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SS - Exam 3 > Disorders Of Orbit & Nasolacrimal System > Flashcards

Disorders Of Orbit & Nasolacrimal System Flashcards

(47 cards)

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1
Q

Bony fossa

A

Separates eye from cranial cavity

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2
Q

foramina & fissures

A

Pathway of blood vessels & nerves

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3
Q

Size, shape & position - closely associated w time of visual activity & feeding behavior

A

Pig & carnivores - incomplete
Large herbivores - complete

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4
Q

Orbital contents

A

Globe
Nicitans membrane
Glands
Fat
Extraocular muscles

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5
Q

Congenital anomalies

A

Anopthlamus
Microphthalmos
Synophthalmus
Cyclopia
Strabismus

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6
Q

Causes for microphthalmus

A

Hereditary
Merle ocular dysgenesis
Collie eye anomalies
Bovine viral diarrhea
Nutritional (hypovitaminosis)

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7
Q

Congenital anomalies w non viable fetus

A

Synophthalmia
Anophthalmia
Cyclopia

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8
Q

Converging strabismus

A

Eyes meet at a point - nose
Bilateral converging strabismus w exophthalmia (BCSE)
Inherited in jersey, German cattle breeds
Inhereited in Siamese cats

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9
Q

Diverging strabismus

A

Eyes going in different directions
Hydrocephalus - sunset eyes
Considered normal in Brachycephalic breeds

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10
Q

Clinical signs for strabismus

A

Change in orbital volume (endo/exophthalmus)
Impaired function of orbital structures
Neuro ophthalmic exam, globe retropulsion

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11
Q
A

Unilateral cranial nerve V lesion
Orbital neoplasia
Large mineralized space occupying lesion
Age related loss of retrobulbar fat
Orbital fracture w eyelid lacteration
Bilateral Extraocular Polymyositis

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12
Q

Exophthalmus

A

Increased orbital volume

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13
Q

Acquired disorders

A

Orbital cellulitis /abscess
Transoral abscess drainage
Sialoceles
MMM
Extraocular muscle myositits
Orbital neoplasia
Proptosis

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14
Q

Orbital cellulitis

A

Acute, unilateral exophthalmos
Pain in globe retropulsion & mouth opening
Protrusion of 3rd eyelid
Conjunctival hyperemia, chemosis
Periocular swelling, mucopurulent discharge

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15
Q

Causes for orbital cellulitis

A

Penetrating wound through mouth
Foreign body
Tooth root abscess
Infection of zygomatic/salivary gland
Idiopathic

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16
Q

Treating orbital cellulitis

A

Drainage
Systemic broad spectrum antibiotics

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17
Q

Sialoceles

A

Cystic structures from glandular or epithelial tissues
Typically exophthalmos and protrusion of third eyelid
Minimal pain, fluctuating swelling

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18
Q

Causes of Sialoceles

A

Trauma of head
Leakage of saliva from zygomatic gland/duct
Ulceration of oral mucosa - obstruction of saliva outflow
Treat w removal of cysts and gland

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19
Q

DX of Sialoceles

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A

Ultrasounds, ct
FNA of yellowish/ fluid and blood

20
Q

MMM

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A

Eosinophilic myositis - IMM inflammatory myopathy
Temporalis, masseter, pterygoid muscles - 2M fibers
Acute phase - severe pain upon palpation, restricted jaw movements, anorexia, +/- blindness

21
Q

DX for MMM

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A

CT, MRI, muscle biopsy

22
Q

TX for MMM

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A

Oral corticosteroids
Immunomodulators for long term therapy
Endophthalmus & atrophy of muscles is common in chronic cases

23
Q

Extraocular muscle myositis

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A

IMM inflammatory myopathy
- extra ocular disease
- CD3 lymphocytic infiltration
Bilateral exophthalmos w/out 3rd eyelid - not painful, retraction of upper eyelid

24
Q

DX for EMM

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A

Ultrasound, CT, MRI - biopsy not ideal

25
TX for EMM
Oral corticosteroids - treatment is shorter term than MMM Endophthalmus and strabismus is common w chronic cases
26
Orbital neoplasia
Primary neoplasia - arises from orbital tissue Secondary neoplasia - invade orbit from adjacent structures or metastasize from distant areas Slowly progressive exophthalmos - non painful, unilateral, decreased globe retropulsion, third eyelid elevation
27
EX for orbital neoplasia
Lymph node evaluation Ultrasound, CT, MRI
28
Treatment for orbital neoplasia
Exenteration or enucleation Palliative vs radiation
29
Proptosis
Sudden, forward displacement of globe w entrapment of eyelids - trauma origin Common in Brachycephalic Breeds due to shallow orbit Cats w this condition, trauma requires greater force = poor prognosis
30
TX of Proptosis
Globe replacement - tarsorrhaphy Enucleation
31
Prognosis for Proptosis
Vision = guarded to poor (20%) Positive - PLR better long term prognosis Two or more of the extra ocular muscles are avulsed - enucleation is recommended due to compromised nerve supply, blood supply ext Hyphens - blood inside anterior chamber = guarded
32
Nasolacrimal system
Thin walled conduit that drains the tear film from the eye into the nasal passages Puncta - super and inferior Canaliculi Lacrimal sac Nasolacrimal duct Nasal puncta
33
Pre corneal tear film (PTF)
Functions to maintain uniform corneal surface, remove debris, deliver oxygen to Avascular cornea, provision of Antimicrobials substances in eye
34
Composition of PTF
Lipid - meibomian glands (outer layer) Aqueous - lacrimal and third eyelid (middle layer) Mucin - goblet cells in conjunctiva (closest to cornea)
35
Quantitative tear film deficiencies
Tear film produced is not a balanced KCS*
36
Causes for quantitiative deficiency
Immune-mediated (most common) • Congenital (alacrima, lacrimal gland hypoplasia) • Infectious (canine distemper virus) • Drug-induced (sulfonamides, atropine, topical anesthetics) • Iatrogenic (T.E gland removal) • Neurogenic (parasympathetic denervation)
37
Qualitative deficiency
Premature evaporation of tears • Lipid or mucin deficiency • Causes • Marginal blepharitis / meibomianitis • Autoimmune diseases affecting mucocutaneous junctions • Severe cicatrization / conjunctival scarring
38
Testing for qualitiative tear film
Swollen rounded eyelid margins, indicating marginal blepharitis Multiple chalazia indicating meibomiantitis Positive uptake for rose bengal stain Tear film breakup time test
39
KCS
Intense hyperemia, mucopurulent discharge, keratitis Mucopurulent discharge & extensive Pigmentary keratitis = chronic Infected axial stromal ulcer, malacia, diffuse corneal edema Neurogenic KCS - dry nose, ipsilateral xeromycteria
40
Treating tear film deficiencies
Cholinergic agents Immunomodulating agents Tear substitutes Antibacterial agents Mucinolytic anticollagenese agents
41
Cholinergic agents
For neurogenic KCS Pilocarpine (topical/oral)
42
Immunomoudlating agents
Topical cyclosporine Topical tarcolimus
43
Antibacterial agents
Broad spectrum use is common in inadequate cleansing of ocular surface
44
Mucinolytic - anticollagenese agents
Topical acetylcysteine Removal of mucous debris
45
Epiphora
Common Obstruction of tear flow through nasal lacrimal system due to over production of tears Mucopurulent punctual, conjunctival and nasal discharge Swelling of medial Cathay region
46
Diagnosing epiphora
Schirmer test Florescent dye passage Flush NSL - normograde = eye to nose, retrograde = nose to eye Cytology
47
Nasolacrimal system disorders
Bilateral punctual atresia = marked epiphora Superior punctual & canicular foreign body = darcryocytisis Tear staining syndrome

SS - Exam 3 (28 decks)

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