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Slatter's Fundamentals of Veterinary Ophthalmology - E-Book

Slatter's Fundamentals of Veterinary Ophthalmology - E-Book

David Maggs | Paul Miller | Ron Ofri

(2013)

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Book Details

Abstract

Recognize, diagnose, and manage a wide range of common ocular conditions with Slatter’s Fundamentals of Veterinary Ophthalmology, 5th Edition. Covering small and large animals including birds and exotic species, this reference provides the latest, most practical information on structure and function of the eye, ocular development, pathology, examination and diagnosis, surgical procedures, ophthalmic pharmacology and therapeutics, and management of ocular emergencies. Nearly 1,000 color photos and illustrations accurately depict ocular conditions and demonstrate surgical techniques. Edited by noted veterinary ophthalmologists David J. Maggs, Paul E. Miller, and Ron Ofri, this reference is an essential aid to clinical decision-making, from differential diagnosis to medical and surgical management.

  • Practical, clinically focused coverage provides a one-stop diagnostic guide to ophthalmic disease in small and large animals including birds and exotic pets.
  • Logical organization by anatomic region makes topics easy to locate.
  • Nearly 1,000 color images present illustrated, step-by-step procedures that guide you through the recognition, diagnosis, and treatment of ocular conditions you are most likely to encounter.
  • A team of three internationally respected veterinary ophthalmologists co-edit this reference to provide comprehensive, clinical expertise.
  • Useful tables and charts summarize important facts and show treatment instructions at a glance.
  • Clinical Tips boxes offer helpful practice advice.
  • NEW pharmaceutical therapies and procedural techniques provide the most current diagnostic and treatment methods.
  • Extensive updates including the latest information on pharmacology, eyelid surgery, tear film deficiencies, and retinal disease help you provide the most current, effective care.
  • NEW sections on ophthalmic diseases of chinchillas and guinea pigs provide expert guidance in the care of these increasingly popular exotic pets.
  • NEW! Detailed table of contents describes the specifics of coverage in each chapter.
  • NEW! Pageburst companion website makes the entire contents of the book fully searchable. Sold separately.

Table of Contents

Section Title Page Action Price
Front Cover cover
Inside Front Cover ifc1
Slatter's Fundamentals of Veterinary Ophthalmology, 5/e i
Copyright Page iv
Contributors v
Dedication vi
Preface and Acknowledgments vii
Table Of Contents viii
1 Basic Structure and Function of the Eye 1
Fundamentals of Vision 1
Luminance 1
Motion 3
Depth Perception 4
Texture (Visual Acuity) 5
Optical Factors in Visual Acuity 6
Retinal Factors in Visual Acuity 7
Estimates of Visual Acuity 9
Color Vision 10
Central Visual Pathways 12
2 Development and Congenital Abnormalities* 13
Development 13
Embryogenesis and Organogenesis 13
Differentiation 16
Retina 16
Optic Nerve 17
Vitreous 17
Lens 19
Primitive Vascular System 20
Ciliary Body and Iris 22
Iridocorneal Angle 22
Cornea and Anterior Chamber 22
Choroid, Sclera and Extraocular Muscles 22
Eyelids and Third Eyelid 23
Nasolacrimal System 24
Congenital Abnormalities 24
Anophthalmos and Microphthalmos 24
Cyclopia and Synophthalmia 25
Coloboma 25
3 Ocular Pharmacology and Therapeutics 27
General Principles of Ocular Pharmacology 27
Routes of Administration 27
Continuous or Intermittent Ocular Surface Lavage Systems 28
Topical Formulations 28
Solutions and Suspensions (Eye Drops) 30
Ointments 30
Subconjunctival, Subtenons, and Retrobulbar Injections 31
Systemic Drug Administration 32
Antibacterial Drugs 33
Selection and Administration of Antibiotics 33
Penicillins 34
Penicillin G 34
Sodium Methicillin 34
Sodium Oxacillin 34
Amoxicillin and Ampicillin 34
Cephalosporins 34
Chloramphenicol 36
Aminoglycosides 37
Neomycin 37
Gentamicin 37
Tobramycin 37
Amikacin 37
Cyclic Polypeptides 37
Bacitracin 37
Polymyxin B 37
Tetracyclines 37
Azithromycin 38
Sulfonamides 38
Fluoroquinolones 38
Enrofloxacin, Orbifloxacin, and Pradofloxacin 38
Ciprofloxacin, Ofloxacin, and Others 39
Antifungal Drugs 39
Natamycin 39
Azoles 39
Flucytosine 39
Amphotericin B 40
Antiviral Drugs 41
Idoxuridine 41
Trifluridine (Trifluorothymidine) 41
Vidarabine 41
Acyclovir and Valacyclovir 41
Cidofovir 41
Ganciclovir 42
Penciclovir and Famciclovir 42
Lysine 42
Corticosteroids 42
Properties of Corticosteroids 42
Ocular Penetration of Corticosteroids 43
Long-Term Therapy 44
General Indications for Corticosteroid Use 44
Nonsteroidal Antiinflammatory Drugs 44
Immunomodulating Therapy (Immunosuppressants and Immunostimulants) 45
Azathioprine 45
Cyclosporine 46
Tacrolimus and Pimecrolimus 46
Immunostimulants 46
Mast Cell Stabilizers and Antihistamines 46
Hyperosmotic Agents 47
Mannitol 47
Topical Hyperosmotic Sodium Chloride 47
Autonomic Drugs 47
Parasympatholytic (Anticholinergic) Agents 47
Atropine 47
Tropicamide 48
Miscellaneous Parasympatholytic Agents 49
Sympathomimetic (Adrenergic) Agents 50
Epinephrine (Adrenaline), Dipivefrin, and Phenylephrine 50
Parasympathomimetic (Cholinergic) Agents 50
Direct-Acting Parasympathomimetic Agents 50
Pilocarpine. 50
Indirect-Acting Parasympathomimetic Agents 51
Demecarium. 51
Carbachol. 51
Sympatholytic Agents (Adrenergic Antagonists) 51
Topical and Systemic Carbonic Anhydrase Inhibitors 51
Prostaglandin Analogues 52
Local Anesthetics 52
Ocular Analgesia 53
Topically Applied Agents 53
Opioids 53
Atropine 53
NSAIDs 53
Systemically Administered NSAIDs and Analgesic Agents 53
Retrobulbar Anesthesia 54
Enzymes and Enzyme Inhibitors 54
Hyaluronidase 54
Tissue Plasminogen Activator 54
Protease Inhibitors 54
Tear Replacement Preparations (Artificial Tears) 54
Miscellaneous Therapeutic Agents 55
Surgical Adhesives 55
Eye Washes (Collyria) 55
Germicides 55
Astringents and Cauterants 55
Vitamins 55
Medical Cataract Treatments 55
Antiparasitic Agents 57
Physical Therapy 57
Contact Lenses 57
Irradiation 57
β-Irradiation 58
γ- and X-Irradiation 58
Hyperthermia 58
Cryosurgery 58
Lasers in Veterinary Ophthalmology 59
4 General Pathology of the Eye 60
Ocular Injury 60
Causes of Ocular Injury 60
Consequences of Ocular Injury 60
Agenesis, Aplasia, Hypoplasia 60
Hypertrophy 61
Hyperplasia 61
Atrophy 61
Metaplasia 61
Dysplasia 62
Dystrophy 62
Necrosis 62
Loss of Barrier Function. 63
Loss of Electrical Activity. 64
Loss of Secretory Function. 64
Initiation of Inflammation: the First Step Toward Normalization. 64
Ocular Inflammation 64
Peculiarities of Ocular Inflammation 65
Corneal Inflammation 66
Uveitis 67
Common Sequelae of Intraocular Inflammation 67
Inflammatory Retinal Detachment 67
Cataract 68
Glaucoma 68
Alterations in the Blood-Ocular Barrier and Implications for Immune-Mediated Disease 69
Etiologic Implications of Inflammatory Exudates 69
Restoration of Homeostasis: Ocular Wound Healing 71
Germinal Cells 71
Tissue Scaffold 73
Adequate Nutrition 74
Diseases Resulting from Defective Wound Healing 74
Ocular Neoplasia 75
Clinical Signs Associated with Ocular Neoplasia 76
Hyphema 76
Glaucoma 76
Uveitis 76
Histologic Basis for Common Clinical Lesions 76
Corneal Edema 77
Corneal Pigmentation 77
Aqueous Flare 77
Keratic Precipitates 77
Hyphema 77
Changes in Pupil Shape 77
Changes in Iris Color 77
Lens Opacity 77
Retinal Pathologic Findings: Tapetal Hyper-reflectivity and Retinal Opacity 78
5 Diagnostic Techniques 79
Medical History 79
Examination Procedure 79
Assessment From A Distance 82
Assessment of Iris and Pupil 82
Retroillumination 82
Pupillary Light Reflexes 83
Other Commonly Performed Neuroophthalmic Tests 84
Menace Response 84
Dazzle Reflex 84
Palpebral Reflex 84
Examination of the Anterior Segment 84
Eyelids 85
Nasolacrimal Apparatus 86
Third Eyelid 86
Conjunctiva 86
Sclera 86
Clinical Differentiation of Episcleral and Conjunctival Hyperemia (or Injection) 87
Cornea 87
Anterior Chamber 87
Iris and Pupil 88
Lens 88
The Posterior Segment 88
The Normal Fundus 89
The Canine Fundus 90
The Feline Fundus 90
The Equine Fundus 91
The Fundus of Sheep, Goats, and Cattle 91
Ophthalmoscopy 92
Direct Ophthalmoscopy 92
Indirect Ophthalmoscopy 93
Monocular Indirect Ophthalmoscopy 93
Examination of the Posterior Segment 94
Vitreous 94
Retina 94
Optic Nerve 94
Additional Diagnostic Testing 95
Schirmer Tear Test and Phenol Red Thread Test 95
Tear Film Break-Up Time 95
Assessment of Aqueous Flare 96
Vital Dyes 96
Fluorescein 96
Rose Bengal 98
Tonometry 98
Indentation Tonometry 99
Applanation Tonometry 99
Rebound Tonometry 100
Normal Intraocular Pressure 100
Tonography 101
Gonioscopy 101
Ocular Surface Sampling 102
Sample Collection by Scraping, Swab, or Cytobrush 102
Microbiologic Samples 103
Cytologic Samples 103
Tests of Nasolacrimal Apparatus Patency 103
The Fluorescein Passage (or Jones) Test 103
Nasolacrimal Cannulation and Flushing 103
Dacryocystorhinography 104
Additional Neuroophthalmic Testing 104
The Swinging Flashlight Test 105
Oculocephalic Reflexes 105
Behavioral Testing of Vision 105
Electroretinography and Visual Evoked Potentials 106
Retinoscopy 106
Imaging Techniques 106
Radiography 106
Computed Tomography and Magnetic Resonance Imaging 106
Contrast Techniques 107
Ultrasonography 107
Fluorescein Angiography 108
6 Eyelids 110
Anatomy, Function, and General Pathologic Responses 110
Anatomy and Function 110
General Pathologic Responses 114
Premature or Delayed Opening of the Eyelids in Neonates 114
Eyelid Agenesis (Coloboma) 114
Prominent Nasal Skin Folds 115
Disorders of the Cilia 116
Clinical Signs of Cilia Disorders 117
Treatment of Distichiasis 117
Cryoepilation 118
Electroepilation 118
Treatment of Ectopic Cilia 118
Treatment of Trichiasis 119
Entropion 119
Clinical Signs of Entropion 120
Treatment of Entropion 120
Temporary “Tacking” Techniques 121
Injection Technique in Lambs 121
Wedge Resection 122
Hotz-Celsus Procedure 122
Combination Hotz-Celsus and Lateral Wedge Resection 122
Lateral Arrowhead Procedure and Tenotomy for Lateral Entropion 123
Medial Canthoplasty for Lower Medial Entropion and Brachycephalic Ocular Syndrome 123
Upper Eyelid Entropion 124
Ectropion 125
Treatment of Ectropion 125
Wedge Resection 125
“V-to-Y” Blepharoplasty 125
Eyelid Injuries 126
Treatment of Eyelid Injuries 126
Nonneoplastic Disorders of the Meibomian and Other Eyelid Glands 127
Chalazia 127
Hordeolum and Meibomian Adenitis 127
Neoplasia 128
Squamous Cell Carcinoma 129
Meibomian Adenoma 131
Feline Multiple Apocrine Hidrocystoma 131
Equine Sarcoid 131
Viral Papillomatosis 132
Mast Cell Tumors 132
Histiocytoma 132
Skin Diseases Affecting the Eyelids 132
7 Conjunctiva 140
Anatomy and Physiology 140
Conjunctival Wound Healing 141
Clinical Signs of Conjunctival Disease 141
Cellular Responses in Conjunctival Disease 141
Conjunctival Hyperemia 142
Chemosis (Conjunctival Edema) 142
Ocular Discharge 142
Conjunctival Swelling, Thickening, or Mass Formation 142
Conjunctival Ulceration 143
Follicle Formation 143
Pruritus 143
Conjunctivitis 143
Classification 143
Differential Diagnosis 143
Diagnostic Methods 144
Bacterial Culturing 144
Conjunctival Scrapings 145
Conjunctival Biopsy 145
General Treatment Considerations for Conjunctivitis 145
Antibiotics 146
Corticosteroids 146
Cleansing Agents 146
Topical Mast Cell Stabilizers and Antihistamines 146
Vasoactive Agents 146
Bacterial Conjunctivitis 146
Chlamydial Conjunctivitis 147
8 Third Eyelid 159
Anatomy and Physiology 159
Examination 160
Clinical Signs of Third Eyelid Disease 160
Structural Abnormalities of the Third Eyelid 160
Amelanotic Leading Edge of the Third Eyelid 160
Scrolling or Eversion of the Third Eyelid 160
9 Lacrimal System 165
Anatomy and Physiology 165
Lacrimal and Third Eyelid Glands 165
Accessory Lacrimal Glands 165
Precorneal Tear Film 166
Mucous Threads 167
Blinking 167
Lacrimal Puncta, Canaliculi, and Nasolacrimal Duct 168
Innervation 168
Disturbances of Lacrimal Function 169
Effects of Precorneal Tear Film Dysfunction 169
Examination 169
Disorders Characterized by Epiphora 170
Dacryocystitis 170
Clinical Signs. 170
Diagnosis. 170
Treatment. 170
Nasolacrimal Catheterization. 170
Dacryocystotomy. 170
Congenital Atresia, Ectopia, and Imperforate Puncta 171
Cystic Disorders 172
Cicatricial Nasolacrimal Obstructions 172
Conjunctivorhinostomy. 173
Conjunctivobuccostomy. 173
Tear-Staining Syndrome in Dogs 173
Treatment. 174
Other Causes of Epiphora 175
Deficiency of the Precorneal Tear Film 175
Mucin Deficiency 175
Lipid Deficiency 175
Deficiency of the Aqueous Layer 176
Keratoconjunctivitis Sicca 176
Etiologic Factors. 176
Drug-Induced. 176
Surgically Induced. 176
Immune Mediated. 176
Idiopathic. 176
Orbital and Supraorbital Trauma. 176
Infectious. 176
Locoweed Poisoning. 176
Other Causes. 176
Congenital. 176
Senile Atrophy. 177
Radiation. 177
Neurogenic. 177
Pathologic Changes. 177
Breed Predisposition. 177
Clinical Signs. 177
Mucoid and Mucopurulent Discharge. 177
Blepharospasm. 177
Corneal Ulceration. 177
Corneal Vascularization and Pigmentation. 177
Dry, Lusterless Cornea. 178
Dry Ipsilateral Nostril. 178
Chronic Staphylococcal Blepharitis. 178
Diagnosis. 178
Natural Course of the Disease. 178
Treatment. 178
Medical Therapy. 178
Stimulate Natural Tear Production. 178
Replacement of the Precorneal Tear Film. 179
Reduce Ocular Surface Inflammation. 180
Control Secondary Infection. 180
Removal of Excess Mucus. 180
Initial Treatment Plan and Follow-up. 180
Surgical Therapy 181
Parotid Duct Transposition. 181
Postoperative Treatment. 181
Operative and Postoperative Complications. 181
Neoplasia 183
10 Cornea and Sclera 184
Anatomy, Physiology, and Wound Healing 184
Cornea 184
Normal Corneal Healing 186
Epithelium 186
Stroma 186
Endothelium and Descemet’s Membrane 186
Effects of Corticosteroids on Corneal Healing 187
Sclera 187
Pathologic Responses 187
Corneal Edema 188
Corneal Vascularization 189
Corneal Fibrosis 190
Corneal Melanosis 190
Stromal Infiltration with White Blood Cells 192
Deposition of Abnormal Substances (Especially Lipid or Mineral) within the Cornea 192
Stromal Malacia (or “Melting”) 193
Corneal Diseases Present at Birth and Corneal Dystrophies 193
Microcornea 193
Dermoid 193
Persistent Pupillary Membranes 194
Corneal Epithelial Dysmaturation or “Puppy Dystrophy” 194
Corneal Lipid Dystrophy 195
Corneal Endothelial Dystrophy 195
Superficial Punctate Keratitis 195
Corneal Ulcers and Erosions in All Species 195
Common Causes of Corneal Ulceration or Erosion 196
Simple versus Complicated Ulcers and Erosions 196
General Principles of Corneal Ulcer and Erosion Treatment 197
Antibiotics 197
Mydriatic Therapy 198
Analgesic and Antiinflammatory Agents 198
Prevention of Self-trauma 198
Temporary Tarsorrhaphy versus Third Eyelid Flap 198
Treatment of Uncomplicated (Simple) Corneal Ulcers and Erosions 199
Treatment of Deep (Stromal) Corneal Ulcers or Descemetoceles 199
Cyanoacrylate Adhesives (Tissue Glue) 201
Protease Inhibitors 202
Corneal Trauma and Foreign Bodies 202
Corneal Lacerations 202
Removal of Corneal Foreign Bodies 203
Epithelial Inclusion Cysts 203
Neurogenic Keratitis 204
“Florida Keratopathy” or “Florida Spots” 204
Corneal Disease of Dogs 204
Pigmentary Keratitis 204
“Pannus” or Chronic Immune-Mediated Superficial Keratoconjunctivitis 205
Indolent Corneal Ulcers and Erosions 206
Canine Herpesvirus 208
Infectious Canine Hepatitis 208
Corneal Disease of Cats 208
Feline Herpetic Keratitis 209
Feline Eosinophilic Keratoconjunctivitis 209
Feline Corneal Sequestration 210
Acute Bullous Keratopathy 210
Ulcerative Mycoplasmal Keratitis 211
Mycobacterial Keratitis 211
Corneal Disease of Horses 211
Equine Fungal Keratitis 211
Stromal Abscesses 213
Equine Eosinophilic Keratoconjunctivitis 214
Chronic Superficial Corneal Ulcers and Erosions in Horses 214
Corneal Disease of Ruminants 214
Infectious Bovine Keratoconjunctivitis 215
Infectious Bovine Rhinotracheitis 216
Malignant Catarrhal Fever 216
Scleral and Limbal Disorders 216
Colobomatous Defects 216
Scleritis and Episcleritis 217
Scleral Trauma 218
Limbal Neoplasia 218
11 Uvea 220
Anatomy and Physiology 220
Iris 220
Ciliary Body 221
Choroid 222
Blood-Ocular Barrier 225
Pathologic Reactions 226
Definitions 226
Immune Mechanisms 226
Congenital Uveal Abnormalities 227
Abnormalities of the Pupil 227
Persistent Pupillary Membrane 227
Coloboma 227
Anterior Segment Dysgenesis 227
Disorders of Pigmentation 228
Heterochromia 228
Iris Nevus 229
Waardenburg Syndrome 229
Uveitis 229
Clinical Signs 229
Sequelae of Uveitis 229
Posterior Synechiae 229
Peripheral Anterior Synechiae 230
Cataract 230
Glaucoma 230
Retinal Detachment 230
Atrophy 230
Preiridal Fibrovascular Membranes 230
Cyclitic Membranes 230
Diagnosis of Uveitis 230
General Therapeutic Principles 231
1. Make an Etiologic Diagnosis 231
2. Control Inflammation 231
Corticosteroids. 231
Nonsteroidal Antiinflammatory Drugs. 233
Immunosuppressive Agents. 233
3. Prevent Undesirable Sequelae 233
Mydriatics and Cycloplegics. 233
Antiglaucoma Drugs. 233
4. Relieve Pain 233
Specific Forms of Uveitis 233
Infectious Uveitis 233
Immune-Mediated Uveitis 234
Uveodermatologic Syndrome. 234
Lens-Induced Uveitis. 234
Leakage through the Intact Lens Capsule. 234
Penetrating Lens Injuries. 234
Uveitis Associated with Dental Disease. 235
Golden Retriever Uveitis. 235
Feline Uveitis. 235
Equine Recurrent Uveitis. 235
History and Geographic Distribution. 236
Etiologic Factors. 236
Leptospira-Associated Uveitis. 236
Clinical Signs of ERU. 237
Active Phase. 237
Quiescent Phase. 237
Treatment. 237
Onchocerca Uveitis. 240
Treatment. 240
Phacoclastic Uveitis in Rabbits. 240
Toxic Uveitis. 241
Trauma 241
Traumatic Uveitis 241
Iris Prolapse 241
Signs 241
Treatment 241
Visual Outcome and Ocular Survival after Iris Prolapse in Horses 241
Hyphema 242
Etiologic Factors 242
Treatment 242
Additional Therapy for Mild Hyphema 242
Additional Therapy for Severe Hyphema 242
Recurrent Hyphema 242
Uveal Cysts and Neoplasms 242
Uveal Cysts 243
Cystic Corpora Nigra in Horses 243
Primary Tumors 243
Adenocarcinoma and Adenoma 243
Melanocytoma and Melanoma 244
Clinical Signs. 244
Treatment. 244
Ocular Melanosis of Cairn Terriers 244
Feline Diffuse Iris Melanoma 245
Primary Feline Ocular Sarcomas 245
Secondary Tumors 245
Lymphosarcoma 245
Miscellaneous Disorders 246
Iris Hypoplasia 246
Iris Atrophy 246
Primary Iris Atrophy 246
Secondary Iris Atrophy 246
Senile Iris Atrophy 246
12 The Glaucomas 247
Aqueous Production and Drainage 247
Balancing Aqueous Production and Outflow 248
Causes of Variations in Intraocular Pressure 248
Diurnal Variation 248
Age 248
Blood Flow 249
Drugs 249
Ocular Inflammation 249
Diagnostic Methods 249
Tonometry 249
Ophthalmoscopy 249
Gonioscopy 249
Clinical Signs 251
Increased Intraocular Pressure 251
Pain, Blepharospasm, and Altered Behavior 251
Engorged Episcleral Vessels 251
Corneal and Scleral Changes 252
Edema 252
Buphthalmos and Descemet’s Streaks 252
Changes in Anterior Chamber Depth 252
Fixed Dilated Pupil 252
Lens Changes 253
Fundus Changes 254
Impaired Vision 254
Optic Disc Cupping 254
Retinal Degeneration 255
Classification 257
Pathogenesis 260
Primary Open-Angle Glaucoma 260
Primary Angle-Closure Glaucoma 260
Secondary Glaucomas 262
Obstruction of the Iridocorneal Angle 262
Pupillary Block 262
Ciliary Body–Vitreous–Lens Block 262
Combined-Mechanism Glaucoma 264
Treatment 264
Emergency Treatment of Acute Glaucoma 265
Long-Term Management of Glaucoma 265
Surgical Therapy for Glaucoma 266
Surgery to Increase Aqueous Humor Outflow 266
Surgery to Reduce Aqueous Humor Production 267
Cyclocryotherapy 267
Laser Cyclophotocoagulation 268
Combined Procedures 268
Lens Luxation 268
Glaucoma Secondary to Uveitis 269
Glaucoma Secondary to Intraocular Neoplasia 269
Absolute Glaucoma 269
Evisceration with Intrascleral Prosthesis 269
Enucleation 270
Feline Glaucoma 270
Equine Glaucoma 271
13 Lens 272
Anatomy and Physiology 272
Lens Components 272
Capsule 272
Lens Epithelium 273
Lens Fibers 273
Metabolism and Composition 273
Nuclear Sclerosis 275
Congenital Anomalies 275
Cataract 276
Molecular and Cellular Pathogenesis of Cataracts 276
Classification 277
Degree of Opacity and Maturation 277
Causes of Cataracts 279
Hereditary Cataracts 279
Congenital Cataracts 279
Diabetic Cataracts 280
Acquired Cataracts 281
Senile Cataracts 282
Diagnosis 282
History 282
Clinical Signs 282
Lens-Induced Uveitis 283
Treatment of Cataract 283
Medical Therapy 283
Surgical Case Selection 284
Surgical Correction 284
Discission and Aspiration. 284
Intracapsular Extraction. 284
Extracapsular Extraction. 285
Phacoemulsification. 285
Postoperative Vision and IOL Implantation 285
Complications, Postoperative Care, and Prognosis 286
Cataracts in Horses 287
Lens Luxation 287
Etiology 287
Clinical Signs and Diagnosis 288
Treatment 290
14 Vitreous 291
Anatomy and Physiology 291
Anatomy 291
Composition 292
Function 292
Pathologic Reactions 292
Congenital and Developmental Abnormalities 293
Persistent Hyaloid Artery 293
Persistent Tunica Vasculosa Lentis 293
Persistent Hyperplastic Tunica Vasculosa Lentis/Persistent Hyperplastic Primary Vitreous 293
Acquired Disorders 294
Vitreous Degeneration 294
Vitreous Hemorrhage 294
Infection and Inflammation 295
Vitreous Opacities (Floaters) 295
Asteroid Hyalosis and Synchysis Scintillans 295
Vitreous Mass 296
Role of the Vitreous in the Pathogenesis of Ocular Diseases 296
Vitreous and Lens Luxation 296
Aqueous Humor Misdirection Syndrome 296
Retinal Detachment 296
Surgical and Diagnostic Procedures 297
Hyalocentesis 297
Vitrectomy 297
Advanced Vitreoretinal Surgical Techniques 297
15 Retina 299
Cellular Anatomy 299
Blood Supply 302
Physiology and Biochemistry 303
Rods and Cones 303
Visual Photopigments 305
Photochemistry 307
Dark Adaptation 307
Electroretinography 307
Applied Anatomy (Ophthalmoscopic Variations) 310
Tapetum 310
Nontapetum 310
Optic Disc 311
Blood Vessels 312
Myelination of Nerve Fiber Layer 313
Pathologic Mechanisms 313
Ischemia 313
Retina-Optic Nerve Interaction 314
Interactions with Choroid 314
Primary Photoreceptor Disease 314
Reactions of Pigment Epithelium 314
Perivascular Cuffing 316
Retinal Hemorrhages 316
Gliosis 316
Congenital Retinal Disorders 317
Retinal Dysplasia 317
Collie Eye Anomaly 318
Coloboma 320
Retinopathy 320
Inherited Retinopathies 320
Classification of Inherited Retinopathies 321
Age of Onset. 321
Affected Cells. 321
Mode of Inheritance. 321
Genetic and Molecular Pathogenesis. 321
Clinical Signs 321
Progressive Loss of Vision. 321
Tapetal Hyperreflectivity. 323
Retinal Blood Vessels. 323
Optic Disc. 323
Nontapetal Fundus. 323
Pupils. 323
Cataracts. 323
Additional Diagnostic Testing 323
Treatment 324
Specific Forms of Inherited Retinopathy 325
Hemeralopia. (Achromatopsia). 325
Retinal Pigment Epithelium Dystrophy. 325
Congenital Stationary Night Blindness. 325
Canine Multifocal Retinopathy. 326
Retinal Dystrophy in Briards. 326
Inherited Retinal Degenerations in Cats. 326
Acquired Retinopathies 326
Retinopathy Secondary to Cardiovascular Diseases 326
Retinopathy Secondary to Infectious and Inflammatory Diseases 327
Active Chorioretinitis. 327
Inactive Chorioretinitis. 329
Specific Retinopathies 329
Glaucomatous Retinopathy 329
Uveodermatologic Syndrome 329
Sudden Acquired Retinal Degeneration 329
Miscellaneous Causes of Retinopathy 329
Nutritional Causes 329
Feline Central Retinal Degeneration. 329
Hypovitaminosis A. 330
Storage Diseases 330
Drug and Plant Toxicities 330
Ivermectin Toxicity. 330
Enrofloxacin Toxicity in Cats. 331
Plant Poisonings in Food Animals. 331
Oxygen Toxicity in Cats and Dogs. 331
Retinal Detachment 331
Etiologic Factors 331
Signs 332
Therapy 332
16 Neuroophthalmology 334
Nerve Supply of the Eye and Adnexa 334
Optic Nerve (Cranial Nerve II) 334
Oculomotor Nerve (Cranial Nerve III) 334
Trochlear Nerve (Cranial Nerve IV) 335
Trigeminal Nerve (Cranial Nerve V) 335
Abducent Nerve (Cranial Nerve VI) 336
Facial Nerve (Cranial Nerve VII) 336
Assessing Vision and Pupillary Light Reflexes 336
Vision and the Menace Response 336
Tracking Moving Objects 339
Maze Test 339
Visual Placing Response 339
Pupillary Light Reflex 339
The Anatomic Basis of the Pupillary Light Reflex 339
Testing the Pupillary Light Reflex 340
Swinging Flashlight Test 341
Dazzle Reflex 341
Electrophysiology 342
Lesions in Patients with Visual and Pupillary Light Reflex Deficits 342
Lesions in Blind Patients with Normal Pupillary Light Reflexes 342
Lesions in Blind Patients with Abnormal Pupillary Light Reflexes 342
Pupils in Patients with Intracranial Injury 346
Lesions Causing Pupillary Light Reflex Abnormalities in Visual Patients 348
Additional Causes of Pupillary Light Reflex Abnormalities 349
Extraocular Muscles and Lesions Causing Strabismus 349
Function of the Extraocular Muscles 349
Lesions Causing Strabismus 350
Strabismus Caused by Disorders of the Vestibular System 350
Strabismus Caused by Lesions in Innervation of the Extraocular Muscles 350
Oculomotor Paralysis. 350
Abducens Paralysis. 351
Trochlear Paralysis. 351
Lesions of Additional Cranial Nerves 351
Facial Nerve Paralysis 351
Causes of Facial Nerve Paralysis and Other Associated Signs 352
Trigeminal Nerve Dysfunction 353
Lesions Causing Eyelid Abnormalities 353
Third Eyelid Abnormalities 353
Protrusion of the Third Eyelid 353
Horner’s Syndrome. 353
Tetanus. 353
Facial Nerve Paralysis. 354
Haws Syndrome. 354
Dysautonomia. 354
Congenital Myotonia. 354
Nonneurogenic Causes. 354
Lesions Causing Abnormalities of the Palpebral Fissure 354
Innervation of the Upper Eyelid 354
Lesions Increasing the Size of the Palpebral Opening 354
Lesions Decreasing the Size of the Palpebral Opening 355
Autonomic Innervation and Abnormalities 355
Parasympathetic Lower Motor Neuron Innervation 356
Sympathetic Lower Motor Neuron Innervation 356
Diseases of the Sympathetic System 356
Horner’s Syndrome 356
Clinical Signs. 356
Etiologic Factors. 357
Diagnosis. 358
Treatment. 359
Dysautonomia (Key-Gaskell Syndrome). 359
Clinical Signs. 359
Diagnosis. 359
Demonstration of Parasympathetic Denervation. 359
Demonstration of Sympathetic Denervation. 360
Treatment. 360
Vestibular System and Nystagmus 360
Nystagmus 360
Normal Vestibular Nystagmus 360
Disorders of the Vestibular System 361
Eye Position in Vestibular Disease 361
Loss of Normal Nystagmus 361
Pathologic Nystagmus 361
Diseases Causing Pathologic Nystagmus 361
Otitis Media and Otitis Interna. 361
Idiopathic Vestibular Disease (Feline Vestibular Syndrome, Idiopathic Benign Vestibular Disease, Old Dog Vestibular Disease). 361
Central Disorders. 362
Congenital Nystagmus. 362
Diseases of the Central Visual Pathways 362
Diseases of the Optic Nerve 362
Congenital Anomalies 362
Aplasia and Hypoplasia. 362
Colobomas. 363
Inflammatory Disorders 363
Optic Neuritis. 363
Etiologic Factors. 363
Clinical Signs. 363
Differential Diagnosis. 364
Treatment. 364
Exudative Optic Neuritis and Optic Neuropathy in Horses. 364
Neoplasms 365
Clinical Signs. 366
Diagnosis and Treatment. 366
Optic Neuropathy 366
Etiologic Factors. 366
17 Orbit 372
Anatomy 372
Extraocular Muscles 376
Pathologic Mechanisms 376
Diagnostic Methods 378
Localization of Foreign Bodies 378
Orbital Diseases 379
Orbital Cellulitis and Orbital Abscess 379
Clinical Signs. 380
Treatment. 380
Cystic Orbital and Periocular Lesions 382
Frontal Sinus Mucocele 382
Zygomatic Mucocele 382
18 Ocular Manifestations of Systemic Diseases 394
Ocular Manifestations of Systemic Diseases in Dogs and Cats (Tables 18-1 to 18-16) 394
Infectious Diseases 394
Canine Viral Diseases 394
Canine Distemper. 394
Infectious Canine Hepatitis. 395
Canine Herpes Virus. 396
Feline Viral Diseases 396
Feline Herpesvirus Infection. 396
Feline Calicivirus Infection. 399
Feline Leukemia Virus Infection. 400
Feline Immunodeficiency Virus Infection. 401
Feline Infectious Peritonitis. 402
Canine Bacterial Diseases 403
Brucellosis. 403
Borreliosis (Canine Lyme Disease). 404
Rickettsiosis (Rocky Mountain Spotted Fever and Ehrlichiosis). 405
Rocky Mountain Spotted Fever. 405
Canine Monocytic Ehrlichiosis. 405
Bacterial Diseases of Dogs and Cats 406
Bartonellosis. 406
Feline Bacterial Diseases 407
Chlamydiosis (Chlamydophilosis). 407
Mycoplasmosis. 407
Mycotic Diseases of Dogs and Cats 408
Blastomycosis. 408
Coccidioidomycosis. 412
Cryptococcosis. 412
Histoplasmosis. 413
Parasitic Diseases of Dogs and Cats 413
Toxoplasmosis. 413
Canine Parasitic Diseases 414
Neosporosis. 414
Visceral Leishmaniasis. 414
Endocrine Diseases 415
Endocrine Diseases of Dogs and Cats 415
Diabetes Mellitus. 415
Canine Endocrine Diseases 416
Hyperadrenocorticism. 416
Hypothyroidism. 416
Metabolic Diseases of Dogs and Cats 417
Hyperlipidemia. 417
Cardiovascular Diseases of Dogs and Cats 417
Thrombocytopenia and Thrombopathy (Thrombasthenia). 417
Systemic Hypertension. 418
Polycythemia. 419
Hyperviscosity Syndrome. 419
Immune-Mediated Diseases in Dogs 421
Uveodermatologic Syndrome (Vogt-Koyanagi-Harada–like Syndrome). 421
Idiopathic Diseases in Dogs 421
Sudden Aquired Retinal Degeneration. 421
Ocular Manifestations of Systemic Diseases in Horses (Tables 18-21 to 18-32) 422
Infectious Diseases 422
Viral Respiratory Diseases 422
Equine Herpesvirus (Rhinotracheitis or Rhinopneumonitis). 422
Equine Viral Arteritis. 422
Equine Influenza. 422
Other Viral Diseases. 423
Bacterial Diseases 423
Leptospirosis. 423
Strangles. 424
Salmonellosis. 425
Lyme Disease. 425
Protozoal Diseases 425
Babesiosis (Piroplasmosis). 425
Potomac Horse Fever. 425
Parasitic Diseases 426
Habronemiasis. 426
Cutaneous Onchocerciasis. 427
Adult Nematode Infections of the Eye. 428
Neurologic Diseases 428
Equine Protozoal Myeloencephalitis. 428
Viral Encephalitis. 428
Meningitis. 429
Photic Head Shaking in Horses. 429
Neuromuscular Diseases 429
Tetanus. 429
Botulism (Shaker Foal or Forage Poisoning). 429
Equine Motor Neuron Disease. 429
Miscellaneous Diseases 430
Lymphoma (Lymphosarcoma). 430
Severe Blood Loss. 430
Lightning Strike 430
Grass Sickness (Equine Dysautonomia). 430
Neonatal Diseases 430
Acquired Entropion. 430
Prematurity. 431
Sepsis and Failure of Passive Transfer. 431
Hypoxic Ischemic Encephalopathy. 431
Neonatal Isoerythrolysis. 432
Rhodococcus Equi Infection. 432
Ocular Manifestations of Systemic Diseases in Ruminants (See Tables 18-21 to 18-32) 432
Infectious Diseases 432
Bacterial Diseases 432
Listeriosis. 432
Ovine Chlamydial Polyarthritis and Conjunctivitis. 432
Mycoplasmal Keratoconjunctivitis in Goats and Sheep. 433
Thromboembolic Meningoencephalitis. 433
Mannheimia (Pasteurella) Pneumonia. 433
Tuberculosis. 433
Septicemia. 433
Viral Diseases 434
Arthrogryposis-Hydrencephaly. 434
Bluetongue. 434
Infectious Bovine Rhinotracheitis. 434
Malignant Catarrhal Fever. 435
Bovine Viral Diarrhea. 435
Maedi-Visna. 435
Protozoal Diseases 435
Babesiosis and Trypanosomiasis. 435
Toxoplasma Gondii Infection. 435
Other Infectious Diseases 435
Scrapie. 435
Coenurosis. 436
Miscellaneous Diseases 436
Lymphosarcoma. 436
Polioencephalomalacia. 436
Toxic Plants. 436
Vetch Toxicity. 436
19 Ocular Emergencies 437
Basic Materials Required to Address Ocular Emergencies 437
Basic Diagnostic Instruments and Supplies 437
Surgical Instruments 437
Medications 437
Proptosis of the Globe 437
Prognosis 438
Avulsion of Extraocular Muscles 438
Hyphema 439
Pupils 439
Skull Conformation 439
Postoperative Therapy 439
Severe Ocular and Adnexal Contusions and Concussion 439
Common Clinical Signs Associated with Ocular Trauma 440
Penetrating Injuries of the Globe 441
Lid Lacerations 441
Treatment 441
Important Facts 442
Corneal Lacerations 442
Severe Corneal Ulceration 442
Glaucoma 443
Interim Therapy 443
Hyphema 443
Acute Anterior Uveitis 443
Acute Anterior Lens Luxation 444
Sudden Blindness 444
20 Ophthalmology of Exotic Pets 445
Ophthalmic Examination and Diagnostic Testing 445
Rabbits 446
Ophthalmic Anatomy 446
Orbital Disease 446
Adnexal Disease 447
Conjunctival Disease 447
Nasolacrimal Disease 448
Corneal Disease 448
Cataract 449
Glaucoma 450
Ferrets 450
Ophthalmic Anatomy 450
Orbital Disease 450
Conjunctival Disease 450
Cataract 451
Mice and Rats 451
Ophthalmic Anatomy 451
Nasolacrimal Disease 451
Corneal Disease 452
Cataract 452
Retinal Disease 452
Chinchillas 452
Ophthalmic Anatomy 452
Ophthalmic Disease 453
Guinea Pigs 453
Ophthalmic Anatomy 453
Adnexal Disease 453
Surface Ocular Disease 454
Corneal Disease 454
Conjunctival Disease 454
Intraocular Disease 454
Cataract 454
Heterotopic Bone 454
Raptors and Pet Birds 455
Ophthalmic Anatomy 455
Ophthalmic Disease 455
Trauma 455
Conjunctival Disease 456
Lizards, Turtles, Tortoises, and Crocodilians 457
Ophthalmic Anatomy 457
Ophthalmic Disease 457
Snakes 458
Ophthalmic Anatomy 458
Diseases of the Spectacle 459
Amphibians 460
Ophthalmic Anatomy 460
Ophthalmic Disease 460
Appendix Breed Predisposition to Eye Disorders* 463
Dogs 463
Afghan Hound 463
Airedale 463
Akbash 463
Akita 463
Alaskan Malamute 463
American Cocker Spaniel 463
American Eskimo Dog 464
American Pit Bull Terrier 464
American Staffordshire Terrier 464
American Water Spaniel 464
Australian Cattle Dog (Queensland Heeler or Blue Heeler) 464
Australian Shepherd 464
Australian Terrier 464
Basenji 464
Basset Hound 464
Beagle 464
Bearded Collie 464
Bedlington Terrier 464
Belgian Malinois 465
Belgian Sheepdog (Belgian Shepherd—Groenendael) 465
Belgian Tervuren 465
Bernese Mountain Dog 465
Bichon Frise 465
Black and Tan Coonhound 465
Bloodhound 465
Border Collie 465
Border Terrier 465
Borzoi 465
Boston Terrier 465
Bouvier des Flandres 466
Boxer 466
Boykin Spaniel 466
Briard 466
Brittany Spaniel 466
Brussels Griffon 466
Bull Mastiff 466
Bull Terrier 466
Cairn Terrier 466
Cardigan Welsh Corgi 466
Cavalier King Charles Spaniel 467
Chesapeake Bay Retriever 467
Chihuahua 467
Chinese Crested 467
Chow Chow 467
Clumber Spaniel 467
Collie (Rough and Smooth) 467
Coonhound 467
Corgi 467
Coton de Tulear 467
Curly Coated Retriever 468
Dachshund (All Varieties) 468
Dalmatian 468
Dandie Dinmont Terrier 468
Doberman Pinscher 468
English Bulldog 468
English Cocker Spaniel 468
English Setter 468
English Springer Spaniel 468
English Toy Spaniel (King Charles, Prince Charles, Ruby, Blenheim) 469
Entlebucher 469
Field Spaniel 469
Flat Coated Retriever 469
Fox Terrier (Smooth) 469
Fox Terrier (Wirehaired) 469
French Bulldog 469
German Shepherd 469
German Shorthaired Pointer 469
German Wirehaired Pointer 469
Giant Schnauzer 470
Golden Retriever 470
Gordon Setter 470
Great Dane 470
Great Pyrenees 470
Greater Swiss Mountain Dog 470
Greyhound 470
Havanese 470
Irish Setter 470
Irish Water Spaniel 470
Irish Wolfhound 471
Italian Greyhound 471
Jack Russell Terrier 471
Japanese Chin 471
Keeshond 471
Kerry Blue Terrier 471
Komondor 471
Kuvasz 471
Labrador Retriever 471
Lakeland Terrier 471
Leonberger 471
Lhasa Apso 472
Löwchen 472
Maltese Terrier 472
Manchester Terrier 472
Mastiff 472
Miniature Australian Shepherd 472
Miniature Bull Terrier 472
Miniature Pinscher 472
Miniature Schnauzer 472
Newfoundland 472
Norfolk Terrier 473
Norwegian Buhund 473
Norwegian Elkhound 473
Norwich Terrier 473
Nova Scotia Duck Tolling Retriever 473
Old English Sheepdog 473
Papillon 473
Parson Russell Terrier 473
Pekingese 473
Pembroke Welsh Corgi 473
Petit Basset Griffon Vendéen 473
Pointer 474
Polish Lowland Sheepdog 474
Pomeranian 474
Poodle (All Varieties) 474
Portuguese Water Dog 474
Pug 474
Puli 474
Queensland Blue Heeler 474
Rat Terrier 474
Redbone Coonhound 474
Rhodesian Ridgeback 474
Rottweiler 474
Saint Bernard 475
Saluki 475
Samoyed 475
Schipperke 475
Scottish Terrier 475
Sealyham Terrier 475
Shar-Pei 475
Shetland Sheepdog (Sheltie) 475
Shiba Inu 475
Shih Tzu 475
Siberian Husky 476
Silky Terrier 476
Skye Terrier 476
Smooth Fox Terrier 476
Soft-Coated Wheaten Terrier 476
Spinone Italiano 476
Spitz 476
Staffordshire Bull Terrier 476
Standard Schnauzer 476
Sussex Spaniel 476
Swedish Vallhund 476
Tibetan Spaniel 476
Tibetan Terrier 477
Toy Havanese 477
Toy Terrier 477
Vizsla 477
Weimaraner 477
Welsh Springer Spaniel 477
Welsh Terrier 477
West Highland White Terrier 477
Whippet 477
Wire Fox Terrier 477
Yorkshire Terrier 477
Cats 477
Abyssinian 477
Albinotic Felidae 477
Birman 477
Burmese 477
Domestic Shorthair 478
Himalayan 478
Korat 478
Manx 478
Persian 478
Siamese 478
Cattle 478
Aberdeen Angus 478
Ayrshire 478
Beef Master 478
Brahman 478
Brown Swiss 478
Charolais 478
Devon 478
Friesian (Holstein) 478
German Spotted 478
Guernsey 478
Hereford 478
Jersey 478
Shorthorn 479
Simmental 479
Sheep 479
Corriedale 479
Hampshire Downs 479
New Zealand Romney 479
Piebald 479
Shropshire 479
Southdown 479
South Hampshire 479
Suffolk 479
Horses 479
Appaloosa 479
Arabian 479
Belgian 479
Clydesdale 479
Lipizzaner 479
Morgan 479
Quarter Horse 479
Rocky Mountain Horse 479
Shire 479
Thoroughbred 479
Goat 479
Angora 479
Pigs 479
Miniature Swine 479
Pot-Bellied 479
Yorkshire 479
Glossary 481
Index 491
A 491
B 491
C 492
D 494
E 495
F 496
G 497
H 497
I 498
J 498
K 498
L 499
M 499
N 500
O 501
P 501
R 502
S 503
T 504
U 505
V 505
W 506
X 506
Y 506
Z 506
Inside Back Cover ibc1