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Exam 3
Equine Optho
45
Veterinary Medicine
Professional
11/17/2016

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Cards

Term
What does the auriculopalpebral nerve block do?
Definition
=blocks motor innervation to the eyelids
-usually the only block needed for exam
Term
What does the supraorbital nerve block do?
Definition
-blocks sensory inenrvation to the superior eyelid
Term
What are the main principles of squamous cell carcinoma?
Definition
-white face/eyelids predispose: appaloosa, american paint, draft breeds
-UV light exposure predisposes
-early recognition and tx give the best prognosis: biopsy early
Term
What are the common locations ofr squamous cell carcinoma in the horse?
Definition
-eyelid, nictitans, bulbar conjunctiva/cornea
Term
Describe a SCC of the bulbar conjunctiva/cornea?
Definition
-raised, pink, proliferative lesion arising at the lateral => progresses medially across the cornea
Term
How do we treat a SCC that is small at the lateral limbus of a horse?
Definition
-keratectomy and cryotherapy is usually curative
Term
How do we treat a large SCC in a horse?
Definition
-keratectomy and cryotherapy
-has fair-good prognosis
Term
How do we treat an extensive SCC in a horse?
Definition
-enucleation usually curative
Term
What does a nictitans SCC look like in a horse?
Definition
-red, raised nodule to proliferative mass originating at the margin of the nictitans
Term
How do we treat nictitans SCC in a horse?
Definition
-tiny nodules can be excised followed by cryotherapy, monitor for recurrence
-excision of ALL of the nictitans is usually curative (do fine)
Term
What happens without early treatment of a nictitans SCC in a horse?
Definition
-can invade locally into the eyelid )lower eyelid, medial canthus) and spread to regional LN (usually submandibular)
Term
What is the most difficult SCC location to treat in the horse?
Definition
-eyelid, difficult if not caught early
Term
Which location of SCC in the horse has the highest risk of local invasion and metastasis to regional LN?
Definition
-eyelid
Term
What are the clinical signs of eyelid SCC in the horse?
Definition
-lid margin erosion or scab (non-healing = RED FLAG)
-thickening of the eyelid (skin can be non-ulcerated) with swollen, hyperemic, proliferative conjunctiva
-ulceration of the eyelid margin with loss of normal architecture = ocular discharge and blepharospasm
Term
How do we deginitively diagnose SCC in the horse?
Definition
-biopsy
Term
How do we treateyelid SCC in a horse?
Definition
-excision
-cryotherapy: only affects superficial tissue
-CO2 laser ablation
-intralesional chemo after excision
Term
What is the point of wearing mask for a horse aftr SCC treatment?
Definition
-UV protection
Term
What is the clinical presentation with conjunctivitis due to EHV?
Definition
-unilateral or bilateral
-recurrences are in the same eye if unilateral
-marked blepharospasm/pain
-marked palpebral conjunctival swelling and hyperemia
Term
What is the clinical presentation of the non-ulcerative and ulcerative keratitis due to EJC?
Definition
-associated with blepharospasm, epiphora, conjunctivitis
=superficial (epithelial)
-corneal surface may appear roughened
-white multifocal punctate opacities
Term
What diagnostics do we run to diagnose EHV?
Definition
-Fluorescein and rose bengal stains
-cytology to rule out fungal if fluorescein or rose bengal stain is positive
Term
How do we treat EHV in the horse?
Definition
-topical antiviral 3-4 times/day
Term
What are the etiologies of corneal ulcers in horses?
Definition
-trauma to corneal epithelium
-herpes virus
-eyelid laceration scar with eyelid margin misalignment
-facial nerve paralysis (corneal exposure, dec tear film spread)
Term
What are the three major corneal ulcer complications in the horse?
Definition
-fungal infection
-bacterial infection
-keratomalacia
Term
How do we diagnose fungal ulcers in the horse?
Definition
-cytology
Term
Which cases are suspect for fungal ulcers in horses?
Definition
-prolonged antibiotic therapy without healing
-previous use of topical corticosteroids
-fluffy, white corneal infiltrates
Term
What diagnostic tests are useful for corneal ulcers in the horse?
Definition
-Fluorescein stain
-Rose bengal if fluorescein negative
-culture
-cytology to ID hyphae
Term
How do we treat corneal ulcers?
Definition
-Antibiotics: Ciprofloxacin, Ofloxacin, Moxifloxacin
-Antifungals: silver sulfadiazine
Term
What are the clinical signs of secondary anterior uveitis in a horse with corneal ulcers?
Definition
-miosis: often first CS
-aqueous flare: inc cells/protein in aqueous
-fibrin
-hypopyon
Term
What is the most common mistake with treating corneal ulcers in a horse? Why is this significant?
Definition
-not treating anterior uveitis
-this can determine if the horse ever sees again
Term
How do we treat secondary anterior uveitis with corneal ulcers in the dog?
Definition
-Atropine
-Systemic NSAIDs: BAnamine
Term
What are the clinical signs of corneal stromal abscess in horses?
Definition
-flourescein negative!!!
-focal area of white or yello stromal cellular infiltrate
-/+ corneal vascularization
-marked anterior uveitis: painful
Term
How do we treat corneal stromal abscesses in the horse?
Definition
-NO STEROIDS even though the fluorescein negative
-aggressively treat the anterior uveitis while waiting for vascularistion to heal the abscess
-topical antibiotic: Fluoroquinolone
-topical antifungal
surgical excision of abscess and graft if not better
Term
Describe the seasonality of corneal stromal abscesses in horses?
Definition
-late summer and early fall
Term
What are the etiologies of equine uveitis?
Definition
-corneal disease: MOST COMMON CAUSE
-ulcer: deeper ulcers and infected ulcers have worse uveitis
-stromal abscess: severe anterior uveitis
-Trauma: blunt or perorating
-Systemic dz: especially in foals
-equine recurrent uveitis
Term
What are the treatment principles of equine uveitis?
Definition
-must suppress inflammation
-must prevent synechia
-must treat underlying cause if identified
Term
HOw do we suppress the inflammation with equine uveitis?
Definition
-BAnamine
-topical steroids (if not contraindicated by corneal disease): Dex or Pred
-Topical NSAIDs: Flurgiprofen or Diclofenac
Term
How do we prevent synechia with equine uveitis?
Definition
=Atropine
-Banamine
Term
In which horses is it especially important to rule in or out systemic disease with uveitis?
Definition
-foals
Term
What are the consequences of equine recurrent uveitis?
Definition
-miosis + persterior synechia
-fibrin (fibrosis across the pupil_
-cataract formation
-vitreous inflammaiton
-retinal degeneration or detachment
-secondary glaucoma
-phthisis bulbi (eye shrinks)
Term
What are the clinical classifications of equine recurrent uveitis?
Definition
-Classic recurrent: active uveitis episodes followed by quiescent period & history also sounds like herpes
-Insidious: persistent low-grade inflammation without overt clinical signs (appaloosa breed predisposed)
-posterior uveitis
Term
Describe the immune-mediated etiology of equine recurrent uveitis?
Definition
-molecular mimicry: homology b/n pathogen and host tissue antigens
-release of normally sequestered autoantigens due to trauma or infection
-alteration of autoantigen structure caused by tissue injury or inflammation
-T-lymphocyte memory cells in the uvea
Term
What infectious agent can cause equine recurrent uvieits?
Definition
-lepto
Term
What is the role of genetics of equine recurrent uveitis?
Definition
-appaloosas are genetically predisposed
Term
Describe acute therapy for equine recurrent uveitis?
Definition
-Topical steroid: Dex or Pred
-Topical NSAID
-Atropine
-Banamine
Client education
Term
Describe chronic/maintenance therapy for equine recurrent uveitis.
Definition
-topical steroid
-topical NSAID
-atorpine
-Cyclosporine suprachoroidal implants
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