eye test part 2

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  1. entropion
    • rolling inward of the lid margin
    • contact between hair and cornea
    • common in dogs less in cats
  2. what breeds is entropion related to
    • Shar Pei
    • Retriver
    • Pointer
    • Setters
  3. what are entropion usually seen in
    • pups or young dogs
    • breed, anatomic
  4. what is entropion secondary to
    • blepharospasm
    • infection, injury
    • corneal disease/changes
  5. what is the diagnosis for entropion
    • physical exam findings
    • spastic forms can be ruled out with topical anesthetics
  6. what is the treatment used for entropion
    • Hotz-Celsus procedure
    • Char Pei may only require tacking sutures
    • 2 roles of tissue and suture it when taken out back to normal
  7. customer education of entropion
    • surgical procedure requires general anesthesia
    • procedure may need revision
    • report any changes notes post operation like blepharospasm, haziness, redness,  and discharge
    • may need to be repeated
  8. ectropian
    • rolling outwar of the lower lid margin
    • normal in some breeds like blood hounds and basset
    • genetic, congenital, or due to injury to others
  9. what does ectropion lead to
    • conjunctivitis
    • maybe corneal disease
  10. what is the diagnoses for ectropion
    physical exam findings
  11. what is the treatment for ectropian
    surgical-wedge resection
  12. client education on ectropion
    surgery, post operation
  13. distichiasis and trichiasis
    • both are inherited
    • chronic disease can stimulate lash growth
    • eyelash problems
    • angles back and touch cornea
  14. distichiasis
    lashed growing form an abnormal area of the lid margin
  15. trichiasis
    • lashes originate from normal area but turn inwards contacting the cornea
    • need split lamp
  16. what does distichia and trichiasis produce
    • some level of cornea disease
    • minimal to severe
    • keratitis/ulcers
    • blepharospam and epiphora
    • need high level of magnification like good direct scope or slit lamp
  17. what treatment is used for distichia and trichiasis
    • electroepilation
    • cryoepilatioon
    • plucking
    • surgery of lid
    • *all surgical in nature*
  18. client education for distichia and trichiasis
    • can recur but revisions lower recurrences
    • report recurrence of signs
    • trouble with meds
  19. eyelid growth
    • varies in species
    • dog benign- MGA meibomian gland donoma
    • cats malignant-SCC, FSA
    • clinical signs depends on type
  20. treatment for eyelid growth
    • past surgery depends on type
    • SX resection if less than 1/3 of lid margin
    • radical excision/other procedures in malignancies
  21. client education on eyelid growth
    depends on what type they have
  22. what are the causes of corneal ulceration
    • trauma is number 1
    • chemical burn from shampoo in eyes
    • infection-bacteria, virus, fungus
    • tear abnormals
    • cilia abnormalities  and exposure
  23. corneal ulceration exams
    may or may not reveal obvious detects if it does its blepharospam and corneal edema-focci or diffused
  24. what test do we use to verify corneal ulceration problems
    • STT- shimmer tear test, make sure vet wants to do this causes has to be done first
    • fluorescein stain
    • slit lamp to get idea of depth
  25. treatment for corneal ulcers
    • atropine for pain relief
    • antimicrobial
    • additional, tear and surgery to protect from 2nd infection
  26. client education for corneal ulcers
    • let them know of recurrence of symtoms or lack of reponse
  27. how does dendritic corneal ulcers look
    light bulb/ tree branch looking stain
  28. how does punctate corneal ulcers look like
    • spotted usually mean herpes
    • causes discomfort
  29. indolent ulcers
    • corneal ulcer refractory to treatment
    • can be breed related in boxers
    • if this kind of ulcers should  heal after 7 days
  30. what treatment can you do for indolent ulcer
    • surgical "roughening" which is breaking back loose tissue to make it rough or grid
    • non surgical-serum drops which is the serum from own blood put in eye
  31. what is the client education on indolent ulcers
  32. what is descmetes membrane
    deepest layer of cornea is all that's left
  33. deep ulcers and descemetoceles
    • bulges forward
    • eyes close to rupture
    • peculiar staining patters vs deep ulcers
    • doughnut of stain
  34. what is the treatment for deep ulcers and descemetoceles
    • urgent to emergency situation
    • surgical grafts or other stabization
  35. what is the client education on deep ulcers and descemetoceles
    • severity should be emphasized
  36. corneal injury/trauma
    • physical or chemical entities like foreign bodies or direct trauma
    • signs same for corneal ulcers
    • additional test to verify like good magnification and staining
  37. what is the treatment for corneal injury/trauma
    • based on the problem but can be medical management or surgical intervention
    • repair for FB removal/keratectomy
  38. what is the client education for corneal injury/trauma
    • surgical risks and recheck
    • importance of meds
    • sutures/appearance if surgical sites
  39. corneal sequestration
    • mainly a problem in cats don't know why but can be herpes
    • dark plaque on or in cornea-asymptomatic to significant irritation
    • use stain to refute ulceration
  40. what is the treatment for corneal sequestration
    • treatment based on symptoms that resolve with time
    • keratectomy with additional supportive graft
  41. what is the client education on corneal ssequestration
    dependent on treatment
  42. keratitis
    inflammation of the cornea cause by injury and irritation from other disease, immune or allergic reaction, infection, or birth defects
  43. what are the varies signs of severity and location with keratitis
    • superficial, interstitial, deep
    • ulcerative and non ulcerative
    • punctate
    • pigmentary
  44. what is the diagnostic test for keratitis
    • based on suspected cause but can be thorough exam-mag, stain, STT
    • cytology and C/S
    • systemic testing like CBC, GHP, immune panel
  45. what is the treatment for keratitis
    • antimicrobials
    • steroids
    • others like tears, chemo, ect.
  46. what is the client education on keratitis
    dependent on the disease process
  47. keratoconjunctivitis sica (KCS)
    • dry eye syndrome
    • tear produced by several glands which is 75% from the gland of the third eyelid
  48. what are some reasons KCS happened
    reduction mainly from the aqueous portion but can be immune mediated, chemical/toxin, neurologic disease, infections, or tumors that caused this
  49. what  are signs of KCS
    drying of the cornea and blepharospasm, keratitis-pigmentary, thick purulent looking discharge
  50. what is the diagnostics for KCS
    • its the most underdiagnosed eye disease but can do STT and staining
    • some will get ulcers because of inflammation
  51. what is the treatment in KCS
    • basic replacement of tears but cyclosporine topically which increases tear production 80-88% of the time and is FDA approved
    • pilocarpine either topical or oral
    • surgical procedures from the eye to corner of the eye
  52. what is the client education on KCS
    patience and good compliance with meds
  53. cherry eye
    • prolapse of the third lid gland
    • rotate up
    • reduce of tear production
    • very rarely self reduce which is goes back down
  54. what is the underlying cause of cherry eye
    • genetic/breed related
    • cartilage change with release of anchor
    • brachycephalics, beagles, American cocker
  55. what are some clinical appearance diagnostics of cherry eye
    occasional inflammation and tumor or lymphoid hyperplasia
  56. what is the treatment for cherry eye
    • best is surgical reduction
    • worst is removal
  57. what is the client education for cherry eye
    patience, surgical intervention, and tears
  58. conjunctivitis-inflammation
    • may be disease or just a symptom
    • causes can be organisms, foreign matters- material aerosolized, allergic reaction, anatomical abnormalities, deeper eye disease
  59. what are some test needed when conjunctivitis is complicated
    • scraping
    • C/S
    • systemic labs
  60. what is the treatment for conjunctivitis
    • topical or systemic
    • antimicrobials or anti-inflammatories
    • correction of the anatomical or systemic defect
  61. client education for conjunctivitis
    some problems chronic (herpes), not zoonotic
  62. what is epiphora caused by
    • -obstructed NL system
    • lack of a puncta
    • acquired obstruction (dacorocystitis, FB)
    • -excessive tearing sometimes no tear duct or inflammation in tear duct can be painful which is caused by lid disease (entr, distichia, trichiasis, inflammation) or third eye lid condition (prolapse, injury) or conjunctivitis or keratitis
  63. what is the diagnostics for epiphora
    • flushing of the NL system
    • c/s
    • rarely rads of nasal passage
  64. what are some additional treatments for epiphora
    • topical antimicrobials and aniinflammatories
    • surgical creation of a puncta
  65. what is the client education on epiphora
    surgical risks, recurrence of signs
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eye test part 2
2013-09-25 01:19:22
eye test part

eye test part 2
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