_ gqp Frans C. Stades Milton Wyman · Michael H. Boevé · Willy Neumann · Bernhard Spiess Ophthalmology for the Veterinary Practitioner Veterinary Ophthalmology for the Recognized as a standard work, this new, completely revised and expanded edition contains: Ophthalmology for • All important eye diseases encountered in the Veterinary Practitioner daily practice • Coverage of pet animals, horses, birds and farm animals • Practical tips for effective diagnosis • The latest drugs, diagnostic and therapeutic methods • Step-by-step surgical procedures • First-class color photographs and instructive drawings to illustrate symptoms and techniques The book’s structure follows the steps of a clinical investigation. It is a reliable and indispensable vet handbook both for the novice in veterinary vet ophthalmology and the general practitioner. Stades · Wyman · Boevé Neumann Spiess Stades · Second, revised and expanded edition ISBN 978-3-89993-011-5 9 783899 9301 1 5 _ gqp Frans C. Stades Milton Wyman · Michael H. Boevé · Willy Neumann · Bernhard Spiess Ophthalmology for the Veterinary Practitioner Veterinary Ophthalmology for the Recognized as a standard work, this new, completely revised and expanded edition contains: Ophthalmology for • All important eye diseases encountered in the Veterinary Practitioner daily practice • Coverage of pet animals, horses, birds and farm animals • Practical tips for effective diagnosis • The latest drugs, diagnostic and therapeutic methods • Step-by-step surgical procedures • First-class color photographs and instructive drawings to illustrate symptoms and techniques The book’s structure follows the steps of a clinical investigation. It is a reliable and indispensable vet handbook both for the novice in veterinary vet ophthalmology and the general practitioner. Stades · Wyman · Boevé Neumann Spiess Stades · Second, revised and expanded edition ISBN 978-3-89993-011-5 9 783899 9301 1 5 Frans C. Stades Milton Wyman · Michael H. Boevé · Willy Neumann · Bernhard Spiess Ophthalmology for the Veterinary Practitioner Second, revised and expanded edition Titel.indd III 13.12.2006 8:57:43 Uhr 1. English Edition 1996 1. Dutch Edition 1996 2. English Edition 2007 1. Spanish Edition 1998 1. German Edition 1996 1. Portuguese Edition 1998 2. German Edition 1998 1. Italian Edition 2000 3. German Edition 2006 1. Japanese Edition 2000 © 2007, Schlütersche Verlagsgesellschaft mbH & Co. KG, Hans-Böckler-Allee 7, 30173 Hannover E-mail: [email protected] Printed in Germany ISBN 978-3-89993-011-5 Bibliographic information published by Die Deutsche Nationalbibliothek Die Deutsche Nationalbibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data are available in the Internet at http://dnb.ddb.de. The authors assume no responsibility and make no guarantee for the use of drugs listed in this book. The authors / publisher shall not be held responsible for any damages that might be incurred by the recommended use of drugs or dosages contained within this textbook. In many cases controlled research concerning the use of a given drug in animals is lacking. This book makes no attempt to validate claims made by authors of reports for off-label use of drugs. Practitioners are urged to follow manu- facturers´ recommendations for the use of any drug. All rights reserved. The contents of this book, both photographic and textual, may not be reproduced in any form, by print, photoprint, phototransparency, microfilm, video, video disc, microfiche, or any other means, nor may it be included in any com- puter retrieval system, without written permission from the publisher. Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages. Titel.indd IV 13.12.2006 8:57:43 Uhr Contents V Contents Authors . X 3.1.2 Subconjunctival . 21 3.1.3 Retrobulbar . 21 Abbreviations . XI 3.1.4 Intraocular . 21 3.1.5 General rules . 22 Origin of Plates and Figures . XII 3.2 Ocular therapeutic agents . 22 3.2.1 Vasoconstrictors . 22 3.2.2 Antihistamines (nowadays mostly replaced 1 Introduction 1 by corticosteroids) . 22 3.2.3 Antiglaucoma agents . 23 2 Clinical and Differential Diagnostic 3.2.3.1 Miotics. Facilitating drainage of Procedures aqueous . 23 3.2.3.2 Moderating production of aqueous: 2.1 Description of the patient . 5 carbonic anhydrase inhibitors . 23 2.2 Patient history . 5 3.2.3.3 Osmotic agents . 23 2.3 Animal handling, equipment, 3.2.3.4 Other agents used to reduce ocular and instruments . 8 pressure . 23 2.3.1 Restraint and sedation . 8 3.2.4. Mydriatics . 23 2.3.2 Materials and instruments . 8 3.2.5 Antimicrobial agents . 24 2.4 Examination of the eye and its adnexa . 8 3.2.5.1 “Initial choice” antibacterials . 24 2.4.1 Head, skull, and orbital area . 8 3.2.5.2 Antimycotics . 25 2.4.2 Tear film and tear production . 9 3.2.5.3 Antiviral drugs: DNA-synthesis inhibitors . 25 2.4.3 Ocular discharge . 10 3.2.6 Corticosteroids . 25 2.4.4 Eyelids (palpebrae) . 10 3.2.6.1 Topical, into the conjunctival sac . 25 2.4.5 Conjunctiva . 11 3.2.6.2 Subconjunctival . 25 2.4.6 Globe (bulbus) . 12 3.2.6.3 Oral . 25 2.4.7 Sclera . 13 3.2.7 Non-steroidal anti-inflammatory drugs 2.4.8 Cornea . 13 (NSAIDs) . 25 2.4.9 Anterior and posterior chambers . 13 3.2.7.1 Prostaglandin synthesis inhibitors . 25 2.4.10 Pupil and iris . 14 3.2.8 Local anesthetics . 26 2.4.11 Lens . 14 3.2.9 Vitamins, epithelializing agents, and 2.4.12 Vitreous . 14 neutral agents . 26 2.4.13 Fundus . 14 3.2.10 Collyria . 26 2.4.14 Additional and specific examinations . 15 3.2.11 Other “drugs” for ocular use . 26 2.5 Differential diagnosis . 16 3.2.11.1 Diagnostic agents . 26 2.5.1 Introduction . 16 3.2.11.2 Chemical cauterizing agents . 27 2.5.2 The “red” eye . 16 3.2.11.3 (Discharge-)dissolving agents . 27 2.5.3 Epiphora without distinct blepharospasm . 16 3.2.11.4 Anti-hypertensive agents (in secondary 2.5.4 Blepharospastic / painful eye (Schirmer tear retinopathy) . 27 test not decreased) . 16 3.2.11.5 Other drugs used on the eye . 27 2.5.5 Protrusion of the nictitating membrane with 3.2.12 Radiation . 27 enophthalmos . 16 3.2.13 Protective devices . 27 2.5.6 Exophthalmos . 16 3.3 Surgical possibilities . 27 2.5.7 The “blue-white” cornea . 17 3.3.1 Anesthesia . 27 2.5.8 The “pigmented” eye . 17 3.3.2 Preparation of the operative field . 28 2.5.9 The “blind” eye . 17 3.3.3 Positioning on the operating table . 28 3.3.4 Draping . 28 3.3.5 Magnification equipment . 28 3 Diagnostics and Therapeutics for 3.3.6 Surgical equipment . 28 Eye Diseases 3.3.7 Suture material . 28 3.3.8 Hemostasis . 29 3.1 Introduction . 19 3.3.9 Cryosurgery . 29 3.1.1 Into the conjunctival sac . 19 3.3.10 Laser techniques . 29 Inhalt.indd V 17.11.2006 11:35:50 Uhr VI Contents 4 Ocular Emergencies 7 Eyelids 4.1 Introduction . 31 7.1 Introduction . 73 4.2 Luxation or proptosis of the globe . 31 7.2 Ankyloblepharon . 74 4.3 Chemical burns . 34 7.3 Aplasia palpebrae . 74 4.4 Blunt trauma . 34 7.4 Dermoids / dysplasia of the lid . 76 4.4.1 Orbital fractures . 34 7.5 Distichiasis . 76 4.4.2 Contusion of the globe . 35 7.6 Entropion . 78 4.4.2.1 Suffusion (hyposphagma) . 35 7.6.1 Entropion in sheep and horses . 86 4.4.2.2 Traumatic corneal edema . 35 7.7 Ectropion and /or oversized 4.4.2.3 Hyphema . 35 palpebral fissure (macroblepharon) 4.4.2.4 Trauma with deeper penetration . 36 (Ect / OPF) . 86 4.5 Penetrating or perforating trauma . 37 7.7.1 Shortening of the lower palpebral 4.5.1 Lid lacerations and conjunctival sac conjunctiva . 87 wounds . 37 7.7.2 V-Y Method . 87 4.5.1.1 Lacerations of the lid edge including 7.7.3 Simple wedge resection . 87 the lacrimal canaliculus . 39 7.7.4 Kuhnt-Szymanowski method, Blaskovic’s 4.5.1.2 Lacerations with loss of tissue . 39 modification . 87 4.5.2 Conjunctival lacerations . 39 7.7.5 Kuhnt-Szymanowski method . 87 4.5.3 Corneal lacerations . 40 7.7.6 Z-plasty / free transplants . 88 4.5.3.1 General rules of treatment . 40 7.7.7. Total fissure shortening methods . 88 4.5.3.2 Non-perforating corneal wounds . 40 7.8 Trichiasis . 89 4.5.3.3 Perforating corneal defects . 43 7.8.1 Nasal fold trichiasis . 89 7.8.1.1 Removal of nasal folds . 89 7.8.1.2 Medial canthoplasty . 90 5 Orbital and Periorbital Structures 7.8.2 Upper eyelid trichiasis . 90 5.1 Introduction . 47 7.8.3 Caruncle trichiasis and trichiasis in 5.2 Congenital abnormalities . 48 other locations . 91 5.3 Trauma . 48 7.9 Blepharophimosis . 94 5.4 Enophthalmos . 48 7.10 Oversized / overlong palpebral 5.4.1 Enophthalmos due to loss of support . 48 fissure . ..