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BVetMed4 - Optho > The Opaque Eye (Cornea) > Flashcards

The Opaque Eye (Cornea) Flashcards

1
Q

What causes “blue eye”?

A

ADENOVIRUS

Inflammation affects endothelium

CORNEAL OEDEMA

Can be reversible in some cases

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2
Q

When might a corneal ulcer NOT stain with fluorescein?

A

Descemetocoele

  • No longer stroma present to take up dye
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3
Q

Where should you apply fluorescein?

A

Sclera not cornea

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4
Q

Describe the typical appearance of a superficial ulcer

A

Cornea relatively clear with small focal area of oedema by lesion

Lesion stains +ve fluorescein

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5
Q

Describe the appearance of a deep stromal ulcer with descemetocele

A

Completely cloudy eye
Diffuse corneal oedema

Lesion doesn’t stain with fluorescein

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6
Q

What causes dendritic ulcers in cats?

A

Herpes

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7
Q

What is the Seidel test?

What is it used for?

A

Clear stream of aqueous is visible on the fluorescein covered cornea

For the detection of perforating corneal injuries with active aqueous leakage

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8
Q

When should you do cytology?

A

If suspicious of a bacterial infection or want to do PCR

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9
Q

Where on the cornea is healing better?

Why?

A

Periphery

Vessels arise from limbus so get there faster

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10
Q

What part of the cornea does not regenerate?

A

Endothelium

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11
Q

What are the key factors involved in corneal healing?

A

Vascularisation
Stroma - proliferation of keratinocytes
Endothelium (does not regenerate)

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12
Q

What can cause ulcerative disease?

A 
Scratch / FB
KCS 
Lid conformation e.g. if they don’t meet -dry
Mechanical irritation 
- trichiasis
-districhiasis
- ectopic cilia
Entropion/ectropion
Degenerative processes
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13
Q

When do you tend to see degenerative processes which affect the cornea?

A

Mineralisation - calcium, lipid

Older dogs
Endocrine disease
High fat diet
Breed predisposition - Beagles and CKCS

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14
Q

Which type or corneal degeneration is associated with pain?

A

Calcium mineralisation

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15
Q

Describe a grade 1 ulcer

A

epithelial defect

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16
Q

Describe a grade 2 ulcer

A

Persistent epithelial defect

SCCED

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17
Q

Describe a grade 3 ulcer

A

Non-progressive anterior stromal ulcer

18
Q

Describe a grade 4 ulcer

A

Deep progressive stromal ulcer

Descemetocele

19
Q

Describe a grade 5 ulcer

A

Corneal perforation and iris prolapse

20
Q

What can cause a superficial ulcer?

A

Scratch
KCS
Mineralisation with CALCIUM
SCCED

21
Q

What is SCCED

A

Spontaneous chronic corneal epithelial defect

Superficial ulcer which takes more than a week to heal

Indicates defect in stroma so not healing properly

22
Q

What animal should you NEVER burr and debride?

Why

A

CATS

Most ulcers caused by FHV so burring etc will put virus further into the stroma

23
Q

What treatment is indicated for dogs with SCCED

A

Debridement
Burring
Contact lens placement

24
Q

What are some sequelae to progressive corneal ulceration?

A

Bacterial invasion -> hypopion
Degradation of corneal stroma
Secondary uveitis due to AXON REFLEX - substance P leads to PG release and uveitis

25
Q

What is a melting corneal ulcer?

A

Droops over the edge
Looks yellow - collagenases

Caused by increased activity of MMPs proteinases and collagenases

26
Q

What activates a melting corneal ulcer?

A

Bacteria - Pseudomonas, Staph and strep

Fungi
Nutrophils
Cornea

27
Q

How would you treat a melting corneal ulcer?

A

Hourly treatment with anti collagenases and antibiotics

28
Q

How can you manage a corneal ulcer medically?

A

Antibiotics
Mydriatic cyclipegic - atropine
Anti-inflammatories

29
Q

How can you manage corneal ulcers surgically?

A 
Conjunctival graft 
Corneo-conjunctival transposition 
Corneal grafting 
- from donor 
- biologic collaenous grafting material 
- amniotic membrane
30
Q

What can cause corneal opacity as a result of NON-ULCERATIVE disease?

A

Superficial or deep keratitis:

Eosinophilic 
CSK
Corneal sequestrum 
Immune mediated keratitis 
Acute bullous 
Pigmentary Mineralisation
Fibrosis
31
Q

What animals get eosinophilic keratitis?

How is it diagnosed?

How do you treat it?

A

Cats and horses

Cytology
White cottage cheese like lesions on the cornea

Long term topical steroid use

32
Q

What is chronic superficial keratitis ?

A

Pannus
GSDs
Immune mediate keratitis
Will lead to complete corneal pigmentation if left untreated

Tx local immunosuppressants - optimmune

33
Q

What animals get corneal sequestrums ?

A

CATS ONLY

34
Q

What causes sequestrums?

A

Brachys
Decreased corneal sensation
Chronic irritation
FHV

Tear film abnormalities

35
Q

What cause would you consider if you saw BVs and pigmentation Bilaterally and affecting the same position of the eye?

A

Immune mediated

36
Q

What is the go to drug for immune mediated conditions / keratitis?

A

Optimmune

37
Q

What generally causes corneal oedema?

A

Breach of barrier of epithelium or endothelium

Swelling causes misalignment of fibrils
- CLOUDY CORNEA

38
Q

What conditions may result in corneal oedema?

A

Epithelial defect - ULCER

Endothelial degeneration

  • UVEITIS
  • GLAUCOMA
  • CHRONIC LENS LUXATION
39
Q

How long does it take for a small epithelial defect to heal?

A

24h

40
Q

How long does it take to re-establish thickness of epithelium ?

A

1 week

BVetMed4 - Optho (8 decks)

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