Image Quiz: Name these 5 ophthalmologic conditions!

September 30, 2019
Clara Williams, DVM, MS, DACVO
Clara Williams, DVM, MS, DACVO

Veterinary ophthalmologist Dr. Clara Williams asks which ocular condition is at play in these patients. Test your skills by examining the following images and selecting the answer you think fits best.

(All images courtesy of Dr. Clara Williams, BluePearl Veterinary Partners)

What's going on with this cat's eye?

A. Lens luxation

B. Free-floating uveal cysts and nuclear sclerosis

C. Aqueous flare and uveitis

D. Chronic glaucoma

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Correct answer:

A. Lens luxation

Lens luxation happens when support ligaments of the lens weaken and/or break. This causes the lens to dislocate from its proper position-falling either backward (posterior luxation) or forward (anterior luxation) into the eye. A luxation can block fluid drainage from the eye and cause increased intraocular pressure, pain and, in more serious cases, blindness. Lens luxation in cats is usually triggered by chronic uveitis, which is inflammation of the uveal, or vascular, layer.

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What condition does this dog have?

A. Unidentified intraocular brown bubbles

B. Multiple intraocular melanomas

C. Anterior uveitis

D. Iris nevus (freckles)

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Correct answer:

C. Anterior uveitis

Uveitis is inflammation of the uvea, or vascular layer of the eye. The resulting vasculitis leads to leakage of protein as well as red and white cells into the usually transparent intraocular fluid (aqueous humor), making it turbid. Clinical signs of uveitis include ocular pain (squinting), redness, increased tearing and/or mucoid discharge, cloudiness, smaller size pupil and iris color change. The condition may be present in one or both eyes. Uveitis can be triggered by infectious, parasitic, neoplastic or autoimmune diseases. A detailed patient history that includes travel history and geographic location is helpful in narrowing the presumptive diagnosis.

This patient, a dog that lives in Massachusetts, has anterior uveitis. The dog and its family spend weekends in Vermont, where blastomycosis is enzootic. Deep mycosis panel results and thoracic radiographs confirmed blastomycosis.

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What's going on with this dog's eye?

A. Indolent corneal ulcer

B. Melting corneal ulcer (corneal collagenolysis)

C. Superficial noncomplicated corneal ulcer

D. Corneal foreign body

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Correct answer:

D. Corneal foreign body

Corneal foreign bodies come in all shapes and sizes. Seen most frequently in cats, dogs and horses, corneal foreign bodies are usually an organic material such as wood or dirt. Clinical signs include acute pain, discharge, tearing, redness and residual abrasion.

Foreign bodies that adhere to the ocular surface can be removed using topical anesthesia. However, material that is embedded within the deeper corneal layer or has penetrated the anterior chamber should be removed while the patient is under general anesthesia. Secondary complications are rare but can include corneal scar formation, septic endophthalmitis, glaucoma and cataracts.

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What's going on with this young Doberman's eye?

A. Dacryops

B. Prolapsed nictitans gland (cherry eye)

C. Third eyelid neoplasia

D. Entropion

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Correct answer:

A. Dacryops

Dacryops, or lacrimal cysts, are rare dilations of the lacrimal gland (either orbital or third eyelid). The lesion, which is recognized as cystic by its fluctuant nature, can be confirmed by centesis. The proximity of the cyst to one of the lacrimal glands is usually suggestive of the origin. Careful surgical excision of the cyst is curative.

Dr. Clara Williams works at BluePearl Veterinary Partners in Waltham, Massachusetts.