OPTHALMOLOGY 2 Flashcards
What is entropion?
eyelid malposition where the eyelid margin rolls inward, causing skin hairs to contact the eye
What are the clinical signs of entropion?
Signs include:
* Pain
* Blepharospasm
* Lacrimation
* Globe retraction
* Photosensitivity
What are the common causes of entropion in dogs?
mostly developmental/pedigree associated:
- Excessively long eyelids relative to the eye size
- Abnormal canthal attachments
- Excessive skin folds
- Loss of skin elasticity and facial droop
- Loss of retrobulbar contents
- Pain-induced globe retraction
How is entropion related to globe confirmation? (feedback loop to the globe due to entropion)
entropion -> pain -> globe retraction -> worse entropion
Why is it important to check the cornea in entropion cases?
Entropion often causes corneal ulceration
What is the goal of Hotz-Celsus repair in entropion treatment?
fix the inward-rolling eyelid margin and addresses underlying causes.
Describe the steps of a Hotz-Celsus repair.
how many mm away from lid margin are the incision made?
excision depth includes skin and ________
strip of skin dissected away using which scissors?
wound closed using rule of _________
Steps include:
* Two incisions made 2-3 mm from the lid margin [two incisions in a keel boat shape. wdth depending on how severe condition is]
* Excision depth includes skin and orbicularis oculi muscle
* Strip of skin dissected away using tenotomy scissors
* Wound closed with simple interrupted sutures using rule of bisection
what is the rule of bisection in regards to closing a hotz-celsus repair?
in order to avoid dog ears due to skin length differences: start a suture in the middle, then middle of either side. distribute the unequal length
What techniques help determine how much skin to remove during Hotz-Celsus repair?
[briefly describe them]
Techniques include:
* Blood staining technique
* Forceps grasp/pinch technique
* Rule of thumb technique
What are potential pitfalls of Hotz-Celsus repair?
Pitfalls include:
* Removing too much tissue, causing ectropion
* not adressing excessive eyelid length
What are causes of senile/atonic entropion?
lack of upper eyelid tone
excessive head skin
what is the breed predisposition to senile/atonic entropion?
older cocker spaniels
What treatments are available for senile/atonic entropion?
Treatments include:
* Stades procedure [remove skin flap above eyelid]
* Rhytidectomies
Lateral cnathal instability si indicated when it is ____________than the medial canthas
lower
What is ectropion?
Ectropion is the outward rolling of the lower lid.
When does ectropion require treatment?
If it causes repeated conjunctivitis, it can be treated with simple lid shortening.
When should cases of ectropion be referred?
Cases caused by scarring should be referred.
When is temporary tacking indicated?
It is used young puppy entropion cases as a temporary fix to delay sx until they are older
How is temporary tacking performed? [what style of suture?]
non-absorbable vetrical mattress sutures
What are the key features of Brachycephalic Ocular Syndrome (BOS)? [theres 8]
Key features include:
* Macroblepharon
* Lagophthalmos
* Reduced corneal sensation
* Medial entropion
* Tear overflow
*hairy caruncle
*corneal ulceration
*nasal folds with trichiasis
what is macroblepharon?
large eyelid openings
what is lagopthalamus
prevention of eyelids form fully closing
What surgical treatment is used for BOS?
Medial canthoplasty, which corrects medial entropion and shortens length of palpebral aperture and allows full eyelid closure.
What is a chalazion?
A firm, cream-colored swelling on the conjunctival surface due to a blocked Meibomian gland duct.
How is a chalazion treated?
Treatment includes:
* Warm compresses
* Incision and curettage if symptomatic
* Topical antibiotics
* Oral NSAIDs
What is a hordeolum?
A bacterial infection of the glands of the eyelids AKA stye
what are the two types of hordeolum and what gland(s) do they affect?
internal- meibomian gland
external- gland of zeis or moll
What is the most common eyelid tumours in dogs?
tarsal gland adenoam
[tarsal gland=mebomian gland]
What are common eyelid tumors in dogs?
Common tumors include:
* Tarsal gland adenoma
* Melanoma
* Viral papilloma
* Histiocytoma
what are features of a tarsal gland adenoma?
-lobulated, warty, cauliflower appearence
-slow growing
-removal not required unless irritating
What is the maximum eyelid margin excision that can be closed without tension?
1/3 of eyelid margin
what suture technique should be used for corneal margin closure?
Figure of 8 suture, which keeps the knot away from the cornea.
describe the technique of a figure of 8 suture
does the nictatating membranes have muscle control?
no
[therefore, their protrusion si awlays due to something else ex globe retropulsion]
What is the name of the forceps that can be used to examine the nictitating membrane?
bennett’s cilia forceps
What are causes of third eyelid (TEL) protrusion?
Causes include:
* Retrobulbar masses
* Globe retraction
* reduction in size of Orbital content
*alteration to nerve control
How is prolapsed nictitans gland (‘cherry eye’) treated?
describe the technique
Morgan pocket technique
create an incision on either side of the gland. suturng the edges of the incision will create a pocket: prolapsed gland will be buried within the pocket
What is nictitans plasmacytic conjunctivitis (plasmoma)?
A plasma cell infiltration of the third eyelid
breed predisposition to nictitans plasmacytic conjunctivitis (plasmoma)?
GSDs and collies.
How is nictitans plasmacytic conjunctivitis treated?
It is treated with long-term topical cyclosporine.
Which surface of the thirdeyelid is a common place for foreign body retention?
posterior surface
