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Opthalmology > The blind eye > Flashcards

The blind eye Flashcards

1
Q

What are the causes of blindness?

A
  1. symblepharon
  2. keratitis
  3. uveal disease
  4. cataracts
  5. glaucoma?
  6. posterior segment disease (vitreous, retina)
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2
Q

How can glaucomas cause blindness?

A

high intraocular pressure
neurodegenrative dz
progressive and ultimately kleads to blindness

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3
Q

What is symblepharon?

A

condition where there is adhesion of conjunctival tissue to another conjunctival surface or the cornea

mostly seen in kittens and feline herpesvirus type 1

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4
Q

What is pigmentary keratophathy?

A

pigment on the cornea
secondary to entropion, trichiasis, euryblepharon

common in brachycephalic

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5
Q

What are the clinical signs of uveitis?

A

flare on tyndall effect
hypopyon (WBC)
hyphema (blood)
synechia (anterior, posterior)
decreased IOP unless chronic (increased)

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6
Q

What are potential causes for hyphema?

A

don’t assume trauma unless injury observed

lung worm dz
systemic hypertension
immune-mediated thrombocytopenia, coagulopathy, intraocular neoplasia
infectious disease: ehrlichia, leishmaniasis

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7
Q

What are the 2 types of sequelae?

A

anterior synechia: corneal perforation causing adhesion of the iris to the cornea

posterior synechia: adhesion of iris to the lens

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8
Q

What is persistent pupillary membranes PPMs?

A

developmental abnormalities that should have regressed
originate strands from the iris collarete
can cause corneal or lens opacity

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9
Q

What are potential complications of uveitis?

A
  • corneal oedema
  • cataracts
  • synechiae
  • pre-iridal fibrovascular membranes
  • retinal detachment
  • lens luxation
  • glaucoma
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10
Q

What are the causes of uveal disease?

A
  • systemic hypertension
  • infectious (viral, parasitic, fungal, bacterial)
  • immune-mediated
  • neoplastic
  • complicated ulcers/reflex uveitis
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11
Q

What are primary and secondary causes for uveal disease?

A

primary: opthalmic causes (complicated ulcer, FB, etc.)

secondary: systemic causes (infl., hypertension, idiopathic, etc.)

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12
Q

How do we treat uveal disease?

A

TREAT CAUSE
start systemic anti-inflammatories if possible
topical anti-inflammatory tx

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13
Q

What are the systemic non-steroidals and steroids we can give as systemic anti-inflammatory for uveal dz?

A

non-sterioidal” carprofen, meloxicam
steroid: prednisolone

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14
Q

What are the types of topical anti-inflammatory tx we give for uveal dz?

A

steroid eye drops: prednisolone acetate, dexamethasone phosphate
cycloplegics: atropine/cyclopentolate
(stop spasms of the ciliary body)

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15
Q

What are the possible ophtalmic findings of animals with hypertension?

A

intraocular haemorrhage
bullous retinal detatchment
iridal haemorrhages
tortuosity of retinal vessels

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16
Q

What is equine recurrent uveitis (ERU) ?

A

heterogenous disease
nonspecific immune mediated
leading cause of blindness in horses
peak initial uveitis episode at 4-6y/o
warmbloods, draft, european

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17
Q

What is the signs of classic ERU?

A

most common type
active inflammatory episodes followed by periods with minimal ocular signs

increasingly severe episodes of uveitis and progress to chronic signs

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18
Q

What are acute classic ERU signs?

A

miosis
iris hyperaemia/swelling
ocular pain
conjunctival hyperaemia
corneal oedema
fibrin in anterior chamber

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19
Q

What are the chronic signs of classic ERU?

A

atrophy
granular iridica
fibrosis iris
ICA
hyperpigmentation iris

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20
Q

What are the complications of classic ERU?

A

cataract
posterior synechia
glaucoma
phthisis bulbi

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21
Q

What are the clinical signs of insidious ERU?

A

minimal signs of ocular discomfort
low-grade immune response that continues and slowly progresses to chronic clinical signs ERU

appaloosa, draft breed
difficult to dx until severe chronic signs

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22
Q

What are the clinical signs of chronic insidious ERU?

A

ICA fibrosis
iris fibrosis
cataract formation
conjunctival hyperaemia
iris hyper pigmentation
granula iridica atrophy
synechia formation

23
Q

What are the clinical signs of posterior ERU?

A

subtle anterior uveitis (miosis)
vitreal opacities (pond-like reflexion of the vitreous)
retinal inflammation
retinal detachment or degeneration

24
Q

What is the first and second aim when tx ERU?

A

first: preserve vision
second: reduce and control ocular inflammation to limit permanent damage to the eye

25
Q

What are the medical tx for acute ERU cases?

A

topical steroids/NSAID
atropine
systemic anti-infl.

26
Q

What are the medical tx for severe chronic ERU cases?

A

subconjunctival or intravitreal injection steroids

27
Q

What are the 3 possible surgical tx for ERU?

A

suprachoroidal cyclosporine implants
pars plana vitrectomy (clears media/remove membranes)
enucleation

28
Q

What are the 2 ways cataracts can cause uveitis?

A

phacolytic: leaky lens (lens protein diffuse through intact lens capsule with chronic cataracts)

phacoclastic: ruptured lens (protein gets into eye via rupture of lens capsule)

29
Q

What are the 2 ways chronic uveitis can cause cataracts?

A

due to poor nourishment of the lens

altered chemistry of the aqueous humour

30
Q

What is the difference between direct illumination and retroillumination of cataracts?

A

direct illumination: cataract will look fully white

retroillumination: shadow/dark from behind the opacity

31
Q

What type of cataracts interfere with sight and cause blindness?

A

incipient, immature and mature interfere with sight

mature only will cause blindness

32
Q

What are the 7 causes for cataracts?

A

inherited
congenital
traumatic
metabolic
nutritional
progressive retinal atrophy
senile

33
Q

Where do congenital cataracts form?

A

always nuclear

34
Q

What are causes of traumatic cataracts?

A

FB
cat scratches

35
Q

What type of uveitis can be induced by traumatic cataracts?

A

phacoclastic uveitis
tear can cause a FB reaction = need to remove the lens material w/ cataract surgery to stop chronic uveitis

36
Q

What causes metabolic cataracts?

A

diabetic cataractogenesis

glucose is small enough to difuse into lens capsule from aqueous humour
its made into sorbitol, too big to leave lens
draws water in w/ osmosis, lens can eventually rupture

37
Q

What are nutritional causes for cataracts?

A

uncommon now
puppies and kittens fed inappropriate milk replacementrs, deficiency of essential amino acids

38
Q

How does progressive retinal atrophy cause cataracts?

A

secondary to retinal degeneration
degenerating retina releases toxins which cause cataracts

39
Q

What is often affected with senile cataracts?

A

the cortex is generally affected
wedge shaped
if small might not occlude vision

40
Q

What are vitreal diseases causing blindness?

A

persistent hyaloid artery and primary vitreous

cataracts +/-

41
Q

What are retinal diseases that can cause blindness?

A

retinal dysplasia
progressive retinal atrophy
retinal toxicity: high dose enrofloxacin in cats
acute retinal diseases (Sudden acquired retinal degeneration syndrome and immune-mediated retinopathy)

42
Q

What are the 3 main types of retinal dyplasia and what breeds are prone?

A

retinal folds
geographic
retinal detachment (severe)

CKCS, ESS

43
Q

What is progressive retinal atrophy PRA?

A

inherited degenerative disease of the retina causing night blindness and eventually day blindness

can lead to cataracts but can’t get sx to tx it

44
Q

What can inidcate progressive retinal atrophy in an ophtalmic examination?

A

clinical hx
breed

hyperreflective tapetum (thinning of retina)
vascular attenuation (thinning retinal vessels)
late stage: cataracts

45
Q

What drugs are toxic to retinas in cats?

A

high dose enrofloxacin
even at current recommended doses
can also cause neuro signs

** all fluoroquinolones to be used with caution but no retinal toxicity is reported w/ pradofloxacin!

46
Q

How can we diagnose sudden acquired retinal degeneration syndrome SARDS?

A

acute/subacute vision loss
PLR may or may not be present
ophtalmic exam unremarkable
diagnostic test: electroretinography!! (shows there is no response in retina)

47
Q

What are the 2 types of retinal detachment?

A

inflammatory: retina pushed by fluid (bullous, seagull shape)

disindertional: retina loses peripheral attachments (rhegmatogenous)

48
Q

What are the causes for optic neuritis?

A

meningoencephalitis of unknown origin/aetiology (MUOA)

infectious dz: distemper, ehrlichia, crypto,…

49
Q

What is the most common neoplasia of the optic nerve?

A

meningioma

50
Q

What are the signs of optic neuritis?

A

hyperaemia of the papilla
vascular congestion
peripapillary hemorrhages

51
Q

What is Collie Eye Anomaly (CEA)?

A

combination of choroidal hypoplasia and optic nerve head coloboma

can develop retinal detachment, hyphema, vitreal haemorrhage

52
Q

What are the causes of blindness?

A

glaucoma: high intraocular pressure

eyelid abnormalities: symblepharon

corneal abnormalities: pigmentation

uveal disease: hypopyon, hyphaema

catarcats

retinal and optic nerve diseases

53
Q
A

Opthalmology (10 decks)

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