Equine Ophthalmology 2 Flashcards
corneal laceration
- look for what? tests?
- treatment?
- prognosis
- Direct or indirect PLR
- Laceration < 15 mm
- Pain
- Corneal edema
- Fibrin clot or prolapsed iris
- Miosis
- Seidel’s test with fluorescein
<><><><> - Enucleation vs graft
- Referral ASAP for reconstruction
- Systemic therapy
> Flunixin meglumine
> IV antibiotics - Fly mask
- Prognosis: guarded
> Best if < 15 mm, no hyphema
> No iris protrusion
Corneal diseases
Foreign body
- what do we do for superficial? deep?
- treatment?
- prognosis?
Superficial: sedation, local blocks and topical anesthesia
* Magnification, good dexterity
* Treat as simple corneal ulcer….recheck until fluorescein stain negative
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Deep: referral….GA
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Treat as complex ulcer – beware of vegetative foreign material (fungus)
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Prognosis: good if superficial, guarded if deep
Corneal diseases
Simple Ulcers > characteristics
- treatments?
- followup?
Superficial, not infected
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* Tobramycin QID
* Atropine BID x 3 days
* Oral NSAID
* Flymask on
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Recheck in 5 days
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10-12 days for healing
Corneal diseases
Complex Ulcers
- what are these? appearance / what happens?
- what to do first?
Infection: bacterial, fungus, viral
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- Descemetocele
- Melting
- Uveitis is present
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Cytology and Culture!
Treatment of complex ulcers
Topical treatment
- Subpalpebral lavage system > makes treatment much easier, medicate through the tubing
* Bactericidal antibiotic
* Antibiotic
* Antifungal
* Atropine
* Serum
* Dilute povidone-iodine
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Systemic treatment
- Flunixin meglumine
* IV vs PO
corneal surgery for deep ulcer,options
- keratectomy
- Conjunctival Pedicle Graft
Corneal diseases
Stromal Abscess
- what is this? what do we see with flurescein?
- appearance?
- cause?
- Epithelial layer is intact
- Fluorescein: no uptake
- Stromal infiltration
- White, yellow, opaque
- Bacteria, fungal hyphae
- Uveitis
Corneal diseases
Stromal Abscess: Treatment
- Careful debridement, curette
- Bactericidal Antibiotics
- Anti-fungal therapy
- Systemic NSAID
Corneal diseases
Keratitis
- causes? types?
- Herpesvirus: punctate circular central lesions
- Eosinophilic: white plaques, granulation tissue by limbus
- Immune-mediated: corneal neovascularization
- Fungal Keratitis: ulceration or deep stromal
Glaucoma
- what is it?
- secondary to what
- observations
- tests
- treatment?
- High intraocular pressures
- Secondary to uveitis
- Corneal edema, red eye, buphthalmia
- Tonometry
- Uveitis treatment
- Anti-glaucoma treatment
- Medical vs laser
Uveitis - General
- definition, observations
Definition: Inflammation of the uvea
* Damage to the uveal tract
* Release of inflammatory mediators
* Compromised blood-ocular barrier
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- Fibrin in anterior chamber
- Diffuse corneal
edema
- hypopyon
- yellow aqueous
- cataract
Causes of Uveitis
- bacterial
Septicemia from any number of bacteria, hoof abscess, tooth
root abscess, Leptospira, Brucella, Streptococcus, E. coli,
Rhodococcus equi
Causes of Uveitis
- viral
Equine influenza virus, Equine herpesvirus, Equine viral
arteritis, equine infectious anemia virus
Causes of Uveitis
- parasitic
Onchocerca spp, Toxoplasma gondii, Strongylus spp
Causes of Uveitis
- fungal
Fungal keratitis (Aspergillosis, Fusarium)
