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VM753 Clin Sci IV > Ophtho Part 2 > Flashcards

Ophtho Part 2 Flashcards

1
Q

name the muscles of mastication

A

pterygoid
masseter
temporalis

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2
Q

what is exophthalmos?

A

Abnormal protrusion of normal sized globe from the orbit

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3
Q

what is a classic sign you see with exophthalmos?

A

Third eyelid protrusion

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4
Q

what are the two most common causes of exophthalmos

A
  1. orbital/retrobulbar neoplasia
  2. orbital cellulitis/abscess
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5
Q

Exophthalmos
Elevated third eyelid
NO pain on mouth opening
Globe deviation (dorsolateral strabismus)

what would you think?

A

retrobulbar neoplasia

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6
Q

Rapid onset, painful
Elevated 3rd eyelid
Conjunctivitis
Pain on opening mouth

what would you think?

A

orbital cellulitis/abscess

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7
Q

common sign of masticatory muscle myositis

A

inflam = exophthalmos
atrophy = enophthalmos
googly eyes

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8
Q

diagnostics for exophthalmos

A

look above or straight on
retropulse globe (limited retropulsion)
nictitans protrusion (present)

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9
Q

orbital neoplasia treatment

A

globe sparing (radiation, surgical explore, chemotherapy)
globe removal (enucleation or exenteration)

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10
Q

orbital cellulitis/abscess treatment

A

medical (NSAID, steroid, abx)
surgical exploration + drainage

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11
Q

what is an example of enophthalmos due to passive globe retraction

A

horner’s syndrome (sympathetic denervation)

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12
Q

symptoms of horner’s syndrome

A

ptosis
enophthalmos
miosis
third eyelid elevation

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13
Q

what do you call an enlarged globe

A

bupthalmos

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14
Q

what is the difference between bupthalmos and exophthalmos

A

bupthalmos has NO 3rd eyelid protrusion

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15
Q

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?

A

proptosis

brachycephalics

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16
Q

what is a common complication from surgery for proptosis

A

lateral strabismus

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17
Q

name the tear film layers in order from inner to outer

A

inner: mucin layer by conjunctiva

middle: aqueous layer by lacrimal and gland of third eyelid

outer: lipid layer by meibomian glands

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18
Q

normal Schirmer tear test in dog? cat? horse?

A

dog > 15mm/min
cat > 5 mm/min
equine > 10mm/min

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19
Q

what does the Schirmer tear test measure?

A

tear quantity

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20
Q

what is the most common form of KCS

A

quantitative - deficiency of aqueous layer

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21
Q

what is the most common cause of KCS? other causes?

A

immune-mediated

metabolic dz - Cushings or DM
drug induced - sulfa, NSAID, atropine
infectious - distemper or FHV1

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22
Q

treatment for KCS in dogs…
which lacrostimulants? include dosage
which abx?
which anti-inflam?
tear replacement?

A

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

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23
Q

what is the most common cause of feline conjunctivitis and feline keratitis

A

FHV-1

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24
Q

FHV-1
age group?
pathogenesis?
what triggers it?
unilateral or bilateral?

A

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

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25
Q

conjunctivitis + keratitis +/- URT signs in cat

what is your number one differential?

A

FHV-1

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26
Q

what is pathognomonic for FHV-1

A

dendritic ulcer

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27
Q

what test can you do for FHV1?

A

none - no definitive test

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28
Q

treatment for FHV-1

A

reduce stress
supportive care - erythromycin
L-lysine 500mg BID (adults), SID (kittens)
cidofovir 0.5% BID
famcliclovir 40mg/kg TID`

29
Q

most common signs of chlamydia felis

A

chemosis
bilateral
no ulceration

30
Q

treatment for chlamydia felis

A

topical ax
- tetracycline (oxytet) BID/TID
- macrolide (erythromycin) BID/TID

31
Q

calicivirus clinical signs

A

conjunctival & oral ulceration (pathognomonic)

32
Q

diffuse episcleral injection
not painful
no intraocular abnormalities
perilimbal corneal edema

what disease process?

A

diffuse episcleritis “red eye”

33
Q

what are the 5 layers of the cornea in dogs/cats

A

tear film
epithelium
stroma
descemet’s membrane
endothelium

34
Q

criteria of simple ulcers

A
  • superficial
  • not infected
  • heals in 5-7 days
  • no complicating factors
35
Q

what is the goal of treating simple ulcers?

A

prevent infection NOT to accelerate healing

36
Q

what is the treatment for a simple ulcer? include dosage

A

erythromycin/tobramycin TID (triple abx ideal)
oral NSAID
oral GABA
topical atropine
e-collar

37
Q

when do you want to recheck a simple ulcer in normal dogs? brachycephalics?

A

5-7 days in normal dogs
2-3 days in brachycephalics

38
Q

criteria of a complicated ulcer

A

deep loss of stroma
infected/melting
delayed wound healing
complicating factors

39
Q

if there is <50% stromal loss/melting/infection how would you want to rule out infection?

A

cytology (rapid)
culture and Se (slower)
use microbrush or cytobrush

40
Q

how to control secondary uveitis with a complicated ulcer?

A

topical atropine 1% q 8-24hrs
oral NSAIDs

41
Q

4-5 A’s of complicated corneal ulcer therapy in dogs & cats
antibiotic topical?
anti-collagenase?
atropine
antibiotic oral?
anti-inflam oral?

A

ofloxacin, cephalexin
serum or EDTA
atropine
clavamox
NSAID

42
Q

4-5 A’s of complicated corneal ulcer therapy in horses
antibiotic topical?
anti-collagenase?
atropine
antifungal?
anti-inflam oral?

A

ofloxacin, cephalexin
serum or EDTA
atropine
voriconazole
NSAID

43
Q

what can you do as a treatment option for horses with a complicated ulcer to administer medications?

A

Subpalpebral lavage tube

44
Q

if a dog has a non-healing superficial ulcer present for weeks-months that is not infected, what is it? treatment?

A

indolent corneal ulcer

grid keratotomy or diamond burr debridement

45
Q

dendritic ulcers are pathognomonic of what

A

FHV-1

46
Q

what does a blue corneal opacity indicate?

A

edema

47
Q

focal corneal edema is due to what?

A

epithelial disease

48
Q

generalized diffuse corneal edema is due to what?

A

endothelial disease

49
Q

corneal edema treatment

A

hyperosmotics (5% saline)

50
Q

what does a red corneal opacity indicate?

A

blood vessels = vascularization of the cornea

51
Q

criteria of pannus and what is it?

A

immune mediated chronic superficial keratitis

  1. superficial vascularization
  2. corneal degeneration
  3. pigmentation
  4. fibrosis
52
Q

treatment for pannus

A

dexamethasone or pred acetate
cyclosporine or tacrolimus
lifelong (not cured, just controlled)
decrease UV exposure

53
Q

what common pigment disease do pugs get and what is the treatment?

A

pigmentary keratopathy
tacrolimus for life long

54
Q

what is the anterior chamber

A

space between cornea and iris

55
Q

what is the posterior chamber

A

space between iris and lens

56
Q

what is aqueous flare

A

protein and cells in anterior chamber that scatters light

57
Q

what other abnormal contents can be seen in the anterior chamber

A

keratic precipitates
neutrophils (hypopyon)
hyphema (blood)
fibrin
lipid

58
Q

what is a specific clinical sign associated with uveitis

A

miosis

59
Q

common INFECTIOUS causes of canine uveitis

A

bacterial (lepto, brucella, borrelia, septicemia)
fungal (blasto, coccidioides, crypto, histo)
rickettsial - ehrlichia, rickettsia

60
Q

common NON- INFECTIOUS causes of canine uveitis

A

idiopathic (most common)

61
Q

hyphema present in dogs, do what? cats, do what?

A

dogs - coag panel
cat - blood pressure

62
Q

common INFECTIOUS causes of feline uveitis

A

4 F’s and T
FIP, FeLV, FIV
fungal (crypto, histo, blasto, coccidioides)
toxoplasma
bartonella

63
Q

common NON- INFECTIOUS causes of feline uveitis

A

idiopathic (most common)

64
Q

treatment of uveitis

A

prolonged, recurrence common
prednisolone acetate

65
Q

uveitis vs anterior uveitis

A

uveitis - ciliary flush, corneal edema, episcleral injection, photophobia, epiphora

anterior uveitis - discharge, anterior flare, iris changes (hyperemia, hyperpigmentation, synechia)

66
Q

what can causes fly biting behavior in the dog

A

iris cysts

67
Q

iris cyst treatment

A

none unless vision changes or increased IOP

68
Q

are intraocular neoplasia more aggressive in dogs or cats

A

cats

69
Q

common intraocular tumor in cats

A

feline diffuse iris melanoma

VM753 Clin Sci IV (12 decks)

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