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RUSVM SAM II-redo > Conjunctival & Lacrimal diseases > Flashcards

Conjunctival & Lacrimal diseases Flashcards

1
Q

How does the appearance of Palpebral conj. differ from Bulbar conj.?

A

Palpebral conju.=thicker, pinker

Bulbar conj.= thin, translucent

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2
Q

C/s of conjunctivitis?

A

Hyperemia Chemosis Serous-mucopurulent d/c Prominent lymphoid follicles Blepharospasm(PAIN!) Pruritus

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3
Q

Although they are uncommon, what is the main type of conjunctival neoplasia in dogs?

MCT-benign

A

MCT-benign

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4
Q

How does conjunctivits in the dog differ from the cat?

A

Dog
-Most common=Secondary -Associated with: Systemic & Ocular diseases

Cat

  • Most common=Primary
  • Associated with: Feline herpesvirus, Chlamydophila, Calici virus, or Mycoplasma
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5
Q

Which of the 4 immune mediated conjunctival disorders of dogs is-
Seen mostly in: Young, Large breed
Causes: Enlarged follicles/blisters
Treatment: Topical abx & anti-inflammatories

A. Lymphoreticular conjunctivitis
B. Ligneous or Membranous
C. Plasmoma
D. Nodular granulomatous episcleritis

A

A. Lymphoreticular conjunctivitis

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6
Q

Which of the 4 immune mediated conjunctival disorders of dogs is-
Seen mostly in: Dobies & Goldens
Causes: Thicken proliferative conjunctiva, +/- systemic dz
Treatment: Difficult

A. Lymphoreticular conjunctivitis
B. Ligneous or Membranous
C. Plasmoma
D. Nodular granulomatous episcleritis

A

B. Ligneous or Membranous

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7
Q

What is the commensal microflora of the conjunctiva?

A

Gram + Cocci

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8
Q

Which of the 4 immune mediated conjunctival disorders of dogs is-
Seen mostly in: GSD
Causes: Thickened depigmented TEL–> “Cobblestone” appearance
Treatment: Topical CyS, steroids

A. Lymphoreticular conjunctivitis
B. Ligneous or Membranous
C. Plasmoma
D. Nodular granulomatous episcleritis

A

C. Plasmoma

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9
Q

Which of the 4 immune mediated conjunctival disorders of dogs is-
Seen mostly in: Collies & Shelties
Causes: Inflammation & proliferation of episclera & conjunctiva
Treatment: Topical & systemic anti-inflammatories

A. Lymphoreticular conjunctivitis
B. Ligneous or Membranous
C. Plasmoma
D. Nodular granulomatous episcleritis

A

D. Nodular granulomatous episcleritis

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10
Q

What is the most common cause of conjunctivitis & surface ocular disease,in general, in cats and kittens?

A

Feline Herpesviral Conjunctivitis

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11
Q

What are the 3 different age presentations of FHC?

A

Neonatal Opthalmia: Ankylo/Symblepharon

8-12 wks: UR & occular signs

Mature: Recrudescence, Harbored in CN V

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12
Q

FHC causes what type of occular signs?

A

Severe kerritoconjunctivitis w/ chemosis, corneal edema, & ulceration

Sequela= KCS, Lacrimal adenitis

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13
Q

How is FHC diagnosed?

A

Tentatively on history & signs

Confirmed via PCR

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14
Q

T/F: We would prefer to use systemic antivirals over topical antivirals for treating FHC.

A

False

Systemic antivirals are Hepatotoxic to cats

Topicals: Cidovir, Trifluridine, Idoxuridine

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15
Q

What systemic antiviral is well tolerated by cats?

A

Famcyvlocir

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16
Q

What is the 2nd most common cause of conjunctivitis in cats?

A

Chlamydophila felis

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17
Q

What other ocular sign does C. felis cause aside from conjunctivitis?

A

Chemosis

Also causes +/- respiratory & GI signs

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18
Q

What is the DOC for C. Felis?

A

Topical tetracyclines-Chloramphenicol(risks for humans!)

Systemic Doxycycline if severe(wash with water!)

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19
Q

Why are we so concerned with Chronic conjunctivitis in cats?

A

It can lead to other ocular diseases

  • KCS
  • Epiphora
  • Eosinophilic Keratoconjunctivitis
  • Sequestrum
20
Q

What special function does the precorneal tear film have?

A

Produces protective proteins-ANTIMICROBIAL!!

21
Q

Impaired drainage of tear film or pain–> Overflow of tears=

A

Epiphora

22
Q

Impaired production of tears by tear film=

A

Keratoconjunctivitis sicca(KCS)–>

  • Hypertoncity & dehydration
  • Frictional irritation
  • Impared cleansing of ocular surface
  • Microorganism overgrowth
23
Q

What are some progressive signs of KCS?

A 
Inflammation
Desiccation of ocular surfaces
Pain
Corneal dz
Impaired vision
24
Q

Which type of KCS causes chronic conjunctivitis during early puppyhood, especially in yorkies & chihuahauas?

A

Congential-acinar hypoplasia

25
Q

T/F: Most cases of Acquired KCS are immune-mediated.

A

True

Lymphoplasmacytic inflammation of lacrimal & nictitans gland

Progressive until complete gland destruction

26
Q

Signalment for acquired KCS:

A

Mid-older aged
Pugs, Cockers, MS, English BD, Lhasa apsos, Westies, CKCS, Shih tzus, Pekingese

Burmese cats=uncommon

27
Q

What are the infectious causes of acquired non-immune mediated KCS?

A

Canine distemper

FHV

28
Q

What drugs can cause acquired non-immune mediated KCS?

A

Sulfa drugs
Etogesic(NSAID)

Atropine & general anesthesia(use eye lube during & after anesthesia!!)

29
Q

T/F: KCS c/s generally have a rapid onset.

A

FALSE!

Usually have a GRADUAL onset

  • Progressive conjunctivitis
  • Lackluster appearance
  • Hyperemic conjunctiva
  • Mucopurlent discharge
  • Discomfort & corneal ulcers
  • Corneal vascularization & pigmentation
30
Q

What ophthalmic test do we always do with any case of conjunctivitis and before applying ANY ophthalmic preparations?

A

Schirmer tear test

31
Q

What level of KCS does a dog with a STT of 8mm/min have?

A

Moderate

Normal > 15 mm/min
Early= 11-14 mm/min
Moderate= 6-10 mm/min
Severe=

32
Q

T/F: There is no cure for KCS and treatment will be lifelong.

A

True

Treatment goals

  • Stimulate tear production
  • Control 2nary inflammation or infection
  • Maintain lubrication with artificial tears
33
Q

What drugs can be used as lacrimostimulants for KCS cases?

A

Cyclosporine A- directly lacrimogenic, inhibits pigmentation & vascularization

Tacrolimus-refractory cases, 30% better response

34
Q

Of the 4 aqueous artificial tears, which 2 last last longer?

A

Viscotears, Lubrithal > Hylasheild, Lacrilube

35
Q

What drug can be used for acquired non-immune mediated KCS, caused by loss of CN V or VII(neurogenic), and ancillary in immune-mediated KCS?

A

Pilocarpine

36
Q

What is the difference between 2% & 0.25% Pilocarpine?

A

2% topical solution is used OVER food

0.25% is used in eyes

37
Q

What can repeated topical application of 0.25% Pilocarpine cause?

A

Uveitis!

Use PO dosing(2%)
Monitor for SLUD

38
Q

Paratoid duct transposition causes ____ on eye and ____ when eating.

A

Saliva on eye, Tears when eating

39
Q

What will happen if in KCS cases that respond to therapy if the meds are stopped?

A

RELAPSE will occur if meds are stopped!!!

40
Q

T/F: KCS is as common in cats as it is in dogs.

A

FALSE

Canine KCS= one of the most common ocular diseases
Feline KCS=uncommon

41
Q

What is needed for Feline KCS diagnosis?

A 
Clinical signs
Low STT( normal >10 mm/min, >5 mm/min can be normal too)
42
Q

What causes physiologic epiphora?

A

Shallow lacrimal lake

43
Q

What inflammatory/acquired cause of epiphora in cats is brought on by herpes?

A

Dacryocystitis

44
Q

Dacryrocystitis vs. Dacryoadenitis

A

Dacryo-

cystitis=inflammed lacrimal SAC

adenitis=inflammed lacrimal GLAND

45
Q

In what direction do we cannulate punctum and flush when diagnosing epiphora?

A

Dorsal-ventral

Lacrimal-nasal

46
Q

What do we suspect the cause of eipihora to be if there is persistant mucopurulent d/c?

A

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RUSVM SAM II-redo (3 decks)

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