LIVE IN THE MOMENT!“The secret of health for both mind and body

is not to mourn for the past, not to worry about the future, or not to anticipate

troubles, but to live in the present moment wisely and earnestly.”

-Buddha

Ophthalmic Diseases

Chapter 4Common Diseases of Companion Animals

Ophthalmic Diseases

Conjunctivitis • CONJUNCTIVA: pink tissue that lines the inner surface of the

eyelids and covers the front portion of the eyeball except for the cornea

• Causes – Allergy (________________)– Anatomic (ectropion, entropion)– Bacterial infection (predisposed by):

• Injury• ↓Tear production• Foreign body• Respiratory disease (bacteria, virus)

• Causes (in cats it is usually infectious)– Feline herpes virus (most common cause of __________________________)– Calicivirus– Chlamydia psittaci bacteria– Mycoplasma

Red, congested/swollen, painful

Conjunctivitis • Signs

– Redness – _________________ (swelling of conjunctiva)– Ocular discharge (tears, mucus)

• Diagnosis– Determine 1º disease, if any– Rule out FB– Rule out ‘dry eye’ in recurrent cases

• Schirmer tear test– 1 min- tears show as blue dye

SCHIRMER TEAR TEST

Cats: ____________________

Conjunctivitis • Rx

– Topical antibiotic ointment • neomycin/bacitracin/polymyxin B(BNP or________________)• Gentamicin ophthalmic ointment• Antibiotic w/ cortisone (if cornea is ______________)

• Client info– Do not allow dogs to ride with head out window– Keep medial canthus of eye clean (warm water, clip hair)– Vaccinate kittens to prevent URI– Do not touch eye with ___________________– Discard unused medication

Epiphora • EPIPHORA: ____________________• Causes (2 causes)

– Overproduction of tears• Ocular pain, irritation (from hair, etc)

– Faulty drainage by___________________• Blockage of duct (swelling, inflam)• Blockage of puncta (hair, debris)• Imperforate puncta (no opening)

– Cockers– Poodles

• Trauma

Epiphora • Signs

– Watering of eye– Discoloration of hair

• Dx– Fluorescein dye test

• Dye __________________ shows duct is open

• Rx– Treat 1º cause

• ________________________ lacrimal ducts• Surgically open imperforate puncta• Topical antibiotic ointment• Keep hair trimmed around eyes

– May act as a wick

• Client info– Staining due to pigment in tears, _______________– Some dogs have life-long problem

EPIPHORA

FLUSHING THE NASOLACRIMAL DUCT

Entropion: eyelids that roll in against the cornea

• Causes– Congenital

• large orbits w/ deep-set eyes (__________________________)– Collies, G. Dane, I. Set, Dobe, G. Ret, Rott, Weim

• Poor ocular muscle development – Chesapeake, Labs, Chow, Samoyed

– Trauma → scarring with distortion of lid– 2º to painful corneal lesion, conjunctiva inflammation (most

common cause in cats)• Signs

– Epiphora (tearing)– Chemosis (swelling of conjunctiva)– Conjunctivitis– Pain– Corneal ulceration (±)– ____________________

Entropion• Treatment

– Surgical correction is treatment of choice• Temporary mattress suture to evert eye (young animal)• ______________________________(to shorten eye lid)• Hotz-Celsus: Remove elliptical piece of tissue from under eye

Ectropion• Causes

– __________________ • Bassets, Blood, C Span, E Bull, St Bern

• Signs– Conjunctivitis– Epiphora– Keratitis (corneal inflammation/scarring), usually from exposure– Purulent exudate

• Rx – Surgery to shorten eye lid– Other procedures

Hypertrophy and Prolapse of 3rd eyelid gland

Hypertrophy and Prolapse of Nictitans Gland (Cherry Eye)

Nictitating membrane is the 3rd eyelid; is a protective structureProduces ___________________of tears

• Cause is unknown– Bassets, Beagle, Bos. Terr, C. Span

• Signs– _____________________(<2 y)– Epiphora– Usually no pain

• Dx– r/o tumor in older dogs and cats

• Rx – Sx to remove gland is an option , but not recommended– Suture back in place