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59 Cards in this Set
- Front
- Back
What is neonatal ophthalmia? |
infection of eyes from dam's genital tract >> can go up nasolacrimal duct >> stophylococcus |
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When do eyelids normally open in puppies and kittens? |
7-10 days |
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Treatment of neonatal ophthalmia? |
-- open eyes early to allow drainage -- lavage with LRS -- broad spectrum topical antibiotic |
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What is eyelid agenesis? Most commonly affects which part? Occurs in? |
-- congenital absence of part of palpebral fissure (colobama) >> usually lateral aspect, upper lid -- most common in cat -- usually bilateral -- exposure of globe causes irritation |
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Treatment of eyelid agenesis? |
-- ophthalmic lubricants or surgical repair >> cryosurgery to remove offending hairs >> grafts to replace lid, lid margin, etc. |
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What is entropion? |
-- inward rotation of part, or all, of the eyelid margin -- periocular skin/fur rubs against cornea and conjunctiva leading to irritation/scarring |
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Common breeds that get entropion? |
-- Shar Peis -- Chows |
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Symptoms of entropion? |
-- ocular discomfort >> blepharospasm (squint) >> epiphora (tearing) >> rubbing (may be secondary to blepharitis) -- possibly secondary corneal ulceration -- +/- mucopurulent ocular discharge -- eyelid margin rolled in |
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Etiology of entropion? |
-- anatomical (breed) -- spastic (painful and squinting) -- cicatricial (secondary to scarring) -- enophthalmos (atrophy of retrobulbar tissue) |
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How can you tell if entropion is spastic? |
-- apply topical anesthesia and see if it resolves |
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It is important to do what before surgically repairing entropion? |
-- correct underlying problems first! >> spastic entropion |
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Entropion repair options? |
-- eyelid tacking (staples or suture) -- Hotz-Celsus surgery for entropion |
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Eyelid tacking procedures? |
-- temporary relief or while growing -- surgical staples or suture to evert eyelid margin -- never go full thickness through conjunctiva |
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What is the Hotz-Celsus entropion repair? |
-- pinch technique -- remove tissue to evert margin -- use 5-0 or 6-0 suture -- place sutures close together -- some dogs may need a brow lift as well |
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Post-op care for entropion repair? |
-- rigid, plastic e-collar!!! -- cool eyelid compresses (dec. swelling) -- blot ocular discharge -- +/- topical antibiotic, oral anti-inflammatory |
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Entropion repair takes how long to resolve? |
-- 6 wks |
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What is ectropion? Primary symptom? |
eyelid margins roll outwards (eversion) >> primary symptom: conjunctivitis |
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Etiology of ectropion? |
-- congenital in some breeds -- cicatritial (scarring) -- physiologic (occasional dec. sympathetic tone) -- myasthenia gravis -- facial n. paralysis |
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Most cases of ectropion require surgical repair. T/F? |
-- FALSE -- most cases do not require surgery |
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Treatment of ectropion? |
-- medical management of conjunctivitis -- wedge resection -- V to Y blepharoplasty |
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Dog breeds predisposed to ectropion? |
-- clumber spaniel -- mastiffs -- basset hounds -- blood hound |
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It is possible to have combined entropion and ectropion. T/F? |
-- true! e.g. St. Bernard |
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What is distichia? |
-- extra cilia arising from meibomian gland |
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Clinical signs of distichia? |
-- most are asymptomatic -- may have epiphora? |
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Treatment of distichia? |
-- pluck hairs >> see if problem resolves -- cryosurgery -- electroepilation -- very mild entropion repair |
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Splitting techniques or laser surgery should be avoided in treatment of distichia. T/F? |
-- true! |
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What are ectopic cilia? |
-- cilia erupting through bulbar conjunctiva -- very painful -- damages cornea (direct contact) -- usually younger dogs -- usually needs to be surgically addressed >> often have distichia, too |
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What is trichiasis? |
-- normal hairs rubbing on eyes >> e.g. hair from nasal folds >> cilia or hair from periocular fur directed toward cornea -- common in Shih Tzus, Pekingese |
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Treatment of trichiasis? |
-- trim offending hairs -- ophthalmic ointment >> gel hair down -- cryosurgery -- nasal fold resection |
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What is a chalazion? |
-- distended meibomian gland >> due to blockage of duct (sm. tumor?) >> collection of secretory products -- painless -- yellow/white swelling -- common in white cats |
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Treatment of chalazion? |
-- conservative: warm eyelid compress and baby shampoo wash 2-3x daily -- surgery: open, clean, and freeze glands |
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Infections at the lid margin include what? |
-- red, swollen, painful areas at lid margin -- external hordeolum (stye): infection of eyelash follicle -- internal hordeolum: infected chalazion |
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Treatment of infections at the eyelid margin? |
-- warm compresses -- antibiotics/anti-inflammatories -- may need to lance and drain -- do not manually express! |
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Staphylococcus hypersensitivity can result in? How does this present? |
-- blepharitis
-- bilateral inflammation, swelling, pustules, discharge (all four eyelid margins) |
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Treatment of staph blepharitis? |
-- warm eyelid compresses -- gentle eyelid cleansing (baby shampoo) -- cool rinse/compress -- topical antibiotic/steroid -- systemic antibiotic/steroid (if ulcerated) >> rare use of abx + steroids! -- may need long term care! |
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Most common eyelid mass in middle-aged or older canines? |
-- meibomian gland adenoma/adenocarcinoma |
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Treatment of meibomian gland adenoma/adenocarcinoma? |
-- clinically benign, but tend to reoccur -- treat if corneal/conjunctival irritation -- excision at eyelid margin is TEMPORARY >> frequent recurrence >> cryosurgery >> eyelid wedge resection |
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When performing eyelid wedge resection, what should you be careful of? Complications? |
-- avoid nasolacrimal puncta! >> can result in epiphora, esp. loss of ventral puncta -- avoid knots on the cornea w/ two layer closure -- complications: dehisence, eyelid notching |
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Squamous cell carcinoma (SCC) is most common in? |
-- horses, cattle, cats |
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Where do you see SCC? Assoc. with? Success is dependent on? |
-- ear tips and nose affected on cat -- non-pigmented tissue most problematic -- assoc. with UV light exposure -- post-op follow up is critical to success >> esp. horses |
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Eyelid papillomas occur in which animals? |
-- young animals -- canine/bovine -- generally self-limiting |
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Mast cell tumors occur in? Appearance? Important to do what before FNA? |
-- common in felines -- tend to be raised, pink, hairless -- give antihistamine before FNA! (mast cell degranulation) |
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What is the second most common eyelid tumor in the horse? |
-- equine sarcoid (first is SCC) |
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What is an apocrine hidrocystoma? |
-- benign cystic proliferations of apocrine secretory glands -- bluish masses on eyelid margin of Persians |
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What is blepharitis? |
-- inflammation of the eyelid |
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Etiology of blepharitis? |
-- self trauma -- infectious -- allergic -- autoimmune -- juvenile cellulitis -- solar -- Persian facial dermatitis -- zinc deficiency -- seborrhea, "mystery rash" |
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Infectious causes of blepharitis? |
-- mites (sarcoptes, demodex), ticks, flies -- fungal (dermatophytosis) -- bacterial (staphylococcus) |
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Allergic causes of blepharitis? |
-- atopy -- food allergies -- contact dermatitis -- drugs |
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Autoimmune blepharitis? |
-- uveodermatological syndrome (UDS) >> inflammation of the uveal tract -- usually ulcerative -- usually see eyelid AND nasal lesions |
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Diagnosis and treatment of autoimmune blepharitis? |
-- skin biopsies (special stains) >> can be pemphigous, lupus -- response to immunosuppressive medication -- rule out SCC (scrape/cytology) |
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Eyelid trauma/laceration repair? |
-- lavage and minimal debridement -- cold compresses for swelling -- assess nasolacrimal puncta >> establish patency if possible -- two-layer closure (no knots touching cornea!) |
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Complications of eyelid laceration repair? |
-- may get scarring leading to entropion -- lower lid repair that is not perfectly apposed may cause chronic tearing |
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Eyelid hematomas may indicate? |
coagulopathy, e.g. warfarin exposure |
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What is lagophthalmos? |
-- decreased/absent ability to blink |
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If lagophthalmos is observed, you should? |
-- check palpebral reflex >> CN V (sensory) and CN VII (motor) -- observe spontaneous blinking -- discuss observation of animal while sleeping >> does it keep eyes shut? |
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Lagophthalmos treatment? |
-- shorten palpebral fissure -- keep eye moist? |
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What is a lateral canthotomy? When is it used? |
-- cut in lateral canthus >> subconjunctival enucleation approach >> proptosed eye (needs to be put back) -- +/- single tarsorrhaphy suture to dec. tension |
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What is a temporary tarsorrhaphy? Types? Pros and cons? |
-- suture lid closed, can be partial or complete -- unable to assess globe when placed -- useful if unable to blink -- sutures do not extend full thickness through eyelid -- stents may be used |
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Permanent partial tarsorrhaphy? |
-- shorten eyelid margins -- permanently reduce size of palpebral fissure |