Equine Ophthalmology 2 Flashcards
(20 cards)
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
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- 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)
Causes of Uveitis
- Immune mediated
Lens-induced phacoclastic uveitis
Causes of Uveitis
- neoplastic
Melanoma, adenoma/carcinoma, lymphoma
Causes of Uveitis
- environmental
Blunt ocular or perforating corneal trauma
Clinical signs of uveitis, from afar
Epiphora, blepharospasm, photophobia
Clinical signs of uveitis in front of eye
Conjunctival hyperemia
Episcleral injection
Corneal edema
Deep peripheral vascularization
Keratic precipitates (KP’s),
Aqueous flare/fibrin
Hypopyon
Hyphema
Miosis
Rubriosis iridis (red iris)
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- Iris colour change with acute uveitis (secondary to infiltration by
inflammatory cells and serum)
