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Questions and Answers
What is the prognosis for complicated KCS in cases with severe ulceration?
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?
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?
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?
What treatment had the patient been receiving prior to the increased discharge in the left eye?
After 2 weeks of increased discharge, what changed in the treatment frequency of carbomer gel by the owner?
After 2 weeks of increased discharge, what changed in the treatment frequency of carbomer gel by the owner?
What complication can occur despite a successful parotid duct transposition?
What complication can occur despite a successful parotid duct transposition?
In the context of the dachshund's medical history, what additional condition was the patient diagnosed with?
In the context of the dachshund's medical history, what additional condition was the patient diagnosed with?
What was observed in the cornea staining with fluorescein?
What was observed in the cornea staining with fluorescein?
What is the purpose of the book as stated in the content?
What is the purpose of the book as stated in the content?
Which chapter is focused on blepharitis?
Which chapter is focused on blepharitis?
Which of the following conditions is addressed in Chapter 10?
Which of the following conditions is addressed in Chapter 10?
What is the main theme of Part 4 of the book?
What is the main theme of Part 4 of the book?
Which condition is outlined in Chapter 40?
Which condition is outlined in Chapter 40?
Which chapter introduces canine uveitis?
Which chapter introduces canine uveitis?
What is the focus of Chapter 56?
What is the focus of Chapter 56?
What is the topic of Chapter 18?
What is the topic of Chapter 18?
Which chapter deals with ocular emergencies?
Which chapter deals with ocular emergencies?
What condition is described in Chapter 22?
What condition is described in Chapter 22?
What type of procedure can be performed if the nasolacrimal punctae are present but misplaced?
What type of procedure can be performed if the nasolacrimal punctae are present but misplaced?
What is a complication associated with the surgical removal of the caruncle?
What is a complication associated with the surgical removal of the caruncle?
What shape is typically required for the piece of skin removed during a Hotz-Celsus procedure?
What shape is typically required for the piece of skin removed during a Hotz-Celsus procedure?
What suture material is commonly used during the Hotz-Celsus procedure?
What suture material is commonly used during the Hotz-Celsus procedure?
What is an alternative to surgical excision for treating caruncular trichiasis?
What is an alternative to surgical excision for treating caruncular trichiasis?
What postoperative care is recommended after cryosurgery of the caruncle?
What postoperative care is recommended after cryosurgery of the caruncle?
Which of the following factors makes surgical intervention more complicated at the medial canthus?
Which of the following factors makes surgical intervention more complicated at the medial canthus?
Why is good magnification important during caruncle surgery?
Why is good magnification important during caruncle surgery?
What is the main factor that contributes to corneal transparency?
What is the main factor that contributes to corneal transparency?
What result can occur if the endothelial pumps in the cornea fail?
What result can occur if the endothelial pumps in the cornea fail?
Which of the following is not a common cause of corneal ulceration?
Which of the following is not a common cause of corneal ulceration?
How do superficial corneal defects typically heal?
How do superficial corneal defects typically heal?
Which eyelid abnormality can contribute to corneal ulceration?
Which eyelid abnormality can contribute to corneal ulceration?
What type of irritant is associated with corneal ulceration?
What type of irritant is associated with corneal ulceration?
In which of the following scenarios would you expect corneal oedema?
In which of the following scenarios would you expect corneal oedema?
Which of the following is a potential cause of corneal ulceration due to trauma?
Which of the following is a potential cause of corneal ulceration due to trauma?
What is the recommended initial treatment for secondary bacterial infections?
What is the recommended initial treatment for secondary bacterial infections?
Why is culture and sensitivity testing important in treating bacterial infections?
Why is culture and sensitivity testing important in treating bacterial infections?
What common mistake leads to the recurrence of problems after treatment?
What common mistake leads to the recurrence of problems after treatment?
What should be done if a conjunctival foreign body is identified?
What should be done if a conjunctival foreign body is identified?
What is recommended if medical management does not yield positive results?
What is recommended if medical management does not yield positive results?
What duration should topical and systemic treatments continue after successful flushing?
What duration should topical and systemic treatments continue after successful flushing?
What could indicate a need for a short course of topical corticosteroid drops?
What could indicate a need for a short course of topical corticosteroid drops?
What should be done if the nasolacrimal duct is patent during surgical intervention?
What should be done if the nasolacrimal duct is patent during surgical intervention?
What is the primary method by which the endothelium heals in dogs and cats?
What is the primary method by which the endothelium heals in dogs and cats?
What color change is associated with neovascularization in the cornea?
What color change is associated with neovascularization in the cornea?
Which breed is mentioned as being commonly affected by recurrent epithelial erosions?
Which breed is mentioned as being commonly affected by recurrent epithelial erosions?
What is a common consequence of damaged endothelium in dogs and cats?
What is a common consequence of damaged endothelium in dogs and cats?
Which of the following is NOT a cause of white corneal lesions?
Which of the following is NOT a cause of white corneal lesions?
What is the typical presentation of a dog with recurrent epithelial erosions?
What is the typical presentation of a dog with recurrent epithelial erosions?
Which color change in the cornea indicates mild corneal oedema?
Which color change in the cornea indicates mild corneal oedema?
Which of the following is a common sign observed with recurrent epithelial erosion in affected animals?
Which of the following is a common sign observed with recurrent epithelial erosion in affected animals?
Flashcards
Ophthalmic Examination
Ophthalmic Examination
A comprehensive assessment of the eye and its structures.
When is an ophthalmic exam performed?
When is an ophthalmic exam performed?
A procedure performed on all animals presenting with eye problems.
Why is an ophthalmic exam important?
Why is an ophthalmic exam important?
Used to ensure accurate diagnosis and appropriate treatment.
What does the ophthalmic exam include?
What does the ophthalmic exam include?
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What are the key structures examined?
What are the key structures examined?
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What is included in the functional assessment?
What is included in the functional assessment?
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What is used to examine deeper structures?
What is used to examine deeper structures?
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What is documented after the exam?
What is documented after the exam?
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How is examination information used?
How is examination information used?
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What is the main goal of the ophthalmic exam?
What is the main goal of the ophthalmic exam?
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What is Keratoconjunctivitis Sicca (KCS)?
What is Keratoconjunctivitis Sicca (KCS)?
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What is the Prognosis for Complicated KCS?
What is the Prognosis for Complicated KCS?
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Describe the Treatment for Severe KCS Ulceration.
Describe the Treatment for Severe KCS Ulceration.
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What are the Long-Term Complications of KCS?
What are the Long-Term Complications of KCS?
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What is Essential for Managing KCS?
What is Essential for Managing KCS?
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Describe the Discharge Seen in KCS.
Describe the Discharge Seen in KCS.
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What is the Schirmer Tear Test?
What is the Schirmer Tear Test?
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What is Hypothyroidism?
What is Hypothyroidism?
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Medial Entropion
Medial Entropion
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Caruncular Trichiasis
Caruncular Trichiasis
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Modified Hotz-Celsus Procedure
Modified Hotz-Celsus Procedure
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Nasolacrimal Punctae
Nasolacrimal Punctae
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Cryosurgery
Cryosurgery
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Canaliculi and Catheterization
Canaliculi and Catheterization
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Importance of Nasolacrimal Punctae
Importance of Nasolacrimal Punctae
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Caruncle Removal and Potential Complications
Caruncle Removal and Potential Complications
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Dacryocystitis
Dacryocystitis
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Nasolacrimal duct flushing
Nasolacrimal duct flushing
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Medical management of dacryocystitis
Medical management of dacryocystitis
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Surgical intervention for dacryocystitis
Surgical intervention for dacryocystitis
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Nasolacrimal duct catheterization
Nasolacrimal duct catheterization
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Secondary bacterial infection
Secondary bacterial infection
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Broad spectrum antibiotics
Broad spectrum antibiotics
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Culture and sensitivity testing
Culture and sensitivity testing
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What is the cornea and its main function?
What is the cornea and its main function?
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How does the cornea maintain its transparency?
How does the cornea maintain its transparency?
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What is the role of the corneal endothelium in maintaining transparency?
What is the role of the corneal endothelium in maintaining transparency?
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Define a corneal ulcer.
Define a corneal ulcer.
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How can eyelid abnormalities lead to corneal ulceration?
How can eyelid abnormalities lead to corneal ulceration?
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Describe the healing process of superficial corneal defects.
Describe the healing process of superficial corneal defects.
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What are some examples of irritants that can lead to corneal ulceration?
What are some examples of irritants that can lead to corneal ulceration?
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How can trauma contribute to corneal ulceration?
How can trauma contribute to corneal ulceration?
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Corneal endothelium
Corneal endothelium
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Hypertrophy
Hypertrophy
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Sliding
Sliding
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Corneal edema
Corneal edema
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Neovascularization
Neovascularization
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Conjunctival hyperemia
Conjunctival hyperemia
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Corgis
Corgis
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Burmese
Burmese
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Study Notes
Ophthalmology Study Notes
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Ophthalmic Examination Importance: A full ophthalmic examination is crucial for all animals exhibiting eye complaints.
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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.
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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.
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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.
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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.
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Secondary Bacterial Infections: Often involve mixed bacteria; culture and sensitivity testing is recommended.
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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.
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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.
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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.
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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.
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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.
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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.
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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).
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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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