cause - epithelial damage - endothelial compromise - vascular infiltrate
45
Identify this condition and its cause ?
Neovascularisation of the cornea This is an inflammatory response to infection / healing or is immune mediated - grow 1/2 mm per day
46
Identify this condition and its cause ?
Lipid infiltration of the cornea - stromal deep layer - may get crystals of cholesterol in the cornea, causing opacification - circular or swirly type pattern - axial central cornea
47
Identify this condition and its cause ?
Corneal calcification - tends to be irritating and uncomfatable - superficial to epithelium - dogs 14yrs and older
48
Identify this condition and its cause ?
Pigmentation of the cornea - usually indicates chronic aging change - irritation to the cornea - often seen in pugs
49
Identify this condition and its cause ?
Neoplasia corneal - conjuntiva tissue - infiltrating and growing into the cornea
50
Identify this condition ?
Corneal ulceration (epithelial erosion) - shallow but dye uptake - can still be painful due to nerve endings in the stroma - no crater effect / no indentation
51
Identify this condition ?
Corneal ulcer - stromal erosion - crater effect - melting ulcer - rapid deepening may be observed to release enzymes/ bacteria/ white cells generating keratosis - collagen analytic - very rapid
52
Identify this condition ?
Corneal ulcer - Descemetocoele basement membrane epithelium - observe cloudy edge - crystal clear centre (little tissue no stain take up) - stains around the edge stroma - oedematous + vascularisation
53
Identify this condition ?
Perforated corneal ulcer - eye will collapse - wrinkled up cornea and the aqueous rushes out
54
Identify this condition ?
Iris prolapse - the eyes puncture repair kit - iris heads up and plugs the gap - eyes attempt to reinflate and heal itself
55
What are the aetiologies of ulcerative keratitis ?
Aetiologies of ulcerative keratitis - simple trauma - secondary (dry eye, lid disease, foreign body etc) - indolent non healing SCCED - Infected (bacterial, fungal) - Immune mediated (as pictured below).
56
Describe the pathology which underlies SCCED ?
Ulcerative kertitis SCCED SCCED = Spontaneous, chronic, corneal, epithelial, defect - indolent non healing ulcer - breed and age related - boxer, staffy > 8yrs of age - epithelial defect - six months of treatment and still not heal is a strong sign
57
Describe your management strategies for ulcerative keratitis ?
Management strategies for ulcerative keratitis First point os to identify the cause Simple trauma - prevent infection (antibiotics and allow time to heal). Secondary - treat the primary disease and prevent infection - antibiotics NON healing ulcers (SCCED) - promote healing and prevent infection (topical antibiotics) - requires surgery Infected - treat infection and promote healing first Immune mediated - can utilise corticosteroids usually contraindicated.
58
Describe the varous types of non ulcerative keratitis ?
Non ulcerative keratitis Keratitis is inflammation of the cornea These are various types of non ulcerative keratitis Pannus Pigmentary keratitis Lipid infiltrate Calcification
59
Describe the consequence of corneal endothelial degeneration ?
Oedema infiltrate of fluid into the cornea
60
Identify this condition and describe its pathology ?
Pannus Non ulcerative kertitis/ inflammation of the cornea - chronic superficial keratitis - immune mediated condition almost exclusive to German Sheppards and occassionally grey hounds - there is a genetic component + immune mediated component and UV component
61
Identify this condition and describe its aetiology ?
Episcleritis / Scleritis Pink lumps on the eye - inflammatory - nodular granulomatous - poorly defined connective tissue between the collagen of the Sclera and conjunctival epithelium
62
Identify this condition ?
Neoplasia Haemangiosarcoma / haemangioma tumour within the cornea - common Nrth QLD - tumours on the surface of the globe - vasculature - sometimes on the surface of the nictitans
63
Identify this condition ?
Neoplasia on the cornea Limbal melanoma - pigmented cells of the limbus - junction of the sclera and cornea - surface of the eye - benign - easy treatment via freezing
64
Identify this condition ?
Neoplasia of the cornea Squamous cell carcinoma - arise from corneal epithelium - very common in horses - excision / freezing
65
Describe the surgical principles for the cornea ?
Cornea non healing ulcer - requires debridement - cotton bud debridement - diamond spur debridement - grid keratotomy - superficial keratotomy Support - nicitans flap - potential temporary tarsorrhaphy (suturing the lids together) Graft (specialist) - magnification and microinstrumentation
66
What corneal condition is likely present in this painful eye ? Describe simple diagnostic aides ? Describe treatment for this condition ?
Answer 1. Corneal ulcer 2. Topical anaesthesia and Fluorescein stain 3. Topical antibiotics and consider surgery - debridement - support - graft
67
Identify this condition and describe its features ?
Anterior uveitis Classification is based on the part of uvea involved - iris and ciliary body - miosis (pupil constriction) - bulbar hyperaemia (vasodilation in the eye) - 'Flare' Tyndall effect, increased protein and cells pick up of the particles through the anterior chamber. - keratic precipitates - hypopyon - iris neovascularisation - posterior synechiae (adhesions of the iris to the lens).
68
Describe the anatomy of the Uvea ?
Uvea = the vascular tunic of the eye comprising of Iris - controls light entry Ciliary body - nutrition + lens shape Choroid - nutrition for retina, absorbs light
69
What are the five classifications of uveitis ?
70
Identify and describe this condition ?
Congenital heterochromia iridis (Non inflammatory condition of the uvea) - incidental normal - eg one blue and one brown eye
71
Identify and describe this condition ?
Iris cyst (degeneration of the uvea). - spherical brown structure - may need to alter view 3D effect to identify - between lens and cornea, sitting in anterior chamber
72
Identify and describe this condition ?
Iris atrophy degeneration of the uvea - moth eaten appearance to iris, thread bear, thinning out - small older bred dogs
73
Identify this condition and describe its features ?
Posterior Uveitis (choroid and retina) Distinguishing features - perivascular exudate - subretinal exudate - exudative retinal detachment
74
Identify this condition and describe its features ?
Pan uveitis (both anterior and posterior segment)
75
Identify this condition and describe its features ?
Endophalmitis (pan uveitis and intraocular fluids) - spread to intraocular fuids (sclera and cornea)
76
Identify this condition and describe its features ?
Panophthalmitis (endothalmitis + the fibrous tunic) - fibrous tunic = sclera and cornea
77
What conditions could lead to secondary uveitis ?
Sequelae of Uveitis - glaucoma - pthisis bulbi (eye shrivels and ciliary body can not produce sufficient aqueous humour). - cataract - retinal damage
78
Describe the aetiologies of uveitis ?
79
Describe the general therapy principles for uveiitis ?
Therapy for uveitis 1. Treat any associated disease, neoplasia, ulcer, infectious agents 2. topical anitinflammatories with anterior uveitis 3. posterior antiinflammatories with posterior uveitis 4. mydriatic atropine to affect Avoid the use of corticosteroids with any systemic disease.
80
Identify and describe this condition ?
Uveal melanocytoma Primary tumour - uveal - benign - iris - heavily pigmented bulging mass formed on the surface of the iris
81
Identify this pathology ?
Ciliary body adenoma, adenocarcinoma Primary tumour - non pigmented coming off the ciliary body' - benign but may end up as a nucleation
82
Identify and describe this condition ?
Lymphoma Secondary tumour - tends to be bilateral - subtle thickening of tissue in both eyes with enlarged lymph nodes - ocular involvement is not a good prognostic for the animals recovery
83
Identify this pathology ?
Metastatic tumour Secondary tumour
84
Describe what is the posterior segment ?
85
What is the fundus ?
Fundus The part of the posterior segment which is visable with an opthalmoscope.
86
Identify this pathology ?
Optic nerve hypoplasia (congenital conditions) - reduced in size and lost its myelin - in health the optic nerve has a triangular shape due to the myelin
87
Identify this pathology ?
Collie eye anomaly congenital condition Abnormal choroid or retina tissue lateral to the optic nerve.
88
Identify this pathology ?
Retinal dysplasia (congenital condition) - strange folds in the retina may appear like worms
89
Identify this pathology ?
Exudative retinal detachment
90
Identify this pathology ?
Optic neuritis Inflammatory condition - Inflamed optic nerve - sort of fuzzy - swollen appearance
91
Identify this pathology ?
Asteroid hyalosis (degenerative condition) - speaks observed in vitreous - age related change / older dogs
92
Identify this pathology ?
Vitreal degeneration and rhegmatogenous retinal detachment. (degenerative disorder) - common in older dogs - certain breeds labs - moonscape effect
93
What is SARDS ?
SARDS Sudden acquired retinal degeneration syndrome - often the retina appears completely normal - will observe degeneral changes later on - middle age to older dogs - zero electrical response from retina - change observed within 7 days
94
What do you call this change in the anterior chamber of the eye ? What dose this change suggest ?
1. Hyopyon 2. Anterior uveitis
95
If you have a bilateral change as pictured what else should you be assessing in this patient ?
96
Define a cataract and its sequalae ?
Cataract An opacity or loss of transparency of the lens as a result of tissue breakdown and protein clumping degenerative. Sequaelae - congenital - hereditary 'primary' - secondary to uveitis, trauma, diabetes
97
Identify the five stages of the cataract ?
The five stages of the cataract incipient immature mature hypermature reasorbing
98
# [](http://) Identify and describe this pathology ?
Incipient cataract - small bubbles of degenerative change in the lens - < 10% of lens lost opacity - the majority of the tapedal reflex still present
99
Identify and describe this pathology ?
Immature cataract - many clumps of opaque material - retro illumination appear as black shadows - 50% of lens black shadows
100
Identify and describe this pathology ?
Mature cataract - the entire lens has lost its opacity - complete black out of tapedal reflex
101
Identify and describe this pathology ?
Resorbing cataract - rare - all the contents of the capsule dissolve with degeneration - left with crystals within the lens capsule - may regain vision and tapedal reflex
102
Identify this pathology ?
Primary Lens luxation aphasic cresent premature breakdown of collagen making up the lens zonule there is genetic testing available
103

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