Page 1235 - Problem-Based Feline Medicine

59 – THE CAT WITH OCULAR DISCHARGE OR CHANGED CONJUNCTIVAL APPEARANCE 1227

If the wound occurs in the area of the lower puncta, Most cases present with tearing, corneal vascular-
scarring may result in epiphora, as tear drainage is ization and ulceration as kittens.
affected.
Diagnosis
Diagnosis There will be a history of chronic epiphora with ker-
atitis and obvious ocular irritation.
Eyelid wounds are obvious on clinical examination.
There will usually be a history of trauma. Careful examination will show that a portion of the
upper eyelid margin is missing or abnormal.

EYELID AGENESIS (COLOBOMA) Differential diagnosis

Eyelid wounds that have healed with a section of lid
Classical signs
margin missing appear similar. Age and a history of
● Unilateral or bilateral abnormality of upper trauma usually differentiate.
outer lid margin.
● Seromucoid ocular discharge. Treatment
● Vascularized adjacent upper cornea with or
without ulceration. Surgical correction is the only curative solution. There
● Most common in Persians but any breed are many surgical techniques that involve rotational or
can be affected. advancement flaps. For details the reader should go to
texts that have details of ophthalmic surgical techniques
See main reference on page 1323 for details. (The Cat or refer the cat to an ophthalmologist.
With Abnormal Eyelid Appearance).

SYMBLEPHARON OCCLUDING THE LOWER
Pathogenesis NASOLACRIMAL PUNCTA
Eyelid agenesis is a congenital anomaly, and strictly
Classical signs
speaking is a coloboma of the eyelid. The eyes should
be checked for other signs of defects, as some cases ● Chronic epiphora with tearing down the
also have a coloboma of the optic disc. face causing brown staining. Unilateral or
bilateral.
● History of cat flu as a kitten.
Clinical signs ● Abnormal appearance of conjunctiva, and
occasionally a cloudy cornea.
Occurs in all breeds of cats including domestic short-
hair cats, but is more common in Persians.
See the main reference on page 1212 for details
The agenesis is usually bilateral, but may be unil- (Herpesvirus conjunctivitis).
ateral.
Pathogenesis
It mainly affects the upper eyelid, and the lateral half to
one third of the eyelid margin is missing or abnormal. Symblepharon is the adhesion of any part of the con-
junctiva to itself or to the cornea. It includes:
Where the eyelid margin is missing, the eyelid hair
● Adhesion of conjunctiva from bulbar conjunctiva to
directly rubs on the cornea, causing trichiasis, kera-
eyelid conjunctiva.
titis and tearing.
● Adhesion of bulbar conjunctiva to cornea.
The conjunctiva is exposed adjacent to the area of the ● Adhesion between third eyelid conjunctiva and eye-
agenesis, causing desiccation and mucoid discharge. lid or bulbar conjunctiva.