Ophthalmology
Based on stage of development - immature, mature or hypermature
How are cataracts classified?
Full thickness wedge or house-shaped excision
How are neoplasms removed?
With simple wedge resection
How can ectropion be repaired?
Giving topical steroids for corneal ulcers
How can humans cause melting ulcers?
PCR test for FHV-1 or chlamydia DNA Viral culture
How do diagnose feline conjunctivitis?
Liquefactive stromal necrosis due to release of proteases by bacteria
How do melting ulcers occur?
Arises from the meibomian gland on the eyelid margin and then a chalazion forms
How do sebaceous adenomas arise?
FHV-1 causes conjunctivitis and URT signs and keratitis
How does FHV-1 cause conjunctivitis?
Chlamydiophila causes conjunctivitis in the absence of any systemic disease
How does chlaymdia cause conjunctivitis?
Reduced aqueous tear production leading to conjunctivitis and superficial keratitis
How does dry eye occur?
Recurrent or persistent blepharospasm
How does entropion present?
Rupture of zonules holding lens in place leads to dislocation of the lens
How does lens luxation occur?
Excision of scrolled portion via a conjunctival approach from the inner aspect of the third eyelid
How is scrolling of the third eyelid treated?
Low Sherman tear test Less than 15mm per min
How to diagnose dry eye?
Give ointment rather drops as it can cause hypersalivation
How to give atropine in cats?
Reduce stress Topical antivirals Systemic antivirals
How to treat FHV-1?
Requires anti-inflammatory medication Topical corticosteroids Systemic NSAIDS Topical atropine Topical antibacterials
How to treat anterior uveitis?
Referral and use EDTA to try to prevent recurrence
How to treat calcium keratopathy?
Fusidic acid Chloramphenical Tricin
How to treat canine conjunctivitis?
Doxycyline and Clavulox
How to treat chlamyiophila?
Superficial lamellar keratectomy
How to treat corneal dermoid?
Emergency treatment of mannitol Topical anti-glaucoma medications Timol Analgesia treat underlying cause
How to treat glaucoma?
Autologous serum Topical fluoroquinolone - Ocuflox Systemic antibiotics and NSAIDs Consider referral for graft Consider swab
How to treat melting ulcers?
Topical corticosteroids or cyclosporin Life-long treatment
How to treat pannus?
Amlodipine
How to treat systemic hypertension
Protrusion of third eyelid with miosis, exophthalmos and ptosis
What are the 3 things seen with Horner's syndrome?
1. intraocular pressure 2. Sherman Tear Test 3. Fluroscein stain
What are the 3 things to always perform for an eye exam?
Sebaceous adenoma
What are the common neoplasms of eyelids?
Dog - 10-25mmHg Cats - 10-25mmHg Horses - <25mmHg
What are the normal intraocular pressure in animals?
Acute blindness Ocular pain Episcleral congestion Corneal vascularisation Corneal oedema Dilated pupil
What are the signs of glaucoma?
Nuclear sclerosis, calcium keratopathy and lipid deposition
What are the three things to differentiate from cataracts?
Inherited disease or terrier breeds
What breeds are predisposed to lens luxation?
Occurs in GSD or GSD cross
What breeds are predisposed to pannus?
Trauma Infections Viral Protozoal Bacterial Parasitic
What can cause anterior uveitis?
Globe trauma Hypertension Secondary to intraocular disease Clotting disorders
What can cause hyphaema?
Chronic superficial keratoconjunctivitis
What can occur from immune mediated keratitis?
Primary due to gram positive infections Secondary due to entropion or other eyelid defects, KCS, conjunctival or corneal foreign body, allergic conjunctivitis or corneal ulceration
What causes canine conjunctivitis?
Inherited - common Metabolic - diabetes mellitus Others - age related, secondary to intraocular disease, traumatic or nutritional
What causes cataracts?
Traumatic injury KCS Entropion Distichiasis Ectopic cilia Foreign body Reduced blink reflex Exposure of keratitis
What causes corneal ulceration?
Autoimmune - most common as a response to cyclosporin Drug induce - systemic sulphonamides Others - canine distemper or FHV1
What causes dry eye?
Caused by Chlamydiophila felis or Feline herpes virus 1
What causes feline conjunctivitis?
Chronic corneal irritation
What causes feline corneal sequestrum?
Corneal ulcers stained with fluorescein
What do these images show?
Entropion
What do these images show?
Testing for dry eye
What do these images show?
Need to assess PLR and intraocular structures
What do you need to do if an animal presents with uveitis?
Figure-of-8 suture for lid
What do you need to remember with lid margins?
Ocular discomfort Corneal vascularisation Lipid and pigment deposition Rarely ulceration
What does pannus cause?
History of night blindness that progresses to complete vision loss
What does progressive retinal atrophy present with?
Sudden onset of blindness
What does retinal detachment cause?
Systemic hypertension in cats
What does this indicate?
Very deep ulcer
What is a descemetocoele?
Dark material within the stroma with or without ulceration
What is a feline corneal sequestrum?
Alcaine
What is a local anaesthetic that can be used?
Nuclear scleorsis
What is an age related change seen in almost all dogs over 9 years of age?
Epithelial loss only with ulcer in superficial layer and under-run but fails to heal
What is an indolent ulcer?
Keratoconjunctivitis sicca
What is another word for dry eye?
Seen in very old dogs, >15 years White opacity on cornea associated with ulceration and pain
What is calcium keratopathy?
Third eyelid gland prolapse
What is cherry eye?
Hairy eyeball
What is corneal dermoid referred to as?
Choristoma or superficial skin-like mass that involves the conjunctival, scleral and corneal temporal limbus
What is corneal dermoid?
Lateral/medial entropion with central ectropion on either lower/upper eyelid
What is diamond eye?
Abnormally positioned cilia that emerge along the eyelid margin usually through the meibomian orifices
What is distichiasis?
Abnormal hairs arising from the meibomian glands however they emerge through the palpebral conjunctiva
What is ectopic cilia?
Outward turning of eyelids
What is ectropion?
Turning in of the eyelid
What is entropion?
Increased ocular pressure and is an ophthalmic emergency
What is glaucoma?
Haemorrhage within the anterior chamber may be unilateral or bilateral
What is hyphaema?
One area of the third eyelid grows quicker than the rest resulting in cartilage becoming bent, everted or scrolled
What is scrolling of the cartilage of the third eyelid?
Globe enlargement Corneal ulceration Iris atrophy Cataract Lens luxation Retinal and nerve head atrophy Phthisis bulbi
What is seen with chronic glaucoma?
White spicules within the cornea with no ulceration and no discomfort
What is seen with lipid deposition?
First incision is 2-3mm from the eyelid margin then remove some underlying orbicularis oculi muscle and suture the skin defect
What is the Hotz-Celsus procedure?
sqaumous cell carcinoma
What is the common neoplasm in cats?
Repeat STT after 4-6 weeks, if improvement then the regime can continue, if no improvement then referral for parotid duct transposition
What is the management for dry eye?
Topical antibiotics - Tricin NSAIDs - carprofen
What is the medical management of superficial corneal ulcers?
Topical antibiotics - Ocuflox or gentamicin NSAIDS
What is the medical management of ulcers either less than or greater than 1/3rd depth?
Progressive retinal atrophy
What is the most common canine inherited retinal disease?
Morgan Pocket Technique
What is the surgical approach for cherry eye?
V-shaped resection and a four-sided section to remove an eyelid tumour with figure of 8 suture for eyelid margin
What is the surgical approach for excision of eyelid mass?
Hotz-Celsus procedure
What is the surgical treatment for adults with entropion?
Temporary tacking sutures
What is the surgical treatment for puppies with entropion?
Not requiered
What is the surgical treatment of superficial corneal ulcers?
Referral for conjunctival pedicle graft
What is the surgical treatment of ulcers either less than or greater than 1/3rd depth?
Cyclosporine BID or Tacrolimus Ocular lubricant QID Topical antibiotic
What is the treatment for dry eye?
Surgical excision of the offending hair
What is the treatment for ectopic cilia?
Medical treatment Chemical cauterants - Phenol Corneal burr Debridement with cotton-bud
What is the treatment for indolent ulcers?
Anterior uveitis
What is this?
Calcium keratopathy
What is this?
Canine conjunctivitis
What is this?
Cataract
What is this?
Chalazion
What is this?
Cherry eye
What is this?
Chronic glaucoma
What is this?
Collie Eye
What is this?
Conjunctival masses
What is this?
Corneal dermoid
What is this?
Corneal foreign bodies
What is this?
Descemetocoele
What is this?
Diamond eye
What is this?
Distichiasis
What is this?
Dry eye
What is this?
Ectopic cilia
What is this?
Ectropion
What is this?
Entropion in cats
What is this?
Feline conjunctivitis
What is this?
Feline corneal sequestrum
What is this?
Glaucoma
What is this?
Horner's syndrome
What is this?
Hyphaema
What is this?
Hyphaema in cats
What is this?
Indolent ulcer
What is this?
Inherited retinal disease
What is this?
Lens luxation
What is this?
Lipid deposition in the cornea
What is this?
Melting ulcer
What is this?
Pannus
What is this?
Progressive retinal atrophy
What is this?
Retinal detachment
What is this?
Scrolling of the third eyelid
What is this?
Uveitis
What is this?
Uveitis in cats
What is this?
VKH syndrome
What is this?
Inflammation of the uvea
What is uveitis?
Mydriacyl
What should be put into eyes to examine the retina?
History of acute onset of ocular pain/redness Conjunctival/episcleral reddening Cloudy cornea
What signs are seen with lens luxation?
Deep ulcers will not stain with fluorescein
What to remember with staining of ulcers?
Prednisolone acetate
What topical corticosteroids can be given?
Staph eyelid infections
When to use Fusidic acid?
Serious corneal infections or when risk of developing infection is high
When to use Ofloxacin (Ocuflox)?
Corneal problems
When to use chloramphenicol?
Infected corneal ulcers
When to use gentamicin?
Non infected ulcers
When to use tricin?
Systemic hypertension Inherited retinal disease Trauma Posterior uveitis Iatrogenic
what causes retinal detachment?
Pannus
what is another name for chronic superficial keratoconjunctivitis?