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Dermatology
Anatomy
- Epidermis
- Ears
- Hair coat
- Glands
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Dermatology
Prupose
- Protection
- Temperature Regulation
- Behavior
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Dermatology
Terminology
- Alopecia- Hair loss
- Pruritis- Itching and scratching
- Pustule- Raised nodule with pus
- Lichenification- thick dlephant like skin
- Seborrea- greasy, oily dermitis
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Dermatology
Clinical Signs
- Pruuitis
- Alopecia
- Fleas
- Foul smell and discharge
- Redness
- Scabs, crust and parasites
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Dermatology
Diagnosis
- Skin scrape and fungal cultures
- Blood profile- organ related problems will cause skin problems
- Allergy test
- Intradermal
- RAST (radioallergosorbent test) Not as accurate as Intradermal
- Skin Biopsy
Skin problems can also be caused by ie. Hypothyroid or diabetes
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Dermatology
Disease
Pyoderma (hotspots, FAD (flea allergy dermatits) atopy
Etiology
- Parasites- fleas and sarcoptes
- Allegic
- Irritation
- Hair mats
- Bite wounds
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Dermatology
Disease
Pyoderma (hotspots, FAD (flea allergy dermatits) atopy
Pathophysiology
- Irritation casues itching and scratching
- Self induced trauma casues hair loss and exudation
- Lesions develop
- Secondary infection by staphylococcus occurs
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Dermatology
Disease
Pyoderma (hotspots, FAD (flea allergy dermatits) atopy
Clinical signs
- Red, moist skin with pus like exudate
- Hair loss
- Scratching and moist area
- Painful and febrile
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Dermatology
Disease
Pyoderma (hotspots, FAD (flea allergy dermatits) atopy
Treatment
- Clip and clean if localized (hot spot)
- Clean with antiseptic
- Chlorhexiderm
- Treat primary cause
- Parasites, fleas, etc.
- Antibiotics
- Cephalexin, baytril, amoxicillin and clavamox
- Short term corticosteroids
- Prednisone
- Vetalog
- E-collar to reduce chewing
- Medicated bedding
- Nolvasan shampoo
- Oxydex
- Benzol peroxide
- astringents
- Antihistamaines- not for cats
- Benadryl (diphenhydramine) and Hydroxyzone (anthrax)
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Dermatology
Abscess
Definition
Deep suppurative infections- under the epidemis
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Dermatology
Abscess
Etiology
- Mostly cats, from cat fight wounds
- Penetrating wounds
- Bites, foreign body
- Self infliction
- Skin infections
- Dermatitis
- Trauma
- HBC (hit by car)
- Aerobic organisms
- Pasteurella- in their mounth, most common
- Actinomyces
- Streptococci
- Anaerobic organisms
- Clostridium
- Bacteroides
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Dermatology
Abscess
Clinical Signs
- Depression and febrile
- Anorexia
- Tissue edema and swollen region
- Ruptured purulent discharge
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Dermatology
Abscess
Treatment
- Surgery
- Debride necrotic tissue
- Provide drainage with penrose drain
- Drain stays in 2-3 days before removal
- Antibiotics
- Supportive Care
- Fluids
- Nutritional Support
Azotemia is a medical condition characterized by abnormally high levels of nitrogen -containing compounds, such as urea, creatinine
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Dermatology
Anal Sac Disease
Definition
- Impactation
- Infection
- Abcess
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Dermatology
Anal Sac Disease
Etiology
- Large quantity thick secretion
- Infection
- Poor Grooming
- Small ducts
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Dermatology
Anal Sac Disease
Pathophysiology
- Anal sacs become impacted
- Secondary infection
- Abcess and rupture
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Dermatology
Anal Sac Disease
Clinical Signs
- Scratching, licking, or dragging anal region
- Tail chasing
- Tenesmus
- Painful defication
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Dermatology
Anal Sac Disease
Diagnosis
- Palpate distended anal sacs
- Fluid normally clean tan or yellow
- Abcess seen
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Dermatology
Anal Sac Disease
Treatment
- Medical
- Express anal sacs and flush with dilute nolvasan or betadine
- Topical anti-inflammatory
- Panalog
- Otomax
- Antibiotics
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Dermatology
Anal Sac Disease
Surgery
- Abscess
- Reoccuring problem
- Analsacculectomy
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Dermatology
Dermatophytosis (ringworm)
Definition
- Infection of keratinaceous structure (hair, nails, skin) by parasitic fungi
- Ringworm
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Dermatology
Dermatophytosis
Etiology
- Microsporum canis
- 50-70% infection in dogs and cats
- 90-98% in cats
- microsporum gypseum
- Trichophytan metagrophytes
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Dermatology
Dermatophytosis
Pathophysiology
- Infection usually young and immunosuppred animals
- Highly contagious (zoonotic)
- Transmission is contact from spores to skin
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Dermatology
Dermatophytosis
Clinical Signs
- Pruritis
- Irregular or circular areas of skin with alopecia and scales
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Dermatology
Dermatophytosis
Diagnosis
- Fungal Culture
- Dermatophyte media (DTM)
- Agar turns orange to red if positive
- Dermatophyte causes PH change
- Observe daily, can take up to a week to turn red
- Woods lamp
- M. Canis fluresce 50-80% times
- Not an absolute test
- Skin Biopsy
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Dermatology
Dermatophytosis
Treatment
- Topical
- Use antiseptic baths
- 2 times weekly
- Ketoconazole or miconazole formulation
- Local miconazole creams
- Systemic
- Griseofulvin
- 10-30 mg/kg PO BId for 4-6 weeks
- Side Effects
- Hepatotoxicity
- Teratogen
- Cats extremely sensitive
- Ketoconazole
- 10mg/kg PO Sid for 3-4 weeks
- Intraconazole
- 10mg/kg PO SID for 3-4 weeks
- Treat 1-2 weeks post negative culture or clinical signs
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Dermatology
Demodicosis
Etiology
- Transmission can occur from the mother to neonate during the first 2-3 days of life.
- Infects hair follicles and caused by immunosuppression
- Caused by demodex canis or demodex cati
- Demodex occurs in 3 forms
- Generalized demodicosis
- Normally caused by immunosuppression on underlying disease
- Juvenile onset
- 3-12 months
- Adult onset
- >1 year
- Pododemodicosis
- Chronic interdigital disease
- Localized demodicosis
- Animals < 1 year of age
- Usually resolves spontaneously in 4-8 months
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Dermatology
Demodicosis
Clinical Signs
- Localized demodicosis
- Non parasitic
- Lesions on muzzle, head, ears, and forelegs
- Generalized demodicosis
- Begins local and spreads
- Diffuse, alopecia, scabs, and erythema
- pyoderma and pruitis
- Generalized lymphadenopathy
- Pododemodicosis
- Digital and interdigital pain, erythema and swelling
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Dermatology
Demodicosis
Diagnosis
- Skin scrape
- Alligator- cigar shaped with six legs
- Skin biopsy
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Dermatology
Demodicosis
Treatment
- Localized demodicosis
- Bathing
- Nolvasan shampoo
- Amitraz (mitaban dip)
- Generalized Demodicosis
- Mitaban dip
- Body clip
- Amatraz dip weekly
- Skin scrap every 2-4 weeks
- Continue dips 3-4 weeks following first negative scrape
- Ivermectin
- 0.4-0.6mg/kg PO SID for 1 month past negative skin scrape
- 0.2-0.3 mg/kg SQ of 2 weeks apart
- Pododemodicosis
- Mitaban dip- soad feet daily
- Usually do not use mitaban dip in animals less than 4 months of age
- Long term antibiotics
- May use lime sulfur dips- very young animals only and cats
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Dermatology
Sarcoptic Mange
Etiology
- Caused by sarcoptes scabei (scabies)
- Notoedres cati (feline scabies)
- Primarily on head and neck
- Cheyletiella
- Walking dandruff
- Scotch tape test
- Highly contagious and pruritic
- Zoonotic
- Burrowing mite
- Transmission is by contact
- Mite causes intense pruritus by mechanical irritation
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Dermatology
Sarcoptic Mange
Clinical Signs
- Intense pruritus
- Alopecia
- Scabs, crust and pyoderma
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Dermatology
Sarcoptic Mange
Diagnosis
- Skin scrape
- 50-75% of skin scrape may be negative
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Dermatology
Sarcoptic Mange
Treatment
- Topical
- 1. Body clip and shave
- 2. Lime sulfur 2% dip every 2 weeks
- Young animal
- 3. Mitaban dip every 2weeks
- Systemic
- Ivermectin 0.2-0.3 mg/kg SQ every 2 weeks for 2 treatments
- Amatraz Dip
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Dermatology
Otisis externa
Etiology
- Parasites
- foreign bodies
- Fox tails, hair, dirt
- Atopy- allergies
- >50% otitis externa
- Food allergy
- Neoplasia
- Conformation abnormalities
- Cocker spaniels, labs, most spaniels
- Have greater number of apocrine glands (sweat gland)and hair
- Narrow ear canals
- Bacterial infection
- Staphlococcus
- Streptococci
- Fungi
- Malassezia pachydermititis (a yeast)
- Gram stain= peanut shape
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Dermatology
Otisis Externa
Pathophysiology
- Ear canal becomes inflamed and erythematous (redness)
- Sebacious and apocrine glandular activity is increased
- Combination of increased epidermal thickness and increased glandular activity leads to wax production and entrapement into cnal causing bacterial and yeast infection
- Chronic inflammation leads to permanent changes as calcification of auricular cartilage and stenosis (colliflower ears)
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Dermatology
Otisis Externa
Clinical Signs
- Pruritus and head shaking
- Painful ear and head tilt
- Discharge or foul odor from ear
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Dermatology
Otisis Externa
Diagnosis
- Otoscope exam
- Inflammation and discharge
- Ear culture
- Cytology of ear canal exudate
- Wright- giemsa stain
- Bacteria, yeast, fungal
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Dermatology
Otisis Externa
Treatment
- Ear cleaning
- Clip and remove hair
- Ear flushing and cleaning
- Remove wax and pus
- Nolvasan otic
- Oto clens
- Clean with ear loops or currettes
- Topical cleaning
- Otomax
- Panalog ointment
- Systemic therapy
- Antibiotics
- Corticosteroids
- Antifungal
- Ketoconazole for malassezia
- Surgery
- lateral ear resection
- Total ear ablation and bulla osteotomy
- Water soluble only if tympatic is ruptured
- Auri flush
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Opthalmology
Anatomy
- Globe
- eye
- Eyelids
- Conjunctiva
- Nictating Membrane (3rd eyelid)
- Lacrimal Glands
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Opthalmology
Function
- Vision
- Tears for defense mechanism
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Opthalmology
Terminology
- Conjunctivitis- Inflammed red conjuntiva
- Chemosis- edema of conjunctiva
- Cataract- opacity of lens
- Canthus- angle at either end of the eyelid
- Ectropian- eversion and turning of the eyelid
- Entropian- inward inversion of eyelis
- epiphora- overflow of tears
- Glaucoma- increased intraocular pressure
- Hyphema- hemmorage in anterior chamber
- Keratisis- corneal inflammation
- Miotic- pupil constriction
- Myosis- pupil dilation
- Photophobia- abnormal sensitiation to light
- Ptosis- droopy upper eyelid
- Synechia- adhesion of iris to cornea or lens
- Uvea- entire vascular eye-iris, ciliary body and choroid
- Uveitis- inflammation of uvea
- Blepharospasm- inability to open eyelids/ closed eye (horses)
- Ciliary body- circumferential tissue inside the eye
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Opthamology
Patholigcal Symptoms
- Ocular and nasal dishcarge
- Conjunctiviti and epiphora
- Keratitis
- Corneal opacity
- Ocular pain and swelling
- cataract
- Hyphema-blood in the front (anterior) chamber of the eye.
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Opthamology
Diagnostic tests
- Opthalmic exam
- Tonometer
- Pressure for glaucoma
- Corneal stain
- Ulcer
- Shirmer Tear test
- Dry eye
- Decreased tear production
- Conjunctival scrape
- Biopsy- looking for cancer
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Opthamology
Diseases
Corneal ulcer
Causes
Corneal damage or abrasion
- Trauma
- Infection
- Foreign body
- Chemical burn
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Opthamology
Diseases
Corneal ulcer
Diagnosis
Corneal Stain
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Opthamology
Diseases
Corneal ulcer
Treatment
- Antibiotics
- Topical and systemic
- Atropine- stop ocular pain
- Surgery
- 3rd eyelid
- Conjunctival flap
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Opthamology
Diseases
Entropion
Inward inversion of eyelid margins causing conjunctivitis and corneal ulcers
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Opthamology
Diseases
Entropion
Causes
- Congenital
- Breeds
- Bradycephalic breeds
- Chows, shar pei, rottweilers, english bull dogs
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Opthamology
Diseases
Entropion
Clinical Signs
- Epiphora, conjunctivitis and chemosis
- Corneal ulcer and scarring
- Ulcerative keratitis
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Opthamology
Diseases
Entropion
Diagnosis
Ocular exam
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Opthamology
Diseases
Entropion
Treatment
- Medical
- Ulcer treatment
- Lubrication
- Surgery
- Corrective entropion surgery preferred to prevent secondary eye damage
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Opthamology
Diseases
Conjunctivitis
- Inflammation of ocular mucous membranes
- Red eye or pink eye
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Opthamology
Diseases
Conjunctivitis
Causes
- Infectious- bacterial, chlamydia, virus
- Foreign body
- Trauma
- Irritants
- Dust, distichia
- Immune mediated
- Allergies
- Keratoconjunctivitis sicca KCS
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Opthamology
Diseases
Conjunctivitis
Clinical Signs
- Ocular dishcarge and scleral congestion
- Chemosis and photophobia
- Epiphora
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Opthamology
Diseases
Conjunctivitis
Diagnosis
- History and eye exam
- Corneal stain
- Topical anesthetic
- Tear test
- cytology
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Opthamology
Diseases
Conjunctivitis
Treatment
- Treat primary disease
- Systemic drugs
- Antibiotic
- Corticosteroids
- allergic, chemosis
- Topical
- Cyclosporine (optimmune)
- KCS
- Antibiotic
- Gentocin, bacitracin, and neomycin (BNP)
- Antiinflammatory combinations
- BNP-HC, gentocin durafilm
BNP- made by your heart and shows how well your heart is working.
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Opthamology
Disease
Prolapse of third eyelid gland (cherry Eye)
- Protrusion of gland of third eyelid
- May be unilateral or bilateral
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Opthamology
Disease
Prolapse of third eyelid gland (cherry Eye)
Causes
- Genetic and breed predisposition
- Cocker spaniel, poodle, shar pei, bull dogs
- Bradycephalic breeds
- Cats- Burmese
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Opthamology
Disease
Prolapse of third eyelid gland (cherry Eye)
Clinical Signs
- Pink mass protruded from medial canthus
- Ocular discharge and conjunctivitis
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Opthamology
Disease
Prolapse of third eyelid gland (cherry Eye)
Treatment
- medical management provides only temporary relief
- Systemic and topical therapy
- antibiotics and corticosteroids
- Surgical repair is recommended
- Removal of gland or securing gland down
- Tack down
- Complete removal of gland can cause KCS
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Opthamology
Disease
Keratonconjunctivistis Sicca KCS
- Inflammatory and degenerative changes of the cornea and conjuctiva caused by reduced tear secretion
- KCS may be primary (Lacrimal secreation failure) or Secondary (failure of tear delivery)
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Opthamology
Disease
Keratonconjunctivistis Sicca KCS
Causes
- Primary
- Infection
- Immune mediated (genetic)
- Cocker spaniels, shitzu, bull dog, Llasa apso
- Drug toxicity- sulfa products
- Truama
- Secondary
- Infection
- allergic
- Chemical
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Opthamology
Disease
Keratonconjunctivistis Sicca KCS
Clinical signs
- Conjunctivitis and ocular discharge
- Corneal ulcer
- Neovasculariazation and corneal scarring
- Loss of vision
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Opthamology
Disease
Keratonconjunctivistis Sicca KCS
Diagnosis
- Schirmer Tear Test
- Diagnostic if low tear production
- <21 mm/min
- Corneal stain
- Conjunctival scrape and culture
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Opthamology
Disease
Keratonconjunctivistis Sicca KCS
Treatment
- Stimulate lacrimation
- Topical cyclosporine
- Provide lubrication
- Methylcellulose or polyvinyl alcohol
- Treat for bacterial infection
- Antibiotics
- Reduce conjunctivis
- Costicosteroids
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Opthamology
Disease
Glaucoma
- Elevation of intraocular pressure causing buphthalmos
- Normal intraocular pressure (IOP)
- 15-30 mmhg
- Glaucoma
- Primary
- Genetically determined
- Secondary
- any ocular disease that results in the obstruction of aqueous outlfow
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Opthamology
Disease
Glaucoma
Causes
- Primary- unknown and genetic
- Secondary
- Uveitis
- Lens luxation
- Tumors
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Opthamology
Disease
Glaucoma
Clinical Signs
- Acute Glaucoma
- Ocular discharge and pain
- Conjunctivitis
- Vascular congestion
- Blindness
- Chronic glaucoma
- Globe enlargement (buphthalmus)
- Corneal edema- turns white
- Lens luxation
- Tapetal hyperreflexivity
- Irreversible vision loss
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Opthamology
Disease
Glaucoma
Diagnosis
- Measure intraocular pressure
- Schiotz tonometer
- Gonioscopy
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Opthamology
Disease
Glaucoma
Treatment
- Immediate control for pressures over 50mmhg
- Hyperosmotic
- Mannitol 1-2g/kg IV over 30-45 min.
- Carbonic Anhydrase inhibitors
- Decrease aqueous production
- Dichlorphenamide (Daranide)
- dog 2-4mg/kg PO Bid- TID
- Cat 1-2 mg/kg PO Bid- Tid
- Methazolamide
- Acetazolamide
- Topical autonomic agents
- Timolol
- Pilocarpine 2%
- Treatment for secondary ocular disease
- Long Term Treatment
- medical
- Carbonic anhydrase inhibitors
- Pilocarpine
- Rarely effective for long term
- Surgical
- Laser cyclophotocoagulation
- Destroys ciliary body, thus reducing aqueous production
- Transscleral cyclocryotherapy
- Freeze ciliary body
- Enucleation
- Salvage for pain
- Athropine never with an animal on Glaucoma
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