Veterinary Ophthalmology Study Notes
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Questions and Answers

What is the prognosis for complicated KCS in cases with severe ulceration?

  • Conjunctival grafting may be needed. (correct)
  • Early diagnosis is unnecessary.
  • The eye will return to normal function.
  • Vision will be completely restored.

    • Which clinical sign was noted in the left eye of the dachshund patient?

  • Healthy corneal appearance
  • Absence of discharge
  • Normal tear production
  • Severe superficial corneal vascularization (correct)

    • What was the Schirmer tear test reading in the left eye of the patient?

  • 3 mm/min (correct)
  • 14 mm/min
  • 8 mm/min
  • 11 mm/min

    • What treatment had the patient been receiving prior to the increased discharge in the left eye?

    <p>Twice daily ciclosporin and carbomer gel</p> Signup and view all the answers

    After 2 weeks of increased discharge, what changed in the treatment frequency of carbomer gel by the owner?

    <p>Increased to four times daily</p> Signup and view all the answers

    What complication can occur despite a successful parotid duct transposition?

    <p>Blepharitis from mineral deposition</p> Signup and view all the answers

    In the context of the dachshund's medical history, what additional condition was the patient diagnosed with?

    <p>Hypothyroidism</p> Signup and view all the answers

    What was observed in the cornea staining with fluorescein?

    <p>Absence of ulceration</p> Signup and view all the answers

    What is the purpose of the book as stated in the content?

    <p>To help practitioners keep up to date and develop confidence in ophthalmologic cases.</p> Signup and view all the answers

    Which chapter is focused on blepharitis?

    <p>Chapter 4</p> Signup and view all the answers

    Which of the following conditions is addressed in Chapter 10?

    <p>Acute conjunctivitis in dogs</p> Signup and view all the answers

    What is the main theme of Part 4 of the book?

    <p>Issues related to the cornea</p> Signup and view all the answers

    Which condition is outlined in Chapter 40?

    <p>Diabetic cataract in a dog</p> Signup and view all the answers

    Which chapter introduces canine uveitis?

    <p>Chapter 32</p> Signup and view all the answers

    What is the focus of Chapter 56?

    <p>Episcleritis</p> Signup and view all the answers

    What is the topic of Chapter 18?

    <p>Chronic purulent conjunctivitis</p> Signup and view all the answers

    Which chapter deals with ocular emergencies?

    <p>Appendix 3</p> Signup and view all the answers

    What condition is described in Chapter 22?

    <p>Deep corneal ulcer</p> Signup and view all the answers

    What type of procedure can be performed if the nasolacrimal punctae are present but misplaced?

    <p>Microsurgical repositioning</p> Signup and view all the answers

    What is a complication associated with the surgical removal of the caruncle?

    <p>Damage to the nasolacrimal punctae</p> Signup and view all the answers

    What shape is typically required for the piece of skin removed during a Hotz-Celsus procedure?

    <p>Triangular</p> Signup and view all the answers

    What suture material is commonly used during the Hotz-Celsus procedure?

    <p>6/0 polyglactin 910</p> Signup and view all the answers

    What is an alternative to surgical excision for treating caruncular trichiasis?

    <p>Cryosurgery</p> Signup and view all the answers

    What postoperative care is recommended after cryosurgery of the caruncle?

    <p>Topical antibiotic/steroid ointment</p> Signup and view all the answers

    Which of the following factors makes surgical intervention more complicated at the medial canthus?

    <p>Tight medial canthal ligament</p> Signup and view all the answers

    Why is good magnification important during caruncle surgery?

    <p>To avoid damaging the canaliculi</p> Signup and view all the answers

    What is the main factor that contributes to corneal transparency?

    <p>Lattice organization of cellular structures</p> Signup and view all the answers

    What result can occur if the endothelial pumps in the cornea fail?

    <p>Corneal oedema</p> Signup and view all the answers

    Which of the following is not a common cause of corneal ulceration?

    <p>Corneal endothelial dystrophy</p> Signup and view all the answers

    How do superficial corneal defects typically heal?

    <p>By migration and mitosis of epithelial cells</p> Signup and view all the answers

    Which eyelid abnormality can contribute to corneal ulceration?

    <p>Blepharitis</p> Signup and view all the answers

    What type of irritant is associated with corneal ulceration?

    <p>Shampoo</p> Signup and view all the answers

    In which of the following scenarios would you expect corneal oedema?

    <p>Corneal endothelial pump failure</p> Signup and view all the answers

    Which of the following is a potential cause of corneal ulceration due to trauma?

    <p>Cat scratch</p> Signup and view all the answers

    What is the recommended initial treatment for secondary bacterial infections?

    <p>Topical and systemic antibiotics</p> Signup and view all the answers

    Why is culture and sensitivity testing important in treating bacterial infections?

    <p>To identify the specific bacteria and appropriate antibiotics</p> Signup and view all the answers

    What common mistake leads to the recurrence of problems after treatment?

    <p>Not treating systemically and using a too short course</p> Signup and view all the answers

    What should be done if a conjunctival foreign body is identified?

    <p>Immediately flush the nasolacrimal duct</p> Signup and view all the answers

    What is recommended if medical management does not yield positive results?

    <p>Referral to a veterinary ophthalmologist for surgical intervention</p> Signup and view all the answers

    What duration should topical and systemic treatments continue after successful flushing?

    <p>3–4 weeks</p> Signup and view all the answers

    What could indicate a need for a short course of topical corticosteroid drops?

    <p>Marked conjunctival inflammation at the medial canthus</p> Signup and view all the answers

    What should be done if the nasolacrimal duct is patent during surgical intervention?

    <p>Immediately suture a catheter in place</p> Signup and view all the answers

    What is the primary method by which the endothelium heals in dogs and cats?

    <p>Hypertrophy and sliding</p> Signup and view all the answers

    What color change is associated with neovascularization in the cornea?

    <p>Red</p> Signup and view all the answers

    Which breed is mentioned as being commonly affected by recurrent epithelial erosions?

    <p>Corgi</p> Signup and view all the answers

    What is a common consequence of damaged endothelium in dogs and cats?

    <p>Corneal oedema</p> Signup and view all the answers

    Which of the following is NOT a cause of white corneal lesions?

    <p>Neovascularization</p> Signup and view all the answers

    What is the typical presentation of a dog with recurrent epithelial erosions?

    <p>Mild conjunctival hyperaemia and increased lacrimation</p> Signup and view all the answers

    Which color change in the cornea indicates mild corneal oedema?

    <p>Blue-grey</p> Signup and view all the answers

    Which of the following is a common sign observed with recurrent epithelial erosion in affected animals?

    <p>Blepharospasm in the affected eye</p> Signup and view all the answers

    Study Notes

    Ophthalmology Study Notes

    • Ophthalmic Examination Importance: A full ophthalmic examination is crucial for all animals exhibiting eye complaints.

    • Keratoconjunctivitis Sicca (KCS) Prognosis: Prognosis for complicated KCS is guarded. Severe cases may require conjunctival grafting and parotid duct transposition, yet the eye won't return to normal. Enucleation may be necessary. Vision can be impaired by chronic pigmentation, with potential complications like blepharitis post-surgery due to mineral build up. Early diagnosis and owner/patient compliance are vital for preventing these complications.

    • Case Example 16.1 (KCS): A 13-year-old male neutered miniature long-haired dachshund presented with a 3-year history of bilateral KCS. The dog was initially well-controlled with medication. However, a worsening discharge and an inability to open the left eye led to presentation. The left eye showed a sticky mucopurulent discharge adhering to the cornea, severe superficial corneal vascularization, and pigment deposition. Schirmer tear test was 3 mm in the affected eye and 11 mm in the unaffected eye. Menace responses and pupillary reflexes were normal and intraocular examination showed no major abnormalities. Eye discharge swab and fluorescein staining revealed no ulceration.

    • Nasolacrimal Punctae Issues: Nasolacrimal punctae present but misplaced, can be surgically repositioned by a qualified colleague if required. Medial entropion and caruncular trichiasis can be addressed in general practice.

    • Medial Entropion Procedures: Surgical procedures for medial entropion, while possible in general practice, are more difficult than lateral procedures due to a tight medial canthal ligament. A modified Hotz-Celsus procedure might be used, with a triangular rather than elliptical skin removal. Thin, soft sutures (6/0 polyglactin 910) are preferred, ensuring nasolacrimal puncta and canaliculi are undamaged (catheterization with colored nylon helps with visualization). Careless surgery can cause damage to the canaliculi. Cryosurgery is another treatment option.

    • Secondary Bacterial Infections: Often involve mixed bacteria; culture and sensitivity testing is recommended.

    • Nasolacrimal Duct Obstructions: The lacrimal sac and nasolacrimal duct are small. Temporary obstructions are easier to manage, and early nasolacrimal duct flushing plays a role, especially with conjunctival foreign bodies.

    • Medical Treatment Options: Initial treatment uses broad-spectrum topical chloramphenicol and systemic cefalexin until culture and sensitivity results obtained. Repeated nasolacrimal flushing is key. Treatment continues for 3–4 weeks even if clinical signs resolve earlier, with systemic treatment being essential to prevent recurrences. Sometimes owners need 6 weeks of oral antibiotics. Topical corticosteroids can be helpful if the medial canthus is inflamed.

    • Surgical Treatment Options: Referral to ophthalmologist is advisable if medical management is not successful due to the potential needing of a surgeon. If the nasolacrimal duct is patent, catheter placement for 3-4 weeks might be considered, alongside medication.

    • Corneal Function: Corneal transparency is essential. Transparency is maintained via the lack of blood vessels, pigment, organized cellular structure and small collagen fibrils. The endothelium removes excess fluid for corneal hydration and clarity. Endothelial pump failure may cause corneal edema and colour changes.

    • Corneal Ulceration: Multifaceted causes are possible including eyelid abnormalities (agenesis, entropion, blepharitis), eyelash/hair abnormalities, irritants (shampoo, smoke, chemicals), tear film problems (KCS), trauma (cat scratches, accidents), and infection (bacterial, viral). Dystrophy can also cause ulceration.

    • Corneal Healing: Superficial defects heal by epithelial migration and mitosis. Endothelial healing involves limited mitosis with hypertrophy and sliding. Endothelial damage can lead to corneal edema which may be permanent.

    • Corneal Colour Changes: Corneal reactions to insults present with color changes, including red (neovascularization, hemorrhage, symblepharon), white (edema, lipid, calcium), blue-grey (mild edema), and pigmented (melanin, sequestrum).

    • Recurrent Epithelial Erosion: Often presents with minor conjunctival hyperemia, increased tearing, and slight blepharospasm in the affected eye. Boxers, Corgis, are commonly affected, along with some Burmese and Persian cats. Typically only one eye is affected, but both can be involved. Discomfort varies.

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    Saunders Solutions in Veterinary Practice: Small Animal Ophthalmology PDF

    Description

    Explore essential knowledge on ophthalmic examinations and the prognosis for keratoconjunctivitis sicca (KCS) in animals. This quiz provides insights into case studies and the importance of early diagnosis to prevent complications. Ideal for veterinary students and professionals seeking to enhance their understanding of ocular conditions in pets.

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