optho 1

Question 1

Answer 1

pigmented meibomian gland adenoma

Question 2

eyelid neoplasia in dogs

Answer 2

95% benign, mostly meibomian adenoma
will grow fast, can cause chalazion

Question 3

eyelid neoplasia tx

Answer 3

1. monitor
2. complete excision under GA
   - wedge resection (remove up to 25%)
3. cryotherapy (triple freeze thaw)-> can recur
   - place chalazion clamp and cut, cautery

Question 4

Answer 4

individual, pedunculated
melanocytoma (2nd most common)
can be single or multiple
slow growing-> monitor, sx (curative), cryotherapy

Question 5

Answer 5

histiocytoma-> central erosion, hair loss
benign, young dogs-> will regress

Question 6

Answer 6

SCC, ulcerative
white cats, older
locally aggressive, low mets, erosive

Question 7

SCC tx

Answer 7

cryotherapy, sx (poor success)

Question 8

focal blepharitis

Answer 8

chalazion-> chronic lipid granuloma (blocked meibomian gland)
tx- monitor or lance and drain

hordoleum-> infected gland, monitor if non painful
lance, warm compress, systemic meds

Question 9

diffuse blepharitis

Answer 9

bacterial-> juvenile cellulitis/pyoderma
big facial LN
tx- pred, cephalosporin

atopic, parasitic, drugs, autoimmune (discoid lupus, pemphigus, uveodermatologic syndrome)

Question 10

Answer 10

eyelid agenesis- lateral upper lid
keratitis, exposure

tx- ocular lube, cryoepilation of hair follicle
surgery (ugly)-> lip to lid procedure

Question 11

entropion

Answer 11

rolled in eyelid, causes ulcer (pigmentation, scarring, vascularization)

Question 12

primary entropion

Answer 12

developmental, breed disposition
tx- temporary tacking, hotz-celsus 6-16wks

Question 13

spastic entropion

Answer 13

secondary to ocular pain (ulceration)
tx underlying problem

Question 14

cicatricial entropion

Answer 14

secondary to scar from trauma or chronic spasm
requires advanced releasing techniques

Question 15

trichiasis, distichiasis, ectopic cilia

Answer 15

-normal hair rubbing
- hair from meibomian gland (both lids), 4-6m, can cause ulceration
tx- cryoepilation
- 12 oclock position of upper lid, tx w en bloc resection

Question 16

Answer 16

prolapsed nictitans membrane (cherry eye)
weak CT attachment to sclera-> decreased tears
tx- sx (morgan pocket)

Question 17

Answer 17

scrolled cartilage of 3rd eyelid, vertical part has 180 degree turn
cosmetic tx- remove cartilage piece, cautery

Question 18

Answer 18

KCS- dry cornea, cloudy, thick dc, blood vessels
lack of tear film production

Question 19

KCS C/S, dx, causes, tx

Answer 19

squinting, redness, mucopurulent dc, keratitis (ulcers, pigmentation)
dx- schirmer tear test (<10)
causes- idiopathic (most common, autoimmune lacrimal adenitis),
congenital,
infectious (distemper)
neurogenic (CN V corneal sensation), xeromycteria
radiation, GA
drugs (sulfas, atropine)

Question 20

feline KCS

Answer 20

difficult to diagnose, no autoimmune cause
FHV-1 (chronic infection)-> tx underlying disease

Question 21

KCS tx

Answer 21

cyclosporine A (optimmune)-> T cell suppression q12 *take 4-12wks

tacrolimus 2nd line
artificial tears, topical abx, steroid
pilocarpine for neurogenic (topical 3x/d, systemic 2 drops/kg q12)

sx- parotid duct transposition