|
|
| (11 intermediate revisions by the same user not shown) |
| Line 1: |
Line 1: |
| − | ==Introduction==
| |
| − |
| |
| − | Immune-mediated uveitis/recurrent uveitis/uveitis is a very important disease. It can be secondary to keratitis, but is common as a primary immune-mediated disorder. The
| |
| − | major problem is its tendency to recur, causing progressive loss of vision. This is the most common cause of blindness.
| |
| − |
| |
| − | The causative agent is unknown but several are implicated, such as ''Onchocerca'' and ''leptospira''. Regardless of the cause, the treatment is as for uveitis which gives effective, immediate results.
| |
| − |
| |
| − | ==Clinical Signs==
| |
| − |
| |
| − | * The acute stage is '''intensely painful''', showing excessive '''lacrimation and photophobia'''
| |
| − | * '''Corneal oedema''' is a characteristic finding
| |
| − | * '''Ciliary and conjunctival injection''' with '''peripheral corneal vascularisation''' is also seen
| |
| − | * More serious findings are '''aqueous flare and hypopyon'''
| |
| − | * '''Miosis''' is always present. Following repeated episodes there may be synechiae, which prevent papillary dilatation in response to mydriatics
| |
| − | * '''Chronic uveitis''' results in shrinking of the globe, cataracts and depigmentation of the fundus around the optic nerve
| |
| − |
| |
| − | ==Diagnosis==
| |
| − |
| |
| − | * If diagnosis is attempted, then '''routine blood tests''' should be run along with '''titres for [[:Category:Leptospiraceae|leptospirosis]] and [[:Category:Brucella species|brucellosis]], [[Equine Herpesvirus 1|equine herpes virus]], [[Strangles|strangles]] and [[Equine Viral Arteritis - Donkey|equine viral arteritis]].
| |
| − | * '''Conjunctival biopsy''' will diagnose the presence of ''Onchocerca''
| |
| − |
| |
| − | ==Treatment==
| |
| − |
| |
| − | '''Systemic [[Anti-Inflammatory Drugs|anti-inflammatory]] treatment is needed urgently''' to reduce the pain and inflammation. [[Steroids|Corticosteroids]] have been recommended and do work, but the risk of complications makes an [[NSAIDs|NSAID]], such as flunixin meglumine, the drug of choice.
| |
| − | * '''Flunixin meglumine''' is given every 12 hours for at least five days but should be continued until clinical signs resolve
| |
| − | * If [[NSAIDs]] need to be continued for a long period, then a transfer to '''phenylbutazone''' will reduce the risk of side effects
| |
| − | * '''Topical [[NSAIDs]]''' are effective in relieving pain short-term: flurbiprofen 0.03% or suprofen 1% ophthalmic solution
| |
| − | * '''Topical [[Steroids|corticosteroids]] are safer than systemic but must only be used if corneal integrity is 100%
| |
| − | * Whilst using [[Steroids|steroids]], '''regular fluorescein staining''' must be used to check for ulceration
| |
| − | * If uncomplicated immune-mediated uveitis is diagnosed with certainty, long term topical corticosteroids are recommended, e.g. four weeks
| |
| − | * Topical '''atropine drops''' (1-2%) should be applied hourly until mydriasis occurs and then twice daily until the acute inflammatory response has subsided, possibly for up to two weeks. Monitor for gut function as long-term atropine slows gut movement
| |
| − | * '''Cyclosporin''' 2% is an ocular immunomodulator, which can produce excellent results but only in about 50% of cases. It can be used to replace corticosteroids if corneal ulceration is present. A ten-day course given at twelve-hourly intervals is recommended
| |
| − |
| |
| − | ==Literature Search==
| |
| − | [[File:CABI logo.jpg|left|90px]]
| |
| − |
| |
| − |
| |
| − | Use these links to find recent scientific publications via CAB Abstracts (log in required unless accessing from a subscribing organisation).
| |
| − | <br><br><br>
| |
| − | [http://www.cabdirect.org/search.html?q=title%3A%28uveitis%29+AND+%28od%3A%28horses%29+OR+od%3A%28donkeys%29%29 Uveitis in horses or donkeys publications]
| |
| − |
| |
| − | ==References==
| |
| − |
| |
| − | * Grove, V. (2008) Conditions of the eye In Svendsen, E.D., Duncan, J. and Hadrill, D. (2008) ''The Professional Handbook of the Donkey'', 4th edition, Whittet Books, Chapter 11
| |
| − |
| |
| − |
| |
| | {{toplink | | {{toplink |
| | |backcolour = D1EEEE | | |backcolour = D1EEEE |
| − | |linkpage =Uveal Tract Diseases - Donkey | + | |linkpage =Eye Disorders - Donkey |
| − | |linktext =Uveal Tract Diseases - Donkey | + | |linktext =Eye Disorders - Donkey |
| | + | |rspace={{Donkey}} |
| | |pagetype=Donkey | | |pagetype=Donkey |
| | }} | | }} |
| − | {{infotable
| |
| − | |Maintitle = [[Sponsors#The Donkey Sanctuary|This section was sponsored and content provided by '''THE DONKEY SANCTUARY''']]
| |
| − | |Maintitlebackcolour = B4CDCD
| |
| − | }}
| |
| − | [[Category:Donkey]]
| |
| − | [[Category:Uveal Tract Diseases - Donkey]]
| |
