What’s Your Diagnosis ?
1. Case Study:
Buddy, a four year old, MN Golden Retriever presents for chronic redness
OS. Previous therapy includes Tobramycin BID for 14 days, with no
improvement.
Findings:
Sclera OS: raised, 5 mm red mass at lateral limbus
Cornea OS: limbal edema at lateral canthus
Diagnosis:
Nodular Granulomatous Episclerokeratitis (NGE) is an immune mediated
disease affecting the sclera and commonly the cornea. Lesions often appear as raised
red nodules over the sclera and/or cornea. Corneal edema and lipid dystrophy may
be seen as well. This disease can progress to involve the entire cornea and sclera,
leading to visual deficits, secondary glaucoma and uveitis. This disease cannot be
cured but it can be managed with the use of topical and oral anti-inflammatory and
immune-modulating medications.
2. Case Study:
Martin, a twelve year old MN DSH, presents for sudden blindness.
Findings:
Reflexes OD: direct and indirect PLR -, menace +, dazzle Reflexes OS: direct and indirect PLR -, menace +, dazzle Iris OD: fixed and dilated pupil
Iris OS: fixed and dilated pupil
Fundus OD: grey subretinal changes surrounding optic nerve
Fundus OS: grey subretinal changes surrounding optic nerve, inactive
chorioretinal scarring medial to the optic disc
Physical Examination: Elevated respiratory rate – 46 bpm. Able to navigate
but circling to the right.
Diagnosis:
Angioinvasive Pulmonary Carcinoma with metastasis to the retina. This
disease is not common in cats, but is a rule out for chorioretinal changes on
exam. Typical presentations includes retinal changes with or without sudden
blindness. Metastasis to the digits is also commonly seen. Thoracic radiographs
and full work up are recommended. Referral to oncologist is the next step.
Prognosis is poor.