DOCSLIB.ORG

Infectious Bovine Keratoconjunctivitis (Pinkeye) in Cattle Michelle Arnold, Veterinary Diagnostic Laboratory, and Jeff Lehmkuhler, Animal and Food Sciences

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Infectious Bovine Keratoconjunctivitis (Pinkeye) in Cattle Michelle Arnold, Veterinary Diagnostic Laboratory, and Jeff Lehmkuhler, Animal and Food Sciences COOPERATIVE EXTENSION SERVICE • UNIVERSITY OF KENTUCKY COLLEGE OF AGRICULTURE, LEXINGTON, KY, 40546 ID-135 Infectious Bovine Keratoconjunctivitis (Pinkeye) in Cattle Michelle Arnold, Veterinary Diagnostic Laboratory, and Jeff Lehmkuhler, Animal and Food Sciences Introduction nfectious Bovine Keratoconjunctivitis conjunctiva retina (IBK), also known as pinkeye, is a costly cornea choroid diseaseI for the beef producer. Tremen- dous losses stem from poor weight gain iris sclera and loss of appetite in affected animals suffering from visual impairment and pupil lens ocular pain. The largest economic loss anterior optic nerve is incurred through decreased growth chamber suspensory as affected calves are on average 35-40 ligament pounds lighter at weaning compared conjunctiva to healthy calves. Lower performance in post-weaning cattle also has also been documented with reduced average Figure 1. Parts of the eye. daily gain, 365th day weight, and final weight. Additionally, the drug cost for treatment, decreased market value due to corneal scarring, the loss of value of effects of the disease. Prevention is based Contributing Factors show and breeding stock, and reduced on maximizing herd immune status, milk production from dairy animals also minimizing the presence of pathogens, Many different combinations of these make this disease a significant economic and maintaining an irritant-free environ- factors working together can occur consideration. ment as much as possible. within one herd at one time. The first reports of pinkeye appeared in 1889. More than a century later, despite UV Light or Sunlight all that is known about how the disease Cause Ultraviolet light or sunlight causes develops, control programs often are damage to corneal epithelial cells, allow- Pinkeye is caused by the bacteria Mo- only partially successful. In particular, ing the bacteria to penetrate the cornea raxella bovis. It sticks to the surface of the pinkeye vaccines are often ineffective in and multiply. Lack of pigment around eyeball (cornea) with hairlike projections preventing outbreaks during the sum- the eye allows increased UV radiation to called pili. Once attached, it releases a mer. It is important to understand that sensitize the eye, resulting in inflamma- toxin that kills the cells on the surface of many factors are involved in the develop- tion and infection. ment of pinkeye, including environment, the cornea, leading to the characteristic season of the year, concurrent diseases, corneal ulcers seen with this disease. Face Flies The organism is located in the eyes and the strain of bacteria involved, and the These pests contribute to pinkeye animal’s genetic makeup and immune nasal cavities of infected cattle. Cattle are the only known reservoir of Moraxella in two ways. First, they irritate the eye system. Once pinkeye begins, it is highly when feeding on secretions. Then they contagious and can spread rapidly within bovis, and infected carrier animals may harbor this organism year-round without efficiently transmit the organism from the herd. Control of contributing factors infected to non-infected animals. These and prompt, effective treatment in the showing any signs of eye problems. Once pinkeye begins in a herd, it is highly insects may harbor the bacteria on their face of an outbreak are necessary to re- wings and legs for up to three days after duce the spread and limit the damaging contagious and can spread rapidly by direct contact through nasal and ocular feeding on infected material. discharges and by vectors such as flies. Agriculture and Natural Resources • Family and Consumer Sciences • 4-H Youth Development • Community and Economic Development EXTENSION Excessive Eye Irritation Clinical Signs Long-acting antibiotics, such as long- acting tetracycline or the prescription Irritation may be due to dust, trauma Pinkeye is a disease principally of the antibiotic tulathromycin, are labeled for or injury, wind, tall grass with seed heads, cornea. It occurs initially in one eye but treatment of pinkeye. Your veterinarian thick-stemmed hay, or high ammonia lev- may cross-infect the other eye. Onset of may prescribe the antibiotics florfenicol els. Grazing close to thorns, barbed wire, clinical signs may begin one day to two or ceftiofur to be used in an off-label and tufts of dry grass can scratch the weeks post-infection. manner for treatment as well. Injectable cornea. Pollen and seed heads, especially Pinkeye is characterized early by antibiotics are generally the best option in unclipped pastures, may injure the eye. tearing, overflow of tears onto the face, because of their long duration of activity When animals eat in to the middle of blinking, and squinting/seeking shade. and effectiveness in eliminating bacteria. round bales, the hay surrounding their These signs progress to corneal edema Topical sprays only remain in the eye a heads may contain stems, seed heads, (the eye becomes cloudy or opaque) and few minutes before tears wash them away, and dust which may cause eye irritation. central corneal ulceration (a circular pit so application is generally required three Any irritation to the eye allows Moraxella develops in the center of the eye), usually to four times daily to be effective. It is dif- bovis to invade and cause pinkeye. within 24-48 hours. ficult for any spray or ointment to remain Other Microorganisms Conjunctivitis (swelling and red- in the eye long enough to eliminate the ness of the tissues) of varying severity is bacteria unless treatments are repeated Certain viral diseases (infectious bo- sometimes seen. Cattle have decreased multiple times daily. vine rhinotracheitis or IBR and bovine appetite due to excessive pain. Some When severe ulceration exists, the viral diarrhea or BVD) and bacteria cases resolve spontaneously, however, eyeball may need extra protection with (Mycoplasma sp., Chlamydophila sp.) severe damage to the cornea can arise if either a patch or the eyelids may need to may be contributors to pinkeye in certain left untreated. In milder cases, corneal be sutured (stitched) together. Patches cases. They either can create the right damage might completely resolve within protect the eye from light, flies and other environment for infection or add to the two to four weeks. More severe corneal irritants but they remove the ability to severity of the disease. A newly isolated damage may lead to deep ulceration and monitor the affected eye. Suturing the strain of bacteria known as Moraxella corneal rupture, possibly with the loss of eyelids together will physically support bovoculi may play an important role in eye contents or a cone-shaped bulging the stability of the globe and offers pro- pinkeye but research has not confirmed of the eye. In contrast to other species, tection from irritants as well. Consult this. Other problems, such as physical cattle may retain all or partial vision after your veterinarian for assistance on how trauma or trauma due to squamous cell corneal rupture. Once the severe stromal and when to apply these extra protective carcinoma, may also predispose the eye defects have healed, a dense corneal scar measures. to secondary bacterial infection. may result that can last years. Stress Treatment Prevention Pinkeye is a complicated, multifac- Weaning, commingling, transport, Preventing spread by treating affected eted disease. It is said that “an ounce of poor nutrition, parasites, and weather are animals is the single most important fac- prevention is worth a pound of cure,” just a few examples of stressors for cattle. tor in controlling a disease outbreak. and nowhere is it more appropriate than Stress tends to decrease the animal’s im- Early detection of animals with the with pinkeye. The best plan is to reduce mune response to disease. first clinical signs (tearing, squinting, or remove as many risk factors as pos- Breed and blinking) and then prompt, effec- sible in order to keep the eyes healthy tive treatment are essential to reducing and better equipped to fend off disease. All breeds of cattle can be affected spread and limiting damage to the eye. If Prevention is based on maximizing herd by pinkeye, but some breed differences possible, isolation of the affected animal immune status, minimizing the presence have been reported. More cases have away from the herd also will help limit of pathogens, and maintaining as irritant- been reported in Hereford cattle. Lower the spread. In cases where a producer is free environment as possible. incidences have been reported in Brah- unable to treat new cases quickly, giving man-type cattle and in cattle with greater an injectable antibiotic to all susceptible Maximize Herd Immune Status pigmentation at the ocular margins. animals along with topical fly repellent An overall good level of nutrition, ad- Older cattle appear less susceptible to may be the best course of action to reduce equate vitamin and trace mineral intake, Moraxella ocular infections compared to the spread of pinkeye in the herd. a comprehensive vaccination program cattle two years old or younger. A higher Early and effective treatment with the including the respiratory viral diseases prevalence has been reported in male correct antibiotic reduces the duration IBR and BVD, parasite control, and basic cattle. of the carrier state, when spread usu- biosecurity practices are all exceptionally ally occurs to unaffected herd mates. 2 important in improving the cow’s or calf’s Minimize the Concentration of preferably when the eye is just begin- ability to fight off any disease process M. Bovis (and M. Bovoculi) ning to tear excessively and before any (not just pinkeye). There is no scientific medications are used. A recent clinical evidence to support feeding excessive Immediate detection and isolation trial of these “homemade vaccines” (au- levels of any vitamin or mineral, includ- of affected animals followed by effective togenous M. bovis vaccines) concluded ing Vitamin A, will prevent diseases of treatment with long-acting antibiotics these are often ineffective in controlling the eye.
Load more

Recommended publications
  • Differentiate Red Eye Disorders
    Introduction DIFFERENTIATE RED EYE DISORDERS • Needs immediate treatment • Needs treatment within a few days • Does not require treatment Introduction SUBJECTIVE EYE COMPLAINTS • Decreased vision • Pain • Redness Characterize the complaint through history and exam. Introduction TYPES OF RED EYE DISORDERS • Mechanical trauma • Chemical trauma • Inflammation/infection Introduction ETIOLOGIES OF RED EYE 1. Chemical injury 2. Angle-closure glaucoma 3. Ocular foreign body 4. Corneal abrasion 5. Uveitis 6. Conjunctivitis 7. Ocular surface disease 8. Subconjunctival hemorrhage Evaluation RED EYE: POSSIBLE CAUSES • Trauma • Chemicals • Infection • Allergy • Systemic conditions Evaluation RED EYE: CAUSE AND EFFECT Symptom Cause Itching Allergy Burning Lid disorders, dry eye Foreign body sensation Foreign body, corneal abrasion Localized lid tenderness Hordeolum, chalazion Evaluation RED EYE: CAUSE AND EFFECT (Continued) Symptom Cause Deep, intense pain Corneal abrasions, scleritis, iritis, acute glaucoma, sinusitis, etc. Photophobia Corneal abrasions, iritis, acute glaucoma Halo vision Corneal edema (acute glaucoma, uveitis) Evaluation Equipment needed to evaluate red eye Evaluation Refer red eye with vision loss to ophthalmologist for evaluation Evaluation RED EYE DISORDERS: AN ANATOMIC APPROACH • Face • Adnexa – Orbital area – Lids – Ocular movements • Globe – Conjunctiva, sclera – Anterior chamber (using slit lamp if possible) – Intraocular pressure Disorders of the Ocular Adnexa Disorders of the Ocular Adnexa Hordeolum Disorders of the Ocular
    [Show full text]
  • Keratoconjunctivitis Sicca (“Dry Eye”) Stephanie Shrader, DVM and John Robertson, VMD, Phd
    Keratoconjunctivitis sicca (“Dry Eye”) Stephanie Shrader, DVM and John Robertson, VMD, PhD Introduction and Overview How Tears Are Produced Keratoconjunctivitis sicca (KCS) is a disease of the eyes, The tear film that covers the eyes is made up of three distinct characterized by inflammation of the cornea and conjunctiva. layers. The outermost layer is made up of oils, which are This condition occurs secondary to a deficiency in formation secreted by the Meibomian glands. This lipid layer provides of the tear film that normally protects the cornea (Best et al, protection against evaporation, binds the tear film to the 2014), which leads to dry, irritated eyes. As a result, KCS is cornea, and prevents tears from simply pouring out over the commonly known as “dry eye” or in veterinary terminology, lower eyelid onto the face. The middle layer of the tear film is xerophthalmia. This disease occurs often in West Highland the aqueous layer, which is produced by the lacrimal glands. As White Terriers, but is also common in many other breeds, its name would suggest, the aqueous layer consists primarily including Lhasa Apso, English Bulldog, American Cocker of water, along with important proteins and enzymes that help Spaniel, English Springer Spaniel, Pekingese, Pug, Chinese Shar remove bacteria and cellular waste material, and lubricate the Pei, Yorkshire Terrier, Shih Tzu, Miniature Schnauzer, German surface of the cornea. The innermost layer of the tear film is the Shepherd, Doberman Pinscher, and Boston Terrier. While the mucin layer, which is is produced by tiny secretory cells in the reported incidence of KCS across all dog breeds ranges from conjunctiva known as goblet cells.
    [Show full text]
  • Cytokine Profiles of Tear Fluid from Patients with Pediatric Lacrimal
    Immunology and Microbiology Cytokine Profiles of Tear Fluid From Patients With Pediatric Lacrimal Duct Obstruction Nozomi Matsumura,1 Satoshi Goto,2 Eiichi Uchio,3 Kyoko Nakajima,4 Takeshi Fujita,1 and Kazuaki Kadonosono5 1Department of Ophthalmology, Kanagawa Children’s Medical Center, Yokohama, Japan 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan 3Department of Ophthalmology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan 4Department of Joint Laboratory for Frontier Medical Science, Faculty of Medicine, Fukuoka University, Fukuoka, Japan 5Department of Ophthalmology and Micro-technology, Yokohama City University, Yokohama, Japan Correspondence: Nozomi Matsu- PURPOSE. This study evaluated the cytokine levels in unilateral tear samples from both sides in mura, Department of Ophthalmolo- patients with pediatric lacrimal duct obstruction. gy, Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami- METHODS. Fifteen cases of unilateral lacrimal duct obstruction (mean, 26.9 6 28.7 months old) ku, Yokohama 232-8555, Japan; were enrolled in this study. Tear samples were collected separately from the obstructed side [email protected]. and the intact side in each case before surgery, which was performed under general Submitted: September 8, 2016 anesthesia or sedation. The levels of IL-2, IL-4, IL-6, IL-10, TNF, IFN-c, and IL-17A then were Accepted: December 2, 2016 measured in each tear sample. A receiver operating characteristic (ROC) curve was constructed for the IL-6 levels in the tears. We also measured the postoperative tear fluid Citation: Matsumura N, Goto S, Uchio levels of IL-6 in those cases from which tear fluid samples could be collected after the surgery.
    [Show full text]
  • Immune Defense at the Ocular Surface
    Eye (2003) 17, 949–956 & 2003 Nature Publishing Group All rights reserved 0950-222X/03 $25.00 www.nature.com/eye Immune defense at EK Akpek and JD Gottsch CAMBRIDGE OPHTHALMOLOGICAL SYMPOSIUM the ocular surface Abstract vertebrates. Improved visual acuity would have increased the fitness of these animals and would The ocular surface is constantly exposed to a have outweighed the disadvantage of having wide array of microorganisms. The ability of local immune cells and blood vessels at a the outer ocular system to recognize pathogens distance where a time delay in addressing a as foreign and eliminate them is critical to central corneal infection could lead to blindness. retain corneal transparency, hence The first vertebrates were jawless fish that preservation of sight. Therefore, a were believed to have evolved some 470 million combination of mechanical, anatomical, and years ago.1 These creatures had frontal eyes and immunological defense mechanisms has inhabited the shorelines of ancient oceans. With evolved to protect the outer eye. These host better vision, these creatures were likely more defense mechanisms are classified as either a active and predatory. This advantage along with native, nonspecific defense or a specifically the later development of jaws enabled bony fish acquired immunological defense requiring to flourish and establish other habitats. One previous exposure to an antigen and the such habitat was shallow waters where lunged development of specific immunity. Sight- fish made the transition to land several hundred threatening immunopathology with thousand years later.2 To become established in autologous cell damage also can take place this terrestrial environment, the new vertebrates after these reactions.
    [Show full text]
  • Herpes Simplex Epithelial Keratitis and Proposed Treatments
    Herpes Simplex Epithelial Keratitis and Proposed Treatments Andrea De Souza, OD Author’s Bio Dr. Andrea De Souza received her Doctor of Optometry Degree in 2012 from the New England College of Optometry in Boston, MA. She continued her optometric training and graduated from the Primary Care and Contact Lens residency at the UC Berkeley School of Optometry in 2013. Today, Dr. De Souza works as a clinical instructor at the UC Berkeley School of Optometry teaching students in the field of ocular disease, contact lens and primary care. ____________________________________________________________________ I. Introduction Herpes simplex virus (HSV) stromal keratitis is the leading infectious cause of corneal blindness in developed nations. In the United States alone, approximately 46,000 cases of HSV ocular infection are diagnosed each year.1 HSV is divided into two categories: type 1 and type 2. HSV-1, which most commonly infects the mouth and eyes, is transmitted through direct contact of skin sores or oral secretions, often via kissing. HSV-2 typically affects the genitals and is most commonly transmitted in adults through sexual contact or via maternal transmission to newborns during childbirth.2 HSV-2 is thought to infect over 500 million people worldwide and approximately 23 million new cases are reported each year; the incidence of HSV-1 infections, however, are even greater.2 More than 80% of individuals carry herpes simplex virus antibodies, however 94% of primary infections are subclinical.3 Most primary initial infections occur between the ages of six months and five years. Once infected, the virus travels along nerves from the skin and mouth to the dorsal root of the trigeminal ganglion, via axoplasmic transport, and lays dormant.
    [Show full text]
  • Obstructed Tear Duct Causes Epiphora and Precocious Eyelid Opening Due
    bioRxiv preprint doi: https://doi.org/10.1101/2020.04.17.046383; this version posted April 17, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY 4.0 International license. Obstructed tear duct causes epiphora and precocious eyelid opening due to disruption of Prickle 1-mediated Wnt/PCP signaling Dianlei Guo1*, Jiali Ru1*, Jiaying Fan2*, Rong Ju1, Kangxin Jin1, Hong Ouyang1, Lai Wei1, Yizhi Liu1, Chunqiao Liu1$ 1, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China 2, Guangzhou Woman & Children’s Medical Center *Equal contribution $Correspondence should be addressed to Dr. Chunqiao Liu: Email: [email protected] bioRxiv preprint doi: https://doi.org/10.1101/2020.04.17.046383; this version posted April 17, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY 4.0 International license. Abstract The tear drainage apparatus evolved in terrestrial animals serving as conduits for tear flow. Obstruction of tear drainage causes a range of ocular surface disorders. Hitherto, genetics of tear duct development and obstruction has been scarcely explored. Here we report that a severe Prickle 1 hypomorph mouse line exhibited epiphora. This phenotype was due to blockage of the tear drainage by the incompletely formed nasolacrimal duct (NLD) and lacrimal canaliculi (CL).
    [Show full text]
  • Molecular Biology Applied to the Laboratory Diagnosis of Bacterial Endophthalmitis
    ATUALIZAÇÃO CONTINUADA Molecular biology applied to the laboratory diagnosis of bacterial endophthalmitis Biologia molecular aplicada ao diagnóstico laboratorial de endoftalmite bacteriana Paulo José Martins Bispo1 ABSTRACT Ana Luisa Höfling-Lima2 Antonio Carlos Campos Pignatari3 Bacterial endophthalmitis is a serious but uncommon intraocular infection which frequently results in vision loss. Early diagnosis and appropriate therapy are associated with better visual outcome. Conventional micro- biological methods are currently used for microbiological characterization of eyes with suspected endophthalmitis. However, the sensitivity of bacterial detection from aqueous and vitreous humor using microbiology techniques is poor, and time-consuming to confirm the results. The appli- cation of molecular methods enhances significantly laboratory confir- mation of bacterial endophthalmitis, demanding a shorter time to draw a definitive result and thereby promoting the early initiation of a more specific therapy to limit the empirical or unnecessary use of broad- spectrum antibiotics. PCR-based techniques, including post-PCR me- thods such RFLP, DNA probe hybridization and DNA sequencing have been successfully used for the diagnostic elucidation of clinically sus- pected bacterial endophthalmitis cases, showing promising application in the routine practice of ocular microbiology laboratories. Keywords: Endophthalmitis/etiology; Eye infections, bacterial; Molecular diagnostic techni- ques; Polymerase chain reaction INTRODUCTION Endophthalmitis is an inflammation of intraocular tissues, which can result from the introduction of a bacterial agent in the posterior segment of the eye. It requires urgent medical attention because it is a potentially Trabalho realizado na Universidade Federal de São destructive condition for the eye, and even with therapeutic and surgical Paulo - UNIFESP - São Paulo (SP) - Brazil. intervention, it can lead to partial or complete vision loss after a few days 1 Biomédico, Pós-graduando (Mestrado) do Laborató- of inoculation(1-2).
    [Show full text]
  • Subepithelial Infiltrates Associated to Viral Keratoconjunctivitis Following
    Eye (2004) 18, 1010–1012 & 2004 Nature Publishing Group All rights reserved 0950-222X/04 $30.00 www.nature.com/eye 1;2 3 1 CASE SERIES Subepithelial ES Arcieri , RS Arcieri , ET Franc¸a and FJ Rocha1 infiltrates associated to viral keratoconjunctivitis following photorefractive keratectomy 1Department of Ophthalmology School of Medicine Federal University of Uberlaˆ ndia Abstract One of the most common complications Minas Gerais, Brazil following PRK is the loss of corneal Purpose To report three cases of adenoviral 2 transparency secondary to corneal wound Department of keratoconjunctivitis in patients who have healing, which has been clinically observed as Ophthalmology undergone photorefractive keratectomy and Glaucoma Service subepithelial reticular opacities, and commonly that just developed subepithelial infiltrates. Campinas UniversityF referred to as haze.2–4 Haze after PRK tends to UNICAMP Methods Description of patients that be maximum at 1–6 months after treatment with Sa˜ o Paulo, Brazil developed postoperative adenoviral progressive resolution up to 18 months after keratoconjunctivitis after photorefractive 5 3 surgery, although it can be followed by myopic School of Medicine keratectomy without influence in the final regression.6,7 Some investigators have reported Federal University of Mato visual outcome. Grosso do Sul, Brazil haze with a late onset after PRK, which has been Results All patients presented adenoviral noticed in a small number of individuals keratoconjunctivitis 2–3 months after Correspondence: ES Arcieri usually starting between 4 months and 1 year Rua Corcovado refractive surgery. They developed multiple after PRK.2,8 no 155 pinpoint subepithelial infiltrates in six eyes, Factors unrelated to surgery, such as apto 402 Bairro without haze development.
    [Show full text]
  • Acquired Etiologies of Lacrimal System Obstructions
    5 Acquired Etiologies of Lacrimal System Obstructions Daniel P. Schaefer Acquired obstructions of the lacrimal excretory outfl ow system will produce the symptoms of epiphora, mucopurulent discharge, pain, dacryocystitis, and even cellulitis, prompting the patient to seek the ophthalmologist for evaluation and treatment. Impaired tear outfl ow may be functional, structural, or both. The causes may be primary – those resulting from infl ammation of unknown causes that lead to occlusive fi brosis—or secondary, resulting from infections, infl amma- tion, trauma, malignancies, toxicity, or mechanical causes. Secondary acquired dacryostenosis and obstruction may result from many causes, both common and obscure. Occasionally, the precise pathogenesis of nasolacrimal duct obstruction will, despite years of investigations, be elusive. To properly evaluate and appropriately treat the patient, the ophthal- mologist must have knowledge and comprehension of the lacrimal anatomy, the lacrimal apparatus, pathophysiology, ocular and nasal relationships, ophthalmic and systemic disease process, as well as the topical and systemic medications that can affect the nasolacrimal duct system. One must be able to assess if the cause is secondary to outfl ow anomalies, hypersecretion or refl ex secretion, pseudoepiphora, eyelid malposition abnormalities, trichiasis, foreign bodies and conjunctival concretions, keratitis, tear fi lm defi ciencies or instability, dry eye syn- dromes, ocular surface abnormalities, irritation or tumors affecting the trigeminal nerve, allergy, medications, or environmental factors. Abnormalities of the lacrimal pump function can result from involu- tional changes, eyelid laxity, facial nerve paralysis, or fl oppy eyelid syndrome, all of which displace the punctum from the lacrimal lake. If the cause is secondary to obstruction of the nasolacrimal duct system, the ophthalmologist must be able to determine where the anomaly is and what the cause is, in order to provide the best treatment possible for the patient.
    [Show full text]
  • Long-Term Results of Medical Treatment and Penetrating Keratoplasty
    ORIGINAL ARTICLE Atopic keratoconjunctivitis: long-term results of medical treatment and penetrating keratoplasty Ceratoconjuntivite atópica: resultados a longo prazo do tratamento clínico e da ceratoplastia penetrante YUSUF KOÇLUK1, ZULEYHA YALNIZ-AKKAYA1, Ayşe Burcu1, Firdevs Örnek1 ABSTRACT RESUMO Purpose: To evaluate the long-term outcomes of medically or surgically treated Objetivo: Avaliar os resultados a longo prazo em ceratoconjuntivite atópica (AKC) patients with atopic keratoconjunctivitis (AKC). pacientes que foram tratados clinicamente ou cirurgicamente. Methods: Charts of 16 patients with AKC (32 eyes) observed between 1996 and Métodos: Os prontuários de 16 pacientes (32 olhos) com AKC, que foram acom- 2013 were reviewed retrospectively. Outcome measures included demographic panhados entre 1996 e 2013 foram avaliados retrospectivamente. As medidas features, follow-up duration, and biomicroscopic findings at the first and most adotadas foram as características demográficas, tempos de seguimento, e resultados recent visits. The corrected distance visual acuity (CDVA; in decimal units) was biomicroscópicos da visita inicial e da visita mais recente. A acuidade visual corrigida evaluated at the initial visit and the 1-, 6-, and 12-month follow-up visits. para distância (CDVA), apresentada em unidades decimais, foi avaliada na visita inicial e Results: In the medically treated group (25 eyes of 15 patients), the median nas visitas do 1o mês, 6o mês e 1o ano de seguimento. follow-up duration was 3 (range, 1-9) years, and the median CDVA values were 0.01 Resultados: No grupo tratado clinicamente (25 olhos de 15 pacientes), a mediana (0.001-1.0) at the first visit and 0.01 (0.001-0.8) at the most recent visit (p=0.916).
    [Show full text]
  • Phlyctenular Keratoconjunctivitis: 12-Year-Old Female with Staphylococcal Blepharitis Arpitha Muthialu, MD, Lauren E
    Phlyctenular Keratoconjunctivitis: 12-year-old Female with Staphylococcal Blepharitis Arpitha Muthialu, MD, Lauren E. Jensen, and Michael Wagoner, MD, PhD February 27, 2009 Chief Complaint: Blurry vision and discomfort Physical and Ocular Examination: in the right eye (OD). • General: healthy-appearing young female • Visual Acuity, without correction: History of Present Illness: A 12-year-old o OD--20/80 (with pinhole improves to female complains of blurry vision, foreign body 20/50) sensation, and photophobia in her right eye. o OS--20/20 While she has had chronic problems for years in • Extraocular Motility: Full, both eyes (OU) both eyes, she has noted the acute onset and • Intra-ocular pressure: OD -- 17mmHg; OS -- progressive worsening of the symptoms in the 14 mmHg right eye for one week. • External and anterior segment examination (see Figure 1A-C and Figure 2A-B) Past Ocular History: Since the age of 6, the o OD patient has struggled with meibomian gland . Lids/adnexa: mild anterior dysfunction and chronic staphylococcal blepharitis blepharoconjunctivitis, as well as seasonal . Conjunctiva/sclera: 2+ diffuse allergic conjunctivitis. She has been treated with conjunctival injection topical corticosteroids, antibiotics, and . Cornea: 1x1 mm elevated yellow antihistamines since age 8 and systemic nodule with central erosion and doxycycline since age 9. fluorescein uptake with surrounding engorged hyperemic Past Medical History: Otherwise healthy. vessels, slightly inferior to the visual axis; there is 360 degree Medications: Since her last exam 8 months prior limbal pannus to this presentation, she was completely . Anterior chamber: deep and quiet asymptomatic on a regimen of: . Iris is normal and lens is clear • Doxycycline (100mg orally once daily) o OS • Prednisolone acetate 1.0% (twice daily .
    [Show full text]
  • Keratoconjunctivitis Sicca (KCS, Dry Eye)
    Glendale Animal Hospital 623-934-7243 www.familyvet.com Keratoconjunctivitis Sicca (KCS, Dry Eye) BASIC INFORMATION Description Keratoconjunctivitis sicca (KCS) is the Latin term for dry eye . KCS usually arises from inadequate production of watery tears. Blockage of the tear ducts is not often involved. There are twomajor tear glands in animals, one beneath the upper eyelid and one that resides on the back side of the third eyelid. Causes Potential causes in dogs include the following: • Dry eye often arises from an immune-mediated inflammation of the tear glands and is common in the American cocker spaniel, English bulldog, Lhasa apso, shih tzu, West Highland white terrier, Cavalier King Charles spaniel, and others. • Removal of a prolapsed gland of the third eyelid can cause KCS, often years later. • Certain drugs are toxic to the tear glands, including sulfa drugs, etodolac, 5-aminosalicylic acid, and others. • Canine distemper virus infection can cause KCS. • Neurogenic KCS is a rare disease in dogs in which the tear gland and membranes of the nostril on the same side are affected. • Congenital underdevelopment of the tear glands can lead to KCS very early in life; this occurs most often in the Yorkshire terrier. Potential causes in cats include the following: • Feline herpesvirus infection may be the most common cause of dry eye in cats. Whether the tear glands are affected by the virus or the tear ducts become scarred and blocked by chronic conjunctivitis is unclear. • Removal of a prolapsed gland of the third eyelid can also result in dry eye, but prolapsed glands are uncommon except in the Burmese.
    [Show full text]