Lens-induced uveitis (endophthalmitis phakoanaphylactica) in domestic animals]

In this paper ophthalmological and clinical results as well as the literature on lens-induced uveitis (LIU), a relatively unknown pathological syndrome in domestic animals, are presented. Out of all ocular material sent to the Institute of Pathology, GSF, from 1970 until 1990 (n = 864), 40 individual cases of LIU (14 cases in dogs, 13 in cats, 10 in rabbits, 1 in a horse and 2 in birds) were diagnosed. The histology of the eyes of the cases is characterized by a lesion of the lens capsule and a consequent reactive phacogenic inflammation of the anterior segment of the eye in the region of the anterior uvea. A comparison of the history and ophthalmological diagnosis indicates that 36 lens-induced uveitis cases occurred following a (spontaneous) traumatic injury to the eye, whereby the anterior lens capsule was perforated with the result of the lens material being exuded into the anterior uvea (iris-ciliary body region). The strongly vascularized anterior uvea is used as a carrier and a connecting link to the immune system. None of the histologically examined cases of LIU were diagnosed as such clinically. This can be explained by the fact that the uveitis is difficult to recognize on account of overlying secondary alterations in the eye. Nevertheless the morphological substrate of LIU is considered to be pathognomonic. The inflammatory and cellular reactions leading to a release of the lens material observed in domestic and laboratory animals exhibit only slight parallels to those observed in man. The case history of animals usually reveals a traumatic injury and an endophthalmitis (with or without secondary glaucoma) which cannot be controlled therapeutically. The therapy for promptly diagnosed cases should be a lens extraction to save the affected eye and its sight. In advanced cases the enucleation of the bulbus is the therapy of choice.