The specialty groups see referral cases

Monday ...... Friday
8:30am ... 5:00pm

by appointment only.


Dentistry, Ophthalmology, and Surgery:
Phone: (727) 535-3500

Dermatology and Internal Medicine:
 Phone: (727) 535-3600
Fax: (727) 539-7865

Ophthalmology Library
The Ophthalmology service at Tampa Bay Veterinary Specialists offers consultation in eye-related disease in all species of animals, as well as the screening of purebred dogs for the presence of inherited eye disorders (CERF examinations). The practice is limited to ophthalmology, and cases other than CERF examinations should be referred by a family veterinarian. Non-ophthalmic problems will be referred back to the client's family veterinarian. Our services include examinations and treatment of eyelid and orbital disease, corneal disorders, cataracts, glaucoma and retinal disorders.

Glaucoma
Glaucoma continues to be a frustrating disease for the practicing veterinarian. However, developments over recent years offer new alternatives in therapy. Of course, the key to successful management is early recognition. Diagnosis requires documentation of intraocular pressure (IOP), and this requires a tonometer. Properly used, a Schiotz tonometer is accurate enough for clinical work, but an applanation tonometer (Tonopen) is more user friendly, taking less practice to become proficient.

Tonometry should be performed on any eye presented with the compliant of redness, pupil abnormalities, corneal edema or loss of vision. Always measure IOP in both eyes; a normal eye can provide a good control to confirm your tonometry technique. Also, a large difference (>10mmhg) in IOP between eyes can signal a problem, even if IOP is not markedly elevated.

Miotic therapy used to be a mainstay of glaucoma therapy. However, as they have fallen from favor in human use, products such as demecarium bromide and phospholine iodide are increasingly hard to find. Pilocarpine is still available and inexpensive, but runs the risk of noncompliance due to the dosage frequency (q.i.d.) and topical irritation. It will also exacerbate existing uveitis.

Topical carbonic anhydrase inhibitors (CAI) are replacing oral CAI. They provide similar levels of IOP control without the systemic side effects (panting, nausea, vomiting), particularly in small dogs and cats. Dorzolamide (TRUSOPT) and brinzolamide (AZOPT) are commonly available choices. Typical dosage frequency is t.i.d.

Prostaglandin derivatives are also a very useful new glaucoma medication. Latanoprost (Xalatan) is perhaps the most potent of all glaucoma medications, giving the best IOP decrease for a single medication. It has the advantage of usually requiring only once daily dosage (evening is best time). The main disadvantage is cost ($50/2.5ml). Because of its potency, Xalatan can be used in emergency cases, where the drop in IOP can be equal to that seen with IV mannitol.

Cases with high IOP may require more than one type of medication for optimal control. Because glaucoma tends to worsen with time, long-term medical management of glaucoma is difficult. The majority of glaucoma cases will eventually become surgical candidates. There are several surgical options available, but that is a topic for another column.