Feline and miscellaneous conditions of ophthalmology

• What are the presenting signs of Eosinophilic keratitis?

  Cottage cheese deposits. White to pale pink elevated spots on the cornea - may coalescence into a raised plaque.
• What is the aetiology of Eosinophilic keratitis?

  Immune mediated, possible connection with FHV-1.
• What is the diagnosis of Eosinophilic keratitis?

  Clinical appearance/cytology: mixed cellular infiltrate.
• What is the treatment for Eosinophilic keratitis?

  Topical corticosteroids (or ciclosporin) successful in most cases.
• Is Eosinophilic keratitis unilateral or bilateral?

  Usually unilateral (may be bilateral in predisposed breeds).
• What are the presenting for corneal sequestrum?

  Varies from amber corneal discolouration to dark brown plaque.
• What is the aetiology of corneal sequestrum?

  Cause remain unknown, chronic irritation may predispose e.g. brachycephalic conformation, entropion, grid keratotomy.
• How do you diagnose corneal sequestrum??

  Based on the characteristic clinical appearance.
• What is the treatment for corneal sequestrum?

  Ideally keratectomy +/- graft placement (may require referral); sometimes lesions will slough over time.
• Is corneal sequestrum unilateral or bilateral?

  Can be either.
• What are the presenting signs of feline diffuse iris melanoma (FDIM)?

  Hyperpigmented iris spots, usually progressing to diffuse hyperpigmentation of whole iris +/- abnormalities in pupil shape +/- uveitis/glaucoma.

  It is a neoplastic condition.
• How do you diagnose feline diffuse iris melanoma (FDIM)?

  Suspect from clinical appearance. Histopathology for definitive diagnosis.
• What is the treatment for feline diffuse iris melanoma (FDIM)?

  Enucleation with histopathology if high index of suspicion.
• Is feline diffuse iris melanoma (FDIM) unilateral or bilateral?

  Unilateral.
• What are the clinical signs of Horner’s syndrome?

  Third eyelid protrusion

  Anisocorias (different pupil sizes)

  Ptosis (drooping of upper eyelid).

  Eye is sunken in slightly.
• How do you diagnose Horner’s syndrome?

  Based off of the clinical signs.

  Confirm diagnosis with the phenylpherine test.
• What nerve is affected in Horner’s syndrome?

  The sympathetic supply to the eye.
• How do you treat Horner’s syndrome?

  Do not need to treat, monitor as eye is comfortable, most cases resolve in 1-6 months, if it keeps developing can send for an MRI.
• What are the most common neurological diseases affecting the eye?

  Horner’s syndrome (common)

  Facial paralysis.

  Neurogenic KCS.
• Neurogenic KCS

  Nerve affected is the parasympathetic.

  Unilateral

  Dry ipsilateral nostril common.

  May see secondary to otitis media.

  Some respond to treatment with oral pilocarpine.
• What are the most common neoplastic diseases of the eye?

  Eyelid masses in dogs - most are benign (e.g. meibomian adenomas)/

  Uveal neoplasia - FDIM in cat, iris melanoma in dog most common.

  Others include: lymphoma, iridociliary adenoma/adenocarcinoma, feline post traumatic sarcoma, metastatic neoplasia.
• Iris cysts

  Start behind the iris, develop from the ciliary body epithelial then float to the front of the eye. Can get light going all the way through them, don’t need to do anything about them unless they start interfering with vision, then refer them to get them drained. Differentiate from neoplasia.

  
• What is chronic superficial keratitis (CSK) aka pannus?

  Characterised by:

  • Cellular infiltrate into cornea with vascularisation.
  • +/- pigment deposition.
  • +/- lipid deposition.

  Non-painful, may affect vision if untreated.

  Breed predisposition in GSD, Belgian Shepherd and Greyhound.

  May see alongside ‘plasmoma’ of the third eyelid.
• How do you diagnose chronic superficial keratitis (CSK) aka pannus?

  Diagnose based on clinical appearance +/- cytology (lymphoplasmacytic inflammation).
• What is the treatment for chronic superficial keratitis (CSK) aka pannus?


  Topical corticosteroids and/or ciclosporin.