Conjunctival Disease

Conjunctival hyperemia

What does conjunctival hyperemia lead you to?

Extraocular disease

Episcleral injection

What does episcleral injection lead you to?

Intraocular disease

What does subconjunctival hemorrhage lead you to?

Trauma/bleeding disorder

Subconjunctival hemorrhage

Describe episcleral injection

Radial pattern from limbus and dark red

Describe subconjunctival hemorrhage

Dark red

What causes serous ocular discharge?

Viral (FHV-1)

Allergies

Epiphora

What causes mucoid ocular discharge?

KCS

What causes mucopurulent ocular discharge?

Bacterial infection

What are the types of ocular discharge?

Serous

Mucoid

Mucopurulent

What are your diagnostic tests for red eye?

Fluorescein stain

Schirmer tear test

IOP

Cytology

Aerobic culture and sens

What is ophthalmia neonatorum?

Infection prior to lid separation

What causes Ophthalmia neonatorum in dogs?

Bacterial infection

What causes Ophthalmia neonatorum in cats?

FHV-1 or Chlamydia

How do you treat ophthalmia neonatorum?

Separate eyelids

Flush with sterile saline

Broad spectrum AB for dogs

Teramycin for cats

Treat 4-6 times a day

Ophthalmia neonatorum

What is the sequelae to ophthalmia neonatorum?

Symblepharon, corneal perforation, corneal scar formation, blindness

What are the C/S of conjunctiviites?

Conjunctival hyperemia

Ocular discharge

Chemosis

Follicles

Blepharospasm

Elevation of 3rd eyelid

T/F canine conjunctivitis is usually infectious?

False

What usually causes canine conjunctivitis?

Secondary to other abnormalities like entropion, ectropion, trichiasis, tumors, KCS, irritants

What bacteria can normally be cultured from the conjunctiva?

Staph, Strep, Corynebacterium, Bacillus

How do we treat canine conjunctivitis?

Treat underlying cause

Corticosteroids if fluorescein negative

What should you do if there is no response to therapy for canine conjunctivitis?

Re-evaluate diagnosis

What usually gets follicular conjunctivitis?

Young dogs

What is follicular conjunctivitis?

Lymphoid follicles bulbar surface of the nictitans usually immune mediated

How do you treat follicular conjunctivitis?

Topical steroids ± antihistamines

Follicular conjunctivitis

What is olopatadine?

Topical antihistamine

What usually causes feline conjunctivitis?

Infectious: FHV-1, Chlamydia, Mycoplasma, Calicivirus

Why do we not use topical steroids for feline conjunctivitis?

It is usually infectious

What is the #1 cause of feline conjunctivitis?

FHV-1

What is a noninfectious cause of feline conjunctivitis that is rare?

Eosinophilic conjunctivitis

What are the C/S of FHV-1 in the eye?

Feline conjunctivitis, Corneal ulcers/keratitis

Why is FHV-1 so hard to get rid of in the eye?

Latency is in the trigeminal ganglion

If you have a cat with conjunctivitis, corneal ulcers, and keratitis what is it 100% of the time?

FHV-1

What age gets FHV-1 the most?

Kittens

How long can FHV-1 survive in the environment?

Short lived (18hrs)

How can you kill FHV-1?

Disinfectant

How far can sneezing cats shed FHV-1?

4 feet

How do you diagnose FHV-1?

C/S pretty much every time

Also cytology, PCR, IFA, Serology, virus isolation

What is seen on cytology of FHV-1?

Intranuclear inclusions and PMNs

What is the problem with virus isolation to diagnose FHV-1?

It is insensitive for chronic infection

What FHV-1 cases should you treat

Moderate to severe conjunctivitis of if they have a corneal ulcer or disease

What is the cause?

FHV-1

Ask what is pathognomonic for FHV-1?

OK

How do you treat FHV-1?

Antiviral medications

Oral lysine

Decrease stress

What are some antiviral topicals you can use?

Trifluridine

Cidofovir

Idoxuridine

What are the problems with giving trifluridine for FHV-1?

It has to be refrigerated, topically irritating, give 4-8 times daily

Why is cidofovir best for treating FHV-1?

It is given 2 times a day which is less stressful

What are some antiviral systemic treatments?

Famciclovir

Lysine

How long should you use antiviral for FHV-1

1 week after resolution of C/S

What are some common sequela to FHV-1?

Recurrence

Corneal disease/ulcer/perforation

Chronic epiphora

Symblepharon

What is epiphora?

Excessive tear production

Describe Chlamydia felis causing eye problems?

URI (upper respiratory infection) in young cats

Chemosis begins unilaterally then bilateral

Follicles with chronicity

How do you diagnose Chlamydia on the eye?

Cytology with intracytoplasmic inclusion bodies

PCR

How do you treat chlamydia?

Doxycycline (liquid)

Azithromycin

Pradofloxain

How long do you treat Clamydia?

At least a month and 2 weeks after resolution of C/S

What topical medications can you add to Chlamydia treatment?

Tetracycline or erythromycin

T/F recurrence of chlamydia is common?

True

T/F chlamydia is rarely zoonotic?

True

What would cause Mycoplasma to cause pathology in the eye?

It is opportunistic

How do you diagnose mycoplasma?

Cytology with inclusion bodies

Culture

PC

What is the pathogenesis of Mycoplasma?

Questionable because it can be isolated from normal cats

How do you treat Mycoplasma?

Tetracyclines, Fluoroquinolones topically

Doxy or Prado orally

How long do you have to treat Mycoplasma?

2 weeks

What are the C/S of calicivurs?

URI, oral and nasal ulceration, low pathogenecity for conjunctiva

What treatment is ineffective for calicivirus?

Topical antivirals

What are some conjunctival neoplasias?

Mast cell tumors, papillomas, hemangioma, lymphoma, melanoma, SCC

Mast cell tumor

Papilloma

What age gets papillomas?

Young dogs

How do you treat papillomas?

Do nothing

Hemangioma/hemangiosarcoma

Lymphosarcoma

Melanoma

What animal gets MALIGNANT conjunctival melanoma?

Cats

What animal gets BENIGN conjunctival melanomas?

Dogs

SCC

What fungus do we get in the eye commonly in kansas?

Histoplasma capsulatum