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  1. 1. Veterinary Ophthalmology MedVet/CVES Worthington, Ohio Amanda Rogers
  2. 2. <ul><li>MedVet/CVES is a specialty and 24-hour veterinary emergency care facility </li></ul><ul><li>With a staff of over 25 veterinarians, including over a dozen specialists </li></ul><ul><li>The largest private veterinary referral/emergency center in the Midwest </li></ul>
  3. 3. <ul><li>CVES operates as an emergency practice only </li></ul><ul><li>No routine veterinary preventative care is offered </li></ul><ul><ul><li>Vaccines </li></ul></ul><ul><ul><li>Heartworm or flea preventative </li></ul></ul><ul><ul><li>Yearly wellness exams </li></ul></ul>
  4. 4. <ul><li>MedVet operates on referrals only </li></ul><ul><ul><li>From your family veterinarian </li></ul></ul><ul><ul><li>From a CVES doctor </li></ul></ul><ul><ul><li>With difficult cases many private practice veterinarians refer their patients to a specialist for a more complete and diagnostic workup </li></ul></ul>
  5. 5. Veterinary Specialists <ul><li>Cardiology </li></ul><ul><li>Ophthalmology </li></ul><ul><li>Internal Medicine </li></ul><ul><li>Surgery </li></ul><ul><li>Radiology </li></ul><ul><li>Oncology </li></ul><ul><li>Neurology </li></ul><ul><li>Dermatology </li></ul><ul><li>Dentistry </li></ul><ul><li>Specialists are required to complete internship and residency programs typically 3 to 5 years. </li></ul><ul><li>Specialists receive board certification by fulfilling clinical training, research, scientific publications, and extensive examination. </li></ul>
  6. 6. Ophthalmology <ul><li>Entire focus is on prevention and treatment of ocular diseases </li></ul><ul><li>Most patients referred by their regular veterinarian </li></ul>
  7. 7. Initial Evaluation <ul><li>Pertinent ocular and related health history </li></ul><ul><li>■ Duration of problem </li></ul><ul><li>■ Medications presently, or recently, administered </li></ul><ul><li>■ Previous related ocular or systemic diseases </li></ul><ul><li>■ All pertinent information from your regular veterinarian is reviewed </li></ul>
  8. 8. Basic Examination <ul><li>■ Evaluations of vision:              Menace              Pupillary Light Reflexes </li></ul><ul><li>■   Ability to navigate in a room </li></ul><ul><li>■ Schirmer Tear Tests </li></ul><ul><li>■ Eye Stains              Fluorescein              Rose Bengal </li></ul><ul><li>■ Tonometry </li></ul><ul><li>■ Slit Lamp Examination </li></ul><ul><li>■ Ophthalmoscopy </li></ul>
  9. 9. Frequent Cases <ul><li>Glaucoma </li></ul><ul><li>Cataracts </li></ul><ul><li>Cherry eye </li></ul><ul><li>Ulcers </li></ul>
  10. 10. Glaucoma <ul><li>Intraocular pressures (IOP’s) are >20 mm Hg </li></ul><ul><li>This is a blinding disease </li></ul><ul><li>Caused by trauma or genetics </li></ul><ul><li>Lifelong treatment </li></ul>
  11. 11. Glaucoma <ul><li>Painful disease </li></ul><ul><li>Even with treatment most cases eventually result in the loss of one or both eyes </li></ul><ul><ul><li>Enucleation </li></ul></ul><ul><ul><li>ISP placement </li></ul></ul>
  12. 12. Enucleation <ul><li>An eye is completely removed due to an ocular disease or trauma to the eye </li></ul><ul><li>The lids are cut and sewn shut and the pet looks like it is “winking” </li></ul>
  13. 13. ISP <ul><li>An incision is made in the eye and the inner contents removed </li></ul><ul><li>A silicone ball is placed inside and the eye is sewn shut </li></ul>
  14. 14. ISP <ul><li>ISPs are placed for cosmetics only </li></ul><ul><li>The pet has no vision as a result from the implant </li></ul><ul><li>The outside of the eye is still subject to abrasion and disease </li></ul>
  15. 15. Cataracts <ul><li>The lens of one or both eyes becomes dense and the animal’s vision is restricted </li></ul><ul><li>Causes </li></ul><ul><ul><li>Diabetes </li></ul></ul><ul><ul><li>Heredity </li></ul></ul><ul><ul><li>Trauma </li></ul></ul><ul><ul><li>Retinal detachment </li></ul></ul>
  16. 16. Cataract screening <ul><li>Evaluation of candidacy </li></ul><ul><li>Ocular ultrasound </li></ul>
  17. 17. Cataract screening <ul><li>ERG tests for retinal function </li></ul><ul><li>If the retina in not functioning the patient will not see, even with the cataract removed </li></ul>
  18. 18. Cataract surgery <ul><li>The patient’s lens is removed </li></ul><ul><li>An artificial lens is placed for optimum vision </li></ul><ul><li>Patient is able to see immediately after surgery </li></ul>
  19. 19. “Cherry Eye” <ul><li>Genetically caused </li></ul><ul><li>Certain breeds have a high incidence </li></ul><ul><ul><li>Bulldogs </li></ul></ul><ul><li>Must be corrected surgically </li></ul><ul><li>Predisposes the patient to “dry eye” </li></ul>
  20. 20. Ulcers <ul><li>An abrasion to the eye </li></ul><ul><li>Many possible causes </li></ul><ul><li>The eye is stained to identify the extent of the ulcer </li></ul><ul><li>Most are treated medically, but some require surgery </li></ul>
  21. 21. Ulcers <ul><li>With deep ulcers the eye may rupture without surgical correction </li></ul>
  22. 22. Daily Activities <ul><li>Evaluate patients during appointments </li></ul><ul><li>Prepare animals for surgery </li></ul><ul><li>Monitor patients during procedures </li></ul><ul><li>Assist in surgical procedures </li></ul><ul><ul><li>Cataract surgery </li></ul></ul><ul><ul><li>ISP placement </li></ul></ul>
  23. 23. Experience <ul><li>Gained a tremendous amount of knowledge in veterinary ophthalmology </li></ul><ul><li>Formed contacts </li></ul><ul><li>Expanded veterinary school application </li></ul><ul><li>Experiences that many veterinarians don’t have </li></ul>