Term
| What is the most common cause of conjunctivitis and corneal ulcers inc ats? |
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Definition
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Term
| Where does FHV stay latent? |
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Definition
| -trigeminal ganglia +/- corneal epithelum |
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Term
| What are the conjunctival clinical signs of FHV? |
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Definition
-acute conjunctivitis
-chronic conjunctivitis
-recurrent conjunctivitis |
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Term
| Describe acute conjunctivitis due to FHV with neonatal infection? |
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Definition
| -bilateral often with resp clinical signs |
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Term
| Describe acute conjunctivitis due to FHV with a juvenile infection? |
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Definition
| -unilateral or bilateral with mild resp clinial signs |
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Term
| Describe chronic conjunctivitis due to FHV with a juvenile infection? |
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Definition
| -unilateral or bilateral: resp clinical signs usually resolve while conjunctivitis persists |
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Term
| Describe recurrent conjunctivitis with adult FHV infections. |
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Definition
=adult recrudescence due to latency
-usually unilateral and always the same eye with preceding mild sneezing |
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Term
| What are the clinical signs of FHV? |
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Definition
-Cornea: corneal ulceration (epi or stromal)
-stromal keratitis: stromal opacification and vascualrization
- |
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Term
| What are the three kinds of corneal ulcer due to FHV? |
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Definition
-punctate
-dendritic
-geographic |
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Term
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Definition
-history and clinical signs (esp URI)
-ALWAYS fluorescein stain +/- rose bengal stain |
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Term
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Definition
-Conjunctivitis: topical antibiotic , topical antiviral (topical +/- oral)
-Corneal ulceration: topical antiviral + topical prophylactic antibiotic
-stromal keratitis: try to refer
-stromal ulcer: anti-collagenase if keratomalacia is present |
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Term
| Why are steroids (topical or systemic) ocntraindicated in any form of FHV? |
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Definition
-exacerbate severity of clinical signs
-prolong course of disease
-enhance viral replication and shedding
-inc the risk of secondary bacterial or fungal ulcer infection |
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Term
| Which topical antibiotic is contraindicated to treat FHV? |
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Definition
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Term
| What are the common mistakes of treating FHV? |
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Definition
-corneal ulcer: topical antibiotic without topical antiviral
-corneal ulcer: grid keratotomy
-conjunctivitis: treat with topical corticosteroid |
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Term
| What are the complications of misdiagnosis or inappropriate treatment with FHV? |
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Definition
-corneal ulcer from useo f a topical steroid for viral conjucntivitis
-corneal sequestrum: from delyaed corneal ulcer healing when a topical antiviral is not used and from grid keratotomy
-corenal stromal ulcer, melting ulcer, descemetocele or perforation from delay in ulcer healing when a topical antiviral is not sued |
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Term
| What is a corneal sequestrum in a cat? |
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Definition
| -focal area of corneal collagen deeneration => sequestration of necrotic tissue within the stroma |
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Term
| What are some of the predisposing factors for corneal sequestrum? |
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Definition
-chronic corneal irritation or ulceration (FHV!)
-grid keratotomy: DO NOT perform on a cat
-Breed: Persian, Himalayan, Burmese |
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Term
| Describe the clinical appearance of corneal sequestrum. |
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Definition
-there is nothing else like it!!!
-focal light brown to black lesion in the central or paracentral cornea
-/+ corneal vascularization |
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Term
| How do you treat corneal suquestrum in a cat? |
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Definition
-surgery to prevent it from becoming larger and/or deeper: keratectomy +/- graft
-sloughing of sequestrum can only occur if very aggressive vascularization is present all around the sequestrum |
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Term
| What is feline eosinophlic keratitis? |
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Definition
| -an eosinophilic infalammation primarily affecting the cornea |
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Term
| What are the clinical signs of feline eosinophilic keratitis? |
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Definition
-unilateral or bilateral
-proliferative, pink-white, superficial keratitis
-starts temporally and progresses centrally
-heavily vascularized
-white exudate on surface |
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Term
| How do we diagnose feline eiosinophilic keratitis? |
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Definition
-clinicl signs
-cytology: eiosinophils!!! |
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Term
| How do we treat feline eosinophilic keratitis? |
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Definition
-topical steroid q6h: pred, dex
-megestrol acetate (synth P4) to induce remission in severe cases but only shortterm and low dose |
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Term
| What is the prognosis of feline eosinophilic keratitis? |
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Definition
-very good with treatment
-some patients may require long term therapy for control |
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Term
| What are the clinical signs of diffuse iris melanoma in a cat? |
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Definition
-diffuse brown discoloration of the iris
-evidence of iris tissue stromal invasion = neoplasia = enucleation time
-advanced neoplastic disease |
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Term
| What are the clinical signs of iris tissue stromal invasion due to diffuse iris melanoma in a cat? |
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Definition
-aniscoria
-dyscoria
-pigmented, raised nodules or mass in the iris |
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Term
| What are the lcinical signs of advanced neoplastic disease due to diffuse iris melanoma in a cat? |
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Definition
-anterior uveitis
-claucoma |
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Term
| Describe the pathogeneisis of diffuse iris melanoma of a cat. |
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Definition
-Benign, superficial, inc pigmentation: focal or multifocal
-neoplastic shift in melanocytes
-tissue invasiton => iris stroma, iridocorneal angle, scleral veins
-distant metastasis => lungs, liber |
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Term
| How do we treat diffuse iris melanoma in a cat? |
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Definition
-intervention with early changes is controversial
-/+ diode laser ablation of pigmented lesions
-regular monitoring for neoplastic changes
-enucleation is secondary glaucoma is present |
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Term
| What are the general characteristics of feline traumatic ocular sarcoma? |
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Definition
-develops in eyes that are permanently blind from severe intraocular trauma: blunt or perforating
-trauma to tumor diagnosis = 1-10 years
-highly metastatic to optic nerve, CNS, regional lymph nodes, and distant metastasis |
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Term
| How do we treat feline traumatic ocular sarcoma? |
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Definition
-exenteration
-prognosis still guarded due to high metastatic rate and typically late diagnosis |
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Term
| How do we prevent feline traumatic ocular sarcoma? |
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Definition
| -recommend enucleation for a permanently blind eye secondary to traua |
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Term
| What is the etiology of hypertensive retinopathy in a cat? |
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Definition
-sustained high blood pressure => ischemic necrosis of the retinal arteriole walls => eventual damage to choroidal capillaries
-serum transudate and/or blood leaks from damaged vessels |
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Term
| What is the typical signalment of feline hypertensive retinopathy? |
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Definition
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Term
| What is the presenting complaint of feline hypertensive retinopathy? |
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Definition
-acute blindness
-dilated puils |
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Term
| What are the clinical signs of hypertensive retinopathy in cats? |
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Definition
-retinal hemorrhages: focal, multifocal, diffuse
-transudatvie retinal detachment: focal, multifocal, or bullus
-/+ hyphema |
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Term
| How do we diagnose feline hypertensive retinopathy? |
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Definition
-systeolic BP > 180 mmHg
-opthalmic clinical signs |
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Term
| How do we treat feline hypertensive retinopathy? |
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Definition
| -anti-hypertensive therapy (amlodipine) and appropriate work-up for systemic hypertension |
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Term
| The prognosis of feline hypertensive retinopathy is either good or guarded. What are the qualifications for good prognosis? |
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Definition
-hemorrhages are not severe
-retina is not torn
-BP responds to medication |
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Term
| What are the qualifications fo a guarded prognosis of feline hypertensive retinopathy? |
|
Definition
-chronic retinal detachment
-diffuse hemorrhages
-retinal tears
-poor BP response to medicaiton |
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Term
| Why do we need to be extra careful during feline enucleation? |
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Definition
| -cats are particularly susceptible to optic nerve |
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Term
| What are the surgical modification options for feline enucleaiton? |
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Definition
-clamp pedicle and cut in the crush
-dec globe volume to provide more space b/n the globe and orbit prior to clamping and severing the optic n |
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Term
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Definition
| -an inc in intraocular pressure incompatible with the health of the eye |
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Term
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Definition
| -produced by the epithelium of the ciliary processes |
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Term
| Describe conventional aqueous flow. |
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Definition
| -posterior chamber => pupil => anterior chamber => trabecular meshwork => scleral vv |
|
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Term
| Describe unconventional aqueous flow. |
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Definition
| -posterior chamber => pupil => anterior chamber => ciliary muscle => suprachoroidal space => scleral vv |
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Term
| What is the physiologic cause of glaucoma? |
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Definition
| -impaired aqueous outflow ONLY |
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Term
| What does increased IOP due to glaucoma damgae? |
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Definition
-optic nerve
-retina
-iris
-cornea |
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Term
| HOw does inc IOP damage optic nerve and retina? |
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Definition
-pressure damage to ganglion cells and nerve fiber lyer => degenration of optic nerve
-results in dark cupped optic disc on fuxic exam, vision loss, and afferent PLR deficit |
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Term
| Describe how inc IOP damage the iris with glaucoma. |
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Definition
-pressure damage to iris constrictor/sphincter msucle
-results in fixed dialted pupil and efferent PLR deficit |
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Term
| Describe how inc IOP damage the cornea with glaucoma. |
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Definition
-pressure exerted on the corneal endothelium impairs the ATPase pumps => aqueous fluid leaks into the corneal stroma
-results in diffuse corneal edema |
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Term
| What is the typical history of glaucoma? |
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Definition
-breed predilection: hounds
-History: eye closed, discharge, bloodhsot, lethargy, anorexia, corneal edema |
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Term
| What are the clinical signs of acute glaucoma? |
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Definition
-pain
-normal to hyperemic optic disc
-prominent sclearal vessels
-corneal edema
-dialted pupil |
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Term
| What are the clinical signs of chronic glaucoma? |
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Definition
-dark, cupped optic disc
-retinal atorphy
-buphthalmos
-prominent scleral vessels
-corneal edema
-dilated pupil |
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Term
| What is the triad of key clinical signs of glaucoma? |
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Definition
-episcleral vascular congestion
-corneal edema: diffuse
-dilated pupil |
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Term
| HOw do we diagnose glaucoma? |
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Definition
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Term
| In general, how do we use a Tonopen tonometer? |
|
Definition
-reuqires topical anesthetic
-slightly higher learning curve
-operator touches cornea therefore can feel degree of IOP |
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Term
| In general, how do we use a TonoVet tonometer? |
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Definition
-no topical anesthetic required
-good for small eyes |
|
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Term
| What drugs do we use to dec queous production to treat glaucoma? |
|
Definition
-CA inhibitors: Dorzolamide, Brinzolamde
-Beta adrenergic antagonists: timolol |
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Term
| What drugs do we use to inc aqueous outflow due to treat glaucoma? |
|
Definition
| -prostaglandin analogs: latanosprost |
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Term
| When do we use a hyperosmotic like mannitol to treat glaucoma? |
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Definition
-used only in acute glaucomaif latanoprost fails
-temporarily lowers iOP by dehydrating thevitreous
-admin IV over 20 mins
-withold water for 3-4h |
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Term
| When is a hyperosmotic such as mannitol used to treat glaucoma? |
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Definition
| -contraindicated with cardiac disease |
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Term
| How do we surgically treat glaucoma? |
|
Definition
-laser cyclophotocoagulation (CPC): selectively destroys ciliary body tissue using laser energy
-Filtering implants: provides a new pathway for aqueous outflow |
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|
Term
| What is primary glaucoma? |
|
Definition
| -no preceding intraocular disease |
|
|
Term
| Describe the physiology behind primary glaucoma. |
|
Definition
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