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Corneal Lipid Infiltrates 205

PEARLS & CONSIDERATIONS Technician Tips • For dogs that lack social stimulation,
• Patients with this behavior should be kept coprophagy may be perpetuated by the
Comments
VetBooks.ir Coprophagy may be initiated and per- a complete and balanced diet, and receive in a response by the owner. Diseases and Disorders
reward of attention when the behavior results
on a monthly parasite prevention schedule,
daily physical activity and social interactions.
petuated by competitive behaviors between
animals in a shared environment. In these
instances, treatment should be focused on • Technicians should also monitor patients over SUGGESTED READING
time for signs indicating GI disturbances,
Horwitz DF, et al: Coprophagia. In Horwitz DF, et
management of group dynamics, particularly including weight loss, changes in appetite, al, editors: Canine and feline behavior, Ames, IA,
around food. and vomiting, so that potential medical 2007, Blackwell, p 236.
causes are not overlooked in lieu of an
Prevention otherwise normal behavior. AUTHOR: Allison Wara, DVM, DACVN
• Supervision and redirection of negative EDITOR: Leah A. Cohn, DVM, PhD, DACVIM
behaviors must be emphasized. Client Education
• Access to feces in the pet’s environment • Stools may be particularly appealing for
should be vigilantly monitored and some dogs, and the behavior can be highly
removed. self-rewarding.

Corneal Lipid Infiltrates Client Education
Sheet

BASIC INFORMATION ASSOCIATED DISORDERS Etiology and Pathophysiology
• Corneal dystrophy: none • Corneal dystrophy: heritable with unknown
Definition • Corneal degeneration: any pathologic pathogenesis; possible local metabolic defect
The accumulation of lipid (mostly unesterified condition that causes chronic corneal in corneal fibroblasts
cholesterol and phospholipids) in the corneal vascularization such as keratitis, episcleritis, • Corneal degeneration: acquired secondary
stroma is a feature shared by three distinct uveitis, limbal neoplasia (melanoma), pannus, to local pathologic changes in the cornea
disorders: and ocular trauma • Lipid keratopathy: acquired secondary to
• Corneal dystrophy: common primary • Lipid keratopathy: any systemic disease hyperlipidemia; likely deposited by perilimbal
hereditary condition with bilateral and that causes hyperlipidemia, such as primary blood vessels
mostly symmetrical lipid deposits in the hyperlipidemia, hypothyroidism, diabetes
central cornea; not associated with underlying mellitus, hyperadrenocorticism, chronic DIAGNOSIS
systemic or ocular disease pancreatitis, and liver disease
• Corneal degeneration: acquired degenera- Clinical Presentation Diagnostic Overview
tive condition with unilateral or bilateral Complete ophthalmic exam with magnification
lipid or calcium deposits in any region of DISEASE FORMS/SUBTYPES and a bright focal light source is recommended
the cornea; associated current or previous Corneal dystrophy, corneal degeneration, and to evaluate corneal lipid infiltrates. Determina-
local ocular inflammation and corneal lipid keratopathy are most commonly differenti- tion of the type of lipid disorder is important
vascularization ated by clinical findings seen on ophthalmic for diagnostic and therapeutic recommendations
• Lipid keratopathy: rare acquired condition exam (see Physical Exam Findings below). and prognosis.
with bilateral lipid deposits in the peripheral
cornea; associated with systemic diseases that HISTORY, CHIEF COMPLAINT Differential Diagnosis
cause hyperlipidemia White corneal opacity White corneal opacities:
• Calcium/mineral deposits (matt chalky
Synonyms PHYSICAL EXAM FINDINGS white; often difficult to differentiate from
• Corneal dystrophy, corneal epithelial dys- Corneal lipid infiltrates appear as well- lipid)
trophy, corneal stromal dystrophy, corneal demarcated, refractile, crystalline white-gray • Fibrosis/scarring (dull, gray-white, and wispy;
crystalline stromal dystrophy opacities in the superficial stroma. does not retain fluorescein stain)
• Lipid keratopathy, corneal lipidosis, corneal • Corneal dystrophy: bilateral and nearly • Inflammatory/infectious infiltrate (yellow-
arcus, arcus lipoides corneae symmetrical circular, oval, or ringlike lipid white and fluffy)
deposits in the central cornea. Lesions are not • Edema (light blue-gray and hazy)
Epidemiology painful and stain negative with fluorescein. • Florida spots, Florida keratopathy: benign,
SPECIES, AGE, SEX Appearance varies somewhat between breeds. usually multifocal corneal opacities in dogs
• Corneal lipid infiltrates are common in dogs • Corneal degeneration: unilateral or bilateral, and cats from tropical regions
and rare in cats. varied shapes of lipid deposits in any location
• Corneal dystrophy usually develops in young of the cornea. Often associated with corneal Initial Database
adult dogs. vascularization. May also be associated with • Complete ophthalmic exam (p. 1137)
corneal ulceration, pigmentation, or fibrosis. ○ Schirmer tear test: should be normal
GENETICS, BREED PREDISPOSITION • Lipid keratopathy: usually bilateral lipid unless corneal degeneration is associated
Breeds most commonly affected with corneal deposits in the shape of an arc in the with keratoconjunctivitis sicca (<15 mm/
dystrophy include the Cavalier King Charles peripheral cornea with a band of clear cornea min)
spaniel, Alaskan malamute, Siberian husky, between the deposits and the limbus. Lesions ○ Fluorescein stain: should be negative unless
Samoyed, rough collie, beagle, Airedale terrier, are not painful, fluorescein negative, and corneal degeneration is associated with
and Shetland sheepdog. variably associated with vascularization. ulcerative keratitis (positive)

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