1. Chronic Superficial Keratitis (Pannus)
Pannus—superficial corneal vascularization/scar tissue
Progressive, bilateral, can result in blindness
Cause
Thought to be immune-mediated
(Infiltration of cornea with lymphocytes, plasma cells)
Increased ultraviolet light/high altitudes increases incidence
Signs
Opaque lesions that begin at limbus and extend into cornea
Milky, pink, or tan

2. Chronic Superficial Keratitis (Pannus)

3. Chronic Superficial Keratitis (Pannus)
Breeds
Ger. Shep, B. Collie, greyhound, Sib. Husky Dx
r/o KCS, corneal ulcers Rx
Corticosteroids often lifelong
Cyclosporine often lifelong
Antibiotic eye ointment
Client info
No cure
If Rx is stopped, disease will return and progress
High altitudes and ↑sun predispose animals

4. DOGGLES!!!!

5. Keratoconjunctivitis Sicca (KCS)
Lack of tear production; tears lubricate, nourish, ↓bacteria, aid in healing
Tears from 2 glands: 70%--Lacrimal gland; 30%--Nictitans gland
Signs
Recurrent conjunctivitis, corneal ulcers, keratitis
Dull, dry, irregular cornea, conjunctiva
Tenacious, mucoid ocular discharge
Blepharospasm
Crusty nares Rx
Tear stimulation—cyclosporine, pilocarpine
Artificial tears
Client info
Px is guarded for resolution
Failure to treat → blindness

6. KCS

7. Cataracts
Opacity of lens that causes reduced vision; most common disease of lens
Cause
Genetic
2º to:
Diabetes mellitus (bilat; within 1 y of disease; ↑glucose → ↑fluid in lens)
Most common cause
Trauma (unilateral; HBC, thorn penetration, shotgun pellet)
Lens luxation
Nutritional deficiency
Uveitis
Hypocalcemia
Electrical shock Rx
Surgical removal of lens
Treat underlying cause (e.g., Diabetes)
Client info
Most cataracts are inherited, so don’t breed affected dogs
Dogs can live quality lives even with bilat. cataracts

10. Cataracts Signs Dx Progressive loss of vision Opaque pupillary opening
Must be distinguished from senile nuclear sclerosis
Normal old age change; graying of lens; bilat; usually does not affect sight

11. CATARACTS

13. Progressive Retinal Atrophy
A group of hereditary disorders causing loss of rods, cones, and/or blood supply
Breeds
Toy/min. Poodle, G. Ret, I. Set, C. Span, Schnauzer, Collie, Samoyed, N. Elkhound
Recessive gene isolated in some breeds
Signs—slow onset of blindness
Loss of night vision (rods) → loss of day vision (cones)
→ cataracts (±) Dx
r/o metabolic disorders that could cause cataracts
Ophth exam
gray, granular appearance of retina
Hyperreflective retina
Vascular attenuation, optic nerve atrophy

15. PROGRESSIVE RETINAL ATROPHY
Normal canine retina
PRA, optic nerve atropy and vessel
attenuation

16. Progressive Retinal AtrophyRx
None
Client info
This is an inherited disease
Avoid buying affected breeds
Have ophth exam by board certified ophth to r/o PRA
Blind animals adapt well
Have trouble in strange surroundings
Cats need well balanced diet
Taurine deficiency can lead to PRA

17. Anterior Uveitis Inflammation of uvea: ciliary body, iris, choroid
Causes
Inflammation/infection – FeLV/FIP, fungal, bacterial
Neoplasia
Trauma

18. Uveitis – Clinical Signs
Blepharospasm
Aqueous flare – increased turbidity of aqueous humor
Miosis of affected eye
Iridal swelling or congestion
Keratic precipitates
Ciliary flush in limbal region
+/- Corneal edema
+/- hyphema

19. Anterior Uveitis – hyphema

20. Anterior Uveitis

21. Anterior Uveitis – keratic precipitates

22. Anterior Uveitis – Treatment
Topical steroids or
Topical Anti-inflmmatory drugs (ocufen)
Or systemic steroids
Atropine – dilates eye, decreases pain
Antibiotics – topically +/- systemically

23. Anterior Uveitis – Client Info
Recheck within 3 days
Secondary glaucoma is frequent complication
Prognosis depends on cause
Treat for 2 months regardless of cause – blood-aqueous barrier disrupted for 6 weeks

24. Proptosed Globe Cause Clinical Signs Trauma Conformation
Retrobulbar abscess or neoplasia
Clinical Signs
Protrusion of the globe,
Eyelids unable to close, may be trapped behind globe

25. Prognosis Favorable Unfavorable indicators brachycephalic dog,
positive direct or consensual pupillary light response
normal findings on posterior segment exam
proptosed eye with vision on initial presentation
Unfavorable indicators
non-brachycephalic
cat breed
hyphema,
no visible pupil
facial fractures
optic nerve damage and avulsion of 3 or more extraocular muscles

26. Proptosed Globe

27. Proptosed Globe – Treatment
Lubricate immediately
Reduce the globe into the socket ASAP to reduce trauma to optic nerve
Enucleation if optic nerve severed
Systemic and topical antibitics
+/- Steroids

28. Proptosed Globe

29. References http://www.vetmed.ucdavis.edu/courses/vet_eyes/
Alleice Summers, Common Diseases of Companion Animals