A Clinical Case from the Archives : 21/03/2005

Posted on March 21, 2005 by davidwilliams

[tab name=”The Case”]What is this condition – a creamy white mass in the lower conjunctiva in a prize show guinea pig?[/tab][tab name=”David’s view”]This so-called fatty eye in which fat deposition is seen in the subconjunctival space. It occurs particularly in guinea pigs being fattened not for the pot (!), but for the show ring. Note how it differs from flesh eye where the tissue is orbital gland.[/tab][end_tabset] 

Posted in Cases | Tagged | Leave a comment

A Clinical Case from the Archives : 08/03/2005

Posted on March 8, 2005 by davidwilliams

[tab name=”The Case”]What signs are present in this horse, referred after failing a pre-purchase examination? Can you arrive at a pathological story which links them all together?[/tab][tab name=”David’s view”]The cornea has a white lesion which is most likely to be corneal oedema, there is a widely dilated pupil, a darkened iris and an upwardly luxated lens. These suggest a chronic uveitis with secondary glaucoma and subsequent secondary lens luxation. This histological image shows the iridocorneal angle in a similar case of glaucoma following uveitis, where the drainage angle is being obliterated by inflammatory cells. Amazingly the horse shown in the clinical picture, while having intraocular pressures in the low thirties (in mmHg), still has vision and was ridden by its owner. Problems with insuring the animal rendered it less that fit for sale.[/tab][end_tabset] 

Posted in Cases | Tagged , , | Leave a comment

A Clinical Case from the Archives : 08/03/2005

Posted on March 8, 2005 by davidwilliams

[tab name=”The Case”]This mastiff has painful red eyes. What other lesions are visible on the ocular surface and what might this tell you about the diagnosis?[/tab][tab name=”David’s view”]There is corneal pigmentation of substantial severity, which might well lead you to think that KCS was the diagnosis. But the pigmentationis on the inside of the cornea and not the outside and the intraocular pressures are in the high twenties even though the animal was referred treated with the topical carbonic anhydrase inhibitor Trusopt three times daily. This suggests that pigmentary glaucoma is a more likely differential as the Schirmer tear tests were over twenty millimitres of wetting in a minute. Pigmentary glaucoma is more commonly seen in the Cairn terrier but can occur in boxers and mastiffs. A useful reference is van de Sandtand colleagues (2003) Abnormal ocular pigment deposition and glaucoma in the dog. Veterinary Ophthalmology 6:273-278.
[/tab][end_tabset] 

Posted in Cases | Tagged , | Leave a comment

A Clinical Case from the Archives : 08/03/2005

Posted on March 8, 2005 by davidwilliams

[tab name=”The Case”]What are the possible causes of this marked bilateral globe prpotrusion in this rabbit?[/tab][tab name=”David’s view”]Here the intraocular pressures were 45mmHg in each eye and the condition was glaucoma caused by the bu gene. Other possibilities might include retrobulbar abscessation, although this would be rare bilaterally, and venous congestion causing retrobulbar plexus engorgement, again a very rare condition. The bu gene is common in New Zealand White rabbits like this one, causing a dysplastic iridocorneal angle where drainage is very poor. A useful paper on the condition is Ueno and colleagues report on Histopathological changes in iridocorneal angle of inherited glaucoma in rabbits. Graefes Arch Clin Exp Ophthalmol. 1999;237:654-60[/tab][end_tabset] 

Posted in Cases | Tagged , | Leave a comment

A Clinical Case from the Archives : 15/02/2005

Posted on February 15, 2005 by davidwilliams

[tab name=”The Case”]This dog has a history of ocular trauma three months ago. What might be the cause of the redness in this eye? Can you link it with the other signs visible in the globe?[/tab][tab name=”David’s view”]The trauma has resulted in uveitis and glaucoma with a lens luxation (note the yellow cataractous lens in the middle of the anterior segment). It is difficult to knoow what order these events occured in. The lens luxation could be post traumatic with resulting uveitis and glaucoma or the uveitis could be the first event with resulting globe enlargement, secondary lens luxation and uveitis. My bet is for the first train of events. The dog is comfortable and, surprisingly seems to need no treatment, at leats according to the owner. Others of you may beg to differ – do click the reply button on the homepage to send me your thoughts![/tab][end_tabset] 

Posted in Cases | Tagged , , | Leave a comment

A Clinical Case from the Archives : 15/02/2005

Posted on February 15, 2005 by davidwilliams

[tab name=”The Case”]The intraocular pressure in this eye is 42mmHg which explains its redness. But what is causing the glaucoma?[/tab][tab name=”David’s view”]The yellowish-white mass in the pupil is a ciliary body adenoma which has gradually enlarged resulting in raised intraocular pressure. Enucleation is the best treatment although these tumour rarely metastasize.[/tab][end_tabset] 

Posted in Cases | Tagged , , | Leave a comment

A Clinical Case from the Archives : 15/02/2005

Posted on February 15, 2005 by davidwilliams

[tab name=”The Case”]This nine month old bulldog has always had watery eyes with blepharospasm and now has a mildly red eye. What might be causing these signs and how would you treat it?[/tab][tab name=”David’s view”]The redness is conjunctivitis and the blepharospams inidcates an irritative focus somewhere. Have a closer look at the lower lid – can you see some tiny black hairs near the medial canthus? These are distichia, aberrant hairs from the meibomian glands, that needed to be removed, either by epilation, electrolysis, cryosurgery or best of all in my book, by sharp knife removal of the meibomian glands in that area which harbour the hair follicles for the aberrant cilia. Here is a case in which the hairs are much more obvious, caught in the light beam used to illuminate the eye. This shows the need for good light and good magnificationin the diagnosis of the condition.[/tab][end_tabset] 

Posted in Cases | Tagged , , | Leave a comment

A Clinical Case from the Archives : 26/01/2005

Posted on January 26, 2005 by davidwilliams

[tab name=”The Case”]This cat has been away from home for a week and returns with its eye appearing as shown here. What abnormalities are seen and what is likely to have caused the lesions here? What treatment might be instituted?[/tab][tab name=”David’s view”]The irregular opacity in this animal’s cornea suggests a collagnolytic process at work and severe infection, probably asssociated with a foreign body, is causing the corneal melting. Bacteriology, cytology and examination under anaesthesia would be essential. Aggressive broad spectrum topical antibiosis and serum therapy to ameliorate the collagenolysis together with atropine to reduce pain from iridociliary spasm would be a first step in treatment.[/tab][end_tabset] 

Posted in Cases | Tagged , | Leave a comment

A Clinical Case from the Archives : 26/01/2005

Posted on January 26, 2005 by davidwilliams

[tab name=”The Case”]What has caused the corneal opacity in this cat’s eye? Are there other ocular signs which give you a clue?[/tab][tab name=”David’s view”]A rather more lateral view shows a wide band of iris adherent to the cornea. This is an anterior synechia and shows that a penetrating injury has occured previously. Iris was swept forward by the exiting aqueous humour during the trauma and has successfully plugged the gap, but the cornea has healed with an area of oedema and scarring.[/tab][end_tabset] 

Posted in Cases | Tagged , | Leave a comment

A Clinical Case from the Archives : 26/01/2005

Posted on January 26, 2005 by davidwilliams

[tab name=”The Case”]A drop of cleaning fluid found its way onto the ocular surface of this dog. What signs of injury do you see and what action would you take?[/tab][tab name=”David’s view”]There is a circular mid-stroma corneal ulcer here, shown well by the application of fluorescein dye as in this photograph. Immediate flushing with copious amounts of sterile saline is imperative and placement of a hood graft of conjunctiva across the eye will give the corneal surface the best chance of healing, as with a melting ulcer – see one of those by using the search facility available.[/tab][end_tabset] 

Posted in Cases | Tagged , , | Leave a comment