Tear-deficient and evaporative dry eye syndromes of the horse

Tear-deficient dry eye (keratoconjunctivitis sicca), and evaporative dry eye, with some overlap between these two categories, are two major categories of dry eye recognized in the horse. Careful examination of the eyelid margins, the inner and outer surfaces of the upper and lower eyelids, assessment of blink and third eyelid movement, specific testing of tear production, assessment of corneal sensitivity, and slit-lamp examination of the ocular surface before and after fluorescein dye application is recommended to detect dry eye problems. Rose Bengal dye application is also recommended in many cases. Facial nerve paresis is a possible complicating factor in some instances. Evaporative dry eye deserves closer scrutiny for it may be a contributory factor when ocular surface disease such as keratomycosis is present. Factors which influence ocular surface health need more close examination in horses.     

Uveitic glaucoma in the horse

Glaucoma is a serious complication of anterior uveitis that can result in significant ocular discomfort and loss of vision. As glaucoma is insidious and mostly asymptomatic until late in the course of disease, it is often undiagnosed. Equine recurrent uveitis is the most common underlying disorder: it is a disease of high prevalence, characterised by recurrent‐remitting episodes of ocular inflammation. Here, the inflammatory cells and mediators they release alter the normal anatomic structure of the anterior chamber and aqueous drainage pathways of the eye. These changes alter the homeostatic mechanisms of intraocular pressure control. Management of glaucoma secondary to uveitis can be challenging due to the difficulties of managing the underlying disorder and its effects on the eye. This article reviews the pathogenesis of uveitic glaucoma in the horse and medical and surgical management options.     

The amphibian eye.

Knowledge of the anatomy of the amphibian eye is important to differentiate normal from abnormal. Special features of the amphibian eye mark the transition from aquatic to terrestrial life. The most often reported spontaneous ocular disease in the anurans (frogs and toads) is lipid keratopathy. An experimental study showed that high dietary cholesterol played a significant role in the development of corneal lipid infiltration. Other diseases, like panophthalmitis, occur with bacterial septicemia.     

Ocular manifestations of systemic disease in the dog and cat. Recent developments

The number of canine and feline clinical diseases that may be manifested as ocular dysfunction continues to increase. Veterinarians are often presented with sick patients who also have eye disease. Conversely, animals are examined for eye disease that on closer inspection also have a systemic illness. A decision must be made; is there a relationship between the observed ocular and systemic problem, or are they separate morbid processes? If they are related, can the ocular signs be used to better define the systemic illness, chart its course, or establish a prognosis? It is hoped this article will aid the clinician in gaining a better perspective on the complex relationship between the eyes and systemic disease.     

Microbiology of the canine and feline eye

Knowledge of the microbiology of the canine and feline eye in normal and pathologic states is an important aspect of the clinician's assessment of external ocular disease. Gram-positive bacteria predominate in surveys of microbial flora in normal and diseased eyes. These same organisms are routinely isolated from skin and the upper respiratory tract. Injury to the eye may result in proliferation and potential pathogenicity of normal ocular flora. A variety of bacterial, fungal, viral, and other microbial isolates affect the diagnosis and treatment of external ocular disease.     

Canine systemic fungal infections.

The principal route of infection for the disseminated fungal diseases discussed in this article is inhalation. In some cases, direct wound contamination and ingestion may also have an important role in the pathogenesis of the disease, especially in histoplasmosis. Another common theme of these diseases is the response of the immune system. If the inoculum is small and the animal is not immunocompromised, the infection may be limited to the respiratory tract and may resolve with few or no clinical signs. Dogs are usually presented to the veterinarian when the fungus has disseminated throughout the body via the circulatory or lymphatic systems, thus causing clinical signs secondary to specific organ infection. Draining skin tracts and lymphadenopathy occur in several of the diseases. The ocular location that is frequently affected is the choroid, where the organisms cause cell-mediated chorioretinitis. Early detection of these changes is important for saving vision and for diagnosing the systemic nature of the disease. Treatment is often effective, especially early in the disease, although it is expensive and long-term, with many animals needing over a year of treatment. Sometimes the treatment must continue lifelong. Ocular disease may not respond to treatment even when respiratory and other organ system clinical signs are rapidly improving. This isolation of the eye is similar to that of the CNS and requires regular monitoring of ocular disease, especially in the fundus, to ensure that systemic drugs are penetrating into the eye. Once the disease progresses to the anterior segment, the ocular prognosis worsens. Better penetration of the blood-retinal and blood-aqueous barriers may be achieved with fluconazole when compared with the other antifungal drugs. Secondary inflammatory ocular disease must also be monitored and treated appropriately to prevent scarring, which may cause vision loss or glaucoma.     

Canine adenovirus: its role in renal and ocular disease: a review

Hypersensitivity reactions to live attenuated and virulent field strains of canine adenovirus can produce renal and ocular disease. The renal lesion is a focal interstitial nephritis which is probably a Type IV hypersensitivity reaction; it has not so far been shown to be of any clinical significance. The ocular lesion, thought to be a Type III immune complex hypersensitivity reaction, is characterized by anterior uveitis and corneal oedema. It is usually transitory but occasionally results in permanent eye defects.     

Ocular pharmacology.

Application of sound ocular therapeutic principle is more difficult in food animals than most other species. Financial or husbandry constraints limit the practitioner's ability to use the entire range of ocular drugs available or to use them with adequate frequency. These problems may be dealt with by using systemically administered drugs when effective or by employing vehicles or delivery techniques that necessitate minimal dosing frequency. By far the most important medically treatable eye disease encountered in food animal practice is IBK. Effective therapies include systemic administration of long-acting oxytetracycline, subconjunctival administration of a variety of antibiotics, or topical application of benzathine cloxacillin. Infectious conjunctivitis in sheep and goats due to a variety of agents may be treated successfully with tetracycline in most cases. Conjunctivitis and keratitis secondary to IBR virus usually are given supportive therapy only, although specific antiviral drugs have been used in the treatment of herpetic eye disease in other species. Anterior uveitis is best treated by corticosteroid and mydriatic therapy in addition to treatment of the underlying cause, if identified.     

Lesions in the ocular posterior segment of raptors

Thirty-eight free-living raptors, including various hawks, owls, and an eagle, had lesions of the ocular posterior segment believed to be the result of trauma. Although lesions of the anterior ocular segment and of the rest of the body often were seen, the lesions of the posterior segment of the eye were disproportionately more severe and usually were not suspected by rehabilitation personnel. The tightly encased raptor eye, with its anteriorly placed scleral ossicles, may have rendered the eye more susceptible to contrecoup damage. In the birds that were treated, ocular lesions were resolved and some vision was restored.     

Metastasis or delayed local extension of ocular squamous cell carcinoma in four horses

Four horses treated for ocular squamous cell carcinoma (SCC) that subsequently developed local tumour extension or local metastases without ocular recurrence are included in this study. Medical records were examined and long‐term follow‐up obtained through contact with owners and referring veterinarians. In 2 horses, SCC developed in the nasolacrimal duct and maxillary sinus one and 3.5 years, respectively, after treatment for SCC in the medial canthus of the eye. No recurrence of the SCC was noted in the ocular structures. Both were treated successfully with surgery and radiation therapy. Two additional horses had delayed metastasis of SCC to the parotid lymph node one and 2 years after excision of the ipsilateral third eyelid for SCC. No recurrence of the SCC was noted in the ocular structures. One was treated with surgery and radiation without success and one was not treated. Ocular SCC can spread to local tissues or lymph nodes without recurrence in the eye. The clinical manifestation of tumour recurrence may be delayed. Delayed local extension or local metastasis in horses after ocular SCC without recurrence in the eye itself has not been previously reported. Clinical signs of ocular squamous cell carcinoma should prompt immediate treatment and local recurrence despite successful treatment of the ocular disease is a possibility.     

Ocular conditions of neonatal foals.

A discussion of ocular conditions of foals with an emphasis on congenital and inherited disorders is presented. An understanding of the normal postnatal development of the eye and adnexae is important. Recognition of inherited abnormalities is essential when giving advice on breeding suitability, and prompt attention or referral of deteriorating ocular conditions in foals ensures the best outcome for future use. Congenital conditions may be recognized for the first time in older animals during their first thorough eye examination.     

Equine infectious keratitis.

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.     

Ocular lesions associated with coccidioidomycosis in dogs: 35 cases (1980-1985)

Thirty-five dogs with ocular lesions associated with coccidioidomycosis were examined. Serologic and/or histologic evaluation confirmed the diagnoses of coccidioidomycosis. The disease most frequently associated with signs referable to the anterior segment of the eye, such as iritis and granulomatous uveitis. Histologic evaluation of the eye revealed a primary posterior segment disease, such as chorioretinitis or retinal separation, with an extension into the anterior segment of the eye.     

Ophthalmic examination findings of Thoroughbred racehorses in Australia

OBJECTIVE: To record the prevalence and document the types of eye disease in population of Thoroughbred racehorses in Victoria, Australia. DESIGN: Prospective study. ANIMALS: Two hundred four Thoroughbred racehorses. PROCEDURE: All horses and both eyes were examined at four metropolitan and two country racing stable complexes. Ophthalmic exam was performed following dark adaptation with a transilluminator, biomicroscope, and direct ophthalmoscope. Intraocular pressures were measured when indicated. Both pupils were dilated with tropicamide when indicated. RESULTS: One hundred eighty-two (89.2%) flat-racing and 22 (10.8%) jump-racing (hurdle or steeple) horses were examined. Age range: 2-9 years (mean 3.7 years, median 3); 97 (47.5%) male-neuter, 74 (36. 3%) female, 33 (16.2%) male. Potential vision-threatening eye disease was present in 15 (7.4%) different horses: complete lenticular cataracts 3, posterior lens luxation and cataract 1, large peripapillary 'butterfly' inactive lesions 3, large peripapillary 'butterfly' active lesions 2, peripapillary focal inactive 'bullet hole' chorioretinal lesions (> 20) 5, optic nerve atrophy 1. Non-vision threatening eye disease was present in 117 (57.4%) different horses, involving one or more ocular structures: lower eyelid scars 3; periocular fibropapillomatous disease 1; third eyelid squamous cell carcinoma 1; corneal scars 6; corneal band opacity 2; anterior iris synechia 1; developmental cataracts 36 (17.2%); peripapillary focal inactive 'bullet hole' chorioretinal lesions (< 20) 103 (50.0%); linear peripapillary hyperpigmentation bands 16 (7.9%). Unusual variations of normal ocular anatomy and colobomata was recorded in 11 (5.4%) different horses: granular iridica hypoplasia 3, granular iridica hyperplasia 2, multilobular granular iridica cyst 1, microcornea 1, hyaloid remnant 1, rotated optic nerve head 1, coloboma of the lens 1, atypical coloboma of the retina 1. CONCLUSIONS: This survey demonstrates that the prevalence of vision-threatening eye disease in racing horses may be greater than previously perceived, and highlights the importance of ocular examination within any routine physical examination of horses.     

Screening and controlling canine inherited ocular diseases in Finland: epidemiological, economical and health promotional aspect

Official eye examination records of 18 146 dogs in 17 breeds were analyzed in order to evaluate the Finnish Kennel Club's eye examination scheme. The most common inherited ocular diseases were the Collie eye anomaly (CEA) in the Rough Collie and the persistent hyperplastic tunica vasculosa lentis (PHTVL) in the Doberman. In both diseases the prevalence has also increased during the study period 1988–1997. The most likely reason for the increase is the change in examination routines that now makes it easier to find milder disease forms that were previously classified as normal. The prevalences of other inherited diseases are so low that no conclusions about the trends can be made. Also, the data have some defects that can cause biased estimations of prevalences. The costs of screening programs are very high and no direct economical benefits can be shown. Methods of improving the screening and effectiveness of the program are also presented.     

Development of the New Zealand White Rabbit Eye: I. Pre‐ and Postnatal Development of Eye Tunics

The New Zealand white (NZW) rabbit has been and is right now regularly utilized in ophthalmic surgery evaluation. Inside NZW rabbit eye, the visibility of ocular structures throughout surgical procedure is fantastic. Younger rabbits are used in different ages for the evaluation of ophthalmic surgery. Complete studies of ocular development in the NZW rabbits have not been reported previously. The aim of the present investigation was to describe the major landmarks and the time course of the pre‐ and post‐natal development of the complete eye tunics of the NZW rabbit to give a superb model as well as a fruitful area for further ophthalmological investigations. Serial histological sections of NZW rabbit prenatal (E13–E28) and post‐natal (P1–P14) stages were examined, respectively. The eye of the NZW rabbit developed in a similar manner to that of the human and domestic animals eyes; the principal differences were at the time of occurrence of certain developmental events, absence of pigmentation which represent an exploited benefit for ophthalmic surgery, remarkable Bowman's membrane at E25, poor developed ciliary stroma and juvenile retinal layer until P9. In human, the basic morphogenetic processes of the development of eye tunics are completed towards the end of the first half of gestation period. However, the latter represents the beginning stage of the development of eye tunics in the rabbit. Thus, allowing various extensive ophthalmic researches to be performed.     

The tear film and ocular mucins

Abstract The trilaminar tear film, composed of the lipid, aqueous and mucin layers, has many functions including defending the ocular surface. The aqueous layer has several soluble antimicrobial factors that protect the ocular surface. Ocular mucins have recently been studied with regard to their role in the defense of the eye as well as in dry eye syndromes. To date, 15 mucin genes have been identified, and six of these mucin genes are localized to or secreted by ocular glands or epithelia. Understanding the production, secretion and function of ocular mucins will aid in the treatment of dry eye syndromes and ocular surface microbial infections.     

Ocular oncology

Neoplasia can affect all ocular tissues. The clinical appearance of ocular neoplasia can vary considerably depending on the specific tissue involved. Intraocular neoplasia may mimic or incite ocular inflammatory disease in addition to causing hyphema or secondary glaucoma. Intraocular neoplasms can be primary tumors or may be secondary to metastatic disease or systemic neoplasia. Primary neoplasms, metastatic tumors, tumors extending from adjacent structures, and systemic neoplasms can also affect the adnexal tissues. Many ophthalmic tumors are histologically benign but are locally invasive and, within the confined space of the eye or orbit, can produce significant tissue distortion. Certain ocular neoplasms, such as many canine eyelid tumors, are amenable to simple excision and can be adequately managed in general practice. The evaluation and treatment of other ophthalmic neoplasms, however, may require the additional equipment available only in larger specialty practices, such as computed tomography and radiation therapy. Early diagnosis of ocular neoplasia is an important aspect of successful management.     

Ophthalmic disease of fish.

Ocular disorders in fish are common and can occur as primary or secondary manifestations of systemic disease. Because most fish are sight feeders, visual impairments usually have fatal consequences for the individual fish and can lead to substantial economic losses for the client. This article encourages practitioners to perform a complete ocular examination as part of routine physical examinations in fish by providing a review of the functional anatomy of the teleostean eye, clinical work-up, ocular examination, ocular diseases, and treatment.     

Bartonella vinsonii subspecies berkhoffi as a possible cause of anterior uveitis and choroiditis in a dog

A 2-year old, neutered, female spaniel mixed breed was referred to the North Carolina State University Veterinary Teaching Hospital for evaluation of bilateral anterior uveitis. The dog was febrile and, in addition to anterior uveitis, multifocal hyporeflective lesions were present in the tapetal fundus of both eyes. The antibody titer for Bartonella vinsonii subspecies berkhoffi was positive (1 : 512). Aqueous paracentesis was performed for PCR in an attempt to detect B. vinsonii in the eye but was unsuccessful. The ocular manifestations of Bartonella infection in humans are currently expanding as more sensitive serologic and PCR techniques are being developed to identify Bartonella spp. In addition to optic neuritis and neuroretinitis, retinochoroidal lesions are one of the most common manifestations of B. henselae infection, and are frequently accompanied by vitreous or anterior segment inflammation. Diagnosis of a Bartonella infection in humans can be made on serology alone, in conjunction with ocular examination findings. The ultimate proof of B. vinsonii (berkhoffi) as a direct cause of ocular disease would be detection of the infectious agent in the eye. However, it is unknown at this time whether Bartonella causes ocular disease primarily, secondarily via an autoimmune reaction, or both. Due to the difficulties associated with culture of Bartonella spp. and the limitations of PCR, serology is currently the most useful tool for screening dogs for possible Bartonella spp. infection. In the case presented here, even though the PCR was negative, the clinical signs of anterior uveitis and choroiditis might reasonably be associated with B. vinsonii (berkhoffi) seroreactivity, which was repeatable on three separate occasions. Clinical improvement was also accompanied by a post-treatment decrease in B. vinsonii (berkhoffi) seroreactivity, potentially supporting resolution of Bartonella infection in this dog. This is the first reported case of a possible association between uveitis, choroiditis and Bartonella infection in the dog, without clinical manifestations of other organ or tissue involvement. Future studies based on PCR analysis of intraocular fluids may clarify the involvement of B. vinsonii (berkhoffi) in dogs with intraocular inflammatory disease. Furthermore, performing fluorescein angiography in dogs with elevated Bartonella titers may also prove useful in the identification and characterization of lesions.