Lacrimal and Conjunctiva

Question 1

what produces soluble mucin that mixes with aqueous?

Answer 1

conjunctival goblet cells

Question 2

what is a normal value in a dog for a schirmer tear test?

Answer 2

> 15 mm/min

Question 3

what are common immune-mediated KCS breeds?

Answer 3

cavalier king charles spaniel
west highland white terrier
american cocker spaniel
english bulldog
lhasa apso
pug

Question 4

which glands are abnormal in lipid deficiency?

Answer 4

meibomian glands

Question 5

what can cause mucin deficiency?

Answer 5

conjunctivitis
allergies
diabetes mellitus

Question 6

what can cause KCS in cats?

Answer 6

herpes
eyelid agenesis

Question 7

what are some calcineurin inhibitors?

Answer 7

cyclosporine
tacrolimus
others

Question 8

when is the maximal effect of calcineurin inhibitors seen?

Answer 8

6-8 weeks

Question 9

how long do cyclosporine implants increase schirmer tear test?

Answer 9

10-11 months

Question 10

are antibiotics usually necessary?

Answer 10

no, unless ulcer

Question 11

what can be done for an imperforate punctum?

Answer 11

can surgically open

Question 12

what is dacryocystitis?

Answer 12

purulent discharge from puncta

Question 13

when is conjunctival pigmentation concerning?

Answer 13

raised

Question 14

what are some infectious causes of conjunctivitis in cats?

Answer 14

felines herpesvirus-1
chlamydophila/Chlamydia felis
Mycoplasma spp

Question 15

how can you treat feline herpesvirus-1?

Answer 15

antivirals
topical hyaluronic acid lubricants
supportive care

Question 16

which oral antivirals can we use in cats?

Answer 16

famciclovir

Question 17

what are the functions of the tear film?

Answer 17

oxygen and nutrients for cornea
lubrication
protection, immune function
optical clarity

Question 18

what is the thickest layer of the tear film?

Answer 18

aqueous layer

Question 19

what is the function of the aqueous layer?

Answer 19

hydrates, nourishes cornea

Question 20

what do thee corneal and conjunctival epithelium produce?

Answer 20

insoluble mucin- glycocalyx
binds tears to ocular surface

Question 21

what are some signs of tear film deficiency?

Answer 21

mucoid discharge
dry corneal surface
conjunctival hyperemia
corneal changes
discomfort
corneal ulceration
blepharitis
decrease in vision

Question 22

how can you diagnose tear film deficiency?

Answer 22

ocular exam
schirmer tear test
ocular stains
tear film breakup time

Question 23

what decreases schirmer tear test?

Answer 23

general anesthesia
proparacaine
atropine
illness

Question 24

what schirmer tear test value is severe KCS?

Answer 24

<5mm/min

Question 25

what is a tear film breakup time?

Answer 25

fluorescein stain and manually keep eyelids open dog <20sec is mucin deficiency

Question 26

is immune mediated KCS unilateral or bilateral?

Answer 26

bilateral

Question 27

when should you be suspicious of a dog with KCS?

Answer 27

unilateral very young acute onset dermatologic disease nasal signs

Question 28

what is neurogenic KCS?

Answer 28

parasympathetic disruption unilateral, acute, severe

Question 29

what drugs induce KCS?

Answer 29

sulfa antibiotics etodolac both in dogs

Question 30

what dogs can have lacrimal gland aplasia?

Answer 30

yorkies

Question 31

what can cause lipid deficiency?

Answer 31

allergies/atopy blepharitis chemical burns

Question 32

what can cause mucin deficiency (loss of conjunctival goblet cells)?

Answer 32

conjunctivitis allergies diabetes mellitus

Question 33

how is KCS treated?

Answer 33

periocular hygiene calcineurin inhibitors lubricants antibiotics steroids? pilocarpine surgery

Question 34

what do calcineurin inhibitors do with KCS?

Answer 34

lacrimogenic effect improve mucin quality decrease inflammation, corneal pigment, vascularization

Question 35

when is the maximal effect of calcineurin inhibitors?

Answer 35

6-8 weeks

Question 36

what are the adverse effects of calcineurin inhibitors?

Answer 36

rarely periocular hair loss, topical irritation ocular squamous cell carcinoma

Question 37

when is pilocarpine (parasympathomimetic) useful for KCS?

Answer 37

neurogenic KCS

Question 38

what are treatments for qualitative KCS with lipids?

Answer 38

warm compress omega 3 supplements treatment of underlying disease

Question 39

what are some mucin tear supplements?

Answer 39

hyaluronic acid/hyaluronate methylcellulose

Question 40

what are the three pathways for tear drainage?

Answer 40

via nasolacrimal system evaporation overflow onto face

Question 41

what is jones test?

Answer 41

apply fluoroscein to eye and monitor nares passive test

Question 42

in whom is dacryocystitis (purulent discharge from puncta) common?

Answer 42

rabbits

Question 43

what cells make up the conjunctiva?

Answer 43

columnar epithelium goblet cells

Question 44

what can cause conjunctivitis in dogs/

Answer 44

follicular conjunctivitis allergies/atopy conformation environmental

Question 45

what can cause infectious conjunctivitis in dogs?

Answer 45

canine distemper virus leishmania thelazia

Question 46

what is pathognomonic of feline herpesvirus 1?

Answer 46

dendritic ulcers

Question 47

where does feline herpesvirus 1 persist?

Answer 47

in trigeminal ganglion

Question 48

what should you avoid with feline herpesvirus 1?

Answer 48

topical anti-inflammatories

Question 49

why can we not use oral antivirals other than famciclovir in cats?

Answer 49

acyclovir causes bone marrow suppression valacyclovir causes bone marrow suppression and fatal hepatic/renal necrosis