Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ophthalmology > Uvea > Flashcards

Uvea Flashcards

1
Q

What are the parts of the uvea?

A
  • Iris
  • Choroid (with tapetum)
  • ciliary body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where is the choroid in relation to the retina?

A
  • It is posterior to it
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where does the iris sit?

A
  • In front of, and rests on the lens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the central opening of the iris?

A
  • Pupil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the role of the iris?

A
  • Controls amount of light entering the back of the eye with sphincter and dilator muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does a blue iris mean?

A
  • Lacks pigment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pupil type and PLRs in the dog

A
  • Round

- Strong consensual PLR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the main blood vessel in the iris?

A
  • Greater arterial circle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the pupillary ruff?

A
  • little projections from the center of the iris
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Equine pupil and PLR

A
  • Horizontal when constricted , round when dilated
  • Moderate consensual PLR
  • Corpora nigra seen in the superior (and inferior) pupil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Camelid pupil and PLR

A
  • Moderate consensual PLR

- Elliptical pupil with large plicating corpora nigra on upper and lower pupillary margins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cat pupil and PLR

A
  • Strong consensual PLR

- Vertical pupil when constricted and round when dilated by sympathetic input

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which CN is involved in constricting the cat pupil?

A
  • Parasympathetic CN III
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bird PLR and pupil

A
  • Round pupil
  • No consensual PLR
  • Hard to assess
  • Can’t menace
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Heterochromia

A
  • 2 colors in the iris or two colored eyes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of blood vessel in the iris is abnormal?

A
  • Blood vessels reaching towards the pupil

- The greater arterial vessel is normal around the peripheral iris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Can you normally see the ciliary body?

A
  • NO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where is the ciliary body?

A
  • At the posterior base of the iris
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What part of the ciliary body epithelium secretes aqueous?

A
  • Pars plicata
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the flat area between the ciliary processes and the retina?

A
  • Pars plana
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the choroid?

A
  • Vascular layer between the sclera (posterior) and the retina (interior)
  • Contains the tapetum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When is the choroid visible?

A

– In non-pigmented eyes (blue eyed animals)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Persistent pupillary membrane

A
  • Can be from the iris to the cornea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Significance of PPM

A
  • Residual and often incidental

- In some breeds it can cause cataracts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does a merle-merle cross mean for the eye?

A
    • Usually bad things

- We had an example with a hole in the iris, medial strabismus, and smaller eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Iris cyst - how can you differentiate from a uveal melanoma?***

A
  • It will transilluminate so that you can see the edge of the iris through it**
  • Usually perfectly round and delineated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Who gets iris cysts?

A
  • Goldens
  • Danes
  • American Bulldog
  • Any breed
  • Cats
  • Horses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When should you refer iris cysts?

A
  • If it’s a Golden Retriever, a Dane, or a Bulldog
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Corpora nigra cyst management

A
  • Should do treatment as it will impact vision
  • Diode laser ablation or aspiration/ablation
  • Needs an ophthalmologist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Iris cyst management

A
  • Usually don’t need anything

- However, if it’s a Golden Retriever, a Dane, or an American Bulldog, you should refer it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Iris atrophy signs

A
  • Holes or imperfect margin in the iris

- Non-responsive, mydriatic pupil in a visual eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Iris freckle appearance

A
  • Flat pigmented area

- Melanosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Importance of iris freckles

A
  • Does not interfere with iris function

- Does not alter iris architecture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Treatment for iris freckle in a cat

A
  • don’t need to do anything
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Diffuse iris melanoma in a cat appearance

A
  • Loss of iris architecture
  • Raised and velvety appearing
  • Often quite smooth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Treatment for iris melanoma in cats

A
  • It will metastasize through the iridocorneal angle

- Take the eye out ultimately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Possible consequences of iris melanoma in cats

A
  • Obstructs drainage angle
  • Results in glaucoma
  • Also metastasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Canine iris melanoma appearance

A
  • Can change the shape and function of the pupil

- May be swollen and distinct line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

% of benign/malignant iris melanomas in dogs

A
  • > 80% are benign but destroy the eye

- Hemorrhage/glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Limbal melanoma - who gets?

A
  • GSD

- Labradors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Age of limbal melanoma

A
  • MAY present at a young age
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Treatment for limbal melanoma

A
  • Surgical excision

- Diode laser

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Ciliary tumor - benign or malignant?

A
  • Most often benign
  • Usually adenoma; may be adenocarcinoma
  • Will destroy the eye
  • Want to find out if it’s gone anywhere else or came from somewhere else
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What forms the blood-eye barrier?

A
  • Uvea
  • Retinal vessels
  • Retinal pigmented epithelium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Function of blood-eye barrier

A
  • Protects the eyes from systemic disease and circulating toxins and drugs
  • Eye responds poorly to inflammation and lacks lymphatic drainage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

WHat is uveitis?

A
  • Intraocular inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is a consequence of uveitis?

A
  • Breakdown of the blood-eye barrier and allows protein and inflammatory cells to enter the eye through the uvea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Anterior uveitis - what’s involved?

A
  • Iris and ciliary body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Posterior uveitis - what’s involved?

A
  • Choroid/choroiditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Panuveitis

A
  • All structures closely related and all are affected to some degre
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Anterior uveitis appearance

A
  • Pain, injection, edema, inflammatory cells in the anterior chamber
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Chorioretinitis appearance

A
  • +/- pain, red eye, vision loss

- Subretinal infiltrate

53
Q

Clinical signs of anterior uveitis

A
  • PAIN!**
  • Blepharospasm
  • Miosis**
  • Photophobia
  • Conjunctival hyperemia
  • Episcleral injection
  • Corneal edema
  • Corneal vascularization
  • Low IOP***
54
Q

What is the IOP in uveitis vs glaucoma?

A
  • LOW in uveitis
55
Q

Main clinical features of anterior uveitis

A
  • Low IOP
  • Miosis
  • Painful eye
  • Flare!
56
Q

What is the first thing that will happen after uveitis starts?

A
  • Protein leaks from vessels into the aqueous

- Flare

57
Q

Flare

A
  • Protein in aqueous

- Seen with slit beam

58
Q

How can you differentiate corneal edema vs flare?

A
  • Flare is flecks that are seen best with a slit beam

- Corneal edema is blue and mottled

59
Q

What’s the 2nd step after proteins leak into the aqueous?

A
  • Inflammatory cells

- May appear as hypopyon or sparkles (KPs)

60
Q

Where do neutrophils go after they accumulate and settle?

A
  • Inferior anterior chamber

- This is hypopyon

61
Q

Keratic precipitants

A
  • Macrophages and lymphocytes adhered to the epithelium
62
Q

Rubeosis iridis

A
  • Vessels grow across the face of the iris perpendicular to the pupil
63
Q

How can hyphema occur with uveitis?

A
  • Fragile vessels in the iris can easily bleed and lead to hemorrhage
64
Q

Posterior synechia

A
  • Iris adhered to the lens
  • Pupil might not be able to move
  • Vessels grow over the iris and stick to the lens
65
Q

Iris bombe

A
  • Complete posterior synechia of pupillary margin to lens

- Aqueous trapped behind the iris and causes the iris to bulge forward

66
Q

Treatment for iris bombe and urgency of treating?

A
  • EMERGENCY SURGERY to create iris window allowing aqueous to enter anterior chamber
67
Q

Signs of chronic uveitis

A
  • Posterior synechia
  • Cataract
  • Pigment on anterior lens capsule
  • Secondary glaucoma
68
Q

Posterior synechia

A
  • Iris adheres to lens
69
Q

Anterior synechia

A
  • Iris adheres to cornea
70
Q

Causes of uveitis - two main categories

A
  • Primary ocular and systemic disease

- If you cannot find a primary ocular cause, look for a systemic cause

71
Q

General primary causes of uveitis?

A
  • Trauma
  • Corneal ulcer
  • Lens induced (cataract, lens perforation, lux or subluxation)
  • Intraocular tumor
  • Equine ERU
72
Q

Systemic disease causes of uveitis

A
  • Immune mediated
  • Infectious
  • Neoplasia
  • Coagulopathy
  • Hypertension
73
Q

When can the lens cause uveitis?

A
  • If it’s unstable (subluxated or luxated)
  • Cataract
  • Perforated
74
Q

Uveal melanoma

A
  • Primary ocular tumor

- Mostly benign but can lead to uveitis, hemorrhage, and secondary glaucoma

75
Q

Equine recurrent uveitis causes

A
  • Can be primary ocular cause of result of systemic disease

- Will become a primary, self-perpetuating, recurring uveitis

76
Q

What can cause hyphema in the anterior chamber?

A
  • Can be the result of or cause uveitis
77
Q

Dfdx for hyphema in the anterior chamber

A
  • Trauma
  • Coagulopathy or anticoagulant rodenticide
  • Immune-mediated
  • Neoplasia
  • Hypertension
78
Q

Diagnosing causes of hyphema

A
  • Check blood pressure
  • Clotting times
  • Platelets
79
Q

Treatment for hyphema secondary to uveitis?

A
  • Dilate pupil with atropine to reduce spasming
  • Prednisolone acetate
  • Address primary cause
  • Avoid NSAIDs
80
Q

Why avoid NSAIDs with treatment of uveitis?

A
  • May potentiate bleeding
81
Q

Golden Retriever Pigmentary uveitis - early signs?

A
  • Translucent ciliary cysts

- NOT SEEN UNLESS LOOKED FOR WITH A LIGHT AND MAGNIFICATION

82
Q

Course of disease with golden retriever pigmentary uveitis

A
  • Progressive

- Ultimately results in glaucoma and loss of the globe

83
Q

Clinical signs: golden retriever pigmentary uveitis

A
  • Minimal to no inflammation or pain (until you hit glaucoma)
  • Entropion uvea
  • Pigment dispersion on lens
  • Posterior synechia
  • Cataract development
  • Ultimate glaucoma and globe loss
84
Q

Treatment of golden retriever pigmentary uveitis

A
  • REFER EARLY
  • Medical management with SID Atropine and topical NSAID may delay progression of disease
  • Secondary glaucoma temporarily managed with dorzolamide and timolol
85
Q

End stage of golden retriever pigmentary uveitis

A
  • Glaucoma
86
Q

Immune mediated diseases that can cause uveitis

A
  • Lens induced uveitis
  • Idiopathic (steroid responsive)
  • Uveodermatologic syndrome
  • Feline lymphocytic-plasmacytic uveitis (most likely infectious)
  • Vaccine reaction
  • ERU
87
Q

Uveodermatologic syndrome - who gets

A
  • Akita, arctic breeds

- Miniature Aussies

88
Q

Clinical signs of Uveodermatologic syndrome

A
  • Often acutely affected and blind
  • VERY high pressure and painful
  • Disease of exclusion
89
Q

Uveodermatologic syndrome - pathophysiology

A
  • Immune system impacts melanocytes

- Results in ocular and cutaneous disease

90
Q

Treatment for Uveodermatologic syndrome

A
  • Often have to take the eye out

- Systemically will be immune suppressed

91
Q

Infectious diseases that can cause uveitis

A
  • Tick borne (RMSF, Ehrlichia, Borrelia)
  • Systemic mycosis (any of the ones we’ve learned about)
  • lepto
  • Brucella
  • Toxoplasma
  • Prototheca
  • CAV1
  • Bartonella
  • Herpes
  • Septicemia
92
Q

What is often the infectious etiology implicated with ERU?

A
  • Leptospirosis
93
Q

What are the most common bacterial infectious agents causing uveitis in rabbits?

A
  • Pasteurella and Staph are common infectious agents in rabbits causing dacryocystitis, dacryoadenitis, conjunctivitis, and uveitis
  • E. cuniculi needs to be ruled out too
94
Q

How does E. cuniculi cause uveitis?

A
  • Parasite within the lens –> rupture –> granuloma –> uveitis
95
Q

Treatment for E. cuniculi

A
  • Remove the eye
96
Q

Neoplasias that can cause uveitis?

A
  • Metastatic ones include:
  • LSA
  • Histiocytic sarcoma
  • HSA
  • MSA
  • Multiple myeloma
  • Adenocarcinomas
97
Q

Typical appearance for lymphoma in the eye

A
  • Nodular, cellular infiltrate in the iris
  • Can cause hemorrhage in the retina
  • Look at the lymph nodes first
98
Q

Treating the eye in a case with neoplasia?

A
  • Must do, especially in the case we talked about with lymphoma
99
Q

Patient work up for uveitis in dogs

A
  • PE
  • CBC/Chem/UA
  • Tick titers
  • Fungal screen
  • Lepto/Brucella/Toxo titers
  • Rule out systemic disease with chest rads and abdominal ultrasound
100
Q

Treatment for immune-mediated disease underlying uveitis

A
  • Steroids - topical and systemic

iF ASLL TESTS ARE NEGATIVE ONLY

101
Q

Uveodermatologic syndrome diagnosis and treatment for uveitis

A
  • SKin biopsy

- Topical and systemic prednisolone

102
Q

Infectious disease diagnosis and treatment for uveitis

A
  • Identify agent and treat accordingly
103
Q

Neoplasia treatment for uveitis

A
  • Chemotherapy depending on the type of cancer I’m guessing
104
Q

General treatment principles for uveitis

A
  • Topical prednisolone acetate 1% OR NSAIDs if inappropriate (topical and systemically)
  • Atropine
  • Possible systemic antibiotic depending on underlying disease
  • Possible topical antibiotics
105
Q

How often to give pred acetate and what must you rule out before giving?

A
  • 1 drop every 4-8 hours based on severity
  • Inflammation MUST be controlled
  • MUST RULE OUT CORNEAL ULCER
106
Q

How does pred acetate help with uveitis?

A
  • Penetrates cornea and enters anterior chamber
  • Do not use with corneal ulcer
  • Decreases inflammatory response
107
Q

When to do systemic NSAIDs or prednisone in dogs with uveitis?

A
  • If infectious disease is ruled out or being treated

- Might try topical treatment first

108
Q

NSAIDs - when to use for anterior uveitis?

A
  • When steroids aren’t indicated

- Diclofenac

109
Q

Function of NSAIDs in treating uveitis

A
  • Block prostaglandins (inflammatory mediators)
  • Facilitate dilating resistant miotic pupil
  • CAN use with corneal ulcers, but use caution
  • Systemic NSAIDs could be used (Carprofen, Deracoxib, Zubrin; banamine or bute in horses)
110
Q

Use of systemic NSAIDs in cats

A
  • Avoid
  • You can use topical NSAIDs
  • Diclofenac is systemically absorbed, so caution in cats with kidney disease
111
Q

Function if atropine

A
  • Mydriatic and cycloplegic
  • Prevent synechia
  • Reduce ciliary spasm and pain
  • Stabilizes blood vessels (Blood-eye barrier)
112
Q

When to use caution with atropine?

A
  • If pupil is dilated, caution (may lead to uveitis)

- Avoid if increased IOP

113
Q

Tropicamide use

A
  • Not cycloplegic

- Probably don’t use

114
Q

Cycloplegia

A
  • Paralysis of the ciliary muscle in the eye
115
Q

Treatment for tick borne diseases and Bartonella

A
  • Oral doxycycline (careful)
116
Q

Treatment for toxoplasmosis or oral disease

A
  • Clindamycin

- Doxy works well for oral disease

117
Q

Treatment for uveitis related to oral disease

A
  • Clavamox
  • Clindamycin
  • Doxycycline
118
Q

When to use topical antibiotics for uveitis

A
  • With corneal ulcers, penetrating wounds

- Other intraocular infections

119
Q

Which topical abx would you give for uveitis due to something penetrating the cornea?

A
  • Want to choose an antibiotic that will go through the cornea
  • Fluoroquinolone (ofloxacin, ciprofloxacin)
  • Chloramphenicol
120
Q

Which antibiotics do NOT penetrate the cornea?

A
  • BNP, erythromycin, gentocin, tobramycin, terramycin
121
Q

What must you consider in uveitis with a normal or high IOP?

A
  • DO NOT TREAT WITH ATROPINE

- MUST ASSESS FOR SECONDARY GLAUCOMA**

122
Q

When is enucleation indicated in uveitis?

A
  • Patients with destructive ocular tumors

- Blind painful eyes (secondary glaucoma)

123
Q

What can cause chorioretinitis?

A
  • Immune-mediated disease
  • Infectious disease
  • Trauma
  • Neoplasia
  • Toxin
124
Q

How do animals with chorioretinitis present?

A
  • Decreased vision
125
Q

Treatment for chorioretinitis

A
  • Systemic treatment specific for the disease, in addition to anti-inflammatory use
  • Generally prednisone
126
Q

Panophthalmitis appearance-

A

ALL OCULAR TISSUES ARE AFFECTED

  • Sclera will be bulging
127
Q

IOP of panophtlamitis

A
  • High normal intraocular pressure
128
Q

Treatment for panopthalmitis

A
  • No effective treatment

- Enucleation is indicated

Ophthalmology (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions