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RUSVM SAM II > Conjunctiva and Lacrimal System > Flashcards

Conjunctiva and Lacrimal System Flashcards

(45 cards)

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1
Q

what are the 3 conditions that cause red eye

A

keratoconjunctivitis

uvetitis

glaucoma

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2
Q

what dis?

A

prominent episcleral vessel - normal conjunctival variation

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3
Q

what is shown here

A

epiphora

Abnormal overproduction of tears. This is a common response to ocular irritation.

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4
Q

what dis?

A

mucoid discharge

goblet cells - overproduce mucus when inflamed

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5
Q

when you see this what should you be thinking?

A

Schirmer Tear Test - KCS

when you see mucopurulent discharge, KCS should be your top differential, do an STT

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6
Q

what structure is only seen normally on the bulbar surface of the 3rd eyelid

A

lymphoid tissue

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7
Q

A dog comes into your clinic and during your ophthalmic exam you see follicles on the palpebral conjunctiva. You determine they are lymphoid follicles. What is your top differential

A

primary conjunctivitis

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8
Q

what condition is shown here

A

conjunctival hyperemia

think of superficial vessels, think of superficial disease

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9
Q

conjunctival hyperemia detected or not detected

A

not detected

episcleral injection - think deep vessels, think of deep or intraocular disease

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10
Q

clinical signs of allergic conjunctivits

A

young, atopic dogs

blepharospasm (squinting)

epiphora

mucoid discharge

hyperemia

lymphoid follicles

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11
Q

minimum database needed to confirm primary conjunctivits

A

STT

fluoroscein stain

tonometry

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12
Q

what can be used to treat allergic conjunctivitis

A

treat underlying cause (allergy/atopy) if present

topical anti-inflammatories: steroid (neo-poly-dex), NSAIDs (diclofenac 0.1%), T-cell inhibitor (optimmune/cyclosporine 0.2%)

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13
Q

functions of tear film

A

nourish

cleanse

protect

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14
Q

3 layers of tear film

A

oil/lipid - outermost

aqueous - middle

mucinous - innermost

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15
Q

2 categories of KCS

A

quantitative

qualitative

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16
Q

causes of KCS

A

immune mediated - most common

excision of glands of 3rd eyelid

drugs (sulfonamides, atropine)

trauma

neurogenic

infectious (distemper)

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17
Q

quantitative KCS is due to

A

aqueous deficiency

one of most common eye diseases seen in practice, STT to Dx

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18
Q

common clinical history and signs of quantitative KCS

A

presents with musopurulent discharge - perscribed topical antibiotics, discharge returns after antibiotics stopped

STT never performed

one of most commonly missed diagnoses

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19
Q

qualitative KCS is due to

Study These Flashcards
A

lipid or mucin deficiency

20
Q

what is the only common cause of bacterial conjunctivitis in dogs

Study These Flashcards
A

quantitative KCS

21
Q

clinical signs of KCS

Study These Flashcards
A

most often bilateral

Keratitis - superficial corneal neovascularization, corneal fibrosis, superficial corneal pigmentation, corneal ulceration, WBC infiltrates

conjuntivitis - mucopurulent discharge

22
Q

KCS treatment

Study These Flashcards
A

majority of cases: topical cyclosporin BID controls clinical signs

must be given lifelong

23
Q

how does cyclosporin work to treat KCS

Study These Flashcards
A

T cell inhibitor, immunomodulator

supresses further destruction of lacrimal tissue

stimulates tear production

anti-inflammatory effect (reduces vessels, clears fibrosis, clears pigment)

24
Q

T/F KCS can be cured with cyclosporin therapy

Study These Flashcards
A

False

cyclosporin controls but does not cure

25
what are the 4 objectives of KCS treatment
**replace** the tears **stimulate** more tears **anti-inflammatory** therapy temporary **antibiotic** therapy - clears secondary BacT infection while tear film recovers
26
clinical presentation of neurogenic KCS
unilateral in older dogs dry nose
27
what are the most common causes of feline conjunctivitis
feline herpesvirus keratoconjunctivitis chlamydial conjunctivitis mycoplasma conjunctivitis calicivirus conjunctivitis
28
what is the most common cause of feline keratits/conjunctivitis
**Herpes!!**
29
2 clinical forms of feline herpesvirus keratoconjunctivitis
**primary** - disease (young cats) of acute lysis followed by latency then.. **recrudescence** with lysis
30
T/F Feline herpesvirus keratoconjunctivitis is easy to diagnose based on history and clinical signs
**False** *diagnosis and treatment difficult - lack evidence based medicine with reguards to effective treament*
31
ulcers associated with feline herpesvirus keratoconjunctivitis will be superficial/deep
**superifical** *FHV has epithelial tropism*
32
what is the typical presentation of primary FHV-1 infection in naive cats/kittens
**URT and simultaneous ocular surface infection** *kittens displaying blepharospasm, epiphora and mucoid discharge in addition to URT infection; naturally resolves in 2-4 weeks*
33
latent FHV-1 becomes reactivated due to:
environmental stress- most common spontaneous corticosteroids co-infection
34
specific clinical signs associated with FHV-1
UTR infection - primary hyperemia **very specific -** conjunctival and possible corneal epithelial ulceration (dendritis ulceration is pathognomonic); symblepharon (permanent adhesions b/w conjunctiva and cornea)
35
**key point** - If you observe conjunctivitis and evidence of present or historic keratitis, then consider FHV-1 over other cause of feline conjunctivitis
36
what dis?
**symblepharon** - adhesion of conjunctiva to cornea
37
FHV-1 treatment
**antivirals** - cidofovir (topical), famcliclovir (oral) **supportive** - topical erythromycin (mocrolide broad spectrum antibiotic - effective against mycoplasma and chlamydia)
38
what is the second most common cause of conjunctivitis in cats
chlamydia
39
what is a specific sign for chlamydial conjunctivitis
**chemosis** ***_Ch_**emosis is for **_Ch_**lamydia*
40
what is chemosis
conjunctival edema
41
how is chlamydial conjunctivits diagnosed
PCR, history, compatible clinical signs **cytology** - intracytopplasmic inclusion bodies
42
T/F mycoplasma conjunctivits can cause corneal or conjunctival ulceration
**False**
43
what is the best way to diagnose mycoplasma conjunctivis
**cytology** *can find membrane associated bacteria*
44
clinical signs associated with calicivirus conjunctivits
conjunctival ulceration - will not have corneal ulceration **oral/tungue ulceration** - pathognomonic when present
45
T/F calicivirus conjunctivitis can be treated with antivirals and supportive topical therapy
**False** *don't respond to antivirals, treat with supportive topical therapy (erythromycin)*

RUSVM SAM II (20 decks)

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