Conjunctival and Nasolacrimal Disease Exam 2

What is conjunctiva?

mucous membranes lining the inside of eyelids

How does conjunctiva respond to disease?

-edema

-hyperemia

-cellular exudate

What are the traits of conjunctivitis?

-hyperemia

-chemosis

-discharge

-blepharospasm

-third eyelid protrusion

-follicular development

Where does conjunctivitis occur?

-palpebral

-palpebral and bulbar

-never just bulbar

What is conjunctival hyperemia?

-excess blood vessels of eye conjunctiva

-non-moveable vessels

-involve scleral vessel only

-90 degrees to limbus

What are the causes of canine conjunctivitis?

-allergic

-follicular

-plasmoma

-keratoconjuncivitis

-infectious (rare)

What are the causes of feline conjunctivitis?

-mainly infectious

-primary bacteria rare

-allergic rare

-eosinophilic

What kinds of agents can cause infectious conjunctivitis in cats?

-herpes

-mycoplasma

-chlamydia

-NOT CALCIVIRUS

What are the signs of infectious feline conjunctivitis?

-bilateral

-hyperemia

-serous then mucopurulent discharge

-chemosis

-may resolve with no long term effects

What is symblepharon?

-loss of conjunctival and corneal epithelium resulting in inappropriate adherence of conjunctiva

-can occur with herpes

T or F: majority cats are latently infected with herpes

True

How to diagnose herpes?

-treatment trial

-PCR

-culture

-IFA

-cytology

How to treat herpes?

-topical trifluridine

-topical cidofivir

-topical idoxuridine

-oral lysine

-topical antibiotics for secondary infection

-oral antiviral famciclovir

T or F: chlamydia often causes upper respiratory infections

False

What are the traits of chlamydial conjunctivitis?

-often in young cats or after introduction of new cats

-fluorescein negative

-discharge, hyperemia, chemosis

-cytology with intracytoplasmic inclusion

How to treat chlamydia?

-topical tetracycline

-erythromycin

-ciprofloxacin

-oral doxycycline

What are the traits of mycoplasma conjunctivitis?

-unilateral or bilateral

-epiphora

-hyperemia

-chemosis

How to diagnose mycoplasma?

-inclusions at cell membrane

-organism isolate

How to treat mycoplasma?

-tetracycline

-erythromycin

-ciprofloxacin

T or F: cytology and culture have high diagnostic yield for conjunctivitis

False

What are the three layers of tear film?

-mucin

-aqueous

-lipid

What are the traits of the mucin layer?

-deepest

-secreted by goblet cells

-glycoprotein

-smooths corneal surface

What are the traits of the aqueous layer?

-middle layer

-secreted by lacrimal glands

-globulins

-lysozymes

-lactoferrin

-water

-electrolytes

-glucose

What are the traits of the lipid layer?

-superficial

-secreted by meibomian glands

-promotes spreading of tears

-prevents evaporation

What is keratoconjunctivitis?

-inflammation of cornea and conjunctiva

-sicca drying

-deficient aqueous layer

What are the signs of keratoconjunctivitis?

-ropey, mucopurulent discharge

-hyperemia

-chemosis

-keratitis

-superficial vascularization and pigmentation

-ocular discomfort

-secondary infection

-dry crusty nares

-non-healing erosions

How to diagnose keratoconjunctivits?

-STT

-cytology

What are the causes of keratoconjunctivitis?

-idiopathic/immune

-congenital

-drug induced

-loss of parasympathetic innervation

-infection

-trauma

-3rd eyelid prolapse

What is the treatment for keratoconjunctivitis?

-stimulate tear production

-supplement tears

-decrease inflammation

T or F: keratoconjunctivitis patients are often on cyclclosporine for life

True

What are examples of tear stimulants?

-t cell modulators

-cyclosporine A

-tacrolimus

What is a surgical procedure for keratoconjunctivitis?

parotid duct transposition

What is the most common primary conjunctival disorder in dogs?

prolapse of third eyelid gland "cherry eye"

What are the consequences of cherry eye?

inflammation and enlargement due to exposure

T or F: surgical removal of gland is a good treatment for cherry eye

False, it can induce KCS

What are good surgical techniques for cherry eye repair?

-replace gland by anchoring orbital rim

-pocket technique

What is plasmoma?

-chronic superficial keratitis

-pannus

-plasma cells infiltrate third eyelid

How to treat plasmoma?

-topical steroids

-topical cyclosporine

What is follicular conjunctivitis?

inflammation of bulbar surface of 3rd eyelid associated with discharge and allergens

How to treat follicular conjunctivitis?

-topical steroids

-debridement

T or F: 3rd eyelid neoplasm is common

False

Where do foreign bodies often hide, causing non-healing erosions?

behind 3rd eyelid

What are the drainage systems of the nasolacrimal system?

-puncta

-canaliculi

-nasolacrimal sac

What is epiphoria?

poor drainage and excessive tearing due to blocked puncta

How to diagnose epiphoria?

-flush duct looking for flow out of opposite puncta

-flush and occlude puncta to look for nasal flow