A Clinical Case from the Archives : 31/10/2006

Posted on October 31, 2006 by davidwilliams

[tab name=”The Case”]This labrador has had a couple of operations to replace what was thought to be a prolapsed nictitans gland but has now developed this substantial unilateral chemosis, resistant to topical steroid. What might be happening?[/tab][tab name=”David’s view”]Well I’m not sure but my concern is that somewhere in that third eyelid there is a mast cell tumour that is pumping out histamine and similar chemicals which could be causing the chemosis. Again I’ll let you know when we find out what really is happening – please e-mail me if you have seen anything similar![/tab][end_tabset] 

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A Clinical Case from the Archives : 30/10/2006

Posted on October 30, 2006 by davidwilliams

[tab name=”The Case”]This duck is presented because of poor vision. Where is the lesion?[/tab][tab name=”David’s view”]Looks like a cataract doesn’t it – here’s a rather beautiful close-up – beauty in the eye of the duck as well as of the beholder hey?! But notice that the pupil is always dilated – the problem is actually primarily retinal. The female offspring of this bird also seem to have vision problems – hopefully we’re en route to further investigations of a potential duck PRA![/tab][end_tabset] 

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A Clinical Case from the Archives : 30/10/2006

Posted on October 30, 2006 by davidwilliams

[tab name=”The Case”]A seemingly easy one here – what is this lesion in this cat eye?[/tab][tab name=”David’s view”]This looks like a limbal melanoma doesn’t it – but my concern is that there is infiltration intoi the cornea from deep sclera. In the dog limbal melanomas are pretty benign but my concern is that this is more worrying. It let you know what happens to it after removal![/tab][end_tabset] 

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A Clinical Case from the Archives : 06/10/2006

Posted on October 6, 2006 by davidwilliams

[tab name=”The Case”]Delightful little Roxy is suddenly blind with other neurological deficits. Nothing on MRI (well a brain for sure but no lesions – you know what I mean!) but a severe inflammatory picture on the CSF tap. What is causing her blindness?[/tab][tab name=”David’s view”]She has optic neuritis as part of Granulomatous Meningioencephalitis – notice the fluffy surface to the disc and raised blood vessels. Here is her optic nerve after a week of cyclophosphamide, vincristine and prednisolone. A somewhat improved disc surface but she is still blind. There is little in the literature about the prognosis for recovery of sight, though we hope that further treatment may improve her condition to allow some return of vision.[/tab][end_tabset] 

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A Clinical Case from the Archives : 06/10/2006

Posted on October 6, 2006 by davidwilliams

[tab name=”The Case”]What is happening in this rabbit’s eye?[/tab][tab name=”David’s view”]Well it looks like an ulcer with purulent inflammatory material at its lower edge doesn’t it? But the cornea was fluorescein-negative and here’s the other eye! No money for cytology and bacteriology so its on topical antibiotic and NSAID and I’ll let you know what happens. Don’t always expect me to have the answer straight away![/tab][end_tabset] 

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A Clinical Case from the Archives : 06/10/2006

Posted on October 6, 2006 by davidwilliams

[tab name=”The Case”]What is causing this 4 month old puppy’s eye to be red and always somewhat irritated?[/tab][tab name=”David’s view”]Did you notice the little hairs in the upper lid? Can you remember a time when you had a hair in your eye – really irritating. No wonder this dog has blepharospasm! We removed the two little hairs coming from the Meibomian gland orifice by removing the gland and the associated hair follicle.[/tab][end_tabset] 

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A Clinical Case from the Archives : 09/08/2006

Posted on August 9, 2006 by davidwilliams

[tab name=”The Case”]Many apologies to those of you who regularly visit this site – I haven’t put any cases on for a couple of months, mainly because I’m hard at work writing my FRCVS dissertation on – believe it or not – ocular abnormalities in farmed halibut! What abnormalities can you see here?[/tab][tab name=”David’s view”]Difficult to see on that picture maybe, but there is gross exophthalmos with iridal haemorrhage and bubbles in the anterior chamber of the eye. Bubbles? Here is another picture of the same thing. The choroid in fish produces high levels of oxygen by a countercurrent multiplier system and when farmed in shallow water this gas can come out of solution giving profound ocular pathology. A few of my papers on this weird subject are available on the recent publications page, if you fancy an unusual read! I won’t have finished writing this up till the end of September, but in October I’ll get back to showing off my favourite cases of the week! Have a good summer till then![/tab][end_tabset] 

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A Clinical Case from the Archives : 09/08/2006

Posted on August 9, 2006 by davidwilliams

[tab name=”The Case”]What is likely to be the cause of the ulcer in this horse – seen in the middle of summer and causing some considerable discomfort? What would you do?[/tab][tab name=”David’s view”]A swab yielded a profuse growth of Aspergillus. We performed a keratectomy and a conjunctival advancement graft to allow serum to be directed at the cornea, while also giving topical itraconazole. Unfortunately the horse went downhill rather suddenly with what turned out to be a corneal perforation as can be seen in this gross specimen of the enucleated eye. Dennis Brookes in Florida has perfected full thickness corneal grafting in such cases (Equine ulcerative keratomycosis: visual outcome and ocular survival in 39 cases (1987-1996). Equine Veterinary Journal 30:109-16) but here in the UK we don’t as yet see enough to be good at such proactive intervention! A bit of global warming will increase our experience I’ve no doubt![/tab][end_tabset] 

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A Clinical Case from the Archives : 09/08/2006

Posted on August 9, 2006 by davidwilliams

[tab name=”The Case”]What’s up with this little guinea pig? What would you do?[/tab][tab name=”David’s view”]Here’s a better view of this wonderful dermoid!They have been reported in guinea pigs before (Wappler et al (2002)Conjunctival dermoid in two guinea pigs: a case report.
Veterinary Ophthalmology 5:245-8) so its nothing new, and isn’t causing the cavy any problems, but the essential treatment is phototherapy isn’t it? Here’s the photo![/tab][end_tabset] 

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A Clinical Case from the Archives : 09/08/2006

Posted on August 9, 2006 by davidwilliams

[tab name=”The Case”]This year old labrador has developed a fluctuant mass in his medial canthus. What might your differentials be and how might you investigate this? By the way, the fluorecein you can see we placed in the eye never got to the nostril on this side while it rapidly appeared there on the right hand side after we put the same amount in the right lower conjunctival sac – just a little clue![/tab][tab name=”David’s view”]This could of course be an inflammatory mass or a neoplasm, but given its position, a swelling of the nasolacrimal duct, sac or cannaliculus is most likely. We flushed fluorescein into the nasolacrimal duct an hey presto, when we aspirated fluid from the ‘mass’ it was tinged with dye. We fully aspirated and with a Jackson’s cat catheter opened the nasolacrimal duct but all to no avail. Two weeks later the mass was back – and this time more obviously on the conjunctival side of the lid as well as the dermal side. We diagnosed dacryops here and deroofed the cyst under general anaesthesia, as you can see here. This was curative.[/tab][end_tabset] 

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