Orbital Disease in Small Animals

Question 1

what is exophthalmos?

Answer 1

rostral deviation of the globe

Question 2

what can cause enophthalmos?

Answer 2

loss/shrinkage of orbital contents
rostral orbital disease

Question 3

what are conjunctival changes often due to?

Answer 3

vascular stasis/congestion

Question 4

what is a major cause of pain with ocular disease?

Answer 4

impingement by mandibular ramus

Question 5

what is CT excellent for?

Answer 5

bone
teeth
adjacent structures

Question 6

what is MRI excellent for?

Answer 6

soft tissue
CNS

Question 7

in who are abscesses/cellulitis fairly common?

Answer 7

dogs

Question 8

how long should you treat an abscess/cellulitis?

Answer 8

minimum of 6 weeks

Question 9

when should you consider fungal disease?

Answer 9

travel history
no response to antibiotic therapy

Question 10

which breeds can get masticatory myositis?

Answer 10

german shepherds
weimaraners
cavaliers
viszlas

Question 11

how can you diagnose masticatory myositis?

Answer 11

serology +/- muscle biopsy

Question 12

what are late effects of radiation to the eye?

Answer 12

permanent KCS
cataracts
retinal degeneration

Question 13

who is proptosis common in?

Answer 13

brachycephalics

Question 14

what percentage of animals with proptosis will retain vision?

Answer 14

10-20%

Question 15

when might an orbitotomy be performed?

Answer 15

localized tumor
foreign body
walled-off infection

Question 16

what glands are in the orbit or neighboring it?

Answer 16

lacrimal gland
zygomatic salivary gland
third eyelid

Question 17

in whom is exophthalmos normal?

Answer 17

brachycephalics

Question 18

what is enophthalmos?

Answer 18

loss/shrinkage of orbital contents
usually with third eyelid protrusion

Question 19

is elevation of the third eyelid a nonspecific sign of pain?

Answer 19

yes

Question 20

what can you give for pain management in orbital disease?

Answer 20

ideally NSAID with some caveats
+/- opioid, gabapentin, tramadol

Question 21

what is ultrasound good for?

Answer 21

soft tissue, poor for bone
biopsies, aspirates, drain fluid

Question 22

what are some infectious etiologies of orbital disease?

Answer 22

abscesses
cellulitis

Question 23

why might an animal with an abscess or cellulitis be blind?

Answer 23

optic nerve compression

Question 24

should you poke behind the last molar for abscess/cellulitis?

Answer 24

no

Question 25

what are some antibiotic combinations good for abscesses/cellulitis?

Answer 25

clindamycin and baytril baytril and metronidazole clavamox and baytril

Question 26

what should you consider if an abscess or cellulitis is having inadequate response to treatment?

Answer 26

foreign body dental disease fungal disease noninfectious causes: lymphoma

Question 27

what parasites can cause orbital disease?

Answer 27

Taenia/cysticercosis: rabbit/chinchilla Toxocara canis Onchocerca spp Toxoplasma gondii Neospora caninum Leishmania Ehrlichia canis

Question 28

what is an orbitotomy?

Answer 28

surgical entry into orbit

Question 29

what is the acute phase of masticatory myositis like?

Answer 29

palpable swelling of muscles pain +/- fever eosinophilia or neutrophilia variable exophthalmia

Question 30

how can you treat masticatory myositis?

Answer 30

immunosuppressives long term: start with prednisone

Question 31

who usually gets extraocular myositis?

Answer 31

young dogs retrievers overrepresented

Question 32

how can you treat extraocular myositis?

Answer 32

usually responds well to immunosuppression

Question 33

what neoplasias can be primary orbital tumors?

Answer 33

meningioma sarcomas

Question 34

what is exenteration?

Answer 34

removal of entire orbital contents including globe

Question 35

what are acute phase effects of radiation to the eye?

Answer 35

decreased tear production keratitis conjunctivitis moist desquamation of skin

Question 36

when should you enucleate an proptosed eye?

Answer 36

globe ruptured hyphema >2 extraocular muscles ruptured extensive conjunctival rupture

Question 37

what is evisceration?

Answer 37

removal of intraocular contents, retaining sclerocorneal shell silicone intrascleral prosthesis placed

Question 38

what is exenteration?

Answer 38

removal of globe and orbital contents

Question 39

what is an orbitectomy?

Answer 39

resection of orbit in its entirety including bony walls