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2015 Technician CE for the Upstate 2/22/2015 My technicians Large & Exotic Animal Ophthalmology Sonia Kuhn, DVM Upstate Veterinary Specialists February 22, 2014 1 2015 Technician CE for the Upstate Horses 2/22/2015 Normal Equine Eye Corpora Nigra Cystic Corpora Nigra Eyelid Lacerations Eyelid Lacerations Corneal Ulcers 2 2015 Technician CE for the Upstate 2/22/2015 Corneal Ulcers Corneal Ulcers Deep Corneal Ulcers Corneal Perforation Corneal Ulcers Stromal Abscess Topical antibiotics Anti-melting drugs Dilating agents Systemic antiinflammatories • Conj graft • Corneal transplant • • • • 3 2015 Technician CE for the Upstate Stromal Abscess • Etiology – Ulcer that healed and trapped organisms/white blood cells – Sterile – Bacterial – Fungal • Cases can be clustered within a farm Equine Recurrent Uveitis • Autoimmune intraocular inflammation • Leptospirosis as inciting cause in some cases • Must be RECURRENT Cyclosporine Implant for ERU 2/22/2015 Stromal Abscess Management • Medical: – Aggressive topical and systemic anti-inflammatories – Topical antibiotics/antifungals • Surgical: Some form of taking the affected piece of cornea out and replacing it with a new piece Equine Recurrent Uveitis • #1 cause of cataracts in horses • Appaloosas • Aggressive antiinflammatories • Cyclosporine implants • Poor long-term prognosis Cyclosporine Implant for ERU 4 2015 Technician CE for the Upstate 2/22/2015 Cyclosporine Implant for ERU Cyclosporine Implant for ERU Ocular Squamous Cell Carcinoma (SCC) Ocular Squamous Cell Carcinoma (SCC) • Limbus (cornea/conj) • Third eyelid • Eyelids • Numerous therapies • Early intervention is key!! • Lack of periocular pigment • Predisposed breeds – Paints – Appaloosas – Drafts Farm Animals Normal Camelid Eye 5 2015 Technician CE for the Upstate 2/22/2015 Bovine Pink Eye • Moraxella bovis • Summer • Fomites and flies as vectors – M bovis can live on the legs of flies for 3 days! • Young cattle • Cost $150 million/year Infectious Keratoconjunctivitis Bovine Pink Eye • Antibiotics – Oxytetracycline (LA-200) – Tulathromycin (Draxxin) • • • • Avoid steroids Fly control Shade Vaccines? Plant Foreign Bodies • Goats and Sheep • Ulcers less common • Organisms – Chlamydophila – Mycoplasma • Treatment = topical or IM oxytetracycline Ocular SCC • • • • • • • “Cancer Eye” Older animals Herefords UV exposure 75% are limbal Locally invasive Mets late, up to 5% of cases Ocular SCC • 4th leading cause of carcass condemnation • Costs $20 million in losses/year • Enucleation 6 2015 Technician CE for the Upstate 2/22/2015 Orbital Lymphoma Dermoids • Cornea • Limbus • Third Eyelid Entropion in Lambs Exotic Animal Eye Diseases • • • • • Entropion in Fat Pigs Reptiles & Amphibians Trauma Infectious Nutritional Husbandry Aging 7 2015 Technician CE for the Upstate Spectacle • Clear covering over cornea • Subspectacular space • Snakes (fused eyelids) • Geckos • Should be shed with the skin (ecdysis) • Blocks topical meds! Subspectacular Abscess 2/22/2015 Retained Spectacle • Dysecdysis (poor shedding) • Poor husbandry • Mites • Soaks • Acetylcysteine • Do not remove it with forceps! Subspectacular Abscess • Abscess between spectacle and cornea • Causes – Penetrating trauma – Stomatitis – Hematogenous • Drainage • Antibiotics Substrate Accumulation • • • • Geckos Poor husbandry Moisture Gentle manipulation Lipid Keratopathy in Frogs • Females most commonly • Underlying cause unknown • High cholesterol diet implicated • Can have high serum cholesterol 8 2015 Technician CE for the Upstate Lipid Keratopathy in Frogs 2/22/2015 Congenital Abnormalities Birds Tubular Globe Scleral Ossicles Avian Third Eyelid • Bones in the sclera 9 2015 Technician CE for the Upstate Avian Ocular Anatomy Ocular Trauma Modified Evisceration 2/22/2015 Avian Pecten Avian Globe/Head Proportions Modified Evisceration 10 2015 Technician CE for the Upstate Modified Evisceration 2/22/2015 Post-op Modified Evisceration Pocket Pets Rabbits • Encephalitozoon cuniculi • Contaminated urine • Renal disease • Neurologic disease • Lens infection in utero • Uveitis • Iris abscess • Cataract Rabbits • Dacryocystitis – Infection/inflammation of NL duct – Often related to tooth problems (50% of cases) – Can be very hard to treat – 6 weeks = avg duration of tx – Complete recovery in 43% Rabbits • Dacryocystitis • Rabbits only have 1 NL puncta and it ventral! 11 2015 Technician CE for the Upstate 2/22/2015 Rabbits- NL duct flush Rabbits • Cherry eye • Prolapse of the gland of the nictitans • LARGE! • Surgical reduction Rabbits Surgery for Rabbit Cherry Eye • Cherry Eye Guinea Pigs Questions/Comments? • Heterotopic bone formation in the eye 12
