SAM II Exam II Material - Ophthalmology Flashcards Preview

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Flashcards in SAM II Exam II Material - Ophthalmology Deck (184)
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1

Primary lens luxations are due to:

Inherited dysplasia or degeneration of zonules​

  • DNA testing can be done for clear, carrier, and genetically affected
  • Predisposed: Terrier breeds, poodles, Shar Peis, others

2

Which of the following treatments would be least indicated in the treatment of a deep corneal ulcer?

  • Autologous serum administration on the eye
  • Conjunctival graft
  • Gentamycin ophthalmic drops
  • Grid keratotomy

Grid keratotomy​

3

This is the most common cause of glaucoma in cats:

uveitis

4

What is the most common eyelid tumor that we see in the cat?

Squamous cell carcinoma​

MALIGNANT!!

5

Holes or defects in uveal tissue (iris or choroid):

colobomas

  • Holes or defects in uveal tissue: iris or choroid
  • Typical at 6 o’clock
  • Choroidal colobomas can result in poor retinal development = impaired vision

6

Which of the following are congenital diseases of the eyelids?

  • Dermoids
  • Entropion
  • Eyelid agenesis

Dermoids and Eyelid agenesis

7

When a dog can’t close its eyes completely (and sleeps with its eyes open), this is termed:

lagophthalmos

8

A cat presented with conjunctivitis (owner called it a ‘red eye’). Fluorescein stain showed a small corneal ulcer. Tear production was also lower than expected for a cat. What is the most likely cause of these signs?

herpes virus

9

Intumescent cataracts are associated with what systemic metabolic disease?

Diabetes mellitus

Hyperglycemia causes high glucose in the lens → Hexokinase becomes saturates so alternate sorbitol pathway is used → Sorbitol and fructose accumulate in the lens → Sorbitol cannot escape from the lens, resulting in hypertonicity → causes water uptake, swelling, and rupture of lens fibers → uveitis

(Note: cats do not have the alternative sorbitol pathway)

10

What IOP is indicative of glaucoma?

> 25 mmHg

11

This is a purulent bacterial infection of the meibomian gland (internal site) or skin gland of the lid (gland of Moll or Zeis/external site):

hordeolum or stye

  • Clinical signs: red raised area on lid margin; epiphora; blepharospasm, blepharedema
  • Painful and comes to a head on outside of lid
  • Often seen in young dogs but also cats
  • May be multiple
  • Treatment: local warm packs, topical & systemic anti-inflammatories & antibiotics
  • May need culture and sensitivity if chronic recurrent infection
  • Rarely need surgical correction

12

A cat presents with this fleshy growth with superficial vascularization on the lateral conjunctiva. You perform a cytology and note infiltrates of eosinophils, plasma cells and lymphocytes. What is your diagnosis?

Feline Eosinophilic Keratoconjunctivitis​

  • May be associated with FHV‐1 immune stimulation or reaction​
  • Treatment: topical glucocorticoids only if no corneal ulcer (may need to use cyclosporine)​
    • ​Could activate herpes infection!

13

What are the 5 basic layers of the cornea?

  • Tear film
  • Epithelium
  • Stroma
  • Descemet's membrane
  • Posterior epithelium

That Eye's So Damn Pimp

14

Glaucoma can be caused by any of the following except:

  • Intraocular neoplasia
  • Lens luxation
  • Uveitis
  • Abnormal iridocorneal angle
  • Optic nerve atrophy

Optic nerve atrophy​

15

What is the term used to describe ingrowth or introversion of the eyelashes resulting in normal hairs contacting the cornea?

trichiasis

  • Normal hairs contacting cornea
    • Eyelids/lashes, nasal fold fur
  • Common in long-haired dogs & brachycephalics
  • Often subclinical
    • Epiphora
    • Corneal pigmentation and ulcerations

16

What treatment for indolent ulcers has the highest rate of success?

superficial keratectomy

  • Best chance of success (99-100%), but most invasive
  • Remove epithelial layer & parts of stroma allowing for reformation of normal epithelial complexes
  • Success proves the poor healing is related to abnormal BM & lack of stroma adhesion
  • Not recommended as first line due to need for general anesthesia and cost
  • Not recommended in cats: may predispose to formation of a corneal sequestrum.
  • Referral procedure usually

17

T/F: The majority of diabetic dogs develop cataracts within 1 year of diagnosis despite adequate glycemic control

True

18

inflammation of the lacrimal sac is termed:

dacryocystitis

19

Identify this progressive, bilateral, inflammatory, non‐ulcerative potentially blinding corneal abnormality:

chronic superficial keratitis​

(aka Pannus or Uberreiter's syndrome)

  • Immune-mediated theory: Reaction to corneal antigens; exacerbated by exposure to UV light & possibly associated with high altitudes.
  • German shepherds:
    • Young, 1–5 yrs, usually severely progressive & extensive
    • Older dogs, 4 ‐6 yrs slowly progressive & extensive
  • Greyhounds: 2‐3 yrs with relatively mild lesions

20

An overflow of tears on the cheek is termed:

epiphora

21

T/F: Lagopathalmos refers to the inability to open the eyelids completely

False

Lagopathalmos refers to the inability to close the eyelids completely

22

T/F: Cyclosporine A is a drug of choice for treatment of KCS and Pannus

True

23

Which one of the following findings is NOT found with acute glaucoma?

  • Cloudy cornea
  • Blindness
  • Buphthalmia
  • Red eye
  • Painful eye

Buphthalmia​

24

  • What kind of ulcer is this?
  • What part of the cornea is affected?
  • How is it treated? 
  • How long will it take to heal? 
  • When will you do a recheck fluorescein stain?

  • Superficial corneal ulcer
    • Superficial epithelial layer is affected
    • Treated with topical antibiotics (BNP if it's a dog)
    • May take ~1 week to heal
    • Recheck in 1-4 days

25

What is the most common cause of cataracts in dogs?

developmental

  • Hereditary
  • Many breeds
  • 1‐7 years old
  • Often bilateral; can be asymmetrical

26

In general, what are the three main tests that should be performed on all eyes and in a specific order?

  1. Schirmer Tear Test (STT)
  2. Fluorescein stain (FS)
  3. Tonometry

27

This dog presents with "big eye" on the left and decreased vision for 2 weeks. He now has ocular cloudiness bilaterally and has also stopped eating. On physical examination, you note exophthalmos on the left, anterior uveitis bilaterally, and peripheral lymphadenopathy. Temperature = 39.5˚C

What diagnostic test could be done next to help with your diagnosis?

Lymph node aspiration or biopsy

  • What are some differential diagnoses for lymphadenopathy?
    • Lymphoma
    • Tick-borne disease 
    • Fungal disease
    • Protozoal disease

28

EXTREME exophthalmos is termed:

proptosis

forward displacement of the globe with simultaneous entrapment of the eyelids behind the equator

29

T/F: Corticosteroids are the drug of choice for treating corneal ulcers

FALSE

IF EVER ASKED ABOUT STEROIDS AND ULCERS, IN GENERAL THE ANSWER IS AVOID.

The only real exception to this is to treat Superficial Punctate Keratitis

30

What is normal IOP in the dog? 

10-25mmHg