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Baseline tear production values were established for both eyes of 19 dogs, using the Schirmer tear test. Atropine sulfate, 1% solution, was administered topically in the left eye of each dog once daily for 14 days. Tear production was then determined for both eyes at 15, 30, 60, 120, 180, 240, and 300 minutes, and 3, 6, 9, 12, and 15 days. A final Schirmer tear test reading was obtained for each eye 5 weeks after the last atropine treatment to check for the possibility of prolonged effect. Both eyes had statistically significant (P less than 0.05) decrease in tear production that was most marked at 120 minutes after atropine instillation, then returned to baseline values by 300 minutes after instillation. Although atropine was placed in the left eye only, statistically significant difference was not apparent in Schirmer tear test values between the left and right eyes. Tear production continued to decrease in both eyes over time, becoming statistically significant (P less than 0.05) on day 9. However, on days 12 and 15, tear production in the untreated eye plateaued, but that in the treated eye continued to decrease. Five weeks after the last treatment with atropine, both eyes still had a statistically significant (P less than 0.05) decrease in tear production, although Schirmer tear test values had increased from day-15 values and appeared to be returning to baseline. Association was not evident between age or body weight and magnitude of response to topically applied atropine.

Objectives: The aim of this study was to retrospectively evaluate the signalment, treatment, surgical technique and outcomes for feline symblepharon., Methods: A retrospective medical record review and standardized grading of clinical descriptions and photographs was undertaken., Results: Forty kittens (54 eyes) aged 3-46 weeks had symblepharon of five types in various combinations: eyelid deformation (24 kittens; 32 eyes); ankyloblepharon (four kittens; four eyes); conjunctiva-to-conjunctiva (11 kittens; 12 eyes); third eyelid-to-conjunctiva (24 kittens; 29 eyes); and corneoconjunctival adhesions (14 kittens; 16 eyes). At initial presentation, 23 (43%) eyes were affected by one type of symblepharon, 25 (46%) eyes by two types and six (11%) eyes by three types; 11 (20%) corneas were ulcerated. Twenty-four (44%) eyes of 18 (45%) kittens were managed medically. Surgery was performed under general anesthesia/sedation (30 occasions) or topical anesthesia (21 occasions) on 30 (56%) eyes of 22 kittens; 12 eyes (40%) underwent multiple surgeries. Four techniques were commonly employed: separation of conjunctival-to-conjunctival adhesions ± eyelid margins (14 eyes); resection of third eyelid adhesions ± temporary tacking of the third eyelid (modified Arlt's pterygium technique; 18 eyes); en bloc resection of the third eyelid (two eyes); and separation of corneoconjunctival adhesions (14 eyes). Median duration of follow-up was 55 days (range 1-1051). Median symblepharon grade in kittens treated surgically improved for all types except corneoconjunctival symblepharon. Median symblepharon grade in kittens receiving medical management remained the same or improved. Corneoconjunctival symblepharon opacity decreased for eyes treated surgically but increased for eyes treated medically. Three eyes were enucleated due to complications of corneoconjunctival symblepharon. At final presentation, symblepharon persisted in 46 (85%) eyes; however, menace response was evident in 13/16 eyes and dazzle reflex in 23/23 eyes., Conclusions and Relevance: Symblepharon is a heterogeneous group of conditions with diverse anatomic involvement, clinical appearance and impact, optimal treatment and prognosis for vision.

Objective: To compare intraocular pressures (IOPs) estimated by rebound and applanation tonometry for dogs with lens instability., Animals: 66 dogs., Procedures: Medical records of dogs examined between September 2012 and July 2018 were reviewed for diagnoses of anterior (ALL) or posterior (PLL) lens luxation or lens subluxation., Results: Estimates of IOP obtained with rebound and applanation tonometry significantly differed from each other for all types of lens instability considered collectively (mean ± SE difference between tonometric readings, 8.1 ± 1.3 mm Hg) and specific types of lens instability considered individually (mean ± SE difference between tonometric readings: ALL, 12.8 ± 2.5 mm Hg; PLL, 5.9 ± 1.7 mm Hg; subluxation, 2.8 ± 0.8 mm Hg). Median (range) differences between rebound and applanation tonometer readings for dogs with ALL was 5 mm Hg (-9 to 76 mm Hg), with PLL was 3 mm Hg (-1 to 19 mm Hg), and with lens subluxation was 3 mm Hg (-9 to 18 mm Hg). In eyes with ALL, rebound tonometer readings exceeded applanation tonometer readings on 44 of 60 (73%) occasions., Conclusions and Clinical Relevance: Rebound tonometry yielded higher estimates of IOP than did applanation tonometry in eyes with ALL and with all types of lens luxation considered collectively. Estimates of IOP in eyes with lens instability should ideally be obtained with both rebound and applanation tonometers. Veterinarians with only one type of tonometer should interpret results for dogs with lens instability concurrent with physical examination findings.

Objectives: The aim of this retrospective case-control study was to report the efficacy of subcutaneous triamcinolone as part of a regimen for feline eosinophilic keratoconjunctivitis (FEK)., Methods: Records and clinical photographs were reviewed and lesions semiquantitatively graded for cats with cytologically confirmed FEK. Clinical data were compared between a study population of nine cats (11 eyes) treated with, and a reference population of seven cats (eight eyes) treated without, a median of 0.11 mg/kg (range 0.10-0.20 mg/kg) of triamcinolone acetonide subcutaneously., Results: Breed, sex, age and prevalence of corneal ulceration at presentation; corneal disease severity before and at the initiation of immunomodulation; and duration of antiviral treatment before immunomodulation did not differ significantly between populations ( P ⩾0.059). Corneal plaques resolved in five cats each from the study and reference populations ( P  = 0.366). Median (range) time from immunomodulation to corneal plaque resolution did not significantly differ ( P  = 0.246) between the study (median 14 days; range 8-38 days) and reference (median 28 days, range 14-46 days) populations. No adverse reactions were attributed to triamcinolone administration, and all corneal ulcers in the study population re-epithelialized within 14 days (range 8-38 days) following triamcinolone injection. Time to corneal ulcer re-epithelialization following triamcinolone injection varied minimally in those receiving antivirals prior to (8 or 30 days until re-epithelialization), simultaneously with (38 days) or after (14 or 24 days) triamcinolone., Conclusions and Relevance: In otherwise healthy cats with FEK, subcutaneous administration of triamcinolone appears to be well tolerated and as efficacious as conventional topical immunomodulatory therapies. It may be especially useful in ulcerated eyes where topical immunomodulation is contraindicated.

Purpose: To retrospectively evaluate the clinical data, diagnostic tests, treatments, and outcomes for dogs with corneal endothelial dystrophy (CED) and determine risk factors for CED when compared with a canine reference population., Methods: Medical records of 99 dogs (1991-2014) diagnosed with CED at the University of California Davis Veterinary Medical Teaching Hospital were reviewed and compared with 458,680 dogs comprising the general hospital population during the study period. Retrieved data included signalment, examination findings, diagnoses, treatments, and outcomes associated with CED. The exact Pearson χ2 test or exact Kruskal-Wallis test was used to compare parameters between the groups. Progression of corneal edema was assessed using 3 independent Kaplan-Meier curves, identifying clinically significant changes in corneal opacity., Results: Boston terriers, German wirehaired pointers, and Dachshunds were overrepresented in the CED-affected group, whereas Labradors were underrepresented. Dogs older than 11 years were overrepresented in the CED-affected group, whereas intact dogs were underrepresented. Surgical intervention was performed (n = 11) based on the severity of disease and secondary complications from CED. Median time to progression of corneal edema was 1) 368 days when an at-risk eye initially without edema developed edema at a subsequent visit, 2) 701 days when there was progression from mild to marked corneal edema, and 3) 340 days when there was progression from focal to diffuse corneal edema., Conclusions: Many CED-affected dogs progress over months to years without surgical intervention, making dogs with CED a useful model for studying genetic predispositions and development of novel therapeutics for Fuchs endothelial corneal dystrophy., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

We describe a case series of photoreceptor dysplasia with secondary retinal degeneration in juvenile Peregrine Falcons. Six Peregrine Falcons ( Falco peregrinus) and three Peregrine Falcon × Prairie Falcon ( Falco mexicanus) hybrids had early-life visual deficits. Eight birds had visual defects shortly after hatching, and one bird had visual deficits first noticed at 5 mo of age. Complete ophthalmic examinations were performed in each animal. Eight of the animals had electroretinograms, and nine of the animals had their eyes examined histologically after euthanasia. Ophthalmic examinations did not reveal consistent and potentially blinding abnormalities, including an absence of ophthalmoscopic retinal lesions. Electroretinographic findings included subnormal amplitudes (with rod responses more abnormal than cone responses), with a negative b-wave amplitude occurring in one bird. Histologically, a reduction in the number of photoreceptors was present with numerous degenerative changes to the remaining photoreceptors, including frequent blunting and disorganization of photoreceptor outer segments, decreased numbers of cells in the inner nuclear layer, decreased numbers of ganglion cells, decreased thickness of the nerve fiber layer, and decreased myelinated axons within the optic nerve. Ultrastructurally, only minor cone outer segment changes and occasional phagocytic cells were seen. Results strongly suggested a primary retinopathy, characterized by photoreceptor dysplasia and secondary retinal degeneration with loss of cellular elements throughout the retina. The presence of a similar spectrum of findings in related individuals, the early age of onset, and the relative lack of other environmental, ocular, or systemic abnormalities suggested possible heritability.

Case Series Summary: Described are 13 cats diagnosed with deep ulcerative keratitis and successfully managed medically without grafting procedures. Typical treatment involved frequent topical application of serum and antibiotics (usually a fluoroquinolone and a cephalosporin). Seven cats also received systemic antibiotics. Analgesia was achieved using various combinations of topical atropine and systemic buprenorphine, robenacoxib or corticosteroids. Six cats were hospitalized for a median (range) period of 2.5 (1-8) days, typically because of frequent medication administration. Median (range) follow-up time was 41.5 (9-103) days. Median (range) number of recheck examinations was 4 (2-6). Median (range) time to corneal re-epithelialization was 21 (9-103) days. Median (range) topical antibiotic course was 29.5 (16-103) days. Median (range) duration of Elizabethan collar use was 28 (13-73) days. At the time of writing, no further recheck examinations were recommended for 10 cats; median (range) time between initial to final examinations in these cats was 35 (20-103) days. All cats retained the affected globes and were apparently comfortable and visual at the latest recheck examination., Relevance and Novel Information: These cases reveal that aggressive medical management is highly successful in select cats with deep ulcerative keratitis, and can result in a cosmetically acceptable, apparently comfortable and visual globe. However, therapy is intensive with frequent administration of multiple topical and sometimes systemic medications, and requires multiple veterinary visits over many weeks. Referral to a veterinary ophthalmologist for consideration of surgical stabilization is recommended, as not all cases may be amenable to the medical therapy described here.

Objective: To compare the effectiveness of retrobulbar anesthesia (RBA) and peribulbar anesthesia (PBA) in dogs., Animal Studied: Six adult mixed-breed dogs (18-24 kg)., Procedures: In a randomized, masked, crossover trial with a 10-day washout period, each dog was sedated with intravenously administered dexmedetomidine and administered 0.5% bupivacaine:iopamidol (4:1) as RBA (2 mL via a ventrolateral site) or PBA (5 mL divided equally between ventrolateral and dorsomedial sites). The contralateral eye acted as control. Injectate distribution was evaluated by computed tomography. Following intramuscularly administered atipamezole, corneal and periocular skin sensation, intraocular pressure (IOP), and ocular reflexes, and appearance were evaluated for 24 hours. Comparisons were performed with mixed-effects linear regression (IOP) or the exact Wilcoxon signed rank test (scores). Significance was set at P ≤ .05., Results: Injectate distribution was intraconal in 2/6 RBA- and 4/6 PBA-injected eyes. Eyes undergoing PBA had significantly reduced lateral, ventral, and dorsal periocular skin sensation for 2-3 hours, and significantly reduced corneal sensitivity for 4 hours, relative to control eyes. Chemosis and exophthalmos occurred in 33%-40% of eyes undergoing RBA and 83%-100% eyes undergoing PBA but resolved within 14 hours. Anterior uveitis developed in 2/6 and 1/6 eyes of RBA and PBA, respectively, of them corneal ulcer developed in one eye of each treatment. Both resolved 1-3 days following medical treatment., Conclusions: Peribulbar injection produced notable anesthesia more reliably than did retrobulbar injection. Both techniques may produce adverse effects, although the uveitis/ulcer could have resulted from the contrast agent used., (© 2018 American College of Veterinary Ophthalmologists.)

Objective: To determine factors associated with sudden acquired retinal degeneration syndrome (SARDS) diagnosed within one referral population., Animals Studied: 151 dogs diagnosed with SARDS., Procedures: Breed, age, sex, and body weight were compared between dogs with electroretinogram-confirmed SARDS and dogs presented to the UC Davis Veterinary Medical Teaching Hospital (UCD-VMTH) from 1991 to 2014., Results: SARDS was diagnosed in 151 dogs, representing 1.3% of dogs presented to the UCD-VMTH for ophthalmic disease. Although dogs of 36 breeds were affected, the Dachshund (n = 31, 21%), Schnauzer (16, 11%), Pug (11, 7%), and Brittany (5, 3%) were significantly overrepresented, and the Labrador Retriever (3, 2%) was significantly underrepresented vs. the reference population (P < 0.001). Median (range) age and body weight of affected vs. reference dogs were 8.9 (3-20) vs. 6.8 (0.1-26) years and 12.4 (2.8-52.7) vs. 22.3 (0.1-60) kg, respectively. Dogs 6-10 years of age and between 10-20 kg in body weight were significantly overrepresented in the SARDS population, while dogs <6 years of age were significantly underrepresented (P < 0.01). Spayed females (59% of affected dogs) were significantly overrepresented compared to the reference population, whereas intact females (1% of affected dogs) were significantly underrepresented., Conclusions: Consistent with previous studies, smaller, middle-aged, spayed female dogs may be at increased risk of developing SARDS. Unlike previous studies, this is the first study comparing a variety of SARDS-affected breeds to a reference population. Potentially increased risk of SARDS in several breeds, particularly Dachshunds, suggests a familial factor that warrants further investigation using genetic techniques., (© 2017 American College of Veterinary Ophthalmologists.)

OBJECTIVE To describe diagnosis, treatment, and outcome of and risk factors for ophthalmic disease in leopard geckos (Eublepharis macularius) evaluated at a veterinary teaching hospital. DESIGN Retrospective case series. ANIMALS 112 of 144 (78%) leopard geckos that were evaluated at a veterinary teaching hospital in January 1985 through October 2013 and for which sufficient medical record information was available. PROCEDURES Information from medical records was used to identify leopard geckos with ophthalmic disease, characterize cases, and determine risk factors for the presence of ophthalmic disease. RESULTS Of the 112 leopard geckos, 52 (46%) had ophthalmic disease (mainly corneal or conjunctival disease). Female geckos were less likely to have ophthalmic disease, and there was a positive association between increasing age and ophthalmic disease. Use of a paper towel substrate, absence of any heat source, and lack of vitamin A supplementation were positively associated with a diagnosis of ophthalmic disease. Head dysecdysis was the only concurrent disorder significantly associated with ophthalmic disease. At necropsy, 5 affected leopard geckos had squamous metaplasia of the conjunctivae. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that ophthalmic disease is a common finding in leopard geckos. The cause of ocular surface disease in leopard geckos may be multifactorial, and hypovitaminosis A may be an important risk factor. Although animals receiving supplemental vitamin A were less likely to have ophthalmic disease, further understanding is required regarding the metabolism of and nutritional requirements for vitamin A in leopard geckos.

OBJECTIVE To assess the effects of topical application of undiluted heterologous serum on time to corneal reepithelialization in dogs with superficial chronic corneal epithelial defects (SCCEDs). DESIGN Multicenter, randomized, double-masked, controlled clinical trial. ANIMALS 41 client-owned dogs. PROCEDURES After collection of baseline clinical and historical data, dogs were randomly assigned to receive topically applied undiluted heterologous serum (n = 22) or isotonic saline (0.9% NaCl) solution (19) along with tobramycin and atropine. Epithelial debridement (at all visits) and grid keratotomy (at visits 2, 3, and 4) of SCCEDs were performed. Ophthalmic examination including fluorescein application was performed once weekly for 4 weeks or until corneal reepithelialization. Clinicians and owners were masked to treatment group. RESULTS No differences in baseline data were detected between treatment groups. No difficulties with medication administration, noncompliance, or adverse reactions were noted. All SCCEDs in both groups healed by 4 weeks after treatment began. Median time to reepithelialization (2 weeks) was not significantly different between serum-treated and placebo-treated eyes. Irrespective of treatment group, median time to reepithelialization was not significantly different for Boxers versus non-Boxer breeds. Direct correlations were detected between time to reepithelialization and vascularization score at study entry, vascularization score at time of reepithelialization, and ulcer area at study entry in both groups. Time to reepithelialization was not correlated with age, sex, or duration of signs in either group. CONCLUSIONS AND CLINICAL RELEVANCE Topical application of undiluted heterologous serum was well tolerated by dogs with SCCEDs but, as an adjunct to standard treatment, did not reduce time to corneal reepithelialization.

Objective: To compare signalment, presentation, treatment, and outcome in horses diagnosed with corneal degeneration (CD) or calcific band keratopathy (CBK) at a referral hospital., Animals Studied: Sixty-nine horses (87 eyes) diagnosed with either CD or CBK., Procedures: Medical records of horses diagnosed with CD or CBK at the University of California-Davis Veterinary Medical Teaching Hospital (UCD-VMTH) between 2000 and 2013 were reviewed. Signalment, concurrent ophthalmic diagnoses, previous therapies, diagnostic tests, systemic diagnoses, treatment, follow-up, and outcomes were compared between horses diagnosed with CD or CBK. Age, breed, and gender were compared between the CD/CBK and UCD-VMTH populations., Results: Thirty-three horses (42 eyes) and 36 horses (45 eyes) were diagnosed with CD and CBK, respectively. Horses with CD or CBK were significantly older (P < 0.001) than the UCD-VMTH population with a median age of 16 or 18 years, respectively. Appaloosas were significantly overrepresented in the CD/CBK population (33%) in comparison with the UCD-VMTH population (1.8%, P < 0.001). Equine recurrent uveitis was concurrently diagnosed in 67% and 84% of horses with CD or CBK, respectively. Pituitary pars intermedia dysfunction (PPID) was diagnosed significantly less often in horses with CD vs. CBK (P = 0.03). Chemical chelation with ethylenediaminetetraacetic acid was performed significantly less frequently in horses diagnosed with CD (7.1%) vs. CBK (31.1% of eyes) (P = 0.012)., Conclusions: Despite some differences, equine CD and CBK are relatively similar conditions and may represent a continuum of disease severity. Horses with PPID should be monitored closely for corneal disease including CBK., (© 2016 American College of Veterinary Ophthalmologists.)

Protein therapeutics are rapidly transforming the pharmaceutical industry. Unlike for small molecule therapeutics, current technologies are challenged to provide the rapid, high-resolution analyses of protein higher order structures needed to ensure drug efficacy and safety. Consequently, significant attention has turned to developing new methods that can quickly, accurately, and reproducibly characterize the three-dimensional structure of protein therapeutics. In this work, we describe a method that uses diethylpyrocarbonate (DEPC) labeling and mass spectrometry to detect three-dimensional structural changes in therapeutic proteins that have been exposed to degrading conditions. Using β2-microglobulin, immunoglobulin G1, and human growth hormone as model systems, we demonstrate that DEPC labeling can identify both specific protein regions that mediate aggregation and those regions that undergo more subtle structural changes upon mishandling of these proteins. Importantly, DEPC labeling is able to provide information for up to 30% of the surface residues in a given protein, thereby providing excellent structural resolution. Given the simplicity of the DEPC labeling chemistry and the relatively straightforward mass spectral analysis of DEPC-labeled proteins, we expect this method should be amenable to a wide range of protein therapeutics and their different formulations.

Objectives: To determine the role of equine herpesvirus (EHV) in idiopathic keratoconjunctivitis in horses and to determine whether sample collection method affects detection of EHV DNA by quantitative polymerase chain reaction (qPCR)., Animals Studied: Twelve horses with idiopathic keratoconjunctivitis and six horses without signs of ophthalmic disease., Procedures: Conjunctival swabs, corneal scrapings, and conjunctival biopsies were collected from 18 horses: 12 clinical cases with idiopathic keratoconjunctivitis and six euthanized controls. In horses with both eyes involved, the samples were taken from the eye judged to be more severely affected. Samples were tested with qPCR for EHV-1, EHV-2, EHV-4, and EHV-5 DNA. Quantity of EHV DNA and viral replicative activity were compared between the two populations and among the different sampling techniques; relative sensitivities of the sampling techniques were determined., Results: Prevalence of EHV DNA as assessed by qPCR did not differ significantly between control horses and those with idiopathic keratoconjunctivitis. Sampling by conjunctival swab was more likely to yield viral DNA as assessed by qPCR than was conjunctival biopsy. EHV-1 and EHV-4 DNA were not detected in either normal or IKC-affected horses; EHV-2 DNA was detected in two of 12 affected horses but not in normal horses. EHV-5 DNA was commonly found in ophthalmically normal horses and horses with idiopathic keratoconjunctivitis., Conclusions: Because EHV-5 DNA was commonly found in control horses and in horses with idiopathic keratoconjunctivitis, qPCR was not useful for the etiological diagnosis of equine keratoconjunctivitis. Conjunctival swabs were significantly better at obtaining viral DNA samples than conjunctival biopsy in horses in which EHV-5 DNA was found., (© 2015 American College of Veterinary Ophthalmologists.)

A 1.5-year-old, intact female khaki Campbell duck (Anas platyrhynchos domesticus) was evaluated for lethargy and a swollen left eye (OS). Mucoid discharge, chemosis, and conjunctival hyperemia with trace aqueous flare, indicating anterior uveitis, in the anterior chamber were evident on ophthalmic examination. There was no fluorescein stain uptake by the cornea. Initial topical antibiotic therapy and systemic anti-inflammatory treatments were unsuccessful, and the lesion progressed to a diffuse, yellow-white plaque, which covered 90%-95% of the cornea 4 days later. There was moderate blepharospasm, mild blepharedema, and epiphora OS. The mobility of the nictitating membrane was impaired because of the presence of the plaque over the cornea. Cytologic examination of a corneal scraping revealed fungal hyphae, and aerobic culture confirmed Aspergillus species. Treatment with topical voriconazole (1 drop OS q4h-q6h) was initiated and was switched to oral voriconazole (20 mg/kg PO q12h) 6 days after initiating treatment. The ocular disease improved during the antifungal treatment period. Eighty-four days after initial presentation (9 days after discontinuation of treatment), there was no clinical evidence of mycotic keratitis on ophthalmic examination.

Intraocular pressure was measured using rebound tonometry in American flamingos (Phoenicopterus ruber), with the head in an upright standing position and when lowered in a feeding position, to establish a reference range. Mean +/- standard deviation (SD) (range) intraocular pressure for flamingos with the head in an upright position was right eye (OD)= 10.9 +/- 1.8 mm Hg (7-15 mm Hg) and left eye (OS) = 11.1 +/- 2.3 mm Hg (8-21 mm Hg). Median intraocular pressure for flamingos with the head in an upright position was OD and OS = 11 mm Hg. Mean intraocular pressure for flamingos with the head in a feeding position was OD = 14.3 +/- 2.5 mm Hg (10-22 mm Hg) and OS = 14.4 +/- 2.7 mm Hg (11-24 mm Hg), which were significantly higher. Median intraocular pressure for flamingos with the head in a feeding position was OD and OS = 14 mm Hg.

Objective: To compare the Welch Allyn SureSight™ wavefront autorefractor with retinoscopy in normal dogs., Animals Studied: Fifty privately owned dogs (100 eyes) of 20 breeds, free of ocular disease. Mean ± SD age: 5.7 ± 3.25 years (range: 6 months-13 years)., Procedures: The refractive error was determined in each eye by two experienced retinoscopists using streak retinoscopy as well as by an autorefractor operated by two different examiners. Measurements were performed before and approximately 30-45 min after cycloplegia was induced by cyclopentolate 0.5% and tropicamide 0.5% ophthalmic solutions., Results: Mean ± SD noncyclopleged retinoscopy net sphere was -0.55 ± 1.14 (range: -3.75 to 3.5) diopters (D). Mean cyclopleged retinoscopy net sphere was -0.52 ± 1.18 (range: -4.25 to 2) D. Mean ± SD noncyclopleged autorefractor spherical equivalent (SE) was -0.42 ± 1.13 D (range: -3.36 to 2.73) D. Mean cyclopleged autorefractor SE was 0.10 ± 1.47 (range: -5.62 to 3.19) D. Noncyclopleged autorefraction results were not significantly different from streak retinoscopy (whether noncyclopleged or cyclopleged, P = 0.80 and P = 0.26, respectively). Cyclopleged autorefraction results were significantly different from noncyclopleged or cyclopleged streak retinoscopy (P < 0.0001 in both states). There was no significant difference between noncyclopleged and cyclopleged streak retinoscopy (P = 0.97)., Conclusions: Noncyclopleged autorefraction shows good agreement with streak retinoscopy in dogs and may be a useful clinical technique. Cycloplegia does not significantly affect streak retinoscopy results in dogs., (© 2012 American College of Veterinary Ophthalmologists.)

Objective: To assess the effects of ketamine hydrochloride, propofol, or compounded thiopental sodium administration on intraocular pressure (IOP) and qualities of induction of and recovery from anesthesia in horses., Animals: 6 healthy adult horses., Procedures: Horses were sedated with xylazine hydrochloride (0.5 mg/kg), and anesthesia was induced with guaifenesin followed by ketamine (2 mg/kg), propofol (3 mg/kg), or thiopental (4 mg/kg) in a crossover study with ≥ 1 week between treatments. For each horse, IOP in the right eye was measured with a handheld applanation tonometer before and after xylazine administration, at the time of recumbency, and every 3 minutes after induction of anesthesia until spontaneous movement was observed. Cardiorespiratory responses and venous blood measurements were recorded during anesthesia. Induction of and recovery from anesthesia were subjectively evaluated by investigators who were unaware of the anesthetic treatment of each horse. Data were analyzed via a repeated-measures ANOVA with Holm-Ŝidák post hoc comparisons., Results: Compared with findings after xylazine administration (mean ± SD, 17 ± 3 mm Hg), thiopental decreased IOP by 4 ± 23%, whereas propofol and ketamine increased IOP by 8 ± 11% and 37 ± 16%, respectively. Compared with the effects of ketamine, propofol and thiopental resulted in significantly lower IOP at the time of recumbency and higher heart rates at 3 minutes after induction of anesthesia. No other significant differences among treatments were found., Conclusions and Clinical Relevance: These findings support the use of thiopental or propofol in preference to ketamine for horses in which increases in IOP should be minimized.

Objective: To determine the distribution and clinical outcome of ocular lesions in snakes., Design: Retrospective case series., Animals: 67 snakes with ocular lesions., Procedures: Signalment, lesion duration, diagnosis, treatment, and clinical outcome were recorded for all snakes with ocular lesions that were examined at a veterinary teaching hospital from 1985 to 2010., Results: 71 ocular lesions were detected in 67 of 508 (13%) snakes examined. Affected snakes were of the families Boidae, Pythonidae, Colubridae, and Viperidae. The distribution of ocular lesions did not vary by taxonomic family, age, or sex; however, snakes from the genus Epicrates with ocular lesions were overrepresented in the population. The most commonly diagnosed ocular lesions were retained spectacle (n = 41), pseudobuphthalmos or subspectacular abscess (13), trauma (8), and cataracts (4). Pseudobuphthalmos or subspectacular abscess developed more frequently in Colubridae than in non-Colubridae snakes. Of the 16 snakes with retained spectacles for which data were available, the lesion recurred once in 4 snakes and multiple times in 5 snakes., Conclusions and Clinical Relevance: Results indicated that retained spectacle was the most common ocular lesion diagnosed in snakes. Compared with other snakes with ocular lesions, snakes of the genus Epicrates had a higher than expected frequency of ocular lesions in general and snakes of the family Colubridae had a higher than expected frequency of pseudobuphthalmos or subspectacular abscess.

Reasons for Performing Study: Equine keratomycosis in the western USA has received little study, probably owing to its low prevalence., Objectives: To determine clinical features, predominant fungal isolates, treatment modalities and outcomes of horses with keratomycosis in California and compare these with results from different geographic regions., Methods: Records of horses presented to the University of California-Davis Veterinary Medical Teaching Hospital (UCD-VMTH) with confirmed keratomycosis between 1987 and 2010 were reviewed for this retrospective study. Information retrieved from the record included background, ophthalmic examination findings, treatment prior to and following presentation, visual outcome, and ocular survival., Results: A total of 48 eyes in 47 horses met the inclusion criteria and comprised 2% of cases presented to the UCD-VMTH ophthalmology service. Prior to presentation, 20 horses (43%) received at least one topically administered anti-inflammatory medication. Keratomycosis was confirmed by fungal culture in 38 horses (81%), by histopathology in 2 horses (4%) and by cytology in 7 horses (15%). Forty-four isolates were identified in the 38 horses cultured; Aspergillus was the most common isolate (64%) and a novel isolate, Papulospora, was identified in 2 horses. Treatment consisted of medication only (73%), medical and surgical treatment (25%), or immediate enucleation (2%). Globe retention was 77% and vision retention was 53%. Corneal perforation was significantly associated with loss of vision (P<0.001)., Conclusions: Keratomycosis is relatively uncommon in horses presented for ophthalmic conditions at UCD-VMTH. Corneal perforation was a negative prognostic indicator for vision in this population of northern Californian horses., (© 2012 EVJ Ltd.)

Objective: To report a case of blindness due to the ingestion of ivermectin and subsequent successful treatment with intravenous lipid (IVL) therapy., Case Summary: A female neutered Jack Russell Terrier was examined for acute onset of apparent blindness after being exposed to ivermectin the previous day. The dog appeared to be blind during initial examination. Pupillary light reflex, menace response, and dazzle reflex were not present in either eye. Fundic examination revealed small areas of linear retinal edema. Electroretinography (ERG) showed diminished activity in both eyes. Ivermectin was present in the serum on toxicological assay. Approximately 20 hours after exposure, IVL was infused. Within 30 minutes of initiating the infusion, the pupillary light reflexes returned in both eyes, and by the end of the infusion the patient behaved as if sighted. Fundic examination and ERG were unchanged at this time. The dog was tested for the multidrug resistance gene mutation and was unaffected., New or Unique Information Provided: Ivermectin toxicity occurs in dogs with apparent blindness being a common clinical sign. This is the first case report of ivermectin-induced blindness evaluated with ERG before and after treatment with IVL in a dog unaffected by the multidrug resistance gene mutation. Treatment with an infusion of IVL therapy appeared to shorten the clinical course of disease in this patient without affecting ERG results., (© Veterinary Emergency and Critical Care Society 2013.)

Objective: Neuroaxonal dystrophy (NAD) is a disease characterized by the sudden onset of neurologic signs in horses ranging from 4 to 36 months of age. Equine degenerative myeloencephalopathy (EDM), a disease that has been associated with low vitamin E concentrations, is considered a more advanced form of NAD. The objective of this report is to describe the electrophysiological features of NAD/EDM in American Quarter horses (QHs). HORSES: Six NAD/EDM-affected QHs and six unaffected QHs were evaluated by ophthalmic examination and electroretinography. Five of the NAD/EDM-affected QH and five unaffected QHs were also evaluated by electroencephalography (EEG)., Results: Ophthalmic examination, ERGs, and EEGs were unremarkable in NAD/EDM cases., Conclusions: Neuroaxonal dystrophy/EDM does not appear to cause clinical signs of ocular disease or functional ERG/EEG deficits in QHs., (© 2012 American College of Veterinary Ophthalmologists.)

Objective: To measure the effect of induced myopia on field trial performance in dogs., Animals: 7 Labrador Retrievers and 1 Chesapeake Bay Retriever trained in field trial competition., Procedures: Dogs were commanded to retrieve targets at 137.2 m (150 yards). Each dog participated in 3 trials while their eyes were fitted with 0- (plano), +1.50-, or +3.00-diopter (D) contact lenses, applied in random order. Retrieval times were measured objectively, and dog performances were evaluated subjectively by masked judges., Results: Retrieval times were significantly faster with plano lenses than with +1.50- or +3.00-D lenses, but there were no significant differences in times between +1.50- and +3.00-D lenses. Masked judges assigned the best performance scores to dogs with plano lenses and the lowest scores to dogs fitted with +3.00-D lenses., Conclusions and Clinical Relevance: Even mild myopic defocusing had a significant negative impact on both the subjective and objective assessments of dogs' performances. Dogs with demanding visual tasks or signs of visual deterioration should be evaluated retinoscopically to determine the refractive state because they may have ametropia.

Objective: To describe clinical and diagnostic imaging features of zygomatic sialadenitis in dogs., Design: Retrospective case series., Animals: 11 dogs with zygomatic sialadenitis and 20 control dogs without evidence of retrobulbar disease., Procedures: Medical records were searched for dogs with zygomatic sialadenitis that underwent some combination of magnetic resonance imaging (MRI), computed tomography (CT), and ultrasonography. Signalment, clinical signs, results of clinicopathologic tests, cytologic and histologic diagnosis, treatment, qualitative disease features, and disease course were recorded. Images obtained via MRI or CT were analyzed for pre- and postcontrast signal intensity or density, respectively; zygomatic salivary gland area was determined. Results were compared with those of control dogs that underwent the same imaging procedures (n = 10/method). Ultrasonographic images of affected dogs were assessed qualitatively., Results: Most (9/11) affected dogs were medium- or large-breed males (mean age, 8 years) with unilateral disease. Affected dogs had clinical signs of retrobulbar disease and cytologic or histologic evidence of zygomatic sialadenitis. Sialoceles were detected in 7 affected glands. Compared with values for control dogs, MRI findings in affected dogs (n = 7) included gland enlargement, T1-weighted hypointensity, T2-weighted hyperintensity, and increased contrast enhancement; CT features in affected dogs (2) included gland enlargement and hypodensity on unenhanced images. Retrobulbar masses were identified via ultrasonography in 9 of 10 orbits examined, and zygomatic salivary gland origin was detected in 4., Conclusions and Clinical Relevance: Visualization of anatomic structures for diagnosis of zygomatic sialadenitis and evaluation of adjacent structures was excellent via MRI and CT Ultrasonography was less definitive but useful for sample collection.

Background: Equine degenerative myeloencephalopathy (EDM) is a neurodegenerative disorder that has been previously associated with low vitamin E concentrations., Objective: To describe the clinical, electrophysiologic, and pathologic features of EDM in a group of related Lusitano horses., Animals: Fifteen Lusitano horses., Procedures: Neurologic examinations were conducted, and serum vitamin E concentrations were measured. Three neurologically abnormal horses were further evaluated by ophthalmologic examination, electroretinography, electroencephalography, muscle and nerve biopsies, and post-mortem examination., Results: Six horses appeared neurologically normal, 6 were neurologically abnormal, and 3 had equivocal gait abnormalities. Abnormal horses demonstrated ataxia and paresis. An inconsistent menace response was noted in 4 neurologically abnormal horses and in 1 horse with equivocal findings. All horses had low serum vitamin E concentrations (<1.5 ppm). Ophthalmologic examinations, electroretinograms, electroencephalograms, and muscle and peripheral nerve biopsies were unremarkable in 3 neurologically abnormal horses. At necropsy, major neuropathological findings in these horses were bilaterally symmetric, severe, neuro axonal degeneration in the gracilis, cuneatus medialis, cuneatus lateralis, and thoracicus nuclei and bilaterally symmetric axonal loss and demyelination mainly in the dorsolateral and ventromedial tracts of the spinal cord. A diagnosis of EDM was made based on these findings. Pedigree analysis identified 2 sires among the affected horses., Conclusions and Clinical Relevance: Equine degenerative myeloencephalopathy is a neurodegenerative disorder that causes ataxia and, in severe cases, paresis, in young Lusitano horses. The disease appears to have a genetic basis, and although vitamin E deficiency is a common finding, low serum vitamin E concentrations also may occur in apparently unaffected related individuals., (Copyright © 2011 by the American College of Veterinary Internal Medicine.)

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used systemically for the treatment of inflammatory ocular disease in horses. However, little information exists regarding the ocular penetration of this class of drugs in the horse., Objective: To determine the distribution of orally administered flunixin meglumine and firocoxib into the aqueous humor of horses., Animals: Fifteen healthy adult horses with no evidence of ophthalmic disease., Methods: Horses were randomly assigned to a control group and 2 treatment groups of equal sizes (n = 5). Horses assigned to the treatment groups received an NSAID (flunixin meglumine, 1.1 mg/kg PO q24h or firocoxib, 0.1 mg/kg PO q24h for 7 days). Horses in the control group received no medications. Concentrations of flunixin meglumine and firocoxib in serum and aqueous humor and prostaglandin (PG) E(2) in aqueous humor were determined on days 1, 3, and 5 and aqueous : serum ratios were calculated., Results: Firocoxib penetrated the aqueous humor to a significantly greater extent than did flunixin meglumine at days 3 and 5. Aqueous : serum ratios were 3.59 ± 3.32 and 11.99 ± 4.62% for flunixin meglumine and firocoxib, respectively. Ocular PGE(2) concentrations showed no differences at any time point among study groups., Conclusions and Clinical Importance: Both flunixin meglumine and firocoxib penetrated into the aqueous humor of horses. This study suggests that orally administered firocoxib penetrates the aqueous humor better than orally administered flunixin meglumine at label dosages in the absence of ocular inflammation. Firocoxib should be considered for the treatment of inflammatory ophthalmic lesions in horses at risk for the development of adverse effects associated with nonselective NSAID administration., (Copyright © 2011 by the American College of Veterinary Internal Medicine.)

Case Description: A 23-year-old female mule was presented for bilateral ocular abnormalities and an abnormal pelvic limb gait., Clinical Findings: Anisocoria, unilateral enophthalmos, medial strabismus, ptosis, pupillary light reflex deficits, and bilateral reticulated pigmentary retinopathy were observed on ophthalmic examination. Neurologic abnormalities included right-sided facial nerve paralysis, extensive symmetric muscle atrophy, and asymmetric pelvic limb ataxia with an abnormal pelvic limb gait. A positive titer (1:40) for equine protozoal myeloencephalitis (EPM) associated with Neospora hughesi was obtained from cerebrospinal fluid with minimal (<1 red blood cell/microL) blood contamination. Muscle biopsies of the sacrocaudalis dorsalis medialis muscle revealed predominantly type I neurogenic muscle atrophy, consistent with a diagnosis of equine motor neuron disease (EMND)., Treatment and Outcome: Treatment included a 2-month course of ponazuril (5 mg/kg PO q24 h), vitamin E (8000 IU PO q24 h), and selenium (2 mg PO q24 h). Clinical improvement was not observed after 2 months although the mule remained stable. Clinical deterioration was reported upon discontinuation of the ponazuril after a 2-month course., Conclusion: Concurrent disease with EPM associated with N. hughesi and EMND should be considered in cases demonstrating cranial nerve abnormalities, pronounced symmetric muscle atrophy, unusual asymmetric gait abnormalities, and reticulated pigmentary retinopathy.

Objective: To characterize heritability and mode of inheritance of cataracts and primary lens luxation in Jack Russell Terriers., Animals: 872 Jack Russell Terriers from which buccal epithelial cells were collected and phenotypes for cataracts and lens luxation were determined and an additional 1,898 Jack Russell Terriers without phenotypic information used to complete pedigree relationships and that were included in the analyses., Procedures: Narrow-sense heritabilities and genetic correlation for cataracts and lens luxation were modeled by use of threshold analysis, whereas complex segregation analysis was used to characterize mode of inheritance. For the analyses, dogs < 6 years old, unless confirmed as having cataracts or lens luxation, were classified as an unknown phenotype. The possible involvement of an HSF4 mutation in cataracts was determined by DNA sequencing., Results: Cataracts and primary lens luxation were highly heritable and genetically correlated, and neither was controlled by a single gene. Cataracts were not associated with an HSF4 mutation., Conclusions and Clinical Relevance: Analysis of the data indicated that concerted selection against both cataracts and primary lens luxation when choosing breeding animals can be used to improve ocular health in Jack Russell Terriers.

Objective: To measure the dimensions of the eyes of living snakes by use of high-frequency ultrasound imaging and correlate those measurements with age, length, and weight. Animals-14 clinically normal snakes., Procedures: Species, age, length, weight, and horizontal spectacle diameter were recorded, and each snake underwent physical and ophthalmic examinations; ultrasonographic examination of both eyes was performed by use of a commercially available ultrasound unit and a 50-MHz transducer. Ultrasonographic measurements included spectacle thickness, subspectacular space depth, corneal thickness, anterior chamber depth, lens thickness, vitreous cavity depth, and globe length. All measurements were made along the visual axis., Results: 2 corn snakes, 5 California king snakes, 1 gopher snake, and 6 ball pythons were examined. There were no significant differences within or between the species with regard to mean spectacle thickness, corneal thickness, or subspectacular space depth. However, mean horizontal spectacle diameter, anterior chamber depth, and axial globe length differed among the 4 species; for each measurement, ball pythons had significantly larger values than California king snakes., Conclusions and Clinical Relevance: Spectacle thickness, subspectacular space depth, and corneal thickness were similar among the species of snake examined and did not vary significantly with age, length, or weight. Measurements of these dimensions can potentially serve as baseline values to evaluate snakes of these species with a retained spectacle, subspectacular abscess, or subspectacular fluid accumulation. Anterior chamber depth and axial length appeared variable among species, but axial length did not vary with age, length, or weight in the species studied.

A 4-year old, male intact, captive-bred chinchilla (Chinchilla lanigera) was presented due to progressive exophthalmos of the right eye over a 5-month period. Ophthalmic examination revealed exophthalmos with dorsal displacement of the right globe. Retropulsion was decreased and a fluctuant, subcutaneous mass could be palpated posterior and dorsal to the central aspect of the zygomatic bone. Transdermal ultrasonography revealed a fluid-filled mass consistent with a cyst located within the ventral right orbit. Computed tomography demonstrated dorsal displacement of the globe, lateral displacement of the zygomatic arch, and numerous mineral-dense foci within the lumen of the cyst. The cyst was removed en bloc by ventral transpalpebral orbitotomy. Histopathology revealed a single capsulated cyst with multiple invaginated protoscolices, characterized by a prominent scolex with refractile hooklets, suckers, and abundant calcareous corpuscles consistent with a Taenia coenurus. Exophthalmos resolved with surgical therapy and there was no evidence of recurrence or postoperative complications over a period of 2 years. To the authors' knowledge, this is the first reported case of an orbital cyst of parasitic origin in a chinchilla.

Objective: To compare client perception of outcome of phacoemulsification in dogs with information obtained from medical records., Design: Retrospective cohort study., Animals: 108 dogs (203 eyes) undergoing phacoemulsification from May 1999 through April 2004., Procedure: Data obtained from medical records included signalment, presence of diabetes mellitus, cataract stage, whether surgery was unilateral or bilateral, intraocular lens (IOL) placement, and postoperative complications. Owners completed a survey concerning outcome of phacoemulsification in their dog. Survey responses from owners classified as satisfied or dissatisfied with the outcome of phacoemulsification on the basis of their willingness, in retrospect, to have the surgery performed again were compared., Results: Data from medical records and survey responses were available for 108 dogs (203 eyes). Median follow-up was 3 months via medical record review and 12 months via owner survey responses. Most (81%) owners were satisfied with outcome. The most common reason for dissatisfaction was loss of vision after surgery; however, most dissatisfied owners did not return their dog for examinations. Owner perception of success was not associated with patient age, sex, presence of diabetes mellitus, cataract stage, or IOL placement in at least 1 eye but was associated with perceived improvement of their pet's vision and activity level. Dissatisfied owners were significantly more likely to report that explanation of risks and complications before surgery was inadequate., Conclusions and Clinical Relevance: Owner perception of outcome after phacoemulsification in dogs was highly favorable. However, surgical risks and the importance of postoperative examinations, particularly in dogs undergoing visual deterioration, must be conveyed to clients.

Although challenging from a technical perspective, many corneal surgical procedures can be mastered by the general practitioner. This article describes a number of procedures that can potentially save both the eye and vision. Procedures include corneal laceration repair, conjunctival pedicle graft, tarsoconjunctival island graft, advancement graft, total conjunctival graft, frozen tectonic corneal graft, porcine small-intestine submucosa graft, and superficial keratectomy. In addition to considerations on how to properly perform these procedures, emphasis is placed on common causes of failure and how to avoid them.

Objective: To compare aesthesiometer-determined corneal sensitivity between diabetic and nondiabetic dogs and to investigate the correlation between corneal sensitivity and duration of diabetes or status of glycemic control, as estimated by use of glycated blood protein concentrations., Animals: 23 diabetic and 29 nondiabetic normoglycemic dogs., Procedure: A Cochet-Bonnet aesthesiometer was used to measure corneal touch threshold (CTT) in 5 corneal regions of each dog. At the time of ocular examination, duration of diabetes mellitus was estimated from the history, and blood was drawn for assessment of blood glycosylated hemoglobin and serum fructosamine concentrations., Results: Median CTT for central, nasal, dorsal, temporal, and ventral corneal regions in nondiabetic dogs (1.6, 2.3, 2.8, 2.8, and 5.1 g/mm2, respectively) was significantly lower than in diabetic dogs (2.8, 4.0, 5.1, 5.1, and 6.6 g/mm2, respectively). Median regional CTT in diabetic dogs was not significantly correlated with estimated duration of diabetes mellitus or blood glycated protein concentrations. No significant difference was found in regional CTT between eyes of normoglycemic dogs with unilateral cataracts., Conclusions and Clinical Relevance: Diabetic dogs have significantly reduced corneal sensitivity in all regions, compared with nondiabetic normoglycemic dogs. Regional variation in corneal sensitivity is similar in diabetic and normoglycemic dogs. Neither glycemic control nor duration of diabetes, as estimated, is significantly correlated with corneal hyposensitivity. Corneal nerve dysfunction may be associated with recurrent or nonhealing ulcers in diabetic dogs for which no other underlying cause can be found.

Canine protothecosis remains a difficult condition to manage. The paucity of clinical cases hinders the development of successful treatment strategies. The clinical signs associated with the disease are nonspecific, and the course is so insidious that, by the time a definitive diagnosis is reached, the organism has often disseminated throughout the body. At this point, the condition is beyond treatment, and death occurs owing to failure of any number of organ systems, including the gastrointestinal, cardiovascular, renal, and central nervous systems. It is of some encouragement that the few patients that have undergone aggressive early treatment have survived longer than patients presenting late in the disease course. Nevertheless, the outlook for any dog with protothecosis is grave, and it remains to be determined whether early diagnosis can truly provide a better long-term prognosis. By including protothecosis as a consideration for dogs initially brought in with a history of chronic diarrhea or acute blindness and with a subsequent finding of exudative retinal separation, early diagnosis is possible. This recognition potentially affords the opportunity for an immune status work-up and intervention with increasingly better treatment options.