Decreased corneal subbasal nerve fiber length and density in diabetic dogs with cataracts using in vivo confocal microscopy.

OBJECTIVE: To determine whether there is a difference in corneal sensitivity and corneal subbasal nerve plexus (CSNP) morphology in cataractous dogs with diabetes mellitus (DM) versus without DM. ANIMALS STUDIED: Twenty six domestic dogs with cataracts of various breeds presented for phacoemulsification, 13 with DM and 13 without DM. PROCEDURE: The inclusion criteria for the study were dogs with bilateral cataracts and no clinical evidence of corneal disease. The diabetic group had documented hyperglycemia and was currently treated with insulin. The non-diabetic group had no evidence of DM on examination and bloodwork. Complete ophthalmic examination, corneal esthesiometry, and in vivo confocal microscopy of the CSNP was performed for both eyes of each dog. The CSNP was evaluated using a semi-automated program and statistically analyzed. RESULTS: The mean (±SD) CSNP fiber length was significantly decreased in diabetic (3.8 ± 3.0 mm/mm2 ) versus non-diabetic (6.7 ± 1.9 mm/mm2 ) dogs. Likewise, the mean (±SD) fiber density was significantly decreased in diabetic (8.3 ± 3.1 fibers/mm2 ) versus non-diabetic (15.5 ± 4.9 fibers/mm2 ) dogs. The corneal touch threshold was significantly reduced in diabetic (2.1 ± 0.8 cm) versus non-diabetic (2.8 ± 0.4 cm) dogs. There was a non-significant trend towards subclinical keratitis in diabetic (9/13) versus non-diabetic (4/13) dogs. CONCLUSIONS: Morphological and functional abnormalities of the CSNP were present in dogs with DM, including decreased fiber length, fiber density, and corneal sensitivity. These findings are consistent with diabetic neuropathy and could contribute to clinically significant corneal complications after cataract surgery.

Nocardia and Streptomyces keratitis in dogs: In vivo detection of filamentous bacteria by confocal microscopy.

OBJECTIVE: To describe the clinical features of dogs with Nocardia and Streptomyces keratitis, including the results of in vivo confocal microscopy examinations. ANIMAL STUDIED: A 15-year-old, male-castrated, miniature Schnauzer was presented with a multilobulated, cystic, pink, ulcerated corneal mass with surrounding dense leukocyte infiltrates. Cytologic evaluation of a corneal scraping identified pyogranulomatous inflammation and filamentous bacteria. Nocardia nova was cultured from corneal samples. Anterior lamellar keratectomy was performed to excise the affected corneal region and histopathologic evaluation confirmed the diagnosis of pyogranulomatous keratitis. A 10-year-old, male-castrated, Yorkshire terrier was presented for evaluation of a chronic anterior stromal corneal ulcer associated with a brown corneal plaque. Cytologic evaluation of a corneal scraping identified suppurative inflammation and filamentous bacteria. A Streptomyces sp. was cultured from corneal samples. The keratitis in both dogs resolved with therapy. PROCEDURES: In vivo confocal microscopy examination of the corneal lesions in both dogs revealed dense accumulations of leukocytes and clusters of hyperreflective, slender, branching bacterial structures that were approximately 1.5-2.0 µm in diameter and 25-50 µm in length. Confocal microscopy imaging of the Nocardia isolate in vitro, and ex vivo canine corneas experimentally infected with the bacteria, was performed to corroborate the in vivo findings. The morphology of the filamentous bacteria was similar between the in vivo, in vitro, and ex vivo confocal microscopy examinations. CONCLUSIONS AND CLINICAL RELEVANCE: Nocardia and Streptomyces spp. can be associated with infectious keratitis in dogs. In vivo detection of filamentous bacteria in the cornea can be accomplished by confocal microscopy.

Surgical correction of third eyelid cartilage eversion in an Anglo-Nubian goat: A case report.

This case of everted third eyelid cartilage in a goat demonstrates that everted cartilage occurs in animals other than domestic dogs and cats. Everted cartilage in the goat can be treated successfully with surgical excision of the abnormally bent cartilage.

Retrospective evaluation of phacoemulsification and aspiration in 182 eyes: Visual outcomes and CDE-predictive value.

OBJECTIVE: To determine the effect of cumulative dissipated energy (CDE) on complications and visual outcome following cataract surgery in dogs. ANIMALS STUDIED: Records of 182 canine eyes that had undergone cataract surgery. PROCEDURES: Retrospective medical record review was conducted on dogs that underwent unilateral or bilateral elective cataract surgery by a single surgeon. Preoperative variables such as age, cataract duration, and pre-existing conditions were recorded. Intraoperative variables such as intraocular lens (IOL) status, phacoemulsification time, average power, irrigation fluid volume, and CDE were recorded. Postoperative complications and visual status at last follow-up were compared to these variables. RESULTS: Eighty-six percent of dogs were visual in one or both eyes at last follow-up (LFU) examination. Median follow-up time was 186 days postoperatively. Eyes that developed glaucoma had a significantly greater mean CDE (77.73 ± 80.11) than eyes that did not develop glaucoma (49.21 ± 38.93). Eyes that remained visual at the LFU examination had a significantly lower mean CDE (48.31 ± 37.14) than eyes that were blind at LFU (82.05 ± 82.73). Significantly lower mean CDEs were found in diabetic eyes, younger eyes, early-operated eyes (<1 month duration), and eyes with preoperative lens-induced uveitis. CONCLUSIONS: Higher CDE may be associated with an increased risk of postoperative glaucoma and loss of vision in dogs. Cumulative dissipated energy may be a useful prognostic indicator for success of canine cataract surgery.

Feline ophthalmomyiasis externa caused by Cuterebra larvae: four cases (2005-2020).

CASE SERIES SUMMARY: Described are four cats diagnosed with ophthalmomyiasis externa caused by Cuterebra larvae. Medical records were retrospectively reviewed to identify cats with ophthalmomyiasis externa between 2005 and 2020 at Cornell University Hospital for Animals. Signalment, history, clinical and diagnostic findings, treatment and outcome were recorded. All cats were young (< 3 years of age), had outdoor access and were initially examined during the summer months. All cases had unilateral disease with the right eye affected. Two cases had nictitating membrane lesions and two had orbital disease. Concurrent superficial corneal ulceration was present in three cats. Two cats suffered from pyrexia, suspected secondary to inflammation from the larval infestation. Successful larval removal was performed in all cats, which resulted in improvement of discomfort and clinical signs. A corneal ulcer persisted in one cat, which was lost to follow-up prior to ulcer resolution. Parasite identification confirmed Cuterebra species infestation in all cases. RELEVANCE AND NOVEL INFORMATION: To the authors' knowledge, this is the first report of feline ophthalmomyiasis externa caused by Cuterebra species. Parasite removal was successful in restoring comfort and resolving clinical signs in all cats with adequate follow-up information.

Applications of in vivo confocal microscopy in the management of infectious keratitis in veterinary ophthalmology.

In vivo confocal microscopy (IVCM) is a relatively new ocular imaging technique that permits morphological and quantitative assessment of the living cornea on the cellular level. The applications for IVCM in clinical ophthalmology are numerous and diverse. There are several advantages inherent to IVCM over standard diagnostic techniques currently used to confirm a diagnosis of infectious keratitis in veterinary ophthalmology. With IVCM, images can be viewed in real-time providing immediate diagnostic information. Traumatic corneal sampling techniques are avoided, and the procedure can be repeated as frequently as is clinically indicated without risk of corneal tissue damage. Both superficial and deep corneal lesions can be evaluated by IVCM in an atraumatic fashion. Microorganism viability is not required for their detection and specialized diagnostic laboratory assay procedures are not necessary. Many larger infectious agents can be directly identified within corneal lesions by IVCM, including fungi and parasites such as Acanthamoeba spp. In other situations, such as bacterial infectious crystalline keratopathy, the biological systems associated with the microorganism can be detected within the cornea. The current resolution of IVCM is inadequate to directly visualize some corneal infectious agents, such as herpesviruses, but host responses and virus-infected epithelial cells can be identified. This review summarizes the current knowledge and applications of IVCM in the management of infectious keratitis in veterinary ophthalmology, including its use in animals with bacterial, fungal, parasitic, and viral keratitis.

Acanthamoeba sclerokeratitis in a cat.

CASE DESCRIPTION: A 12-year-old neutered male domestic shorthair cat with chronic anterior uveitis and secondary glaucoma of the right eye was examined for persistent blepharospasm 2 weeks after corneal debridement and grid keratotomy for nonhealing superficial ulcerative keratitis. CLINICAL FINDINGS: Examination of the right eye revealed a central superficial corneal ulcer associated with corneal epithelial and subepithelial infiltrates and mild aqueous flare. Structures consistent with amoeboid cysts and trophozoites were detected in the cornea by in vivo confocal microscopy. Suppurative keratitis was identified cytologically. An Acanthamoeba spp was isolated through culture and identified by a PCR assay of corneal specimens. TREATMENT AND OUTCOME: Symptomatic and antiamoebic (polyhexamethylene biguanide 0.02% ophthalmic solution) treatments were instituted. Over the following 6 weeks, the cat lost vision in the affected eye and lesions progressed to nonulcerative stromal keratitis associated with a dense paracentral corneal stroma ring infiltrate and anterior lens luxation. The globe was enucleated, and lymphoplasmacytic sclerokeratitis, anterior uveitis, and retinal detachment were noted. Acanthamoeba organisms were detected within the corneal stroma and anterior sclera with histologic and immunohistochemical stains. The amoebae were classified to the Acanthamoeba T4 genotype by DNA sequencing. The cat had no medical problems attributed to Acanthamoeba infection over 36 months after enucleation, until the cat was lost to follow-up. CLINICAL RELEVANCE: Naturally acquired Acanthamoeba sclerokeratitis is described in a cat for the first time. Acanthamoeba infection should be considered for cats with superficial corneal disease refractory to appropriate treatments and especially occurring after ocular trauma, including keratotomy.

Choroidal melanocytic tumors in dogs: A retrospective study.

OBJECTIVE: To describe clinical features of dogs diagnosed with choroidal melanocytic tumors at a veterinary teaching hospital. ANIMALS STUDIED: Retrospective case series of 13 dogs (14 melanocytic tumors) with choroidal melanocytic tumors. PROCEDURES: Medical records of dogs evaluated by the Cornell University ophthalmology service with a clinical diagnosis of a choroidal melanocytic tumor between 2008 and 2020 were reviewed. A choroidal melanocytic tumor was clinically defined as any well-demarcated, raised pigmented choroidal lesion underlying the retina. Histopathology results were consulted when available. Signalment and clinical features were recorded, including fundoscopic location, histopathologic findings, treatment, and outcome. RESULTS: Choroidal melanocytic tumors were identified in 14 eyes of 13 dogs. The mean (±standard deviation) of dogs was 8.6 (±3.5) years. Seven different breeds were represented, with Labrador/Labrador mix being the most common. Ten of the 14 melanocytic tumors were diagnosed incidentally. Four dogs presented for vision loss and ocular discomfort, and diagnosis was made on histopathology examination following enucleation. Pulmonary metastasis was suspected in one dog with an incidentally found choroidal melanocytic tumor OD. Fundoscopic location was available for 8 melanocytic tumors, with 6 (75%) located in the tapetal fundus. Histopathologic diagnosis was melanocytoma for 3 and malignant melanoma in 1 globe, with optic nerve head invasion in 50%. Local recurrence was not seen in any orbit following enucleation. CONCLUSION: Choroidal melanocytic tumors are uncommon in dogs. Metastasis appears to be rare and was only suspected in one dog, but intraocular tumor growth can lead to retinal detachment, glaucoma, and necessitate enucleation.

Evaluation of the short- and long-term complications and outcomes of phacoemulsification surgery in alpacas.

OBJECTIVE: To describe the complications and determine the visual outcomes associated with phacoemulsification surgery in alpacas. ANIMALS: Five alpacas (nine operated eyes). PROCEDURES: Medical records of alpacas with a clinical diagnosis of cataracts that received elective phacoemulsification surgery at Cornell University over a 15 year period were reviewed. RESULTS: The mean (± standard deviation) age of the five operated alpacas was 104 days (±64 days). The cataracts were suspected to be congenital in all alpacas. Concurrent congenital ocular abnormalities were common in the operated eyes and included microphakia, persistent patent hyaloid arteries, and persistent patent tunica vasculosa lentis. No significant intraoperative complications were identified in any cases. In the immediate postoperative period, uveitis was mild-to-moderate in most operated eyes, ocular hypertension was not detected, and clinically significant corneal edema did not occur in any eyes. The mean (± standard deviation) duration of clinical follow-up after surgery was 32 months (±25 months). A peri-incisional corneal stromal ulcer associated with fibrinous uveitis was identified in a single eye during recheck examination 4 weeks postoperative that resolved with medical therapy. Long-term complications included unilateral glaucoma in two alpacas that resulted in vision loss. On the final recheck ophthalmic examination, 78% (7 of 9) of operated eyes were visual and all operated alpacas had vision in at least one operated eye. CONCLUSIONS AND CLINICAL RELEVANCE: In this series, the visual outcomes associated with elective phacoemulsification surgery in alpacas were good. Glaucoma was the most common vision-threatening long-term postoperative complication.

Analgesic effect of topical and subconjunctival morphine in dogs after phacoemulsification: A pilot study.

OBJECTIVE: To determine the efficacy of a single treatment of topical and subconjunctival 0.1% preservative-free morphine sulfate (PFMS) in providing analgesia following phacoemulsification in dogs. ANIMALS STUDIED: Ten diabetic and ten non-diabetic client-owned dogs treated with bilateral phacoemulsification. PROCEDURES: A prospective, randomized, masked, negative-controlled clinical trial was performed. All dogs received topical (0.2 mL) and subconjunctival (0.1 mL) 0.1% PFMS in one eye following phacoemulsification. The other eye received an equal volume and mode of administration of balanced salt solution (BSS). Ophthalmic examination, blinking rates, tearing, conjunctival hyperemia, aqueous flare, and central corneal esthesiometry (CCE) were evaluated in all eyes 1 day prior to surgery and at 4, 24, and 48 hours after surgery. Complete physical examination, ocular ultrasound, electroretinogram, hemogram, and serum biochemistry panel were performed in all dogs prior to phacoemulsification. All dogs received the standard of care treatment before and after surgery, including uniform anesthetic protocol. RESULTS: Baseline ophthalmic exams were unremarkable, except for the presence of cataracts, in all dogs. The mean CCE (±SD) at 4 hours post-operatively was 1.76 ± 1.27 g/mm2 and 1.85 ± 1.5 g/mm2 for the negative control and PFMS groups, respectively. There were no statistical differences in blepharospasm, conjunctival hyperemia, tearing, aqueous flare, blinking rates, CCE, or intraocular pressure (IOP) between the treatment groups for any of the time points for the non-diabetic and diabetic dogs, or for all dogs combined (P > .05). CONCLUSIONS: Topical and subconjunctival 0.1% PFMS did not affect the evaluated parameters after phacoemulsification in the study dogs at the timepoints assessed.

Clinical and diagnostic evaluation of intraocular expulsion of a corneal epithelial inclusion cyst in a dog.

CASE DESCRIPTION: An 8-year-old spayed female mixed-breed dog was presented for evaluation of an axial, raised, vascularized, lightly pigmented 3 mm diameter corneal lesion affecting the left eye (OS) that was present since adoption three years prior to presentation. The presumed cyst ruptured into the anterior chamber 5 months following initial presentation with progressive extrusion of intralesional contents into the anterior chamber. High-frequency ultrasound and in vivo confocal microscopy revealed minimal normal stroma posterior to the corneal lesion. Due to the lack of stroma, a deep anterior lamellar keratoplasty (DALK) was attempted using the viscodissection technique. While separating the stroma from Descemet's membrane, a tear in the membrane was observed, and the procedure was converted to a penetrating keratoplasty (PK). The mass was excised en bloc, and a frozen corneal allograft and conjunctival pedicle graft were utilized to restore corneal thickness. The extruded material was irrigated out of the anterior chamber and submitted for culture and cytology. There was no growth on aerobic, anaerobic, or fungal cultures, and cytology revealed mixed neutrophilic and macrophagic inflammation with keratinizing squamous epithelium. Histopathology identified the mass to be a corneal epithelial inclusion cyst lined with well-differentiated stratified squamous epithelium. The dog is doing well 10 months post-operatively with no signs of recurrence along with good comfort and vision.

Ocular dermoids in dogs: A retrospective study.

OBJECTIVE: To describe clinical features of dogs diagnosed with ocular dermoids at two veterinary teaching hospitals. ANIMALS STUDIED: Retrospective case series of 44 dogs (49 dermoids) with ocular dermoids. PROCEDURES: Medical records of dogs evaluated by the Cornell University and University of Pennsylvania ophthalmology services were evaluated to identify dogs with a clinical diagnosis of ocular dermoids between 2004 and 2018, and 2011 and 2018, respectively. Signalment, historical, and clinical details were recorded, including dermoid location, concurrent diseases, treatment, histopathologic findings, and outcome. RESULTS: A total of 49 ocular dermoids, involving 47 eyes, were diagnosed in 44 dogs. The mean ( standard deviation) age of the study population at the time of diagnosis was 1.19 years (1.85 years). Of the 44 dogs evaluated, 28 (63.6%) were male and 30 (68.2%) were intact at time of diagnosis. Twenty-two different breeds were represented in the study, with mixed breed, French Bulldog, and Shih Tzu being the most common. Twenty-two dermoids were categorized as limbal (44.9%), 14 as eyelid (28.6%), eight as corneal (16.3%), and five as conjunctival (10.2%). Concurrent ocular findings were noted in 29 of the 47 eyes (61.7%), including corneal pigmentation, epiphora, and conjunctival hyperemia. Nine dogs (20.5%) suffered from concurrent systemic disease, with the majority being cardiac in origin. A total of 34 dermoids (69.4%) were surgically excised with no recurrences. CONCLUSIONS: Ocular dermoids are an uncommon condition in dogs. Concurrent congenital cardiac disease was relatively common in the dogs of this study. Surgical excision of dermoids was curative.

Lipemic uveitis and its etiologies in dogs: 75 cases.

OBJECTIVE: To describe clinical features of dogs with lipemic uveitis (LU). ANIMALS STUDIED: Seventy-five dogs (114 eyes) with LU. PROCEDURES: Medical records of dogs examined by the Cornell University ophthalmology service with a clinical diagnosis of LU between 2008 and 2017 were analyzed. Signalment and clinical case aspects, including concurrent ocular disease, systemic disease, and previous ophthalmic surgery, were recorded. RESULTS: Lipemic uveitis was diagnosed in 114 eyes of 75 dogs. The mean (±standard deviation) age of dogs was 9.0 years (±2.7 years). Miniature Schnauzers and Yorkshire Terriers were statistically overrepresented compared to the ophthalmology canine referral population. Lipemic flare varied in severity with loss of menace response due to markedly opaque flare seen in 15/114 eyes (13%). Two dogs developed LU after dietary indiscretion. Forty-nine eyes (43%) had concurrent ocular disease, most commonly keratoconjunctivitis sicca, ulcerative keratitis, and cataracts. Pseudophakia was present in 75/114 eyes (66%) and LU developed within 30 days of an intraocular surgical procedure in 63/114 eyes (55%). Hypertriglyceridemia was noted in 52 dogs of the 55 dogs tested (95%). Systemic disease affected 54/75 dogs (72%), of which diabetes mellitus, hyperadrenocorticism, and hypothyroidism were overrepresented compared to the referral population. Primary hyperlipidemia was identified in 12 dogs. Lipemic uveitis resolved at first reevaluation in 92/110 eyes (84%) and recurred in 6/114 eyes (5%) after complete resolution. CONCLUSIONS: Development of lipemic uveitis in dogs appears to require the combination of hyperlipidemia and uveitis. Systemic disease is commonly associated with LU in dogs.

Incidence and characteristics of acute-onset postoperative bacterial and sterile endophthalmitis in dogs following elective phacoemulsification: 1,447 cases (1995-2015).

OBJECTIVE To characterize and determine the incidence of acute-onset (ie, developing ≤ 6 weeks after surgery) postoperative infectious and sterile endophthalmitis in dogs following elective cataract surgery. DESIGN Retrospective case series. ANIMALS 2,630 eyes of 1,447 dogs that underwent elective unilateral or bilateral cataract surgery by phacoemulsification at Cornell University from 1995 through 2015. PROCEDURES Medical records were reviewed to collect and summarize data regarding dog signalment, clinical findings, diagnostic test results, surgery characteristics, eye or eyes affected, concurrent major systemic diseases, treatments, and clinical outcome. RESULTS Infectious endophthalmitis developed in 4 eyes of 4 dogs during the follow-up period, representing 0.15% of eyes and 0.28% of dogs that underwent surgery. Unilateral sterile endophthalmitis developed in 3 (0.11%) eyes of 3 (0.21%) dogs. All cases of infectious endophthalmitis were unilateral and in pseudophakic eyes and followed bilateral cataract surgeries. Clinical signs consistent with infectious endophthalmitis developed a median of 18 days after surgery and included marked and progressive hypopyon; Staphylococcus or Streptococcus spp were recovered from aqueous and vitreous humor samples. All eyes with infectious endophthalmitis responded poorly to medical treatment and were enucleated. In 2 eyes with infectious endophthalmitis, corneal incision nonunion with epithelial downgrowth was identified histologically and postulated as the route of bacterial entry into the globe. CONCLUSIONS AND CLINICAL RELEVANCE Bacterial endophthalmitis following elective phacoemulsification was uncommon in the dogs of this study. Introduction of bacteria into the eye may occur during surgery or in the postoperative period from corneal incisions that fail to heal normally.

Capnocytophaga keratitis in dogs: clinical, histopathologic, and microbiologic features of seven cases.

OBJECTIVE: To describe the clinical, microbiologic, and histopathologic features of Capnocytophaga keratitis in dogs. ANIMALS STUDIED: Seven dogs with naturally acquired Capnocytophaga keratitis. PROCEDURES: Medical records of dogs with a clinical diagnosis of keratitis and corneal cultures positive for Capnocytophaga spp. were reviewed. Dog signalment, medical history, clinical findings, and diagnostic assay results were recorded. RESULTS: Breeds included Boston terrier (n = 3 dogs), Rat terrier (n = 2), and single cases of mixed breed and Pug. All dogs examined had expansive corneal ulceration involving the majority of the corneal surface. Marked corneal infiltrates, keratomalacia, and hypopyon were present. Progression of corneal disease was rapid with extensive dissolution of the corneal stroma. Corneal lesions progressed to catastrophic perforations within 24 h of the initial examination in three dogs, requiring enucleation. One globe was enucleated after failure to resolve with long-term medical therapy. Globes and vision were retained in three dogs following aggressive medical therapy (two dogs) or 360° conjunctival graft surgery (one dog). Capnocytophaga cynodegmi, Capnocytophaga canimorsus, or unspeciated Capnocytophaga spp. were cultured from corneal samples of all dogs. Long, thin, gram-negative rods were present during cytological evaluation of the cornea in some dogs. Histopathologic evaluation of enucleated globes revealed severe and diffuse neutrophilic and collagenolytic keratitis. CONCLUSIONS: Capnocytophaga keratitis is a severe, rapidly progressive corneal infection in dogs that is associated with diffuse corneal involvement, extensive keratomalacia, and a relatively poor prognosis. Clinical features of canine Capnocytophaga keratitis are similar to human cases of this infection.

Punctate retinal hemorrhage and its relation to ocular and systemic disease in dogs: 83 cases.

OBJECTIVE: To describe clinical aspects of dogs with punctate retinal hemorrhage (PRH). ANIMALS STUDIED: 83 dogs (119 eyes) with PRH. PROCEDURES: Medical records of dogs evaluated by the Cornell University ophthalmology service with a clinical diagnosis of PRH between 2006 and 2015 were reviewed. For this study, PRH was defined as retinal hemorrhages ≤ 1 optic disk diameter in size and dogs with other posterior segment ocular diseases were excluded. Signalment and clinical features of the dogs were recorded, including concurrent ocular and systemic diseases. RESULTS: Punctate retinal hemorrhage was identified in 119 eyes of 83 dogs. The mean (±standard deviation) age of dogs was 10.0 (±3.8) years. Mixed-breed dogs, Golden Retrievers, Jack Russell Terriers, and English Springer Spaniels were statistically overrepresented relative to the ophthalmology service canine referral population during the same period. Hemorrhages were found in all retinal locations and varied in number. Concurrent ocular disease was present in 78 eyes (66%) including keratoconjunctivitis sicca, uveitis, and cataracts. Fifty dogs (60%) suffered from concurrent systemic disease and diabetes mellitus, multiple myeloma, and systemic hypertension were statistically overrepresented in the PRH population. Less frequently, other serious systemic diseases were present in dogs with PRH including immune-mediated thrombocytopenia, leptospirosis, metastatic neoplasia, and thromboembolic disease. CONCLUSIONS: The risk of PRH in dogs may be increased by certain ocular and systemic diseases. As the presence of PRH can be associated with underlying systemic disease in dogs, it may prompt further clinical investigation and diagnostics.

In vivo confocal microscopy for detection of subconjunctival Onchocerca lupi infection in a dog.

A seven-year-old male castrated mixed-breed dog was diagnosed with bilateral subconjunctival masses. In vivo confocal microscopy facilitated visualization of Onchocerca lupi adult nematodes and their characteristic cuticular morphology. Long, thin, white nematodes were extracted during excisional biopsy. Histopathologic and parasitologic evaluation confirmed the diagnosis of O. lupi. In addition to surgical debulking of the parasitic granulomas, the dog received systemic doxycycline, prednisone, and ivermectin therapy. In vivo confocal microscopy was repeated one year after initial diagnosis, and no remaining nematodes were visible. To the authors' knowledge, this is the first report of use of in vivo confocal microscopy as a noninvasive diagnostic and monitoring tool for canine onchocerciasis.

Phacoemulsification of bilateral mature cataracts in a Texas rat snake (Elaphe obsoleta lindheimeri).

CASE DESCRIPTION A 10-year-old sexually intact male client-owned Texas rat snake (Elaphe obsoleta lindheimeri) was referred for evaluation because of a 5-month history of progressive bilateral ocular opacities and abnormal behavior. CLINICAL FINDINGS On ophthalmic examination, the snake had bilateral mature cataracts and uveal cysts. No additional ophthalmic or physical abnormalities were detected. Results of CBC, serum biochemical analysis, and ocular ultrasonography were unremarkable. TREATMENT AND OUTCOME Bilateral spectaculotomy was performed, followed by bilateral phacoemulsification and uveal cyst aspiration, without complication. Histologic evaluation of the phacoemulsified lens material revealed only nonspecific findings associated with cataractogenesis. Vision was restored and the abnormal behaviors resolved after cataract surgery. Long-term follow-up examination performed 60 weeks after surgery revealed no additional ocular or physical abnormalities. CLINICAL RELEVANCE The ocular anatomic and physiologic characteristics of snakes can pose intraoperative and postoperative challenges to phacoemulsification, but the outcome achieved for this surgical case suggested that successful cataract surgery is possible in these species. This case further demonstrated that cataracts may be associated with reversible behavioral abnormalities in captive snakes.

Intracorneal stromal hemorrhage in dogs and its associations with ocular and systemic disease: 39 cases.

OBJECTIVE: To describe clinical features of dogs diagnosed with stromal intracorneal hemorrhage (ICH). ANIMALS STUDIED: Retrospective case series of 39 dogs (44 eyes) with ICH. PROCEDURES: Medical records of dogs evaluated by the Cornell University ophthalmology service were searched to identify animals with a clinical diagnosis of ICH between 2005 and 2014. Signalment and clinical details, including concurrent ocular disease, concurrent systemic disease, diagnostic tests performed, outcome of hemorrhage, presenting client complaint, and treatment, were recorded. RESULTS: Intracorneal hemorrhage was identified in 44 eyes of 39 dogs. The mean (±standard deviation) age of dogs was 11.5 years (±2.8 years). The Bichon Frise breed and older dogs were statistically over-represented relative to the entire ophthalmology service canine referral population during the same time period. Concurrent ocular disease was present in 40 eyes (91%) and included keratoconjunctivitis sicca, cataracts, and corneal ulcers. Twenty-three dogs (59%) suffered from concurrent systemic disease, most frequently diabetes mellitus, hyperadrenocorticism, hypothyroidism, and systemic hypertension. Less commonly, life-threatening systemic conditions were identified in dogs with ICH including immune-mediated hemolytic anemia, immune-mediated thrombocytopenia, metastatic neoplasia, and sepsis. Intracorneal hemorrhage was found in all corneal locations, and corneal vascularization was present in each affected eye. CONCLUSIONS: Intracorneal hemorrhage is an uncommon condition in dogs that occurs in association with corneal vascularization. The risk of ICH may be increased due to certain ocular and systemic diseases. Although uncommon, ICH may also be an ocular manifestation of severe immune-mediated, infectious, and neoplastic systemic diseases in dogs.

Infectious crystalline keratopathy in dogs and cats: clinical, in vivo confocal microscopic, histopathologic, and microbiologic features of eight cases.

OBJECTIVE: To describe clinical, in vivo confocal microscopic, histopathologic, and microbiologic features of canine and feline cases of infectious crystalline keratopathy (ICK). ANIMALS STUDIED: Six dogs and two cats with naturally acquired ICK. PROCEDURES: Medical records of dogs and cats with a clinical diagnosis of ICK were reviewed. Signalment, medical history, clinical findings, and diagnostic evaluations were retrieved, including corneal cytology, histopathology, in vivo confocal microscopy, and microbiology results. RESULTS: All animals presented with fine, needle-like, and branching white crystalline anterior stromal opacities emanating from corneal facets or corneal epithelial defects. Mild conjunctival hyperemia and anterior uveitis were frequently present. Concurrent ocular and systemic diseases were common, including keratoconjunctivitis sicca, corneal sequestrum, diabetes mellitus, hyperadrenocorticism, and malignant neoplasia. Bacteria, with minimal or absent leukocytes, were identified by cytology and histopathology. Histopathologically, the crystalline corneal opacities corresponded with dense accumulations of bacteria present in the interlamellar stromal spaces and forming cord-like projections within the stroma. In vivo confocal microscopy demonstrated deposits of reflective crystalline or amorphous structures within the stroma with a paucity of associated inflammatory changes. The most frequently cultured bacteria were alpha-hemolytic Streptococcus and Staphylococcus species. Resolution of clinical lesions was achieved in most cases with long-term medical or surgical therapy; however, the initiation of medical treatment was associated with an acute, dramatic onset of severe keratitis and anterior uveitis in some animals. CONCLUSIONS: Infectious crystalline keratopathy in dogs and cats shares many features with this condition in human patients. Prolonged medical therapy, or surgical intervention, is required for resolution.