capsule equine lens problems cortexmedia.news.health.ufl.edu/misc/largeanimal/equine lens.pdfthe...
TRANSCRIPT
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Equine Lens Problems
Equine Ophthalmology Service
University of Florida
Capsule
Cortex Nucleus
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•The lens sits in the
patellar fossa of the
vitreous.
The horse has weak accommodation (< 2.0 D) to maintain a
focussed retinal image.
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Cataracts
Post-inflammatory
etiologies
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???
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ERU cataract/synechia
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Matt Stevens
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Multifocal lens with horizontal pupil
Zones of optical discontinuity
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Nuclear cataract
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Immature cataract
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Morgan horse hereditary nuclear cataract
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Whip injury
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Therapy for Uveitic Cataracts
Medical: Oral aspirin might delay cataract
formation in a few ERU horses
10 mg/kg q24h
Surgery: Only chance for vision
– Not easy
– Client must be educated about the risks and
benefits, and must have realistic expectations!
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Cataract Patient
Criteria healthy foals
(Rhodococcus free) and
adult horses
no uveitis
visual impairment
the personality to tolerate
topical therapy
Brisk PLRs and a dazzle
indicate a functional
retina.
US (RDs)
ERG (esp Appaloosas)
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ERG: Dark adapt 20
minutes
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ERG
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Light Stimulus
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X
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US: mature cataract
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US: posterior lens capsule rupture
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RD: “seagull” sign
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Lens fragments lying on retina.
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“Phaco”
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Phaco Surgical Procedure
• Paralysis with atracurium
• Scleral tunnel w/cautery
• CCC
• Standard SA needle; 15 mm
• Horse needle is 23 mm
• Machines
• Hylartin-V™ viscoelastic
• Mean phaco time: 10:05
minutes (range 4:32 – 15:49)
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Medications Postoperatively
Sulfas systemically for 5 days
Banamine (+/- omeprazole): several weeks
Topical Atropine: 2 weeks
Topical antibiotics: 2 weeks
Topical Prednisolone acetate: 1-3 months
Hospital stay: avg 8 days, range 3-15 days
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Phacoemulsification.
Success rate ~ 83-98%
initially in horses.
– Declines rapidly with time
due to capsuler scarring
and persistent uveitis
– 49% at one month (OSU)
– 44% at one year (TAMU)
– 39% at 18 months (UF)
Surgery is easiest in foals
and yearlings.
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Complications: corneal ulcers, persistent corneal edema and ulcers, glaucoma, hyphema, and infectious endophthalmitis – Vision is functional but the aphakic horse should be hyperopic
“far-sighted”
The aphakic equine globe is +9.9 D hyperopic (20/1200). – A 25 D IOL = +8.0 D
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IOL
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Intraocular Lenses (IOLs) in Horses
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Knotty06
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Lens Luxation in Horses
Anterior lens luxation
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Trauma from cross ties
Aphakic crescent
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X
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4 wks later
Lens subluxation
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Lens Cysts