Diseases and surgery of the lens

McMullen, Richard J.; Gilger, Brian C

doi:10.1002/9781119047919.ch9

Cited by 7 publications

(7 citation statements)

References 110 publications

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“…Iridodialysis, previously reported anecdotally in the veterinary literature, is defined as separation of the peripheral iris from its insertion at the sclera 2,5,15,35 . Cyclodialysis is an extension of this injury to include separation of the iris and pars plicata portion of the ciliary body from the sclera 2 .…”

Section: Discussionmentioning

confidence: 99%

Clinical findings associated with blunt ocular trauma in horses: a retrospective analysis

Charnock

Keys²,

McMullen

2021

Veterinary Ophthalmology

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Objective Identify ocular findings associated with blunt ocular trauma to aid in differentiation from other equine ocular diseases. Study design Retrospective case‐control study. Methods Medical records of horses at the Equine Clinic Munich‐Riem, Munich, Germany and Auburn University, College of Veterinary Medicine were reviewed. Age, sex, breed, laterality, and clinical findings on ophthalmic examination, as well as an observed (confirmed) or unobserved (suspected) history of trauma, were recorded. Statistical analysis was performed to identify any correlation between clinical signs and blunt ocular trauma. Fifty‐nine clinical signs were evaluated, and their association with blunt ocular trauma and non‐traumatic uveitis was determined. The frequency of clinical signs associated with non‐traumatic uveitis was also reported. Results Fifty‐five eyes affected with blunt trauma were included. The comparison group consisted of 233 eyes (168 horses) diagnosed with non‐traumatic uveitis. The most frequent ocular findings after BOT included cataract (36/55, 65.5%), corneal edema (26/55, 47.2%), decreased intraocular pressure (23/55, 41.8%), aqueous flare (19/55, 34.5%), lens subluxation, luxation, or lens loss (18/55, 32.7%), fibrin in the anterior chamber (18/55, 32.7%), hyphema (16/55, 29.1%), peripapillary depigmentation (“butterfly lesion”) (16/55, 29.1%), conjunctival hyperemia (16/55, 29.1%), corneal fibrosis (15/55, 27.3%), corpora nigra avulsion (14/55, 25.5%), blepharospasm (13/55, 23.6%), and iridodialysis (11/55, 20.0%). Conclusions The characteristic pattern of ocular signs associated with blunt ocular trauma may assist in differentiation from other types of uveitis and may improve interpretation of ocular lesions identified during pre‐purchase examinations. This study also represents the first peer‐reviewed documented and photographed cases of iridodialysis in the horse.

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Section: Discussionmentioning

confidence: 99%

Clinical findings associated with blunt ocular trauma in horses: a retrospective analysis

Charnock

Keys²,

McMullen

2021

Veterinary Ophthalmology

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“…Phacoemulsification employs ultrasound waves to break down, or emulsify, the lens with a high frequency ultrasound probe and then aspiration of the cortex and nucleus through a single needle [30]. Small‐incision phacoemulsification with aspiration utilizing instrumentation specifically modified for the equine eye is the current standard of care for cataract surgery in the horse, the species which this surgery was modeled after [16, 31–36]. Phacoemulsification and aspiration are most commonly performed through a single incision, utilizing a single needle to infuse irrigating solution, aspirate, and deliver ultrasonic phacoemulsification [15].…”

Section: Discussionmentioning

confidence: 99%

“…Utilizing a trilaminar (three‐step) corneal incision, whereby a proximal hinge is created at the base of the incision, helps to prevent the incision from leaking. This technique is advantageous in the horse, since it prevents the iris/corpora nigra from migrating to the corneal incision during phacoemulsification of the lens and aspiration of the cortex [36]. The trilaminar corneal incision also enables the anterior chamber to remain formed throughout the surgical procedure, thus reducing the amount of viscoelastic utilized throughout the surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The trilaminar corneal incision also enables the anterior chamber to remain formed throughout the surgical procedure, thus reducing the amount of viscoelastic utilized throughout the surgery. This procedure also requires a small surgical incision, which minimizes the risk of intraoperative iris prolapse and results in fewer postoperative complications and quicker recovery [30, 36].…”

Section: Discussionmentioning

confidence: 99%

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Bilateral Phacoemulsification in an African Elephant (Loxodonta africana)

Cerreta

McMullen

Scott

et al. 2019

Case Reports in Veterinary Medicine

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A 37-year-old bull African elephant (Loxodonta africana) at the North Carolina Zoo (NCZ) was diagnosed with bilateral cataracts leading to behavioral changes and significant weight loss secondary to functional blindness. On initial examination, a weight loss of 234 kg, a mature cataract in the right eye, and a focal cataract in the left eye were diagnosed. Ultrasound and electroretinography (ERG) indicated normal retinal attachment and both eyes were viable candidates for surgery. After careful planning and behavioral training, the left cataract was surgically removed via phacoemulsification and irrigation/aspiration. The right eye subsequently developed a ventral lens subluxation, and phacoemulsification and irrigation/aspiration were performed six months after the first procedure. Four years after surgery, menace response, palpebral reflex, dazzle reflex, and pupillary light reflexes were present in both eyes. Body weight was 5,515 kg, 88kg more than at the time of the second surgery. This is the first published report of an African bull elephant undergoing bilateral cataract removal using phacoemulsification and irrigation/aspiration. The lack of significant postoperative inflammation and uneventful recovery of the elephant suggests that this surgical procedure along with proper preoperative planning and postoperative medical management can be a safe and effective treatment option for elephants with cataracts.

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“…It is important to note that a positive dazzle reflex does not imply vision, since the higher parts of the visual pathway are not assessed with this test (Fig 2). Moreover, eyes with severe intraocular opacities, such as mature cataracts, can present an intact dazzle reflex but have completely impaired vision (McMullen and Gilger 2017). We recommend not using this reflex on its own to neurolocalise as the exact anatomical pathways have not been fully elucidated.…”

Section: Assessing Visionmentioning

confidence: 99%

Clinical approach to equine neuro‐ophthalmology

Pont¹,

Beltrán²

2019

In Practice

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Background: Neuro-ophthalmic disorders, although still uncommon, are being reported more often in horses. Cases can present with a wide range of clinical signs, from chronic, non-healing corneal ulcers to behavioural changes due to visual impairment. Achieving the correct diagnosis is not always easy. Using a systematic approach to examine horses with suspected neuro-ophthalmic disorders will help the clinician to achieve a neuroanatomic diagnosis and a list of differential diagnoses. The diagnostic tests are always planned based on this list of differentials and the treatment is targeted to the final or most likely diagnosis. Understanding the neuro-ophthalmic anatomy is mandatory to achieve the correct neurolocalisation and plan the appropriate diagnostic modalities.Aim of the article: This article reviews the most important neuro-ophthalmic pathways to interpret the clinical signs and underlying causes seen in this field.

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Diseases and surgery of the lens

Cited by 7 publications

References 110 publications

Clinical findings associated with blunt ocular trauma in horses: a retrospective analysis

Clinical findings associated with blunt ocular trauma in horses: a retrospective analysis

Bilateral Phacoemulsification in an African Elephant (Loxodonta africana)

Clinical approach to equine neuro‐ophthalmology

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