Dzz Of The Anterior Uvea

Front 1

State congenital abnormalities of the anterior uvea

Back 1

1. Persistent pupillary membrane (PPM) - remnants of the vasculasa lentis seen at the iris collarette. Focal lens opacity present if adherent to corneal endothelium

2. Heterochromia irides

3. Coloboma - notch in iris

Front 2

State acquired anomalies

Back 2

1. Iris atrophy

2. Iris cyst

3. Anterior uveitis

4. Uveal neoplasia

Front 3

State clinical findings associated with iris atrophy

Back 3

1. Decreased to absent PLR

2. Dilated pupil

3. Photophobia

Front 4

State 3 aetiologies of iris atropy

Back 4

Age related, 2° to glaucoma or chronic uveitis

Front 5

Iris cyst arise from where? Describe

Back 5

Arise from posterior iris epithelium. They transilluminate unlike neoplasia (melanoma). Free-fliating in dogs. Attached to the pupillary margin in cats.

Front 6

State non-infectious aetiologies of anterior uveitis

Back 6

1. Trauma - release of inflammatory mediators. Trigeminal reflex

2. Lens induced uveitis - phacolytic (1°- leaks; ccs responsive) vs. phacoclastic (2° - rupture, severe). Rapid cataract.

3. 2° to neoplasia or abscess - trigeminal reflex

4. Uvodermatological syndrome -IM response to melanocytes; retinal detachment + glaucoma . Akita, samoyed, malamute, husky.

5. Equine recurrent uveitis - previous lepto or onchocerca cervicalis infection

6. Idiopathic

Front 7

State infectious aetiologies of anterior uveitis in dogs

Back 7

1. Fungal - granulomatous chorioretinitis and optic neuritis.

2. Ehrlichiosis

3. Rickettsia Rickettsia - necrotizing vasculitis

4. Toxoplasmosis

5. Bacterial - infectious canine hepatitis (type 1 adenovirus) - blue eye. Type 2 for vacvines.

6. Parasites - dirofilaria immitis . Immature can be in eye. Also fly larva.

Front 8

What 4 agents caue fungal anterior uveitis ?

Back 8

Blastomycosis dermatitidis, cryptococcosis neoformans, histoplasmosis capsulation, coccidioides immitis

Front 9

State infectious aetiologies of anterior uveitis in cats

Back 9

1. FIV - lentivirus.

2. FIP - coronavirus. 1° lesion - generalized vasculitis causing pyogranulomatous panuveitis or granulomatous anterior uveitis

3. FeLV - tan-pink choroid masses (LSC). + retinal haemorrage + severe anemia.

Front 10

State infectious aetiologies of anterior uveitis in horse

Back 10

1. Lepto

2. Strep.

3. Brucellosis

4. Septicaemia

5. Onchocerca cervicalis

6. Equine viral arteritis

7. Toxoplasmosis

8. Influenza

Front 11

What clinical signs are associated with anterior uveitis?

Back 11

1. Pain signs (blepharospasm, epiphora, Photophobia, enophthalmos)

2. Bulbar conjuctival hyperemia and scleral injection

3. Corneal edema and miosis (anisocoria + incomplete dilation with mydratics) via inflammatory mediators

4. Aqueous flare

5. Hypopyon - break down of bab

6. Thick, hazy, dark iris

7. Keratic precipitate

8. Hypotony -> decreased aqueous production

9. Rubecosis iridis

10. Corneal vascularization (360° in growth from linbus)

Front 12

What diagnostics and treatment are used for the following causes of anterior uveitis:

A. Fungal

B. Ehrlichiosis

C. Rickettsia Rickettsia

D. Toxoplasmosis gondii

E. Infectious canine hepatitis

F. FIV

G. FIP

H. FeLV

Back 12

A. Vitreous centesis - topical/systemic antifungal

B. Serology - tetracycline and symptomatic

C. Rising IFA titre - same B

D. Blood/aqueous titres, histopatholgy - clindamycin or trimethoprim sulpha

E. ELISA, serology - BS antibiotics

F. ELISA - symptomatic

G. Serology, CS - symptomatic

H. ELISA - symptomatic and chem

Front 13

What sequale may follow chronic uveitis?

Back 13

1. Synechiae

2. Corneal odema

3. Cataract

4. Pthisis bulbi

5. Lens luxation

6. Retinal detachment

7. Retinal degeneration (vascular attenuation, tapetal hyper-reflectivity)

8. Glaucoma

Front 14

T/F. Aqueous centesis is mainly for anterior uveitis dx while virtuous centesis is for both

Back 14

True

Front 15

What are the goals of tx for chronic uveitis ?

Back 15

1. Stabilize BAB. 2. Decrease pain 3. Stop synechiae 4. Decrease inflammatory reaction

Front 16

State treatment options for chronic uveitis

Back 16

1. Topical 0.1% dexamethasone or 1% prednisolone QID to every hourv (unless ulcers )

2. Subconjunctival ccs 1 per 2week; 0.2mls of triamcinolone acetonide or methylprednisolone (40mg/ml)

3. Systemic ccs if severe. Soludelta cortref (1-2 mg/kg BID)

4. Topical 1% atropine QID to Q1hr (unless glaucoma )

5. Systemic NSAIDS flunixin meglumine 0.5-10mg/kg in horse

6. Topical NSAIDS suprofen QID (unless ulcers)

7. Topical sympathetomimetic - 10% phenylephrine + atropine

Front 17

What is the effect of atropine in the eye?

Back 17

1 . dilation of pupil

2. Alleviate ciliary spasms

3. Decrease potential for iris bombe

4. Stabilize BAB

Front 18

State 2 primary uveal neoplasms

Back 18

Adenoma or adenocarcinoma, melanoma (most common)

Front 19

State 2° uveal neoplasms

Back 19

LSC (most common), adenocarcinoma from mammary or renal, SCC

Front 20

Describe Uveal neoplasms

Back 20

Cats - diffuse infiltrates or iris patch to a thick dark iris with mets. Dog - discrete nodular mass

Front 21

How are uveal neoplasms treated

Back 21

Laser photo coagulation of 1° in dog. Enucleation if large or in cats. Chemo in 2°

Front 22

Describe horners syndrome

Back 22

Miosis (sympathetic decrease)

ptosis (decreased signal to superior tarsal m.)

Enophthalmos (decreased signal to band m.)

3rd eyelid protrusion

Front 23

What locations can cause horners syndrome and the dx tool?

Back 23

Pre ganglion - chest xray

Post ganglion - vestibular dzz and facial paralysis

Central- CNS signs

Front 24

State causes of horners syndrome

Back 24

Neoplasia , brachial plexus evulsion, gutteral pouch mycosis