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1.
Uveitis is a common sequela to many ocular diseases. Primary treatment goals for uveitis should be to halt inflammation, prevent or control complications caused by inflammation, relieve pain, and preserve vision.Systemic and topical NSAIDs are essential components of the pharmaceutic armamentarium currently employed in the management of ocular inflammation by general practitioners and veterinary ophthalmologists worldwide. NSAIDs effectively prevent intraoperative miosis; control postoperative pain and inflammation after intraocular procedures, thus optimizing surgical outcome; control symptoms of allergic conjunctivitis;alleviate pain from various causes of uveitis; and circumvent some of the unwanted side effects that occur with corticosteroid treatment. Systemic NSAID therapy is necessary to treat posterior uveitis, because therapeutic concentrations cannot be attained in the retina and choroid with topical administration alone, and is warranted when diseases, such as diabetes mellitus or systemic infection, preclude the use of systemic corticosteroids.Risk factors have been identified with systemic and topical administration of NSAIDs. In general, ophthalmic NSAIDs may be used safely with other ophthalmic pharmaceutics; however, concurrent use of drugs known to affect the corneal epithelium adversely, such as gentamicin, may lead to increased corneal penetration of the NSAID. The concurrent use of NSAIDs with topical corticosteroids in the face of significant preexisting corneal inflammation has been identified as a risk factor in precipitating corneal erosions and melts in people and should be undertaken with caution[8]. Clinicians should remain vigilant in their screening of ophthalmic and systemic complications secondary to drug therapy and educate owners accordingly. If a sudden increase in patient ocular pain (as manifested by an increase in blepharospasm, photophobia, ocular discharge, or rubbing)is noted, owners should be instructed to contact their veterinarian promptly.  相似文献   

2.
Many variables affect the outcome of keratomycosis and systemic fungal infections in animals. These include pathogenicity of the fungal organism(toxins, trophisms, and evasion of host response); previous treatment with topical or systemic corticosteroids, which can have a dramatic negative impact on host defense mechanisms: concurrent systemic illness or immunocompromise: severity/extent of infection; and degree of pain (ie,increased reflex tearing dilutes topical medication) [14]. Experimental work suggests that antibiotics may occasionally exacerbate fungal infections [142],and some researchers advocate that concurrent antibiotic therapy is contraindicated in horses with yeast infections and septate fungal infections unless bacterial infection is also suspected [14]. Nevertheless, given that normal conjunctival flora often include bacteria and fungi and because care of keratomycoses often includes mixed bacterial and fungal infections, the possible dynamics (natural influences and local competition) between ocular surface microorganisms merit further investigation. There are many unanswered questions regarding the accuracy of in vitro susceptibilities and corneal concentration capabilities for antifungal topical medications [14].Inherent host resistance or other immune interactions between the patient and fungus are perhaps the most important determinants of the outcome but are currently difficult to measure or assess except by subjective clinical observation [14].  相似文献   

3.
Corneal ulcers are one of the most common ocular disease presentations in the horse. With the use of correct diagnostic techniques and selection of an appropriate treatment regimen, most cases result in a satisfactory outcome. The eye does not respond well to inflammation, and in complicated ulcers, this should be managed aggressively using systemic NSAIDs with a high priority assigned to removing the infectious agent. Care needs to be taken to avoid topical or systemic corticosteroid use for the treatment of equine ocular disease, however, unless the clinician is completely sure that the corneal disease is not caused by an infectious process. The use of combination corticosteroid-antibiotic ophthalmic preparations without an appropriate treatment rationale can result in doing more harm than good. It is important to have a treatment plan and to monitor the elected treatment regimen. The clinician should decide on some objective criteria at initiation of treatment so that any changes are made rationally. This approach should also include consideration of early referral of the eye's care to a veterinary ophthalmologist.  相似文献   

4.
Advances in topical glaucoma therapy   总被引：1，自引：0，他引：1  
Significant advances have recently been achieved in the development of topical glaucoma medications. The primary advantage of a topical preparation is the reduced incidence of adverse systemic effects attributable to a given drug compared to its systemically administered counterpart. However, the strong protective barrier of the eye forces topical ophthalmic preparations to be highly concentrated and in some cases, they have the potential to produce unwanted systemic effects, particularly in smaller animals. Oral carbonic anhydrase inhibitors are commonly associated with adverse effects in both humans and animals. Two recently developed topical carbonic anhydrase inhibitors, dorzolamide and brinzolamide, have shown promise in reducing intraocular pressure in animals and systemic side effects are apparently limited with their use. The topical alpha2-agonist apraclonidine, on the other hand, effectively reduces intraocular pressure in cats and dogs, but in its currently available form is likely to induce unwanted systemic effects. Latanoprost is a topical prostaglandin F2alpha analog that has proven effective in reducing intraocular pressure in dogs and horses, but while systemic side effects have not yet been reported, this topical preparation may exacerbate pre-existing or concurrent ocular inflammatory disease.  相似文献   

5.
Ocular emergencies can be very intimidating for veterinarians. Most ocular emergencies can be stabilized by the veterinarian until an ophthalmologist can be consulted if necessary. Proptosis, or forward displacement of the globe, can occur secondary to any blunt trauma to the head. The two options for a proptosed eye are enucleation or replacement with tarsorrhaphy depending on the viability of the extraocular tissues and eye. Glaucoma, or increased intraocular pressure (above 35 mm Hg), is diagnosed by measuring the intraocular pressure using a Shiotz or electronic tonometer. Emergency treatment includes intravenous mannitol and topical pilocarpine. Uveitis, or inflammation of the iris, ciliary body and/or choroid, can have many underlying causes such as neoplasia, infection, lens induced, and trauma. The treatment consists of treating the underlying cause, and administering topical atropine to alleviate pain and topical corticosteroids to decrease inflammation. Corneal ulcers, or defects in the corneal epithelium, are classified according to the depth of the defect. The treatment consists of topical antibiotics and topical atropine. If the ulcer is deep, is melting, or is a descemetocele, then a third eyelid or conjunctival flap is usually necessary. The cornea should be sutured if it is perforated or lacerated. Hyphema, or blood in the anterior chamber, can occur secondary to trauma, neoplasia, infection, or a coagulapathy. The treatment consists of treating the underlying cause and topical corticosteroids with or without antibiotics.  相似文献   

6.
This report describes post-traumatic ocular lymphoma in 3 companion rabbits; 2 rabbits with unilateral disease and 1 with bilateral disease. Historical findings suggestive of a traumatic event included either external unilateral ocular trauma or bilateral phacoemulsification. Severe corneal changes, presence of an anterior chamber mass(es), low intraocular pressures, and ocular discomfort were noted on ophthalmic examinations. All eyes were treated for variable courses with standard ophthalmic topical medications (antibiotic, anti-inflammatories, and steroid) and systemic anti-inflammatories. Based upon progression of disease, all affected eyes were ultimately enucleated; lenticular capsular rupture and a round cell neoplasm effacing normal structures with variable mitotic indices were noted on histopathology. Neoplastic lymphocytes strongly expressed CD79a via immunohistochemistry and lacked expression for CD3, indicating B lymphocyte lineage and not of T cell lineage. A single animal had evidence of local metastasis to a regional lymph node. Post-traumatic sarcomas have been reported in this species previously, however, these cases are the first reports of this novel round cell variant, named post-traumatic ocular lymphoma due to the B cell lineage confirmed through immunohistochemistry. Clinicians should be aware of this clinical presentation and the possibility of metastasis when evaluating ocular pathology in this species.  相似文献   

7.
Corticosteroids are invaluable therapeutic agents for treatment of ocular inflammation in small animal patients. The use of potent anti-inflammatory agents carries with it the risk of some side effects, however. Although some of these may be lessened by topical or subconjunctival administration, these routes are associated with specific ocular side effects about which the practitioner must be aware. With judicious use, corticosteroids remain a mainstay for the prevention and treatment of many painful and potentially blinding ocular diseases.  相似文献   

8.
OBJECTIVE: To investigate the spectrum, prevalence and treatment response rate of ocular manifestations associated with natural canine monocytic ehrlichiosis (CME) due to Ehrlichia canis. METHODS: The medical records of 90 dogs that were admitted for primary ocular problems and reacted positive for E. canis serum antibodies were reviewed. All the dogs were treated with oral doxycycline. In 79 dogs, a combination of systemic corticosteroids and/or topical anti-inflammatory, mydriatics/cycloplegics and antibacterial agents were applied. RESULTS: The dogs ranged from 0.5 to 15 years in age; 55 were male and 35 female. A total of 19 breeds were represented. In the majority of dogs, ocular abnormalities were noticed in conjunction with other CME-induced clinical signs. In 30/90 dogs, ophthalmic signs were the sole presenting complaint. Unilateral (22/90, 24.5%) and bilateral (68/90, 75.5%) uveitis was the most common ophthalmic diagnosis and was classified as anterior, posterior or panuveitis in 58 (64.5%), 8 (8.9%) and 24 (26.6%) of the dogs, respectively. Bilateral uveitis was significantly more common than unilateral uveitis (P < 0.0001), and anterior significantly more common than posterior uveitis (P < 0.0001) or panuveitis (P < 0.0001). In addition, corneal ulceration (12/90, 13.3%), necrotic scleritis (10/90, 11.1%), low tear production (8/90, 8.9%) and orbital cellulitis (3/90, 3.3%) were seen. Of the 45 (50%) dogs with a satisfactory follow-up, 25 (55.5%), 11 (24.5%), and 9 (20%) showed complete, partial and poor response to treatment, respectively. The number of dogs exhibiting complete resolution of the ocular manifestations was significantly higher than those with partial (P < 0.0001) or poor (P < 0.0001) response. CONCLUSIONS: CME should be considered a major differential for a wide range of ocular manifestations exhibited by dogs residing in the endemic areas of the disease. Anterior bilateral uveitis appears to be the most prevalent ocular lesion and a favorable outcome to systemic and topical treatment may be expected in the majority of the affected dogs.  相似文献   

9.
Objective To determine the transcorneal penetration and systemic absorption of a compounded 0.2% terbinafine solution following repeated topical administration to normal equine eyes. Sample population Six healthy adult horses with normal ocular examinations. Procedures One eye of each horse received 0.2 mL of a compounded 0.2% terbinafine solution every 4 h for seven doses. During the 1 h following administration of the final dose, multiple peripheral blood samples were obtained, and a single aqueous humor (AH) sample was collected at the end of the hour. AH and plasma concentrations of terbinafine were determined using high pressure liquid chromatography (HPLC). Stability of the formulation was assessed with HPLC analysis over a 14‐day time period. Results Terbinafine was not detected in the AH or plasma of any horse at any time point. No signs of ocular irritation or systemic toxicity were noted in any horse at any time point. The solution was stable over 14 days. Conclusion Topical ocular administration of compounded 0.2% terbinafine solution does not result in detectable AH or plasma levels following administration to normal equine eyes, suggesting its use for deep corneal or intraocular fungal infections in equine ophthalmology may be limited.  相似文献   

10.
Corneal fungal diseases, including fungal keratitis and stromal abscess, are uncommon in small animals. Ocular infection secondary to systemic mycosis is reported far more frequently. Suspicion of a fungal corneal ulcer should be raised based on a history of underlying trauma, especially with plant material, geographic location, chronic use of topical antibiotics or corticosteroids, or an extremely prolonged course of disease despite appropriate treatment. Clinical signs observed with fungal keratitis may include blepharospasm, epiphora, miosis, corneal opacity, and vascularization. Unfortunately, none of these signs is specific to fungal infection. If fungal keratitis is suspected or confirmed, then aggressive medical therapy should be instituted. Medications used include topical antifungals, parasympatholytics, anticollagenases, and antibacterials as well as systemic anti-inflammatory drugs. Because there are very few fungicidal medications, the course of medical treatment for fungal corneal disease requires a prolonged duration with frequent re-examination and assessment. Surgical treatment is sometimes required to save the eye and vision. Surgeries to be considered include debridement, conjunctival graft placement, and corneal transplantation.  相似文献   

11.
The purpose of this retrospective study was to determine the prevalence, type, and prognosis of ocular lesions associated with leishmaniasis in dogs. One hundred and five dogs (24.4% of all cases of leishmaniasis diagnosed during the study period) had ocular or periocular leishmaniasis, and 16 dogs (15.2% of ocular cases) had only ocular lesions and systemic signs were not apparent. Anterior uveitis was the most common manifestation and other prevalent findings included blepharitis and keratoconjunctivitis. Several distinct variations of eyelid lesions were seen including a dry dermatitis with alopecia, diffuse blepharedema, cutaneous ulceration, and discrete nodular granuloma formation. In some cases with keratoconjunctivitis, corneal lesions clinically resembled nodular granulomatous episclerokeratitis. Twenty-seven of the 34 cases with ocular lesions had improvement in signs following systemic antiprotozoal and topical anti-inflammatory therapy, although many cases with anterior uveitis required long-term topical therapy. Response of ocular signs correlated highly with overall, systemic response to therapy. Ophthalmic manifestations of systemic leishmaniasis are common in the dog, and this disease should be considered in the differential diagnosis of most adnexal and anterior segment ocular inflammatory lesions in dogs in endemic areas.  相似文献   

12.
The purpose of this study is to report a case of methicillin‐resistant Staphylococcus aureus (MRSA) keratitis in a dog. A 7‐year‐old intact male American cocker spaniel that had undergone removal of a nictitating gland was referred for severe ulcerative keratitis. Slit‐lamp examination showed swelling of the eyelid, mucopurulent discharge, conjunctival injection and chemosis, diffuse corneal edema and opacity, and a deep ulcer in central cornea. Gram staining of discharge from the eye demonstrated Gram‐positive cocci. Despite topical ofloxacin, oxytetracycline and polymyxin B ophthalmic solution and intravenous cefazolin, there was no improvement. Cultures revealed MRSA that was sensitive only to chloramphenicol, vancomycin, lincomycin, and clindamycin. The antibiotic regimen was changed to topical and systemic chloramphenicol. After 9 days of treatment, although inflammation started to be resolved, the dog developed nonregenerative anemia. The antimicrobial regimen was changed again to topical and systemic vancomycin. Inflammation continued to improve over the next week. MRSA should be considered a potential organism in infectious keratitis, especially when general antibiotics are not effective. Although topical and systemic chloramphenicol and/or vancomycin are effective for treating MRSA keratitis, vancomycin should only be used when culture and susceptibility results indicate it is appropriate and no other options are available. To our knowledge, this is the first detailed case report of MRSA keratitis in a dog.  相似文献   

13.
Feline ocular emergencies include any ophthalmic condition that has rapidly developed or is the result of trauma to the eye or periocular structures. Common feline emergencies include proptosis, lid lacerations, corneal ulcers, and foreign bodies. Complete ophthalmic examination including procurement of the minimal ophthalmic database (Schirmer tear test, fluorescein stain, and intraocular pressure measurement) should be obtained whenever possible to ensure that the complete and correct diagnosis is made. Concern for the patient's vision and ocular comfort should guide the practioner's diagnostic and therapeutic plan. This article reviews some of the more common feline ocular emergencies, including conditions affecting the orbit and globe, adnexa, conjunctiva, and cornea. Feline uveitis, glaucoma, and lenticular diseases are covered more thoroughly elsewhere in this issue.  相似文献   

14.
Feline infectious peritonitis is a noncurable viral disease affecting cats worldwide. Recent evidence suggests that the FIPV has evolved as a deletion mutation of FECV. Immune complex deposition and vasculitis with pyogranulomatous lesions are the hallmark of FIP. The only definitive antemortem diagnostic test for FIP is histopathologic examination of tissue. Ocular manifestations occur commonly with noneffusive FIP. The most common clinical sign is a bilateral granulomatous anterior uveitis often accompanied by chorioretinitis. Treatment of ocular FIP is symptomatic, and the mainstay of palliative therapy is topical or systemic corticosteroids or both.  相似文献   

15.
A perception exists amongst referring veterinarians and the lay public that blue‐eyed horses have increased frequency of ocular disease. The aim of this retrospective study was to assess the prevalence of ocular disease in horses with blue or heterochromic eyes relative to those with brown eyes. The medical records of horses presenting to either the Comparative Ophthalmology services or Equine Medicine/Surgery services at 2 institutions were reviewed. Signalment, ocular and nonocular diagnoses were recorded. Ocular disease was divided into 4 categories: adnexa, cornea, intraocular/orbit and squamous cell carcinoma (SCC). Owners were contacted by telephone to confirm iris colour. Chi‐square analysis was used to compare group proportions. A total of 164 eyes of horses with ocular disease and 212 eyes of horses without ocular disease were included. Blue eyes were equally common in the ocular disease and nonocular disease groups (P = 0.265). There was no significant difference in the proportion of blue‐ and brown‐eyed horses when comparing the adnexal and corneal (P = 0.548), corneal and intraocular/orbit (P = 0.379) and adnexal and intraocular/orbit (P = 0.843) categories. A significant difference was detected in the proportion of blue‐eyed horses between the adnexal (P = 0.000), corneal (P = 0.033), intraocular/orbital (P = 0.000) and SCC categories, with a higher proportion of blue‐eyed horses in the SCC than in the other 3 groups. Horses with blue or heterochromic irides are more likely to develop ocular SCC than horses with brown irides, but are not more likely to have adnexal, corneal or intraocular/orbital disease or to be presented for evaluation of ophthalmic disease. Veterinarians should consider the results of this study when answering questions from the lay public regarding the predisposition of blue‐eyed horses to ocular disease.  相似文献   

16.
Cataract removal using phacoemulsification was performed in 10 loggerhead turtles being rehabilitated after stranding. All turtles had significant systemic abnormalities and had cataracts either at the time of rescue or developed them during rehabilitation. Surgical difficulties encountered included an extremely soft globe that did not allow for a partial thickness corneal incision, incomplete topical anesthesia of the ocular surface with proparacaine, inability to dilate the pupil pharmacologically, a markedly shallow anterior chamber, a thick posterior capsular plaque in most cases, and difficulty creating a watertight closure with sutures. Minimal to no intraocular inflammation was seen in all cases following surgery, but all cases in which corneal sutures were used developed a marked inflammatory reaction surrounding the sutures and appeared uncomfortable until sutures were removed or sloughed. All turtles appeared to have improved vision following surgery and were eventually released. Two turtles were re‐encountered a year or more after release. Both showed signs of normal growth and the ability to capture prey in the wild. This report documents successful outcomes associated with cataract surgery in loggerhead turtles, but also presents significant surgical challenges that should be taken into account before attempting this procedure in this species.  相似文献   

17.
Topical administration of drugs is the treatment of choice for diseases of the anterior segment. Drug levels attained by this means are usually of short duration, however, necessitating frequent therapy or continuous perfusion if prolonged drug levels are required. A drug-delivery device (collagen shield or contact lens) or subconjunctival injections can be used to augment topical therapy if frequent treatment is not possible. Subconjunctival injections are recommended for drugs that have low solubility and, hence, low corneal penetration. Retrobulbar injections are seldom indicated, except for regional anesthesia. Systemic administration is useful for anti-inflammatory therapy but it may be difficult to establish therapeutic levels of antibiotic agents in the eye because of the blood-ocular barrier. In severe cases, intraocular injection may be required.  相似文献   

18.
Objective  To describe historical, clinical and diagnostic features of dogs with Brucella canis endophthalmitis and the response to medical therapy.
Animals studied  Three dogs with naturally acquired B. canis endophthalmitis.
Procedure  Dogs were treated symptomatically with topical ophthalmic anti-inflammatories and a novel antimicrobial protocol that included doxycycline, enrofloxacin, rifampin and streptomycin.
Results  All dogs presented with chronic or recurrent uveitis in the absence of overt systemic disease. Clinical ophthalmologic abnormalities were unilateral in each dog and included mild-to-moderate anterior uveitis, iris hyperpigmentation, marked vitreal infiltrates, and multifocal chorioretinitis. Dogs were diagnosed with canine brucellosis serologically and by blood culture ( n  = 2 dogs) or polymerase chain reaction of aqueous humor and blood ( n  = 1 dog). Active ocular inflammation resolved in all dogs during treatment, with preservation of vision in 2 dogs. Following treatment, B. canis could not be cultured from blood samples and serological values declined with seronegativity achieved in all dogs after a median of 96 weeks (range: 36–112 weeks) of therapy.
Conclusions  Brucella canis infection should be included in the differential diagnosis for dogs with intraocular inflammation, regardless of previous history or neuter status. This is the first report of apparently successful medical therapy of canine brucellosis with ocular involvement.  相似文献   

19.
A 2-year-old Thoroughbred filly presented with ocular pain and epiphora of the left eye. The pupil was miotic and the cornea edematous near the ventro-temporal limbus, but did not retain any fluorescein. The topical antibiotics and atropine and diclofenac, and systemic flunixin meglumine and antibiotic therapy did not resolve the condition. A pink and fleshy infiltrate developed near the limbus indicating nonulcerative keratouveitis. The anterior uveitis deteriorated as manifested by the presence of dyscoria, hypopyon, and organized fibrin in the anterior chamber. Ocular signs were improved by topical and subconjunctival corticosteroids, but repeatedly deteriorated as the frequency of medication was reduced. The horse was seropositive to three serovars of Leptospira interrogans. The animal was diagnosed as blind on day 91 by the absence of pupillary light and menace reflexes, and donated for histopathologic diagnosis. The corneal opacity was histologically fibrotic and infiltrated predominantly by lymphocytes with Descemet's membrane partially disrupted by macrophages. The choroid was infiltrated by lymphocytes, eosinophils and basophils, and was positive to IgG and C3. There were filamentous or spiral structures positive to Warthin-Starry stain in the renal cortex. There was also polymerase chain reaction amplification of the leptospiral gene in the kidney. From these findings nonulcerative keratouveitis was believed to be caused by systemic infection with Leptospira.  相似文献   

20.
A 5‐year‐old Thoroughbred mare presented with an intermittently mildly painful right eye with a nonulcerative corneal opacity of several weeks' duration that had improved with topical steroids but recurred when steroids were withdrawn. Ophthalmic examination demonstrated a focal region of moderate corneal oedema and midstromal corneal infiltrate centrally but no other significant ocular abnormalities, and suggested a diagnosis of immune‐mediated keratitis. Empirical courses of both topical and systemic anti‐inflammatory drugs, both nonsteroidal and steroidal, led to initial improvement but bullous keratopathy developed when corneal oedema became profound. Due to the rapidly progressive nature of the bullous keratopathy combined with poor response to medical therapy, a keratectomy and conjunctival graft were performed under general anaesthesia. Intraoperative corneal culture of the keratectomy site grew Pseudomonas alcaligenes, a common soil and water contaminant. Histopathology of the keratectomy specimen revealed neutrophilic inflammation. Keratectomy and conjunctival graft led to resolution of ocular pain and inflammation, with an acceptable cosmetic and visual outcome. This report describes an unusual case of a nonulcerative Pseudomonas keratitis that responded well to surgical therapy, and underscores the complicated nature of nonulcerative keratitis in horses.  相似文献   

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