Sa Medicine Iii -- Uveal Tract

Front 1

The uveal tract consists of?

Back 1

-- iris

-- ciliary body

--choroid

Front 2

Type of muscle in the iris for birds and reptiles? Mammals?

Back 2

-- birds and reptiles: striated muscle

-- mammals: smooth muscle

Front 3

Why won't birds and reptiles respond to atropine?

Back 3

-- atropine targets smooth muscle, not striated

Front 4

Things to consider with regard to pupil size?

Back 4

-- light

-- species

-- stress

-- age

-- light responses

Front 5

What is mydriasis? Miosis? Anisocoria?

Back 5

-- mydriasis: large pupil

-- miosis: small pupil

-- anisocoria: different sized pupils

Front 6

What is heterochromia iridis?

Back 6

-- both eyes, one eye, or a portion of one eye is one color

Front 7

What is waardenburg's syndrome?

Back 7

-- deafness

-- white coat

-- heterochromia iridis (e.g. blue and green eye)

Front 8

What is merle ocular dysgenesis?

Back 8

-- merle gene is autosomal dominant

-- heterochromia iridis

-- microphthalmia

-- iris coloboma frequent (pupil deviated ventral)

-- corectopia (iris position displaced)

-- dark-rimmed pupil

-- cataract frequent

-- don't respond normally to dilating agents

Front 9

What is iris coloboma?

Back 9

-- area of the iris that didn't develop normally

-- pupil deviated ventrally

Front 10

What is iris atrophy?

Back 10

-- iris literally just falls apart

-- Senile uveal changes

-- common in older small breed dogs

-- pupillary light response will be reduced

Front 11

What is a persistent pupillary membrane?

Back 11

-- persistence of the fetal membrane that supplies blood to the lens

Front 12

Where does the persistent pupillary membrane arise?

Back 12

-- from the colarette region (mid iris)

>> NOT from the pupil edge

Front 13

If strands attached to the pupil are coming off of the pupil edge/margin?

Back 13

-- it's probably from a previous perforation

>> anterior synechiae

Front 14

Types of persistent pupillary membranes?

Back 14

-- iris to iris (most common)

-- iris to cornea

-- iris to lens

>> could make cataract

Front 15

Poster child for PPM?

Back 15

-- basenji

Front 16

Remember that dermoids and PPMs are ______.

Back 16

-- congenital

Front 17

Anterior synechia come off of the ____ ____.

Back 17

-- pupillary margin

Front 18

Anterior synechiae are? Do what to the eye?

Back 18

-- secondary to injury

-- make eye prone to other problems

Front 19

Iris cysts arise form where?

Back 19

-- ciliary body epithelium

-- back side of the iris has a dark layer of double epithelium that can blip off and float in pupil

-- these are freely mobile & benign

Front 20

Poster child for iris cysts?

Back 20

-- golden retrievers

Front 21

What is uveitis? Commonly occurs with what?

Back 21

-- inflammation of the uveal tract

-- commonly occurs concurrently with corneal ulcers

Front 22

Presentation of uveitis? (clinical signs)

Back 22

-- conjunctival hyperemia

-- corneal edema, vascularization, and keratic precipitates

-- aqueous flare (cloudy aqueous)

-- aqueous/inflammatory debris (fibrin)

-- hyphema (free blood), hypopyon (WBCs)

-- iritis, vitritis, cataract, lens luxation

-- miosis, posterior senechiae, chorioretnitis

-- debris on anterior lens capsule

Front 23

Things that can cause hyphema?

Back 23

-- blood dyscriasis

-- uveitis (inflammation >> leaky blood vv.)

-- trauma

-- neoplasia

-- congenital causes (retinal detachment)

-- systemic diseases, e.g. hypertension

-- neovascularization

Front 24

Hyphema can cause what?

Back 24

-- glaucoma

-- fibrinous bands and synechiae

-- occulsion of the pupil

-- cataract

-- phthisis bulbi

-- recurrent hyphema

-- corneal opacity

Front 25

Corneal changes that are seen with uveitis?

Back 25

-- edema, vascularization, keratic precipitates (KPs)

Front 26

What is aqueous flare? How can you observe this?

Back 26

-- protein in the anterior chamber fluid

-- visible with slit beam lamp

Front 27

What is a posterior synechia?

Back 27

-- iris forms adhesions to the lens (fibrin)

Front 28

What is chorioretinitis? What might you see?

Back 28

--inflammation of the choroid and retina

-- can see chorioretinal scars

>> indicate past infection, parasite migration

Front 29

What is granulomatous uveitis?

Back 29

-- lumpy, horrible looking iris

-- usually due to significant underlying problem

>> systemic disease

-- end up with cataract

Front 30

Etiology of uveitis?

Back 30

-- infectious disease

-- neoplasia

-- trauma

-- autoimmune

Front 31

Infectious disease that may cause uveitis?

Back 31

-- FeLV/FIV, toxoplasmosis, FIB, hemobartonella

-- leptospirosis

-- fungal (blasto, histo, crypto, coccidio)

-- viral

-- often idiopathic

-- heartworm (inside the eye)

Front 32

Autoimmune disease that can cause uveitis?

Back 32

-- uveodermatological syndrome

-- equine recurrent uveitis

-- pigmentary uveitis

Front 33

What is uveodermatological syndrome?

Back 33

-- immune mediated

-- usually snow breed dogs (akita, samoyeds, etc)

-- suspect pigmented cells are target

>> loss of pigment

Front 34

What is pigmentary uveitis?

Back 34

-- eye appears normal initially

-- changes occur around middle age

-- decreased pressure

-- increased pigmentation

>> pigmentation of lens capsule

-- posterior synechiae stuck to anterior lens

-- progress to cataracts and secondary glaucoma

Front 35

Therapy for uveitis?

Back 35

-- identify/treat underlying problem

-- anti-inflammatory (topical, subconj., systemic)

-- immunosuppressive medication

-- atropine (watch for glaucoma)

Front 36

Atropine is bad with glaucoma why?

Back 36

-- cause dilation (midriasis)

>> further inhibit drainage at the drainage angle

Front 37

Pressure in the inflamed eye should be ____.

Back 37

-- low

>> should be lower than the "good" eye

Front 38

Sequelae of uveitis?

Back 38

-- cataracts, lens luxation (loss zonular fibers)

-- keratic precipitates

-- corneal edema

-- posterior synechia

-- vitritis

-- retinal scars or retinal detachment

-- secondary glaucoma

-- posterior synechiae

-- lipemic aqueous

Front 39

Dark keratic precipitates?

Back 39

-- neoplasia

Front 40

DDx for posterior synechiae? How can you differentiate them?

Back 40

-- iris with iris atrophy

>> will move

Front 41

How can uveitis cause retinal detachment?

Back 41

-- choroid inflammation can rip the retina off

-- inflammatory substances in retina can rip off parts of uvea

Front 42

Confirmation of lipemic aqueous?

Back 42

take a blood sample and look for lipemia

Front 43

Lipemic aqueous usually indicates? Will it resolve?

Back 43

-- hx high-fat food in the last 48h

-- will usually clear quickly once high fat clears from system

Front 44

Iris prolapse occurs with? Common in?

Back 44

-- occurs with corneal damage/perforation

-- horses

Front 45

What is enophthalmitis? Treatment?

Back 45

--inflammation of the globe but not the episcleral tissue

-- enucleation and histopathology

Front 46

Iris/choroidal tumors?

Back 46

-- primary intraocular tumors

>> generally good prognosis for patient

-- often involves ciliary body

>> e.g. ciliary body melanoma

-- send in globe for pathology

Front 47

Melanoma presentation?

Back 47

-- iris freckle, diffuse iris melanoma

-- flat, not elevated

-- likely to cause secondary glaucoma

>> once the cat develops glaucoma, remove eye

>> otherwise, can go on for years w/o problem