Test Your knowledge (Eye Case)

A 3yo female working Springer spaniel is presented to your practice one day after a field trial, with acute onset right ocular pain and discharge.

Q1: Describe the abnormalities seen, and give the most likely diagnosis.

Q2: What is the most likely aetio-pathogenesis for this condition in this case?

Q3: List the treatment options.

(Answers below image)

A1: Profuse mucopurulent ocular discharge, chemosis and corneal oedema, associated with a large corneal abnormality which is most likely an area of corneal stromal collagenolysis (‘melting’ corneal ulceration). 

A2: Traumatic injury to the eye, followed by infection with a bacteria associated with corneal melting (Pseudomonas aeruginosa or beta-haemolytic streptococcus)

A3: Topical treatment with anti-collagenase (topical serum, EDTA, acetylcysteine), appropriate topical and systemic antibiotics (swab and Diffquik staining/ bacterial culture recommended), systemic analgesia, conjunctival grafting if progressive

Pug Eye Problem (Case)

Question

A 4yo neutered male pug is presented for chronic corneal scarring and recurrent corneal ulceration. History taking and general physical examination identified signs of upper airway disease but no other significant abnormalities.

Q1: Describe the ophthalmic abnormalities.

Q2: List possible treatment options.

Answer

A1: The patient is showing signs of bilateral breed-related exophthalmos, pigmentary keratitis, exposure keratitis, macropalpebral fissure, probable lagophthalmos (inability to completely close the eyelids), nasal fold trichiasis and medial lower eyelid entropion

A2: Bilateral medial canthoplasty is indicated to correct the medial entropion, improve tear film distribution and shorten the eyelids. A nasal fold resection may be indicated for the nasal fold trichiasis.

Eye Test

Question

A 3yo neutered female domestic shorthair cat is presented for evaluation of a left ocular abnormality (see Figure). The cat is a confirmed FHV-1 carrier but is otherwise healthy. The owner reports that the eye condition was first noticed around 3 weeks previously and that it has gradually progressed since that time. No signs of ocular discomfort have been noted and the other eye is unaffected.

What is the most likely diagnosis in this case?

How could the diagnosis be confirmed?

Answer

The clinical appearance is characteristic of eosinophilic keratitis.

Diagnosis can be confirmed by corneal cytology, which should show a mixed inflammatory response including eosinophils.