Microphthalmia with multiple ocular abnormalities in a foal.

OBJECTIVE: The aim of this report was to provide a clinical description and clinical, ultrasonographic, and histologic images of a foal with microphthalmia and multiple ocular abnormalities. ANIMALS STUDIED: A 12-h old Friesian-American Paint Horse crossbred filly presented for blindness, microphthalmia and marked ventral strabismus in both eyes. PROCEDURE: A complete ophthalmic examination was performed. Ultrasound biomicroscopy and B-mode ultrasonography were performed. The globes were submitted for histopathology. RESULTS: Ultrasound biomicroscopy demonstrated a hyperechoic cornea void of the typical epithelium, stroma, and Descemet's membrane layers. The anterior chamber was spanned by thick strands of hyperechoic tissue extending from the iris to the cornea. The lens was not visualized. B-mode ultrasound showed aphakia and mild, mottled echogenicity within the vitreous with no evidence of retinal detachment. On histopathology, both globes were microphthalmic with poorly defined corneal tissue. The anterior chambers were poorly formed and contained lacrimal glandular tissue. Portions of iridal tissue were present, but no lenses were noted. The retinas were segmentally detached and markedly atrophied with areas of retina dysplasia noted. CONCLUSIONS: This report provides a clinical, ultrasonographic and histologic description of a rare, congenital condition in a foal characterized by microphthalmia, aphakia, poorly defined corneal tissue, choristomatous differentiation of the anterior segment and retinal dysplasia.

Endoscopic-guided diagnosis of and interventional stent placement for nasolacrimal duct obstruction in a horse.

OBJECTIVE: To describe the successful use of endoscopy to visualize and place a soft canine ureteral stent to relieve a chronic nasolacrimal duct (NLD) obstruction in a horse. ANIMAL STUDIED: A 7-year-old, Quarter horse gelding. PROCEDURE: Under general anesthesia, retrograde nasolacrimal endoscopy was performed using an 8.5 Fr Storz Flex XC ureteroscope through the nasal punctum (NP). An obstructive web of fibrous tissue was visualized approximately 20 cm proximal to the NP. A 0.035″/150 cm hydrophilic guidewire was passed normograde from the ventral lacrimal punctum and used to puncture the stenotic tissue. Then, a 5.0Fr/70 cm open-end ureteral catheter was threaded normograde over the guidewire and NLD patency was re-established. The catheter confirmed a NLD length of 30 cm and was then removed. A 5.0Fr/22-32 cm Universa© Soft Ureteral Stent was threaded normograde over the guidewire until the loops of the stent were exposed at each end. The guidewire was removed and the stent loops were sutured in place. RESULTS: The stent was withdrawn 1 month after the procedure. Telephone follow-up with the client reported significant improvement in the amount of ocular discharge and decreased sensitivity around the face and ears. CONCLUSION: Endoscopy is a safe and effective procedure allowing for definitive diagnosis of NLD obstruction and to assist in interventional procedures. Placement of a canine indwelling ureteral stent seems to be an effective alternative treatment option for equine NLD obstruction compared to conventional invasive surgical procedures.

Evaluation of equine corneal disease using ultrasound biomicroscopy.

OBJECTIVE: To describe the clinical use of ultrasound biomicroscopy (UBM) to evaluate equine corneal disease. METHODS: Images were obtained using a 50-MHz probe ultrasound biomicroscopy system (Quantel Aviso) and Clear Scan® probe cover. Six horses with corneal disease were evaluated via UBM for lesion size, lesion depth, and continuity of Descemet's membrane. Horses were sedated and received auriculopalpebral nerve blocks and application of topical anesthetic prior to UBM. RESULTS: Ultrasound biomicroscopy was easily performed in all cases. UBM evaluation of three cases of corneo-limbal squamous cell carcinoma yielded information regarding lesion depth for planning of keratectomies using fixed-depth keratomes and subsequent ß-radiation therapy. Corneal depth and continuity of Descemet's membrane were determined in two horses with stromal abscesses and allowed for planning of therapeutic options. In one horse with a corneal foreign body, UBM contributed to accurate assessment of the foreign body's stromal depth, which could not be assessed during ophthalmic examination due to extensive corneal cellular infiltrate. The information regarding corneal depth allowed for more accurate pre-surgical planning in patients with opaque corneal lesions. CONCLUSIONS: Ultrasound biomicroscopy was easily performed and provided useful information regarding lesion depth and continuity of Descemet's membrane for patients with corneo-limbal squamous cell carcinoma, stromal abscesses, and a corneal foreign body, allowing for increased precision in pre-surgical planning and development of therapeutic protocols.

Double drape tectonic patch with cyanoacrylate glue for surgical repair of corneal defects: 8 cases.

OBJECTIVE: To describe the use of a double drape tectonic patch with cyanoacrylate glue technique for the treatment of deep or penetrating corneal defects in cats and dogs. ANIMALS STUDIED: Eight client-owned animals of which five were cats and three were dogs. PROCEDURE: Eight cases: Four with descemetoceles, three with corneal perforations, and one with a deep stromal ulcer were treated with a double layer of plastic drape material adhered to the cornea with a cyanoacrylate (2-octyl or 2-octyl, N-butyl)-based tissue adhesive. The patch was then covered with a third eyelid flap. RESULTS: Seven of the eight eyes healed uneventfully with a median time to healing time of 20 days (range 14-28 days). After healing, the glue patch had loosened and was removed. One eye of one cat developed bacterial keratitis with an iris prolapse adjacent to the patch and was subsequently enucleated. Only two of the eight eyes had increased corneal neovascularization. CONCLUSION: Treatment of deep or penetrating corneal defects with a double drape tectonic patch and cyanoacrylate glue is a viable option which may be a faster and less expensive alternative to other globe sparing surgical options.

Golden retriever pigmentary uveitis: Vision loss, risk factors for glaucoma, and effect of treatment on disease progression.

OBJECTIVE: In previous reports, almost half of Golden Retrievers with Pigmentary Uveitis (GRPU) have lost vision in an eye within a year of diagnosis. The purpose of this study was to determine the proportion of GRPU affected dogs with vision loss, risk factors for the development of glaucoma, and effect of treatment on disease progression. ANIMALS STUDIED: Client owned Golden Retrievers. PROCEDURES: Two complete ophthalmic examinations were performed at least 6 months apart. Visual status, presence of glaucoma, GRPU score, and treatment were recorded. A proportional odds (ordinal logistic) model was fitted to determine whether the use of topical steroidal or non-steroidal (NSAID) ophthalmic preparations was associated with a change in GRPU scores. RESULTS: Twenty-nine Golden Retrievers, 58 eyes, were included. One eye was enucleated after the first examination. On first examination, 57/58 (98.3%) eyes and 29/29 (100%) dogs were visual. At the second examination, 48/57 (84.2%) eyes and 25/29 (86.2%) dogs were visual. Vision loss in 7/9 (77.8%) eyes was secondary to glaucoma. Posterior synechia and fibrinous material in the anterior chamber were significant risk factors for the development of glaucoma (P < .001). There was no significant difference in the change in GRPU score between eyes receiving topical steroids and topical NSAIDs (P = .14). Time between examinations was a significant factor in disease progression (increased GRPU score; P = .016). CONCLUSION: The number of eyes and dogs that retained vision was higher than previous reports. No topical treatment was superior in slowing disease progression. Golden Retriever Pigmentary Uveitis is a slowly progressive disease.

Golden retriever pigmentary uveitis: Challenges of diagnosis and treatment.

Pigmentary uveitis (PU), also known as Golden Retriever Pigmentary Uveitis (GRPU), is a common ocular condition of Golden Retrievers that has severe, vision-threatening ocular complications and can require surgical intervention. In order to ensure consistency in the diagnosis of GRPU between examiners, a specified set of diagnostic criteria must be applied. This is critical to ensure owners, breeders, and veterinary ophthalmologists maintain confidence in the ocular certification process. Therefore, current and former members of the American College of Veterinary Ophthalmologists' Genetics Committee came together to draft this Viewpoint Article on the challenges of diagnosis and treatment of Golden Retriever Pigmentary Uveitis for veterinary ophthalmologists, Golden Retriever owners, and Golden Retriever breeders.

Canine panuveitis: a retrospective evaluation of 55 cases (2000-2015).

OBJECTIVE: To determine the most common etiologies of panuveitis in a group of dogs, patient response to therapy, and visual outcome. DESIGN: Retrospective study. MATERIALS AND METHODS: Medical records of 55 dogs diagnosed with panuveitis at the Purdue University Veterinary Teaching Hospital between December 2000 and December 2015 were reviewed. Data collected included signalment, season of diagnosis, descriptions of ocular lesions, diagnostic testing, treatment protocols, etiologic diagnoses (when determined), and visual outcome. RESULTS: The most common clinical sign in the anterior segment was aqueous flare and in the posterior segment was serous retinal detachment. The most common diagnosis was idiopathic/immune-mediated disease followed by systemic blastomycosis, lymphoma, and other causes (leptospirosis, aspergillosis, and histoplasmosis). Of the 43 dogs for which follow-up was available, 40% of dogs had resolution of visible inflammation and retinal reattachment, 32% of dogs had slight to moderate improvement, and 28% of dogs had no improvement or deterioration of lesions. Mean follow-up time was 11 months, and mean time to resolution of visible inflammation and retinal reattachment was 32 days. Sixty-five percent of dogs either retained or regained vision in one or both diseased eyes with initial medical therapy. CONCLUSIONS: Idiopathic/immune-mediated panuveitis was the most common diagnosis. Dogs with idiopathic/immune-mediated panuveitis tended to respond more favorably to medical therapy than dogs with infectious panuveitis. Visual outcome was favorable in those dogs that responded to initial medical therapy, but long-term therapy was required in many dogs to maintain vision and prevent recurrence of disease.

Disease and Surgery of the Equine Lens.

Examination of the lens is critical, particularly when evaluating horses with visual impairment or performing prepurchase examinations. To adequately evaluate the lens, the pupil must be pharmacologically dilated. A cataract is any lens opacity. The size, density, and position of a cataract determine the impact on vision. Cataracts may be congenital or inherited or occur secondary to trauma or equine recurrent uveitis. Surgical removal is the only treatment option for vision impairing cataracts, but careful selection of surgical candidates is critical for successful outcomes.

An association between systemic cyclosporine administration and development of acute bullous keratopathy in cats.

OBJECTIVE: To determine whether any association exists between the onset of feline acute bullous keratopathy (ABK) and administration of systemic corticosteroid or immunosuppressive therapy. ANIMALS STUDIED: Medical records of cats diagnosed with ABK between the years of 2000 and 2008 were retrospectively reviewed. Breed, age at diagnosis, weight, systemic disease status, eye affected, ophthalmic examination findings, systemic and topical therapy instituted, dosage and duration of therapy, visual outcome and histopathological analyses were recorded in cases meeting the inclusion criteria. RESULTS: A total of 12 cats of a surveyed population of 70 167 met the inclusion criteria with 17/24 eyes affected by ABK. Medical and/or surgical therapy was utilized for management of ABK with 13/17 eyes remaining sighted at the time of last follow-up. In a subset of cases corneal cytology, aerobic bacterial culture, FHV-1 PCR, virus isolation and/or histopathology were performed; no infectious organisms were identified. A rupture in Descemet's membrane of the cornea was identified histologically in two globes. A total of 10 of 12 cats had been previously diagnosed with ongoing systemic disease. A total of 10 of 12 cats were receiving systemic therapy, and a significant association (P < 0.001) was noted between systemic administration of corticosteroids and/or cyclosporine A and the development of ABK. A total of 8 of 10 cats were administered oral prednisolone at doses between 1-2 mg/kg every 12-24 h. A total of 5 of 8 cats receiving oral prednisolone were concurrently administered oral cyclosporine at doses of 1.5-7 mg/kg every 12-24 h. Systemic cyclosporine therapy was found to be a significant risk factor (P < 0.001) for ABK development, while systemic prednisolone was not significant (P = 0.10). CONCLUSIONS: Systemic cyclosporine administration appears to be a risk factor for development of ABK in the population of cats studied.

Prevalence of methicillin-resistant Staphylococcus spp. in the conjunctival sac of healthy dogs.

OBJECTIVES: To determine the prevalence of selected coagulase-positive methicillin-resistant Staphylococcus aureus (MRS) in the conjunctival sac in a group of healthy dogs and to compare the prevalence of ocular MRS colonization with colonization of typically assessed body sites including the nasal cavity and rectum. ANIMALS STUDIED: 123 healthy dogs were used in the prevalence study: 40 dogs from a shelter and 83 privately owned dogs. PROCEDURES: The sampling procedure included culturing three separate sites per subject in the following order: the lower conjunctival fornices, the nares, and rectum. RESULTS: A low prevalence of 1.6% (2/123) of MRS was detected in healthy dogs. Methicillin-resistant Staphylococcus pseudintermedius was isolated from two dogs, one from a conjunctival swab and the other from a rectal swab. CONCLUSION: The survey data indicate the ocular surface is a potential site of MRS colonization, although the prevalence was low in healthy dogs.

Ocular and neural distribution of feline herpesvirus-1 during active and latent experimental infection in cats.

BACKGROUND: Herpes simplex virus 1 (HSV-1) and varicella zoster virus (VZV) cause extensive intra-ocular and neural infections in humans and are closely related to Felid herpes virus 1 (FeHV-1). We report the extent of intra-ocular replication and the extent and morphological aspects of neural replication during the acute and latent phases of FeHV-1 infection. Juvenile, SPF cats were inoculated with FeHV-1. Additional cats were used as negative controls. Cats were euthanized on days 6, 10, and 30 post-inoculation. RESULTS: FeHV-1 was isolated from the conjunctiva, cornea, uveal tract, retina, optic nerve, ciliary ganglion (CG), pterygopalatine ganglion (PTPG), trigeminal ganglion (TG), brainstem, visual cortex, cerebellum, and olfactory bulb of infected cats during the acute phase, but not the cranial cervical ganglion (CCG) and optic chiasm. Viral DNA was detected in all tissues during acute infection by a real-time quantitative PCR assay. On day 30, viral DNA was detected in all TG, all CCG, and 2 PTPG. Histologically mild inflammation and ganglion cell loss were noted within the TG during acute, but not latent infection. Using linear regression, a strong correlation existed between clinical score and day 30 viral DNA copy number within the TG. CONCLUSIONS: The correlation between clinical score and day 30 viral DNA copy number suggests the severity of the acute clinical infection is related to the quantity of latent viral DNA. The histologic response was similar to that seen during HSV-1 or VZV infection. To the author's knowledge this is the first report of FeHV-1 infection involving intraocular structures and autonomic ganglia.

Commercial amniotic membrane extract for treatment of corneal ulcers in adult horses.

BACKGROUND: Amniotic membrane extract enhances the rate of epithelialisation after corneal ulceration in several species but has not been studied in the equine cornea. OBJECTIVES: To evaluate the effect of amniotic membrane extract on re-epithelialisation of equine corneal ulcers compared with ulcers treated with antibiotic, antifungal and mydriatic medical therapy alone, and to evaluate equine corneal healing after experimentally induced superficial ulceration. STUDY DESIGN: Masked, randomised, controlled experimental trial. METHODS: Superficial, 8 mm corneal ulcers were created bilaterally in each horse. One eye was treated with amniotic membrane extract and the opposite was control. Both eyes were treated with medical therapy. Treatment eyes received amniotic membrane extract, and control eyes received the amniotic membrane extract vehicle. Ulcers were stained with fluorescein and photographed in 12-hour increments until completely healed. Ulcer surface area was determined by analysing photographs with ImageJ. A mixed linear model was used to compare ulcer surface area and hours until healing between treatment groups. A regression model was also used to calculate corneal re-epithelialisation rate over time. RESULTS: Regardless of therapy, healing occurred in two phases: an initial rapid phase of 0.88 mm2 /hr (95% CI: 0.81-0.94 mm2 /hr) for approximately 48-54 hours followed by a second, slow phase of 0.07 mm2 /hr (95% CI: 0.04-0.09 mm2 /hr). Most eyes healed within 135.5 ± 48.5 hours. Treatment (amniotic membrane extract vs. control) was not significantly associated with size of ulcers over time (P = .984). Discomfort was minimal to absent in all horses. MAIN LIMITATIONS: Results achieved experimental studies may differ from outcomes in the clinical setting. CONCLUSIONS: There was no significant difference in healing rate with addition of amniotic membrane extract to medical therapy for equine superficial corneal ulcers. A biphasic corneal healing process was observed, with an initial rapid phase followed by a slow phase. Further study will be needed to determine whether amniotic membrane extract will be helpful for infected or malacic equine corneal ulcers.

Proliferation of Streptococcus zooepidemicus and Pseudomonas aeruginosa within a simulated subpalpebral lavage flushed with equine serum.

OBJECTIVE: To evaluate whether equine serum administered via a simulated subpalpebral lavage system (SPL) supports proliferation of Streptococcus zooepidemicus or Pseudomonas aeruginosa within the tubing. PROCEDURES: A sterile i.v. catheter with injection cap was inserted into sterilized silicone tubing (Mila). To mimic an SPL within the dorsal conjunctival fornix, the tubing was secured to an elevated platform. The tip of the tubing extended from the platform into a vial containing culture medium just inoculated with approximately 1.5 x 10(8) CFU/mL P. aeruginosa or S. zooepidemicus. To mimic administration of medication, the tubing was infused twice daily with equine serum, sterile saline (negative control), or culture medium (positive control) followed by air. Incubation was at 25 or 37 degrees C. At 24, 48, and 72 h postinoculation, samples were obtained for bacterial culture from one simulated SPL for each experimental variant. The following sections were cultured: (i) tubing tip previously submerged in the inoculated culture medium, (ii) tubing mid-section, and (iii) tip of the i.v. catheter. The experiment was performed in triplicate. RESULTS: Streptococcus zooepidemicus or P. aeruginosa were isolated from 100% of the tubing tips. Streptococcus zooepidemicus was isolated from one mid-section flushed with culture medium incubated at 37 degrees C. All other samples were negative for growth of the inoculated agents. CONCLUSIONS: Streptococcus zooepidemicus and P. aeruginosa did not proliferate within silicone tubing infused with equine serum. These data suggest that topical serum can be safely administered through a superiorly placed SPL in clinical cases.

Heterologous penetrating keratoplasty for treatment of a corneal sequestrum in a cat.

A corneal sequestrum was diagnosed in an 8-year-old, neutered male Burmese cat. A heterologous penetrating keratoplasty (PK) (fresh canine corneal tissue) was performed to restore a clear visual axis. A heterograft was selected in order to decrease the risk of viral transmission as a screened donor was not available. One month postoperatively the graft was vascularized and opaque. The owner failed to return for recheck examinations until 16 months postoperatively at which time only a faint central nebula remained.

Canine and feline uveitis.

The clinical signs of uveitis occur as a result of inflammation within the vascular coat of the eye, which causes breakdown of the blood-aqueous barrier and blood-retinal barrier. Many infectious and noninfectious causes can incite episodes of uveitis. Although a complete diagnostic evaluation is highly recommended to identify any underlying etiologic agent, many cases remain idiopathic in nature. The goals of therapy are preserving vision, minimizing pain, and halting inflammation.

Antibacterial activity and safety of commercial veterinary cationic steroid antibiotics and neutral superoxidized water.

Antibiotic resistance of bacteria common to the ocular surface is an evolving problem. Thus, novel treatment options with new modes of action are required. We investigated the antibacterial activity and safety of three commercially available topical veterinary ophthalmic products (cationic steroid antibiotics, products A and B, and a neutral superoxidized water, product C) to determine their potential use as antimicrobial alternatives. The minimum inhibitory concentrations (MIC) of the three products were determined against 17 antibiotic resistant bacterial clinical isolates from the ocular surface. Using a standard cytotoxicity assay, the products at varying concentrations were evaluated with a corneal fibroblast cell line and a macrophage-like cell line to determine their potential toxic effect in vitro. The commercial ophthalmic solutions, ofloxacin 0.3%, tobramycin 0.3% and gentamicin 0.3% were used as positive controls for the MIC and tobramycin 0.3% was used as positive control for the cytotoxicity assays. For the MIC, Product C showed no inhibition of growth for any organisms, while Products A and B showed inhibition of growth similar to slightly less than the positive controls. For the cytotoxicity assays, Product C exhibited minimal toxicity while Products A and B exhibited toxicity similar to the controls. In conclusion, Product C had no antibacterial activity in these assays, while Products A and B had antibacterial profiles similar to slightly less than common topical ophthalmic antibiotics and cytotoxicity profiles similar to common topical ophthalmic antibiotics. To our knowledge, this is the first report on the antibacterial activity and safety of the cationic steroid antibiotics and superoxidized water.

Comparison of the in vitro anticollagenase efficacy of homologous serum and plasma on degradation of corneas of cats, dogs, and horses.

OBJECTIVE To compare the anticollagenase efficacy of fresh feline, canine, and equine serum and plasma on in vitro corneal degradation. SAMPLE Grossly normal corneas from recently euthanized dogs, cats, and horses and fresh serum and plasma from healthy dogs, cats, and horses. PROCEDURES Serum and plasma were pooled by species and used for in vitro experiments. Corneas were collected and stored at -80°C. Sections of cornea were dried, weighed, and incubated in saline (0.9% NaCl) solution with clostridial collagenase and homologous fresh serum or plasma. Corneal degradation was assessed as the percentage of corneal weight loss and hydroxyproline concentration, compared with results for positive and negative control samples. RESULTS Homologous fresh serum and plasma significantly reduced the percentage of corneal weight loss, compared with results for positive control samples. No significant difference was found in percentage of corneal weight loss between incubation with serum or plasma for feline, canine, and equine corneas. Canine serum and plasma significantly reduced hydroxyproline concentrations, whereas inclusion of feline and equine serum or plasma did not, compared with results for positive control samples. Hydroxyproline concentrations were moderately correlated with percentage of corneal weight loss for feline samples and weakly correlated for equine samples, but they were not correlated for canine samples. CONCLUSIONS AND CLINICAL RELEVANCE In this study, the anticollagenase efficacy of fresh feline, canine, and equine serum was not different from that of plasma. Plasma should be an acceptable substitute for serum in the topical treatment of keratomalacia.

The use of carbon dioxide laser for the ablation of meibomian gland adenomas in dogs.

Twelve eyelid meibomian gland adenomas in dogs were surgically ablated using the carbon dioxide (CO(2)) laser. The laser site was not sutured. All procedures resulted in complete removal of the adenoma with no recurrences at 6 months. In addition, no dogs developed corneal disease secondary to the procedure, and the cosmetic appearance of the eyelid margins was good at the end of the 6-month study. Based on results of this study, CO(2) laser ablation of canine meibomian gland adenomas is an effective alternative to standard surgical removal.

Evaluation of species differences and the effects of storage duration and temperature on the anticollagenase efficacy of canine, feline, and equine serum on in vitro corneal degradation.

OBJECTIVE To evaluate species differences and effects of storage duration and temperature on the anticollagenase efficacy of canine, feline, and equine serum on in vitro corneal degradation. SAMPLES Corneas and serum from dogs, cats, and horses. PROCEDURES Clinically normal corneas from dogs, cats, and horses were harvested within 2 hours after euthanasia. Serum samples from dogs, cats, and horses were collected and pooled by species. Corneal specimens were incubated with collagenase derived from Clostridium histolyticum, 5mM calcium chloride in saline (0.9% NaCl) solution, and feline, canine, or equine serum that had been stored for 0, 30, 90, or 180 days at -20° or -80°C. Following incubation, the corneal weight loss percentage and hydroxyproline concentration in the incubation fluid were calculated and compared among experimental combinations. RESULTS Feline serum was more effective than canine or equine serum for minimizing corneal weight loss. Incubation with feline or equine, but not canine, serum significantly reduced hydroxyproline production. Serum storage duration did not affect corneal weight loss, but the hydroxyproline concentration was greater for corneal specimens that were incubated with serum that was stored for 90 days, compared with that for corneal specimens incubated with serum that was stored for 0, 30, or 180 days. Serum storage temperature did not affect corneal weight loss or hydroxyproline concentration. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that serum reduced corneal degradation in vitro, and the duration and temperature at which serum was stored did not affect its anticollagenase efficacy.

Comparison of ultrasound biomicroscopy and standard ocular ultrasonography for detection of canine uveal cysts.

OBJECTIVE: To compare ultrasound biomicroscopy (UBM) with standard ocular ultrasonography for detection of canine uveal cysts and to determine the sensitivity, specificity, and interobserver agreement for detection of uveal cysts with UBM. SAMPLE: 202 enucleated eyes from 101 dogs. PROCEDURES: 2 examiners examined 202 eyes by means of UBM (50 MHz) to identify uveal cysts. A board-certified radiologist then examined 98 of the 202 eyes by means of standard ocular ultrasonography (7- to 12-MHz linear transducer). Subsequently, 1 examiner dissected all 202 eyes under magnification from an operating microscope to definitively identify uveal cysts. Each examiner was masked to other examiners' findings. Sensitivity, specificity, and interobserver agreement were calculated for detection of cysts by UBM. RESULTS: Cysts were detected by use of UBM in 55 of 202 (27%) eyes by one examiner and 29 of 202 (14%) eyes by the other. No cysts were detected in the 98 eyes examined with standard ocular ultrasonography. Dissection results revealed that cysts were present in 64 of 202 (32%) eyes, including 29 of 98 (30%) eyes examined by standard ocular ultrasonography. Mean sensitivity of UBM for cyst detection was 47%; mean specificity was 92%. Uveal cysts not identified with UBM were often small (mean diameter, 490 üm). Interobserver agreement was high (κP = 0.81). CONCLUSIONS AND CLINICAL RELEVANCE: UBM was more effective than standard ocular ultrasonography for detection of uveal cysts in enucleated eyes. Small-diameter cysts were difficult to visualize even with UBM.