Diagnosis, management, and outcome of an intralenticular foreign body in a dog: A case report.

Background: Intra-lenticular foreign bodies are rare in veterinary medicine and uncommon in human medicine. Approximately 50% of perforating ocular injuries in canines have lenticular involvement. Treatment choices include conservative management and surgical options. Retained intra-lenticular foreign body with delayed removal has not been reported in animals. Case Description: A 3-year-old male neutered Lurcher presented with right-sided ocular discomfort and a sealed full-thickness corneal perforation. The full ophthalmic examination could not be performed at the initial presentation due to miosis. Recrudescence of anterior uveitis was seen post-drug cessation. Re-evaluation of the eye with a mydriatic pupil revealed an intra-lenticular foreign body. Surgical removal via phacoemulsification was performed 8 weeks after the initial perforating injury. The eye remains visual, comfortable, and normotensive 50 months post-operatively. Conclusion: This is the first report of an encapsulated, retained intra-lenticular foreign body with delayed removal in a dog. Mydriasis and repeat examinations are of crucial importance when evaluating eyes post-perforation.

Eye trauma from a cat scratch with retention of the claw in the anterior chamber in a dog.

Background: Cat scratches and ocular foreign bodies are frequent reasons for consultation in veterinary ophthalmology. Case Description: We here present an unusual case combining trauma to the cornea and lens by a cat scratch with retention of the claw in the anterior chamber. Management consisted of the removal of the claw, reconstruction of the cornea, and mechanized ablation of the lens by phacoemulsification with implantation of an artificial lens. Conclusion: The progression during the follow-up period was considered satisfactory, with positive responses to visual tests and intraocular pressure within the norms. Only dyscoria and a tear of the endothelium and Descemet membrane, secondary to the trauma, remained.

The Role of Environmental Factors in the Epidemiology of Infectious Bovine Keratoconjunctivitis.

Environmental factors that contribute to the pathogenesis of infectious bovine keratoconjunctivitis (IBK) include face flies, ultraviolet (UV) radiation, and mechanical irritation from plant awns or dust. Limited research has shown face fly control to be associated with lower incidence of IBK. UV radiation is known to cause corneal irritation and damage in mammalian species. The increased formation of corneal dark cells has been observed following UV radiation in exposed calves. Moraxella bovis preferentially binds to corneal dark cells where it can be found in pits, which may be formed due to bacterial contact. Little is known about the efficacy of management of pasture plants on the prevention of IBK.

Migration of retrobulbar wooden foreign body between diagnostic imaging and surgical extraction in a German shepherd dog.

A 2-year-old, male castrated German shepherd dog was presented to the University of Tennessee Veterinary Medical Center (UTVMC) with periorbital swelling and conjunctival mucopurulent discharge 2 days following removal of a twig from the medial canthus by the owner. Diagnostic imaging was pursued due to the suspicion of a retrobulbar foreign body (FB). A cylindrical FB approximately 3.0 cm in length and 1.0 cm in diameter with concentric rings, suspected to be wooden material, was identified on computed tomography (CT) imaging. An attempt to remove the FB via a stab incision using ultrasound guidance was unsuccessful, and postmanipulation ultrasound confirmed the FB position was unchanged. An exploratory orbitotomy was performed, using the acquired CT images for guidance in locating the FB; however, the FB was not present at the predicted site. The CT imaging was repeated and showed that the FB had migrated rostrally approximately 3.0 cm, compared to the originally acquired study and its same location during attempted ultrasound-guided removal. A combination of CT-guided needle placement and contrast injection was then used with repeat imaging in an attempt to better localize the FB and its soft tissue tract. The dog was taken back into the operating room, and the wooden FB was successfully removed.

Tarantula Hair Keratoconjunctivitis with Concurrent Fungal Infection in a Rat Terrier.

A 9 yr old rat terrier presented with corneal ulceration and conjunctivitis that developed acutely after digging among dry leaves in wooded northern Arizona. Ophthalmic examination revealed multiple linear foreign bodies throughout the adnexal tissue and cornea of the left eye. Manual removal of material was unsuccessful. The palpebral conjunctiva required excision with tenotomy scissors to remove structures and allow corneal healing. Microscopic examination revealed structures believed to be setae from a Theraphosidae tarantula. This was confirmed morphologically by an entomologist and by comparison with hairs from a captive spider of the suspected species. The excised tissue also contained fruiting bodies, hyphae, and microconidia consistent with Aspergillus spp. The captive spider hairs also cultured positive for Aspergillus, suggesting a relationship between this fungus and tarantulas in captivity and in their native habitat. This is the first report in the veterinary literature to confirm tarantula hair as the causative agent in keratoconjunctivitis and corneal ulceration, adding it to the list of differential diagnoses for ocular foreign body. This is also the first report to suggest a relationship between Aspergillus and tarantulas of the Theraphosidae family, which should be considered in the diagnostics and treatment of patients with suspected tarantula hair keratoconjunctivitis.

Corneal and anterior segment foreign body trauma in dogs: a review of 218 cases.

OBJECTIVES: To review clinical data on dogs that suffered a corneal and anterior segment foreign body (CASFB) trauma and to determine the risk factors for foreign body (FB) trauma and subsequent enucleation. ANIMALS STUDIED: Dogs with CASFB presented to the Animal Health Trust (AHT) from January 2000 to December 2012. PROCEDURES: Clinical data for CASFB cases were compared to those available for the remaining AHT ophthalmic population over the same period. The depth of the FB trauma was divided into five categories. The type of FB and method of removal were described for each category. The degree of secondary uveitis and lens involvement was graded and correlated with subsequent enucleation. RESULTS: The mean age (standard deviation) of 218 identified CASFB cases was 3.96 (2.95) years. Risk factors for CASFB trauma were dogs younger than 5 years, English Springer Spaniels, Labrador Retrievers, and working dogs. Most dogs required general anesthesia for FB removal, and hypodermic needles were the most commonly used instrument. The lens was involved in some cases with a full-thickness CASFB trauma (n = 49, 45%), but most suffered a minor lens trauma (n = 37, 76%). The lens trauma and phacoclastic uveitis were managed medically in most dogs (n = 37, 76%), and phacoemulsification was only elected as initial treatment in some dogs (n = 10, 20%). Enucleation was required overall in 6% of dogs. Statistically significant associations were found between enucleation and depth of FB trauma, degree of uveitis, and severity of lens trauma (P < 0.001). CONCLUSIONS: Young dogs, English Springer Spaniels, Labrador Retrievers, and working dogs had an increased risk of CASFB trauma. Risk factors for enucleation were full-thickness FB penetration, severe lens trauma, and severe uveitis.

Retrobulbar lymphoma associated with a ballistic foreign body in a cat.

A seven-year-old domestic shorthair cat, adopted 5 years previously with a corneal perforation of the left eye, was presented for investigation of a left orbital mass. Computed tomography revealed a metallic foreign body within a contrast-enhancing, heterogeneous orbital mass. Large cell lymphoma was diagnosed from a fine needle aspirate. The cat staged negatively and was treated with L-asparaginase, prednisolone and three fractions of radiation therapy. A rapid clinical remission was obtained and the cat remained in remission for 3 years after therapy. This is the first report of large cell lymphoma likely occurring secondary to a foreign body.

Corneal Emergencies.

Corneal emergencies can be due to a number of different causes and may be vision threatening if left untreated. In an attempt to stabilize the cornea, it is of benefit to place an Elizabethan collar on the patient to prevent further corneal damage. This article discusses the diagnosis, prognosis, and management of corneal emergencies in dogs and cats.

Use of hydropulsion for the treatment of superficial corneal foreign bodies: 15 cases (1999-2013).

OBJECTIVE: To describe the use of hydropulsion with sterile isotonic buffered ophthalmic solution (ie, eyewash) for the treatment of superficial corneal foreign bodies in veterinary patients and evaluate signalment, clinical findings, and outcomes following the procedure. DESIGN: Retrospective case series. ANIMALS: 11 dogs, 2 cats, and 2 horses. PROCEDURES: Medical records were retrospectively reviewed to identify patients that underwent hydropulsion treatment for a superficial, nonpenetrating corneal foreign body confirmed by ophthalmic examination. Data regarding signalment, reason for evaluation, ocular diagnoses, and treatment were recorded. Hydropulsion was performed with a 6-mL syringe filled with eyewash solution and a 25-gauge needle with the needle tip removed. Owners and referring veterinarians of patients that did not have a recheck examination recorded were contacted by telephone for follow-up information. RESULTS: The corneal foreign body was an incidental finding in 3 of 15 patients. The most common clinical signs included blepharospasm, conjunctival hyperemia, and corneal vascularization. Hydropulsion was successful for foreign body removal in all 15 cases. No complications were observed during or following the procedure. In the 9 patients that had a follow-up examination, the cornea tested negative for retention of topically applied fluorescein (with a mean of 6.3 days from treatment to follow-up). At the time of last follow-up examination or telephone follow-up, no patients were reported to have clinical signs of ocular discomfort or corneal opacity associated with the affected site. CONCLUSIONS AND CLINICAL RELEVANCE: In these patients, hydropulsion was easily performed with readily available materials and was successful for the removal of superficial corneal foreign bodies with no adverse effects.

In vivo confocal microscopy of corneal microscopic foreign bodies in horses.

OBJECTIVE: To describe in vivo corneal confocal microscopy of horses with microscopic corneal foreign bodies and to correlate findings with clinical, cytological, and histopathologic evaluations of clinical cases and foreign body morphologies observed in vitro with the confocal microscope. ANIMAL STUDIED: Five horses with microscopic corneal foreign bodies. PROCEDURES: Sedated and anesthetized horses were examined with a modified Heidelberg Retina Tomograph II and Rostock Cornea Module. Confocal microscopy images were compared with images from cytologic and histopathologic corneal samples. To establish microscopic morphologic features, confocal microscopy images of burdock pappus bristles and surgical glove powder were obtained by in vitro examination. RESULTS: Horses were examined by in vivo confocal microscopy to assist in identifying corneal opacities detected by slit-lamp biomicroscopy, to determine the etiology of clinically idiopathic keratitis, or to localize corneal opacities presumed to be foreign bodies for surgical planning. Corneal foreign bodies presumptively identified by confocal microscopy included burdock pappus bristles, other plant foreign materials, and surgical glove powder. The corneal foreign bodies appeared as moderately or hyper-reflective linear, circular, or oval structures by confocal microscopy and did not resemble any normal anatomic structures. The confocal microscopic identification of the foreign bodies was corroborated by cytologic and histopathologic findings in some horses. The in vivo confocal microscopic appearance of the foreign bodies was consistent with morphologies observed during examination of foreign bodies in vitro. CONCLUSIONS: In vivo corneal confocal microscopy provides a noninvasive method for the detection, characterization, and localization of microscopic foreign bodies in the equine cornea.

Identification of a periorbital wooden foreign body as the cause of chronic ocular discharge in a horse.

The clinical, diagnostic and therapeutic features of a horse with a wooden foreign body embedded in the deep portion of the right masseter muscle adjacent to the right orbit are presented. The purpose of this report is to describe the clinical presentation, magnetic resonance imaging findings and treatment of a penetrating wooden foreign body in a horse that had no history of trauma or evidence of a puncture wound. This report documents the usefulness of magnetic resonance imaging to detect a wooden foreign body embedded in the soft tissues of a horse with a chronic copious ocular discharge. Two surgical procedures were necessary, which is a frequent complication encountered with wooden foreign bodies.

Conjunctivitis and ulcerative keratitis secondary to conjunctival plant foreign bodies in a herd of alpacas (Lama Pacos).

PURPOSE: To describe six cases of conjunctivitis and ulcerative keratitis secondary to plant foreign bodies from weed-contaminated grass hay which were lodged within the temporal conjunctival fornix in a herd of alpacas. METHODS: A total of 21 alpacas from the same farm developed blepharospasm and mucopurulent ocular discharge. Six of the 21 were evaluated at the University of Tennessee College of Veterinary Medicine within a 2-week period. The six animals evaluated received an ophthalmic examination including slit-lamp biomicroscopy, fluorescein staining, and topical corneal anesthesia for foreign body removal when necessary. RESULTS: Six animals had conjunctivitis characterized by hyperemia and mucopurulent discharge. Five animals had superficial ulcerative keratitis with intense corneal neovascularization and edema. In all cases, the keratitis was located at the temporal limbus. Seven plant foreign bodies were observed and were removed following topical corneal anesthesia in five animals. The plant seeds were identified as three common weed species found in orchard grass hay. Complete resolution of all clinical signs was achieved with foreign body removal and medical therapy. CONCLUSIONS: Fan-shaped temporal corneal ulcers may signify the presence of conjunctival foreign bodies in alpacas. Plant foreign bodies should be considered in addition to ocular infection when multiple animals of a herd are affected as outbreaks may occur with weed-contaminated hay.

Scleral and suprachoroidal foreign body in a dog--a case report.

A 2-year-old male castrated Springer Spaniel with a 3-week history of waxing and waning right sided exophthalmos, periorbital swelling, chemosis, and fundic changes was examined. Ophthalmic examination of the right eye revealed slight chemosis and nictitating membrane protrusion. Indirect ophthalmoscopy showed an approximately 8 mm peripapillary hyporeflective tapetal lesion with subretinal edema consistent with a bulbar/retrobulbar disease process. Inflammatory or neoplastic diseases were the main differential diagnoses. Ancillary diagnostics (ocular ultrasound and computed tomography) showed a focal, poorly defined dense tissue involving the caudomedial aspect of the right globe, adjacent to the optic nerve head without apparent orbital involvement. Considering the duration, location, and severity of the clinical findings, enucleation of the right globe was performed. Histopathology revealed focal thickening of the posterior wall with severe pyogranulomatous inflammation, surrounding a foreign body most consistent with plant material embedded between the sclera and the choroid (suprachoroidal). This report describes a rare case of a scleral/suprachoroidal foreign body (plant material), and outlines the difficulty of establishing an etiological diagnosis using standard ocular imaging.

C-arm fluoroscopy for the removal of an intraorbital foreign body in a cat.

This report describes the clinical manifestations, diagnosis and minimally surgical intervention of a cat with an intraorbital foreign body. A spayed female cat of unknown age was presented with a recurrent cutaneous sinus tract of the left suborbital region. The cat had not vocalized at all since the adoption. A sharp-edged radiopaque foreign body was visualized on dental radiography. Computed tomography outlined the length of the foreign body from the intraorbital soft tissue to the pharynx. The foreign body was removed under the guide of C-arm fluoroscope with minimal skin incision. The surgical site healed completely on the 11th postoperative day, and the cat vocalized normally after healing.