Island Veterinary Eye Specialist

Island Veterinary Eye Specialist Dr. Stephanie Osinchuk, a Board Certified Veterinary Ophthalmologist, is a local expert in animal eye disease. Your pet's vision and health are our focus.

She offers advanced ophthalmic surgery out of a state of the art clinic in Victoria, BC.

03/15/2025

Making an incision through the cornea and anterior lens capsule!
Cataract surgery is MICROSURGERY which requires the eye to be placed under an operating microscope to allow precision. This is a video of the corneal and lens incisions. They are made with a 2.7mm double sided surgical knife. The cornea is 0.6mm thick, and the posterior lens capsule is only HALF a red blood cell in thick. There is literally no room for error! Microsurgery requires years of training which is intensive and repetitive to develop high levels of microcontrol and dexterity.

03/08/2025

LENS INJECTION**
After the cataract is removed via phacoemulsification a lens implant is placed into the lens capsule. This is possible throught a small incision because the lens is folded into an injection system! The lens iis folded on its long axis in the injector. It is shaped like a bowtie with the arms extending out to the lens capsule equator to hold it in position. The center of the lens is called the optic and it is corrected to allow emmetropia or perfect visual acuity for the species. The refractive power of the lens is different between species:
Dogs: 42 diopters
Cats: 53 diopters
Rabbits: 58 diopters
Horses: 14-18 diopters
Birds: Bald eagle 16.4-17.4,
Canada lynx: 46 diopters
Black kite: 17.5 diopters

03/01/2025

Cataract surgery or Phacoemulsification is the standard of care for restoring vision in animals blinded by cataracts. It is completed through a 2.7 mm incision. The instrument uses ultrasound energy to break up the lens and a vacuum to suction the small fragments from the eye. The lens capsule is left in place and used to hold the new lens implant. The phacoemulsification machine and equipment are the same as used for cataract surgery in humans. Follow-up studies in cats and dogs undergoing cataract surgery report a 93% and 80% success rate respectively for return of and maintenance of vision.

Intumescent cataracts occur in dogs with diabetes. Referral for these cataracts is URGENT especially if clients are inte...
02/22/2025

Intumescent cataracts occur in dogs with diabetes. Referral for these cataracts is URGENT especially if clients are interested in cataract surgery. The excessive levels of glucose cause shunting towards an alternative energy pathway increasing sorbitol in the lens. The sorbitol creates a strong osmotic gradient imbibing water into the lens. The expansion of the lens physically compresses the drainage angle, and causes lens capsule tears- which incite a severe phacoclastic uveitis (you can see keratic percipitates in the first photo). These sequellae can rapidly lead to glaucoma. Cataract surgery before the development of these sequellae is typically quite successful but if surgery is not completed in a timely fashion the success rate is less. For this reason we do not make diabetics with cataracts wait until the next available cataract surgery opening. They are done asap!

Intumescent cataracts occur in dogs with diabetes. Referral for these cataracts is URGENT especially if clients are inte...
02/16/2025

Intumescent cataracts occur in dogs with diabetes. Referral for these cataracts is URGENT especially if clients are interested in cataract surgery. The excessive levels of glucose cause shunting towards an alternative energy pathway increasing sorbitol in the lens. The sorbitol creates a strong osmotic gradient imbibing water into the lens. The expansion of the lens physically compresses the drainage angle, and causes lens capsule tears- which incite a severe phacoclastic uveitis (can you see the keratic percipitates in the first picture?). These sequalae can rapidly lead to glaucoma. Cataract surgery before the development of these sequalae is typically quite successful but if surgery is not completed in a timely fashion the success rate is less. For this reason we do not make diabetics with cataracts wait until the next available cataract surgery opening. They are done asap!

Hypermature cataracts- This is a later stage of cataract where the lens cortex begins to liquify and crystalize. The len...
02/16/2025

Hypermature cataracts- This is a later stage of cataract where the lens cortex begins to liquify and crystalize. The lens may also turn an amber yellow colour during this stage. It is associated with a more severe form of lens induced uveitis called phacolytic uveitis. These cataracts are associated with a higher incidence of glaucoma, retinal detachment, and lens luxation. Younger dogs with cataracts often have a faster progression to the hypermature stage. In cats, hyper mature cataracts frequently lead to lens luxation. Eyes with hypermature cataracts have a deeper anterior chamber because the lens is smaller as a result of the liquefaction of the lens fibers. They also can develop hyperpigmentation of the iris, or rubidosis iridis as a result of the chronic phacolytic uveitis.

Mature cataracts are cataracts that occupy the full lens💯and cause complete blindness🙀. My recommendations for these eye...
02/08/2025

Mature cataracts are cataracts that occupy the full lens💯and cause complete blindness🙀.
My recommendations for these eyes are:
1) BID NSAID dosing 💧
2) They are excellent candidates for cataract surgery🤩
3) The phacolytic uveitis in these eyes puts them at high risk of sequela including glaucoma, retinal detachment, and lens luxation😵‍💫. The topical NSAID can reduce or delay these sequelae.
4) If they do not receive cataract surgery, they should be monitored every 6-12 months for sequelae of the cataracts/lens induced uveitis

What are the topical NSAID drop options for cataracts? Diclofenac, Nepfenac, Ketorolac, and Bromfenac. What are the diff...
02/01/2025

What are the topical NSAID drop options for cataracts? Diclofenac, Nepfenac, Ketorolac, and Bromfenac. What are the differences? Mostly cost. Bromfenac and Nevanac (Nevanac) have some studies in humans supporting a reduced frequency of application but there are no canine studies that support lower frequency dosing in dogs. A meta-analysis (reviewing 7234 patients) in humans found Diclofenac to improve anterior chamber inflammation and no difference in adverse events of any NSAIDS compared to placebo (Duan et al 2017). The cost can vary 10-20 fold. I typically will use the generic diclofenac as a first choice due to the cost efficacy for my clients and the human based evidence of the greatest control of inflammation. When it was on backorder last year I used Voltaren (brand name diclofenac), Nepfenac, and Ketorolac in that order solely based on what is most cost effective for our clients. These were all available through either AVP or WDDC.

Immature cataracts occupy >10% of the lens volume but NOT the whole lens, which is appreciated by the detection of a tap...
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.

Incipient cataracts occupy
01/18/2025

Incipient cataracts occupy

The answers to yesterdays post!!:1) A cat with a mature cataract2) A dog with an immature cataract3) A dog with an intum...
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.

Address

1045 Linden Avenue
Victoria, BC

Opening Hours

Monday 8am - 5pm
Tuesday 8am - 5pm
Wednesday 8am - 5pm
Thursday 8am - 5pm

Telephone

+17784040680

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