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Flashcards in Ocular conditions Deck (29)
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1

Define entropian

Eyelids roll inwards causing the eyelashes to irritate the eye

2

What are the clinical signs of entropian?

Excess tear production

Epiphora (overflow of tears down the face)

Conjunctivitis

Corneal ulceration

3

Why should an entropian animals eyes be assessed prior to pre-med?

ACP will make the eyelids droop

4

Describe surgery for entropian

Slivers of skin are removed to turn the eyelid out

More than one surgery may be required

5

Define ectropian

The eyelid is oversized and bags/ droops open exposing the conjunctiva

6

What are the clinical signs of ectropian?

Appearance

Conjunctivitis

Chronic keratitis (inflammation of the cornea)

7

Describe surgery for ectropian

As before the eye should be assessed prior to any pre-med being given

Slivers of skin are removed to ‘take up the slack’ of the eyelid

8

Describe post-op care for entropian and ectropian

Buster collar must be applied immediately on recovery

Use of cold compresses if indicated to reduce swelling

9

Describe distichiasis

A whole row of extra eyelashes inside the normal lashes

10

Describe ectopic cillia

One or two abnormally positioned eyelashes

11

What are the clinical signs of distichiasis and ectopic cillia?

Epiphora

Conjunctivitis

Blepharospasm (spasm of the eyelids, blinking lots)

Corneal ulcer

Chronic keratitis (corneal inflammation)

12

Describe surgery options for Distichiasis and Ectopic Cillia

Can simply pluck extra lashes away under sedation, but they will grow back

Electrolysis gives longer lasting results but again will grow back

Delicate surgery performed at referral centres to remove the eyelash roots

Cryotherapy can be used

13

Describe eyelid tumours

Marginal tumours are common in older dogs

Cause irritation by rubbing in the surface of the cornea

Removed by excising a wedge of the eyelid margin

Patient interference should be prevented immediately on recovery

14

Describe cataracts

Increase in the opacity of the fibres or capsule of the eye lens.

Primary or secondary condition

Can be left untreated or removed at referral centres

15

Describe cataracts surgery

Phacoemulsification technique is used

Needle vibrated by ultrasound and this breaks up the cataract

Particles are then aspirated

Alternatively the lens is removed

16

Describe 'blue eye'

Older animals will have a ‘blue’ colour to the lens of their eyes

Occurs as a result of the aging process

Not a cataract the animal can still see

Senile nuclear sclerosis, a natural aging process

17

Describe first aid for a prolapsed eyeball

Prevent the eye from dehydrating

Use of saline, ophthalmic ointment or water soluble jelly to prevent this

Prevent the animal traumatising the eye

18

Describe surgery for a prolapsed eyeball

Lateral canthotomy is an incision at the lateral canthus to extend the eyelids

Eyelids sutured together for approx 2wks to prevent reoccurrence

19

Describe post-op management for a prolapsed eyeball

Buster collar to prevent self trauma post operatively

20

Describe corneal damage

Most common corneal damage is ulceration

Blepharospasm

Epiphora

Pain

Animal may rub at the eye

21

Describe treatment for corneal damage (ulcer)

Medical treatment in the form of regular eye drops and NSAID can normally heal an ulcer

Ulcer gently debrided using a cotton bud to remove any loose tissue

22

Describe a third eyelid flap

3rd eyelid pulled closed over the eye and sutured in place

Acts as a bandage and prevents the eyelid irritating the ulcer

Eye drops are still applied

23

Describe a conjunctival flap

A pedicle of conjunctivia is sutured to the cornea, covering the ulcer

Again acts as a bandage, but this method also supplies nutrition the ulcer to encourage healing

24

Describe a punctate ketatotomy

Sedation and local anaesthetic eye drops are required

Gently debride the ulcer

Ulcer being debrided with cotton buds

Sterile hypodermic needle is used to scratch grid lines on the surface of the damaged area

Stimulates healing in tissues that have become dormant

25

Describe enucleation

Enucleation is indicated if the eye is too damaged to save as a result of –


Gross trauma

Neoplasia – of the eye or behind the eye

Untreatable glaucoma

Irreducible prolapse

Cosmetic appearance is of a concern to many clients prior to this surgery


More time and reassurance may be needed prior to surgery to ‘council’ these clients


The animal will tolerate enucleation well and in some cases improves their quality of life

26

Describe surgery for enucleation

Many techniques are available

Commonly a Trans Palpebral Enucleation is performed

Eyelids are first sutured together using a continuous suture

Eye is then removed by dissection of the conjunctiva

Optic nerve and blood vessels are clamped and carefully ligated

An ‘emovet’ pad sometimes required - encourages haemorrhage to clot

Oculocardiac reflex can occur. A stimulus to the eye pressure, manipulation or traction gets transmitted to the vagal nerve and onto the heart.

Causes profound bradycardia, arrhythmias or asystole

Critical to monitor the heart very closely/continuously throughout the procedure

If any signs are noticed to a change in the heart the surgeon must be notified immediately so they can re consider their surgical technique

27

Describe post-op care for enucleation

Buster collar

Observation for haemorrhage

28

Describe cherry eye

Describes the protrusion of the tear gland associated with the 3rd eyelid

Occurs due to a weakness of the glands normal attachment

29

Describe surgery for cherry eye

Surgery involves replacing the gland into its normal position and suturing in place.

Better success with surgery if it is carried out as soon as possible