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81 Cards in this Set
- Front
- Back
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Corneoscleral junction also known as the...
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Limbus
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Corneal endothelial damage results in corneal edema due to this defect
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Decreased pump function
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True or false: Corneal endothelium is readily regenerative in the adult animal.
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False. Does not regenerate
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How do corneal epithelial defects contribute to corneal edema?
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Allow leakage of fluid from tear film to leak into the cornea
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If ocular neovascularization occurs superficially on the cornea and undergoes significant branching, then it it likely due to...
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Corneal disease
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If ocular neovascularization occurs deep in the cornea and undergo little branching, it is most likely due to...
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Intraocular inflammation
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Corneal pigmentation occurs in response to these two things.
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Chronic corneal irritation or inflammation
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Congenital mass with ectodermal and mesodermal origins. Often arises at the lateral lumbus and extends onto the cornea, appearing as a haired mass.
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Dermoid
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How is a corneal dermoid treated?
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Complete excision
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Arise from the iris and may be attached to the endothelial surface of the cornea, causing focal/multifocal opacities
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Persistent pupillary membranes
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Full thickness loss of corneal epithelium, exposing the underlying stroma
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Corneal ulcer
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Partial thickness loss of corneal epithelium
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Corneal erosion
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Clinical signs associated with corneal ulceration
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Acute onset ocular pain
Blepharospasm Localized corneal edema Conjunctival hyperremia Epiphora +/- purulent ocular discharge |
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Which type of corneal ulcer is more painful: Superficial or deep?
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Superficial
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List some causes of corneal ulcers
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Trauma (most common)
KCS Exposure keratitis Chemical contact |
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Most common cause of secondary corneal infection in the dog.
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Bacteria
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Most common cause of secondary corneal infection in the horse.
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Fungus
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With this type of corneal ulcer, only the basement membrane remains and the globe is very susceptible to rupture
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Descemetocele
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Severe condition in which proteolytic degradation of corneal stromal collagen occurs, resulting in rapid corneal destruction
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Melting ulcer
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List two agents that may incite the enzymes that cause a melting corneal ulcer.
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Pseudomonas
Neutrophils |
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Test that allows you to visualize a corneal ulcer's margins.
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Fluoroscein
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List four diagnostic tests used to identify a corneal ulcer and its cause.
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Fluoroscein stain
Search for underlying cause Corneal cytology Culture/sensitivity |
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Treatments for corneal ulcers include:
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Topical antibiotics (tid broad spectrum)
Topical atropine to minimize spasm Protease inhibitors, for melting ulcers Conjunctival flap surgery (blood supply and cells) |
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When is atropine use contraindicated?
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Concurrent glaucoma
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When are 3rd eyelid flaps contraindicated for treatment of corneal ulcers?
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Most cases, especially with infection present
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With a corneal ulcer, for how long should topical antibiotics be administered?
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Until epithelium covers the defect.
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These drugs are absolutely contraindicated with a corneal ulcer!!!
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Corticosteroids
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Superficial corneal lesion in a Boxer that heals very slowly. Elevated recurrent risk.
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Spontaneous Chronic Corneal Epithelial Defect
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How is SCCED treated?
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Debride loose epithelium from cornea with a cotton applicator
Striate keratotomy or punctate keratotomy Broad spectrum antibiotic drops TID until healed |
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Adverse consequence that may occur while removing a corneal foreign body.
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Perforated globe
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How should superficial corneal lacerations be addressed?
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Like a corneal ulcer
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How should deep corneal lacarations be addressed?
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Sutured primarily
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This sign makes recognition of corneal rupture easy
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Prolapse of the iris
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Describe the emergency management for a corneal perforation.
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Topical antibiotics q 4-6h in SOLUTION form
Topical atropine Systemic antibiotics E-collar |
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Prognosis for corneal rupture
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Variable but generally fair to good
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Negative prognostic indicators with corneal rupture
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Rupture due to blunt trauma
Severe hyphema Lens rupture Obvious intraocular infection Chronic rupture |
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Stromal accumulation of inflammatory cells, appearing as an off-white to yellow opacity within the cornea. Extremely uncomfortable, as evidenced by epiphora and blepharospasm.
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Corneal abcess
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How are corneal abcesses treated?
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Topical antibiotic capable of penetrating an intact corneal epithelium (fluoroquinolones or chloramphenicol)
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Common causes of pigmentary keratitis
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KCS
Nasal fold trichiasis Entropion DIstichiasis Exposure keratitis Recurrent corneal ulceration |
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Can corneal pigmentation interfere with vision?
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Yes
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Treatment to reduce corneal pigmentation
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Cyclosporine
Tacrolimus |
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Other term for chronic superficial keratitis
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Pannus
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Breeds most commonly affected by pannus
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German shepherds and their crosses
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Disease marked by superficial vascularization and depigmentation of the cornea. Lesions slightly raised and may eventually cover entire cornea.
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Chronic superficial keratitis, or pannus
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Is pannus a painful condition?
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No
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Cause of chronic superficial keratitis
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Immune mediated condition
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How is age related to severity of pannus?
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The younger the age of onset, the more severe and non-responsive to treatment the condition is
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How is chronic superficial keratitis treated?
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No cure
Antinflammatory steroids, cyclosporine, or tacrolimus Cyclosporine used for long-term management to control flare-ups |
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ICH Keratouveitis is associated with this vaccine.
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Infectious canine hepatitis (CAV-1 > CAV-2)
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How long after receiving an adenovirus vaccine may a dog develop keratouveitis?
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10-14 days
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CS of keratouveitis
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Severe corneal edema
Endothelial precipitates Anterior uveitis Unilateral |
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Treatment for keratouveitis.
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Topical corticosteroids
Topical atropine (as long as there is no glaucoma) |
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Lipid deposition in the cornea
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Lipid ketatopathy
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List three causes of lipid keratopathy
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Inherited dystrophic condition (corneal lipid dystrophy)
Lipid metabolism disturbance Previous or ongoing corneal disease |
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Appears as a sparkly, crystalline, or white amorphous accumulation in the cornea.
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Lipid keratopathy
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When is lipid keratopathy likely to be bilateral?
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Inherited lipid dystrophy
Systemic disease |
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Is lipid keratopathy usually sight threatening?
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No
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Treatment for lipid keratopathy
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Usually none
Dietary fat restiction Keratectomy |
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Spontaneous degeneration of corneal endothelial cells resulting in severe bilateral corneal edema
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Endothelial dystrophy
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Breeds predisposed to endothelial dystrophy
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Boston Terrier
Chihuahua Dachshund Basset Hound |
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Treatment for endothelial dystrophy
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Topical antibiotics when ulcerations occur
Topical hyperosmotics Corneal transplant Thin conjunctival flap over cornea |
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How prevalent is corneal cancer?
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Rare
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Tumor type associated with chronic keratitis and neovascularization
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Squamous cell carcinoma
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Frequent cause of corneal ulcers in cats
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FHV-1
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Dendritic ulceration is pathognomonic for this viral disease
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FHV-1
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Corneal manifestations of FHV-1.
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Dendritic ulcers, geographic ulcers, stromal keratitis
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Stain best used to visualize corneal defects caused by FHV-1
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Rose bengal
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Treatment for FHV-1 keratitis.
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Topical antibiotics if ulcerated
Topical antivirals Oral famcyclovir |
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Focus of inflammatory cells within the corneal stroma. Non ulcerated and extremely painful.
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Corneal abcess
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Medical treatments for corneal abcessation in cats.
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Topical chloramphenicol or ciprofloxacin
Topical atropine Surgical excision of affected stroma and conjunctival flap over defect All depends upon degree of neovascularization (healing) |
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Characterized by variable sized, raised, proliferative lesions on the corneal surface. Usually pink, vascularized, with multifocal small white nodules scatteres over their surface. Seen in cats.
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Eosinophilic keratoconjunctivitis
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Studies suggest that there is a link between eosinophilic keratoconjunctivitis and this other disease.
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FHV-1
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How is eosinophilic keratoconjunctivitis diagnosed?
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Corneal scrapings-- eosinophils and mast cells, lymphocytes and plasma cells
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Treatment for eosinophilic keratoconjunctivitis
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Topical corticosteroids (but relapses common when meds discontinued)
Oral megesterol acetate |
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Tan to black plaque in the central cornea. Usually accompanied by vascularization.
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Corneal sequestrum
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Is a corneal sequestrum usually painful?
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Yes
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Two cat breeds predisposed to corneal sequestrum.
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Persians and Himalayans
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Slow healing corneal ulcers can preclude the development of...
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Corneal sequestrum
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Suggested causes of corneal sequestrums include...
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Qualitative tear film abnormalities
FHV-1 infection |
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Treatment for corneal sequestrum includes...
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Removal by keratectomy
OR Partial-full thickness corneal transplantation and corneoconjunctival transposition Conservative management and sloughing |
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Most common corneoscleral neoplasm in the cat.
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Limbal melanoma
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