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Flashcards in Conjunctiva Deck (39):
1

What cells make up the conjunctiva?

Epithelium
Goblet cells
Lymphoid tissue
Vasculature

2

How can you get a sample of conjunctiva for cytology?

Cotton swab, kimura spatula, back of scalpel blade

3

What do you see in the typical cytology of a dog with conjunctivitis ?

Epithelial cells and neutrophils

4

The mucous part of the tear film is produced by??

Globlet cells of the conjunctiva

5

Mucous provides a good media for bacterial growth and recruitment of white blood cells creating a ___________ discharge?

Mucopurulent

6

Mucopurulent discharge is most commonly found with what ocular disease?

Keratoconjunctivitis sicca

7

Where are conjunctival lymphoid follicles usually found?

Bulbar surface of the third eyelid

8

Enlarged lymphoid follicles on the injunctive indicates?

Non-specific antigenic stimulation
(Likely a primary conjunctivitis)

9

What are the two types of vessels in the conjunctiva ?

Conjunctival vessels — superficial small vessels

Episceral vessels — larger deeper vessels

10

Conjunctival hyperemia is secondary to?

Superficial irritation (eg conjunctivitis, superficial corneal ulcer, keratoconjunctivitis)

11

Episceral injection is usually secondary to?

Deeper inflammation or congestion

— large identifiable vessels that course perpendicular to the limbus

12

What are disorders of the canine conjunctiva?

KCS
Allergic conjunctivitis
Infectious conjunctivitis (adenovirus, herpesvirus, distemper)

13

Clinical signs of allergic conjunctivitis?

Blepharospasm
Epiphora
Mucoid discharge
Hyperemia
Lymphoid follicles

14

Signalment associated with allergic conjunctivitis ?

Young atopic dogs

15

What are causes of viral conjunctivitis?

Adenovirus
Herpesvirus
Distemper

16

How can you make a diagnosis of primary conjunctivitis?

Compatible signalment (young dog with allergies)

Clinical signs (conjunctival pathology without keratitis or episceral/intraocular pathology)

Minimum data base in normal limits

17

How do you treat a primary conjunctivitis?

Often self limiting

Irrigation with eyewash
Symptomatic used of topical anti-inflammatories

Treat underlying cause of atopy
- avoid offending allergen/hyposensitization
-symptomatic use of topical anti-inflammatories

18

What topical anti-inflammatories are the mainstay for primary conjunctivitis?

Neomycin - polymixin- dexamethasone - steroid

Diclofenac -NSAID

Optimmune (cyclosporine) - Tcell inhibitor

19

What are the most common causes of feline conjunctivitis?

Feline herpesvirus keratoconjunctivitis

Chlamydia conjunctivitis

Mycoplasma conjunctivitis

Calicivirus

20

What are the 3 forms of FHV1 ?

Primary (young cats) - acute lysis

Latency

Recrudescence - lysis and disease

21

What is the pathophysiology of herpesvirus?

Mucosal eatery followed by viral replication and systemic viremia

Incorporation into host DNA

Epithelial tropism — epithelial cytolysis
—> blepharospasm, epiphora, and mucoid discharge (concurrent URI)

Latency —> FHV invades sensory nerve endings of trigeminal nerve and travels to ganglion

Recuredescent —> reactivation of virus, usually be stress , Replication in sensory axon and migration back to epithelial tissues

22

Clinical signs associated with FHV?

Blepharospasm, epiphora, mucoid discharge

Hyperemia

Conjunctival and possible corneal ulceration
Symblepharon (adhesion between conjuntiva and cornea)

23

What stain can you use to determine conjunctival ulceration

Rose bengal stain

24

What stain can you use to determine corneal ulceration?

Fluorescein stain

25

What pattern of corneal ulceration if pathognomic for FHV infection?

Dendritic

26

What occurs if two ulcerated surfaces (conjunctival and corneal) heal together?

Symblepharon

27

What are possible tests to diagnose FHV?

Cytology — intranuclear inclusion bodies
Fluorescent antibody testing
PCR
Virus isolation

28

Treatment of FHV?

Antiviral therapy
-topical cidofovir
-oral famciclovir
-lysine ( substitutes for arginine and inhibits viral replication)

Supportive care
-erythromycin (topical)

29

What is a common autoimmune sequela from FHV1 infection?

Feline eosinophilic keratoconjunctivitis

30

Clinical signs of feline eosinophilic keratoconjunctivitis ?

Blepharospasm, epiphora, mucoid, or mucopurulent discharge, +/- corneal ulceration

Raised white or yellow corneal or conjunctival infiltrates

31

T/F: finding a single eosinophil on cytology of the conjunctiva is diagnostic for feline eosinophilic keratoconjunctivitis

True

32

Treatment for feline eosinophilic keratoconjunctivitis ?

Immunomodulation - topical cyclosporine

Anti-inflammatory —NSAIDS or steroids

Antiviral — cidofovir or famcyclovir

33

What is a specific clinical sign for chlamydial conjunctivitis ?

Chemosis (conjunctival edema)

34

T/F: chlamydial conjunctivitis causes corneal or conjunctival ulceration

False

35

How can you confirm diagnosis of chlamydial conjunctivitis ?

Cytology — intracytoplasmic inclusion bodies

PCR, history, compatible clinical signs

36

Treatment of chlamydial or mycoplasma conjunctivitis?

Topical
-oxytetracycline (tetracyclines)
-erythromycin (macrolides)

Oral
-doxycyline

37

You do a cytology in a cat with blepharospasm, epiphora and mucoid discharge.
It shows numberous coccidia membrane associated bacterial illusions. What is this?

Mycoplasma associated conjunctivitis

38

How is calicivirus differentated from herpesvirus?

Oral ulceration are pathognomic for calicivirus

39

Treatment for calicivirus?

Erythromycin - topical