Ocular discharge

image of Ocular discharge
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Ocular discharge is a common but non-specific clinical sign in cats, and may have numerous potential causes. This chapter looks at differential diagnoses and investigation.

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5.25.1 Typical serous and mucoid discharge from the eye and nose of a kitten with FHV infection. Purulent ocular discharge, chemosis dorsally and ventrally along with conjunctival hyperaemia of all visible conjunctival surfaces, and corneal opacity due to fibrovascular infiltration of a corneal ulcer. The cat was diagnosed with infection.
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5.25.2 Eyelid abnormalities. Mucopurulent ocular discharge with brown crusting caused by entropion of the lateral lower eyelid. Purulent ocular discharge in a kitten with upper eyelid agenesis. The lateral half of the upper eyelid is missing. Poor blinking and the lack of meibomian glands to create tear film lipids have resulted in corneal neovascularization and a dull, dry appearance to the cornea. Serous ocular discharge in a kitten with lagophthalmos due to left globe enlargement secondary to glaucoma, which also resulted in a ruptured corneal ulcer when it was not treated. The kitten was infected with FHV, and symblepharon (adherent conjunctiva) can also be seen on the right cornea. The left third eyelid is protruding due to ocular pain (as this can result in enophthalmos); the right third eyelid is partially protruded due to the conjunctival adhesions.
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5.25.3 Serous ocular discharge in a cat with absence of the lower lacrimal punctum.
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5.25.4 Conjunctival disease. Mucoid to mucopurulent discharge typical of conjuctivitis in a cat with infection. Chemosis, conjunctival hyperaemia and third eyelid protrusion are also present. Previous FHV infection has caused scarring over the lacrimal puncta, resulting in serous ocular discharge in the left eye. Third eyelid protrusion is present due to developing symblepharon along with typical signs of cat ’flu conjunctivitis, including chemosis, conjunctival hyperaemia and serous nasal discharge. The cornea was ulcerated behind the third eyelid, which is the cause of the symblepharon.
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5.25.5 Corneal disease. Purulent ocular discharge in a cat with a melting corneal ulcer due to infection. Corneal sequestrum inciting corneal neovascularization from the dorsal limbus, with some black crusty discharge on the lower eyelid.
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5.25.6 Orbital disease. Purulent discharge with third eyelid protrusion due to exophthalmos caused by a retrobulbar tumour. Fluorescein dye has drained on to the face as the lacrimal puncta are closed due to conjunctival congestion. Mucopurulent ocular discharge and third eyelid protrusion in the right eye of a Persian cat with a retrobulbar sialocele.
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5.25.7 Jones test in a British Shorthaired cat. Fluorescein at the left naris (positive result) shows that the left nasolacrimal duct is patent. There is no fluorescein at the right naris, with fluorescein-stained tear overflow at the medial canthus (negative result), indicating an obstruction.
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5.25.8 Seidel’s test. The right eye of a cat that had sustained a cat scratch injury. At the 11 o’clock position on the cornea, there is a dark linear opacity which is a wound, surrounded by a grey-whitish area of corneal oedema. Below this is a large pale brown area which is a fibrin clot in the anterior chamber. Liberal fluorescein dye was applied and is a green colour. Beneath the corneal wound there is a dark triangular area which represents dilution of the dye with aqueous humour leaking from the wound. (Courtesy of John Mould.)
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