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Opthalmology2 > Nasolacrimal/Conjunctiva > Flashcards

Nasolacrimal/Conjunctiva Flashcards

1
Q

Conjunctival anatomy

A

stratified squamous to columnar non-keratinizing epithelium

goblet cells! (produce tear film)

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2
Q

Third eyelid is in the _______ portion of the eye

A

ventro medial

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3
Q

support structure for TE

A

T shaped cartilage

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4
Q

Breakdown of ______ leads to TE prolapse

A

T shaped cartilage

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5
Q

secretory components of the nasolacrimal apparatus?

A

orbital lacrimal gland

gland of TE

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6
Q

Upper and lower eyelid puncta enter canaliculi and connect at the _________.
Then the Nasaolacrimal duct opens into the _____.

A

lacrimal sac

nasal vestibule

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7
Q

tear overflow results from

A

overproduction or decreased drainage

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8
Q

layers of the tear film and what they do

A
  1. outer oil layer (prevents evaporation)
  2. aqueous layer (Moisturize me!! -put the lotion on the skin or else it gets the hose again)
  3. Deep Mucous Layer (smooths irregularities of the epithelial cells)
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9
Q

7 Functions of the Tear film

A

S SMOOTH ocular surface for light refraction
L Lubrication
I Give INFLAMMATORY cells access to cornea
P defend from Pathogens

O provide OXYGEN and nutrients
R REMOVE waste products and debris

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10
Q

The STT is a _______ test

A

quantitative

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11
Q

Fluorescein stain

A

hydrophilic

identifies ulcers, stability of tear film

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12
Q

Rose Bengal/Lissamine Green

A

tests tear film integrity/quality
Conj and corneal epithelium retain stain if mucin is deficient
(can indicate KCS, viral keratitis, fungal keratitis)

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13
Q

Tear Film Break-Up Time

A

indicates tear stability, hold eye open after applying fluorescein and blinking, observe first break in tear film under cobalt-blue light
*< 10 sec is abnorma. If abnormal it might indicate globlet cell dysfunction

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14
Q

normal epithelial cells from a corneal cytology

A

often in sheets with round/oval nuclei, basophilic cytoplasm

Inclusions or bacteria are abnormal findings

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15
Q

common inclusions to see on corneal cytology?

A
  • chlamydia in cats with acute conjunctivitis
  • herpes least common
  • multiple basophilic inclusions suggests Mycoplasma
    (don’t confuse with melanin granules!)
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16
Q

what do lymphoid follicles in conjunctiva suggest?

A

chronic conjunctivitis

or immune mediated disease

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17
Q

clinical signs of conjunctivitis

A

signs vary but hyperemia, chemosis (swelling) , discharge, blepharospasm.
(no fluoresceine retention?)

18
Q

how do you diagnose primary conjunctivitis?

A

by excluding secondary conjunctivits

19
Q

how does ocular discharge change with progression of conjunctivitis?

A

serous - early and mild
mucoid - chronic KCS!!!
purulent - bacterial

20
Q

Differing Etiologies of conjunctivitis?

A 
KCS
Allergic
Bacterial
Viral
Parasitic
Physical irritation/trauma
intraocular disease uveitis
systemic illness
21
Q

most common cause of conjunctivitis in dogs

vs. cats?

A

dogs - secondary (dry eye, allergy, follicular (antigenic), environmental
cats - primary (usually infectious)

22
Q

uncommon conjunctivitis dobermans get

A

ligneous

23
Q

Treatment for conjunctivitis

A 
depends on etiology....
Tear stimulants
anti viral tx
topical anti-inflammatories 
topical abx
topical lubricants
24
Q

common in young, stressed, immunocompromized cats

A

FHV-1 - conjunctivits

25
Q

sequela of chronic conjunctivitis

A

discomfort, follicles, tear film abnormalities

symblepharon - adhesions to itself or cornea

26
Q

conjunctival hemorrhage

A

trauma (especially strangulation)

bleeding disorders

27
Q

KCS stands for?

A

kerato conjunctivitis sicca

28
Q

KCS

A

quantitative tear deficiency, looks like eye boogers
(blepharospasm, hyperemia, mucoid ropy tenacious discharge, ulcers, dry appearance, dull cornea with neovascularization, dry crusting mucus, blepharitis,loss of vision)

29
Q

Cause of Most KCS in dog?

other causes?

A
  • immune mediated (affecting the glands)

- congenital, drug related(SULFA DRUGS, phenazopyradine, atropine), traumatic, neurologic, distemper, TE ectomy

30
Q

Same dogs predisposed to KCS are predisposed to _____.

A

TE prolapse

bulldogs, westies, cockers, pugs, dachshunds

31
Q

topicals that increase tear production in 80% of cases

A

Cyclosporine (1-2%) and Tacrolimus (.02%)

-have T helper cell inhibitory activity

32
Q

Mucinolytics (drugs that break up mucus so drug can get in the eye better)

A

use as infrequently as possible! its protecting the eye!
Clean eyes with saline first
*Acetylcystein can be used 2-4x/day for excessive mucous

33
Q

surgical treatment for KCS

A

parotid duct transposition
patial permanent tarsorrhaphy/canthoplasty
punctal occlusion

34
Q

Ephiphora

A

flow of tears onto face resulting from decreased drainage/tear flow disruption (NLD obstruction)

35
Q

why do tears stain brown?

A

something about porphyrins and the UV light conversion

36
Q

How to flush the NLD

A

use topical anesthesia, identify the punctum and use a small gauge catheter

37
Q

small dog epiphora

A

small dogs and brachycephalic cats
medial canthal entropion, irritation causes excessive tear production, obstruction, facial folds
….. its a multifactorial disease

38
Q

medial canthal pocket syndrome

A

large dogs with deep orbits, nasal fornix is large and traps debris causing conjunctivitis, mucous at medial canthus (especially dobbies and labs)

39
Q

Cherry eye

A

prolapsed TE, can progress to KCS, don’t amputate gland!

40
Q

Neoplasia conjunctiva

A

both - Melanoma,SCC, lymphoma
bulbar/palpebral also gets - hemangioma, Mast cell
TE also gets - Adenocarcinoma

Opthalmology2 (10 decks)

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