Optho

Question 1

Micropthalmos

Answer 1

congenitally small globe +/- abnormalities
animal was born with an abnormal eye
+/- vision present
pupils tend to not dilate well

Question 2

Exopthalmos

Answer 2

prominant (NOT enlarged) globe
difficult to retropulse, conjunctival hyperemia, chemosis, +/- oral cavity lesions bc there is no bone in the ventral orbit, elevated 3rd eyelid

Question 3

What are the big 2 etiologies of exopthalmos?

Answer 3

retrobulbar cellulitis/ abscess is the major concern as well as neoplasia

Question 4

How do we determine bupthalmos (enlarged eye) vs exopthalmos

Answer 4

usually eyes that are being pushed forward don’t have concurrent eye disease

Question 5

Enopthalmos

Answer 5

decreased volume of orbital contents
globe looks “sunken” into orbit

common owner complaint: eye has “rolled back” into head when really it is the prolapsed 3rd eyelid

Question 6

Etiologies of enopthalmos

Answer 6

Pain
atrophy of retrobulbar fat
atrophy of muscle tissue in the orbit
dehydration
horners syndrome
skull fracture

Question 7

Proptosis

Answer 7

forward displacement of the globe
the lid margins are behind the globe equator of the eye
proptosis is an emergency
grave visual prognosis of the eye

Question 8

Pthisis Bulbi

Answer 8

chronic, diffuse intraocular inflammation with contraction may result in a shrunken, disorganized, atrophic globe

Question 9

Enucleation techniques (2)

Answer 9

Subconjunctival approach
-dissect under conjunctiva

Transpalpebral approach
-lid margin. conjunctiva and eye are taken out all together

Question 10

What are the complications that can occur with enucleation

Answer 10

hemorrhage (incision/ nares)
pain
draining fistula or orbital swelling (retained lacrimal tissue)
orbital infection - rare
orbital emphysema

Question 11

Exenteration

Answer 11

sx removal of globe + orbital contents (extrocular muscles) down to the bone
-not as cosmetically pleasing
-leaves a deeper cavitation behind

Question 12

What procedures are considered “comfort procedures” in opthalmology + when do we do them?

Answer 12

performed in patients that are blind + painful
-enucleation
-intraocular prosthesis
-chemical ciliary body ablation (k9 only)

Question 13

Entropion

Answer 13

inward rotation of part or all of the eyelid margin
-periocular skin + fur rubs against the cornea + irritation + scarring

Question 14

CS of entropion

Answer 14

blepharospasms (squint)
epiphora (tearing)
rubbing
+/- secondary corneal ulceration
may see mucopurulent ocular discharge
+/- pigment loss of eyelid in a region that is constantly moist

Question 15

Etiology of enopthalmos

Answer 15

-enopthalmosis - senile atrophy of retrobulbar tissue
-spastic
Cicatrical: secondary to scarring
Anatomical: MUST correct underlyin gproblem before sx repair

Question 16

Post- op for entropion

Answer 16

-rigid e-collar until every single suture has been removed
-cool eyelid compress
-gently clean out ocular discharge
-topical or systemic anbx
-oral anti-inflammatories + pain meds

Question 17

Ectropion

Answer 17

eversion of the eyelid margin
primary cs in conjunctivitis

Question 18

Distichia

Answer 18

most are asymptomatic
extra cilia arising from the meibomian gland opening at eyelid margin

Question 19

Chalazion

Answer 19

enlargement of the meibomian gland due to blockage of duct + collection of secretory byproducts

generally painless

Question 20

T or F manually express infections at the eyelid margin as a part of treatment

Answer 20

False! don’t manually express!

Question 21

Etiologies of blepharitis

Answer 21

self trauma, infectious, allergic, autoimmune, Staphylococcus hypesensitivity!!!!!!! (most commonly all 4 lids are involved simultaneously!

Question 22

Meibomina gland tumors

Answer 22

adenoma + adenocarcinoma
most common in middle aged to older dogs
clinically benign- build up of sebaceous material

sx excision at the eyelid margin alone is only a temporary solution

tx of choice: sx debulk + cryotherapy or eyelid wedge resection