Island Veterinary Eye Specialist

01/25/2025

Immature cataracts occupy >10% of the lens volume but NOT the whole lens, which is appreciated by the detection of a tapetal hue. Distinguishing immature cataracts from incipient cataracts is important👉 because once the cataract exceeds 10% of the lens the amount of inflammation is detectable with fluorophotometry. This inflammation is called lens induced uveitis. Lens induced uveitis is detectable with immature and larger cataracts AND should be treated with a topical daily NSAID drop💧 to decrease and delay potentially painful complications from the lens induced uveitis. The NSAID drop should be administered either 1 x or 2 x per day depending on the size of cataract and if other uveitic changes are detectable.
👉Immature cataracts are also candidates for cataract surgery🏥 which can be life changing! (More on this to come!)
Immature cataracts that are not surgically removed should still be monitored every 6-12 months for complications or sequela from the lens induced uveitis.

01/18/2025

Incipient cataracts occupy

01/11/2025

The answers to yesterdays post!!:

1) A cat with a mature cataract
2) A dog with an immature cataract
3) A dog with an intumescent cataract
4) A cat with a hypermature cataract
5) A horse with an incipient cataract

Over the next few posts we will explain why diagnosing the different types of cataract matters! hint: the treatment plan is different for each type!

Follow to find out which cataracts should be monitored and how often, which should be medicated, which are candidates for surgery, and which could be catastrophic for the eye.

01/11/2025

Cataracts 🙀
Can pets have cataract surgery? YES! 🥳Can it be life changing for them YES! 😻Is it one of our favorite interventions? ALSO YES! Over the next several weeks I will be doing a mini series on cataracts and cataract surgery. 🤓
Cataracts are denatured lens protein that result in an opacity. They cause two main problems for our animal friends. The first and most obvious problem is that they disrupt their vision, and the second is that they cause inflammation inside the eye that can lead to severe painful and permanently blinding sequelae.
There are 5 main categories of cataracts. They are incipient, immature, mature, hyper mature, and intumescent. Test yourself on the photos in this post and see if you can identify each type. Give yourself a bonus point if you also recognize the species!

11/11/2024

Thank you to the 100 veterinarians who came out this weekend for our day of Ophthalmology and Cardiology continuing education in Victoria!!

What a pleasure it is to work with our local veterinarians to bring the very best Veterinary care to the pets of Vancouver Island. Thank you for your interest, dedication, and curiosity. Together we are making a difference.

Special thanks to my co-presenter Dr.Lichtenberger for the excellent presentations, Alex and Madi for organizing, and our sponsors The Accounting Agency and Boehringer for making it possible.

What a fabulous day!!!

11/01/2024

Iris Diode Photocoagulation⚡
This is where Dr. Osinchuk uses laser to treat early tumors of the iris. Melanocytomas, or tumors of the pigmented cells, are the most common intraocular tumor in the dog. They cause blindness through secondary glaucoma, retinal detachment, and intraocular hemorrhage.
There are two main treatment modalities Dr. Osinchuk offers for these. Smaller earlier lesions can be treated with laser. The laser energy has a thermal effect on pigmented cells, resulting in a process called coagulation necrosis. The mass immediately shrinks with the laser treatment. In the study on iris laser 23 dogs were treated, 18 of them required no further treatment, while 5 required 1-2 more laser treatments (Cook and Wilkie 1999). The second technique is for thicker masses where the laser cannot pe*****te, these should be removed surgically.

10/25/2024

Transscleral cyclophotocoagulation ⚡
This treatment provides laser to the ciliary body from outside the eye. It is less invasive (no incisions into the eye) and much faster however the success rate is lower with variable reports from different studies of between 50 and 90% of dogs having their pressure controlled one year later, 50% of dogs having vision one year later 👀. Eyes treated with transscleral laser are more prone to side effects like corneal ulcers or cataracts due to the collateral damage of the laser entering the eye from the outside and the target not being visualized during lasering.
If this technique is less successful then when do we do it?
1) For clients where endolaser or a glaucoma shunt are out of reach financially (it is about 1/3rd the cost
2) Dogs where we have concerns regarding prolonged anesthesia. This can be done under sedation and topical freezing

10/18/2024

Endoscopic Cyclophotocoagulation!!⚡
Find a treatment with more syllables, we dare you!
This form of laser treatment is for glaucoma and targets the ciliary body, the organ inside the eye that produces aqueous.
In this picture the brown on the left is the back of the iris 👁, the finger like projections to the right of the brown sheet are the processes of the ciliary body. The white spots on them are the areas they have been treated with laser. On the far right you can see white strands, these are the lens zonules (ligaments holding the lens 🔍 in place).

A recent study on Endoscopic Cyclophotocoagulation revealed 90% of dogs had there intraocular pressures controlled at 1 year post procedure and 63% maintained vision. (Sosnowik et al 2024, DOI: 10.1111/vop.13176 )

The success of glaucoma shunts in maintaining vision is higher for patients with primary glaucoma so we typically use endoscopic cyclophotocoagulation for treatment of secondary glaucoma.

10/04/2024

Do we use laser in Veterinary Ophthalmology?! Yes! There are many forms of laser treatment used in veterinary ophthalmology and they include:
- endoscopic laser
- transscleral laser
- iris laser
- large anterior chamber cysts
- retinopexy for eyes with a high risk of retinal detachment

Can you match the pictures to the type of laser?

02/22/2024

Bigger and bigger eyes

02/15/2024

L❤️VE IS BLIND, YOUR PET DOESN'T HAVE TO BE!!!

Request a referral to Dr. Osinchuk!!
Happy Valentine's Day ❤️

02/14/2024

Happiest Valentine's Day to all of our furry valentines out there!!
❤❤❤❤❤❤

02/12/2024

This is the pathology image for the mass removed in this weekend's posts.

The majority of canine eyelid masses are benign tumors called meibomian gland adenomas, A few other more common masses are papilloma's, or melanocytomas. More malignant masses of the canine eyelid may include squamous cell carcinoma, sarcomas or lymphoma.

This eyelid mass was a meibomian gland adenoma and it was growing inside the meibomian gland duct here in this pathology image. This led to a back of of meibum. Meibum is the oil that is secreted into the tear film to prevent evaporative loss. If you are removing an eyelid mass and it pops like a pimple, it is a back up of meibum!

02/10/2024

Two weeks post H-plasty large eyelid mass removal. That is much BETTER!

For the H-plasty surgery
- The area above the - of the H is removed as it contains the mass
- The area below the - of the H is slid towards the eyelid margin

and Voila the mass is removed!!

02/09/2024

Canine Eyelid Masses
Most are benign, but do they need to be removed? How do you decide? and How do you do it?!
The easy answer is: YES! they should be removed. This allows for timely diagnosis, the least invasive surgery, and the shortest anesthesia. The larger the mass grows the larger and longer the surgery is to remove it. So if the initial concern is the anesthesia, earlier removal actually shortens the time to remove the mass. In most cases the dog is also not getting any healthier with age so earlier removal again increases the anesthetic safety.
The technique for removal depends on a few factors including:
- Size of the mass
- Involvement of the eyelid margin
- Surgeon experience

This mass was removed with a surgery called an H-plasty. See tomorrows post for the results!

02/07/2024

What is involved in an OFA Eye certification exam? This video gives an example.
These exams can only be offered by Board Certified Veterinary Ophthalmologists to ensure nothing is missed!
Dr. Osinchuk is the ONLY Board Certified Ophthalmologist on Vancouver Island and she offers these exams for breeders the last Wednesday of every month.
They are completed in breeding animals to screen for any inherited eye disease.

Dr. Osinchuk has had the pleasure of meeting many wonderful responsible breeders here on the island. Feel free to drop your link and share!

Example of an OFA screening eye exam. The use of a slit-lamp microscope is required which means dogs have to sit quite still, but it is only for a couple min...

02/03/2024

NON infectious feline conjunctivitis!
While most cases of feline conjunctivitis are do to the infections discussed over the past month, there are a few non infectious causes.

Two of them are pictured here. Can you discern which is which?

There is lipogranulomatosis conjunctivitis and eosinophilic keratoconjunctivitis.