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162 Cards in this Set
- Front
- Back
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How long do you need to wait between eye drops?
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5 minutes
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what's the main site of resistance to drug penetration in the eye? what do you need to get through it?
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cornea.
need biphasic meds to penetrate an intact cornea? |
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where in the conjuctiva do you want to give an injection and why?
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bulbar.
stays a bit and slowly leaks out. |
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max volume for small/large animal subconjunctival injections?
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small - .25mL
large - 1mL |
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what's the main use for retrobulbar administration?
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large animal anesthesia.
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which chamber is usually used for intraocular injection? (anterior/posterior)
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anterior
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T/F if you have a systemic infection AND a topical infection you can knock both of them out with a systemic administration.
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false! you need to give a topical ALSO for the front of eye problem.
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T/F for retina, optic nerve, vitreous and eyelid disease you need to administer systemic drugs.
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true.
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what are 3 advantages to subpalpebral lavage and in what species is it usually used?
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1) allows frequent therapy
2) can mix meds 3) can use retrograde nasolacrimal tube horses. |
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draw the diagram on L1 S12.
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that was fun!
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mydriatics ______ the pupil
miotics _______ the pupil |
dilate
constrict |
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PILOCARPINE
______ the pupil main use? |
constricts the pupil!
glaucoma! |
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T/F pilocarpine is often used to treat uveitis.
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FALSE! not used because the iris can attach to the lens, which is bad.
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CARBACHOL
______ the pupil. give main use and administration. |
constricts the pupil.
post cataract surgery to prevent pressure spikes. given intracamerally. |
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demecarium bromide is an ________ indirect miotic that must be __________ before it's used.
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indirect......compounded
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what are 2 uses for anticholinesterase (indirect) miotics?
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glaucoma and lens luxation.
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what's the biggest function and main use for xalatan/travatan?
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lower ocular pressure via increased uveoscleral outflow for glaucoma treatment.
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T/F with many eye meds you can assume it will not go systemic.
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false.
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ATROPINE: _______ the pupil.
effect on parasympathetic NS? main use? |
dilates the pupil.
used in cycloplegia to paralyze the ciliary body to manage uveitis/pain. |
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miotics _____ the eye "drain"
mydriatics ______ the eye "drain" |
miotics open
mydriatics close |
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length of action for atropine vs. tropicamide (both mydriatics)
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atropine = long
tropicamide = short |
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TROPICAMIDE
effect on PS nervous system? main use? |
parasympatholytic
mydriasis and weak cycloplegic. |
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EPINEPHRINE/PROPINE: ___the pupil
effect on sympathetic NS. main use? |
weakly dilates.
used for glaucoma. |
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if the animal has both an eye problem AND another dz you want to use a (selective/nonselective) beta blocker.
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selective.
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what is the main use for beta blockers?
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glaucoma.
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HOW do beta blockers treat glaucoma? there are 2 mechanisms here.
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1) decreased cAMP in ciliary body -> decreased aqueous humor formation
2) alter trabecular cell shape and increase aqueous outflow. |
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Which abx can sometimes cause bone marrow suppression in people so it's not really used much?
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chloramphenicol.
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CHLORAMPHENICOL
spectrum? effect on bacT and how? penetration ability? (hehe) |
broad spec.
bacteriostatic via protein synth inhibition. exc. penetration (fat soluble) |
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AMINOGLYCOSIDES
-spectrum -aim for gram____bacteria |
broad.
gram negative! |
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out of the following 4 "mycins", which one doesn't kill pseudomonas?
neo, kana, genta, tobra |
kanamycin
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NEOMYCIN
-spectrum? -bacterial effect + mechanism -big issue...? |
broad
bacteriocidal can cause hypersensitivity rxn. |
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Gentamicin is basically the same as neomycin but what complication can it cause?
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renal toxicity!
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what drug should you use for gentamicin resistant bugs? why isn't it used in the first place?
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tobramycin. it's expensive.
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what's the drug-of-choice for melting ulcers?
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tobramycin.
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POLYMYXIN B
-how it kills -penetration ability |
restricts cell membrane function
poor penetration |
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what three abx are in triple antibiotic?
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neomycin, polymyxin, bacitracin
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TETRACYCLINE
-bacT effect (static/cidal?) -spectrum |
bacteriostatic.
broad spectrum |
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which abx is good at killing chlamydia and mycoplasma?
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tetracyclines.
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when should you use fluoroquinolones?
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melting ulcers that have not responded to therapy.
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most common fluoroquinolone?
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ofloxacin.
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what should you tell your client if you are putting their cat on baytril?
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it can cause retinal degeneration.
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what is the only currently approved topical antifungal drug?
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pimaricin (natamycin)
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what's the drug-of-choice for subpalpabral lavage?
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voriconazole
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which antifungal is used orally in horses?
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fluconazole.
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what are the main uses for amphotericin B and itraconazole?
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fungal endophthalmitis in small animals.
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what are trifluridine, idoxuridine, vidarabine?
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antiviral meds.
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what's the use and mechanism for oral lysine?
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antiviral by competing with arginine that the virus uses.
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what is famcyclovir?
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systemic antiviral medication.
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CORTICOSTEROIDS: fx on ->
1) exudation 2) fibro/collagen formation 3) epithelial regeneration 4) neovascularization 5) capillary permeability |
1) decrease exudate
2) decrease fibro/collagen 3) decrease regeneration 4) decrease neovascularization 5) decrease capillary permeability |
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T/F topical corticosteroid therapy has systemic effects
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true
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out of the following 4 corticosteroids, which 2 have good corneal penetration?
which is the BEST? betamethasone, hydrocortisone prednisolone, dexamethasone |
prednisolone, dexamethasone
pred is the best. |
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corticosteroid effect on corneal healing?
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delays it!
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triamcinolone, betamethasone and methylprednisolone are all what?
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subconjunctival steroids
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T/F you shouldn't use topical steroids with a corneal ulcer, you should use a NON-steroidal.
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true!
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T/F you shouldn't use systemic NSAIDS and steroids at the same time.
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true!
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what is the use for carbonic anhydrase inhibitors?
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local/systemic acidosis
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T/F using topical and systemic carbonic anhydrase inhibitors at the same time is bad.
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false. they're not additive.
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what is cosopt?
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a combination drug.
dorzolamide (topical CAI) + timolol (topical beta blocker) |
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T/F topical anesthetics are bacteriostatic not bacteriocidal
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true.
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how do topical anesthetics work and should they be used for chronic pain?
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no NOT for chronic pain
they inhibit mitosis of corneal epithelial cells. |
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what type of diuretics should be used to treat glaucoma?
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osmotic only.
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mannitol and glycerol are what?
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systemic osmotic agents
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what class of drug should be used to treat corneal edema?
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topical osmotics
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what does cyclosporin A do (around the eye)?
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lacrimogenic
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what class of drug is acetylcysteine?
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anticollagenase
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what is TPA? how is it given?
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tissue plasminogen activator.
intracamerally. |
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if a dog has ptosis (droppy eyelid) would it still have a palpebral reflex?
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yes.
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what 2 CN's does the palpebral reflex test?
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5 and 7
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what is it called when you have a cutoff of sympathetic innerv. to the eyes?
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horner's syndrome.
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what CN innervates the orbicularis oculi?
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7
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what CN innervates the levator palpebrae superioris?
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3
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what is the function of the Meibomian (tarsal) glands?
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make the lipid part of tear film.
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what anatomical structure marks the margin of the eyelid?
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the opening of the meibomian glands (polka dots)
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what can you use to roughly estimate the length of the meibomian glands for an enucleation?
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the tarsal plate.
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what is neonatal ophthalmia?
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when a puppy's eyes don't open.
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what is an enlarged palpebral fissure?
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when the globe wants to leave the head. big buggy eyes.
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what is distichiasis?
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when little hairs poke out of the meibomian gland opening.
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what's the difference between distichia and ectopic cilia?
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ectopic cilia poke directly at the eye in the middle of the cornea. distichia lies parallel and floats in the tear film.
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what is cicatricial entropion?
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from scar tissue that forces eyelid into weird places.
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what is entropion?
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when the eyelid rolls in.
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who gets congenital vs. spastic entropion?
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congenital - youngins
spastic - mature |
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how do you tell between spastic and congenital entropion?
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numb the eye and if it fixes it that means its spastic.
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what is the pathway from photon to visual center?
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photon-retina-optic nerve-optic chiasm-optic tracts/radiation-visual center
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T/F PLR indicates vision.
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False!
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what is the cutoff point for an intact PLR with no vision? what does this mean?
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the lateral geniculate. this means that if the lesion is behind this, PLR will work but the animal could be blind.
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where in the eye is the tapetum located and what is its relative death?
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in the choroid and it's superficial.
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which CN is the AFFERENT for the PLR?
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CN II
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which CN is the AFFERENT for the PLR?
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CN II
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which CN is involved in pupil dilation?
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CN II
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what 5 muscles are innervated by CN III?
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dorsal, ventral, medial rectus muscles
ventral oblique levator palpebrae (eyelid raiser) |
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what CN and muscle are involved in focusing?
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CN III
the ciliary muscle. |
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what is ptosis?
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droopy eyelid
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with strabismus, how can you tell which muscle is working?
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the eye points toward them.
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mydriasis, ventrolateral strabismus, and ptosis are all signs of a lesion of which CN?
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CN III
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which nerve is efferent to the superior oblique?
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CN IV
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what are the afferent and efferent CN's for the palpebral reflex?
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5 in, 7 out
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which CN is sensory to the cornea and eyelids?
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CN V
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which CN is motor to the lateral rectus and the eyeball retractor muscle?
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CN VI
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facial paralysis, abnormal palpebral reflex are symptoms of lesions of which CN?
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VII
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explain:
(LR RB6 SO4)3 |
?
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which 2 CN's are involved with the PLR?
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II and III
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what's the correlation between age and the menace test?
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puppies don't have it, it's learned.
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which two CN's are involved in the corneal reflex?
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V and VI
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what does an ERG look like in an animal with sudden acquired retinal degeneration?
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flat.
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what's the most common cause of optic neuritis?
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infectious disease.
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what happens to both vision AND PLR if there is injury to the optic chiasm.
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both are affected in both eyes.
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how can a pituitary tumor affect vision?
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because of it's proximity to the optic chiasm.
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miotics, uveitis and organophosphate toxicity are all causes of what?
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bilateral constriction
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CN II, death, fear, mydriatics, and retinal atrophy are all causes of what?
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bilateral dilation
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what happens to the pupils in anisocoria?
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they are unequal in size.
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ptosis, miosis, and enophthalmos are all clinical signs of what?
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horner's syndrome
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T/F tumors, vascular occlusion and trauma can all cause horner's syndrome.
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true
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juvenile pyoderma is also known as....
+ what 2 things will be apparent upon physical exam? |
puppy strangles.
swollen, ulcerated eyes and profound lymphadenopathy. |
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what is Hordoleum or stye?
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a fat impacted mybomian gland.
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what is chalazion?
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when the mybomian glands basically explode due to fat impaction + staph infection.
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what type of derm disease are snow-living dogs prone to?
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uveo-dermatologic syndrome.
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what is a dermoid tumor?
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hair growing where it shouldn't
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T/F most eyelid tumors in dogs are malignant
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false. they are benign.
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what kind of tumor usually looks like a little red dot that goes away really fast?
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histiocytoma.
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what kind of tumors can change in size from day to day and tend to take up 3/4 of the eyelid margin?
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mast cell tumor.
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what 2 species tend to get squamous cell carcinomas?
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cats and horses. especially white ones.
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what species gets sarcoid tumors?
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horses.
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T/F removing the 3rd eyelid is an option for cherry eye treatment.
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false. don't do it.
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what GENERAL type of dog breed gets bent cartilage of the 3rd eyelid?
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giant breeds.
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what kind of cats tend to get prolapsed 3rd eyelid glands?
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Burmese.
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what is special about cats' third eyelid?
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they have skeletal muscle and can move it at will.
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what is different about the inside of a puppy's third eyelid vs an adult's and why?
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a puppy's will have many more follicles aka little raspberries because of it's developing immune system.
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a big pink fleshy growth on a horse's third eyelid is probably what?
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squamous cell carcinoma.
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what is thickening, bumpiness-ing and depigmentation of the 3rd eyelid called?
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chronic superficial keratitis (pannus)
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what is swelling of the conjunctiva called?
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chemosis
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herpesvirus can cause what two eye diseases?
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conjunctivitis and keratitis
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what is stromal keratitis?
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diffuse vascularization, fibrosis of the cornea. you can hardly see the cornea.
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besides eye disease what else can cats have with herpes?
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upper respiratory as well
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whats the best test for herpes? how reliable is it?
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PCR. it's great but 5% of cats will ALWAYS be PCR positive so rely on clinical signs mainly.
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what's the best/only oral antiviral to treat herpes with?
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famcyclovir.
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do you want to give topical steroids for conjunctivitis? why or why not?
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NO. it suppresses the immune system and the virus can kick ass.
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what 2 eye problems are caused by chlamydia? what is NOT?
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conjunctivitis and chemosis. NOT keratitis!
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what's the basic shape and color of superficial epithelial eye cells in a dog?
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sheets with round/oval nuclei and basophilic
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what does an inclusion body in epithelium mean?
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chlamydia!
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what do many small inclusion bodies mean in the eye epithelium?
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maybe mycoplasma?
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what are the 3 layers of the tear layer?
what are their functions and sources? |
lipid-stops evap-meibomian
serous-lacrimal/3rd eyelid mucus-attaches film down-goblet cells |
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what is epiphora?
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excessive tearing.
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what are 2 ways to test the nasolacrimal system? which is better?
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fluorescein dye test (patentcy AND function)
flush (patentcy only) |
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what's wrong with a dog with excessive mucoid discharge and excessive tearing? how do you treat it?
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dacryocystitis ie blocked NL duct. use a tube!
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what is the scale for a Schirmer tear test?
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up to 5......bad
5-15....suscpect 15.......normal but be smart. look at the dog! |
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what is a schirmer 1 vs. schirmer 2?
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1 is while awake
2 is with topical anesthesia and it should be about 1/2 normal. |
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what 2 CNs can be involved with keratoconjunctivitis?
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5 and 7
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T/F you can drug induce dry eye
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TRUE
sulfa drugs! |
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T/F you should always culture the conj/cornea with KCS
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FALSE. it's inflamed not infected.
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what are 2 lacrimogenic drugs used to treat KCS?
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cyclosporin A (t cell suppressor)
tacrolimus |
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what are 2 surgeries to treat KCS?
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parotid duct transposition
medial canthoplasty |
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what is the limbus?
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the jxn of the cornea and the sclera/conjunctiva that has corneal epithelial stem cells
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what kind of cells make up the cornea?
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stratified squamous nonkeratinized epithelium
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if you see neovascularization and pigmentation of the cornea what should you suspect?
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chronic irritation
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corneal stroma: how much of cornea? and whats it made of? what does it do to water?
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90%
collagen. absorbs water like crazy. |
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what is descemet's membrane?
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the saran wrap layer.BM for endothelium. the last layer before aqueous.
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T/F the corneal endothelium is highly regenerative.
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false! little to none.
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how is the corneal epithelium attached to the stroma?
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hemidesmosomes
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there are 5 things that can make the cornea white....
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1) corneal edema
2) change in lamellar arrangement (scratch) 3) mineral/lipid buildup 4) pus 5) pressure increase = crack in descemet's membrane = glaucoma |
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how can you fix corneal edema?
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hypertonic saline
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what 2 CNs does the menace check?
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II and III
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T/F you treat corneal ulcer pain with topical anesthetic
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false.
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