Ocular Path Flashcards by Corinne Perra

What are the two main causes of corneal opacity?

Corneal edema

Corneal deposits

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What are causes of corneal edema?

Injury to epithelium (ulceration)

Injury to endothelium

corneal endothelial dystrophy
increased IOP (glaucoma)
immune mediated

Keratitis- neovasculrization with leaky capillaries

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How can you visualize a corneal ulcer?

Flourescein dye

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What causes the “blue eye” seen in puppies infected with canine hepatitis ?

Diffuse corneal edema due to immune complex deposition

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What do you call blood in the anterior chamber of the eye?

Hyphema

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What is usually the source of hyphema?

Blood vessels in the uvea or retina

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What is retinal hypertensive vasculopathy?

Protein deposits in the blood wall

-> hypertension see in cats

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A dog in the clinic presents with corneal opacity..

You can see blood vessels within the sclera due to production of the eye. What is the probable cause of the corneal opacity?

Glaucoma

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What is he cause of primary glaucoma ?

Goniodysgenesis-> detectable malformation of trabecular meshwork (blocking drainage angle)

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What is secondary glaucoma?

Anything that obstructs the pupil or trabecular meshwork

exudate (endophthalmitis)
lens luxation
posterior synechia
peripheral anterior synechia
compression of filtration angle

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Retinal degeneration and atrophy, optic disc cupping, and optic nerve atrophy are all consequences of ____________

Glaucoma

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What is a cataract?

Swelling/degeneration of lenticular fibers-> opacity

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What is the response of the lens to injury?

Hydronic swelling of injured fibers -> fiber fragmentation and disintegration

Hyperplasia and fibrous metaplasia of lens epithelium

Posterior lens epithelial migration

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What is the response of the lens to chronic injury?

Shrinking and wrinkling of lens capsule and mineralization

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T/F: lenticular sclerosis can occur due to senile change

Yes..

Lens differentiate throughout life -> cataract common in old dog

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What are indications of retinal degeneration and atrophy?

Decreased vascularity
Optic disc atrophy
Changes in tapetal reflection

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What are causes of retinal degeneration and atrophy?

Senile change 
Inherited metabolic defect of photoreceptor cells 
Toxicity 
Metabolic deficiencies 
Increased IOP 
Retinal detachment

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Histology shows lost photoreceptor and outer nuclear and plexiform layers of the retina

What is your MDx?

Retinal atrophy (and degeneration)

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What are causes of retinal detachment?

Choroiditis, retinitis
Hemorrhage
Neoplasm
Trauma

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What is retinal detachment? What will the the consequence of this?

Separation between neural and pigmented layers

Rentals degeneration and atrophy

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What is your MDX?
On conjunctiva..

Hyperemia
Swelling/edema
Discharge
Chemosis

Conjunctivitis

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What is chemosis?

Severe conjunctival edema

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What are the causes of conjunctivitis ?

Primary pathogens are rate (except in cats)

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What pathogens of cats cause conjunctivitis?

Herpesvirus
Chlamydophilia felis
Mycoplasma felis

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For an eye that has.. conjunctivitis, purulent discharge, and corneal edema.. ``` What is the most likely cause? A.glaucoma B. Corneal endothelial dystrophy C. Antigen-antibody complex disease D. Corneal ulceration ```

D. Corneal ulceration

What is the response of the cornea to injury?

``` Edema Epithelial regeneration Neutrophil mediated stromal lysis Neovascularization Stromal fibrosis ```

T/F: if the cornea is eroded, epithelial regeneration can occur rapidly

True

If the cornea is ulcerated, _______________ repair must proceed epithelial regeneration

Stromal

A chronically injured corneal may result in ____________ which is a combination of keratinization, epithelial hyperplasia, pigmentation, subepithelial fibrosis, and vacularization

Cutaneous metaplasia

What primary pathogen of cattle causes keratitis

Moraxella bovis (pink eye/ keratoconjunctivitis)

What are the possible etiologies of keratitis?

``` Trauma Bacteria Chlamydia/mycoplasma Virus Drying and desiccation Idiopathic ```

German shepherds get what type of idiopathic keratitis

Chronic superficial keratitis (Pannus)

Boxers are predisposed to _____________________ which is an idiopathic keratitis

Superficial indolent ulcer

What is a melting ulcer?

Necrosis of corneal epithelium and stroma, usually due to innocent bystander injury from leukocytes

What bacteria is often found in cases of keratitis and is an opportunistic infection?

Pseudomonas aeruginosa

What is a descemetocele?

A full thickness ulcer that leaves only the descmeths membrane intact

Horse with corneal ulcer, you treat with antibiotics.. few days later comes back with descemetocele. What went wrong?

You should have also treated with anti fungal at same time as the antibacterial

What is a staphyloma?

A staphyloma is an abnormal protrusion of the uveal tissue through a weak point in the eyeball

What do you call an eye that is shrunken/atrophic and fibrotic?

Phthisis bulbi

What is a corneal sequestrum ?

Area of necrosis of the epithelium and anterior stroma from severe corneal injury Porphyria pigments in tear film -> black lesion in the cornea

What is the disease name for a chronic ulcerative keratitis in boxer dogs

Superficial indolent ulcer

What is the pathogenesis of keratoconjunctivitis sicca?

Dry eye Immune mediated injury to lacrimal glands -> decreased tears or change in tear composition -> drying out of cornea/conjunctiva -> chronic irritation

What is a hypopyon?

Exudate in the anterior of the eye

2yr old cat with photophobia, miosis, blepharospasm, and hypopnyon. MDX?

Anterior uveitis

What is inflammation of the iris and ciliary body

Anterior uveitis

Inflammation of the choroid?

Posterior uveitis

Inflammation of the choroid and retina?

Chorioretintitis

What is inflammation of the uvea, retina, and vitreous?

Endophthalmitis

What do you call inflammation of the whole eye

Panophthalmitis

What are causes of uveitis?

Hypersensitivity (immune complex deposition) Infectious Lens-induced

Feline hypersensitivity reaction that causes uveitis?

Feline idiopathic lymphoplasmacytic uveitis

What is equine recurrent uveitis?

Periodic ophthalmia Moon blindness Iridocyclitis Hypersensitivity rxn (Leptospira) causing uveitis

How can you differentiate FIP form feline idiopathic lymphoplasmacytic uveitis?

FIP-> should have pyogranulomatous lesions and/or effusions elsewhere in body Blood test Feline idopathic lymphoplasmacytic uveitis -> localized to eye

What is iris bombe ? What condition can result from this?

An anterior or posterior synechia Glaucoma

What is a posterior synechia?

Fibrous adhesion between the iris and lens

What is an anterior synechia?

Fibrous adhesion between the iris and cornea

What are consequences of uveitis?

``` Synechia Preiridal fibrovascular membrane Iris bombe Cataracts Lens luxation Glaucoma Retinal detachment Phthisis bulbi ```

What do you call leakage of lens proteins from hypermature cataract?

Phacolytic

What do you call rupture of the lens?

Phacoclastic

What viral infections can cause a retinitis?

Rabies Pseudorabies Distemper (Neurotrophic viral infections)

What parasitic infections can cause a retinitis?

Toxocara canis Baylisascaris procyonis (Ocular larval migrans)

What is the MDx for a goat that has fused orbits and globes? What is the cause?

Cyclophthalmia -> ingestion of Veratrum californium at day 14 of gestation

What is the MDx for an orbit that is small and the eyelids close around it

Microphthalmia | Can be caused by teratogen, in utero infection, and genetics

What is an infectious cause of developmental abnormalities common in cattle?

Bovine viral diarrhea

What do you call the fusion of the eyelids

Ankyloblepharon

What is a corneal dermoid? What can the consequences be?

Growth of dermal tissue on the corneal -> haired skin on the cornea Obstruction of vision Irrigation of cornea -> ulceration/inflammation..ect

What are the waits a luxated lens can be acquired?

Inflammation Trauma Glaucoma

What is the cause of primary glaucoma?

Goniodysgenesis | Filtration angle is filled in with CT -> prevents drainage --> glaucoma

What is the difference between iris hypoplasia and iris coloboma?

Iris hypoplasia-> failure of iris to form fully (notch out of the margin) Iris coloboma -> hole in the iris (not involving the margin)

What common disease of collies is inherited that has retinal vessel tortuously, focal to diffused choroidal and tapetal hypoplasia, and optic nerve coloboma?

Scleral ectasia

What does coloboma mean?

Notch like defect of the optic disk, retina, and/or uvea as a result of defective closure of embryonic tissue of the eye

What is the most common intra-ocular neoplasm of cats? Is it usually benign or malignant?

Feline diffuse iris melanoma Malignant

How can you differentiate feline diffuse iris melanoma from a melanosis

Melanosis "iris freckle" -> flat pigmentation Melanoma-> raised lesion, velvet surface, distortion of pupil/iris

What is the most common benign intra-ocular neoplasm in the dog?

Uveal melanoma

T/F: species and location are the most important prognostic factors for melanocytic neoplasms

True

A tumor that appears as discrete nodules in the posterior uvea, usually is benign and seen more commonly in dogs, rather than cats/

Ciliary adenoma/carcinoma

Why is secodary glaucoma, hyphema, and retinal detachment occur in ciliary adenoma/carcinoma?

Blockage of drainage angle-> glaucoma -> increased pressure --> hyphema and retinal detachment

What malignant neoplasm of the eye is unique to the cat, following ocular trauma? What tissue does it arise from?

Intraocular sarcoma Lenticular epithelium -> metastasize ->> through eye, down optic nerve, and distance metastasis occurs following enucleation

What is the most common metastasis involving the eye, especially in cats, causing thickening/pallor of the uvea?

Uveal lymphoma

On the eyelid.. | Greasy cauliflower like mass.

Meibomian (sebaceous) adenoma

What condition of the eye is associated with hyperlipidemia

Corneal lipidosis "Tropical keratocytes" -very fixed, focal, and discrete margins

In what causes can you get corneal pigmentation?

Staphyloma- derived from uvea Chronic keratitis- response to injury Corneal sequestrum in cats- porphyrins in tear film