CAL - case examples

Question 1

When can LPI of the cornea (Corneal pannus) recur?

Answer 1

especially if the patient is taken off medication (topical ciclosporin and/or a topical steroid) too abruptly or early and if there is exposure to sunlight. In such cases, maintaining a low frequency application of a drop (once every other day) might help keep the CSs under control)

Question 2

Why do sequestra form in cats?

Answer 2

d/t chronic irritation, trauma or repeated, subtle microtrauma (small amount of medial canthal entropion, dry eye etc). Sometimes they appear spontaneously without an obvious cause and we tend to suspect the latter is the most likely.

Question 3

Tx - sequestra

Answer 3

• keratectomy for removal of the entrue sequestrum, this should be followed by corneal grafting, a conjunctival pedicle or a corneo-limbo-conjunctival transposition. REFER!

Question 4

Are distichiae usually bilateral?

Answer 4

Yes

Question 5

Tx - distichiae

Answer 5

• removal of hairs through electrolysis
• supportive medical therapy for the cornea (topical AB such as chloramphenicol and preservative free viscous tears such as Cellusvisc 1% so the cornea can heal naturally in a few days without further trouble)

Question 6

Why might you get corneal stroma overhydration?

Answer 6

• defective epithelium or endothelium

- overhydration can happen secondary to vessel ingrowth into the cornea