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Comparative Veterinary Ophthalmology: Quicktime and A Yuv420 Codec Decompressor Are Needed To See This Picture
Comparative Veterinary Ophthalmology: Quicktime and A Yuv420 Codec Decompressor Are Needed To See This Picture
OPHTHALMOLOGY
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Lights
Pelican Lights
Pelican Lights Web Site WelchAllyn Web Site
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Lenses
• Cotton Balls
• Maze Testing
Menace Response
• This is a response and
it is learned.
• The endpoint is a
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Cotton Balls
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Maze Testing
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Video provided by
Sinisa Grozdanic D.V.M., Ph.D. Iowa State University
Gross Evaluation of the Head
• Symmetry
– Compare one side with the other
Gross Evaluation of the Head
• Step back and compare the palpebral
fissures for their size, symmetry, position
of the upper eyelid cilia and the general
eyelid form, as well as characterization of
any ocular discharge.
• Ocular discharge if present should be
characterized as serous, mucoid, purulent,
hemorrhagic, seromucoid, mucopurulent, or
serosanguinous.
Gross Evaluation of the Head
– The position of the upper eyelid cilia normally should be
directed nearly perpendicular -semivertical to the
corneal surface. Subtle ptosis or drooping of the eyelid
without noticeable narrowing of the fissure would be
detected by observing more ventrally directed cilia.
Horner's syndrome: sympathetic denervation (ptosis,
miosis, enophthalmia, prolapsed third eyelid) can be due
to pre or post ganglionic sympathetic denervation.
Pupillary symmetry
• Palpebral Reflex
• Corneal Reflex
• Dazzle Reflex
• Pupillary Light Reflex
Reflexes and Neurological
Responses Video on the left shows a
clinical example of the
• Palpebral Reflex technique as well as clinical
patient with a CN 5 lesion.
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Dazzle Reflex
- not a vision test
- tests continuity of
retina, optic nerve
Reflexes and Neurological
Responses
The Pupillary Light Reflex is not a vision test.
MUST USE A BRIGHT FOCAL LIGHT
CATARACTS WILL NOT BLOCK A PLR
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Pterygopalantine Fossa
Optivisor or Loupe
Click here
For Info.
About slit light
Anterior Chamber
Slit Lights
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Iris
Step One
LOCALIZE LENS OPACITIES
Step Two
Vitreous and Fundus
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Fluorescein
Note: If an Immunofluorescent
Antibody Test (IFA for Herpes or
Chlamydia) is planned in a cat, do not
apply Fluorescein before doing the
conjunctival scraping. Fluorescein will
cause a false positive test result to
occur. Fluorescein may affect the
IFA result for up to 7 - 10 days.
Tonometry
Tonopen
PREFERRED INSTRUMENT
Schiotz
Not Preferred unless all that
is available
Burdock Pappus Fiber
Foreign Body
Eyelid Eversion
Retropulsion to prolapse
Third Eyelid for Inspection
Adson 1 x 2
Double Eversion
Muscle Hook
5
Try to Group Problem
“Refine” Problem List
• For Example:
– Conjunctival hyperemia
– Serous ocular discharge
– Aqueous Flare
– Miosis
– Enophthalmia with prolapse of the third eyelid
• Group to: ANTERIOR UVEITIS
Initial Differential Diagnosis
For Each Problem
• For Example: There are at least twelve possible
reasons for the Red Eye
• Blepharitis
• Cherry Eye
• Conjunctivitis
• Corneal Hemorrhage
• Episcleritis
• Glaucoma
• Hyphema
• Iris Hemorrhage
• Intraocular Neoplasia
• Keratitis
• Subconjunctival Hemorrhage
• Uveitis
Clinical Diagnosis
• The Tentative Clinical Diagnosis is based
upon the findings in the previous steps.
– Combination of the
• Signalment
• Primary Complaint
• History
• Ophthalmic Examination
• A Final Diagnosis can be made initially or
after subsequent diagnostic tests have
been performed.
Therapy
• The therapy of course depends on the diagnosis
– Many times there are pending laboratory test or other
diagnostic procedures and the exact clinical diagnosis
can not be made yet. However the patient needs some
form of therapy started immediately.
– The decision of what therapy to initially institute is
based on the findings up to this point. One must be
cautious and avoid therapies that could cause harm if
given in the face of a condition where that therapy
was contraindicated.
Prognosis
• Depends on severity of the problems.
• Depends on accuracy of diagnosis.
• Depends on the diagnosis; some disorders
are more serious than others.
Re-examination Plan
• Hospitalize
• Send home on treatment
– Re-examine 24 hours to 7 days
• Depending on the severity and what the diagnosis is.
Key Points to Consider During
General Physical Examination
• SIGNALMENT
• PRIMARY COMPLAINT
• HISTORY
• GROSS APPEARANCE OF THE
HEAD
• SYMMETRY
• RED EYE ?
• CLARITY OF THE OCULAR MEDIA
• MONOCULAR INDIRECT
OPHTHALMIC EXAMINATION
COMPARATIVE VETERINARY
OPHTHALMOLOGY