_superficial keratitis （pannus） yola慢性浅表性角膜炎（血管翳）约拉课件

Chronic Superficial Keratitis (Pannus) Pannussuperficial corneal vascularization/scar tissue Progressive, bilateral, can result in blindness Cause Thought to be immune-mediated (Infiltration of cornea with lymphocytes, plasma cells) Increased ultraviolet light/high altitudes increases incidence Signs Opaque lesions that begin at limbus and extend into cornea Milky, pink, or tan Chronic Superficial Keratitis (Pannus) Chronic Superficial Keratitis (Pannus) Breeds Ger. Shep, B. Collie, greyhound, Sib. Husky Dx r/o KCS, corneal ulcers Rx Corticosteroids often lifelong Cyclosporine often lifelong Antibiotic eye ointment Client info No cure If Rx is stopped, disease will return and progress High altitudes and sun predispose animals DOGGLES! Keratoconjunctivitis Sicca (KCS) Lack of tear production; tears lubricate, nourish, bacteria, aid in healing Tears from 2 glands: 70%-Lacrimal gland; 30%-Nictitans gland Signs Recurrent conjunctivitis, corneal ulcers, keratitis Dull, dry, irregular cornea, conjunctiva Tenacious, mucoid ocular discharge Blepharospasm Crusty nares Rx Tear stimulationcyclosporine, pilocarpine Artificial tears Client info Px is guarded for resolution Failure to treat blindness KCS Cataracts Opacity of lens that causes reduced vision; most common disease of lens Cause Genetic 2 to: Diabetes mellitus (bilat; within 1 y of disease; glucose fluid in lens) Most common cause Trauma (unilateral; HBC, thorn penetration, shotgun pellet) Lens luxation Nutritional deficiency Uveitis Hypocalcemia Electrical shock Rx Surgical removal of lens Treat underlying cause (e.g., Diabetes) Client info Most cataracts are inherited, so dont breed affected dogs Dogs can live quality lives even with bilat. cataracts Cataracts Signs Progressive loss of vision Opaque pupillary opening Dx Must be distinguished from senile nuclear sclerosis Normal old age change; graying of lens; bilat; usually does not affect sight CATARACTS Progressive Retinal Atrophy A group of hereditary disorders causing loss of rods, cones, and/or blood supply Breeds Toy/min. Poodle, G. Ret, I. Set, C. Span, Schnauzer, Collie, Samoyed, N. Elkhound Recessive gene isolated in some breeds Signsslow onset of blindness Loss of night vision (rods) loss of day vision (cones) cataracts () Dx r/o metabolic disorders that could cause cataracts Ophth exam gray, granular appearance of retina Hyperreflective retina Vascular attenuation, optic nerve atrophy Normal canine retinaPRA, optic nerve atropy and vessel attenuation PROGRESSIVE RETINAL ATROPHY Progressive Retinal Atrophy Rx None Client info This is an inherited disease Avoid buying affected breeds Have ophth exam by board certified ophth to r/o PRA Blind animals adapt well Have trouble in strange surroundings Cats need well balanced diet Taurine deficiency can lead to PRA Anterior Uveitis Inflammation of uvea: ciliary body, iris, choroid Causes Inflammation/infection FeLV/FIP, fungal, bacterial Neoplasia Trauma Uveitis Clinical Signs Blepharospasm Aqueous flare increased turbidity of aqueous humor Miosis of affected eye Iridal swelling or congestion Keratic precipitates Ciliary flush in limbal region +/- Corneal edema +/- hyphema Anterior Uveitis hyphema Anterior Uveitis Anterior Uveitis keratic precipitates Anterior Uveitis Treatment Topical steroids or Topical Anti-inflmmatory drugs (ocufen) Or systemic steroids Atropine dilates eye, decreases pain Antibiotics topically +/- systemically Anterior Uveitis Client Info Recheck within 3 days Secondary glaucoma is frequent complication Prognosis depends on cause Treat for 2 months regardless of cause blood -aqueous barrier disrupted for 6 weeks Proptosed Globe Cause Trauma Conformation Retrobulbar abscess or neoplasia Clinical Signs Protrusion of the globe, Eyelids unable to close, may be trapped behind globe Prognosis Favorable brachycephalic dog, positive direct or consensual pupillary light response normal findings on posterior segment exam proptosed eye with vision on initial presentation Unfavorable indicators non-brachycephalic cat breed hyphema, no visible pupil facial fractures optic nerve damage and avulsion of 3 or more extraocular muscles Proptosed Globe Proptosed Globe Treatment Lubricate immediately Reduce the globe into the socket ASAP to reduce trauma to optic nerve Enucleation if optic nerve severed Systemic and topical antibitics +/- Steroids Proptosed Globe Re