Today's Veterinary Practice

MAY-JUN 2013

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| CLINICAL APPROACH TO THE CANINE RED EYE TABLE2.CAUSESOFCANINEANTErIOrUVEITIS41,42 TYPE DISEASE Autoimmune Immune-mediatedthrombocytopenia Immune-mediatedvasculitis Lens-induceduveitis(secondarytocataracts) Pigmentaryuveitis(goldenretrievers) Phacoclasticuveitis(secondarytolenscapsularrupture) retinaldetachmentsyndrome(steroidresponsive) Uveodermatologicsyndrome(Vogt-Koyanagi-Harada-likesyndrome) Infectious Algae: Protothecaspecies Bacteria:Leptospirosis,Bartonella and Brucellaspecies Mycoses: Blastomyces and Cryptococcusspecies,Coccidioides immitis, Histoplasma capsulatum Parasitic: Angiostrongylus vasorum, Dirofilaria immitis Protozoa: Toxoplasma gondii, Leishmania donovani, Neosporium caninum Tick-borne disease: Borrelia burgdorferi, Ehrlichia canis and platys, Rickettsia rickettsii Viruses:Canineadenovirus(types1and2),caninedistempervirus Histiocyticproliferativedisease Neoplastic/ Paraneoplastic Hyperviscositysyndrome Lymphosarcoma Metastatictumors Primaryintraoculartumors:Adenomas,adenocarcinomas,melanomas Other Endotoxemia Idiopathic(approximately50%–60%indogs) Metabolic:Coagulopathies,hyperlipidemia,systemichypertension radiationtherapy reflexuveitis:Episcleritis,keratitis(ulcerativeandnonulcerative),scleritis Trauma hyphema (blood in the anterior chamber [Figure 7]) With anterior uveitis, IOP is generally low, unless the and rubeosis iridis (iris neovascularization; Figure 12, animal has developed secondary glaucoma. As a rule, page 15). IOP less than 10 mm Hg, or a difference of 5 to 10 mm 1,2 Clinical Note: Subtle and early uveitis may cause only Hg between eyes, suggests uveitis. All patients with anterior uveitis should have the folmild ocular redness; be careful not to misdiagnose it as lowing performed: conjunctivitis. • Complete blood count and serum biochemical profile Diagnosis Other intraocular clinical signs of anterior uveitis include: • Urinalysis • Aqueous flare (cloudiness of the aqueous humor) • Titers for tick-borne diseases » Identified with a small focal light or slit beam • Thoracic (3 views) and abdominal radiographs » The fluid in the anterior chamber should be crystal • Abdominal ultrasound. clear; when flare is present, the light is visualized as Clinical Note: Ocular ultrasound can help deterit passes through the aqueous (Tyndall effect) mine extent of ocular disease if anterior segment • Fibrin within the anterior chamber changes are severe and the posterior segment cannot • Hypopyon be visualized. • Keratic precipitates • Synechiae. Systemic Disease Nonspecific clinical signs include: • Blepharospasm • Epiphora • Miosis • Ocular discharge. 18 Today's Veterinary Practice May/June 2013 Uveitis, whether unilateral or bilateral, is most often due to a systemic cause. Systemic causes of uveitis include infectious, autoimmune, and neoplastic disorders (Table 2). Uveitis is considered nonsystemic if there is evidence of: (continued on page 40)

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