Feline

Ophthalmology
University of Florida
Which represents
the color vision
found in cats?
1. Top
2. Bottom
Which line can the cat see
at 20 feet?
 Acuity

Row 1 is 20/200 Legally blind

Row 2 is 20/100 Cat
Row 3 is 20/70
Row 4 is 20/50 Dog
20/33 Horse
Row 8 is 20/20 Human
 Orbital disease
 exophthalmos
– retrobulbar neoplasia or
abscess
 proptosis
– occurs with severe head
trauma
– concurrent orbital bone
fractures

*
Orbital Osteosarcoma
Proptosis
High risk of skull
damage cats.
Repair with TE flap.
Poor prognosis if
hyphema.
??
Eyelid agenesis
 portion of the temporal upper
eyelid fails to develop
 concurrent congenital defects
– PPMs, optic disk
colobomas, lenticonus,
microphthalmos,
choroidal hypoplasia

Dermoid
Optic nerve coloboma
 Eyelid agenesis

 Corneal exposure,
trichiasis, + KCS
– corneal vascularization
& scarring
 Repair the defect with a
rotational eyelid pedicle
flap, and cryotherapy for
the trichiasis
 3 wks postop
186381
Eyelid disorders
 entropion
– secondary to symblepharon
– most common in Persian cats
 distichia- rare
 ectropion due to injury

Postop
Preop Preop

Day 1 postop 13 days postop

Squamous cell carcinoma
 most common eyelid neoplasm
 associated with actinic radiation
 prevalent sites: nose, lower eyelids
and pinnae
 slowly progressive, ulcerative
lesions
 increased incidence in white, aged
cats
 SCC-diagnosis & therapy
 diagnosis based on age, clinical signs, cytology and
histopathology
 surgically excise with wide margins
– radiation therapy
– cryotherapy
– hyperthermia
– CO2 laser
– bleomycin chemotherapy
Round cell tumor
Third eyelid disorders
 Horner’s Syndrome: loss of
sympathetic innervation to the eye
from otitis, chest, neck disease

– Miosis, ptosis, TE protrusion

– + treat with topical 2.5%
phenylephrine
– may resolve spontaneously in 3-
8 wks
Post
 Haws syndrome- nictitans
protrusion
– Idiopathic
– must rule out the presence of
any underlying systemic/ocular
diseases
 Oral

TE adenocarcinoma in a cat
Third eyelid gland eversion

 “cherry eye”
 Burmese cats are predisposed
 nictitans gland eversion, +
cartilage eversion
 defect in the retinaculum
binding the gland to the
periorbita

ASH
Lacrimal system
keratoconjunctivitis sicca (KCS)
– Cat Normal STT 20.2
+/- 4.5 mm wetting/minute
– congenital in Burmese cats
– secondary to herpesvirus
induced conjunctivitis-
obstruction of lacrimal
gland ductules
– treat with tear supplements,
and antibiotics when
indicated
Congenital atresia
and imperforate puncta
 cause of epiphora in kittens
 Persian cats
– entropion of the lower
medial eyelid with
malalignment of the lower
punctum
 Burmese cats
– imperforate puncta and
canaliculi
 Conjunctivitis: most common cat eye problem

 Herpesvirus
– hyperemia
 Chlamydia psittaci
– chemosis
– Zithromax 5 mg/kg SID
PO
 Mycoplasma felis
– ulcers
 calicivirus
 various types of bacteria
 allergic/environmental
Chlamydia Mycoplasma
 Clinical signs
 epiphora
 ocular discharge (exudative)
 chemosis
 hyperemia
 blepharospasm
Herpesvirus
 80% of cats have it
– Most do not have disease
 early acute signs of infection
– sneezing, fever, lethargy,
inappetance
 Systemically ill
– serous ocular discharge, hypermic
conjunctivitis
 chronic (recurrent) signs of infection
– mucopurulent ocular discharge,
dendritic corneal ulcers, stromal
ulcers, corneal
vascularization/scarring, KCS
Cobalt blue filter
 Stromal Herpes Keratitis

Stromal large ulcers occur following dendritic ulcers

 Herpesvirus-diagnosis
 best to test during active disease
– Lots of viral shedding
 IFA testing of conjunctival scrapings
– fluorescein stain after collecting samples to avoid false
positives
– Not accurate
 PCR is best and detects virus DNA in corneal and conjunctival
scrapings but results vary according to the lab
 Tests are less reliable in chronic cases
 Dendritic ulcers are pathognomonic (acute stages)
 Clinical signs are important in the diagnosis.
 Herpesvirus-therapy
 topical antiviral medications
– idoxuridine (0.5%) five times/day or vidarabine (3%) are best topically
– cidofovir 0.5% BID
 topical antibiotics
– controls secondary bacterial infections
 recurrent herpesvirus
– rule out FeLV and FIV co-infections
– Oral famciclovir 7.5 mg/kg BID for 3 weeks
– oral lysine (500 mg BID PO); VIRALYS for cats
– interferon alpha-2 (300 units/day PO)
– topical Alomide 0.1% (Lodoxamide): mast cell and eosinophil stabilizer
Corneal ulcers
 Bacterial ulcers
 Traumatic lacerations
 Iris prolapse
Superficial ulcer 1 week later. Better?
Melting!!!
Superficial ulcer Descemetocele
Iris Prolapse
Corneal sequestrum
 black necrotic cornea, +
corneal vascularization
 unknown etiology
– history of chronic herpetic
keratitis, KCS, entropion or
traumatic ulcers
– Himalayan, Persian, and
Siamese cats are
predisposed
Corneal sequestration
 Therapy
– keratectomy plus corneo-
conjunctival transposition
– cover defect with a
conjunctival flap if > 1/2
corneal thickness
– topical antibiotics and
atropine
– recurrences are infrequent
in most cases
 1 day postop

Note gridding

3 months postop
Eosinophilic keratitis
 proliferative, white to pink,
irregularly surfaced,
vascularized corneal mass
– most commonly originates
from the temporal or nasal
limbus
– may involve adjacent
conjunctiva and nictitans
Eosinophilic keratitis
 diagnosis
– cytology of corneal
scrapings
– eosinophils, mast cells,
lymphocytes, plasma cells
 therapy: recurrences are
common
– topical corticosteroids
– systemic megestrol acetate
10 DAYS LATER
Limbal melanomas

Histoplasmosis
Bullous keratopathy

 acute, profound corneal

edema
 bullae formation
 rapidly progresses to
perforation
 unknown etiology
 CF or TE flap
Dermoids
Foreign bodies
Ouch!!
 D-shaped pupil in cats

Nasal short ciliary nerve and malar short ciliary nerve innervate the iris sphincters.
The nasal short ciliary nerve is abnormal in the OD. It cannot constrict.
180721
Glaucoma in the cat
 defined as an IOP above that
compatible for normal ocular
function
 ranges from 15 to 25 mm Hg
 secondary types of glaucoma
are most common
– uveitis, lens luxation,
intraocular neoplasia
Noah
 Glaucoma-therapy
 correct underlying cause when
possible
 mannitol in acute cases
 carbonic anhydrase inhibitors
 beta blockers
– cautious use in asthmatics
 laser cyclophotocoagulation
 enucleation
Uveitis in cats
 viral: FeLV, FIV, FIP, herpes
 toxoplasmosis
 crypto, blasto, histo, coccidioides
 neoplastic
 idiopathic/immune-mediated
– Food allergies- “green pea and duck
diets are curative!!”
Uveitis-clinical signs
 aqueous flare
 hypotony
 miosis
 iridal hyperemia
 iris color change
 keratic precipitates
 synechiae
Which cat used to have 2 blue eyes?
Iris bombe
Feline infectious peritonitis (FIP)

 coronavirus infection-often in
younger cats
 uveitis is more common with
the non-effusive form of FIP
 ocular lesions may be the only
sign of infection or preceed
systemic signs
 FIP-ocular diagnosis
 anterior > posterior uveitis
 aqueous flare, keratic precipitates
 fibrin and/or hypopyon in AC
 retinal vasculitis, optic neuritis
 elevated total plasma protein
 polyclonal gammopathy
 Toxoplasmosis
 ocular lesions + generalized
disease
 hematologic spread of
sporozoites
 multiplication of tachyzoites in
ocular tissues
 uveitis
– multifocal retinitis or
retinochoroiditis
 Toxoplasmosis
 diagnosis
– high single IgG titre or a 4-fold increase in titer 4
weeks later
– fecal analysis
 therapy
– systemic clindamycin
– topical corticosteroids and atropine
Lymphoma Uveitis
Persistent Pupillary Membranes
 PPM
 Embryologically there is no
pupil. A pupillary
membrane is present that is
supposed to break down.
 Persistence can lead to
cornea and lens opacities.
 Iris cysts

Remnant of optic vesicle

Most anterior part of the

Optic cup

X
Uveal tumors
 Melanoma-most common
primary tumor
– diffuse iridal tumors can
obstruct the iridocorneal
angle causing glaucoma
– hepatic metastasis may
occur
 LSA-most common
secondary tumor
– associated with FeLV
infection
Microphakia
Cataracts

 uncommon in cats
 usually due to iridocyclitis,
trauma, glaucoma or diabetes
 hereditary cataracts are rare
 occasionally senile and
congenital cataracts are
observed
Tigger Lanoie 162586
 “Cat” Smith 173466
 0524411 Vascular cataracts
129352 Morgagnian cataract
Baytril toxicity: Safe dose 2.5 mg/kg BID PO;
Original dose: 11mg/kg PO q24h
Retinal degeneration
 Taurine deficiency
– cats fed dog food or
“homemade” diets
– chronic deficiency can lead
to severe retinal
degeneration & irreversible
blindness
– daily taurine requirement is
10 mg/kg
 Head Trauma
– Retinal folds
Hemorrhagic retinopathy
 anemia-variety of causes
– multifocal intra &
preretinal hemorrhages
 hypertension
 coagulopathies
 systemic infections
Hypertensive retinopathy (HR)
 causes
– primary: comprises
<5% of all cases
– secondary: renal failure,
hyperthyroidism, high-
salt diet, atherosclerosis
 HR-clinical signs
 often presented for acute
blindness
 dilated, poorly to unresponsive
pupils
 retinal detachment with retinal
and vitreal hemmorhages
 heart murmur: hypertrophic
cardiomyopathy
 HR-diagnosis
 CBC, serum chemistry, urinalysis
 blood pressure
 echocardiogram
 thoracic & abdominal rads
 HR-therapy
 identify and treat underlying
cause(s)
 systemic therapy
– calcium channel blockers
(amlodipine 0.6 to 1.2
mg/cat/day PO)
– beta blockers, ACE
inhibitors
– prednisone, + furosemide
Retinitis

 FIP, FeLV, Toxo, Fungi

 Neoplasia
Panuveitis and RD
Ophthalmomyiasis
 Fly larval migration
 No therapy
Optic Nerve Aplasia