Test 2: lecture 25 lacrimal

Question 1

lacrimal glands found — in the eye

Answer 1

above- orbital lacrimal gland
gland of third eyelid

Question 2

tear film is made by

Answer 2

lacrimal glands
meibomian glands
conjunctival goblet cells

Question 3

dry eye

Answer 3

KCS

Question 4

function of tears

Answer 4

nourish, lubricate and clean cornea

optical clearity

antibacterial

Question 5

tears are a trilaminar fluid made of

Answer 5

meibomian gland: lipid outerlayer
lacrimal: watery layer
conjunctival goblet cells: mucus

Question 6

aqueous layer is made by — glands

Answer 6

orbital lacrimal gland and
gland of third eyelid

Question 7

— layer of the tear film feeds the avascular cornea and lubricates and cleanses the eyeball

Answer 7

aqueous

made by the orbital lacrimal gland and gland of third eyelid

Question 8

meobomian glands makes — that will —

Answer 8

chosterol waxy lipid

prevent evapotation of aqueous layer (lacrimal gland)

lipid layer and mucin layer help stabilize tear film

Question 9

conjunctival goblet cells will make — that promote — and trap—

Answer 9

mucin

smooth ocular surface

bacteria and foreign material

lipid layer and mucin layer help stabilize tear film

Question 10

drainage of tears

Answer 10

puncta x2
canaliculi x2
converge at lacrimal sac
nasolacrimal duct
nasal puncta

Question 11

dry eye is called

Answer 11

KCS
keratoconjunctivitis sicca

Question 12

KCS is caused by low—

Answer 12

aqueous layer (lacrimal gland not working)

cause desiccation, inflammation of conjunctiva and cornea, pain, ulcers, discharge, melanin pigmentation and vascularization

Question 13

what causes dry eye

Answer 13

immune mediated damage of lacrimal glands

breed associated: little white dogs

Question 14

besides for immune mediated, what else can cause dry eye

Answer 14

radiation

infectious disease- feline herpes and distemper

removal or 3rd eye lid, which has one of the lacrimal glands

loss of PARA innervation to the gland: neurogenic KCS

Question 15

how to measure tear production

Answer 15

schirmer tear test

measures aqueous tear production

cats can have low results

Question 16

treatment of dry eye

Answer 16

eyedrops
treat underlaying condition
cyclosporine/optimmune or tacrolimus

pilocarpine for neurogenic KCS- stimulates PARA to eyelid

Question 17

prognosis of KCS

Answer 17

good if you treat- may need to give artifical tears for life

but if you leave untreated, can cause scarring, pigmentation and blindness

Question 18

parotid duct transposition

Answer 18

move parotid so “spitting into eye”

surgical treatment for KCS

Question 19

Answer 19

meibomian gland disease- issue with lipid layer of tear

-tears evaporate

-will look like KCS, but SST normal cause aqueous production is normal

will form yellow lipid clumps/accumulations

Question 20

abnormalities of the goblet cells will cause

Answer 20

loss of mucin layer- tears can’t adhere to eyes (loss of tear film stability)

clinical signs and treatment similar to KCS

can be caused by feline herpes or chronic conjunctivitis

Question 21

— can cause mucin abnormalities

Answer 21

feline herpes
chronic conjunctivitis

attacks goblet cells in the eyelid- leading to mucin abnormalities and loss of tear film stability

Question 22

how to measure tear film stability

Answer 22

tear film break up time (TBUT)

place stain, and time for dry spots

normal less then 20 secs

Question 23

— is tear overflow

Answer 23

epiphora

Question 24

how to check for drainage of the tears

Answer 24

jones test
add stain and see if it comes out of the nose

Question 25

interior punctum occluded is called

Answer 25

imperforate
micro-punctum

can be congenital, stenosis from feline herpes or atresia

can do surgery to open

Question 26

dacryops

Answer 26

cyst in lacrimal duct

Question 27

dacryocystorhinography

Answer 27

image of lacrimal tract

Question 28

Hx:
* discharge OU x months

PE:
* blepharospasm
* sero-mucinous discharge
* conjunctival hyperemia

DX:
* STT (mm/min) OD:8, OS:10
* Jones test: positive OU
* fluorescein stain: negative OU

Q1 . what is your diagnosis?
Q2. what is your initial treatment plan?

Answer 28

dog normal SST 15-25

dry eye- KCS

give eye drops: cyclosporine or tacrolimus

neoploydex BID OU
artificial tears