Ophtho2- Uvea

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  1. The uvea is aka the __________.
    vascular tunic
  2. What are the 3 regions of the uvea?
    iris, ciliary body, choroid
  3. What is the anterior most portion of the uvea?
    the iris
  4. What are the functions of the iris? (2)
    • regulates the amount of light entering the posterior portions of the eye
    • blood aqueous barrier
  5. Anterior SEGMENT versus posterior SEGMENT
    • anterior segment= everything in front of the lens
    • posterior segment= behind the lens (vitreous, choroid, retina)
  6. anterior CHAMBER versus posterios CHAMBER
    • anterior chamber= in front of the iris
    • posterior chamber= behind the iris
    • [both are within the anterior segment]
  7. What are the muscles of the iris? (2)
    • sphincter muscle (smooth muscle under involuntary parasympathetic control)
    • dilator muscle (smooth muscle under involuntary sympathetic control)
  8. Describe the innervation to the sphincter muscle of the iris.
    parasympathetic control from CN III
  9. The iris sphincter muscle can be blocked (causing mydriasis) with ____________, such as... (2)
    parasympatholytic agents; topical Tropicamide or atropine
  10. Describe Horner's Syndrome. (1 cause, 6 signs)
    sympathetic denervation of the eye--> miosis, ptosis, enophthalmos, prolapsed third eyelid, ocular hyperemia, (horses only) unilateral sweating
  11. What is the corpora nigra?
    aka granula iridica; in herbivores, these are the extension of the posterior epithelium into the pupil and appear as pigmented, irregular masses; normal finding
  12. Where does outflow of aqueous humor occur?
    iridocorneal angle
  13. Describe the outflow of aqueous humor.
    ciliary epithelium--> between the iris and the lens--> pupil--> anterior chamber--> iridocorneal angle--> trabecular meshwork--. scleral venous plexus
  14. What are the 2 components of the ciliary body?
    pars plicata (superior/ dorsal), pars plana (inferior/ ventral)
  15. The ciliary body is located...
    posterior to the iris
  16. The ciliary body is under ____________ control; inflammation results in __________.
    parasympathetic; contraction
  17. What are the functions of the ciliary body? (3)
    • it gives rise to ciliary processes, which produce aqueous humor
    • blood-aqueous barrier
    • accommodation
  18. The vascular core of the ciliary body is covered by __________, which is one site of the ____________; when this is disrupted, ___________ results clinically.
    2 layers of epithelium; blood-aqueous barrier; aqueous flare
  19. The ciliary body gives rise to the ____________, which...
    lenticular zonules; attach to the lens, so when the ciliary body contracts, tension on the zonules is relaxed, allowing the lens to thicken [accommodation]
  20. Aqueous humor production by the ciliary processes is by a combination of....
    • passive filtration
    • diffusion
    • active secretion- under the control of carbonic anhydrase
  21. When there is loss of zonular support, it leads to...
    lens luxation.
  22. The choroid is located...
    in the posterior portion of the uvea, from the ciliary body to the optic nerve.
  23. What is the function of the choroid? (2)
    • provides nutrition for the outer portions of the retina (rods and cones) in dogs, cats, and cows; provides nutrition to the entire retina in horses
    • cools the highly metabolically active retina
  24. What is the tapetum lucidum?
    • shiny part of the choroid (in the vascular tunic) that reflects and amplifies light, allowing animals to see in the dark
    • cellular in carnivores and fibrous in herbivores
  25. What is a pathognomonic sign of retinal thinning?
    tapetal hyperreflection- tapetum appears much brighter than normal
  26. The tapetum is not __________.
  27. All red eyes, painful eyes, blind eyes, eyes with anisocoria, and eyes with anterior uveitis should have...
    • intraocular pressures taken
    • Normal 10-20mmHg
    • Glaucoma > 30mmHg
    • Anterior Uveitis <7-10mmHg
  28. What are persistent pupillary membranes? (5 principals)
    • congenital hereditary (autosomal recessive in basenjis)
    • remnants of fetal iridal vascular arcades, which originate from the collarette zone of the iris 
    • fail to regress
    • attach to corneal, iris, or lens
    • must r/o synechiae
  29. What is the treatment of persistent pupillary membranes?
  30. What is heterochromia?
    • part or all of the iris stroma lacks pigment, resulting in a variation of color within or between the irises
    • associated with dilute coat color (blue merle, siamese, harlequin)
  31. What is the clinical significance of heterochromia?
    alone it has no significance, but it can be associated with other ocular or systemic abnormalities (deafness, blindness)
  32. What is coloboma?
    • a notch defect in the iris, usually in the inferonasal portion of iris
    • must differentiate from iris atrophy
  33. Iris cysts are _________ lesions that can occur in... (3)
    acquired; dogs, cats, horses
  34. What is an iris cyst?
    cystic accumulation of aqueous humor within a layer of the posterior iris or ciliary body epithelium; can be attached or break free and float around
  35. How can you differentiate an iris cyst from a ocular mass on exam?
    a cyst allows light to pass through it (transilluminates), while a melanoma mass will not
  36. What is the treatment of iris cysts? (3 options)
    none (benign neglect), laser ablation, irrigation/ aspiration
  37. What is the clinical significance of iris cysts in cats?
    they cause increased intraocular pressure
  38. Primary iris atrophy is most often seen in __________, and it must be differentiated from ___________ clinically.
    small breed old dogs; coloboma
  39. Iris atrophy can be secondary to __(2)__.
    uveitis or glaucoma
  40. Iris atrophy leads too...
    decreased PLR; differentiate it from neurologic causes of decreased PLR
  41. How is iris atrophy treated?
    it's not
  42. What are clinical signs of anterior uveitis? (8)
    • miosis
    • aqueous flare (continuous beam of light from the cornea to the lens)
    • redness
    • photophobia
    • pain - epiphora, blepharospasm, rubbing eyes
    • keratic precipitates- accumulations of protein and mononuclear cells, usually indicate granulomatous anterior uveitis
    • hypotony- decreased intra-ocular pressure
    • diffuse corneal edema
  43. What are etiologies of anterior uveitis? (9)
    • Ocular: corneal ulceration, lens induced (hypermature cataract), ocular trauma, primary ocular neoplasia
    • Systemic: bacteremia, viremia, septicemia, autoimmune, secondary to metastatic neoplasia
  44. When trying to determine the cause of anterior uveitis,...
    rule out ocular causes first (only 4 ocular causes of anterior uveitis)
  45. What are primary ocular neoplasias? (3)
    • melanoma
    • adenoma/ adenocarcinoma originating from the ciliary body
    • spindle cell sarcoma (cats only)
  46. What are commonly neoplasias that secondarily go to the eye? (5)
    • lymphosarcoma 
    • metastatic carcinoma
    • undifferentiated sarcoma (histiocytic sarcoma), hemangiosarcoma, osteosarcoma, etc
  47. In dogs, the majority of systemically caused anterior uveitis is ____________; other causes include.. (2)
    idiopathic/ immune-mediated; neoplasia, systemic infectious disease
  48. What is Uveo-dermatologic syndrome, and what are its components?
    auto-immue disorder directed against melanin [dogs]; poliosis, vitiligo, uveitis
  49. What systemic infectious diseases can cause uveitis in dogs? (8)
    Ehrlichia canis, Blastomycosis dermatitidis, Crypto, Histoplasmosis, Rocky Mountain Spotted Fever, Dirofilaria immitis, Lyme Disease, Leishmaniasis
  50. The majority of anterior uveitis in cats is caused by __________; other causes include...
    idiopathic/ immune- mediated; systemic infectious disease, neoplasia (least)
  51. What infectious diseases cause uveitis in cats? (6)
    FeLV, FIP, Toxoplasma, FIV, Cryptosporidium, Bartonella
  52. Describe the "specific treatment" for anterior uveitis.
    • directed towards the inciting cause
    • requires correct identification of etiologic agent
    • antimicrobials, immunotherapies, chemotherapy, etc
  53. What are the non-specific treatments for anterior uveitis? (3)
    • Topical atropine (parasympatholytic): reduce pain by dilating pupil
    • topical corticosteroids or NSAIDs (not with an ulcer!): reduce discomfort and inflammatory mediators
    • systemic NSAIDS: only with involvement of posterior uvea, if there's an ulcer, or if no response to topical
  54. What are sequelae of anterior uveitis? (6)
    anterior +/- posterior synechia, cataracts, glaucoma, blindness, phthisis bulbi (shrunken, non-functional eye), lens luxation
  55. What is the etiology of equine recurrent uveitis? (1 main, 6 underlying)
    • [all postulated, not proven] Leptospira, Onchocerca, viral infection hypersensitivity, Toxoplasmosis, Brucellosis, Streptococcal
  56. What are clinical signs of equine recurrent uveitis? (6)
    • same as uveitis+
    • chorioretinitis (butterfly lesions around optic nerve)
    • synechia
    • atrophy of corpora nigra
    • cataract
    • chorioretinal scars
    • blindness
  57. What is the treatment for equine recurrent uveitis? (3)
    • Active phase: atropine, prednisolone acetate topical drops, systemic banamine
    • Inactive disease: cannot reverse effects
  58. The choroid has extremely __________; therefore...
    high blood flow; it is predisposed to blood borne diseases and posterior uveitis (bacteremia, septicemia, mycotic infections, disseminated neoplasia)
  59. The __________ is one of the few places in the body where you can directly view blood vessels; therefore,...
    choroid; the eye is an excellent location to look for vasculitis and bleeding disorders.
  60. The posterior uvea is predisposed to what auto-immune diseases? (2)
    • SLE
    • uveo-dermatologic syndrome
  61. Signs of chorioretinitis. (8)
    • thinning of retina (tapetal hyperreflection)
    • fundic depigmentation
    • hemorrhage
    • vasculitis
    • edema
    • transudate
    • exudate (granulomatous, non-granulomatous)
    • +/- retinal detachment
  62. What is the treatment for posterior uveitis? (2)
    • if infectious, carprofen (SA) or banamine (Eq)
    • corticosteroids if etiology does not contraindicate it
  63. What is hyphema?
    blood in the anterior chamber of the eye
  64. What are differentials for hyphema? (7)
    • coagulopathy/ vascular disorder
    • trauma
    • intraocular neoplasia
    • hypertension
    • sequelae of anterior uveitis
    • retinal detachment
    • seen with other ocular anomalies (Collie eye)
  65. All eyes with hyphema should have __________ performed.
    intra-ocular pressures
  66. What is the treatment for hyphema?
    treat underlying cause
  67. Prognosis is better with __________ than __________ trauma.
    sharp; blunt
  68. Iris prolapse is always associated with ___________; principals of treatment include...
    • anterior uveitis
    • avoid topical ointments until the fibrous tunic is repaired (will cause granulomatous inflammation in the eye), atropine, antiinflammatories, surgical repair
  69. Intraocular neoplasia can result in... (6)
    • intraocular hemorrhage
    • uveitis
    • lens displacement
    • cataracts
    • glaucoma
    • retinal detachment
  70. What are differences in ocular melanoma between dogs and cats?
    • Dogs- usually benign, enucleate only if mass interferes with normal ocular function, young retrievers are predisposed (hereditary)
    • Cats- usually metastasizes, all tumors should be enucleated
  71. What are characteristics of adenoma/ adenocarcinoma of the ciliary body?
    • may be benign or malignant
    • enucleate if mass interferes with normal ocular function
  72. What are the tunics of the eye and the components of each?
    • Fibrous tunic: cornea and sclera
    • Vascular tunic: uvea (iris, ciliary body, choroid)
    • Nervous tunic: retina
  73. Define the fundus.
    Everything behind the iris: retina and choroid
  74. What is synechia?
    adhesion of the iris to the cornea (anterior synechia) or to the lens (posterior synechia)
Card Set:
Ophtho2- Uvea
2016-10-25 19:42:24
vetmed ophtho2

vetmed ophtho2
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