Page 1206 - Problem-Based Feline Medicine

1198 PART 15 CAT WITH EYE PROBLEMS

Clinical signs Classical signs—Cont’d

Sub-conjunctival hemorrhage is common after blunt ● The cornea is cloudy.
trauma to the eye, especially from motor vehicle ● The eye is obviously painful with
accidents. blepharospasm (closed eyelids) and
photophobia (squinting).
The most common presentation is a diffuse reddening
● Usually is unilateral, and may become
of the conjunctiva over the sclera, with very little
bilateral.
swelling. This may be focal or diffuse over the entire
sclera.
See the main reference on page 1294 for details (The
In severe cases, there may be frank hemorrhage with Cat With Abnormal Iris Appearance).
swelling of the conjunctiva. This may be present after
orbital trauma, and frank orbital hemorrhage may cause
severe bulging of the conjunctiva around the globe, and Clinical signs
bulging of the eye forward (exophthalmos). Any age of cat may be affected.
The hemorrhage may be seen as a diffuse redness Uveitis is commonly seen unilaterally, but may
between the conjunctiva and sclera, or as a frank become bilateral.
bleed under the conjunctiva.
The bulbar conjunctiva can appear very red with
Petechia (multiple small red spots) or ecchymotic uveitis. This is caused by congestion of the deep epi-
hemorrhage (larger patches of red color) may be seen in scleral and conjunctival vessels secondary to inflam-
blood clotting disorders, e.g. rodenticide toxicity and mation within the eye.
thrombocytopenia.
There may be hemorrhage in the anterior chamber
Diagnosis (hyphema), with bleeding originating from inflamma-
tion in the iris and ciliary body.
The clinical signs of diffuse or focal redness with a his-
tory of trauma are diagnostic. There is frequently no The eye has a cloudy appearance (anterior chamber
other associated problem. flare) from the accumulation of protein and white
blood cells that leak from the inflamed iris and ciliary
If in doubt, fine-needle aspirates may be beneficial. body blood vessels (hypopyon).
It is important to differentiate between hemorrhage The inferior surface of the cornea may show keratic
caused by trauma and bleeding disorders (See “The precipitates, commonly called “mutton fat deposits”.
Bleeding page 485). They are accumulations of protein and white blood

If there is no history of trauma, laboratory tests should be cells that have adhered to the endothelium in focal
done to check for clotting or platelet disorders spots. The cornea may be edematous. Corneal
(page 488). changes also cause a cloudy appearance to the eye.

Orbital radiology may be needed in cats with severe The pupil is miotic (constricted) because the iris
peri-orbital trauma to check for orbital fractures. sphincter muscles are stimulated by a prostaglandin-
induced inflammation. Sometimes there is anisocoria
Orbital ultrasound (10-MHz probe) is useful to check (unequal-sized pupils) and dyscoria (abnormal-shaped
the posterior sclera, optic nerve and the muscle cone. pupil). There is often swelling and color change of the
iris.
UVEITIS***
Cats with uveitis show pain by keeping the eye closed
Classical signs (blepharospasm), and it is very sensitive to light (photo-
phobia).
● Any age of cat.
● Usually seen as a cloudy, red eye. Cats may be anorexic and lethargic, as it is usually
secondary to systemic disease.