Term
| What does the auriculopalpebral nerve block do? |
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Definition
=blocks motor innervation to the eyelids
-usually the only block needed for exam |
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Term
| What does the supraorbital nerve block do? |
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Definition
| -blocks sensory inenrvation to the superior eyelid |
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Term
| What are the main principles of squamous cell carcinoma? |
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Definition
-white face/eyelids predispose: appaloosa, american paint, draft breeds
-UV light exposure predisposes
-early recognition and tx give the best prognosis: biopsy early |
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Term
| What are the common locations ofr squamous cell carcinoma in the horse? |
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Definition
| -eyelid, nictitans, bulbar conjunctiva/cornea |
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Term
| Describe a SCC of the bulbar conjunctiva/cornea? |
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Definition
| -raised, pink, proliferative lesion arising at the lateral => progresses medially across the cornea |
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Term
| How do we treat a SCC that is small at the lateral limbus of a horse? |
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Definition
| -keratectomy and cryotherapy is usually curative |
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Term
| How do we treat a large SCC in a horse? |
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Definition
-keratectomy and cryotherapy
-has fair-good prognosis |
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Term
| How do we treat an extensive SCC in a horse? |
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Definition
| -enucleation usually curative |
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Term
| What does a nictitans SCC look like in a horse? |
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Definition
| -red, raised nodule to proliferative mass originating at the margin of the nictitans |
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Term
| How do we treat nictitans SCC in a horse? |
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Definition
-tiny nodules can be excised followed by cryotherapy, monitor for recurrence
-excision of ALL of the nictitans is usually curative (do fine) |
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Term
| What happens without early treatment of a nictitans SCC in a horse? |
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Definition
| -can invade locally into the eyelid )lower eyelid, medial canthus) and spread to regional LN (usually submandibular) |
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Term
| What is the most difficult SCC location to treat in the horse? |
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Definition
| -eyelid, difficult if not caught early |
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Term
| Which location of SCC in the horse has the highest risk of local invasion and metastasis to regional LN? |
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Definition
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Term
| What are the clinical signs of eyelid SCC in the horse? |
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Definition
-lid margin erosion or scab (non-healing = RED FLAG)
-thickening of the eyelid (skin can be non-ulcerated) with swollen, hyperemic, proliferative conjunctiva
-ulceration of the eyelid margin with loss of normal architecture = ocular discharge and blepharospasm |
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Term
| How do we deginitively diagnose SCC in the horse? |
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Definition
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Term
| How do we treateyelid SCC in a horse? |
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Definition
-excision
-cryotherapy: only affects superficial tissue
-CO2 laser ablation
-intralesional chemo after excision |
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Term
| What is the point of wearing mask for a horse aftr SCC treatment? |
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Definition
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Term
| What is the clinical presentation with conjunctivitis due to EHV? |
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Definition
-unilateral or bilateral
-recurrences are in the same eye if unilateral
-marked blepharospasm/pain
-marked palpebral conjunctival swelling and hyperemia |
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Term
| What is the clinical presentation of the non-ulcerative and ulcerative keratitis due to EJC? |
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Definition
-associated with blepharospasm, epiphora, conjunctivitis
=superficial (epithelial)
-corneal surface may appear roughened
-white multifocal punctate opacities |
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Term
| What diagnostics do we run to diagnose EHV? |
|
Definition
-Fluorescein and rose bengal stains
-cytology to rule out fungal if fluorescein or rose bengal stain is positive |
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Term
| How do we treat EHV in the horse? |
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Definition
| -topical antiviral 3-4 times/day |
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Term
| What are the etiologies of corneal ulcers in horses? |
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Definition
-trauma to corneal epithelium
-herpes virus
-eyelid laceration scar with eyelid margin misalignment
-facial nerve paralysis (corneal exposure, dec tear film spread) |
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Term
| What are the three major corneal ulcer complications in the horse? |
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Definition
-fungal infection
-bacterial infection
-keratomalacia |
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Term
| How do we diagnose fungal ulcers in the horse? |
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Definition
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Term
| Which cases are suspect for fungal ulcers in horses? |
|
Definition
-prolonged antibiotic therapy without healing
-previous use of topical corticosteroids
-fluffy, white corneal infiltrates |
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Term
| What diagnostic tests are useful for corneal ulcers in the horse? |
|
Definition
-Fluorescein stain
-Rose bengal if fluorescein negative
-culture
-cytology to ID hyphae |
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Term
| How do we treat corneal ulcers? |
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Definition
-Antibiotics: Ciprofloxacin, Ofloxacin, Moxifloxacin
-Antifungals: silver sulfadiazine |
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Term
| What are the clinical signs of secondary anterior uveitis in a horse with corneal ulcers? |
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Definition
-miosis: often first CS
-aqueous flare: inc cells/protein in aqueous
-fibrin
-hypopyon |
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Term
| What is the most common mistake with treating corneal ulcers in a horse? Why is this significant? |
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Definition
-not treating anterior uveitis
-this can determine if the horse ever sees again |
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Term
| How do we treat secondary anterior uveitis with corneal ulcers in the dog? |
|
Definition
-Atropine
-Systemic NSAIDs: BAnamine |
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Term
| What are the clinical signs of corneal stromal abscess in horses? |
|
Definition
-flourescein negative!!!
-focal area of white or yello stromal cellular infiltrate
-/+ corneal vascularization
-marked anterior uveitis: painful |
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Term
| How do we treat corneal stromal abscesses in the horse? |
|
Definition
-NO STEROIDS even though the fluorescein negative
-aggressively treat the anterior uveitis while waiting for vascularistion to heal the abscess
-topical antibiotic: Fluoroquinolone
-topical antifungal
surgical excision of abscess and graft if not better |
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Term
| Describe the seasonality of corneal stromal abscesses in horses? |
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Definition
| -late summer and early fall |
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Term
| What are the etiologies of equine uveitis? |
|
Definition
-corneal disease: MOST COMMON CAUSE
-ulcer: deeper ulcers and infected ulcers have worse uveitis
-stromal abscess: severe anterior uveitis
-Trauma: blunt or perorating
-Systemic dz: especially in foals
-equine recurrent uveitis |
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Term
| What are the treatment principles of equine uveitis? |
|
Definition
-must suppress inflammation
-must prevent synechia
-must treat underlying cause if identified |
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Term
| HOw do we suppress the inflammation with equine uveitis? |
|
Definition
-BAnamine
-topical steroids (if not contraindicated by corneal disease): Dex or Pred
-Topical NSAIDs: Flurgiprofen or Diclofenac |
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|
Term
| How do we prevent synechia with equine uveitis? |
|
Definition
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Term
| In which horses is it especially important to rule in or out systemic disease with uveitis? |
|
Definition
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Term
| What are the consequences of equine recurrent uveitis? |
|
Definition
-miosis + persterior synechia
-fibrin (fibrosis across the pupil_
-cataract formation
-vitreous inflammaiton
-retinal degeneration or detachment
-secondary glaucoma
-phthisis bulbi (eye shrinks) |
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Term
| What are the clinical classifications of equine recurrent uveitis? |
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Definition
-Classic recurrent: active uveitis episodes followed by quiescent period & history also sounds like herpes
-Insidious: persistent low-grade inflammation without overt clinical signs (appaloosa breed predisposed)
-posterior uveitis |
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Term
| Describe the immune-mediated etiology of equine recurrent uveitis? |
|
Definition
-molecular mimicry: homology b/n pathogen and host tissue antigens
-release of normally sequestered autoantigens due to trauma or infection
-alteration of autoantigen structure caused by tissue injury or inflammation
-T-lymphocyte memory cells in the uvea |
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Term
| What infectious agent can cause equine recurrent uvieits? |
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Definition
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Term
| What is the role of genetics of equine recurrent uveitis? |
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Definition
| -appaloosas are genetically predisposed |
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|
Term
| Describe acute therapy for equine recurrent uveitis? |
|
Definition
-Topical steroid: Dex or Pred
-Topical NSAID
-Atropine
-Banamine
Client education |
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|
Term
| Describe chronic/maintenance therapy for equine recurrent uveitis. |
|
Definition
-topical steroid
-topical NSAID
-atorpine
-Cyclosporine suprachoroidal implants |
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