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My 2017 RUSVM SAM 2 > Opthomology > Flashcards

Opthomology Flashcards

1
Q

OD

A

right eye

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2
Q

OS

A

left eye

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3
Q

OU

A

both eyes

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4
Q

photopic

A

in well lit environment

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5
Q

scotopic

A

in a dark environment

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6
Q

retroillumination

A

using light that is shone into the eye to reflect against internal structures and highligt normal/abnormal features during the ophthalmic exam

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7
Q

retropulsion

A

applying light pressure to both eyes (through the eyelids) simultaneously with your index finger to detect for asymmetry.

This is useful for decrecting dz of the orbit or space occupying lesion behind the globe

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8
Q

corneal ulcerstion

A

disruption of the corneal epithelium & exposure of the corneal stroma

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9
Q

positive Jones test

A

application of fluorescein dye to the ocular surface which then appears at the nares.

This is a test of nasolacrimal patency

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10
Q

positive Seidel test

A

application of fluorescein dye to the ocular surface and subsequent appearance of aqueous humor leaking through dense fluorescein stain.

This test confirms corneal perforation

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11
Q

Specular reflection

A

the mirror-like reflection of light from the surface of the eye

Can be used to assess the health of the ocular surface

This reflection becomes disturbed when the surface is irregular

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12
Q

what is the gold standard for discerning depth when examing eye

A

slit lamp biomicroscope

  • requires a focused, narrow, bright, beam of light
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13
Q

what are the 3 types of vision tests

A

cotton ball test

photopic maze

scotopic maze

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14
Q

what do the menace response, PLR & dazzle reflex specfically identify?

A

the function of cranial nerves that also help assess for presence of vision

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15
Q

what are the tests of orbital symmetry

A

orbital palpation

dorsal view assessment

retropulsion

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16
Q

what doest retroillumination do

A

help visualize the deepest structures of the eye

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17
Q

what are the 6 cranial nerve assessments

A

palpebral reflex

menac response

PLR

dazzle reflex

oculocephalic reflex

corneal reflex

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18
Q

what nerves does the palpebral reflex check

A

CN V (afferent)

CN VII (efferent)

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19
Q

What nerves doe the menace response check

A

CN II (afferent)

CN VII (efferent)

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20
Q

What nerves does the pupillary light reflex (PLR) check

A

CN II (afferent)

CN III (efferent)

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21
Q

What nerves does the dazzle reflex check

A

CN II (afferent)

CN VII (efferent)

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22
Q

What nerves does the oculocephalic reflex check

A

Intact CN II*, peripheral & central vestibular components, CN III, IV & VI

*CN II does not need tofunction in order to elicit a positive oculocephalic reflex, though it is necessary to develop the reflex initially

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23
Q

What nerves does the corneal reflex check

A

CN V (afferent)

CN VI & VII (efferent)

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24
Q

What is considered the minimum database of testing for ocular disorders

A

STT

Fluorescein stain

Tonomety

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25
Q

how does fluorescein stain help with the dx & characterization of corneal ulceration

A

Jones test

Seidel test

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26
Q

what are the 2 types of tonometry

A

applanation

rebound

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27
Q

what does the Schirmer tear test do

A

assesses the aqueous portion of the tear film

  • 60 second test time

normal:

Dogs = >15mm wetting/minute

  • basal & reflex tearing

Cats = unpredictable-

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28
Q

what if fluorescein stain and how does it work

A

Hydrophilic dye that fluoresces green under cobalt blue light

Tear fluid - hydrophillic - will stain & needs to be flushed

Epithelium - hydrophobic - will not stain

Stroma - hydrophilic - will stain bright green

Descemet’s membrane - hydrophobic - will not stain

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29
Q

how is a corneal ulceration dx’d by fluorescein

A

if the corneal stroma is exposed by ulceration there will be uptake by stroma of fluorescein stain

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30
Q

what does the Jones test assess

A

nasolacrimal patency

  • patent lacrimal ducts will allow flow of fluoroscein dye from upper & lower punctum > lacrimal sac > nasolacrimal duct > nasal & pharyngeal openings

will see green coming from nares

  • blockag of this system could cause epiphora
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31
Q

What does a postive Seidel test confirm

A

corneal perforation

demonstrats aqueous leakin through fluorescein stain

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32
Q

what are the 2 types of tonometry

A

applanation & rebound

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33
Q

what do tonometers measure

A

intraocular pressure in mmHg

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34
Q

How is intraocular pressure interpreted

A

10-20 mmHg normal

should be < 25mmHg at all times

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35
Q

what would high or low IOP indicate

A

>25mmHg w/ vision loss = Glaucoma

Low IOP consistent w/ Uveitis

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36
Q

What is commonly seen in Bovine SCC

A

blepharitis

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37
Q

How can you tell if the cornea is damaged

A

specular reflection

38
Q

How does specular reflection assist in lesion localization

A

disturbance of the reflection indicates irregularity of the ocular surface

39
Q

bony orbit

A

A part of the adenexa, the conical bony structure that contains the eyeball and periobital cone

40
Q

periobital cone

A

Supportive cone like structure that contains the eyeball, extraocular muscles, fat, vessels, nerves, and fascia that reside within the orbit

41
Q

orbital ligament

A

Ligamentous structured that forms the lateral boundary of the bony orbit in cats and dogs

42
Q

exophthalmos

A

Abnormal protrusion of the eye from the orbit. The position is abnormal. The globe size is normal.

43
Q

Buphthalmos

A

Literally means “cows eye” that refers to the abnormal enlargement of the eyeball. For practical purposes, buphthalmos is only caused by glaucoma. The sizes is abnormal, the position is normal.

44
Q

enophthalmos

A

Abnormal recession of the eye within the orbit

45
Q

strabismus

A

Deviation of one or both eyes, so that both eyes are not directed at the same object

46
Q

Horner’s syndrome

A

Sympathetic denervation to the eye and ocular adnexa. There are four classic clinical signs:

enophthalmos

Ptosis - drooping of eyelid

Miosis

Protrusion of the third eyelid

47
Q

microphthalmos

A

A congenitally small and malformed globe

48
Q

phthisis bulbi

A

Acquired shrunken globe, most often from severe or chronic inflammation

49
Q

Proptosis

A

Anterior displacement of the globe such that the eyelids are caught behind the equator of the globe

50
Q

what do these skulls show

A

Species and breed differences in bony orbit structure

51
Q

What makes cat and dog orbits special

A

They have open orbits

The have an orbital ligament which forms the lateral boundary of the orbital rim

much shorter in cats giving their orbit more bony protection relative to the dog

52
Q

What are two features of brachycephalic dog skulls that are different th dolichocephalic skulls that make them are very susceptible to ocular disease

A

Orbital ligament Spans a greater portion of the orbital rim

Orbit is much shallower

53
Q

What are three disorders of globe position

A

exophthalmos

enophthalmos

strabismus

54
Q

What are three disorders of globe size

A

buphthalmos

phthisis bulbi

microphthalmos

55
Q

What are commonly associated clinical signs with exophthalmos

A

Third eyelid protrusion

Facial swelling

Soft palate bulging

Pain opening mouth

Fever

56
Q

What is the single most common mechanism of exophthalmos

A

Orbital volume imbalance

57
Q

What are the two most common conditions that cause exophthalmos

A

Orbital neoplasia - often malignant, slowly progressive, often non-painful

Orbital cellulitis/abscess - working dogs and stick chewers, acute onset, often painful

58
Q

when would exophthalmos be considered “normal”

A

In brachycephalic breeds

59
Q

What is this an example of

A

exophthalmos & lateral strabismus

60
Q

What is this an example of

A

buphthalmos

d/t glaucoma 2o to uveitis

61
Q

what is exophthalmos dx approach

A

Complete general and ophthalmic examination
tests of orbital symmetry
Oral examination
Complete blood count, Serum Chemistry
+/-Chest radiographs
Advanced imaging (CT and/or MRI)
Tissue sampling
Fine needle aspiration
Biopsy

62
Q

orbital neoplasia tx options

A

enucleation - removal of eye

exenteration - removal of the eye & all orbital contents

63
Q

orbital cellulitis/abscess 2 tx approaches

A

medical

sx

64
Q

common CS w/ enophthalmos

A

facial mm loss (unilat or bilat)

3rd eyelid protrusion

entropion

65
Q

3 common mechanisms for enophthalmos

A

orbital volume imbalance

active globe retraction

passive globe retraction

66
Q

common causes of enophthalmos

A

dehydration

emaciation or cachexia

myopathies

spce occupying lesions anterior to the globe

Ocular pain

horner’s syndrome

67
Q

don’t confuse enophthalmos with these 2 disorders of globe size

A

microphthalmos

phthisis bulbi

68
Q

what are congenital & acquired causes of strabismus

A

congenital:

normal variation (think pug heads)

siamese cats

hydrocephalus

acquired:

mechanical or n. dysfuntion of any rectus mm.

CN III - D, V & M rectus mm & v. oblique

CN IV - d. oblique

CN VI - retractor bulbi & L rectus

69
Q

what are 2 considerations for proptosis px

A

vision - poor (>75% blind d/t ON trauma)

globe retention - variable

if >3 rectus mm torn poor px

70
Q

what is 1 of proptosis complicatons

A

strabismus - medial rectus is shortest & most easily torn

71
Q

tarsus

A

The fibrocartilagenouslayer of the eyelid that contains the meibomonianglands (aka tarsal glands). This is the holding layer surgical eyelid closures

72
Q

Meibomian glands

A

These are glands within the tarsal layer of the eyelid that produce lipid, or, sebum, to the tear film. This is the outermost, or most external layer of the three-layered tear film

73
Q

Ptosis

A

drooping of the eyelids (most often evident by upper eyelid drooping) caused by sympathetic denervation to the eyelid.

74
Q

lagophthalmos

A

incomplete eyelid closure/coverage of the eyeball

75
Q

blepharospasm

A

Spasm of the orbicularis oculi muscle resulting in eyelid closure. AKA squinting

76
Q

trichiasis

A

Hairs growing from normal skin reach the corneal and/or conjunctival surface. Technically speaking, entropion causes trichiasis, however, trichiasisis most often used to describe hairs from the nasal folds (nasal fold trichiasis) that are directed toward the eye in brachycephalic dog breeds.

77
Q

distichia

A

cilia (eyelashes) which emerge from the Meibomian (tarsal) glands

78
Q

ectopic cilia

A

cilia (eyelashes) protruding through the palpebral conjunctiva. These hairs typically cause severe, intermittent pain and often cause corneal ulceration. They most commonly arise from the 12 o’clock eyelid position

79
Q

what are the 4 layers of the eyelid

A

Skin and reference points
Muscle

Tarsus and Meibomian glands
Conjunctiva

tarsus is fibrocartilaginous support for Meibomian glands

80
Q

main function of eyelid skin

A

sensory protection

81
Q

what are the clinically relevent eyelid muscles

what do they do

which CN innervates

what will dysfunction cause

A

Orbicularis oculi
Closes the eyelids like a zipper
CN VII (general somatic efferent) innervation
Dysfunction will cause lagophthalmos

Levator palpebrae superioris
Opens the upper eyelid
CN III (general somatic efferent) innervation
Dysfunction will cause ptosis

Müller’s muscle
Opens the upper eyelid
(General visceral efferent) sympathetic innervation
Dysfunction will cause ptosis

82
Q

how does the palpebral conjunctiva look relative to bulbar conjunctiva

A

slightly hyperemic

83
Q

what is the key concept to remember about entropion

A

This is an abnormal relationship of the eyein relation to the eyelids.
•
NEED TO IDENTIFY THE CAUSE OF THE IMBALANCE BEFORE TREATING!!!

84
Q

what are 2 etiologic catagories for entropion

A

Anatomic entropion –the eyelids are not appropriately conformed to the eye and its presence is unrelated to ocular pain
Hereditary
Acquired
Blepharospasmassociated entropion –Ocular pain stimulates active globe retraction and an altered eyelid to eye relationship.

85
Q

what is important to remember about hereditary entropion

A

Hereditary* -It is important to remember that dogs can ‘grow into their faces’. Permanent correction may not be necessary until 6-9 months of age

86
Q

what are the hereditary causes of anatomic entropion

A

Abnormal canthus
common in brachycephalic dogs

Abnormal palpebral fissure
Often too large/loose in hounds and giant breeds

Excessive facial folds

87
Q

what is the vicious cycle of blepharospasm associated entropion causes

A

Chronic ocular surface pain –from keratitis, conjunctivitis, or both >>>>
Entropion>>>>

Chronic ocular surface pain –from keratitis, conjunctivitis, or both>>>>
Entropion>>>>

88
Q

why do we care to differentiate anatomic & blepharospastic components

A

failure to assess the spastic comoponent can lead to over correction & ectropion

89
Q

How can we differentiate anatomic & blepharospasm entropion

A

take away the ocular pain that induces blepharospasm

90
Q

Now that you have identified the cause of the eye to eyelid imbalance, you need to determine if it is temporaryor permanent

T or F?

Why?

A

We wouldn’t want to permanentlyalter eyelid anatomy in an animal that has a temporaryproblem

Example: Entropion from dehydration-related enophthalmos

(septic dehydrated foals)

91
Q

what is the name of the tech for permanent correction of entropion

A

Modified Hotz-Celsus

92
Q
A

My 2017 RUSVM SAM 2 (8 decks)

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