SPECIAL ARTICLE James Wardrop and Equine Recurrent

Danielle T. Paglia, DVM; Paul E. Miller, DVM; Richard R. Dubielzig, DVM

ames Wardrop should be remembered not only as one of the founders of ocular pathology but also for his contributions to the field of comparative ophthalmology. He described a “specific inflammation” that veterinarians today know as equine recurrent uveitis. As de- scribed by Wardrop in the 19th century, this condition is known today to eventually lead J to blindness. Arch Ophthalmol. 2004;122:1218-1223

In 1782, James Wardrop was born in Lin- lithgow, Scotland, a small township near Edinburgh (Figure 1). He had exten- sive training as a general surgeon, and by the age of 22 years had completed a 4-year surgical apprenticeship in Scotland; a 2-year appointment as house surgeon in London, England; part of a year at a pres- tigious Paris, France, medical school; and a year under Georg Joseph Beer in Vi- enna, Austria. Beer had established the first clinic limited to the practice of ophthal- mology in Europe some 17 years earlier. In 1823, Wardrop was appointed Sur- geon Extraordinary to the Prince Regent, who later became King George IV. War- drop’s reputation as one of the foremost surgeons in his day, however, rested more on the accuracy of his diagnoses, his abil- ity to be an original and forceful thinker, and the number and value of his publica- Figure 1. Portrait of James Wardrop as a young tions rather than on his technical skills.1 man in the early 19th century. Copy of an engraving believed to have been made from a Although Wardrop was considered a portrait by Andrew Geddes. Illustration courtesy general surgeon, his greatest contribu- of Daniel M. Albert, MD, MS. (Digitally tions included establishing the founda- processed image.) tions for ophthalmic pathology and being the first to classify ocular diseases accord- he coined the term . He also had ing to the anatomical parts involved.1 One a passion for hunting and horse racing and may speculate that at least some of his in- was considered “one of the best judges of terest in ophthalmology was fostered by horseflesh in the Kingdom.”3 In 1819, he his having an exotropic left eye as a child.1 combined his fascination for ocular pa- In 1808, he published one of his most im- thology with his extensive knowledge of portant works, entitled Essays on the Mor- horses in An Essay on the Diseases of the bid Anatomy of the Human Eye,2 and in it Eye of the Horse.4 This important work helped to build a foundation for equine From the Department of Clinical Sciences, School of Veterinary Medicine, University of ophthalmic anatomy and aided in the dif- California–Davis (Dr Paglia); and the Departments of Surgical Sciences (Dr Miller) ferentiation of inflammatory diseases of the and Pathobiological Sciences (Dr Dubielzig), School of Veterinary Medicine, University equine eye based on the tissue of origin. of Wisconsin–Madison. The authors have no relevant financial interest in this article. More specifically, the essay is notable be-

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©2004 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 10/01/2021 cause it is among the first to differ- inflammation.4 The first form, which globe. As today, he also recognized entiate a form of ocular inflamma- he called simple or common inflam- the importance of “paying atten- tion that Wardrop termed specific mation, was a keratoconjunctivitis tion to the air of the stable; for this inflammation from other forms of that was characterized by swollen is often impure.” In addition, he rec- ocular inflammatory disease in eyelids, conjunctival hyperemia, ommended avoiding exposure to horses. Today this condition is called ocular discharge, and diffuse or fo- light and not feeding the animal a equine recurrent uveitis (ERU), and cal loss of “pellucidity and lustre” of large amount of grain.4 Modern it affects 10% to 15% of all horses, the .4 In advanced stages, cor- equine medicine has recognized that making it the leading cause of blind- neal perforation and loss of “appear- housing in a stable increases fungal ness in horses then and now.5-8 The ances and utility” of the eye oc- contamination of the equine con- essay is also noteworthy for its al- curred.4 The critical observation, junctiva10 and that sunlight in- lusion to the notion of sympathetic however, was that anterior uveitis duces intense ocular pain and pho- inflammation between the 2 eyes and was secondary to corneal disease. tophobia in horses with keratitis. its description of several surgical Systemic signs such as fever, loss of Wardrop correctly argued against a techniques for treating ocular dis- appetite, thirst, “frequency of the common practice at the time of scari- ease in horses, including the use of pulse,” unhealthy appearance of the fying the eyes and removing the third glass eyes to prevent deformity in coat, and alternate “heat and chills” eyelid, although in some circles in horses that have lost an eye.3 often accompanied this form.4 the United States this unfortunate Wardrop’s interest in equine Trauma was a common cause, but practice persisted until well into the ophthalmology appears to stem from it was also seen as a consequence of 1900s. He advocated extreme cau- the critical economic role horses colds and fevers. Young horses and tion in draining a hypopyon and em- played in his day, his innate scien- those in “high condition” were more phasized careful surgical technique tific curiosity, and an aesthetic ap- commonly affected,4 as they were when doing so.4 Today, rather than preciation for the animal’s strength under the greatest amount of stress. trying to treat an obvious clinical and beauty. In 19th-century Geor- We can assume by “high condi- sign of the condition (eg, ocular sur- gian society, human productivity tion” he meant horses that were used face vascular injection) by limiting and physical safety were heavily de- for racing purposes and, hence, may ocular blood flow by means of thera- pendent on the animal having good have also been more commonly peutic bleeding and inducing sys- vision. Wardrop recognized that treated because of their value. temic hypotension with purgative chronic ERU was the most com- Today’s veterinary ophthal- balls, the veterinary ophthalmolo- mon cause of visual loss in horses mologist would easily recognize the gist uses many of the same antimi- and, hence, was of great economic patients that Wardrop describes, and crobial agents familiar to the physi- importance, because it often ren- in addition to traumatic keratitis cian, along with systemic and topical dered the animal useless for its in- would include as possible causes anti-inflammatory medications. tended purpose and sometimes sterile corneal stromal abscesses, cor- Wardrop was among the first to bankrupted its owner in the pro- neal foreign bodies, bacterial kera- clearly differentiate in horses the pri- cess. However, Wardrop was also in- titis (especially due to Streptococ- marily corneal origin of simple in- sightful because as a physician- cus species, Staphylococcus species, flammation from the uveal origin of scientist, he saw human and Acinetobacter species, and Pseudo- the second form of ocular inflam- veterinary medicines as a single monas species), fungal keratitis (due mation that he called specific inflam- medicine in which a better under- to Aspergillus species and Fusarium mation.4 Although the 2 forms ap- standing of the diseases of one spe- species), viral keratitis (equine her- pear superficially similar, the latter cies would benefit the other, and vice pesvirus 2, equine influenza virus A2, has more serious consequences for versa. Although he erroneously be- and adenovirus), ocular parasites vision and is the “most dangerous lieved horses had fewer and more such as Onchocerca cervicalis and disease of the Eye of the Horse.” Un- uniform ocular diseases than hu- Thelazia species, and allergic and like the corneal origin of simple in- mans4 (perhaps in part because chemical irritations.9-16 The similari- flammation, he noted that the uveal horses have a much more florid in- ties between these causes and those origin of specific inflammation was flammatory response than do hu- seen in humans are striking and also more frequent in “particular mans), his appreciation for the link- speak to the validity of Wardrop’s lines of blood.”4 This observation age between species allowed him to concept of applying medical prin- was later borne out in studies that make significant contributions to ciples across species lines. found certain horse breeds such as both human and veterinary medi- Although the methods of treat- the Appaloosa to have an 8-fold in- cine. It was also Wardrop’s hope that ing these disorders have improved creased frequency of ERU.5 It af- differentiation between the various greatly from the “bleeding, purg- fected animals of all ages, all classes, types of ocular inflammation based ing, and blistering” of Wardrop’s and all states of condition, al- on anatomy would facilitate improv- day,4 he recognized that the out- though horses that were “high bred” ing the selection and breeding of come often depended on the imme- or in high condition were believed quality animals.4 diate and aggressive treatment of the to be more commonly affected. Dark, In An Essay on the Diseases of inflammation if the course of the dis- ill-ventilated stables were thought to the Eye of the Horse, Wardrop elu- ease was not to be protracted or to have a great influence on the inci- cidated 2 principal forms of ocular result in long-term damage to the dence of the disease.4

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©2004 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 10/01/2021 veled at how astute some dealers in horses were in identifying horses that have had an episode of specific in- flammation and how the dealers would sell an animal (often during a period of quiescence) before the animal’s value was lost owing to blindness.4 As with simple inflammation, Wardrop’s description of specific in- flammation is easily recognized by today’s veterinary ophthalmolo- gist. It is most commonly known as ERU but has also been referred to as periodic ophthalmia, recurrent iri- docyclitis, relapsing uveitis, and “moon blindness.” The latter term purportedly originated with Veget- ius in the fourth century AD, who Figure 2. Chronic equine recurrent uveitis in a horse. Subluxated lens and striae indicate glaucoma with thought that the cyclic nature of the globe stretching. (Digitally processed image.) inflammatory outbreaks was asso- ciated with changes in the phases of the moon.18 In Wardrop’s essay, he diverged from this traditional use of the term moon blindness and in- stead used it to describe a dense white that perhaps re- sembles a brightly illuminated moon. Nevertheless, his description of re- curring bouts of epiphora, photo- phobia, anterior chamber opacifica- tion, ocular vascular injection, and the visually devastating sequelae of synechiae, cataract, and retinal de- tachment could be easily found in today’s textbook descriptions of horses with ERU (Figure 2 and Figure 3). With the compar- atively recent advent of tonometers such as the Mackay-Marg and Tono- Pen (Mentor Ophthalmics, Nor- Figure 3. Chronic equine recurrent uveitis in a horse. Severe posterior synechiae and anterior cortical are present. (Digitally processed image.) well, Mass) that are suitable for use in horses, glaucoma also has been Wardrop noted that specific in- eye may then look quite normal or found to be a sequelae of ERU.19 flammation usually develops very may have adhesions that distorted Equine recurrent uveitis is the most suddenly, that it is characterized by the (posterior ). He as- common cause of glaucoma in swelling of the eyelids and copious tutely noted that inflammatory epi- horses, although glaucoma itself is tearing, but that the conjunctival in- sodes typically recur at varying and relatively uncommon in horses, per- jection is not as great as in simple sometimes quite distant intervals, haps because of their very large inflammation.4 A key differentiat- and that ultimately the accumu- uveoscleral outflow pathway.20 ing feature, however, is lack of a “dis- lated damage leads to a cataract and Today ERU is regarded as an tinct speck on the cornea,” and the visual loss.4 Well before the intro- umbrella term for a diverse set of dis- whole anterior chamber is “dim and duction of the ophthalmoscope in eases characterized by episodes of ac- clouded.”4 As in simple inflamma- 1850,17 Wardrop described dissect- tive uveitis alternating with vary- tion, this form may exhibit varying ing the eyes of these horses and find- ing intervals of clinical quiescence.9 degrees of hypopyon.4 The condi- ing a collection of fluid “between the It undoubtedly remains one of the tion is often, at least initially, uni- choroid coat and retina,” conden- leading causes of blindness in horses lateral and may be quite asym- sation of the vitreal elements, and a worldwide.5-8 The typical initial epi- metrical in severity. He described retina that is detached and com- sode consists of severe anterior uve- spontaneous resolution of the pressed “into a chord or bundle.”4 itis, but subsequent episodes are less inflammation over a period of a Finally, as some of today’s horse buy- severe and more chronic in nature. few weeks and observed that the ers can still attest, Wardrop mar- Ultimately, the accumulated ef-

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©2004 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 10/01/2021 fects of the inflammation lead to pro- gressively more destructive patho- logic changes and visual loss. Causes believed to be important today in- clude the spirochetes Leptospira in- terrogans and Borrelia burgdorferi; other bacterial infections that in- clude brucellosis, salmonellosis, streptococcus hypersensitivity, Esch- erichia coli, and Rhodococcus equi; the parasites Onchocerca cervicalis, Toxo- plasma gondii, and various other in- testinal parasites; and viral agents that include equine influenza vi- rus, equine herpesvirus 4, equine ar- teritis virus, and possibly equine ane- mia virus.9,21 In addition, blunt or penetrating trauma may play an in- citing role by breaking down the relatively labile equine blood- Figure 4. Photomicrograph of the pars plicata of the ciliary body in a horse with equine recurrent uveitis. Infiltration of aggregates of lymphoplasmacytic inflammation is evident (hematoxylin-eosin, original aqueous barrier. Wardrop’s admo- magnification ϫ200). (Digitally processed image.) nition to consider the environment proved to be prescient, since it is clear that many of the infectious gans serovar pomona are 13.2 times ERU undergoing an acute episode, causes of ERU in horses are ac- more likely to have uveitis than se- a perivascular lymphoplasmacytic quired through less-than-optimal ronegative horses,5 not all seroposi- inflammatory infiltrate within the husbandry practices.9 Again, the tive horses will develop uveitis.26,27 choroid, retina, optic nerve, and striking similarities between the rec- this finding, in conjunction with the anterior uveal tract is often identi- ognized causes of ERU in horses and recognized heritable nature of ERU, fiable.33 An exudative retinal detach- the causes of uveitis in humans has led some to suggest that ERU in ment may result from the chorio- speaks to Wardrop’s insight into horses occurs in a manner analo- retinitis. These retinal detachments comparative ophthalmology. gous to that in humanswho posses may focally reattach because of fi- The pathophysiology of ERU is the tissue marker HLA-B27 and de- brous organization or may progress unclear, but the disease undoubt- velop uveitis in assiciation with Kleb- to total separation.33 Vitreous opaci- edly has an immune-mediated ba- siella species.28,29 That is, uveitis de- ties, chorioretinitis, retinal detach- sis.9 It has been speculated that a velops only if the horse possesses an ment, and optic nerve atrophy are common theme of all of these incit- as yet undefined specific tissue an- frequently observed in chronic ERU ing causes is that they disrupt the tigen and is also exposed to L inter- (Figure 6). relatively unstable blood-aqueous rogans. Nevertheless, a significant Although Wardrop viewed spe- barrier of the equine eye and allow number of horses with uveitis are se- cific inflammation as usually incur- immunologically reactive compo- ronegative to all serovars of L inter- able, he thought there was some ben- nents to enter the eye. Hypersensi- rogans, indicating that this organ- efit from bleeding (Յ2.9-4.8 L from tivity to L interrogans serovars (es- ism alone is not the sole cause of the jugular vein closest to the af- pecially pomona) is commonly ERU in horses. fected eye), administering purga- implicated as a cause, and the equine The histopathological changes tive balls, feeding a “cooling diet” cornea and lens have been shown to in ERU have built on Wardrop’s de- (less high-energy feedstuffs such as share antigenic properties with this scriptions, and today ERU is char- grain), and improving the ventila- organism.22 Although anti-Lepto- acterized as a uveal lymphoplasma- tion of the stable.4 Given that ERU spira antibodies are found in the cytic inflammatory infiltrate that frequently resolves spontaneously serum, tears, and aqueous humor most commonly affects the nonpig- (at least initially), and that chronic of horses infected with Leptospira, mented ciliary epithelium of the cili- forms may require slitlamp biomi- living organisms are not necessary ary processes7,30-33 (Figure 4). Other croscopy to identify that they are ac- for ERU to occur.23,24 Frequently, histologically identifiable lesions in- tive, it is highly likely that many uveitis may not be seen until 15 volving the nonpigmented ciliary treatment strategies—perhaps even months after systemic infection epithelium include linear eosino- those used today—are erroneously with Leptospira,25 and the fact that philic intracytoplasmic inclusions believed to be effective. He also ap- it can resolve with only anti-in- that may be located within mito- plied a “vinous tincture of opium” flammatory drugs again suggests chondria and thick acellular hya- with a brushlike camel’s-hair pen- that it is primarily immune-medi- line membranes closely adherent cil to the globe 2 to 3 times daily, ated in nature. to the inner aspect of the non- meaning he applied medicine that Although horses that are sero- pigmented ciliary epithelium31 stained the eye, using a whisker- positive for antibodies to L interro- (Figure 5). In patients with chronic like instrument for its application.

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©2004 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 10/01/2021 interphotoreceptor retinoid-bind- ing protein or retinal S antigen34 and, hence, could result in disease in the contralateral eye, to date no study has demonstrated a benefit to de- stroying the affected eye; in addi- tion, the histological changes seen in ERU are not consistent with sym- pathetic ophthalmia. Currently, ERU is not regarded as a variant of sym- pathetic ophthalmia but instead as a disease that often affects both eyes asymmetrically. The slitlamp bio- microscope, a tool not available to Wardrop, has allowed the detec- tion of low-grade inflammation in the fellow eye of a substantial num- ber of horses that have what ap- pears to the naked eye to be unilat- Figure 5. Photomicrograph of a portion of the ciliary process in a horse with equine recurrent uveitis. eral disease. Linear eosinophilic intracytoplasmic inclusions are located within the nonpigmented ciliary epithelium (NCE) (arrows). Lymphoplasmacytic inflammatory infiltrate affecting and internal to the NCE is seen Today’s veterinary ophthal- (Masson trichrome, original magnification ϫ400). (Digitally processed image.) mologist uses many of the same medications that the physician uses to treat humans with recurrent uve- itis. Because it may be difficult to safely approach the eye of a very large animal that has considerable ocular pain, a subpalpebral lavage system is occasionally placed to fa- cilitate treatment of fractious ani- mals. This system consists of a tube that is placed into the dorsal or ven- tral conjunctival fornix and out through the skin of the upper or lower lid, respectively. This tube connects with a port that is secured near or through the mane of the horse and allows medication to reach the corneal surface safely through the opening in the fornix. The treat- ment of ERU is also complicated by the fact that even topical Figure 6. Fundus photograph of a horse with a classic, peripapillary “butterfly” typical of equine recurrent sulfate can induce gastrointestinal uveitis. The winglike altered fundus reflectivity on both sides of and inferior to the optic disc represents tract stasis and colic (which can be previous chorioretinitis. Wardrop did not describe such lesions, as his observations were made before fatal to large herbivores), and that the origin of the ophthalmoscope. (Digitally processed image.) systemic corticosteroid therapy may result in the keratinized hoof sepa- He believed that this procedure was ported that the animal did not expe- rating from the underlying bone helpful in some cases,4 although the rience an episode in the opposite eye (laminitis), thereby potentially per- real value of this therapy may sim- for up to 6 years later. He noted that manently crippling the animal.35 Re- ply have been to provide some de- others before him used less refined cently topical and intravitreal cyclo- gree of pain relief. techniques for destroying the dis- sporine (administered as a sustained- Of interest is Wardrop’s obser- eased eye such as putting quicklime release intravitreal implant) has vation that, as in humans, ERU is of- between the eyelids or by thrusting shown promise in reducing the se- ten initially unilateral. He ques- a nail into the eye in hopes of pre- verity of the disease and the fre- tioned whether destroying the first eye venting the disease in the opposite quency of attacks.36 Although pars would arrest the progress of the dis- eye.4 Obviously, such therapy would plana vitrectomy has been sug- ease in the fellow eye, and so he be considered cruel today. gested as another avenue to prevent treated a valuable race horse with uni- Although there is some sugges- recurrent episodes,37 this approach lateral disease by incising the cornea tion that severe ERU might allow the requires longer-term follow-up and and expressing the lens, vitreous, and exposure of immunologically iso- replication at other centers before it other intraocular contents. He re- lated antigenic constituents such as can be widely advocated.

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©2004 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 10/01/2021 As evident, our understanding (1986-1993). J Am Vet Med Assoc. 1995;207: tionship between Leptospira and equine cornea. of ERU has come a long way since 1327-1331. Vet Immunol Immunopathol. 1985;10:215-224. 6. Jones TC. Equine periodic ophthalmia. Am J Vet 23. Halliwell RE, Brim TA, Hine MT, Wolf ED, White James Wardrop differentiated be- Res. 1942;3:45-71. FH. Studies on equine recurrent uveitis, II: the role tween the various forms of ocular in- 7. Whitley RD, Miller TR, Wilson JH. Therapeutic con- of infection with Leptospira interrogans serovar flammation in the horse. Neverthe- siderations for equine recurrent uveitis. Equine Pomona. Curr Eye Res. 1985;4:1033-1040. less, ERU remains the most common Pract. 1993;15:16-23. 24. Parma AE, Fernandez A, Santisteban C, Bowden 8. Deeg CA, Ehrenhofer M, Thurau SR, Reese S, Wild- R, Cerone S. Tears and aqueous humor from cause of blindness in horses, and ner G, Kaspers B. Immunopathology of recur- horses inoculated with Leptospira containing an- much more needs to be done if we rent uveitis in spontaneously diseased horses. Exp tibodies which bind to cornea. Vet Immunol Im- are to address the economically im- Eye Res. 2002;75:127-133. munopathol. 1987;14:181-185. portant and aesthetically disfigur- 9. Brooks DE. Equine ophthalmology. In: Gelatt KN, 25. Morter RL, Herschler RC, Fessler JF, Lavignett A. ing condition effectively. Unfortu- ed. Veterinary Ophthalmology. Philadelphia, Pa: Experimental equine leptospirosis (Leptospira Lippincott Williams & Wilkins; 1999:1053-1116. pomona). Proc Annu U S Anim Health Assoc. nately, despite potent modern 10. Moore CP, Heller N, Majors LJ, Whitley RD, Bur- 1964;68:147-152. immunosuppressive drugs and gess EC, Weber J. Prevalence of ocular microor- 26. Williams RD, Morter RL, Freeman MJ, Lavi- broad-spectrum antibiotics, to- ganisms in hospitalized and stabled horses. Am gnette AM. Experimental chronic uveitis: ophthal- day’s veterinary ophthalmologist J Vet Res. 1988;49:773-777. mic signs following equine leptospirosis. Invest 11. Moore CP, Fales WH, Whittington P, Bauer L. Bac- Ophthalmol. 1971;10:948-954. would have to agree with Ward- terial and fungal isolates from Equidae with ul- 27. Roberts SJ. Sequelae of leptospirosis in horses rop’s observation in 1819 that “how- cerative keratitis. J Am Vet Med Assoc. 1983;182: on a small farm. J Am Vet Med Assoc. 1958;133: ever beneficial these remedies may 600-603. 189-194. be in diminishing the severity of the 12. Moore CP, Collins BK, Fales WH. Antibacterial sus- 28. White L, McCoy R, Tait B, Ebringer R. A search symptoms, yet they never prevent pectibility patterns for microbial isolates associ- for gram-negative enteric micro-organisms in ated with infectious keratitis in horses: 63 cases acute anterior uveitis: association of Klebsiella with the repetition of attacks, and the ul- (1986-1994). J Am Vet Med Assoc. 1995;207: recent onset of disease, HLA-B27, and B7 CREG. 4 timate destruction of the organ.” 928-933. Br J Ophthalmol. 1984;68:750-755. 13. Andrew SE, Brooks DE, Smith PJ, Gelatt KN, 29. Sahly H, Podschun R, Kekow J, Nolle B, Gross WL, Chmielewski NT, Whittaker CJ. Equine ulcerative Ullmann U. Humoral immune response to Kleb- Submitted for publication July 1, 2003; keratomycosis: visual outcome and ocular sur- siella capsular polysaccharides in HLA-B27– final revision received October 26, vival in 39 cases (1987-1996). Equine Vet J. 1998; positive patients with acute anterior uveitis and 2003; accepted December 11, 2003. 30:109-116. ankylosing spondylitis. Autoimmunity. 1998;28: Correspondence: Paul E. Miller, 14. Kershaw O, von Oppen T, Glitz F, Deegen E, Lud- 209-215. DVM,DepartmentofSurgicalSciences, wig H, Borchers K. Detection of equine herpesvi- 30. CooleyPL,WymanM,KindigO.Parsplicatainequine rus type 2 (EHV-2) in horses with keratoconjunc- recurrent uveitis. Vet Pathol. 1990;27:138-140. School of Veterinary Medicine, Univer- tivitis. Virus Res. 2001;80:93-99. 31. Dubielzig RR, Render JA, Morreale RJ. Distinc- sity of Wisconsin–Madison, 2015 Lin- 15. Lavach JD. Ocular manifestations of systemic dis- tive morphologic features of the ciliary body in den Dr, Madison, WI 53706-1102 eases. Vet Clin North Am Equine Pract. 1992;8: equine recurrent uveitis. Vet Comp Ophthalmol. ([email protected]). 627-636. 1997;7:163-167. 16. Moore CP. Eyelid and nasolacrimal disease. Vet 32. Miller TR, Whitley RD. Uveitis in horses. Mod Vet Clin North Am Equine Pract. 1992;8:499-519. Pract. 1987;68:351-357. REFERENCES 17. Albert DM. The ophthalmoscope and retinovitre- 33. Wilcock RP. The eye and ear. In: Jubb KVF, ous surgery. In: Albert DM, Edwards DD, eds. The Kennedy PC, Palmer N, eds. Pathology of Domes- History of Ophthalmology. Malden, Mass: Black- tic Animals. Vol 1. Orlando, Fla: Academic Press 1. Albert DM, Robinson N. Wardrop Lecture, 1974: well Publishers; 1996:177-202. Inc; 1993:441-529. James Wardrop: a brief review of his life and con- 18. Magrane WG. Early history. In: Magrane WG, ed. 34. Deeg CA, Kasper B, Gerhards H, Thurau SR, Wol- tributions. Trans Ophthalmol Soc U K. 1974;94: A History of Veterinary Ophthalmology. Elkhart, lanke B, Wildner G. Immune responses to retinal au- 892-908. Ind: Franklin Press Inc; 1988:1-16. toantigens and peptides in equine recurrent uve- 2. Wardrop J. Essays on the Morbid Anatomy of the 19. Miller TR, Brooks DE, Smith PJ, Sapienza SJ. itis. Invest Ophthalmol Vis Sci. 2001;42:393-398. Human Eye. 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