Ophthalmology

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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?


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