Equine stromal abscesses Flashcards
(14 cards)
1
Q
DDX stromal abscesses
A
- Uveitis alone
- EK
- Neoplasia
- Ulcerative stromal keratitis
- Granulation tissue
- Corneal degeneration
2
Q
Deep stromal ulcers more likely to be
A
fungal
- less likely to vascularize
- more likely to req sx
3
Q
Clinical signs of uveitis (7)
A
- miosis
- aq flare and cell infiltrates
- Hypopion
- Fibrin in AC
- Corneal edema
- Corneal vascularization
- Keratic precipitates
4
Q
Decision to go to surgery determined by (5)
A
- no response to med management
- Severe, vision threatening uveitis
- severe pain
5
Q
Client should expect medical therapy after sx
A
for 4-6 weeks
6
Q
Surgical procedure depends on (2)
A
- lesion location
2. Lesion depth
7
Q
PK
A
Penetrating keratoplasty
-for big lesions maybe?
8
Q
PLK
A
Posterior Lamellar keratoplasty
-good for axial lesion
9
Q
DLEK
A
Deep lamellar endothelial keratoplasty
-good for peripheral lesions
10
Q
Stromal abscess goals of therapy (4)
A
- Control uveitis
- dilate pupil
- improve comfort
- clear cornea - Consolidation, then vascularization of lesion
- Incorporation graft if placed
- Return to vision and function
11
Q
Antibiotics if endophthalmitis or to go to surgery
A
- TMS: 30 mg/kg PO q12h
- Doxycycline or minocycline: 10 mg/kg PO q12h
- K-Pen/Gentamicin
12
Q
When to stop treatment for stromal abscess (6)
A
- At least 4-6 weeks of antifungal therapy (up to 2-3 months)
- Mydriasis maintained w/ atropine QD or EOD
- SA changes from cream to grey-white (fibrosis as opposed to active dz)
- Corneal blood vessels start receding, not just from NSAIDS
- Other signs of Uveitis disappear
- Restart if Uveitis signs reappear
13
Q
Intrastromal injection (4)
A
- Voriconazole around lesion with 30 ga needle
- Will see stroma fracturing
- injections disrupt lamellae - Don’t enter anterior chamber
- Continue medical therapy after
14
Q
Fibrin behind abscess indication for
A
surgery
