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Flashcards in Equine Deck (174)
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Questions to ask regarding the equine eye

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•DO NOT trim lid margin

•May need to delay surgery

•Cover eye/wound with pad covered in antibiotic cream

•Careful debridement if necessary, then suture

•Eyelid margins have a very important role - specialised tissue

•DO NOT REMOVE EYELID MARGIN

•Use appropriate suture material - 4/0-6/0 Nylon

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* Purulent discharge

* Check under third eyelid

* May need ocular ultrasound

* Surgery common

Treatment: may need ocular ultrasound, surgery common- GA, exploration of any sinus tracts, antibiotics, anti-inflammatories

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What will you see in corneal disease in horses? (most common ocular disease)

* oedema, vascularisation, scarring, pigmentation, cellular infiltration, other abnormal infiltrates

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Tests? What can occur with this?

* Tests: corneal cytology, MC&S, fluorescein stain, wash stain from conjunctival sac, do not confuse stain uptake in corneal granulation

* Corneal ulceration--> melting cornea chemotaxis for neutrophils, neutrophils important in melting corneas, not all ulcers are infected... caused by Pseudomonas, Staphs, Strep, Fungi (more common in horses, rare in dogs)...

- you would see: usually stromal loss, toxins and enzymes released by bacteria

Treatment: topical antibiotics/antifungals, consider compounded oral antifungal medication, serum topically...surgery- keratectomy/ conjunctival graft, consider transpalpebral lavage tube, pain control important- Bute twice daily

•Use dedicated topical ophthalmic antibiotics eg. Ofloxacin - Gram negatives

 

•Can use fortified drops eg. fortified cefazolin (50mg/ml - add 750 mg cefazolin to 12 ml artificial tears) - Gram positives

•Fungal infections in cornea most common in horses

•Use in horses with unresponsive chronic keratitis

•Topical - Voriconazole 1% drops or itraconazole 1% ointment (compounded), fluconazole (Diflucan), silver sulfadiazine (Silvazine), miconazole

•Oral - fluconazole (compounded)

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What will you see with corneal infection?

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From a corneal ulcer in a horse, what is the likely bacterial spp?

Pseudomonas

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From corneal ulcer in a horse

Fungal hyphae

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Used after keratectomy/ conjunctival graft

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Describe what you see

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Describe? Treatment?

•Most corneal lacerations need surgery - suture cornea

•Need suitable instruments, suture material

•Replace iris prolapse as suturing

•Fencing wire, tree branch laceration

•If a corneal laceration is suspected, examine very carefully to prevent expulsion of intraocular contents

•Prognosis poor if laceration extends into the sclera

 

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Uveitis in horses? Two kinds? Acute signs?

Primary- equine recurrent uveitis

Secondary- to other ocular diseases such as trauma and ulcer

** Acute signs: blepharospasm, corneal vascularisation, photophobia, miosis, aqueous flare and/or hypopyon

 

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Tests? DDX? Diagnosis? Treatment?

Tests: Fluorescein stain, cytology, MC&S

DDX: trauma- whip/lead injuries, corneal infection, corneal ulceration

Diagnosis: Bullous keratopathy (horses cornea sucks in a lot of fluid)

- trauma- usually whip/lead injuries; corneal infection

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DDX: Trauma, corneal oedema/infection, hypopyon

Tests: Fluorescein stain, tonometry

Diagnosis: acute uveitis (uncommon)... primary or secondary?

Treatment: treat primary cause, timely anti-inflammatory therapy- corticosteroids, NSAIDs, other immune modulating agents; atropine, poor treatment- loss of vision

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* Adhesions- synechia; Darkened iris; cloudy pupil- cataract

Diagnosis? What are the signs and symptoms?

 

Chronic Uveitis (phthisis bulbi, cataract formation, posterior synechia, retinal detachment (ocular ultrasound), hyperpigmented iris, vitreous opacity, lens luxation, glaucoma)

 

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What type of medication should you avoid in a corneal ulceration?

Topical anti-inflammatories

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