NAVLE Special Senses

Equine Glaucoma (Secondary to Uveitis) – NAVLE Study Guide

Glaucoma is a multifactorial neurodegenerative ocular disease characterized by elevated intraocular pressure (IOP) that leads to progressive loss of retinal ganglion cells and optic nerve damage, ultimately resulting in blindness.

Overview and Clinical Importance

Glaucoma is a multifactorial neurodegenerative ocular disease characterized by elevated intraocular pressure (IOP) that leads to progressive loss of retinal ganglion cells and optic nerve damage, ultimately resulting in blindness. In horses, glaucoma is most commonly secondary to equine recurrent uveitis (ERU), making it a critical sequela to recognize and manage. The prevalence of equine glaucoma is reported between 0.07% and 0.5%, though it is likely underdiagnosed because clinical signs are often subtle and easily confused with ongoing uveitis.

Understanding the pathophysiology, clinical presentation, and management of glaucoma secondary to uveitis is essential for the NAVLE, as horses with ERU represent a significant proportion of equine ophthalmology cases encountered in general practice.

High-YieldApproximately 85-91% of horses with glaucoma have underlying equine recurrent uveitis (ERU). Always measure IOP in any horse with a history of chronic or recurrent uveitis, especially Appaloosas.
Type Description Clinical Features
Congenital Associated with anterior segment dysgenesis; present at birth or early life Marked buphthalmos, uveal hypoplasia, elongated ciliary processes, microphakia; rare
Primary No identifiable underlying ocular disease; bilateral potential; some prefer term 'idiopathic' More common in older horses (greater than 15 years); subtle early signs; dilated pupil
Secondary (Most Common) Identifiable underlying cause: chronic uveitis (ERU most common), neoplasia, lens luxation, trauma Signs of primary disease plus elevated IOP; often miotic pupil due to synechiae; cataracts common

Anatomy and Physiology of Aqueous Humor Dynamics

Aqueous humor is produced by the ciliary body epithelium through both active secretion (involving carbonic anhydrase and Na+/K+ ATPase) and passive ultrafiltration. This clear fluid provides nutrients to the avascular lens and cornea while removing metabolic waste products.

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