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Opthalmology > Opaque eye > Flashcards

Opaque eye Flashcards

(62 cards)

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1
Q

What is red/pink cornea?

A

neovascularisation

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2
Q

What can cause neovascularisation of the cornea?

A

mechanical irritation: eyelid abnormalities, chemical burn

chronic dz: chronic superficial keratitis, eosinophilic keratitis, KCS, immune-mediated keratitis

corneal ulceration
scleritis/episcleritis
granulation tissue
neoplasia

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3
Q

What is white/yellow cornea?

A

deposit/infiltrate

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4
Q

What causes deposit/infiltrate of the cornea?

A

lipid
calcium
abscess/infiltrate
scar/fibrosis
fluorescein

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5
Q

What is blue cornea?

A

oedema

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6
Q

What causes oedema of the cornea?

A

corneal ulcer
vascularisation (leaky vessels)
intraocular disease: uveitis, glaucoma, lens luxation

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7
Q

What is brown/black cornea?

A

pigment

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8
Q

What causes pigment of the cornea?

A

mechanical irritation
sequestrum
pigmentary keratitis
melanoma
FB
corneal perforation with entrapped iris

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9
Q

Why is the healthy cornea transparent?

A

no blood vessels
no myelinated nerves
no pigment
relatively dehydrated

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10
Q

What are the layers of the cornea?

A

epithelium
stroma (thickest)
descemet’s membrane
endothelium

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11
Q

How does the epithelium of the cornea heal?

A

enlargement and sliding of epithelial cells
1-2h

mitosis of epithelial cells
completely healed in 1-2 weeks

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12
Q

How does the stroma of the cornea heal?

A

Epithelium will heal first: epithelial cell sliding and mitosis (1-2 weeks)
the epithelia will roll over the stromal defect

stroma will need weeks to months to generate new collagen fibers and lamellae

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13
Q

How does the endothelium of the cornea heal?

A

limited capacity for mitosis
enlarge in size, reduve in numbers and lose their hexogonal appearance

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14
Q

How is vascularisation indicative of corneal healing?

A

there is a lag phase
and then when healing starts vessels grow about 0.5mm per day

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15
Q

What is important to know about SCCED?

A

Spontaneous chronic corneal epithelial defect
only type of ulcer that should be debrided, causes a haz layer which stops epithelium from sticking over the stroma = needs to be removed
its always superficial

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16
Q

How does KCS cause corneal opacity?

A

KCS = dry eye
discharge stick to the cornea

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17
Q

What does a superficial ulcer look like?

A

similar to scedd w/o haz layer
hard to see with the naked eye
1-2weeks healing

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18
Q

What does a deep ulcer look like?

A

crater into the eye, in the stroma

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19
Q

What does a descemetocoele look like?

A

very deep ulcer
single layer left before eye is ruptured: EMERGENCY
oedema around ulcer
florescein + flush: stain doesn’t stain the bottom layer only walls of ulcer

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20
Q

What is a melting/malacic ulcer?

A

cornea starts degrading/melting away

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21
Q

What is the only type of ulcer you should use steroids on?

A

immune-mediated superficial punctate keratitis

common in daschund

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22
Q

What shoudl we always consider until proven otherwise with corneal ulcers in cats?

A

that its feline herpesvirus (dendritic or geographic)

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23
Q

What is a corneal perforation?

A

ulcer/other that goes through all the layers of the cornea

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24
Q

What are the 6 medical management tx of ulcerative keratitis and when are they used?

A

topical antibiotic (prophylactic), antiviral, antifungal

topical mydriatic/cycloplegic (vs uveitis/myotic pupil)

topical anti-collegenase (vs melting ulcer enzyme)

systemic analgesic (pain)

+/- topical immunomodulator

+/- topical anti-inflammatory (but risk of delayed corneal healing)

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25
What are the non-medical management treatments for ulcerative keratitis?
corneal collagen crosslinking surgical grafting tarsorrhaphy (partially close eyelid) 3rd eyelid flap contact lens
26
Why could a corneal ulcer be non-healing?
aka longer than 2 weeks on appropriate tx mechanical irritation infection malacia/melting SCCED neoplasia
27
What is eosinophilic keratitis?
immune mediated in rabbits and cats plaque like white/pink cottage cheese in corners of the eye only 1 eosinophil is diagnostic! steroids indicated
28
What is chronic superficial keratitis?
pannus grey-pink film over the eye that can become opaque with progression immune mediated, steroids indicated
29
What is corneal sequestrum?
piece of cornea that has died off and taken brown discoloration could be ulcerative around the edge or started off as an ulcer
30
What is an acute bullous keratopathy?
severe form of corneal oedema rare indication for 3rd eyelid closure
31
What is pigmentary keratitis?
black or brown pigment is deposited on the cornea caused by chronic inflammation or irritation
32
What is mineral deposition on the cornea?
calcium/lipid have a sparkly look, white part of degenerative process
33
What is endothelial degeneration?
corneal oedema from being compromised or from age/genetics when it can no longer compensate blue or cloudy
34
What are the types of corneal oedema?
endothelial degeneration uveitis lens luxation glaucoma
35
What are the clinical signs of lens instability?
decreased transparency (corneal oedema) phacodonesis iridodonesis aphakic crescent
36
What is phacodonesis?
wobbly lens
37
What is iridodonesis?
wobbly iris
38
What is aphakic crescent?
clear crescent shape in the pupil where lens has moved "out of the way"`
39
What are the diagnostic tests used for disease of the lens?
clinical appearance tonometry (IOP may be high) * lens luxation = emergency
40
What are the primary lens luxation causes?
genetic mutations (especially terrier breeds)
41
What are the secondary lens luxation causes?
chronic uveitis (zonular degradation) glaucoma (stretched zonules) cataract (secondary uveitis) trauma (mech. rupture, uveitis) intraocular neoplasm
42
What is the path of the aqueous humour flow?
ciliary body -> pupil -> iridocorneal angle (drainage angle) in the anterior chamber
43
What is the blood aqueous barrier?
epithelial barrier in ciliary body and iris separates the eye from systemic circulation becomes "leaky" when inflammed
44
What are clinical signs of uveitis?
aqueous humor flare hyphaema hypopyon
45
What are diagnostic tests used for anterior chamber disease?
clinical signs tonometry (usually decreased due to loss of function from infl.)
46
What is liquefaction?
disease of the vitreous goes from gel to liquid causes vitreal opacity
47
What is persistent hyaloid artery?
part of foetal vasculature that should regress after a few weeks of life most cases not clinically relevant is an opacity in the vitreous
48
What is PHTVL/PHPV?
vitreal opacity persistent hyperplasia of vitreous embryon vasculature that didn't regress no tx unless client wants cataract sx
49
What is vitreal degeneration?
in older ptx vitreous humour shrinks causing condensed vitreous materal/ "floaters"
50
What should we know about vitreal haemorrhage?
generally self-resolves turnover of vitreous is very slow and can take a few months to heal
51
What is vitritis?
cellular infiltration inflammation from surrounding tissues
52
What is asteroid hyalosis?
cholesteol clumps in the vitreous that jiggle but keep position caused by age
53
What is synchysis scintillans?
cholesterol crystals that have a snowball effect degenerative condition
54
What are the clinical signs of acute glaucoma?
corneal oedema episcleral congestion conjunctival hyperaemia epiphora mydriasis aqueous flare abscent menace
55
What are the clinical signs of chronic glaucoma?
signs of acute glaucoma optic nerve head cupping Haab's stria buphtalmia lens subluxation/luxation
56
What is a normal tonometry result?
10-25 if 25-30: mild stage, low pressure of day, false elevation, poor restraint
57
How do we know how to interpret tonometry results?
use alongside the clinical signs
58
What is congenital glaucoma?
aqueous humour can't drain properly and young eyes stretch easily once enlarged won't go back and vision is likely lost
59
What is an open/closed angle during glaucoma?
open: fibers of pectinate in the iridocorneal angle are normal but tibecular meshwork is abnormal stopping the draining of the aqeuous humour closed: loss of ligament fibers, aqueous humour has nowhere to go
60
What are causes of secondary glaucoma?
lens luxation (lens blocks drainage) uveitis
61
What are the medical management options for glaucoma?
carbonic anhydrase inhibitors (stops enzyme producing aqueous humour) prostaglandin analogues (increases outflow) adrenergic agents (when no cvs/syst. issues it helps potentiate CAI) cholinergic agonists osmotic agents
62

Opthalmology (10 decks)

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