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Genetic diseases of sheep and goats.

Congenital malformations and inherited disorders constitute a substantial proportion of the afflictions seen in sheep and goats. Of these, malformations tend to be similar in both species, whereas the genetic diseases encountered to date, with the exception of a few, are different. Of the 28 genetic diseases of sheep and goats described in this review, 60% and 62.5%, respectively, are monogenic disorders. For a majority of the monogenic recessive disorders encountered in these species, the carrier state is not detectable at present, whereas in others, in which a biochemical lesion is known (dermatosparaxis, erythrocyte glutathione deficiency, globoid cell leukodystrophy and glycogen storage disease), the carrier state is detectable with the aid of enzyme and surface protein markers. The latter group and the dominant disorders (anury, cataract, glomerulonephritis, and lethal grey in sheep; gynecomastia and anotia-microtia complex in goats) are easy to eliminate through selective breeding. The polygenic disorders (entropion, epidermolysis bullosa, hereditary chondrodysplasia, and muscular dystrophy of sheep, and udder problems in goats) are more difficult to eradicate, because the mutant genes responsible for these traits generally do not declare themselves until inbreeding brings together a critical concentration to create a health crisis in some, whereas others, which are only short of a few of these mutant genes, might go totally unaffected and therefore undetected. Chromosome defects of the structural nature (translocations) seen in sheep and goats generally create meiotic disturbances, which in a majority of cases lead to subfertility, whereas sex chromosome aneuploids are generally sterile.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Eyelid and nasolacrimal disease.

An understanding of normal structure and function of the equine eyelid is essential to make an accurate diagnosis and appropriately treat equine eyelid diseases. Entropion, eyelid trauma, neoplasia, and nasolacrimal disorders are reviewed. Methods of diagnosis and treatment are presented.

Animals↗

Hereditary and congenital ocular disease in the cat.

The aim of this review of hereditary and congenital ocular disease in cats is to present an overview of the most common disorders seen in this species, the pathogenesis of the problems and wherever possible, how they are treated. Several defects are common in breeds such as the Persian, Himalayan and Burmese cats and affect the anterior segment of the eye. Examples are agenesis of the eyelids, dermoids, entropion and corneal sequestrum. Other problems such as cataracts, lens luxation and retinal dysplasia, cause problems of the intraocular structures, but are less common in cats compared to dogs. Finally, various parts of the retina and in some diseases other parts of the eye, are specifically affected by hereditary diseases. Examples of these are lysosomal storage disease, Chediak-Higashi syndrome and progressive rod cone degeneration and rod cone dysplasia. Research of the latter two hereditary diseases, both described in the Abyssinian breed of cat, have made affected individuals important animal models for research into comparable diseases of humans.

Animals↗

Corneal stem cell grafting after chemical injury.

PURPOSE: To evaluate the clinical and histological outcome after corneal stem cell grafting in unilateral chemical burns in eight consecutive patients. METHODS: The visual performance and degree of irritation were evaluated following autologous corneal stem cell grafting. Scar tissue overlying the injured corneas as well as two corneal buttons obtained at penetrating graft performed a year or more after the stem cell graft were evaluated histologically. RESULTS: Seven of the 8 grafted eyes obtained useful vision postoperatively. Two of these eyes had undergone a penetrating graft following initial surgery. The chronic irritation before surgery was significantly reduced. In one eye a penetrating graft was opacified due to a late developing scar entropion. CONCLUSIONS: Autologous corneal stem cell grafting proved successful in restoring vision and reduce irritation in unilateral chemical burns. Histological examination indicates that the conjunctival overgrowth is replaced by regular corneal epithelium.

Adult↗

The management of congenital malpositions of eyelids, eyes and orbits.

Congenital malformations of the eye and its adnexa which are multiple and varied can affect the whole eyeball or any part of it, as well as the orbit, eyelids, lacrimal ducts, extra-ocular muscles and conjunctiva. A classification of these malformations is presented together with the general principles of treatment, age of operating and surgical tactics. The authors give some examples of the anatomo-clinical forms, eyelid malformations such as entropion, ectropion, ptosis, levator eyelid retraction, medial canthus malposition, congenital eyelid colobomas, and congenital orbital abnormalities (Craniofacial stenosis, orbital plagiocephalies, hypertelorism, anophthalmos, microphthalmos and cryptophthalmos).

Eye Abnormalities↗

Low frequency of bacteraemia during eye surgery obviates the need for endocarditis prophylaxis.

PURPOSE: To determine the incidence of bacteraemia following eye surgery, and thereby evaluate the need for antibiotic cover during such procedures, in patients who are at risk for bacterial endocarditis. METHODS: This prospective study involved 50 consecutive patients undergoing extraocular surgery at the Sultan Qaboos University Hospital, Muscat, Oman. Local preparation of the surgical site in all patients included pre-operative instillation of 0.3% gentamicin and 3% povidone-iodine eye drops. Two eye swabs (one from the conjunctival sac and another from the eyelid margin) and two venous blood samples (one taken just before the procedure and the second 10 min into it) were collected and cultured for aerobic and anaerobic bacteria. Surgery-related bacteraemia was defined as a negative pre-operative blood culture followed by a positive intraoperative blood culture of the same bacterium identified in the positive eye swab. RESULTS: Only two patients (4%) demonstrated surgery-related bacteraemia: one caused by Staphylococcus epidermidis (following entropion correction) and the other by Haemophilus influenzae (following dacryocystorhinostomy). Four other patients had positive conjunctival swabs without bacteraemia, the causative organisms being Haemophilus influenzae in two, and Staphyloccus aureus and Klebsiella pneumoniae in one each. CONCLUSION: Ophthalmic surgery is not associated with significant bacteraemia, and therefore does not mandate routine antibiotic cover in patients at risk for bacterial endocarditis. Stringent pre-operative preparation of the surgical site may suffice to minimise bacteraemia; however, this requires further study.

Adolescent↗

Trachoma in Jimma zone, south western Ethiopia.

A population-based survey on trachoma was carried out in Jimma zone. The survey showed that trachoma is hyperendemic: of 7,423 people examined, 33.02% had signs of trachoma, 28.9% of males and 37.01% of females; 26.13% of the urban and 34.09% of the rural population had clinical signs of trachoma. Active trachoma (TF/TI) was seen in 24.5% of the study population (an estimated half million people). The prevalence of signs of active trachoma among children 0-10 years of age was 35.7%. Blinding trachoma (CO/TT) was seen in 3.81% of the population: 6.86% of the female population aged 15 years had trichiasis and/or entropion. Both active and critical trachoma were significantly associated with the female gender (P < 0.0000001 for each), living in rural areas (P < 0.0001 for each type), parental illiteracy (P < 0.0000001 for each) and absence of a latrine (P < 0.01 for each). Shorter distance of the household water supply was associated with a higher prevalence of both active and cicatricial trachoma. This was significant only for cases of active trachoma living in households within 16 to 30 minutes walking distance from the water source (P < 0.03). An estimated 17000 people in the zone are blind; 3500 of these from trachoma. About 52,000 people are in danger of blindness from trichiasis. Primary eye care activities such as promoting health education (face washing) among community members, especially women and children, mass chemotherapy for trachoma, training of health workers and establishment of community-based surgical services are recommended. These are to be executed by the Zonal Health Department in close collaboration with the community, governmental and non-governmental organisations.

Adolescent↗

Congenital and hereditary ocular abnormalities in cats.

Congenital and inherited ocular diseases are reported less frequently in the cat than the dog. The 2 species also differ in their array of disorders, with familiar canine abnormalities like cataracts overshadowed by unique feline diseases such as eyelid agenesis and corneal sequestration. Organized according to the primary ocular structure affected and commingling congenital and inherited disorders in each section, the review begins with multiple ocular anomalies and their impact on globe-orbit relationship. Adnexal disorders include eyelid agenesis, entropion, dermoid, and nictitans gland protrusion. Corneal abnormalities range from the routine sequestrum and PPM-related opacity to those rare infiltrates accompanying inborn errors of metabolism. Brief descriptions of uveal anomalies, primary glaucoma, cataracts, and lens luxations follow. Retinal dysplasia and progressive retinal atrophy complete the summary. Suspicions of heritability are often based on small numbers of animals in sporadic reports of ocular disease, but the Persian, Burmese, and Siamese are among the breeds repeatedly linked with one or more of these disorders.

Animals↗

Feline corneal disease.

The cornea is naturally transparent. Anything that interferes with the cornea's stromal architecture, contributes to blood vessel migration, increases corneal pigmentation, or predisposes to corneal edema, disrupts the corneas transparency and indicates corneal disease. The color, location, and shape and pattern of a corneal lesion can help in determining the underlying cause for the disease. Corneal disease is typically divided into congenital or acquired disorders. Congenital disorders, such as corneal dermoids are rare in cats, whereas acquired corneal disease associated with nonulcerative or ulcerative keratitis is common. Primary ocular disease, such as tear film instability, adenexal disease (medial canthal entropion, lagophthalmus, eyelid agenesis), and herpes keratitis are associated with the majority of acquired corneal disease in cats. Proliferative/eosinophilic keratitis, acute bullous keratopathy, and Florida keratopathy are common feline nonulcerative disorders. Nonprogressive ulcerative disease in cats, such as chronic corneal epithelial defects and corneal sequestration are more common than progressive corneal ulcerations.

Animals↗

Treatment of orbital floor blowout fractures with conchal auricular cartilage graft: a report on 14 cases.

PURPOSE: We sought to present follow-up on 14 cases in which conchal cartilage graft was used to span small orbital floor defects (up to 2 x 2 cm). MATERIALS AND METHODS: Fourteen patients with orbital floor blowout fractures were included in the study; in 8 cases, there was associated fracture of the inferior orbital rim. The decision to proceed surgically was based on the presence of at least one of the following conditions: diplopia, enophthalmos, herniation of orbital tissues through gaps in the orbital floor bone, and concomitant displacement of bone fragments of the inferior orbital rim. Auricular cartilage was used in all cases. Access to the orbital floor was via subtarsal incision unless a laceration was present and useable. RESULTS: The incidence of clinical signs during follow-up and the surgical complications found (1 case of entropion, 1 case of palpebral edema) are fully comparable with those reported in the literature; they do not appear to be correlated to the use of a cartilage graft. CONCLUSIONS: The use of auricular cartilage has wide application for small orbital floor defects. The conchal graft is easy to harvest. It provides an optimal support function for the globe with minimum donor-site morbidity. A graft of adequate size ensures adequate stability.

Ear Cartilage↗

Techniques for surgical correction of adnexal disease.

The adnexa frequently requires the general practitioner to intervene surgically to manage underlying disease or as an ancillary aid in the management of corneal disease. Both acquired and hereditary disorders are encountered. This article reviews general anatomy and physiology of the eyelids and discusses indications for the more commonly performed surgical procedures and their execution. Procedures include tarsorrhaphy, management of eyelid lacerations, eyelid tumor resection, correction of upper and/or lower lid entropion, ectropion, a medial and lateral canthoplasty, colobomatous syndrome in the cat, management of distichiasis, trichiasis and ectopic ciliae, and reduction of a prolapse of the gland of the third eyelid. Finally a surgical pack inventory useful for adnexal surgery is described.

Animals↗

Reconstruction of orbital floor fractures using bioactive glass.

INTRODUCTION: The management of orbital floor fractures continues to be debated. Bioactive glasses and glass-ceramics are in the new group of materials developed for the repair of bone defects which are beyond any innate healing capacity due to their size. OBJECTIVE: We compared the use of alloplastic implants (bioactive glass) with conventional autogenous grafts (cartilage--plus or minus Iyophilized dura) for the repair of orbital floor defects after trauma. MATERIAL AND METHODS: Twenty-eight patients having orbital floor fractures with persistent diplopia, enophthalmos, and/or infraorbital nerve paraesthesia were operated on from 1991 to 1995 at Turku University Central Hospital. Reconstruction was either with bioactive glass (S93P4) or autogenous cartilage implants. RESULTS: Postoperative tomograms in the 28 patients showed adequate maintenance of orbital and maxillary sinus volume without any evidence of resorption in either group. None of 14 patients in the study group had any evidence of dystopia or complications relating to implants follow-up. One had infraorbital nerve paraesthesia and another had entropion postoperatively. Among the 14 control subjects there were three cases of persistent diplopia, two of infraorbital nerve paraesthesia and one of enophthalmos. CONCLUSION: Bioactive glass implants are well-tolerated and seem to be a promising repair material for orbital floor fractures. Their use leads to less morbidity as no donor site operation is needed. Also it provides favourable healing as it is bioactive, biocompatible and causes new bone formation.

Adolescent↗

[Use of botulinum toxin in ophthalmology].

BACKGROUND: Botulinum Toxin A produces muscle palsies by blocking the neuromuscular transmissions. The numerous applications of Botulinum-chemodenervation in ophthalmology are demonstrated. RESULTS: In blepharospasm und facial hemispasm Botulinum Toxin A injections represent an excellent alternative to medical and surgical therapy. They have to be repeated after several weeks or month. Other indications are spastic entropium and lagophthalmos. In paralytic strabismus Botulinum Toxin injections (intramuscular under EMG control) serve to prevent contracture of the homolateral antagonist and thus to facilitate recovery of the agonist with restauration of binocular single vision or in non recovering cases to simplify the surgical treatment by making no more necessary the usual recession of the homolateral antagonist. In concomitant strabismus Botulinum-chemodenervation is applicable above alle in small angle deviations under 25 degrees, in sensory strabismus, in residual squint angles after surgery and in contraindications against surgery of any cause. Botulinum Toxin can also be used to stimulate a weakening procedure with control of resulting binocular function or disturbing diplopia. CONCLUSIONS: Botulinum Toxin A injections are of considerable therapeutic value in blepharospasm, spastic entropion, lagophthalmus, as well in paralytic strabismus and certain cases of concomitant strabismus.

Blepharospasm↗

[Spontaneous hematocornea after keratitis of various etiology].

BACKGROUND: Corneal blood staining may occur as a serious complication of persisting hyphema. In our two cases the corneal blood staining is a result of direct bleeding in the corneal stroma. HISTORY AND SIGNS: A female patient presented with a corneal blood staining through rupture of reopened vessels in interstitial keratitis of congenital syphilis after physical effort with high blood pressure. The second patient presented with a blood staining caused by a vessel errosion after corneal ulceration. THERAPY AND OUTCOME: The clearing of the blood staining is thought to be a result of the phagocytic action of the keratocytes and from a diffusion of hemoglobin into the conjunctival circulation and the anterior chamber (2). The therapeutic efforts are directed toward prevention of corneal blood staining. At the first sign of microscopic blood staining of the cornea a surgical evacuation of hyphema is necessary. In our two cases there wasn't a hyphema, so it was only possible to treated the corneal ulcer, entropion and systemic hypertension. CONCLUSION: The clinician has to wait for a spontaneous clearing, although it may take 2 or 3 years or more. In this case a penetrating keratoplasty is indicated.

Aged↗

[New developments in 1991 in the field of the eyelids].

The publications of the year 1991 dealing with new developments in the field of lids have been reviewed. New methods of reconstruction of the upper and lower eye lid are presented. Chondroplast is a substitute for the tarsal plate which is preserved in a new way and is available in an unlimited amount. A four snip procedure for the correction of lower lid entropion is presented. A new technique of ectropion correction which allows great flexibility in the extent of the approximation of the lower lid to the globe is available. New simplified variations of the surgical treatment of Graves' disease provide a predictable height and contour of the eye lid as well as improved cosmetic results. Alternatively to Botulinum toxin Doxorubicin was injected as a treatment for benign essential blepharospasm and hemifacial spasm in an experimental study.

Eyelid Diseases↗

Modified grading system for upper eyelid trachomatous trichiasis.

AIM: This study was conducted to determine the level of inter-observer agreement in the modified grading scheme for trichiasis of the upper eyelid. METHODS: A grading system that covers the entire spectrum of trachomatous trichiasis, extending from the simple to the severe forms, was initially developed by the first and second authors and field-tested. The grading scheme recognizes three levels of severity, based on deviation of the lid margin (TT1, TT2 and TT3); and four anatomical locations indicating where the eyelashes touch the globe in TT1 (nasal, central, temporal, or combined). The grading of trichiasis patients was then conducted on the basis of the modified grading scheme. RESULTS: The inter-observer agreement between the grades of simple trichiasis (TT1) and entropion (TT2) using Cronbach's alpha was 0.84, and the agreement within each sub-grade was 0.86. The weighted Kappa value was 0.68 (95% CI 0.57-0.79) for the main grades and 0.49 (95% CI 0.23-0.79) for the sub-grades. CONCLUSIONS: The inter-observer agreement was very reliable and could easily be attained by all levels of ophthalmic professionals. As the grading follows the natural progression of trichiasis from the simple to the severe forms in relation to the anatomical site involved, it helps to determine the degree of correction and how far to extend the surgical incision.

Eyelashes↗

Lax eyelid syndrome or 'progeria' of eyelid tissues.

PURPOSE: The lax eyelid syndrome was described by Van den Bosch and Lemij as an uncommon disorder seen in non-obese elderly people and characterised by chronic ocular surface irritation symptoms and a "floppy upper eyelid". The authors present some new features of the lax eyelid syndrome. METHODS: The authors report five patients, belonging to a younger age group, who presented with premature laxity of all the eyelid tissues. This caused medial and lateral canthal dystopia and eyelid malposition including ptosis, entropion and ectropion. Initial surgical correction was often followed by recurrence after some time. CONCLUSIONS: The authors highlight the differences between lax eyelid syndrome, cutis laxa, floppy eyelid syndrome and the blepharochalasis syndrome and suggest that lax eyelid syndrome can be thought of as "progeria" or premature ageing of the eyelid tissues to distinguish it clearly from these other conditions.

Adult↗

Adnexal surgery for severe ocular surface disease.

Secondary causes of ocular surface disease are-to a large extent-due to disorders of the ocular adnexae. The main pathomechanisms involved include exposure, abrasion and malnutrition, resulting from a multitude of disorders such as ec- or entropion (e.g. in cicatrizing conjunctivitis), lid retraction and severe aqueous deficiency. In the presence of these problems, surgical attempts of ocular surface reconstruction frequently fail. Here we review established and evolving new techniques in the field of adnexal surgery to specifically address these problems.

Corneal Diseases↗