1
Q
What is the normal eye p?
A
15 - 25 Hgmm.
2
Q
Schirmer time in a normal dog test.
A
1 min.
3
Q
Which sp has multi- line eyelash?
A
Dog.
4
Q
Which is the most important examining technique?
A
Flourescein staining +Opthalmoscope.
5
Q
In which sp is glaucoma a frequent hereditary disease?
A
Dog.
6
Q
What does symblepharon mean?
A
- Adhesion of conjunctiva on itself/ on the cornea.
- Typically found in young cats with viral conjunctivitis (FHV).
7
Q
In which sp is cataract inheritible?
A
Dogs.
8
Q
What doesn’t have a role in the amt of aq humour?
A
Light reflection of tapetum + non- tapetal fundus.
9
Q
What can be a reason for lens surgery?
A
Ant lens luxation, Cataract.
10
Q
Co blue light?
A
Provides a suitable means of exciting Na fluorescein ( orange dye) for examination of ocular surface integrity.
11
Q
What doesn’t cause glaucoma?
A
Post lens luxation.
12
Q
What you do ø do before taking sample for bacteriology?
A
Do local anesthesia.
13
Q
How to treat cataract?
A
Surgery is the only way.
14
Q
When can you see a “ cresecent moon”?
A
At lens subluxation.
15
Q
Symptoms of Horner’s syndrome?
A
- 3rd eyelid prolaps.
- Myosis, Enophtalmos.
- Narrowing of palpebral fissure.
- Peripheral vasodilatation may occur causing increased facial warmth, best observed in ipsilat ear.
- Golden retriever- idiopathic.
- Other causes- trauma, otitis, tumour.
16
Q
What is true for sub- conjunctival inj in Eq?
A
- Local supf anest.
- Full anest.
- Max 3 ml.
??
17
Q
What grows together when there is post synechia?
A
The iris adheres to lens.
18
Q
What are the consequences of chronic inflammation in Eq?
A
- Chronic uveitis.
- Corneal endothelial degeneration/ dystrophy.
> corneal vascularization/ precipitates. - Lens luxation, subluxation.
> vitreal opacities.
> focal chorioretinitis, retinal detachment.
19
Q
Definition of glaucoma:
A
Disturbance in the drainage of aq, which can elevate IOP.
20
Q
How to examine the retina detachment in the most precise way?
A
By monocular indirect ophthalmoscope–> greater field of view.
21
Q
What is true for direct ophthalmoscope?
A
Monocular.
22
Q
Sus has ø light reflecting layer/ tapetum
A
T.
23
Q
How descemetocele is stained by fluorescence?
A
Fluorescence adheres only to the walls of ulcer, the central floor of the ulcer appears black.
24
Q
What is phacoemulsification?
A
A modern cataract surgery in which the eye’s int lens is emulsified with an ultrasonic handpiece + aspirated from the eye.
25
What doesn't get damaged in glaucoma/ ø in this way.
Destroy all intraocular structures: cornea, lens, sclera, ant uvea, vitreous, retina ONH.
26
Statements of sub- palpebral drains.
Continuous eye drops in horse, tarsorrhaphy.
27
Jone's test?
Fluorescein staining for corneal integrity and it appears at the nares within 1- 10 minutes in ipsilateral nose.
28
Components of uvea?
Iris, corpus cilliare + choroid.
29
Purkinje's images?
On the lens/opacity on the lens.
30
Connection of retina?
At 2 sites: behind the ciliary body- parts plana, + near optic n head.
31
What do ciliary bodies do?
Produce aq fluid.
32
Normal p in the ant chamber?
15 - 25 mmHg.
33
Which n blocks do you use for the subpalpebral drainage?
Auricopalpebral + frontal n block.
34
Why do you perform a subpalpebral drainage?
Continuous eye drops in Eq.
35
How long can the drain stay?
3 - 4 wks.
36
Nasolacrimal drainage used?
Only when you can't use subpalpebral?
37
Why do you use a 3rd eyelid flap?
For protection + healing, only small animals?
38
How long can the 3rd eyelid flap stay on?
2 wks?
39
What is a tarsorraphy?
Suturing eyelids together.
40
What is the lat canthotomy?
Cutting the lat canthus.
41
When is lat canthotomy used?
Porobtosis, ocular trauma + release of IOP?
42
Contraindication of lat canthotomy?
Globe rupture?
43
Stay sutures of globe?
Into sclera, ø penetrating--> gives support for surgery, 3+ 9 o'clock?
44
Neuromuscular blockers used?
Atracurium/ Pancuronium 0.2 mg/kg- paralyse breath for 30 mins?
45
Human ophthalmological sutures?
10/0 + 11/0 non absorbable atraumatic nylon?
46
Veterinary ophthalmologic sutures?
6 - 8/0 monofilamentous/ polyfilamentous ABs, atraumatic?
47
Cannula for inj of fluid?
30G?
48
Extraoccular tampon?
Cotton?
49
Intraocular tampon?
Cellulose?
50
Viscoelastic material?
Methycellulose injected into the ant chamber to replace the aq humor.
51
What is the fundus?
Visible background of the eye seen through dilated pupil.
52
How to dilate the pupil?
- 1 dp of tropicamide, wait for 20 mins.
| - It should last for 4 - 6 hrs.
53
When do you ø perform this examination? IOP
Glaucoma/ lens luxation?
54
Direct ophthalmoscope?
Lens + light together is the best- slit lamp.
55
Diopter for fundus?
Tapetal fundus.
56
Role of tape fundus?
Reflective tissue ( ø pigments), amplify light ( ø in Sus + humans).
57
What is ø true about tapetum?
Located between the chorioid + retina vent on the globe.
58
Which sp have tapetum fibrosum?
Herbivores.
59
Which sp have tapetum cellulosum?
Car.
60
Who has stars of Winslow in the fundus?
Eq.
61
What is the Progressive Retinal Atrophy Syndrome ( PRA)?
- Pigmented change in the tapetal fundus with attenuation of vasculature + atrophy of the optic dic + V.
- Prone in middle aged labradors.
- The retina absorbs less light + therefore there is more light being reflected.
62
What is seen in PRA?
Very reflective tapetum, atrophy of v + pale optic n. head.
63
What is seen in the collie eye anomaly ( CEA)/ Retinal dysplasia ( RD)?
?
64
How is the CEA seen on an ophthalmoscope?
Folds seen are epsilon- like stripes.
65
Reasons for retinal haemorrhage?
Cat with hypertension, ethylene glycol toxicosis + Erlichiosis.
66
Retinal detachment?
Separation of inner layer of retina from the choroid plexus- holes in the retina.
67
Solution?
pH 3.5- 10.5, should be sterile, pH + temp stabile.
68
Suspension?
Drug is included in small particles, the tear dissolves the particles, it has long contact time, absorption in form of solution: prolonged contact time.
69
Ointment?
pH + temp is ø important, oil/ H2O base, disadvantages: inhibit corneal wound healing.
70
Absorption after topical administration?
Mostly washed out, absorption by the conjunctival capillaries/ penetration to the cornea- lipid best.
71
Subconjunctival inj?
Corticosteroids mostly, max 1 ml in the dors palpebra.
72
Retrobulbar inj?
Lower lat quadrant into the retrobulbar space, anesthetic for eye removal in cow, Ab in small animal.
73
Intravitreal inj?
- At lat canthus, quadrant, with 2- 3 mm from limbus, the needle is inserted intoo the vitreous.
- Gentamycin inj in glaucoma.
74
Systemic inj?
Only if inflammed, Ab/ hyperosmotics are the most common.
75
Mydriasis?
Sympathetic innervation m. dilator pupillae, glandula lacrimalis.
76
Miosis?
Parasympathetic innervation- M. Sphincter pupilla, M. Ciliaris + glandular lacrimalis.
77
What is ø a topical treatment?
Subconjunctival/ installation.
78
When doing bacterial sampling?
Take sample before anaesthesia.
79
What do you do immediately with a Eq that has pink eyes?
Fluorescin test.
80
Which is false for 3rd eyelid?
Well muscled in large + small animals, covered both sides by conjunctiva, position supported by the globe?
81
What is mydriasis?
Pupil dilation.
82
What effect do Parasympatholytics have on eye?
- They inhibit the pupil sphincter m + ciliary m. function.
| - Mydriasis with cycleopegia.
83
What are solutions?
ø easily infected.
84
Fluorescein stain?
Hydrophilic + stains exposed stroma.
85
The tear test?
Is done without anaesthesia?
86
What do you ø use for melting ulcers?
Supf keratectomy/ pedicle Graft transplantation/ Free island transplantation?
87
What do you do with descemetocele?
It requires surgical intervention.
88
What is Ankyloblepharon?
Inability to close the lids/ lid margins partial/ total closure.
89
How to treat blepharospasm in Eq?
Frontal n. block/ auriculopalpebral n. block/ tropicamide solution.
90
What are the indications for vitrectomy in a Eq?
Recurrent uveitis?
91
Effectiveness of Atropine to keep the pupil dilated gives us information about?
The severity of uveitis.
92
When are glucucorticoids contraindicated?
If fluorescin stains the cornea.
93
What is blepharitis?
Inflammation of eyelids.
94
What are the glds of eyelid?
Zeis, Mill, Meibomian/ Tarsal.
95
What is Chemosis?
Oedematic swelling of the conjunctiva.
96
What are the borders of the eye chamber?
Iris, pupil + cornea.
97
What is the dazzle reflex?
Subcortical reflex.
98
Which animals have cilia on the lower eyelid?
None?
99
The shape of pupil in herbivores?
Horizontal elliptical.
100
What is false about ointments?
Can be used intraocularly.
101
Johnes test?
The appearance of something at the nostril?
102
Most important drain.outflow in Eq?
Uveo- scleral route?
103
What is ectropion?
- Eversion, turning of eyelid, always the lower eyelid is affected.
- Etiology: developmental/ structual, acquired/ cicatrical, intermittent.
104
What is ø a CS of acute uveitis?
Mydriasis.
105
Rose Bengal:
- ( Hydrophilic red stain).
| - Stains the degenrated, necrotic cells + the mucus in brillant red.
106
Which one is false when examining the fundus?
Examiner needs to sit.
107
Adjustments needed for direct + indirect opthalmoscope?
Direct: form - 3 to + 20?
108
There is a strong connection between the post lens + ant surface of vitrous body in animals?
True.
109
Cataract surgery, which one has the post lens capsule intact?
ECE- Extracapsular lens extraction.
110
Is Phaco ICE/ ECE?
ECE.
111
ERU in Eq, what can it lead to?
In influx of inflammatory cells into the eye + hypersensitivity of the uvea.
112
About aq humor + what does ø have an effect on it's production?
..
113
Entropion is never?
Intermittent.
114
When is it appropriate to take bacterial sample?
Before topical anaesthesia.
115
3rd eyelid is well developed in SA?
ø true?
116
What do parasympatholytics do?
They block function of M. sphincter pupillae + M. ciliaris causing mydriasis with cyclopegia.
117
Which route is ø topical treatment?
Subconjunctival, retrobulbar, intravitreal inj.
118
Fluorescent dye?
Hydrophilic, stains exposed stroma green.
119
How do you perform Schirmer's tear test?
Fold strip at the mark + place in the lower conjunctival sac for 1 mn.
120
Which drugs ø to use in cases of KCS?
Hyaluronic acid.
121
Chemosis?
- Swelling/ oedema of the conjunctiva.
| - Sign of conjunctivitis.
122
Cherry eye syndrome.
- Defect, laxity in the retinaculum that binds the gl + the nicitans to the periorbita--> protrusion of 3rd eyelid gl.
- In dog, breed and age predisposition.
- Surgical treatment, replacement of prolapsed gl.
123
Entropion + Ectropion.
- Entropion = inward of the eyelid margin.
| - Ectropion= eversion, turning out of the eyelid.
124
Solutions, Suspensions + Ointments.
- All used topically.
- Solution:
> pH 3.5 - 10.5.
> pH + temp --> determine stability.
> should be sterile.
- Suspension:
> Drug is included in small paticles.
> Tear dissolves the particles -> absorption in the form of solution, prolonged contact time.
- Ointment:
> Oil/ H2O based.
> pH + temp is ø as important in the stability.
> Inhibit the corneal wound healing.
125
Topical treatment.
By using solutions, suspensions, + ointments.
126
Trichiasis.
- Cilia arising from normally located follicles, are pointed in abnormal direction.
- Ectopia ciliae: Additional ciliae originating from abnormally located follicles.
127
Extirpation vs Evisceration.
- Extirpation: Complete excision/ surgical destruction of a body part.
- Evisceration: The removal of the eye's contents, leaving the scleral shell + extraocular m intact.
128
Jone's test.
- To see if the lacrimal duct is obstructed/ ø.
- Method: Put Fluorescein in the conjunctiva + wait a few mins.
- +ve: Dye is detected in the nostril of the same side of the eye in question --> lacrimal gl is working fine + is ø obstructed.
- -ve: Dyes is ø detected in the nostril of the same side fo the eye in question --> a partial/ complete obstruction/ failure of the lacrimal gl.
129
Abnormalities regarding the hair??
- The eyelids can have deformities which can cause hair to be in const contact with the cornea, causing irritation + excessive lacrimation + may lead to corneal vascularization + corneal ulceration.
- Deformities:
> Prominent nasal fold in brachycephalic breeds.
> Disorders of the ciliae.
• Distichiasis.
• Trichiasis.
• Ectopia ciliae.
> Entropion.
> Ectropion.
> Hordeolum.
> Blepharitis.
> Traumas.
130
Dazzle reflex.
Type of reflex blink where the eyelids involuntarily blink in response to a sudden bright light.
131
Properties of Atropine.
- Mydriactic--> dilates pupil.
> Min adhesions( synechiae).
> May ø be able to break down synechiae in chronic cases.
> Keep the pupil dilated gives us information about how severe an uveitis case is --> the longer the pupil is dilated, the milder the uveitis case.
> Eyes with a brown iris stay dilated longer than eyes with a blue iris.
- Cycloplegic --> relaxes the ciliary m.
> Relieve ciliary m pain.
> Pain relief.
- Stabilises blood aq barrier.
132
Contraindications of corticosteroids.
Corneal ulcers --> make sure eye is fluorescein -ve.
133
ø eyelashes on lower lid.
Abscence of ciliae in lower eyelid is physiological in cat, Eq, cow.
134
Shape of pupil.
- Eq, cow, Sus --> horizontal elliptical.
- Dog --> rounded.
Cat --> perpendicular rhomboid.
135
Draining tracts of the Eq eye??
Eye has the iridocorneal angle for the drainage of the aq humour.
136
What is used to decrease blepharospasm in eq?
Merck: Auriculopalpebral n block.
137
What is done 1st to diagnose Descemetocele?
Fluorescein stain.
138
What is ankyloblepharon?
Fusion of part/ all of the eyelid margins.
139
What is the main indication for pars plana virectomy in Eq?
Eq recurrent uveitis.
140
Detected painful red eye in Eq: What do you do 1st?
Stain with fluorescein.
141
What is ø a topical treatment?
Subconjunctival inj.
142
When do we do bacterial sampling?
Before topical anaesthesia.
143
The 3rd eyelid: which is false?
It is well muscled both in large + small animals.
144
What is mydriasis?
Pupil dilation.
145
What effect do Parasympatheticolytics have on the eye?
They block the function of the M. splinter pupillae + M. ciliaris--> mydriasis with cyclopegia.
146
What are solutions?
ø easily infected?
147
Fluorescein stain?
Is hydrophilic + stains exposed stroma.
148
The tear test.
Is done without anesthesia.
149
What do you ø use for melting ulcers?
Supf keratectomy.
150
Jone's test:
Fluorescence stain appear at nares after 1- 10 mins.
151
Components of uvea:
- Vascular layer.
a. Ant uvea- Iris + cilia.
b. Post uvea- Choroid.
152
Connection of retina:
Pars plana- joins the retina- Ora ciliaris retinae.
153
What does the ciliary body do?
Produces aq humour, accomodation, lens zonules.
154
Normal p in ant chamber:
12 - 22 mmHg.
155
What n blocks for sub- palpebral drainage?
Auriculopalpebral n block + Supra- orbital n block.
156
Why sub- palpebral drainage?
Eq sub- palpebral lavage- continuous eyedrops in Eq.
157
How long can drain stay?
SPL system can remain in place for 2 - 6 wks/ more, if it is ø damaged + kept clean.
158
Nasal lacrimal drainage:
Only when cannot use sub- palpebral?
159
Why 3rd eyelid flap?
- Protection + healing, only in SA.
- SA- Indolent supf corneal ulcer, deep corneal ulcer- 3rd eyelid flap as a supportive technique, post- op management.
- IBo keratoconjunctivitis ' pink eye'- Tarsorrhaphy +/ or 3rd eyelid flap in severe cases.
160
How long can 3rd eyelid flap stay?
2 wks?
161
What is tarsorrhaphy?
Suturing eyelids together.
162
What is lat canthotomy?
Multi- purpose general intervention in eye surgery- release increased orbital p.
163
Contraindication of lat canthotomy:
Globe rupture.
164
Stay suture of globe:
Into sclera, ø penetrating - support for surgery, 3 + 9 o'clock?
165
Neuro- muscular blockers used:
Atracurium + Pancoronium.
166
Human opthalmology sutures
10/0, 11/0, non- absorbable, atraumatic nylon.
167
Vet opthalmology sutures:
6 -8/0 mono- filamentous/ polyfilamentous, absorbable, atraumatic.
168
Cannula for inj of air:
27 G.
169
Cannula for inj of fluid:
30 G.
170
Extra- ocular tampon:
Cotton.
171
Intra- ocular tampon:
Cellulose?
172
Visco- elastic material:
Methyl- cellulose inj into ant chamber to replace aq humour.
173
What is the fundus?
- Every structure which can be seen on the ocular background.
- Visible background of eye, seen through dilated pupil.
174
How to dilate pupil:
- Mydriasis= Dilation of pupil.
| - 1 drp of Tropicamide, wait for 20 mins, last for 4 - 6 hr.
175
When ø to dilate:
Glaucoma/ Lens luxation?
176
Direct ophthalmoscope:
- Mono- ocular- Lens system with changeable diopter- Changeable illumination light- High mag X15, small field of view- Erected picture.
- Lens + light together.
177
Diopter for fundus:
- 1-3?
178
Dors 1/2 of fundus:
Tapetal.
179
Role of tapetal fundus:
Reflective tissue, amplify light, ø in Sus nor humans.
180
Who have tapetum fibrosum?
Cows, sheep, goats, Eq.
181
Who have tapetum cellulosum?
Car, rodents, cetecea.
182
Who has stars of Winslow in the fundus?
Eq.
183
What is Progressive retinal atrophy syndrome ( PRA)?
Pigmented change in tapetal fundus w attenuation of vasculature + atrophy of optic disc, middle aged labrador.
184
What is seen in PRA?
Disorder of fundus, very reflective tapetum, atrophy of v, pale optic n head.
185
What is collie ey anomaly ( CEA)/ retinal dysplasia ( RD)?
Scleral actasia= Sclera protrude into eye around optic n head.
186
How is CEA seen with ophthalmoscope?
Folds seen as epsilon- like stripes.
187
Reason for retinal hemorrhages:
Tumor, conjunctivitis, traumatic injury, uveitis with infective systemic disease.
188
Retinal detachment:
- Separation of inner layer of retina from choroid- Holes in retina.
- Due to tumors, uveitis.
189
Solution:
pH 3.5 - 10.5, sterile, pH + temp = determine the stability.
190
Suspension:
Drug in small particle--> Tears dissolve the particles--> Absorption in the form of solution: Prolonged contact time.
191
Ointment:
- Oil/ H2O- based, pH + temp are ø so important in the stability.
- Disadvantage: Inhibits corneal wound heal.
192
Absorption of topical administration:
- Drops, ointment, sub- palpebral + naso- lacrimal methods.
- After administration, either washed out by tears/ absorption by the conjunctival capillaries/ penetration into the cornea.
- Lipid soluble drugs--> Easy, trans- cellular absorption.
- H2O soluble drugs--> Poor, inter- cellular absorption.
193
Sub- conjunctival inj:
- Cornea- conjunctiva barrier is bypassed.
- High drug conc in the ant segment.
- After topical anesthesia, fine needle used.
- Mild hemorrhage.
- Mydriasis, Abs, corticosteroids.
- Max 1ml in dors palpebral.
194
Retrobulbar inj:
- High drug conc in the orbit + the post segment.
- SA --> general anesthetics--> Ab.
- Cow --> local anesthetics for extirpation.
- Needle is inserted at the lower- lat quadrant into the retro- bulbar space.
> IOP may increase afer administration.
195
Intra- vitreal inj:
- At lat canthus, with 2- 3 mm from limbus the needle is inserted into the vitreous.
- Ab under general anesthesia.
- Gentamycin in glaucoma.
196
Systemic inj:
Only if inflammation, ab/ hyper- osmotics.
197
Mydriasis- Sympathetic innervation:
M. dilator pupillae, glandula lacrimalis.
198
Tropicamide:
- Mydriatic, poor analgesic.
- Fast acting, effective mydriatic, poor cycloplegic.
- Ideal for induction of diagnostic mydriasis.
- ø side effects.
199
Miosis- Parasympathetic innervation:
M. sphincter pupilla, M. ciliaris, glandula lacrimalis.
200
Pilocarpine:
Miosis, help decrease IOP.
201
What is the job of uvea?
Prevent leakage of protein to the eye, vascular part of bulbus.
202
What is the job of iris?
- Separates the ant + post chambers.
| - Regulates
203
What is the job of corpus ciliare?
Produce aq humour + accomodation.
204
What is corpora nigra?
Aid in control of bright light entering hrough constricted pupil, only herbivores.
205
What part of ciliary body joins retina?
Pars plana- joins the retina- Ora ciliaris retiane.
206
How many layers in choroid?
Histologically has 4 layers.
207
Which spp does choroid supply entire retina?
Eq.
208
Where is tapetum lucidum?
At the dors fundus btw retina + choroid.
209
Most common tumor in uvea:
- Melanoma esp in grey Eq.
210
What is corectopia?
Abnormal location of pupil.
211
Ant uveitis:
- Changes of aq humor- Hyphemia.
- Kerati precipitates KPs.
- Iridocyclitis --> inflammation of iris + ciliary body.
212
Post uveitis:
Choroiditis --> inflammation of chorois, retina often affected as well.
213
Most common reason for uveitis in SA:
Idiopathic + autoimmune.
214
Signs of acute uveitis:
Decreased IOP, miosis, aq flare, inflammatory deposits, corneal oedema.
215
Ant synechia:
Iris adhere to cornea.
216
Post synechia:
Iris adhere to lens.
217
IOP in chronic uveitis:
Up/ down ( eye atrophy)?
218
Eq corneal ulcer pathogens:
Strep, Staph, P aerugnosa, fungi, aspergillosis, fusarium?
219
CS of melting ulcer:
Severe pain, purulent discharge, diffuse corneal oedema, greyish- white gelatin- like material at the base + edge of ulcer, hypopyon, 2º uveitis.
220
Surgery for Eq corneal ulcer:
Pedicle conjunctival graft transposition, direct suturing of the cornea.
221
Corneal stromal abscess with fluorescein:
-ve?
222
Surgery for stromal abscess:
Cornea transplant surgery- Keratoplasty.
223
Long term consequence of Eq uveitis:
Cataract, lens luxation, blindness.
224
Cause of Eq uveitis:
Idiopathic, auto- immune, with infective systemic disease, with non- infectice systemic disease, trauma, reflex uveitis, toxic, lens induced, uveo- dermatological, ERU.
225
Conseauence of Eq uveitis:
Proteins, fibrocytes in aq humor + vitreous body?
226
CS of acute Eq uveitis:
Aq flare, inflammatory deposits, miosis, decreased IOP.
227
CS of chronic Eq uveitis:
Corneal endothelial degeneration/ dystrophy, lens luxation/ sub- luxation.
228
Surgery for Eq uveitis:
Pars plana vitrectomy in the comfortable period?
229
Treatment for Eq uveitis:
Topical anti- inflammatory, mydriatics + cycloplegics, topical anti- inflammatory.
230
Glaucoma:
Pathological cond with increased IOP, resulting in destruction of ocular structures function.
231
How does aq drain?
Shlemm's canal in iridocorneal angle + oveoscleral route.
232
Reason for glaucoma:
Decreased angle of pectinate lig, / defect in draining - Rare in cat.
233
What is gonioscopy?
Special lens _ optical instrument to examine ant chamber _ determine ocular motility + rotation.
234
What does increased IOP do?
Destroy all ocular structures.
235
What is goniodysgenesis?
Abnormal development of the iridocorneal angle- familial in cocker spaniel + basset hound.
236
Hereditary open angle glaucoma:
Beagle + poodle, sec obstructed angle- uveitis?
237
2º closed glaucoma:
Pupillary block, w/ pupillary block?
238
CS of acute glaucoma:
IOP ? 25 mmHg, ø PLR.
239
CS of chronic glaucoma:
IOP increased/ normal, vascularization, pigmentation, Descemet's streaks, vision disturbance, iris + disc atrophy, bupthalmus.
240
Therapy of glaucoma:
- Medical- Carbonic anhydrase inhibitor, ß- blocker, hyper- osmotics, prostaglandins.
- Surgical- Intra- ocular surgery, cyclo- destructive methods.
241
Intraocular surgery for glaucoma:
Cyclodialysis, intra- capsular lens extraction ICE of luxated lens, corneoscleral trepanation, drainage implant.
242
What does cyclo- destructive surgery mean:
Decrease aq production.
243
How to do cyclophotocoagulation?
Trans- scleral laser cyclophotocoagulation- Iris- oculight diode laser equipment- Decreases aq production.
244
What is TSCP?
Trans- Scleral cyclophotocoagulation at 35 sites, 3 mm behind limbus.
245
What is the pt of intra- ocular surgery?
Improve drainage of the aq.
246
Regeneration of ant ep of lens?
Limited regeneration.
247
Function of ant epi?
- Produces the lens cells.
| - Actively transports nutritives from the aq
248
What is hordeolum?
- Externum --> Purulent inflammation of a lash follicle + Associated gl of Zeis.
- Int --> Purulent inflammation of a tarsal gl.
- Stap aureus.
249
What is chalazion?
Cyst of tarsal gl.
250
What is ectropion?
Eversion of eyelid, always loxer lid is affected.
251
What breed is ectropion normal?
May have genetic basic, breed related --> St Bernard, Spaniel, Bloodhound, Mastiff.
252
Acquired/ Cicatrical ectropion:
- Trauma to the lids + healing without treatment --> formation of cicatrix --> Fibrosis + contraction of the tissues --> Ectropion.
- Fibrosis _ contraction may be associated to periocular surgery + chronic inflammatory proc --> Ectropion.
- Eq.
253
What is intermittent ectropion?
- In larger hunting breeds of dog.
| - Lids are normal in the morning, ectopion occurs in the night.
254
Treatment of intermittent ectopion?
Nothing, surgery contraindicated.
255
Surgery of ectropion:
- Surgery is indicated --> IF there are 2º signs/ if desired by owner.
- Remove triangle in lat part of eyelid, modified Kuhnt- Szymanowski method.
256
What to evaluate in traumatic eyelid injury?
Cond of globe + lacrimal punctae.
257
What is blepharitis?
Inflammatory cond of eyelids.
258
Site of immune- mediated disease- ex pemphigus?
Mucocutaneus junction?
259
Layers of conjunctiva?
- 3 layers.
| - PTF, ep, substantia propria.
260
Ciliary v when injected?
Dark red, brush like, short + straight, v at the limbus affected, topical adrenalin has ø effect.
261
Conjunctival v when injected?
Bright red, branch- like + tortuous, v in the fornix affected, v are mobile with the conjunctiva, adrenaline has good effect.
262
What is conjunctival dermoid?
Skin tissue in conjunctiva- ectopy.
263
Why conjunctival cyst?
Obstruction of duct of the conjunctical gl, ectopic glandularly tissue.
264
What is symblepharon?
Adhesions of any portion of the conjunctiva to itself/ to the cornea.
265
Why symblepharon?
Young cats with viral conjunctivits- FeHV.
266
Ab for conjunctivitis?
Neomycin + gentamycin.
267
Conjunctival tumor in cattle?
Squamous cell carcinoma, hemangioma, hemangiosarcoma.
268
Conjunctival tumor in dogs?
Papilloma.
269
What is chemosis?
Swelling of conjunctiva.
270
What determines position of 3rd eyelid?
Partially determined by sympathetics tone.
271
What is the T- shaped cartilage?
Cartilaginous skeleton at base of 3rd eyelid gl.
272
What does gl of 3rd eyelid do?
Seromucoid; prod of 30 - 50% of PTF + in dog 1/3 of tear prod.
273
What is Harders' gl + who has it?
Deep portion of 3rd eyelid gl in Sus + rodent.
274
Tear prod?
Gl of 3rd eyelid, tear gl, accessory tear gl.
275
What is cherry eye syndrome?
Protrusion of 3rd eyelid gl, mostly dogs.
276
Treat of cherry eye?
Surgery.
277
Protrusion of T- shaped cartilage?
Eq + dog, developmental abnormality, rare in LA, ø 2º inflammation, ø discharge/ hyperemia.
278
What is Horner's syndrome?
Sympathetic denervation causing prolapse of 3rd eyelid, enophtalmus, ptosis, myosis, in dog + cat + Eq/.
279
What is consequence of myositis eosinophilica?
3rd eyelid prolapse + eno-/ exophtalmus.
280
What does tetanus cause?
Bilat eversion of 3rd eyelid.
281
Layers of cornea?
- PRF.
- Ep.
- Stroma.
- Descement membrane.
- endothelium.
282
Which part of cornea has elastic collagen fibres?
Descement membrane.
283
How are the collagen fibres arranged?
Parallel layers.
284
Where do fluid accumulate in case of corneal oedema?
Stroma.
285
Reason for corneal oedema?
Glaucoma, inflammation, endothelium dystrophy.
286
Where does vascularization come from?
Deep, supf / mixed- conjunctiva.
287
What is ø a topical treatment?
Subconjunctival inj/ instillation.
288
When doing bact sampling?
Take sample before topical anesthesia/ after anesthesia.
289
What do you do immediately w/ Eq w/ pink eyes?
Fluorescens test.
290
For the 3rd eyelid, which is false?
Well muscled in large + small animals.
291
Mydriasis?
Pupil dialtion.
292
What effect do parasympatheticolytics have on the eye?
They block function of M. sphincter pupillae + M. ciliaris --> mydriasis with cyclopegia.
293
What are solution?
ø easily inf?
294
Fluorescent stain?
Hydrophilic + stains exposed stroma/ hydrophobic + stains stroma.
295
ø use for melting ulcers?
Supf keratectomy.
296
What do you do with descemetocele?
Require surgical intervention, special staining by fluorescein, medical treat contraindicated.
297
How to treat blepharospasm in Eq?
Auriculopalpebral n block.
298
What are indication for vitrectomy in Eq?
Recurrent uveitis.
299
Use of atropine?
Analgesia in ciliary body, mydriatic/
300
When is glucocorticoids contraindicated?
If fluoresceine stains the cornea?
301
What are the gl of the eyelid?
Tarsal gl?
302
What is chemosis?
Oedematic swelling of conjunctiva.
303
What are the borders of the ant eye- chamber?
Iris, pupil + cornea.
304
What is dazzle reflex?
Subcortical reflex.
305
Which animal has cilia on lower eyelid?
Dog.
306
Shape of pupil?
- Herbivore + Sus: horizontal, elliptical.
- dog: rounded.
- Cat: perpendicular rhomboid.
307
What is false about ointment?
Intraocular use.
308
Most important outflow/ drain of aq in Eq?
Uveo- scleral route.
309
What is ectropion?
Eversion + outward turning of eyelid w/ imperfect of eyelid.
310
What is ø CS of acute uveitis?
Mydriasis.
311
Extirpation/ evisceration?
- Extirpation: removal of globe transconjunctival.
312
Trichiasis?
Cilia arise from normal located follicles, pointed in abnormal direction.
313
How to diagnose descemetocele?
Bottom of ulcer is formed by protruded Descement membrane, blackish + shining, mucopurulent discharge, pain, special staining by fluorescein + 2º uveitis.
314
Which equipment do you need for microsurgery?
Hand- held microsurgery instruments, magnifier, operation microscope.
315
What can ø entropion be?
Intermittent.
316
What is ø typical?
Subconjunctival inj.
317
What is ø microsurgery?
Eyelids.
318
What belongs to microsurgery?
Lacrimal punctas, corneal- conjunctiva, intraocular interventions.
319
Preparation + isolation for general eye surgery?
Trimming/ shaving with betadine soap, disinfection of fornix + lid marginds with betadine 1: 10, disinfect lids + periocular areas with cc betadine, isolation textiles.
320
Which is ø a general intervention in eye surgery?
Tarsorrapy, 3rd eyelid flap, approach 3rd eyelid, med canthotomy, stay sutures in globe.
321
Hypopyon:
Pus in ant chamber.
322
Hyphema:
Blood in ant chamber.
323
What is mydriasis?
Pupil dilation.
324
What are solutions?
- Should be sterile.
- pH 3.5 - 10.5.
- pH + temp determine stability.
325
Fluorescein stain.
Hydrophilic + stains exposed stroma bright green.
326
What is Ankyloblepharon?
Lid margins partially/ totally closed.
327
What's the job of the uvea?
- Prevent leakage of proteins to the eye.
| - Vascular part of the bulbus.
328
What is the job of iris?
Regulate amt of light.
329
What is corpora nigra?
Aif in control of light entering through constricted pupil - only in herbivores.
330
What part of ciliary body joins the retina?
Pars plana.
331
How many layers in choroid?
4.
332
Which sp does choroid supply entire retina?
Eq.
333
Most common tumour in uvea?
Melanoma in the iris.
334
What is corectopia?
Abnormal location of pupil.
335
Ant uveitis?
Iritis, cyclitis.
336
Post uveitis.
Choroiditis.
337
Most common reason for uveitis in SA?
Idiopathic + autoimmune.
338
Signs of acute uveitis?
Decreased IOP, miosis, cornea oedema.
339
Ant synechia?
Iris adhere to lens.
340
Post synechia?
Iris adhere to lens.
341
IOP in chronic uveitis.
Decerased.
342
Eq corneal ulcer pathogens.
- Strep, Staph, P aeruginosa.
| - Fungi: aspergillus, Fusarium.
343
CS of melting ulcer?
Pain, Ant uveitis, corneal oedema, Hydropyon.
344
Surgery for Eq corneal ulcer?
Grid keratectomy, debridement keratomy, pedicle conj flap.
345
Corneal stromal abscess with fluorescein?
-ve.
346
Surgery for stromal abscee?
Cornea transplant- Keratoplasty.
347
Long term consequence of Eq uveitis?
Cataract, lens luxation, blindness.
348
Cause of Eq uveitis?
Leptospira, Borrelia, Riboflavin def, hereditary, autoimmune.
349
Consequences of Eq uveitis?
Proteins, fibrocytes in aq humor + vitreous body.
350
CS of acute Eq uveitis?
Enophtalmus epuphora, ciliary inj in cornea, hypopyon, opacity.
351
CS of chronic EQ uveitis?
Permanet corneal opacity, cataract, 2– glaucoma, choroiditis, bulbi atrophy= end stage.
352
Surgery for Eq uveitis?
Pars plan vitrectomy in the comfortable period.
353
Treatment for Eq uveitis?
Local cortiscosteroids, atropine, cyclosporin, topical + systemic NSAID.
354
Glaucoma ?
Pathological cond with increased IOP.
355
How does aq drain?
Schlemm's canal in iridocorneal angle + uveoscleral route.
356
Reason for glaucoma?
Decreased angle of pectinate lig/ defect draining.
357
What is goniodysgenesis?
Abnormal development of the iridocorneal angle- familial in C. spaniel, Basset hound.
358
Hereditary open angle glaucoma?
- Beagle + poodle.
| - 2º- obstruction of angle uveitis.
359
2º closed glaucoma?
Can be with/ without pupillary block.
360
CS of acute glaucoma?
IOP> 25 mmHg, opacity, mydriasis, ø PLR.
361
CS of chronic glaucoma.
May be normal IOP, vascualrzation, pigmentation, descmet's streaks in cornea, iris + optic disc atrophy, buphtalmos, blindness.
362
Therapy for glaucoma?
Carbonic anhydrase inhibitor, ß- blocker, myotics, hyperosmotics, PG.
363
Intraocular surgery for glaucoma?
Cyclodialysis, intracapsular lens extraction.
364
What does cyclodestructive surgery mean?
Decrease aq production.
365
How to do cyclophotocoagulation?
Transscleral laser cyclophotocoagulation- destroy ciliary p.
366
What is TSCP?
Transcleral laser cyclophotocoagulation at 35 sites, 3 mm behind limbus.
367
What's the pt of intraocular surgery?
Improve drainage.
368
Regeneration of ant ep of lens?
Limited.
369
Function of ant ep?
Transport glucose from aq, produce lens cells.
370
What is hordeolum?
Inflammation of sebaceous gl of eyelids, Microabscesses.
371
What is hordeolum externum?
Purulent inflammation of lash follicle + zeis gl.
372
What is hordeolum int?
Purulent inflammation of lash follicle + meibomian ( tarsal ) gl.
373
Site of immune mediated diseases?
Mucocutaneous junction.
374
Lab test for blepharitis?
Cotton swab, skin scraping, biopsy.
375
What is important when applying clotrimazole _ amitraz?
ø corneal drug contact.
376
Most common eyelid tumours?
Adenoma, sarcoma melanoma, papilloma.
377
How much of eyelid can be removed?
1/4 of it with V- shaped incision.
378
What is conjunctiva?
Well vascularized MM.
379
Which gl produce PTF?
Lacrimal gl of 3rd eyelid, tarsal gl, globlet cells in conjunctiva.
380
Ciliary v?
Dark red, v at limbus, adrenaline has ø effect.
381
Conjunctival v?
Bright red, v in fornix, adrenaline has good effect.
382
What is conjunctival dermoid?
Skin tissue in conjunctiva, inherited in Herefords.
383
Why conjunctival cyst?
Obstruction of duct of conjunctival gl, ectopic glandular tissue.
384
What is symblepharon?
Adhesions of conjunctiva on itself/ on the cornea.
385
Why symblepharon?
Young cats with viral conjunctivitis- FEHV.
386
Ab for conjunctivitis?
Neomycin + gentamycin.
387
Conjunctival tumours in cattle?
SCC, hemangioma/ sarcoma.
388
Conjunctical tumours in dogs?
Papilloma virus, SCC.
389
What is chemosis?
Swelling of conjunctiva.
390
What determines position of 3rd eyelid?
Sympathetic tone.
391
What is the T- shaped cartilage?
Cartilaginous skeleton at base of 3rd eyelid gl.
392
Treatment of cherry eye syndrome?
Replace gl with Morgan's technique, don't cut off ----> KCS.
393
Protrusion of T- shaped cartilage?
Eq + dog, developmental problem, rare in LA; ø 2º inflammation, ø discharge/ hyperaemia.
394
What is Horner's syndrome?
Sympathetic denervation causing prolapse of 3rd eyelid, enopthalmus, ptosis, miosis in dog, cat + Eq.
395
What is consequence of myositis eosinophilica?
3rd eyelid prolapse + eno/ exophtalmus.
396
What does tetany cause?
Bilat eversion of 3rd eyelid.
397
Layers of cornea?
PTF, Ep,stroma, descemet's membrane, endothelium.
398
Which part of cornea has elastic collagen fibres?
Descemet's membrane.
399
How are collagen fibres arranged?
Parallel layers.
400
Where do fluid accumulate in case of corneal oedema?
In the stroma.
401
Reasons for corneal odema?
Glaucoma, inflammation, endothelial dystrophy.
402
Where does vasculatisation come from?
Deep- ciliary, supf conjunctiva.
403
What is ø a topical treatment?
Subconjunctival/ retrobulbar/ intravitreal inj/ systemic.
404
When to do bacterial sample?
Before topical anaesthesia.
405
Parasympatholytic effect on eye:
Mydriasis with Cyclopegia.
406
Solutions:
pH 3 - 10/ buffer/ pH + temp determines stability/ should be sterile.
407
Fluorescin:
Hydrophilic, stains the stroma won't stain the descements memebrane/ ep cells as they are hydrophopic.
408
Grid keratotomy:
Only in non- melting ulcers.
409
What to do with descemetocele:
Emergency intervention, eliminate the cause, ø medical therapy- surgery- free island graft in SA, pedicle graft LA + direct suture the cornea.
410
Indication for vitrectomy in Eq
ERU?
411
Atropin
ø a diagnostic mydriatic, but for therapy.
412
When are glucocorticoids/ corticosteroids contraindicated?
With corneal ulcer + +ve fluorescein test.
413
Borders of ant chamber:Dazzle reflex:
is elicited by sudden stimulation of eye with an extremely bright/ shiny light.
414
Most important drainage if aq in Eq:
Uveo- scleral.
415
CS of acute uveitis:
miosis: swollen + injected iris, pain, photophobia, cornea oedema, dec IOP.
416
CS of chronic uveitis:
Ant synechia- Iris adheres to cornea, Post synechia- iris adheres to the lens, Decrease IOP= eye atrophy, increase IOP= glaucoma.
Ophthalmology FINAL
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