Ophtho Part 2 Flashcards
name the muscles of mastication
pterygoid
masseter
temporalis
what is exophthalmos?
Abnormal protrusion of normal sized globe from the orbit
what is a classic sign you see with exophthalmos?
Third eyelid protrusion
what are the two most common causes of exophthalmos
- orbital/retrobulbar neoplasia
- orbital cellulitis/abscess
Exophthalmos
Elevated third eyelid
NO pain on mouth opening
Globe deviation (dorsolateral strabismus)
what would you think?
retrobulbar neoplasia
Rapid onset, painful
Elevated 3rd eyelid
Conjunctivitis
Pain on opening mouth
what would you think?
orbital cellulitis/abscess
common sign of masticatory muscle myositis
inflam = exophthalmos
atrophy = enophthalmos
googly eyes
diagnostics for exophthalmos
look above or straight on
retropulse globe (limited retropulsion)
nictitans protrusion (present)
orbital neoplasia treatment
globe sparing (radiation, surgical explore, chemotherapy)
globe removal (enucleation or exenteration)
orbital cellulitis/abscess treatment
medical (NSAID, steroid, abx)
surgical exploration + drainage
what is an example of enophthalmos due to passive globe retraction
horner’s syndrome (sympathetic denervation)
symptoms of horner’s syndrome
ptosis
enophthalmos
miosis
third eyelid elevation
what do you call an enlarged globe
bupthalmos
what is the difference between bupthalmos and exophthalmos
bupthalmos has NO 3rd eyelid protrusion
what do you call anterior displacement of the globe such that eyelids are caught behind the quarter of the globe? who are they common in?
proptosis
brachycephalics
what is a common complication from surgery for proptosis
lateral strabismus
name the tear film layers in order from inner to outer
inner: mucin layer by conjunctiva
middle: aqueous layer by lacrimal and gland of third eyelid
outer: lipid layer by meibomian glands
normal Schirmer tear test in dog? cat? horse?
dog > 15mm/min
cat > 5 mm/min
equine > 10mm/min
what does the Schirmer tear test measure?
tear quantity
what is the most common form of KCS
quantitative - deficiency of aqueous layer
what is the most common cause of KCS? other causes?
immune-mediated
metabolic dz - Cushings or DM
drug induced - sulfa, NSAID, atropine
infectious - distemper or FHV1
treatment for KCS in dogs…
which lacrostimulants? include dosage
which abx?
which anti-inflam?
tear replacement?
topical cyclosporine 0.2% or topical tacolimus 0.01-0.02% TID
oral pilocarpine
abx if conjunctivitis or ulcer is present - tobramycin/terramycin or neopolybac
anti-inflam (use if keratitis, no ulcer): diclofenac or neopolydex
gel or ointment
what is the most common cause of feline conjunctivitis and feline keratitis
FHV-1
FHV-1
age group?
pathogenesis?
what triggers it?
unilateral or bilateral?
young cats
acute lysis, latent in trigeminal ganglion, active with stress (spontaneous, enviornmental, corticosteroids, co-infection) + epithelial tropism = surface dz
stress or chronic steroids
unilateral
conjunctivitis + keratitis +/- URT signs in cat
what is your number one differential?
FHV-1
what is pathognomonic for FHV-1
dendritic ulcer
what test can you do for FHV1?
none - no definitive test