Management of corneal epithelial defects in a population of mature chuck-will's-widows (Antrostomus carolinensis) in South Florida.

PURPOSE: To describe ocular clinical findings, gross/histopathologic findings, and treatment regimens in a series of migratory chuck-will's-widows (Antrostomus carolinensis) (CWW) with corneal epithelial defects. METHODS: Seven CWW were presented to the South Florida Wildlife Center (SFWC). Four presented with bilateral (OU) corneal ulceration; two developed corneal ulceration OU; one had no ocular lesions. Treatment protocols for patients with corneal ulcers included the following: medical therapy only or medical therapy combined with an additional procedure. Four patients including the bird with no ocular lesions were euthanized, and one patient died. Their globes were submitted for histopathology. Two patients were released. RESULTS: Clinical findings prior to enucleation included superficial corneal ulceration with redundant epithelium persisting weeks to >1 month. On histopathology, epithelium in nonulcerated globes was remarkably thin; this was considered normal. Common histopathologic findings of ulcerated globes revealed epithelial and conjunctival attenuation with an acellular superficial stromal layer and hypercellular mid-stromal layer. One globe healed with medical therapy and cotton tip applicator debridement. Four globes healed by combination of medical therapy, equine amnion, nictitating membrane (NM) flap, and temporary tarsorrhaphy. No globes healed with diamond burr debridement or grid keratotomy. CONCLUSIONS: Factors that may be contributing to these corneal epithelial defects include, but are not limited to, normally thin epithelium, exposure keratopathy, neurotrophic disease, epithelial turnover and inadequate stem cell recruitment, inherited/genetic causes, and unidentified infectious agents (eg, viral etiologies). Of the 12 eyes treated, one healed with medical therapy/cotton tip applicator debridement, and four healed with medical therapy/equine amnion/nictitating membrane flap/temporary tarsorrhaphy.

Use of lidocaine-bupivacaine-infused absorbable gelatin hemostatic sponges versus lidocaine-bupivacaine retrobulbar injections for postoperative analgesia following eye enucleation in dogs.

OBJECTIVE: To compare use of lidocaine-bupivacaine-infused absorbable gelatin hemostatic sponges versus lidocaine-bupivacaine retrobulbar injections for postoperative analgesia in dogs following eye enucleation. DESIGN: Randomized case-control study. ANIMALS: 19 dogs that underwent eye enucleation. PROCEDURES: 19 client-owned dogs admitted to a referral hospital for routine eye enucleation were enrolled with owner consent and randomly assigned to receive an orbital absorbable gelatin hemostatic sponge infused with lidocaine and bupivacaine after globe removal (n = 8) or retrobulbar injection of lidocaine and bupivacaine before globe removal (11). Baseline pain scores were recorded on the basis of an ordinal pain scale. Anesthetic premedication consisted of hydromorphone, midazolam, and glycopyrrolate. Propofol was used for anesthetic induction and isoflurane for maintenance. A transpalpebral eye enucleation was performed by a board-certified ophthalmologist. Pain scores and heart rate were again recorded 15 and 30 minutes and 1, 2, 4, 6, 8, and 24 hours after extubation by trained observers masked to treatment groups. Dogs were given hydromorphone as rescue analgesia if the total pain score was ≥ 9 of 18 or any categorical pain score was ≥ 3 (on a scale from 0 to 3 or 0 to 4). RESULTS: There were significant differences over time for comfort level, response to touch, behavior, heart rate, and total pain score; however, there was no difference between treatment groups. One dog in the absorbable gelatin hemostatic sponge group required rescue hydromorphone 4 hours after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: The absorbable gelatin hemostatic sponge proved to be as effective in providing local analgesia for eye enucleation in dogs as the retrobulbar injections.

Ocular bacterial flora, tear production, and intraocular pressure in a captive flock of Humboldt penguins (Spheniscus humboldti).

The purpose of this study was to determine normal ocular surface bacterial flora, tear production, and intraocular pressure in a captive flock of Humboldt penguins, Spheniscus humboldti. Twenty-eight healthy penguins were studied and equally divided between fresh- and saltwater habitats. The population consisted of 15 female and 13 male penguins, ranging from 3-20 years of age. Following complete ophthalmic exam, 4 penguins with cataracts were removed from the study. Eight penguins from each habitat were randomly selected for ocular surface aerobic bacterial culture. Corynebacterium spp. and Staphylococcus spp. were the most common isolates. Twenty-five organisms consisting of 17 species, and 15 organisms consisting of 9 species, were identified in fresh- and saltwater groups, respectively. Tear production and intraocular pressures were evaluated on 24 penguins with normal ocular exams. The range and mean (+/- standard deviation) tear production, measured with the Schirmer tear test, was 1-12 mm/min and 6.45 mm/min +/- 2.9, respectively. The mean tear production for penguins housed in the freshwater habitat was greater (8.5 mm/min) than those in saltwater (4.8 mm/min). The range and mean (+/- standard deviation) intraocular pressure, measured by applanation tonometry using a Tono-Pen XL tonometer, was 10-27 mmHg and 20.36 mmHg +/- 4.1, respectively. This data should be utilized as a reliable resource for those involved in avian and zoo medicine.

Keratoconjunctivitis associated with Toxoplasma gondii in a dog.

A 12-year-old Pug presented with a 3-mm corneal mass OD. The dog was currently being treated for keratoconjunctivitis sicca (KCS) and pigmentary keratitis OU. A superficial keratectomy followed by cryotherapy was performed OD. A histopathologic diagnosis of epithelial dysplasia and suppurative keratitis was made and the lesion resolved. Two months later, a yellow/tan conjunctival mass, diffuse chemosis and conjunctival thickening was discovered OD. Necrotizing conjunctivitis with protozoal parasites was diagnosed with histopathology. Complete blood count and a serum biochemistry panel were normal. Neospora caninum and Toxoplasma gondii titers were negative. The conjunctivitis resolved after a 6-week course of oral clindamycin. Two months later, the patient presented with a similar conjunctival mass OS. Toxoplasma gondii was confirmed as the etiologic agent with immunohistochemical staining. Repeat T. gondii titers were negative. Oral clindamycin was re-instituted. The corneal biopsy was re-reviewed and protozoal organisms were discovered. Three months later, a recurrence was suspected and oral ponazuril was initiated for 28 days. There has been no evidence of recurrence since this treatment. Ocular toxoplasmosis is rare in the dog but reports have included episcleritis, scleritis, retinitis, anterior uveitis, ciliary epithelium hyperplasia, optic neuritis and polymyositis. To our knowledge, this is the first confirmed report of toxoplasmosis causing only corneal and conjunctival disease in the dog. We hypothesize that these localized lesions may be associated with topical immunomodulating therapy for KCS. Toxoplasmosis should be considered as a differential for canine conjunctivitis and corneal disease and has the potential to manifest in one or both eyes.