Term
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Definition
| -highly vascular mucus membrane that lines the inside of the eyelids, both surfaces of hte nictitans, and the globe up to the limbus |
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Term
| What is the purpose of the conjunctiva? |
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Definition
| -provides friction-free movement of the eylids and nictitans |
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Term
| True or False: Since the cornea is avascular the conjunctiva is the first line ofdefense and will become inflamed with any ocular inflammatory process |
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Definition
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Term
| True or FAlse: An ophthalmic exam is only indicated for convunctivitis if it is painful. |
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Definition
| -FALSE, a thorough ophthalmic exam is required for any conjunctivitis presentation |
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Term
| Describe the clinical apearance of conjunctivitis. |
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Definition
-hyperemic conjnctiva
-/+ ocnjunctival thickening
-/+ chemosis |
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Term
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Definition
| -inflammation of the conjunctiva |
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Term
| What ophthalmic diagnostic tests are indicated for the canine, feline, and equine presenting with conjunctivitis? |
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Definition
-Canine: Schirmer tear test & Fluorescein stain
-Feline: Fluorescein stain
-EquineL Fluorescein stain |
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Term
| What is the only major indication for ocular cytology? |
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Definition
| -inclusion bodies for Chlamydophila |
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Term
| What is the primary etiology of conjunctivitis in the dog? |
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Definition
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Term
| What is the primary etiology of conjunctivits in the cat? |
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Definition
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Term
| HOw do we treat conjunctivitis due to environmental or non-specific allergies? |
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Definition
-topical steroid with antibiotic
-topical NSAID
-topical antiistamine |
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Term
| How do we treat UV-induced conjunctivits? |
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Definition
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Term
| How do we treat conjunctivitis due to contact irritant? |
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Definition
-rinse eye
-topical anti-inflammatory ONLY IF FLUORESCEIN NEGATIVE |
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Term
| What neoplasia is seen in the conjunctiva of the dog? |
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Definition
-Dermoid (choristoma): congenital
-Hemangioma/hemangiosarcoma
-Melanoma
-Mast cell tumor |
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Term
| What neoplasia affects the equine conjunctiva? |
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Definition
-99.9999999% SCC
-also hemangioma/hemangiosarcoma |
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Term
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Definition
| -normal tissue in an abnormal location |
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Term
| What are the possible causes of subconfuntival hemorrhage? |
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Definition
-trauma to globe
-choking
-cleeding disorder: thromboycytopenia or clotting disorder |
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Term
| What are the three layers of the tear film? |
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Definition
-lipid layer
-aqueous layer
-mucin layer |
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Term
| What is under the tear film? |
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Definition
| -corneal epithelial cells |
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Term
| What is the purpose of the tear film? |
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Definition
| -to support corneal nutrition |
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Term
| Which layer of the tear film is the innermost layer? What produces it? |
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Definition
-mucin layer
-produced by goblet cells of the ocnjunctiva |
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Term
| What is the purpose of the mucin layer of the tear film? |
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Definition
-coats the epithelium of the cornea to have an optically smooth surface and ats as the glue to attract the aqueous layer of the tear film
-contains immunoglobulins and lysozymes
-traps bacteria and debris |
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Term
| What characteristic of the mucin layer halps it tor "attract" the aqueous layer on a molecular level? |
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Definition
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Term
| What is the middle layer of the tear film? What produces it? |
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Definition
-aqueous layer
-produced by the orbital and nictitans lacrimal gland |
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Term
| True or FAlse: The mucin layer accounts for the majority of the tear film volume. |
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Definition
| -FLASE, the aqueous layer accounts for the majority of the tear film volume |
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Term
| What is the purpose of the aqueous layer of the tear film? |
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Definition
-primary layer for lubrication of the cornea and cojunctiva
-contains antimicrobial proteins (immunoglobulins, lysozymes, and lactoferrin)
-important for corneal nutrition: contains water, glucose, electrolytes, oxygen
-removes metaboites (CO2, lactic acid) and mechanically flushes away debris and bacteria |
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Term
| Which layer of the tear film is deficient in clinical dry eye? |
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Definition
|
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Term
| What is the outermost layer of the tear film? What produces it? |
|
Definition
-lipid layer
-produced by the meibomian glands of the eyelids |
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Term
| What is the purpose of the lippid layer of the tear film? |
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Definition
-thin, oily layer that prevents aqueous tear evaporation
-also smooths out the surface of the cornea |
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Term
| True or False: The tear film is dynamic. Justify your answer. |
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Definition
-TRUE
-every blink redistributes the tear film and restructures the trilaminar anatomy |
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Term
| What two things does a healthy tear film require? |
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Definition
-normal tear film production
-normal eyelid function |
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Term
| What is keratoconjunctivitis sicca (KCS)? |
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Definition
| -disease of the lacrimal secretory system in which there is a decrease in the aqueous layer of the tear film |
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Term
| What are a few of the breeds of dog that are predisposed to KCS? |
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Definition
| -PUg, Lhasa Apso, Shih Tzu, English Bulldog, American Cocker Spaniel, West Highland White Terrier, Miniature Schnaurzer, Pekengese |
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Term
| What are the etiologies of KCS? |
|
Definition
-#1: immune-mediated lacrimal gland adenitis which eventually can lead to fibrosis of the lacrimal glands
-ecision ofo the nectitans lacrimal gland
-Neurogenic (damage to parasympathetic fibers of CN7)
-drugs: sulfa antibiotics, etodolac
-canine distemper virus
-congenital
-hypothyroidism, diabetes |
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Term
| What are the clinical signs of KCS? |
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Definition
-mucopurulent discharge adhered to lids and cornea
-dull, lackluster appearance ot the cornea
-conjunctivitis
-Keratitis: edema, vascularization, pigmentation, fibrosis, ulcers
-blepharospasm
-dry crusted ober nostril |
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Term
| What is the significance of seeing a dry crusted ober nostril with KCS? |
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Definition
| -means it is neurogenic etiology |
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Term
|
Definition
-Schirmer tear test AND clinical signs
->15mm/min = normal |
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Term
| What are the major things to keep in mind with STT and KCS? |
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Definition
-ALWAYSA perfom STT on red eye
-ALWAYS perform STT on NOTH eyes
-ALWAYS fluorescein stain eyes with KCS |
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Term
|
Definition
-Cyclosporine 1-2% drops
-Tacrolimus |
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Term
| How does Cyclosporine treat KCS? |
|
Definition
-immunosuppressive class of drugs
-stimulates tear production in KCS by inhibiting T-helper lymphocytes in the lacrimal glands
-improves comfort and decreases discharge
-can be used with corneal ulcers
-can break up corneal pigment over long-term use
-MEDS CAN NEVER BE STOPPED!!!! |
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Term
| In addition to Cyclosporine/Tacrolimus therapy, how else do we treat KCS? |
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Definition
-topical antibiotics if bacterial growth is present
-topical steroid IFF NO ULCERS
-moisture/tear replacement drops |
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Term
| How do we treat neurogenic KCS? |
|
Definition
| -Pilocarpine (parasympathomymetic) in addition to Cyclosporine/Tacrolimus |
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Term
| What is our last resort in treating KCS? Why does this work? |
|
Definition
-parotid duct transporition surgery
-saliva lubricates the ee |
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Term
| What is the purpose of blinking? |
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Definition
| -required to move the tears to the medial canthus |
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Term
|
Definition
-slits in the conjunctiva located just inside the upper and lower eyelid margins at the medial canthus
-the lower punctum is most important for tear drainage |
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Term
| Where does the nasolacrimal duct run? |
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Definition
| -travels within the lacrimal bone and medial surface of the maxillary bone to the nares |
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Term
| What are the nasal puncta? |
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Definition
| -ventral slits just inside the nares |
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Term
| Where is the second opening of the nasolacrimal duct? |
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Definition
| -hard palate near the canine teeth |
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Term
| What diagnostic tests do we use to assess the patency fo the nasolacrimal system? |
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Definition
-Fluorescein dye
-Flushing the NLS through the puncta: normograde
-Dacryocystorhinogrophay (DCR): radiopaque dye is flushed into the puncta and skull rads are taken |
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Term
|
Definition
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Term
| What are the two general possible causes of epiphora? |
|
Definition
-increased tear production
-decreased tear outlflow |
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Term
| What are the two categories that cause increased production of tears? What are some examples of each? |
|
Definition
-Ocular irritation (no blepharospasm): conjunctivitis, distichiasis, trichiasis, entropion, minor foreign body
-Ocular pain (blepharospasm): herpes conjunctivitis, ectopic cilia, entropion, corneal ulceration/laceration/perforation/foreign body, anterior uveitis, glucoma |
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Term
| How do we look at the dog and differentiate between inc in tear production and dec in tear outflow causes epiphora? |
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Definition
| -dec in tear drainage only shows at the medial canthus while inc rear production shows everywhere |
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Term
| What are some possible causes of abnormal tear drainage leading to epiphora? |
|
Definition
-imperforate puncta: congenitally closed puncta that is usually the lower one
-Tight eyelid-globe conformation
-larimal sac foreign body
-Dacryocystitis: inflammation of the NLS
-Nasolacrimal duct obstruction |
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Term
| What should we do if we suspect dacryocystitis? |
|
Definition
-mucupurulent discharge at medial canthus usually seen
-culture to select the antibiotics
-repeated NLD flushes with topcial antibiotics and steroids |
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Term
| What are the possible causes of NLD obstruction? |
|
Definition
-foreign body, scarring, stricture within he duct
0adjacent nasal cavity disease (abscess, neoplasia)
-dental disease: big in rabbits |
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