Computed tomographic diagnosis of unilateral cavernous sinus syndrome caused by a chondrosarcoma in a dog: a case report

An eight-year old Rottweiler dog was presented with signs of enophthalmia, ptosis, anisocoria and mydriasis of the right eye, which showed visual disturbance, reduced or absent reflexes, and ophthalmoplegia. Consensual pupillary light reflex was also absent in the left eye. These neurological deficits were compatible with cavernous sinus syndrome. Computed tomography images of the cavernous sinus and the optical fissure revealed a mildly calcified mass arising from the right presphenoid bone extending further caudally into the orbital foramina. This extension of the mass affected the normal function of several cranial nerves. The dog was euthanased within one year of the initial presentation following development of forebrain signs. A chondrosarcoma was diagnosed histologically after necropsy.     

Nasal adenocarcinoma with diffuse metastases involving the orbit,cerebrum, and multiple cranial nerves in a horse

A 9-year-old Trakehner gelding was examined because of right exophthalmus. Clinical findings included a lack of menace response in the right eye, reduced direct and consensual right pupillary light reflexes, ventrolateral strabismus of the right eye, mild right-sided facial asymmetry, a head tilt to the left, and increased extensor tone in the right limbs. Findings were suggestive of a multifocal lesion affecting the right forebrain; right optic, oculomotor, and facial nerves; and left vestibulocochlear nerve. Ultrasonographic examination of the right eye revealed a vascular retrobulbar mass. Computed tomographic imaging revealed a mass that filled the nasal cavity and invaded the forebrain. Necropsy revealed an undifferentiated nasal adenocarcinoma affecting the orbit with metastases to the right parotid gland, cranial cervical lymph nodes, fascial planes of the neck, and lungs. No evidence of direct involvement of the right facial and left vestibulocochlear nerves was found, suggesting the possibility of paraneoplastic peripheral neuropathy.     

Mast cell tumour in the third eyelid of a mare

A 4‐year‐old Missouri Fox Trotter mare was referred to the Veterinary Teaching Hospital, Koret School of Veterinary Medicine with a reddish mass protruding from the third eyelid and adjacent palpebral conjunctiva of the left eye. On ophthalmic examination, the mare showed mild blepharospasm, mild mucopurulent discharge and mild corneal oedema in the left eye. Menace response, pupillary light reflexes and intraocular examination were normal. A rounded, fleshy red ulcerated mass, approximately 3 cm in diameter, expanded the edge of the outer surface of the medial third eyelid and conjunctiva of the ventromedial palpebral region. Physical examination was otherwise unremarkable. Based on history and clinical findings, surgical removal was elected. The tumour was excised and the conjunctiva in the area of tumour treated with cryotherapy. Histological evaluation revealed a mast cell tumour on the third eyelid. Nine months follow‐up revealed no recurrence.     

A retrobulbar meningioma as a cause of unilateral exophthalmos and blindness in a horse

This report describes the unusual diagnosis of a retrobulbar syncytial meningioma in a 16‐year‐old Thoroughbred gelding. The horse initially presented with unilateral left sided exophthalmos and apparent blindness characterised by unilaterally absent menace and pupillary light responses. Magnetic resonance imaging (MRI) identified a well‐defined soft tissue mass intimately associated with the optic nerve. Based on the characteristic MRI appearance, a meningioma was suspected. The eye was enucleated under general anaesthesia and partial excision of the mass was achieved. Histopathology confirmed the diagnosis and the horse underwent a course of adjuvant radiotherapy. Twelve months following surgery the horse is back in work, no neurological abnormalities have been detected and follow‐up computed tomographic imaging of the skull has revealed mild bone sclerosis with no remnants of the mass identified.     

Bilateral lymphosarcoma of the nictitating membrane in a Quarter Horse

A 21-year-old Quarter Horse mare presented for a mass of the right nictitating membrane. The entire right nictitating membrane was surgically removed and diagnosed as a mixed cell lymphosarcoma and squamous cell carcinoma. The horse had no systemic signs of lymphosarcoma. Approximately 1.5 years later, the horse presented with a similar mass in the left nictitating membrane. The entire left nictitating membrane was surgically removed and diagnosed as a mixed cell lymphosarcoma. In this case, complete surgical removal of the masses resulted in a cure. The horse has remained free of systemic lymphosarcoma for over 3 years.

Case report

A 21-year-old gray Quarter Horse mare was presented to the Kansas State University Veterinary Medical Teaching Hospital for evaluation of a mass involving the right nictitating membrane. The mass was first noticed 5 weeks before presentation and had been treated by the referring veterinarian with a topical steroid solution twice daily. Administration of the topical steroid caused some decrease in the swelling, but it quickly returned once medication was discontinued. The horse had no other medical complaints and appeared to be otherwise healthy. On ocular examination, chemosis of the third eyelid and conjunctiva of the right eye was evident. Direct and indirect pupillary light reflexes, Schirmer tear test, and intraocular pressures were normal in both eyes. Fluorescein stain uptake was negative in both corneas. Cranial nerve and vision examinations did not reveal any abnormalities. On further examination of the right nictitating membrane, a firm mass was palpated under and protruding from the palpebral conjunctiva (Fig 1). No other abnormalities were found on physical examination.     

Phacoemulsification and +14 diopter intraocular lens placement in a Saddlebred foal

A 2‐month‐old, 110‐kg Saddlebred filly presented for evaluation of bilateral cataracts. A hypermature cataract in the left eye (OS) and an incipient nuclear cataract in the right eye (OD) were diagnosed. Electroretinography and ocular ultrasound revealed no contraindications for surgical removal of the cataractous lens OS. Phacoemulsification and implantation of a +14 diopter (D) intraocular lens (IOL) OS were performed at 4 months of age without complication, with the exception of a partial iridectomy performed on a small iris section that prolapsed through the corneal incision. Complete ophthalmic examinations, including ocular ultrasound and streak retinoscopy, were performed 1, 2, 6 weeks, 4 months, 1, and 2 years postoperatively. Diffuse corneal edema and a superficial corneal ulcer developed OS during the early postoperative period and resolved without complication. Dyscoria was identified owing to anterior synechia of the dorsomedial iris at the incision site. Two years after surgery, menace response, palpebral reflex, dazzle reflex, and pupillary light reflexes were present in both eyes (OU). The IOL remained centrally positioned within the capsule, with mild anterior tilting of the superior portion of the IOL and mild fibrosis of the lens capsule. The postoperative net refractive error was +0.31 D OS. Based on this report, a +14 D IOL may be the appropriate choice following lens extraction in a foal to achieve refraction near emmetropia at maturity. To our knowledge, this is the first report of phacoemulsification and IOL implantation in a foal with long‐term follow‐up.     

Anterior lens capsule disruption and suspected malignant glaucoma in a dog

A Boston Terrier puppy presented with a full-thickness peripheral corneal defect, iris prolapse and anterior lens capsule tear in the left eye (OS). Phacofragmentation and primary repair of the corneal laceration was performed. At surgery, subluxation of the lens was also apparent. One day postoperative, there was severe corneal edema, diffuse hyphema, an intraocular pressure (IOP) of 65 mmHg and a small amount of vitreous that protruded from the corneal incision OS. Malignant glaucoma or pupillary block glaucoma were suspected. Intravenous mannitol was administered preoperatively and had no effect. An anterior vitrectomy was performed on the vitreous within the anterior chamber and pupil. One day postoperative the IOP was 16 mmHg in the right eye (OD) and 20 mmHg OS. Postoperative iridocyclitis was managed medically, and additional elevations in IOP were not recorded. Resolution of the elevated IOP following anterior vitrectomy was supportive of pupillary block or malignant glaucoma. Vision returned 3 weeks after the initial surgery. Two years after the initial injury, the eye is visual and comfortable with infrequent topical anti-inflammatory therapy.     

Effect of topical phenylephrine on the equine pupil

The mydriatic effect of 10% phenylephrine was evaluated in 9 horses. Base-line pupillary size in mesopic conditions and during light stimulation was ascertained before application of pharmacologic agents. In study 1, 10% phenylephrine was applied to each eye (n = 5 horses). After 15 minutes, the pupillary size was determined in both lighting conditions. Phenylephrine was again applied to each eye, and after an additional 15 minutes, the pupillary size was determined. In study 2, 1% tropicamide was applied to each eye (n = 4 horses), and after 30 minutes, the pupillary size was determined in both lighting conditions. Tropicamide and phenylephrine were applied to each eye immediately after determination of pupillary size, and after an additional 30 minutes, the pupillary size was determined. There was no significant change (P greater than 0.9) in pupillary size when phenylephrine was used alone or when phenylephrine was used in an eye that had been dilated with tropicamide.     

Successful medical treatment for globe penetration following tooth extraction in a dog

A five‐year‐old entire male Tibetan Terrier was referred for left‐sided periorbital swelling and blepharospasm 4 days following ipsilateral maxillary tooth extraction. Examination of the left eye revealed mild exophthalmos, pain on retropulsion, and absent menace response and pupillary light reflexes. Examination of the posterior segment was not possible owing to the anterior segment pathology. Differential diagnoses considered were iatrogenic globe penetration and peribulbar abscess/cellulitis. Ocular ultrasound was consistent with a penetrating wound to the globe. Treatment with systemic prednisolone and marbofloxacin, and topical atropine sulfate 1%, prednisolone acetate, and brinzolamide was started. Marked clinical improvement allowed visual confirmation of the perforation. Oral prednisolone was tapered over the following 10 weeks. At final re‐examination (10 months), the patient was visual, and fundic examination revealed an additional chorioretinal scar, most likely an exit wound that was obscured by vitreal debris on initial examinations. Neither scar was associated with retinal detachment. To the authors' knowledge, this is the first reported case of successful medical management of iatrogenic globe penetration following exodontic procedures.     

Evoked potential and electroencephalographic assessment of central blindness due to brain abscesses in a steer

Central blindness in a 3.5-year-old crossbred steer was evaluated by electrodiagnostic techniques. When admitted the steer was depressed, head pressed, and circled to the left. Ptosis and absence of menace response were seen with the right eye, while the left eye was normal; direct and consensual pupillary light responses were normal in both eyes. Brainstem auditory evoked potentials and electroretinograms were essentially normal. The flash visual evoked potential (VEP) was greatly reduced upon stimulation of the right eye, while no VEP peaks could be recognized after flash stimuli were presented to the left eye. The amplitude of the electroencephalogram was depressed over right occipital cortex. Multiple brain abscesses were detected on postmortem examination adjacent to the left thalamus, in the left caudal cerebrum, and right frontal cerebrum. Corynebacterium pyogenes was cultured from abscess exudate; however, no origin for the infection could be determined. Both eyes were microscopically normal. The thalamic abscesses were postulated to have produced the EEG depression. Correlations between the VEP abnormalities and the abscess locations are discussed, based on proposed central nervous system generators of the VEP.     

Collie eye anomaly in a mixed-breed dog

A 5-year-old, mixed-breed dog was presented for tetraparesis. Neurologic alterations included a decreased menace response in both eyes. Therefore, an ophthalmic examination was requested. The dog was visual, but menace response, dazzle and pupillary light reflexes were reduced bilaterally. Indirect ophthalmoscopy revealed bilateral optic nerve coloboma and severe choroidal hypoplasia. These lesions closely resembled the ophthalmoscopic features of Collie eye anomaly (CEA). In spite of treatment, the dog's condition worsened and the animal was therefore euthanized. Histology of the globes confirmed severe choroidal hypoplasia and optic disc coloboma in both eyes. The dog was diagnosed to have a lymphoma involving the spinal cord. The two entities were considered not related. As only moderate sight impairment was caused by the posterior segment anomalies, it is by chance that these lesions resembling CEA were found in this mixed-breed dog.     

Nonulcerative keratouveitis as a manifestation of Leptospiral infection in a horse

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.     

Lateral canthoplasty for facial nerve paralysis and exposure keratitis in a mouse

An 11-month old entire male mouse was presented with mucopurulent discharge and corneal scarring of the left eye. This mouse previously had a history of ear mites that responded to therapy, and had undergone surgery to remove a large discharging mass from the left side of the neck. The eye problem was noted prior to surgery, but after the ear mite infection. Examination revealed absence of a palpebral reflex in the left eye, and no spontaneous movements of the left ear or lip and whiskers. Examination of the left eye revealed extensive corneal vascularisation and pigmentation. Intraocular structures were not visible. A diagnosis of facial nerve paralysis and secondary exposure keratitis was made. Surgery was performed to close the lateral canthus and reduce corneal exposure. Following surgery the eye discharge ceased and corneal vascularisation resolved, however corneal pigmentation persisted.     

Uveitis and pupillary block glaucoma in an aphakic dog

Unilateral uveitis with pupillary occlusion and secondary glaucoma was treated with neodymium:YAG laser iridotomy and iridencleisis in an aphakic 2-year-old male Miniature Schnuauzer. The dog presented 4 months after bilateral phacoemulsification with a complaint of blepharospasm of the left eye. Examination revealed anterior uveitis with pupillary occlusion and iris bombé. A slit-lamp mounted Q-switched Nd:YAG laser was used to create a central iridotomy to deepen the anterior chamber and an iridencleisis was performed to recreate a pupil. The eye remained visual and normotensive over a 6-month follow-up period.     

Clinical, cytologic and histopathologic manifestations of protothecosis in two dogs

Two cases of sudden onset of blindness associated with ocular protothecosis in dogs are reported. Both were adult, spayed female, mixed-breed dogs that lacked the usual clinical signs of systemic infection with Prototheca species. Physical abnormalities at the time of presentation were limited to the affected eyes which had serous discharge, hyperemic conjunctiva, and aqueous flare. The pupillary light reflexes were slow, and the menace reflexes were absent. Both dogs had glaucoma. Results of complete blood counts and serologic titres for antibodies to Blastomyces dermatitidis and Histoplasma capsulatum were within reference intervals. Protothecosis was diagnosed by cytologic analysis of vitreous humor and was confirmed at necropsy. These two cases were unusual because of their presenting signs and prolonged course of disease progression.     

Mydriatic effect of topically applied rocuronium bromide in tawny owls (Strix aluco): comparison between two protocols

Objective To evaluate the mydriatic efficacy of a neuromuscular blocking agent (rocuronium bromide) applied topically to only one eye of nocturnal birds of prey and to assess for any general and/or local adverse effects due to its use. Animal studied Twelve healthy adult tawny owls (Strix aluco) were randomly divided in two groups. Procedures Six birds (Group 1) received a single dose of 0.35 mg of rocuronium bromide. The second group of subjects (Group 2) received two doses of 0.35 mg of rocuronium bromide (total 0.70 mg/eye). In both groups, the curariform agent was instilled topically. Pupil diameter was measured with a pupillary gauge in 10 min intervals for a total of 100 min and then every 20 min for a total of 240 min. The assessment of the pupillary light reflex was performed using a standard light source during pupillary size recording. Results Maximal pupillary diameter was 11.5 ± 0.3 mm for Group 1 and 11.0 ± 0.6 mm for Group 2 and no statistically significant differences were detected among the two groups. The maximal pupillary diameter was achieved at T80 for Group 1, and at T60 for Group 2. A complete fundus examination was possible on all treated eyes of subjects of both groups. The drug did not cause any noticeable adverse effects in any of the examined birds. Conclusion Results of the present study suggest that a single topical administration of 0.35 mg of rocuronium bromide to the eyes of healthy tawny owls results in sufficient mydriasis to allow for a complete examination of the fundus.     

Multiple limbal haemangiosarcomas in a border collie dog: management by lamellar keratectomy/sclerectomy and strontium-90 beta plesiotherapy

An eight-year-old, neutered, male border collie dog was presented with a six-week history of left ocular discomfort and a raised, red mass at the lateral limbus. The right eye had been enucleated approximately 12 months previously following suspected trauma when the eye had become red and painful. The mass was excised using superficial keratectomy/sclerectomy and the surgery site was treated with strontium-90 beta radiation. Histopathological findings were consistent with a diagnosis of haemangiosarcoma. Immunohistochemical staining showed uniform expression of CD31 in neoplastic cells, confirming their endothelial origin. Two further treatments with strontium-90 beta radiation were applied to the surgical site at weekly intervals. Twenty-six weeks after surgery, a second, raised, red limbal mass became apparent at the medial limbus of the left eye. Surgical excision and adjuvant strontium-90 beta plesiotherapy were performed as described for the initial tumour. Routine histopathological analysis confirmed haemangiosarcoma at this site. Eighty-six weeks following the initial presentation, no recurrence of ocular haemangiosarcoma was evident.     

Spontaneous buphthalmos in the Djungarian hamster (Phodopus sungorus campbelli)

Four Djungarian hamsters ( Phodopus sungorus campbelli ) were examined because of insidious globe enlargement, visual impairment and secondary altered behavior. Buphthalmos, deep anterior chambers, widely dilated pupils and poor to absent pupillary light reflexes were evident bilaterally in all four animals. Pale retinae and atrophic optic nerve heads were observed in the oldest hamsters. Light microscopic findings, including uveal atrophy, retinal atrophy (especially the inner retina), and a relative decrease in ganglion cells and optic nerve atrophy, were consistent with glaucoma. The etiology was unclear, but a genetic predisposition cannot be excluded.     

Evaluation of patients with decreased vision or blindness

A good ocular examination and careful evaluation of the pupillary light reflexes will localize most lesion(s) producing a complaint of blindness. Lesions of the clear media severe enough to produce blindness will prohibit fundus examination. Retinal, optic nerve, and complete chiasmal lesions will produce dilated, slowly reactive pupils. Retinal blindness is usually associated with dramatic ophthalmoscopic lesions of diffuse altered reflectivity and vascular attenuation, the major exceptions being the sudden acquired retinal degeneration syndrome and some patients with glaucoma. Optic nerve lesions may involve the optic disc where they may be recognized by either pallor or hyperemia and cupping or elevation. Confirmation of optic nerve blindness in practice usually is by ruling out retinal blindness, but a more definitive methodology is to have a normal electroretinogram, slow or absent direct pupillary light reflexes (PLR), and abnormal visual evoked potentials. Central blindness is diagnosed by normal eyes, normal PLR, and often central nervous system (CNS) signs indicative of a diffuse or multifocal CNS disease.     

Blindness due to retinal dysplasia in broiler chicks

Thirty-three live 9-day-old broiler chicks were submitted for laboratory evaluation because of blindness. Blindness was observed in up to 1% of 25,000 birds from four different houses. All the chicks were from the same breeder source. Blindness was apparent when the chicks were 2-3 days old. Clinically, the blind chicks were smaller than their counterparts, were unable to find feed and water, and wandered aimlessly. Necropsy did not reveal any lesions. Two chicks examined clinically at 14 days of age lacked pupillary reflexes after light stimulation, and the anterior and posterior segments of the eye were normal. Microscopically, degeneration of photoreceptor cells characterized by vacuoles was evident at 9 days of age, and rosette formation of the retina, disorganization of retinal layers, synechia of the retina with mild inflammation in the choroid, and proliferation of the retinal pigment epithelial cells were evident by 15 days of age. Because the chicks came from the same breeder source and the incidence of blindness was low, a probable genetic etiology is suspected as the cause of blindness in this flock.