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In vivo confocal microscopy (IVCM) is a relatively new ocular imaging technique that permits morphological and quantitative assessment of the living cornea on the cellular level. The applications for IVCM in clinical ophthalmology are numerous and diverse. There are several advantages inherent to IVCM over standard diagnostic techniques currently used to confirm a diagnosis of infectious keratitis in veterinary ophthalmology. With IVCM, images can be viewed in real-time providing immediate diagnostic information. Traumatic corneal sampling techniques are avoided, and the procedure can be repeated as frequently as is clinically indicated without risk of corneal tissue damage. Both superficial and deep corneal lesions can be evaluated by IVCM in an atraumatic fashion. Microorganism viability is not required for their detection and specialized diagnostic laboratory assay procedures are not necessary. Many larger infectious agents can be directly identified within corneal lesions by IVCM, including fungi and parasites such as Acanthamoeba spp. In other situations, such as bacterial infectious crystalline keratopathy, the biological systems associated with the microorganism can be detected within the cornea. The current resolution of IVCM is inadequate to directly visualize some corneal infectious agents, such as herpesviruses, but host responses and virus-infected epithelial cells can be identified. This review summarizes the current knowledge and applications of IVCM in the management of infectious keratitis in veterinary ophthalmology, including its use in animals with bacterial, fungal, parasitic, and viral keratitis.

A oftalmologia veterinária abrange o diagnóstico das alterações oculares, perioculares e retrobulbares primárias, e também suas manifestações sistêmicas e secundárias, o que se torna possível a partir da avaliação completa do bulbo ocular, órbita e anexos por meio do exame oftálmico completo e de exames complementares. Dentre os exames de imagens que auxiliam no diagnóstico das afecções oculares, a ultrassonografia está entre os exames de imagem mais utilizados na rotina veterinária, auxiliando na observação de anormalidades retrobulbares e na avaliação das estruturas bulbares na presença de opacificação de meios transparentes, por exemplo. Além da ultrassonografia, existem outras modalidades de exames, dentre eles a tomografia computadorizada, ressonância magnética, angiografia, microscopia especular, tomografia de coerência óptica (OCT) e angiografia por tomografia de coerência óptica (OCT-A). Em virtude dos avanços tecnológicos na obtenção de imagens, a avaliação globo ocular e das estruturas orbitárias pode ser realizada com maior precisão, o que favorece o diagnóstico e a escolha terapêutica adequada. Objetiva-se com esta revisão enumerar os exames disponíveis, suas principais indicações, bem como sua aplicabilidade e estudos em animais domésticos.

Mike Rhodes, European and RCVS Recognized Specialist in Veterinary Ophthalmology, provides an overview for the first-opinion clinician, highlighting which ocular drugs to stock and use in practice.*

Glaucoma is a disorder of all species due to a rise of intraocular pressure (IOP) beyond which is compatible with ganglion cell and axon function, often resulting in optic nerve degeneration and irreversible blindness. Glaucoma treatment with surgical intervention aimed at either reducing aqueous production, or increasing or altering aqueous outflow has evolved over preceding decades, but there remains no cure. The present article is intended to provide a concise review of glaucoma surgical therapies in veterinary ophthalmology.

Equine gammaherpesvirus 2 (EHV-2) has been linked to keratitis and keratoconjunctivitis but has also been isolated in horses showing no signs of disease. The aim of the current study was to assess the importance of EHV-2 infection in the aetiopathogenesis of ocular disease, where the applied treatment failed. Seventy-eight horses with nonhealing ocular disease were examined at the Equine Clinic of the University of Veterinary Medicine and Pharmaceutical Sciences, Brno, Czech Republic, between the years 2009 and 2016. In total, 96 conjunctival swabs were taken and, starting from 2014, peripheral blood leukocytes (PBLs) were also examined in 42 patients. Positive EHV-2 results were detected in 53 ocular swab samples (54.64%) and in 22 PBL samples (51.16%). The horses were divided into three groups according to age, up to 3 years, from 3 to 15 years and older than 15 years. Depending on the clinical presentation, horses were also divided into nonulcerative or ulcerative keratitis, keratouveitis, keratoconjunctivitis, and corneal degeneration groups. The group of young horses had a significantly higher ocular swab positivity compared to the middle group (P = 0.01). Increased bilateral ocular occurrence with decreasing age was observed, although it was not significant (P = 0.04). Significant correlation was confirmed between PBL samples and ocular swabs (P = 0.01). This correlation was even higher in cases of bilateral infection. No significant differences were detected when comparing the groups according to the clinical presentation. This study describes the prevalence of EHV-2 in different age group horses with non-healing keratopathies.

Diagnosis of causes of blindness in veterinary ophthalmology is an urgent issue. There are a large number of diseases of central and peripheral nervous system, which can lead to partial or complete loss of visual function in animals. Visual evoked potentials (VEP) of brain can be a reliable diagnostic research method to clarify the location of the disfunction and causes of blindness in dogs and cats. Together, the visual evoked potentials and electroretinography complement each other and give a greater idea of electrophysiology of visual process. In this article on the basis of large quantity of information we examine the ways of applying this method and the problems, connected with its use. It is important to understand that the VEP can reveal the functional disturbances of visual way, but does not give the information about the structural changes.

The treatment of pathologies of posterior segment of eye, such as chorioretinitis, uveitis, various neuroretinopathies, vitreous diseases, intraocular hemorrhage, is a rather serious problem due to the difficulties of the adequate delivery of preparations into area of pathological process. One of the most effective ways to deliver drugs to eye tissue in posterior segment are intravitreal injections. The introduction of drugs is carried out directly into vitreous body through a puncture of sclera. This article presents the indications for intravitreal injections, a detailed description of properties of numerous therapeutic agents that can be delivered through intravitreal injections, potential complications of this technique and recommendations for prevention of side effects.

Purpose Healthcare-associated infection (HAI) is a well-known problem in human medicine. The contamination of medical devices with pathogenic organisms is less studied in veterinary medicine. The purpose of this multicenter study was to evaluate the bacterial contamination of slit lamps throughout Europe and part of the United States. The efficacy of standard cleaning was additionally investigated. Methods Samples from adjustment wheels of slit lamps were taken by different veterinary ophthalmologists and submitted for culture (n = 29). The efficacy of cleaning protocols was evaluated by taking a second sample after routine cleaning (n = 29). Sensitivity testing was performed for pathogenic bacteria using the minimum inhibitory concentration (MIC) or disc diffusion (Kirby-Bauer) method. Statistical analysis was performed using Fisher's exact test. Results Seventeen of 29 slit lamps were contaminated before cleaning. The most frequently cultured bacteria were Staphylococcus spp. and coliform bacteria. Twelve of 29 slit lamps showed no bacterial growth before and after cleaning. There was a significant difference before and after cleaning (P = 0.0008), with only 4/29 contaminated samples after cleaning. Conclusion Contamination with pathogenic bacterial species is frequent in slit lamps used by veterinary ophthalmologists. A risk of cross-contamination in clinical patients has to be considered. Routine cleaning reduces bacterial contamination significantly.

The present study describes the prevalence of bacterial cross-contamination in a veterinary ophthalmology setting, a serious issue that can result in healthcare-associated (or nosocomial) infections among patients and staff. Retrospective (n = 5 patients) and prospective (n = 23 patients) studies evaluated bacterial isolates in companion animals presenting with ulcerative keratitis, sampling the patients' cornea and surrounding examination room, including the environment (exam table, countertop, floor) and ophthalmic equipment (slit lamp, transilluminator, direct ophthalmoscope, indirect headset, tonometer). Results of bacterial culture and antibiotic susceptibility testing were recorded, and degree of genetic relatedness was evaluated in six pairs of isolates (cornea + environment or equipment) using pulse-field gel electrophoresis (PFGE). Overall contamination rate of ophthalmic equipment, environment, and examination rooms (equipment + environment) was 42.9% (15/35 samples), 23.7% (9/38 samples) and 32.9% (24/73 samples), respectively. Methicillin-resistant Staphylococcus pseudintermedius (MRSP), a multi-drug resistant (MDR) pathogen with zoonotic potential, was isolated in 8.2% (6/73) of samples. The patient's cornea was likely the source of cross-contamination in 50% (3/6) of MRSP pairs as evaluated by PFGE; notably, two of the three similar bacterial strains did not have an exact match of their antibiotic susceptibility profiles, highlighting the importance of advanced diagnostics such as PFGE to assess cross-contamination in healthcare facilities. Future work could examine the contamination prevalence of specific equipment or the efficacy of cleaning protocols to mitigate cross-contamination in veterinary practice.

This paper discusses the diagnosis and clinical management of a case of equine keratomycosis. A pregnant Iberic mare was diagnosed with Aspergillus subgenus Circumdati section Circumdati, by direct microscopic examination, cytology, and fungal culture after being treated with a topical antibiotic and steroid drops in her left eye for over a month. The mare developed a melting ulcer and, as a result, topical miconazole 1% was prescribed; while being treated the iris prolapsed, and surgery was suggested but not conducted. After the treatment, the eye was not visual but in the orbit. Se discute el manejo clínico y diagnóstico de un caso de queratomicosis en un equino. Una yegua Ibérica preñada fue diagnosticada con Aspergillus subgénero. Circumdati sección Circumdati mediante examen microscópico directo, citología y cultivo micológico, después de haber sido tratada por un mes con gotas de corticoesteroides y antibiótico tópico en su ojo izquierdo. Desarrolló úlcera colagenolítica, se prescribió tratamiento con miconazol tópico al 1% y posteriormente presentó prolapso de iris, la cirugía fue sugerida pero no fue realizada. Al final del tratamiento médico, el ojo no es visual, pero está en órbita. Discute-se o manejo clínico e diagnóstico de um caso de ceratomicose em um equino. Uma égua ibérica prenha foi diagnosticada com Aspergillus subgen. Circumdati seção Circumdati por exame microscópico direto, citologia e cultura micológica, após ter sido tratada por um mês com colírio de corticosteróides e antibiótico tópico no olho esquerdo. Desenvolveu úlcera colagenolítica, foi prescrito tratamento com miconazol tópico a 1% e posteriormente apresentou prolapso de íris, cirurgia foi sugerida, mas não realizada. No final do tratamento médico, o olho não é visual, mas está em órbita. Universidad Nacional, Costa Rica Escuela de Medicina Veterinaria

En Veterinary Anaesthesia and Analgesia. Amsterdam : Elsevier. Vol. 47, n. 6 (01 nov. 2020), pp. 846-847. ISSN 1467-2987. e-ISSN 1467-2995. Este artículo se encuentra disponible en la siguiente URL: https://www.vaajournal.org/article/S1467-2987(20)30190-2/fulltext#relatedArticles This is the pre-peer reviewed version of the following article: Hernández, E.Z., Redondo, J.I., Gutiérrez Bautista, A.J. & Viscasillas, J. (2020). A modified retrobulbar block for microphthalmia using ultrasound guidance in a cat. Veterinary Anaesthesia and Analgesia, vol. 47, i. 6 (01 nov.), pp. 846-847, which has been published in final form at https://doi.org/10.1016/j.vaa.2020.05.011 Este es el pre-print del siguiente artículo: Hernández, E.Z., Redondo, J.I., Gutiérrez Bautista, A.J. & Viscasillas, J. (2020). A modified retrobulbar block for microphthalmia using ultrasound guidance in a cat. Veterinary Anaesthesia and Analgesia, vol. 47, i. 6 (01 nov.), pp. 846-847, que se ha publicado de forma definitiva en https://doi.org/10.1016/j.vaa.2020.05.011

PURPOSE To examine variables that affect publication of ACVO meeting abstracts in peer-reviewed journals and compare results to ECVO publication rate (PR). METHODS Published papers were identified via online searches for abstracts from 2008 to 2012 ACVO/ECVO meetings. Variables analyzed (via Pearson's chi-Squared test) included the following: oral presentation/poster, type of abstract (clinical/basic science/case report), species, ocular tissue, nationality, funding, first/last/any author a diplomate, resident as first author, and author affiliation (private practice/university). RESULTS One hundred and eighty-six of 577 ACVO abstracts were published within 608 ± 479 days, with 103 published in Veterinary Ophthalmology. Significant factors included the following: nationality of first/last authors (P = .005); English as first language (P < .001); presentation type (P < .001, oral 40% PR, poster 22% PR); type of study (P = .037, clinical study 35% PR, basic science 30% PR, case report 16% PR); resident as first author (P < .001); diplomate as any author except first/last (P < .001); first author affiliation (P = .001, university 37% PR, practice 21% PR); last author affiliation (P = .003, university 36% PR, practice 22% PR); and species (P < .001, horses 53% PR, multiple species 50% PR, cats 35% PR, food animals 31% PR, exotics/wildlife 31% PR, dogs 27% PR, laboratory animals/in vitro 24%). Nonsignificant factors were as follows: diplomate as first/last author, funding, and ocular tissue. Presentation type, resident as first author, university affiliation of first author, and species had the greatest effect on publication probability. For the same period, ECVO PR was 87 of 299, which was not significantly different from ACVO PR (P = .342). CONCLUSION At 32%, ACVO PR for the study years is similar to ECVO PR of 29%.

Veterinarians are required to use clinical reasoning skills to successfully manage their patients with eye diseases. Case-based assignments can be an effective tool for teaching problem-solving skills. Very few models or online modules exist to deepen the instruction of veterinary ophthalmic clinical reasoning skills. The current study aims to assess the value of online case-based assignments given to students during the Ontario Veterinary College’s Phase 4 ophthalmology rotation over a 4-year period. Nine case-based assignments were developed as an online module and provided signalment, history, ophthalmic database, and clinical photography. For each case, students were required to describe the ocular lesions, provide a diagnosis, and develop a short-term and long-term treatment plan. A grading rubric was created, and student feedback was collected using an online survey. A frequency analysis was conducted to evaluate final grades across each case. This analysis was also completed for grades of each question across all cases. A total of 285 students were graded individually. Students’ grades were normally distributed across each assignment. Students performed better on lower-order cognitive skills (description of ocular lesions) but poorer on high-order cognitive skills (therapeutic plans). These results suggest that students tend to have difficulty with the analysis and interpretation of these cases. Student feedback reported case-based assignments were useful. Online case-based assignments may be a useful adjunctive teaching tool for students rotating through ophthalmology in their clinical year, and this tool could be considered for other specialized rotations.

This study aimed to evaluate changes in lacrimation and intraocular pressure (IOP) in dogs with unilateral corneal ulceration using the Schirmer tear test (STT) and rebound (TonoVet®) tonometry. IOP and STT values were recorded in both ulcerated and non-ulcerated (control) eyes of 100 dogs diagnosed with unilateral corneal ulceration. Dogs presented with other ocular conditions as their primary complaint were excluded from this study. The mean ± standard deviation for STT values in the ulcerated and control eyes were 20.2±4.6 mm/min and 16.7±3.5 mm/min respectively. The mean ± standard deviation for IOP in the ulcerated and control eyes were 11.9±3.1 mmHg and 16.7±2.6 mmHg respectively. STT values were significantly higher (p

PURPOSE: To review abstracts presented at five consecutive meetings of the European College of Veterinary Ophthalmologists (ECVO), and identify abstract characteristics that affect the probability of their publication in peer‐reviewed journals. METHODS: An online search was conducted for peer‐reviewed publications (PRPs) stemming from abstracts from five ECVO meetings (2008–2012). Time to publication and journal were noted. Effects of ocular tissue/discipline, species, type of presentation and study, funding acknowledgment and affiliation, professional qualifications, and nationality of the first and last authors on probability of publication were analyzed. RESULTS: Of presented abstracts, 29% (87/299) were published as PRPs in Veterinary Ophthalmology (n = 50), other veterinary journals (n = 22), and nonveterinary journals (n = 15). During the 5 years studied, there was no significant difference between the impact factor of Veterinary Ophthalmology and the 25 other journals in which PRPs were published (P = 0.369). Median time to PRP acceptance or publication was 468 days. Independent variables most significant in determining the probability of PRP were oral presentation (P = 0.002), resident authorship (P < 0.0001), and species (P = 0.002), with food animal abstracts having the highest odds ratio. Ocular tissue/discipline (P = 0.13) and type of study (P = 0.33) did not affect publication probability. Funding acknowledgment (P = 0.02), author nationality (P = 0.02), and academic affiliation (P = 0.04) were also significant factors. CONCLUSIONS: Publication rate of ECVO abstracts is lower, but time to publication is similar, compared with most biomedical meetings.

The tear lipid layer (oily outer layer) reduces evaporation and prevents tear overflow. In dogs, reductions in the lipid components of this layer (cholesterol, triglycerides and phospholipids) can cause eye serious diseases. In this way, the tear crystallization test analyzes the lacrimal quality, however, it is less used in veterinary. As phytosterol reduces blood cholesterol, the objective of this study was to investigate, through the tear crystallization test, whether the systemic administration of this drug influences the lacrimal quality of healthy dogs and, in addition, to verify differences in the interpretation of the ophthalmic test between different evaluators. Eight beagles, healthy, of both sexes, young and adults, without clinical ophthalmic signs apparent were selected. Basal lacrimal samples (D0) were collected from the right and left eye of all animals with glass capillary tube and arranged on a glass slide for scanning the images and subsequent microscopic analysis. Subsequently, all were medicated with the phytosterol (Collestra® 650 mg: 1 capsule, orally, every 12 hours, for 15 days). After seven (D7) and fifteen (D15) days of this systemic administration, the tear crystallization test in both eyes of all dogs was again performed for statistical comparison with the baseline results. The photographs of the slides were classified by four evaluators (AV1 and AV2 with professional experience in ophthalmology and AV3 and AV4 without previous professional experience in ophthalmology), following standards established by Rolando (1984). The results were statistically verified by analysis of simple variance (ANOVA One-Way). There was no statistical difference in the tear crystallization test between the established periods and in relation to the different ophthalmic test evaluators (p≤0.05). Although phytosterols reduce blood cholesterol levels, it was observed in the present study that these drugs when administered systemically did not interfere in the tear lipid layer and, consequently, in the lacrimal quality of healthy dogs, and may be prescribed as lipid-lowering agents for patients with ocular diseases, especially the lacrimal ones. A camada lipídica lacrimal (camada externa oleosa) reduz a evaporação e previne o transbordamento lacrimal. Em cães, reduções nos componentes lipídicos desta camada (colesterol, triglicérides e fosfolipídios) podem causar doenças graves nos olhos. Desta forma, o teste de cristalização lacrimal analisa a qualidade lacrimal, no entanto, é menos utilizado em veterinária. Como o fitoesterol reduz o colesterol sanguíneo, o objetivo deste estudo foi investigar, através do teste de cristalização lacrimal, se a administração sistêmica deste fármaco influencia na qualidade lacrimal de cães hígidos e, além disso, verificar diferenças na interpretação do teste oftalmológico entre diferentes avaliadores. Oito beagles, saudáveis, de ambos os sexos, jovens e adultos, sem sinais oftalmológicos clínicos aparentes foram selecionados. Amostras lacrimais basais (D0) foram coletadas do olho direito e esquerdo de todos os animais, com tubo capilar de vidro e, dispostas em lâmina de vidro para escaneamento das imagens e posterior análise microscópica. Ato contínuo todos foram medicados com o fitoesterol (Collestra® 650 mg: 1 cápsula, por via oral, a cada 12 horas, durante 15 dias). Após sete (D7) e quinze (D15) dias desta administração sistêmica, o teste de cristalização lacrimal em ambos os olhos de todos os cães foi novamente realizado para comparação estatística com os resultados basais. As fotografias das lâminas foram classificadas por quatro avaliadores (AV1 e AV2 com experiência profissional em oftalmologia e AV3 e AV4 sem experiência profissional prévia em oftalmologia), seguindo padrões estabelecidos por Rolando (1984). Os resultados foram estatisticamente verificados pela análise de variância simples (ANOVA One-Way). Não houve diferença estatística no teste de cristalização lacrimal entre os períodos estabelecidos e em relação aos diferentes avaliadores de teste oftalmológico (p≤0,05). Embora os fitoesteróis reduzam os níveis de colesterol no sangue, observou-se no presente estudo que esses fármacos quando administrados sistemicamente não interferiram na camada lipídica da lágrima e, consequentemente, na qualidade lacrimal de cães hígidos, podendo ser prescritos como agentes hipolipemiantes para pacientes com doenças oculares, especialmente as lacrimais.

Background Keratometry is clinically important and is routinely performed as part of human ophthalmic examination. In veterinary ophthalmology, little is known about keratometry in dogs, and its practical application has been limited. The present study aimed to describe keratometry in some dog breeds popular in Japan using a handheld keratometer. Methods Client-owned dogs of various signalment were enrolled prospectively in the keratometry examination. Interbreed variations in mean corneal curvatures (R1R2avg) and corneal astigmatism (Δ(R1−R2)) were evaluated statistically with respect to their bodyweight based on the data which fulfilled the predetermined inclusion criteria. P

Background The Schirmer tear test (STT) is widely used in both human and veterinary ophthalmology. Two types of STTs have been developed: STT I and SST II. The STT I measures the basal and reflex tear production and is the most widely used STT. However, several factors influence the STT results such as the person performing the test and the location of the strip placement within the conjunctival sac. The aim of this study was to measure the basal and reflex tear production (STT I) in clinically normal horses with open versus closed eyes. Results Forty clinically healthy horses without any ocular diseases were included. On day 1, the STT I was first performed on all the horses with the eyes open followed by an STT I with closed eyes performed 30 min later. On day 2, all horses had their eyes closed during the first STT and the eyes open during the second test performed 30 min later. The mean value of the STTs performed on open eye was significantly less than the STT performed on closed eye on both days of examination. Conclusion This study showed a small but statistically significant difference between STT values obtained with open versus closed eyes in clinically normal horses.

Tonometry is one of the basic diagnostic tests used for the diagnosis of glaucoma and uveitis in veterinary ophthalmology. The Icare® Rebound Tonometer which is a new tonometric device has been shown to be useful in a wide range of species. Eyes (n = 48) of 24 Simmental and Montafon calves with a mean age of 7.5 weeks (2–16 weeks), male and female, were subjected to intraocular pressure (IOP) measurement using the Icare® Rebound Tonometer with calves standing and in lateral recumbency. The mean IOP was measured as 9.02 ± 2.38 mmHg in the right eye and 9.08 ± 2.55 mmHg in the left eye. No age-related change was found in intraocular pressure of the calves between 2 and 16 weeks of age. No difference in IOP values was observed between Simmental and Montafon calves. Body position had no effect on IOP in calves. The Icare® Rebound Tonometer was shown to be a suitable diagnostic device for IOP measurement in calves.

Five cases of canine keratomycosis were diagnosed and treated at a private Veterinary Ophthalmology Practice in Melbourne, Australia. Clinical presentations varied between dogs. Predisposing factors were identified in 4 of 5 cases. Diagnostic modalities utilized were corneal cytology and fungal culture. Corneal cytology confirmed the presence of fungal organisms in all five cases. Aspergillus, Scedosporium, and Candida were cultured from three cases, respectively. Specific antifungal treatment included 1% voriconazole solution or 1% itraconazole ointment. Keratectomy and conjunctival grafting surgery was performed in two patients. Resolution of infection and preservation of vision were achieved in 4 of 5 patients.

Este artículo se encuentra disponible en la página web de la revista en la siguiente URL: https://veterinaryrecord.bmj.com/content/vetrec/180/19/474.full.pdf This is the pre-peer reviewed version of the following article: Mayordomo-Febrer, A., Rubio-Zaragoza, M., Martínez-Gassent, M. & López-Murcia, MM. (2017). Effects of morphine-alfaxalone-midazolam premedication, alfaxalone induction and sevoflurane maintenance on intraocular pressure and tear production in dogs. Veterinary Record, vol. 180, n. 19 (13 may), art. 474, which has been published in final form at http://dx.doi.org/10.1136/vr.104040 Este es el pre-print del siguiente artículo: Mayordomo-Febrer, A., Rubio-Zaragoza, M., Martínez-Gassent, M. & López-Murcia, MM. (2017). Effects of morphine-alfaxalone-midazolam premedication, alfaxalone induction and sevoflurane maintenance on intraocular pressure and tear production in dogs. Veterinary Record, vol. 180, n. 19 (13 may), art. 474, que se ha publicado de forma definitiva en http://dx.doi.org/10.1136/vr.104040 Intraocular pressure (IOP) and tear production are ocular parameters commonly affected by general anaesthesia. A good control of both of them is necessary to guarantee a successful ophthalmic surgery. The purpose of this research was to analyse the effect of a common anaesthetic protocol based on morphine-alfaxalone-midazolam premedication, alfaxalone induction and sevoflurane maintenance on IOP and Schirmer tear test (STT-1) in healthy dogs. Twenty two adult mixed dogs scheduled for an ovariohysterectomy were used for this study. IOP and STT-1 were registered at baseline (T0), 5 (T1), 10 (T2) and 15 (T3) minutes after premedication with morphine-alfaxalone-midazolam combination; after induction (T4) with alfaxalone and 15 (T5) and 25 (T6) minutes after maintenance with sevoflurane. A paired Student´s t-test and a Wilcoxon test were used to analyse the difference between IOP and STT-1 over time respectively. This anaesthetic protocol produced a statistically significant increase in IOP (P

Electroretinography (ERG) in the form of full-field, flash ERG is the most commonly used technique in veterinary ophthalmology for diagnosing the functioning of the outer retina. Under light stimulation spatially distributed different cell types within the retina produce time-varying electric responses. These are recorded in the form of ERG traces consisting of a series of positive and negative wavelets. The possibility of selective stimulation of individual types of retinal cells and the analysis of constituent components of ERGs are the basis for determining the source of abnormalities and diagnosis of various types of dysfunction. In many cases, the ERG allows diagnosis of hereditary retinal disorders in dogs before the appearance of behavioural and ophthalmoscopic symptoms. This review is an introduction to the electrophysiology of vision, intended for small animal practitioners, and aimed at presenting the benefits of ERG for early ophthalmic diagnostics in dogs.

The present article describes the penetrating keratoplasty using the technique of rehydration of donor cornea dehydrated over silica gel, as well as complications that can arise. The indications included corneal ulcers, descemetocoele, corneal sequestrum and corneal perforation. 37 (88.37%) out of 43 corneal transplants had a favorable outcome in surgeries with complete excision of abnormal tissues. In 5 cases (11.63%), the authors faced such complications as suture failure, formation of anterior synechias, incomplete epithelization after the suture removal, and transplant swelling reversed with the preservation of eye optical functions, and secondary glaucoma in the late postoperative period that ended up in eyeball endoprosthesis transplantation. Due to a high rate of efficiency of the proposed method, penetrating keratoplasty with rehydrated grafts can be recommended for the treatment in case of medical emergency experienced by cats and dogs.

Objective The aim of this study was to examine the association of various aspects of veterinary ophthalmology residency training with the first-time pass rate (FTPR) of the American College of Veterinary Ophthalmologists (ACVO) examination, as well as the individual written, image recognition, animal examination, and surgical sections of the examination. Procedures Program type, resident evaluations, cumulative surgery and case logs, and scores from ACVO examinations from 2007 to 2010 were evaluated. Results Data were available for 71 candidates. The overall FTPR was 35% (n = 25). For the different sections of the examination, FTPRs were as follows: written (68%), image recognition (76%), intraocular surgery (80%), extraocular surgery (65%), and animal examination (75%). The overall FTPR among candidates from academic residency (AR) programs was 43% (20 of 47), while the FTPR of residents in private practice (PPR) programs was 21% (5 of 24; P = 0.07). The AR candidates were more likely to pass the written portion than PPR residents (P = 0.02), and AR candidates had significantly more time off clinics (median 25%) vs PPR residents (median 18%; P = 0.007). The AR residents also had a higher reported percentage of direct supervision than PPR residents (95% vs 76%, respectively). Although PPR residents did significantly more surgeries and examined significantly more dogs and cats, those from ARs examined significantly more equine, bovine, avian, camelid, and reptile species. Conclusions Overall, AR residents had a higher FTPR and were more likely to pass the written portion of the examination. Total case and surgery numbers were not associated with FTPR.

The aim of this study was to evaluate the effects of canine amniotic membrane, previously preserved in glycerin, used as a patch on the repair of experimentally-made superficial corneal ulcers and to compare corneal epithelization between the treated and non-treated groups. Xenogeneic amniotic membranes were collected aseptically and preserved in 99% glycerin at room temperature. Each animal was anesthetized and submitted to superficial corneal keratectomy of the left eye. The treated group received a fragment of canine amniotic membrane as a patch, while the control group had no treatment. The treated group showed blepharospasm, ocular discharge and conjunctival congestion. The membrane accelerated corneal repair in the beginning of the process, however, it delayed its conclusion (p

Stem cell technology has evoked considerable excitement among people interested in the welfare of animals, as it has suggested the potential availability of new tools for several pathologies, including eye disease, which in many cases is considered incurable. One such example is ulcerative keratitis, which is very frequent in horses. Because some of these corneal ulcers can be very severe, progress rapidly and, therefore, can be a possible cause of vision loss, it is important to diagnose them at an early stage and administer an appropriate treatment, which can be medical, surgical, or a combination of both. The therapeutic strategy should eradicate the infection in order to reduce or stop destruction of the cornea. In addition, it should support the corneal structures and control the uveal reaction, and the pain associated with it, in order to minimize scarring. In this study, we address how stem cells derived from peripheral blood can be used also in ophthalmological pathologies. Our results demonstrate that this treatment protocol improved eye disease in four horse cases, including corneal ulcers and one case of retinal detachment. In all cases, we detected a decrease in the intense inflammatory reaction as well as the restoration of the epithelial surface of the central cornea.

Objective To evaluate and to validate the accuracy of the Perkinshandheld applanation tonometer in the measurement of IOP in dogs and cats. Animals Twenty eyes from 10 dogs and 10 cats immediately after sacrifice were used for the postmortem study and 20 eyes from 10 clinically normal and anesthetized dogs and cats were used for the in vivo study. Both eyes of 20 conscious dogs and cats were also evaluated. Procedure Readings of IOP postmortem and in vivo were taken using manometry (measured with a mercury column manometer) and tonometry (measured with a Perkinshandheld applanation tonometer). The IOP measurement with Perkins � tonometer in anesthetized and conscious dogs and cats was accomplished by instillation of proxymetacaine 0.5% and of 1% fluorescein eye drops. Results The correlation coefficient (r 2 ) between the manometry and the Perkins � tonometer were 0.982 (dogs) and 0.988 (cats), and the corresponding linear regression equation were y ¼ 0.0893x + 0.1105 (dogs) and y ¼ 0.0899x + 0.1145 (cats) in the postmortem study. The mean IOP readings with the Perkinstonometer after calibration curve correction were 14.9 ± 1.6 mmHg (range 12.2-17.2 mmHg) in conscious dogs, and were 15.1 ± 1.7 mmHg (range 12.1-18.7 mmHg) in conscious cats. Conclusion There was an excellent correlation between the IOP values obtained from direct ocular manometry and the Perkinstonometer in dogs and cats. The Perkins � handheld tonometer could be in the future a new alternative for the diagnosis of glaucoma in veterinary ophthalmology.

Photodynamic therapy (PDT) involves the use of photochemical reactions mediated through the interaction of photosensitizing agents, light and oxygen. PDT, while now commonly used in physician ophthalmology and oncology, is uncommonly used for the veterinary ophthalmic patient. It is an emerging new therapy in veterinary ophthalmology for the treatment of periocular tumors. This article reviews the basic principles of PDT to provide the veterinary ophthalmologic community with a succinct reference for this emerging treatment modality in our field.

Summary Twelve American Staffordshire terriers, gestational day 60, and 10 dogs de Bordeaux, gestational day 57 were examined in respect of the morphology and morphometry of their intraorbital muscles. The location of the retractor bulbi, recti and oblique muscles was described and the length of the muscles, the length and breadth of their tendons as well as the distance of the distal insertions of the muscle tendons from the corneal limbus were measured. Similarly, the shape of the line of distal insertions was investigated. The measurements were taken with an electronic caliper to the nearest 0.1 mm. The distance insertion–corneal limbus was measured by means of the Hifny and Misk method (1982). The following differences between the breeds in the morphometry of the intraorbital muscles and their tendons were found out. The distal insertions of the tendons of the dorsal, ventral and lateral recti muscles are further from the corneal limbus in American Staffordshire terriers than in dogs de Bordeaux. The muscular funiculi of the retractor bulbi muscle are further from the corneal limbus in dogs de Bordeaux, except the dorsolateral funiculus (1.96/1.94 mm). In addition, there are differences in the morphometry of the intraorbital muscles and their tendons. No differences, however, were found in the morphology of the intraorbital muscle tendons (their insertion line) and their location. The study can be applied to clinical sciences (surgery) and veterinary ophthalmology, in particular.

Many variables affect the outcome of keratomycosis and systemic fungal infections in animals. These include pathogenicity of the fungal organism(toxins, trophisms, and evasion of host response); previous treatment with topical or systemic corticosteroids, which can have a dramatic negative impact on host defense mechanisms: concurrent systemic illness or immunocompromise: severity/extent of infection; and degree of pain (ie,increased reflex tearing dilutes topical medication) [14]. Experimental work suggests that antibiotics may occasionally exacerbate fungal infections [142],and some researchers advocate that concurrent antibiotic therapy is contraindicated in horses with yeast infections and septate fungal infections unless bacterial infection is also suspected [14]. Nevertheless, given that normal conjunctival flora often include bacteria and fungi and because care of keratomycoses often includes mixed bacterial and fungal infections, the possible dynamics (natural influences and local competition) between ocular surface microorganisms merit further investigation. There are many unanswered questions regarding the accuracy of in vitro susceptibilities and corneal concentration capabilities for antifungal topical medications [14]. Inherent host resistance or other immune interactions between the patient and fungus are perhaps the most important determinants of the outcome but are currently difficult to measure or assess except by subjective clinical observation [14].

A constellation of factors affects the success of therapy in veterinary patients treated for diseases of or injury to the eye. The veterinarian must consider the pathophysiologic process of the disease or the sequelae of the injury, the differences in the ocular anatomy and physiology of various species, the usual responses of the treated species to therapy, the pharmacologic characteristics of the medication used (including stability), and whether the drug is commercially available in the appropriate dosage and form. Also important are the ease of administering the medication, the likelihood of the owner’s compliance with the regimen, the patient’s willingness to submit to treatment, the need to modify the preparation, and the cost of therapy [1].

The parasympathetic and sympathetic divisions of the autonomic nervous system are involved in homeostatic control of a wide variety of ocular functions, including accommodation, pupillomotor control, lacrimation, eyelid position, and aqueous humor production. Familiarity with the functional anatomy of the autonomic nervous system is paramount to the understanding and application of the large number of autonomic drugs used in veterinary ophthalmology. The cholinergic and adrenergic agents discussed in this article are commonly employed to facilitate routine ophthalmic examination, in the diagnosis of autonomic dysfunction, and in the treatment of a variety of ocular diseases.

The recent development of a 20-MHz, high-frequency ultrasound probe has allowed tissue to be visualized at resolutions of 20 to 80 microm, which is similar to a low-power histologic view. This high degree of resolution, however, limits tissue penetration to 5 to 10 mm, which is ideal for examination of the anterior segment of the eye. The detail provided by high-resolution ultrasound readily permits the clinician to distinguish between various anterior segment entities that may appear similar but are treated quite differently, such as anterior uveal tumors, iridociliary cysts, and iris bombé. High-frequency ultrasound is also a valuable aid in creating a surgical plan for treatment of ocular disorders in which the cornea is opaque, such as feline corneal sequestrum and tumor invasion into the cornea. Other applications of this technology include elucidation of the pathogenesis of glaucoma in veterinary patients and evaluation of regions of the lens that are difficult to examine directly.

In this overview the current status of the role of veterinary ophthalmology in laboratory animal studies is discussed. Attention is devoted to current regulatory requirements and study construction, examination techniques commonly used in studies, and a consideration of species characteristics that may be important to investigators. Methods for recording data are discussed with examples of recording systems.

These procedures described for the dog ERG were approved at the 1st European Conference on Veterinary Visual Electrophysiology in Vienna, Austria, May 30, 2000. Dr. Narfstrom was Chair of the Committee for a Harmonized ERG Protocol, appointed by the European College of Veterinary Ophthalmology (ECVO), and Dr. Ofri was secretary. The other coauthors are committee members. Guidelines for ERG procedures in other animal species for clinical and laboratory studies are planned for in the future and the present guidelines are planned to be revised on a biannual basis. A brief report of the recommended procedures is available in the Conference Proceedings book.

Inherited retinal degenerations, such as retinitis pigmentosa (RP) and age-related macular degeneration (AMD), represent leading causes of incurable blindness in humans. This is also true in dogs, where the term progressive retinal atrophy (PRA) is used to describe inherited photoreceptor degeneration resulting in progressive vision loss. Because of the similarities in ocular anatomy, including the presence of a cone photoreceptor-rich central retinal region, and the close genotype-phenotype correlation, canine models contribute significantly to the understanding of retinal disease mechanisms and the development of new therapies. The screening of the pure-bred dog population for new forms of PRA represents an important strategy to establish new large animal models. By examining 324 dogs of the Swedish vallhund breed in seven countries and across three continents, we were able to describe a new and unique form of PRA characterized by the multifocal appearance of red and brown discoloration of the tapetal fundus followed over time by thinning of the retina. We propose three stages of the disease based on the appearance of the ocular fundus and associated visual deficits. Electroretinography revealed a gradual loss of both rod and cone photoreceptor-mediated function in Stages 2 and 3 of the disease. In the few dogs that suffered from pronounced vision loss, night-blindness occurred first in late Stage 2, followed by decreased day-vision in Stage 3. Histologic examinations confirmed the loss of photoreceptor cells at Stage 3, which was associated with the accumulation of autofluorescent material in the adjacent retinal pigment epithelium. Pedigree analysis was suggestive of an autosomal-recessive mode of inheritance. Mutations in six known canine retinal degeneration genes as well as hypovitaminosis E were excluded as causes of the disease. The observed variability in the age of disease onset and rate of progression suggest the presence of genetic and/or environmental disease modifiers.

The aim of this article was to describe Descemet's membrane detachment (DMD) following phacoemulsification in five equine eyes and to review the human literature on this topic. In the last decade, there has been increased reporting of DMD in the human literature, in particular following cataract surgery. The natural history of DMD remains unknown and although various medical and surgical treatments have been advocated there is no recognized 'gold standard' treatment for DMD. This case series reports the diagnosis of DMD in four horses (5 eyes) in association with phacoemulsification surgery. The diagnosis of DMD in these patients was made intra-operatively, postoperatively or on subsequent histopathological examination. The surgical reports, photographic or video recordings, and ultrasound data were evaluated and possible factors associated with the pathophysiology of DMD are discussed. This is the first description of DMD in the veterinary literature, and the authors believe that DMD might hitherto have been overlooked in veterinary ophthalmology due to a lack of awareness of the condition. The possible causes, clinical signs, and treatment of DMD as described in the human literature are also reviewed.

Laboratory investigation is an important diagnostic tool in veterinary ophthalmology. As well as being the primary target for many diseases, the eye is also often involved in systemic disease processes, including infectious, neoplastic and immune-mediated conditions. Laboratory investigation can be the gateway to the accurate diagnosis of such diseases, which in turn plays a fundamental role in patient care and management. This chapter considers sample collection and handling; microbiological investigation; cytological evaluation; histopathological examination.

Tear secretion is important as it supplies water to the ocular surface and keeps eyes moist. Both the parasympathetic and sympathetic pathways contribute to tear secretion. Although intracellular Ca2+ elevation in the acinar cells of lacrimal glands is a crucial event for tear secretion in both the pathways, the Ca2+ channel, which is responsible for the Ca2+ elevation in the sympathetic pathway, has not been sufficiently analyzed. In this study, we examined tear secretion in mice lacking the inositol 1,4,5-trisphosphate receptor (IP3R) types 2 and 3 (Itpr2−/−;Itpr3−/−double-knockout mice). We found that tear secretion in both the parasympathetic and sympathetic pathways was abolished in Itpr2−/−;Itpr3−/− mice. Intracellular Ca2+ elevation in lacrimal acinar cells after acetylcholine and epinephrine stimulation was abolished in Itpr2−/−;Itpr3−/− mice. Consequently, Itpr2−/−;Itpr3−/− mice exhibited keratoconjunctival alteration and corneal epithelial barrier disruption. Inflammatory cell infiltration into the lacrimal glands and elevation of serum autoantibodies, a representative marker for Sjogren’s syndrome (SS) in humans, were also detected in older Itpr2−/−;Itpr3−/− mice. These results suggested that IP3Rs are essential for tear secretion in both parasympathetic and sympathetic pathways and that Itpr2−/−;Itpr3−/− mice could be a new dry eye mouse model with symptoms that mimic those of SS.