Page 1237 - Problem-Based Feline Medicine

59 – THE CAT WITH OCULAR DISCHARGE OR CHANGED CONJUNCTIVAL APPEARANCE 1229

Clinical signs Definitive diagnosis is based on histopathological
examination of affected tissue.
Usually the central portion of the lower eyelid margin
rolls inwards towards the globe. Lid hair adjacent to
the margin may appear moist or be coated in con- CORNEAL DISEASE CAUSING
junctival mucus. OCULAR DISCHARGE
Enophthalmos is often present as the underlying cause,
or chronic blepharospasm caused by painful corneal HERPETIC KERATITIS***
diseases.
Classical signs
Corneal surface disease is present from the eyelid
● Ocular pain seen as blepharospasm and
hair rubbing on the cornea. This can include super-
ficial ulceration, sequestrum formation, and a vas- photophobia.
● Mild serous ocular discharge. Superficial
cular response from the limbus adjacent to the area
of lid irritation. corneal ulceration in a dendritic or
geographic distribution.
Chronic discharge occurs ranging from mucoid to ● Superficial vascularization and scarring, if
mucopurulent. chronic.

Diagnosis See main reference on page 1237 (The Cat With
Abnormalities Confined to the Cornea).
Diagnosis is based on the characteristic sign of
an inward rolling eyelid margin with secondary
corneal changes and chronic ocular discharge. Clinical signs
Cats present with signs of ocular pain, seen as ble-
MEIBOMIAN GLAND ADENOCARCINOMA pharospasm and photophobia.
A mild serous discharge is common.
Classical signs
Superficial ulceration in an irregular (geographic) or
● Localized or diffuse eyelid swelling.
linear (dendritic) pattern is seen when the cornea is
● ± Surface ulceration.
examined under magnification, or with a slit lamp bio-
microscope. The corneal lesion is in the epithelium or
See main reference on page 1324 for details. (The Cat
superficial stroma.
With Abnormal Eyelid Appearance).
There may be varying degrees of superficial vascular-
Clinical signs ization and scarring.
Meibomian gland adenomas or carcinomas are seen There is often a history of quiescent phases, followed
as a nodular or diffuse mass causing localized thick- by recurrence of serous discharge, and eye discomfort
ening of the eyelid. The tumor may have an ulcerated after stress.
surface.
A history of prior cat flu, often as a kitten, with
signs consistent with feline herpesvirus-1 infection,
Diagnosis
may be present. Corneal involvement (keratitis) may
Tentative diagnosis is based on the appearance of first occur 1–2 weeks after upper respiratory signs, or
the eyelid lesion. may be unassociated with respiratory signs.
Exfoliative cytology is useful in some cases that
show ulceration. Diagnosis
Fine-needle biopsy can be useful in cases where A history of respiratory infection as a kitten, followed by
there is discreet swelling. chronic episodes of ocular discharge and pain, indicates