Podcast
Questions and Answers
What is the primary cause of keratoconjunctivitis sicca (KCS) in dogs?
What is the primary cause of keratoconjunctivitis sicca (KCS) in dogs?
Which clinical sign is NOT typically associated with keratoconjunctivitis sicca (KCS)?
Which clinical sign is NOT typically associated with keratoconjunctivitis sicca (KCS)?
What diagnostic test is used to measure tear production in suspected cases of KCS?
What diagnostic test is used to measure tear production in suspected cases of KCS?
Which treatment is primarily aimed at stimulating tear production in immune-mediated KCS?
Which treatment is primarily aimed at stimulating tear production in immune-mediated KCS?
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What is the expected effect of long-term use of cyclosporine in KCS patients?
What is the expected effect of long-term use of cyclosporine in KCS patients?
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Which part of the nasolacrimal drainage system is responsible for initiating drainage from the eye?
Which part of the nasolacrimal drainage system is responsible for initiating drainage from the eye?
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What is the purpose of using fluorescein dye in assessing nasolacrimal drainage?
What is the purpose of using fluorescein dye in assessing nasolacrimal drainage?
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What potential benefit does pilocarpine have in the treatment of KCS?
What potential benefit does pilocarpine have in the treatment of KCS?
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What is the main anatomical structure responsible for the production of aqueous humor?
What is the main anatomical structure responsible for the production of aqueous humor?
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Which pathway does aqueous humor follow through the eye before exiting?
Which pathway does aqueous humor follow through the eye before exiting?
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What is the normal range for intraocular pressure (IOP) in mmHg?
What is the normal range for intraocular pressure (IOP) in mmHg?
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Which breed is most commonly associated with primary glaucoma?
Which breed is most commonly associated with primary glaucoma?
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What is a common clinical sign of glaucoma in dogs?
What is a common clinical sign of glaucoma in dogs?
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Which condition is characterized by impaired outflow leading to increased IOP in dogs?
Which condition is characterized by impaired outflow leading to increased IOP in dogs?
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What anatomical change is typically seen in closed-angle glaucoma?
What anatomical change is typically seen in closed-angle glaucoma?
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What is the effect of increased intraocular pressure on the optic nerve?
What is the effect of increased intraocular pressure on the optic nerve?
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Which of the following is a recognized cause of secondary glaucoma?
Which of the following is a recognized cause of secondary glaucoma?
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What is the main goal in managing primary glaucoma?
What is the main goal in managing primary glaucoma?
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What common treatment is used for uveitis that may also be applied in cases of hyphema?
What common treatment is used for uveitis that may also be applied in cases of hyphema?
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In chronic uveitis, which complication can occur that leads to pupillary block?
In chronic uveitis, which complication can occur that leads to pupillary block?
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What is a necessary action when managing secondary glaucoma regarding its underlying cause?
What is a necessary action when managing secondary glaucoma regarding its underlying cause?
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What is the characteristic feature of distichiasis?
What is the characteristic feature of distichiasis?
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Which condition involves hair growing from the palpebral conjunctiva?
Which condition involves hair growing from the palpebral conjunctiva?
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What is the primary clinical sign of entropion?
What is the primary clinical sign of entropion?
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What procedure is indicated for temporary correction of entropion in puppies?
What procedure is indicated for temporary correction of entropion in puppies?
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What common eyelid tumor is associated with the meibomian gland?
What common eyelid tumor is associated with the meibomian gland?
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Which statement about ectropion is accurate?
Which statement about ectropion is accurate?
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Which condition involves inflammation of the eyelids?
Which condition involves inflammation of the eyelids?
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What is the function of the nictitating membrane?
What is the function of the nictitating membrane?
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What is the primary goal of treatment in cases of chronic glaucoma where the affected eye is permanently blind?
What is the primary goal of treatment in cases of chronic glaucoma where the affected eye is permanently blind?
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Which hyperosmotic agent administers intravenously and lowers intraocular pressure within 30-60 minutes?
Which hyperosmotic agent administers intravenously and lowers intraocular pressure within 30-60 minutes?
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What should be avoided for use of glycerin in patients with which condition?
What should be avoided for use of glycerin in patients with which condition?
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Which surgical procedure aims to increase aqueous humor outflow?
Which surgical procedure aims to increase aqueous humor outflow?
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What is a significant risk associated with diode laser cyclophotocoagulation?
What is a significant risk associated with diode laser cyclophotocoagulation?
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When is enucleation recommended as a procedure for glaucoma intervention?
When is enucleation recommended as a procedure for glaucoma intervention?
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What is the primary effect of chemical ablation using gentamicin?
What is the primary effect of chemical ablation using gentamicin?
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Which medication should be given immediately to a patient with potential for regaining vision affected by glaucoma?
Which medication should be given immediately to a patient with potential for regaining vision affected by glaucoma?
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What is the expected outcome when spastic entropion is treated with proparacaine?
What is the expected outcome when spastic entropion is treated with proparacaine?
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Which layer of the cornea is involved in maintaining corneal clarity through fluid regulation?
Which layer of the cornea is involved in maintaining corneal clarity through fluid regulation?
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What is the predominant treatment method for superficial, non-infected corneal ulcers?
What is the predominant treatment method for superficial, non-infected corneal ulcers?
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In cases of reflex uveitis in dogs, which is a common trigger?
In cases of reflex uveitis in dogs, which is a common trigger?
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What characterizes rhegmatogenous retinal detachment?
What characterizes rhegmatogenous retinal detachment?
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What is a contraindication for using topical NSAIDs in cases of corneal ulcers?
What is a contraindication for using topical NSAIDs in cases of corneal ulcers?
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What systemic condition in dogs can lead to uveitis?
What systemic condition in dogs can lead to uveitis?
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Which clinical sign is NOT typically associated with glaucoma?
Which clinical sign is NOT typically associated with glaucoma?
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Study Notes
VMED 7502: Ophthalmic Exam
- A detailed ophthalmic examination includes examining the adnexa, globe, orbit, and reflexes. Findings are interpreted within a clinical context.
- Globe size assessment includes large buphthalmos and small microphtalmos or phthsis bulbi.
- Globe position includes exophthalmos vs enophthalmos and retropulsion.
- Menace response assessment includes vision, blink, afferent (vision-retina, optic nerve, visual cortex), and efferent (blink-facial nerve; motor to eyelids).
- Palpebral reflex assesses eyelid sensation and blink, with afferent (eyelid sensation- trigeminal nerve) and efferent (motor to eyelids- facial nerve) components.
- Pupillary light reflex (PLR) assessments include the direct, indirect (consensual), afferent (retina and CN2), and efferent (CN3 and iris sphincter m.) aspects.
- Ophthalmic diagnostic tests are selected based on the patient's history, signalment, and clinical signs.
- Basic ophthalmic exam procedures include accurate technique and identification of incorrect technique.
Ophthalmic Diagnostic Tests
- Indirect ophthalmoscopy has advantages: larger field of view, better view through opacities, viewer depth perception, and distance from the patient. Disadvantages include an upside-down and reversed image and the need for learned technique.
- Direct ophthalmoscopy has advantages: easy to perform, upright image, and a magnified image. Disadvantages include a small field of view, and opacities interfering with the view.
Contraindications and Specific Tests
- Recall contraindications for specific ophthalmic diagnostics, including the use of proparacaine and tropicamide.
- Schirmer Tear test assesses basal and reflex tears. Afferent is corneal sensation and efferent is parasympathetic fibers of CN7 to the lacrimal gland
- Tonometry (requires topical anesthesia) measures pressure in dogs (10-25 mmHg), cats (10-30 mmHg), and horses (15-30mmHg), ideally with less than or equal to 5mmHg difference in a healthy animal.
- Hallmark of inflammation in the eye is uveitis.
Neuro-ophthalmology
- Assess vision using techniques and differentiate vision loss from abnormal mentation.
- Interpret pupillary light reflex (PLR) abnormalities and localize lesions (afferent: sensory, going toward CNS; efferent: motor, going away from CNS).
- Diagnose anisocoria (unequal pupil size) using pupillary light reflex, increasing or decreasing room lighting to assess for lack of parasympathetic or sympathetic innervation in the abnormal pupil.
Ocular Pharmacology
- Topical drugs do not penetrate beyond the lens. This must be considered when choosing the appropriate route of administration for different ocular regions.
- Ointments provide longer lubrication compared to solutions.
- Ointments are easier to administer in large animals and solutions are easier in smaller animals.
- Solutions are contraindicated with deep corneal ulcers, perforation, or laceration.
- Use of topical medications includes ophthalmic solutions, ointments, and subconjunctival injections, tailored to the patient's condition.
Ophthalmic Drugs and Diseases
- Topical, systemic antibiotics, antifungals, and other ophthalmic treatments are important in treating various ocular diseases (e.g., keratitis, scleritis, anterior uveitis, uveitis, etc.).
- These different classes of drugs target different pathogens or inflammatory responses and are used in conjunction with local ophthalmic treatments in a variety of situations.
Orbital Disease
- Clinical signs of enophthalmos include globe sunken into the orbit, elevated nictitating membrane, and decreased palpebral fissure size.
- Clinical signs of exophthalmos may include globe protruding anteriorly, increased palpebral fissure size, and elevated nictitating membrane.
- Differentiate between inflammatory and neoplastic etiologies of orbital disease based on clinical signs, medical history, and signalment.
Corneal Disease
- Relate basic corneal anatomy and physiology to corneal disease pathology.
- Systematically rule out etiologies for corneal disease based on animal signalment, history, and examination findings.
- Identify ophthalmic diagnostic tests and evaluate and interpret findings.
- Recognize clinical signs of corneal disease, including pain, chronicity, and severity, and predict prognosis of vision.
- Formulate an appropriate treatment plan for corneal disease, considering ideal to palliative care, potential referrals, and justification.
Lens Disease
- Relate lens anatomy and physiology to nuclear sclerosis, cataract formation, and lens luxation.
- Diagnose cataracts by performing a complete ophthalmic exam and identify etiology and stage.
- Formulate a treatment plan that accounts for referral and pharmacological aspects.
- Differentiate between phacolytic and phacoclastic uveitis.
Uvea Conditions
- Recognize the common non-inflammatory conditions of the uvea (iris atrophy, iris cyst, persistent pupillary membranes) based on history, signalment, and clinical signs (e.g. iris atrophy, uveal cysts).
- Formulate a treatment plan for a patient with lens luxation, considering the signalment, chronicity, and the potential for vision restoration.
- Differentiate between characteristic clinical signs of inflammatory versus neoplastic etiologies of orbital disease.
Fundus
- Recognize normal variations in the ocular fundus of common domestic species (e.g., tapetum).
- Relate retinal and choroidal anatomy and physiology to appearance of normal variations in the fundus, and to the pathogenesis of chorioretinitis, hemorrhage, and retinal detachment.
Retinal Detachment
- Recognize the clinical signs of retinal detachment and conclude the most likely etiology.
- Formulate an appropriate treatment plan for retinal detachment that considers signalment, severity, and potential for vision restoration.
- Understanding of the appropriate referrals for further management.
Feline Ophthalmology
- Develop a differential list for feline conjunctivitis and/or keratitis, including diagnostic tests, therapeutic recommendations, and follow-up considerations.
- Differential diagnoses of ocular conditions in feline patients (e.g, herpesvirus, chlamydophila, mycoplasma).
Equine Ophthalmology
- Identify ophthalmic clinical signs that can be manifestations of systemic disease.
- Describe the pathogenesis of feline diffuse iris melanoma.
- Evaluate the difference between uveal melanoma in canines vs that found in felines when performing differential diagnosis.
- Recommend appropriate diagnostic tests, therapeutic recommendations, and follow-up considerations.
Food-Animal Ophthalmology
- Develop an accurate differential diagnosis list for an animal presenting with corneal opacity.
- Recommend management strategies to help prevent and/or manage outbreaks of IBK.
- Recognize various stages of Bovine Ocular Squamous Cell Carcinoma (BOSCC).
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Description
Test your knowledge on the comprehensive ophthalmic examination processes. This quiz covers key assessment techniques such as globe size evaluation, menace response, and reflex tests, all within a clinical context. Prepare to enhance your understanding of veterinary ophthalmology.
