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Unit 2 - Feline Ophthalmology Flashcards

(80 cards)

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1
Q

What are the general practices that you should maintain for a feline ophthalmic exam (room, restraint)?

A

Quiet room that can be darkened

Gentle restraint on the exam table and ‘less is more’ approach

If not compliant, wrap patient in a towel

Have assistant elevate rear end for you to view ventral cornea

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2
Q

What is the normal STT in cats?

A

> 9 mm/min

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3
Q

What is the preferred device to test IOP in cats?

A

TonoVet

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4
Q

If you need to use atropine in a cat, what form should you use? Why?

A

Use atropine ointment to minimize hypersalivation

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5
Q

When shouldn’t timolol be used in cats?

A

Cats with asthma - be careful regardless

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6
Q

What orbital condition results in a grave prognosis for a cats eye?

A

Proptosis

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7
Q

Eyelid agenesis causes what in cats?

A

Trichiasis and keratitis

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8
Q

What is the most common eyelid neoplasia in cats?

As a generality, are feline eyelid neoplasias typically benign or malignant?

A

SCC

Malignant > benign

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9
Q

What lacrimal conditions do brachycephalic cats typically get?

A

Fucntional nasolacrimal obstructions

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10
Q

What virus causes a lack of tear production in cats?

A

FHV-1

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11
Q

What is the most common cause of cataracts and lens luxation in cats?

A

Uveitis

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12
Q

What clinical signs are associated with feline conjunctivitis?

A

Blepharospasm

Tearing/discharge

Conjunctival redness +/- swelling (chemosis)

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13
Q

What is the common cause of conjunctivitis in cats (general)?

A

Primary pathogens are common

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14
Q

What primary pathogens are common causes of feline conjunctivitis?

A

Chlamydia felis

Mycoplasma felis and gatae

Feline herpesvirys-1

Calicivirus

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15
Q

What individuals are especially susceptible to feline conjunctivitis?

A

Young, immunosuppressed, sick, or stressed cats at highest risk

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16
Q

T/F: Feline conjunctivitis is one of the few conditions that can be treated with topical steroids.

A

False - do not, no bueno

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17
Q

What are the bacterial causes of conjunctivitis?

A

Chlamydia or Mycoplasma

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18
Q

What does bacterial conjunctivitis look like?

A

No corneal changes; more chemosis

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19
Q

How do you treat bacterial conjunctivitis?

A

Topical antibiotics - TID-QID: erythromycin, tetracycline, chloramphenicol, ciprofloxacin or ofloxacin

Systemic treatment - Doxycycline

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20
Q

What is the most common cause of feline conjunctivitis and keratitis/ulcers?

A

Feline herpesvirus-1

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21
Q

What cases of FHV-1 conjunctivitis require treatment?

A

More severe conjunctivitis

Concurrent keratitis or corneal ulceration

Severe rhinosinusitis, pneumonia, or dermatitis

Frustrated owners

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22
Q

How is FHV-1 conjunctivitis treated?

A

Antivirals:

Topical: Cidofovir 0.5% 1 drop BID or Idoxuridine 0.1% 5-6 times daily

Systemic: Famcyclovir 90 mg/kg po BID

Reduce stress, avoid steroids, nursing care

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23
Q

What systemic antiviral should not be used for FHV-1 conjunctivitis treatment?

A

Valacyclovir

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24
Q

How long should FHV-1 conjunctivitis be treated?

A

At least 2 weeks past resolution of clinical signs

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25
What are 'other' FHV therapies?
Treat other issues Analgesic Immune boosting supplement Proniotic
26
What used to be the old gold standard for the treatment of FHV-1 conjunctivitis?
Lysine
27
What is a possible complication of FHV1 conjunctivitis?
Symblepharhon
28
What is symblepharon?
Conjunctival +/- corneal adhesions
29
Why don't you want to treat feline conjuntivitis with steroids?
It can make the infection worse Remember: dogs can get allergic conjunctivitis, but cats do not
30
What are the causes of corneal ulceration?
**FHV-1** Trauma - abrasions, cat stratch Adnexal diseases (entropion)
31
How are corneal ulcers treated?
Topical antibiotic TID-QID: Erythromycin, oxytetracycline, chloramphenicol, tobramycin, ciprofloxacin, ofloxacin +/- Atropine ointment SID-BID +/- Pain medication Antiviral tx if FHV-1
32
What topical antibiotics are not recommended for corneal ulcer treatment in cats?
Neomycin/polymyxin drugs
33
When should corneal ulcers be rechecked after treatment has been initiated?
3-5 days
34
When should corneal ulcers heal?
Within 7-10 days
35
What should you do in cases of non-healing superficial ulcers?
Look for a persisting cause Debride loose epithelium with sterile dry cotton swab Diamond burr or superficial keratectomy (NO GRID)
36
When is culture and cytology indicated in corneal ulcer cases?
If they are infected or melting
37
What is the recommended treatment for infected or melting ulcers?
Aggressive treatment - frequent antibiotics, serum 6-8x daily, atropine SID-BID, and systemic NSAID +/- analgesic
38
When should infected or melting ulcers be rechecked?
In 1-2 days
39
What is a corneal sequestrum?
A necrotic area of the cornea
40
What clinical signs/findings are associated with corneal sequestrium?
Brown to black, round to oval lesion in central/paracentral cornea Variable signs of pain Variable corneal vascualrization and edema
41
What breeds are predisposed to corneal sequestrum?
Persian, Himalayan, burmese
42
What can cause corneal sequestrum?
Heredity - Brachycephalics Non-healing ulcer Chronic irritation FHV-1
43
How are corneal sequestrum diagnosed?
Appearance
44
How is corneal sequestrum treated?
Possibly benign neglect Keratectomy surgery +/- graft Medications (abx, lubricant, antiviral?)
45
T/F: Corneal sequestrum can recur or happen in the opposite eye
True
46
What clinical signs/findings are associated with eosinophilic keratitis?
Proliferative pinkish-white, vascularized lesion Not usually painful May be edematous or irregular Starts near limbus Unilateral or bilateral
47
What is the cause of eosinophilic keratitis?
Immune-mediated Suspect FHV-1
48
How is eosinophilic keratitis diagnosed?
Corneal cytology - eosinophils +/- mast cells
49
How is eosinophilic keratitis treated?
Topical - **steroid (pred acetate or dex sp),** cyclosporine A or tacrolimus BID, megestrol acetate antiviral Systemic - L-lysine
50
What is the Sebbag protocol for eosinophilic keratitis?
SQ triamcinolone acetate 0.2 mg/kg + topical cidofovir + topical tacrolimus
51
What is acute bullous keratopathy?
Spontaneous edema (DM rupture)
52
How is acute bullous keratopathy treated?
Stabilize cornea to prevent rupture - corneal graft or **third eyelid flap (2-3 weeks)** Abx and 5% NaCl meds
53
What is the prognosis for acute bullous keratopathy?
Good
54
What may be a risk factor for acute bullous keratopathy?
Cyclosporine or steroid use
55
What clinical signs/findings are associated with feline uveitis?
Enophthalmos, third eyelid elevation, photophobia Conjunctival and episcleral injection Corneal edema, ciliary flush, keratic precipitates Aqueous flare +/- fibrin and cells Miosis and iris changes Fundus changes low IOP
56
What are the causes of uveitis?
Infectious Immune-mediated - chronic lymphoplasmacytic uveitis Neoplasia - lymphosarcoma Trauma Idiopathic
57
What work-up is recommended for uveitis cases?
complete ocualr exam and diagnostics complete physical exam Diagnostic tests - CBC, chemistry, UA, BP, infectious disease testing, LN aspirate and cytology, radiographs, ocular ultrasound
58
What is the recommended therapy for uveitis?
Address underlying cause if identified Topical therapy - prednisoolone acetate, atropine Systemic therapy - NSAID or prednisolone, doxycycline
59
How long should you treat uveitis for?
At least 2 weeks past resolution of clinical signs
60
What is the recommended course of treatment for end-stage uveitis?
Enucleate irreversibleblind eyes
61
What is diffuse iris melanoma?
Progressive iris pigmentation - malignant melanoma
62
What is the common signalment for melanosis?
middle-aged to older cats
63
What should be monitored to determine if it is a diffuse iris melanoma or melanosis? How often?
Monitor progression/extent, surface dusting, extension into iridocorneal angle, pupil changes, intraocular pressure Monitor every 3-6 months
64
How is diffuse iris melanoma treated?
Diode laser (early) Enucleation - preanesthetic imaging, ocular histopathology
65
What concerning ocular findings are indicative of diffuse iris melanoma?
Iris swelling or dyscoria Pigment cells in aqueous humor or on lens Rapid pigment progression Glaucoma
66
Why should you not put traction on the globe during an enucleation in a cat?
You could damage the optic nerve or chiasm resulting in blindness in the 'good eye'
67
When performing a cat enucleation, what do you need ot make sure to remove?
All secretory tissues - don't want a postop cyst
68
What are the causes of feline glaucoma?
Uveitis Lens luxation Neoplasia
69
What is aqueous misdirectio syndrome?
A rare syndrome that causes feline glaucoma where aqueous humor moves posteriorly into the vitreal cavity
70
What clinical signs and findings are associated with aqueous misdirection syndrome?
Older felines with increased IOP Anisocoria Shallow anterior chamber
71
How is aqueous misdirection syndrome treated?
Dorzolamide +/- Timolol (BID-TID) Possible surgery
72
What is the signalment for hypertensive retinopathy?
Older cats - \>10 years
73
What are the clinical signs/findings associated with hypertensive retinopathy?
Dilated pupils Acute vision loss Hyphema Retinal hemorrhage Retinal detachment Subtle retinal cobblestone appearance if fluctuating detachments
74
What are the causes of hypertensive retinopathy?
Kidney disease Hyperthyroidism Heart disease Endocrine disease Primary hypertension
75
T/F: You should always perform a 30 second ophtho exam during all PEs
True
76
How is hypertensive retinopathy diagnosed?
Visible ocular/retinal changes Systolic pressure of \>160 mmHg CBC/Chem/T4/UA
77
How is hypertensive retinopathy treated?
Amlodipine +/- topical steroid if hyphema Address underlying disease
78
What causes toxic retinal degeneration?
Systemic enrofloxacin
79
What clinical signs are associated with toxic retinal degeneration?
Dilated pupils Acute blindness
80

Ophthalmology (13 decks)

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