Ophtho Vmd 422 Exam 2

Front 1

Specific signs of acute/active anterior uveitis

Back 1

aqueous flare
hypopyon
hyphema
keratic precipitates
swollen/inflamed iris
iris bombe

Front 2

non-specific signs of acute/active anterior uveitis

Back 2

corneal edema
episcleral injection
corneal vascularization
initial decrease in IOP

Front 3

Specific signs of chronic anterior uveitis

Back 3

posterior synechia
iridal scarring

Front 4

non-specific signs of chronic anterior uveitis

Back 4

corneal scarring, cataracts, glaucoma/buphthalmos

Front 5

secondary effects of anterior uveitis on other ocular structures?

Back 5

iridal scarring
cataracts (lens nutrition from aqueous/ occurs with lens cell death)
glaucoma

Front 6

*****
Underlying cause for anterior uveitis/pathogenesis of aqueous flare

Back 6

damage to anterior uvea releases inflammatory mediators --> increase vascular permeability --> breakdown of BAB --> leakage of protein/fibrin/cells into aqueous

Front 7

What is the number one cause of anterior uveitis?

Back 7

idiopathic

Front 8

What are other causes of anterior uveitis?

Back 8

infectious (bacteria/fungal/viral/rickettsial)
immune-mediated: equine recurrent uveitis, VKH, lens-induced
Neoplasia: anterior uveal
Metabolic: systemic hypertension
Trauma: blunt or perforating

Front 9

Workup for anterior uveitis?

Back 9

PE, CBC/Chem/UA, specific tests: FeLV/FIV, fungal titers, BP, imaging, CSF, LN aspirates

Front 10

Tx for anterior uveitis?

Back 10

Tx underlying cause if possible
topical steroids: pred or dex
topical NSAID: flurbiprogen or diclofenac
topical atropine (if no glaucoma)
systemic steroids or NSAIDs

Front 11

3 locations of a uveal cyst

Back 11

Attached to the posterior surface of the iris/ciliary body
Attached to the pupillary margin
Free floating in the anterior chamber

Front 12

How do you tell a uveal cyst from a uveal neoplasm?

Back 12

uveal cysts can be transilluminated and the are usually perfectly spherical to oval in shape

Front 13

What is the cause of iris atrophy?
what are the signs of iris atrophy?
How do you treat iris atrophy?

Back 13

normal aging change
signs:
Scalloping at pupil margin
Moth eaten appearance to iris stroma
Slow PLRs
Anisocoria/dyscoria

tx: none

Front 14

What are the signs of persistent pupillary membranes? Which ones cause opacities?
Tx?

Back 14

Originates from collarette region of iris, can be iris-iris, iris-anterior lens capsule (opacity) or iris-posterior cornea (opacity)
Tx for iris-lens is cataract surgery

Front 15

what is the most common anterior primary neoplasm in dogs, cats and horses?

What is the 2nd most common anterior primary neoplasm?

What is the most common secondary neoplasia?

Back 15

melanoma - most common

ciliary body adenoma/adenocardinoma = 2nd most common

secondary = lymphoma

Front 16

How do melanomas look vs. ciliary body adenomas/adenocarcinomas?

Back 16

melanomas: arise from anterior surface of iris; cats can have multiple dark spots that may coalesce

Ciliary body adenoma/ac: fleshy mass peeking thorugh the pupil

Front 17

What is the px for lymphoma?

Back 17

poor

Front 18

What are the 2 classifications of glaucoma?

Back 18

Primary and secondary

Front 19

What species/breeds are commonly affected by primary glaucoma?

What is the cause of the disease?

What are the signs/course/progression?

Back 19

-seen in purebred dogs: Cocker spaniels, Basset hounds, beagles, Samoyeds

-caused by iridocorneal angle becoming increasingly compromised during the first few years of life, drainage angle collapses

signs: peracute onset of a pressure spike, initially unilateral, fellow eye affected in 6-12 months

Front 20

What drugs are used to treat glaucoma? How do they work?

Back 20

IV mannitol: dehydrates vitreous humor osmotically

oral carbonic anhydrase inhibitors: methazolamide, acetazolamide: decreases aqueous humor production

Topical meds
-dorzolamide: topical CA inhibitor
-latanoprost: synthetic prostaglandin analog
-timolol maleate: beta blocker
-pilocarpine: parasympathomimetic miotic

Front 21

What is secondary glaucoma? Which breeds/age affected?

Back 21

glaucoma that results from some other ocular disease; has no age/breed predisposition

Front 22

What are some of the most common causes of secondary glaucoma?

Back 22

anterior uveitis
lens luxation/subluxation
intraocular neoplasia

Front 23

3 layers of the lens

Back 23

lens capsule
lens epithelium
lens fiber cells

Front 24

3 factors of lens transparency

Back 24

absence of blood vessels
lack of pigmentation
orderly arrangement of lens fibers

Front 25

What is the source of nutrition for the lens?

Back 25

The aqueous

Front 26

general and secondary signs of lens disease?

Back 26

general: cataracts, luxation (sub, anterior or posterior)
secondary: corneal changes, anterior uveitis, glaucoma

Front 27

what is the pathogenesis of cataracts?

Back 27

Disruption of the orderly arrangement of the lens fiber cells

Front 28

Inherited cataracts is common in ____, most commonly _____ (age) and is _____ (non/symmetric) with ______ progression

Back 28

Inherited cataracts is common in _dogs_ most commonly _2-4 years_ (age) and is _non-symmetric__ with _variable_ progression

Front 29

Diabetic cataracts is common in _____ and is _____ (non/symmetric) with _____ progression

Back 29

Diabetic cataracts is common in _dogs_ and is _symmetric_ with __rapid_ progression

Front 30

What is the pathogenesis of diabetic cataracts?

Back 30

increased glucose in the aqueous goes up --> increased lenticular glucose --> converted to sorbitol by aldose reductase which won't diffuse and creates an osmotic gradient (fluid rushes in)

Front 31

What is the most common cause of cataracts in cats and horses?

Back 31

anterior uveitis

Front 32

4 types of cataracts and how they are classified?

Back 32

incipient: focal, no interference with vision
incomplete/immature: diffuse, but can still see tapetal reflection
complete/mature: opaque w/vision loss
resorbing/hypermature: crystalline/sparkling appearance, wrinkling of anterior lens capsule, some degree of lens-induced uveitis

Front 33

***What is the cause of nuclear sclerosis?
What does it look like?
Tx?

Back 33

Normal aging change from continually reproducing lens fiber cells --> compression of lens fibers within the nuclear portion of the lens

Looks like a smoke filled bubble in the center of the lens; can see through it when doing ophthalmoscopy

No tx

Front 34

***4 types of retinal vascular patterns and species they are found in?

Back 34

holangiotic: retinal vessels extend to periphery (most mammals)
paurangiotic: very short retinal vessels (equine)
Merangiotic: retinal vessels extend to periphery in horizontal band (rabbits)
Anangiotic: not retinal vessels (birds/fish/reptiles)

Front 35

***Progressive Retinal Atrophy
-cause
-common signs/course
-tx

Back 35

-cause is inherited --> retinal degeneration and dysplasia
-for retinal atrophy: see night blindness first progressing to complete blindness,
-signs: PLR slowly weakens but anterior chamber is quiet. See tapetal hyperreflectivity, retinal vascular attenuation and a pale optic disk

for retinal dysplasia: vermiform gray areas through fundus, more severe: complete retinal separation and blindness

tx: none

Front 36

***Sudden acquired retinal degeneration
-cause
-common signalment
-signs/course
-tx

Back 36

-cause is unknown, may related to Cushings?
-signalment: middle-aged spayed females
-signs: hx of acute blindness, initially no fundic changes
4-8 weeks: see tapetal hyperreflectivity, retinal vascular attenuation, optic disk pallor, flat line ERG
-tx: none

Front 37

***Chorioretinitis
-cause
-signs
-dx
-tx

Back 37

-cause: systemic illness, usually both retina and choroid involved; infectious agents, hypertension, autoimmune dz, neoplasia, coagulopathies
-signs: multifocal cellular infiltrates, retinal separation (serous, hemorrhagic, exudative), retinal hemorrhage
-dx: systemic workup
-tx: depends on cause

Front 38

***Orbital neoplasia
-onset
-painful?
-retropulsion?
-systemic condition?

Back 38

-onset: slowly progressive exophthalmos
-not painful, not painful to open mouth
-difficult to retropulse
-systemically well

Front 39

***Retrobulbar abscess/cellulitis
-onset
-painful?
-retropulsion?
-systemic condition?

Back 39

-acute onset exophthalmos
-painful to open mouth or palpate head, swollen periocular tissue
-can retropulse to some degree
-systemically ill: fever, leukocytosis, etc.

Front 40

***3 neurons that supply sympathetic innervation to the eye/related structures

Back 40

1) sympathetc fibers from hypothalamus through spinal cord to T1-T3 and synapse
3) leave SC and course back to head in cervical sympathetic trunk and synapse at the cranial cervical ganglion
3) passes by the middle ear and goes tot he eye, innervates smooth muscles of orbital cone, Muller's muscle, pupillary dilator

Front 41

***3 signs of Horner's
extra sign in the horse?

Back 41

dog/cat: miosis, 3rd eyelid protrusion/enophthalmos, ptosis
horses: ipsilateral head and neck sweating

Front 42

***Pharmalogical testing of Horners?

Back 42

1% hydroxyamphetamine (indirect sympathomimetic) --> encourages release of NE at NMJ
-post-ganglionic lesion: no effect
-pre-ganglionic lesion:dilation

2.5% phenylephrine (direct sympathomimetic)
-post-ganglionic with denervation hypersensitivity: resolution of signs

or by time <20 min post-ganglionic
>20 min (30-40) pre-ganglionic lesion