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Ophthalmology > Unit 2 - Feline Ophthalmology > Flashcards

Unit 2 - Feline Ophthalmology Flashcards

1
Q

What are the general practices that you should maintain for a feline ophthalmic exam (room, restraint)?

A

Quiet room that can be darkened

Gentle restraint on the exam table and ‘less is more’ approach

If not compliant, wrap patient in a towel

Have assistant elevate rear end for you to view ventral cornea

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2
Q

What is the normal STT in cats?

A

> 9 mm/min

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3
Q

What is the preferred device to test IOP in cats?

A

TonoVet

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4
Q

If you need to use atropine in a cat, what form should you use? Why?

A

Use atropine ointment to minimize hypersalivation

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5
Q

When shouldn’t timolol be used in cats?

A

Cats with asthma - be careful regardless

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6
Q

What orbital condition results in a grave prognosis for a cats eye?

A

Proptosis

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7
Q

Eyelid agenesis causes what in cats?

A

Trichiasis and keratitis

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8
Q

What is the most common eyelid neoplasia in cats?

As a generality, are feline eyelid neoplasias typically benign or malignant?

A

SCC

Malignant > benign

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9
Q

What lacrimal conditions do brachycephalic cats typically get?

A

Fucntional nasolacrimal obstructions

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10
Q

What virus causes a lack of tear production in cats?

A

FHV-1

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11
Q

What is the most common cause of cataracts and lens luxation in cats?

A

Uveitis

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12
Q

What clinical signs are associated with feline conjunctivitis?

A

Blepharospasm

Tearing/discharge

Conjunctival redness +/- swelling (chemosis)

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13
Q

What is the common cause of conjunctivitis in cats (general)?

A

Primary pathogens are common

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14
Q

What primary pathogens are common causes of feline conjunctivitis?

A

Chlamydia felis

Mycoplasma felis and gatae

Feline herpesvirys-1

Calicivirus

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15
Q

What individuals are especially susceptible to feline conjunctivitis?

A

Young, immunosuppressed, sick, or stressed cats at highest risk

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16
Q

T/F: Feline conjunctivitis is one of the few conditions that can be treated with topical steroids.

A

False - do not, no bueno

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17
Q

What are the bacterial causes of conjunctivitis?

A

Chlamydia or Mycoplasma

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18
Q

What does bacterial conjunctivitis look like?

A

No corneal changes; more chemosis

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19
Q

How do you treat bacterial conjunctivitis?

A

Topical antibiotics - TID-QID: erythromycin, tetracycline, chloramphenicol, ciprofloxacin or ofloxacin

Systemic treatment - Doxycycline

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20
Q

What is the most common cause of feline conjunctivitis and keratitis/ulcers?

A

Feline herpesvirus-1

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21
Q

What cases of FHV-1 conjunctivitis require treatment?

A

More severe conjunctivitis

Concurrent keratitis or corneal ulceration

Severe rhinosinusitis, pneumonia, or dermatitis

Frustrated owners

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22
Q

How is FHV-1 conjunctivitis treated?

A

Antivirals:

Topical: Cidofovir 0.5% 1 drop BID or Idoxuridine 0.1% 5-6 times daily

Systemic: Famcyclovir 90 mg/kg po BID

Reduce stress, avoid steroids, nursing care

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23
Q

What systemic antiviral should not be used for FHV-1 conjunctivitis treatment?

A

Valacyclovir

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24
Q

How long should FHV-1 conjunctivitis be treated?

A

At least 2 weeks past resolution of clinical signs

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25
Q

What are ‘other’ FHV therapies?

A

Treat other issues

Analgesic

Immune boosting supplement

Proniotic

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26
Q

What used to be the old gold standard for the treatment of FHV-1 conjunctivitis?

A

Lysine

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27
Q

What is a possible complication of FHV1 conjunctivitis?

A

Symblepharhon

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28
Q

What is symblepharon?

A

Conjunctival +/- corneal adhesions

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29
Q

Why don’t you want to treat feline conjuntivitis with steroids?

A

It can make the infection worse

Remember: dogs can get allergic conjunctivitis, but cats do not

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30
Q

What are the causes of corneal ulceration?

A

FHV-1

Trauma - abrasions, cat stratch

Adnexal diseases (entropion)

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31
Q

How are corneal ulcers treated?

A

Topical antibiotic TID-QID: Erythromycin, oxytetracycline, chloramphenicol, tobramycin, ciprofloxacin, ofloxacin

+/- Atropine ointment SID-BID

+/- Pain medication

Antiviral tx if FHV-1

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32
Q

What topical antibiotics are not recommended for corneal ulcer treatment in cats?

A

Neomycin/polymyxin drugs

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33
Q

When should corneal ulcers be rechecked after treatment has been initiated?

A

3-5 days

34
Q

When should corneal ulcers heal?

A

Within 7-10 days

35
Q

What should you do in cases of non-healing superficial ulcers?

A

Look for a persisting cause

Debride loose epithelium with sterile dry cotton swab

Diamond burr or superficial keratectomy (NO GRID)

36
Q

When is culture and cytology indicated in corneal ulcer cases?

A

If they are infected or melting

37
Q

What is the recommended treatment for infected or melting ulcers?

A

Aggressive treatment - frequent antibiotics, serum 6-8x daily, atropine SID-BID, and systemic NSAID +/- analgesic

38
Q

When should infected or melting ulcers be rechecked?

A

In 1-2 days

39
Q

What is a corneal sequestrum?

A

A necrotic area of the cornea

40
Q

What clinical signs/findings are associated with corneal sequestrium?

A

Brown to black, round to oval lesion in central/paracentral cornea

Variable signs of pain

Variable corneal vascualrization and edema

41
Q

What breeds are predisposed to corneal sequestrum?

A

Persian, Himalayan, burmese

42
Q

What can cause corneal sequestrum?

A

Heredity - Brachycephalics

Non-healing ulcer

Chronic irritation

FHV-1

43
Q

How are corneal sequestrum diagnosed?

A

Appearance

44
Q

How is corneal sequestrum treated?

A

Possibly benign neglect

Keratectomy surgery +/- graft

Medications (abx, lubricant, antiviral?)

45
Q

T/F: Corneal sequestrum can recur or happen in the opposite eye

A

True

46
Q

What clinical signs/findings are associated with eosinophilic keratitis?

A

Proliferative pinkish-white, vascularized lesion

Not usually painful

May be edematous or irregular

Starts near limbus

Unilateral or bilateral

47
Q

What is the cause of eosinophilic keratitis?

A

Immune-mediated

Suspect FHV-1

48
Q

How is eosinophilic keratitis diagnosed?

A

Corneal cytology - eosinophils +/- mast cells

49
Q

How is eosinophilic keratitis treated?

A

Topical - steroid (pred acetate or dex sp), cyclosporine A or tacrolimus BID, megestrol acetate antiviral

Systemic - L-lysine

50
Q

What is the Sebbag protocol for eosinophilic keratitis?

A

SQ triamcinolone acetate 0.2 mg/kg + topical cidofovir + topical tacrolimus

51
Q

What is acute bullous keratopathy?

A

Spontaneous edema (DM rupture)

52
Q

How is acute bullous keratopathy treated?

A

Stabilize cornea to prevent rupture - corneal graft or third eyelid flap (2-3 weeks)

Abx and 5% NaCl meds

53
Q

What is the prognosis for acute bullous keratopathy?

A

Good

54
Q

What may be a risk factor for acute bullous keratopathy?

A

Cyclosporine or steroid use

55
Q

What clinical signs/findings are associated with feline uveitis?

A

Enophthalmos, third eyelid elevation, photophobia

Conjunctival and episcleral injection

Corneal edema, ciliary flush, keratic precipitates

Aqueous flare +/- fibrin and cells

Miosis and iris changes

Fundus changes

low IOP

56
Q

What are the causes of uveitis?

A

Infectious

Immune-mediated - chronic lymphoplasmacytic uveitis

Neoplasia - lymphosarcoma

Trauma

Idiopathic

57
Q

What work-up is recommended for uveitis cases?

A

complete ocualr exam and diagnostics

complete physical exam

Diagnostic tests - CBC, chemistry, UA, BP, infectious disease testing, LN aspirate and cytology, radiographs, ocular ultrasound

58
Q

What is the recommended therapy for uveitis?

A

Address underlying cause if identified

Topical therapy - prednisoolone acetate, atropine

Systemic therapy - NSAID or prednisolone, doxycycline

59
Q

How long should you treat uveitis for?

A

At least 2 weeks past resolution of clinical signs

60
Q

What is the recommended course of treatment for end-stage uveitis?

A

Enucleate irreversibleblind eyes

61
Q

What is diffuse iris melanoma?

A

Progressive iris pigmentation - malignant melanoma

62
Q

What is the common signalment for melanosis?

A

middle-aged to older cats

63
Q

What should be monitored to determine if it is a diffuse iris melanoma or melanosis? How often?

A

Monitor progression/extent, surface dusting, extension into iridocorneal angle, pupil changes, intraocular pressure

Monitor every 3-6 months

64
Q

How is diffuse iris melanoma treated?

A

Diode laser (early)

Enucleation - preanesthetic imaging, ocular histopathology

65
Q

What concerning ocular findings are indicative of diffuse iris melanoma?

A

Iris swelling or dyscoria

Pigment cells in aqueous humor or on lens

Rapid pigment progression

Glaucoma

66
Q

Why should you not put traction on the globe during an enucleation in a cat?

A

You could damage the optic nerve or chiasm resulting in blindness in the ‘good eye’

67
Q

When performing a cat enucleation, what do you need ot make sure to remove?

A

All secretory tissues - don’t want a postop cyst

68
Q

What are the causes of feline glaucoma?

A

Uveitis

Lens luxation

Neoplasia

69
Q

What is aqueous misdirectio syndrome?

A

A rare syndrome that causes feline glaucoma where aqueous humor moves posteriorly into the vitreal cavity

70
Q

What clinical signs and findings are associated with aqueous misdirection syndrome?

A

Older felines with increased IOP

Anisocoria

Shallow anterior chamber

71
Q

How is aqueous misdirection syndrome treated?

A

Dorzolamide +/- Timolol (BID-TID)

Possible surgery

72
Q

What is the signalment for hypertensive retinopathy?

A

Older cats - >10 years

73
Q

What are the clinical signs/findings associated with hypertensive retinopathy?

A

Dilated pupils

Acute vision loss

Hyphema

Retinal hemorrhage

Retinal detachment

Subtle retinal cobblestone appearance if fluctuating detachments

74
Q

What are the causes of hypertensive retinopathy?

A

Kidney disease

Hyperthyroidism

Heart disease

Endocrine disease

Primary hypertension

75
Q

T/F: You should always perform a 30 second ophtho exam during all PEs

A

True

76
Q

How is hypertensive retinopathy diagnosed?

A

Visible ocular/retinal changes

Systolic pressure of >160 mmHg

CBC/Chem/T4/UA

77
Q

How is hypertensive retinopathy treated?

A

Amlodipine

+/- topical steroid if hyphema

Address underlying disease

78
Q

What causes toxic retinal degeneration?

A

Systemic enrofloxacin

79
Q

What clinical signs are associated with toxic retinal degeneration?

A

Dilated pupils

Acute blindness

80
Q
A

Ophthalmology (13 decks)

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