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DVOS VETS Online veterinary ophthalmology consulting service to practicing veterinarians as well online veteri

28/02/2025

Answer case 7
Most of you were correct it is a conjunctival hemangioma / hemangiosarcoma. In my opinion most of the 100 % conjunctival masses are hemangioma, if there is corneal involvement most likely hemangiosarcoma. They respond well to surgical excision.

What is your diagnosis ? Case 7Signalment: 7 year old male Cross breed dog. Very active outdoor dog.History: Small red ...
26/02/2025

What is your diagnosis ?
Case 7
Signalment: 7 year old male Cross breed dog. Very active outdoor dog.

History: Small red nodule on the eye became visible about 1 month previously. Slowly enlarging
Growth on eyelid has been there for months owner refusing treatment.

Clinical findings: Lesion as seen on photograph [OD]
Mild ocular discomfort.
Schirmer tear test 23 mm/min
Cornea fluorescein negative.
Intraocular pressure OS 14 mmHg OD 16 mmHg

24/02/2025

Answer Case 7
Subconjunctival hemorrhage
The most common cause for this is trauma, but clotting disorders can also cause lesions like this. This is normally a very dramatic presentation but resolve qu**ky.
Do thorough ocular and systemic examination to rule out any other ocular symptoms for example secondary uveitis as well systemic disease leading to a bleeding tendency.

If everything is normal I usually start a short course of topical corticosteroids Prednisolone acetate 1 % or Dexamethasone 0.1 % drops q6h for 5 – 7 days

What is your diagnosis ? Case 7Signalment: 5 year old active healthy non-descript breed dogHistory: Being barking outsid...
13/02/2025

What is your diagnosis ?
Case 7
Signalment: 5 year old active healthy non-descript breed dog

History:
Being barking outside the previous night
Owners found him like this in the morning.

Clinical findings:
Lesion as seen on photograph [OS]
Mild ocular discomfort.
Normal menace
Normal PLR
No aqueous flare
Schirmer tear test 21 mm/min
Cornea fluorescein negative.
Intraocular pressure OS 15 mmHg OD 18 mmHg

13/02/2025

Answer Case 6
Well done to you who got this one !!
Persistent Hyperplastic Tunica Vasculosa Lentis/Persistent Hyperplastic Primary Vitreous (PHTVL/PHPV) is characterized by fetal and postnatal hyperplasia of the hyaloid system, tunica vasculosa lentis, and primary vitreous, resulting in a variable but often significant opacity. This disorder has been observed in cats and numerous dog breeds, with hereditary transmission documented in Bouvier des Flandres, Staffordshire Bull Terriers, and Doberman Pinschers. Research on Doberman Pinschers in the Netherlands suggests an autosomal incompletely dominant mode of inheritance with variable expressivity. Clinically, PHTVL/PHPV manifests as a white or fibrovascular plaque on the posterior lens capsule and anterior vitreous. Additional potential findings include vascular ingrowth and hemorrhage within the vitreous and lens cortex, calcium deposits, posterior lenticonus, microphakia, lens coloboma, intralenticular melanosis or hemorrhage, progressive cataracts, and elongated ciliary processes.

What is your diagnosis ? Case 6Signalment: 2 year old DobermanHistory: Presented with a cataract. Clinical findings: Ca...
09/02/2025

What is your diagnosis ?
Case 6
Signalment:
2 year old Doberman

History:
Presented with a cataract.

Clinical findings:
Cataract visible
Due to the cataract the fundus is not visible Durgin ophthalmoscopy
As part of complete workup, an ultrasound is done
Lesion as seen on photograph [OU]
No ocular discomfort.
Intraocular pressure OS 18 mmHg OD 19 mmHg

07/02/2025

Another one of the Focus products that I think may have some ophthalmological impact is calmfocus. FHV is very much a stress driven condition when we think about recrudescent disease

26/01/2025

Case 5 Answer
Well done to all who got this one !!!
Lipid aqueous
This is not a specific condition, but rather one of the possible clinical signs of active uveitis. Lipid-laden aqueous is possible if the patient has concurrent hyperlipidemia in which the aqueous assumes a milky-white appearance.
The hyperlipideamia may be normal post prandial after eating a very fatty meal. True hyperlipidaemia can be either primary or secondary to other diseases. Secondary hyperlipidaemia is the most common form in dogs, and it can be a result of endocrine disorders, pancreatitis, cholestasis, protein-losing nephropathy and obesity. Primary hyperlipidaemia is less common in the general canine population but it can be very common within certain breeds. Hypertriglyceridaemia of Miniature Schnauzers is the most common form of primary hyperlipidaemia in dogs.
Lipid laded aqueous can occur very acutely, and the clinical appearance is dramatic with the entire anterior chamber appearing white. It is often misdiagnosed as corneal edema or a mature cataract in patient with mydriatic pupil.
Treatment is the same as the general treatment for uveitis combined with fasting for 12 hours or a low fat diet. If the lipemic aqueous is a recurrent event further investigation for an underlying cause resulting in recurrent lipemia is justified.

What is your diagnosis ? Case 5 Signalment: 5 year old SchnauzerHistory: Diabetic for the last 14 months under control ...
25/01/2025

What is your diagnosis ?
Case 5

Signalment: 5 year old Schnauzer

History: Diabetic for the last 14 months under control with insulin
Acute onset blindness. Dog was perfect the previous day. It was the owner's birthday and they had roast lamb. They “spoiled” the dog by giving him some leftovers after the meal.

Clinical findings:
Lesion as seen on photograph [OU]
Mild ocular discomfort.
Acute onset blindness
Schirmer tear test 17 mm/min
Cornea fluorescein negative.
Intraocular pressure OS 14 mmHg OD 11 mmHg

25/01/2025

Answer case 4
Feline geographic corneal ulcer
This is caused by Feline Herpes virus. It looks exactly like SCCED in dogs, but the treatment is completely different. Unlike dogs where a striate keratotomy is indicated in these cases striate keratotomies are contraindicated and in most may very often lead to secondary corneal sequestrum formation.
Treatment:
Debride the cornea using a dry cotton bud under topical anesthesia. It is very important to get rid of that very typical lip of unattached corneal epithelial cells. Without removing those cells these ulcers do not heal.
Topical antivirals. My product of choice is Cidofovir as this is only a q12h treatment compared to drugs like Idoxuridine that needs to be given q4h.
Chondroitin sulphate / High molecular hyaluronic acid. FHV affects the conjunctival goblet cells leading to qualitative KCS
Topical antibiotic as prophylactic.

What is your diagnosis ? Case 4Signalment: 6 year old Domestic shorthair catHistory: History of recurrent episodes of b...
24/01/2025

What is your diagnosis ?
Case 4
Signalment: 6 year old Domestic shorthair cat

History: History of recurrent episodes of bilateral conjunctivitis. Painful eye for the past 2 weeks

Clinical findings:
Lesion as seen on photograph [OD]
Ocular discomfort.
No visual deficits present.
Schirmer tear test 22 mm/min
Cornea fluorescein negative. Note the staining pattern.
Rest of ocular examination was normal.

Answer will be posted over the weekend

23/01/2025

Answer Case 3
Diagnosis: Limbal squamous cell carcinoma . Confirm diagnosis with cytology using a cytobrush under topical anesthesia.
Treatment
The ideal treatment for conjunctival / corneal SCC is surgical resection. However in very early cases like this topical mitomycin c may be curative.
0.04% MMC drops q 8 h) for a cycle of 7 days on followed by 7 days of. Repeat cycle three times.
Differential diagnosis
Corneal granulation

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