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Small Animal Medicine II > Conjunctival Diseases > Flashcards

Conjunctival Diseases Flashcards

1
Q

What is the normal flora of the conjunctiva like in dogs, cats, and horses?

A

DOGS and CATS - Gram + predominate

HORSES - Gram + and -, fungi

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2
Q

What are the 3 functions of conjunctiva?

A
  1. immunologic
  2. tear film
  3. barrier
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3
Q

What are the 5 most common conjunctival reactions?

A
  1. subconjunctival hemorrhage
  2. conjunctival hyperemia
  3. episcleral congestion
  4. mucopurulent discharge
  5. chemosis - swelling (or edema) of the conjunctiva
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4
Q

If conjunctivitis is seen on a physical exam, what should be examined?

A

interpret as a clinical sign —> all ocular diseases can cause it, always perform the big 3 tests

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5
Q

What is the most common conjunctival disease in dogs? What else is seen?

A

dry eye disease

  • bacterial conjunctivitis commonly secondary to dry eye
  • neoplasia - papillomas, hemangioma/sarcoma, lymphoma
  • allergic
  • canine herpesvirus infection
  • distemper
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6
Q

What dogs are most commonly affected by conjunctival hemangioma/hemangiosarcoma? What causes its development?

A

middle-aged, outdoor, Border Collies

UV light exposure

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7
Q

Where is conjunctival hemangioma/hemangiosarcoma most commonly found? What is the treatment of choice?

A
  • third eyelid margin
  • conjunctival fornix
  • lateral bulbar conjunctiva
  • cornea
    (non-pigmented areas)

complete surgical excision with possible half removal of third eyelid and cryotherapy

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8
Q

How does conjunctival hemangioma/hemangiosarcoma typically develop?

A

10% recurrence rate, rarely metastasizes

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9
Q

What do conjunctival viral papillomas need to be differentiated from? How do they typically develop?

A

SCC, however it is most commonly seen in young animals

spontaneous regression can occur

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10
Q

What are 3 treatment options for conjunctival viral papillomas?

A
  1. surgical removal
  2. cryotherapy
  3. interferon - immune system related

(remember, spontaneous regression is common!)

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11
Q

What is episcleritis? What are the 2 types and causes of each?

A

nonpainful inflammation of thin layer of tissue between the conjunctiva and sclera, which looks like blood vessels growing over the sclera

  1. nodular granulomatous - immune-mediated
  2. diffuse - tickborne disease
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12
Q

What breeds have a predilection for developing episcleritis? Specifically nodular granulomatous?

A
  • Golden Retriever
  • American Cocker Spaniel

Collie and Collie-type breeds

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13
Q

How is episcleritis treated?

A

topical immunomodulators - steroid and/or cyclosporine

  • may bee systemic steroids for severe cases
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14
Q

What are acute and chronic causes of allergic conjunctivitis? What needs to be ruled out?

A

ACUTE: insect stings, contact with environment allergens

CHRONIC: atopy, environmental allergens - causes lymphatic tissue to form follicles

  • dry eye - perform STT
  • bacterial infection - cytology
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15
Q

What are 3 treatment options for allergic conjunctivitis?

A
  1. topical steroids
  2. oral antihistamines
  3. topical antihistamines - Zaditor (OTC option)
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16
Q

What ocular signs are associated with canine distemper virus infection? How is it diagnosed?

A
  • dry eye disease
  • conjunctivitis

conjunctival/pharyngeal swabs - IFA for viral DNA detected by PCR

+ point of care ELISA for CPV and CDV for blood samples

17
Q

What 4 ocular clinical signs are associated with canine herpesvirus infection?

A
  1. conjunctivitis
  2. dendritic corneal ulcers
  3. conjunctival ulcers
  4. blepharitis
18
Q

What dogs most commonly exhibit ocular signs of herpesvirus infection? How is it diagnosed?

A

mature or juvenile dogs, immunocompromised (thought to only cause severe neonatal fatal disease)

PCR

19
Q

What are 2 options for treating canine herpesvirus conjunctivitis? What is avoided?

A
  1. Ganciclovir gel
  2. Famciclovir oral

Cidofovir - causes corneal pigmentation

20
Q

What are 4 general conjunctival diagnostics commonly used?

A
  1. Schirmer tear test
  2. conjunctival cytology
  3. conjunctival culture - normal flora will grow!
  4. conjunctival biopsy - incisional, tumor removal
21
Q

What is the most common cause of feline conjunctivitis? How is it differentiated from other causes?

A

feline herpesvirus - also causes keratitis (ulcers)

  • Chlamydophila felis - IC IB in epithelial cells
  • Mycoplasma spp. - “dust particles” attached to epithelial cells
  • Calicivirus - oral ulcers
  • allergic
  • FB
22
Q

How is feline herpesvirus-1 transmitted? Where does it replicate?

A

respiratory secretion

conjunctival, nasal, and pharyngeal epithelium

23
Q

What acute clinical signs are seen with feline herpesvirus infection?

A
  • OCULAR = hyperemia, chemosis, serous to purulent discharge, blepharospasm, corneal ulceration (dendritic)
  • SYSTEMIC = sneezing, coughing, nasal discharge, pneumonia
24
Q

Where does feline herpesvirus undergo neuronal latency? How are cats affected?

A

trigeminal ganglia

will remain asymptomatic, but stress related to housing changes, steroids, and parturition can cause reactivation of ocular clinical signs

(50% of cats spontaneously shed)

25
Q

How do the ulcers caused by feline herpesvirus develop?

A
  • EARLY = dendritic/branching
  • RAPIDLY DEVELOPS into larger areas commonly affected by secondary bacterial infection and corneal perforation
26
Q

What chronic clinical signs are associated by feline herpesvirus?

A
  • epiphora
  • symblepharon - ulcer forms and heals into an adhesion of conjunctiva to cornea
  • KCS
27
Q

What is pathognomonic of feline herpesvirus infection? How is this seen?

A

dendritic ulcers stained with Rose Bengal (early) or fluorescein

28
Q

If ulcers are not seen, how can feline herpesvirus infection be diagnosed?

A
  • virus isolation from swabs of conjunctiva or oropharynx (commonly + in young cats)
  • PCR from conjunctival biopsy, scraping, or swab, which is more sensitive and able to detect small amounts of DNA (can be + in non-clinical cats)
29
Q

What topical and systemic treatment options are available for feline herpesvirus infection?

A

TOPICAL - Ganciclovir (TID, less irritating), Cidofovir (BID, long half-life)

SYSTEMIC - Famciclovir (BID, 14-21 days, 250 and 500 mg tablets BEST)

30
Q

In what 3 situations are adjunctive antibiotics needed for feline herpesvirus infection? What is the purpose? Some options?

A
  1. corneal ulceration
  2. other courses of conjunctivitis present
  3. Mycoplasma and Chlamydophila +

prevent secondary bacterial invaders

  • oxytetracyclines (TID-QID)
  • erythromycin or chloramphenicol ointment
31
Q

What are 2 options for adjunctive treatment for feline herpesvirus infection?

A
  1. L-lysine - competes with arginine, which the virus needs to replicate
  2. interferon

(not much evidence, can’t hurt)

32
Q

What does feline SCC commonly mimic? How does it act?

A

chronic conjunctivitis or keratitis in cats

locally invasive

Small Animal Medicine II (57 decks)

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