1. Anterior Seg Vocab

Front 1

what is hyperemia?

Back 1

hyperemia = injection = congestion of BV = redness

Front 2

What must you evaluate when the eye is red?

Back 2

1) which layer?
2) how much? how bad?
3) how is it distributed?

Front 3

types of discharge?

Back 3

1) mucopurulent/purulent
2) ropy/stringy
3) tearing
4) serous

Front 4

is mucopurulent discharge a thin or thick material?

Back 4

thick material

Front 5

color of mucopurulent dicharge?

Back 5

varies from white to cream to yellow to green

Front 6

what is mucopurulent discharge associated with?

Back 6

associated w/ BACTERIAL and less commonly fungal infxns

Front 7

what type of discharge often has an offensive odor?

Back 7

mucopurulent discharge

Front 8

what is ropy/stringy discharge?

Back 8

serous discharge w/ mucus threads

Front 9

what is ropy/stringy discharge associated with?

Back 9

associated w/ allergic and vernal conjunctivitis

Front 10

Patients may complain of excess tearing that is not associated with infection. Describe the viscosity of this type of discharge.

Back 10

Tearing discharge has SAME viscosity as regular tears

Front 11

what is serous discharge?

Back 11

thick tears

Front 12

The diff b/w ___ and ___ discharge is subtle and does not have significant diagnostic value, but it is important to recognize descriptive terms that may be used to describe a clinical presentation

Back 12

tearing;
serous

Front 13

is papilla a specific or nonspecific response?

Back 13

nonspecific response

Front 14

what causes papilla?

Back 14

caused by many acute and chronic INFLAMMATORY disorders

Front 15

What is the histopathological definition of a papilla?

Back 15

diffuse infiltration (exudation/leakage) of various types of inflammatory cells into the conjunctival stroma (lymphocytes, PMNs, plasma cells, eosinophils)

Front 16

___ is primarily comprised of blood-borne inflammatory exudate

Back 16

a papilla

Front 17

what is serous discharge often associated with?

Back 17

associated with viral infxns

Front 18

which has a central blood vessel, papilla or follicle?

Back 18

papilla

Front 19

the central blood vessel in papilla is the origin of the _________

Back 19

focal exudation

Front 20

what is papilla associated with?

Back 20

1) allergic disease
2) bacterial disease
3) Chlamydia

Front 21

what type of response is seen in adults with Chlamydia?
children with Chlamydia?

Back 21

adults - mixed follicular and papillary response

children - papillae only (lymph system not fully developed)

Front 22

papillae are often seen in what part of the eye?

Back 22

superior palpebral

Front 23

what is the histopathological definition of a follicle?

Back 23

focal hyperplasia (swelling/overgrowth) of lymphoid tissue

Front 24

_______ are slightly milky, translucent lobular projections

Back 24

follicles

Front 25

which are USUALLY larger, papilla or follicles?

Back 25

follicles

Front 26

where do follicles arise from?

Back 26

pre-existing avascular lymphoid tissue in the conjunctival stroma

Front 27

which are avascular, papilla or follicles?

Back 27

follicles

Front 28

what is in the central core of follicles?

Back 28

immature lymphocytes and macrophages with surrounding mature lymphocytes

Front 29

follicles are more common in what part of the eye?

Back 29

lower fornix

Front 30

what are follicles often associated with?

Back 30

1) viral disease
2) Chlamydia (in adults only)
3) toxic conditions

Front 31

Staining shows areas of corneal ____

Back 31

epithelial breakdown

Front 32

staining usually refers to _____ unless otherwise specified

Back 32

NaFl

Front 33

NaFl represents areas where _______

Back 33

epithelial cells are missing

Front 34

which stain is a true stain?

Back 34

Rose Bengal

Front 35

Rose Bengal represents areas of ____

Back 35

dead/dying epithelial cells and mucus

Front 36

what is it called when staining is observed in a punctate fashion?

Back 36

PEK, SPK, or PEE

Front 37

PEK =

Back 37

punctate epithelial keratopathy

Front 38

SPK =

Back 38

superficial punctate keratitis

Front 39

PEE =

Back 39

punctate epithelial erosions

same as PEK!

Front 40

What does PEK refer to?

Back 40

refers to any breakdown of epithelium

Front 41

____ is a catch-all term most clinicians use most frequently to refer to epithelial disruption

Back 41

SPK

Front 42

what is SPK?

Back 42

epitheliopathy secondary to infectious process

Front 43

Compare Rose Bengal and Lissamine Green

Back 43

they are used for similar clinical situations. but Lissamine Green is not as good at detecting herpes simplex keratitis

Front 44

Lissamine Green is best for ______ staining

Back 44

dry eye syndrome

Front 45

what does trace staining mean?

Back 45

there are only a very tiny few punctate staining areas (tiny dots of staining)

Front 46

Tx for trace staining?

Back 46

usually requires NO Tx other than AT

Front 47

T/F: AT are used in nearly all cases of corneal staining as supportive therapy

Back 47

True

Front 48

what is 1+ staining equivalent to?

Back 48

MILD staining

Front 49

Tx for mild staining?

Back 49

1) if cause is INFLAMMATORY and there is NO threat of bacterial load --> steroid
2) if cause is INFLAMMATORY and there is a threat of bacterial load --> steroid-antibiotic combo

Front 50

moderate staining = ____+ staining

Back 50

2-3+

Front 51

Tx for moderate staining?

Back 51

1) if the cause is INFECTIONS --> Tx the infxn 1st. no steroids on 1st day
2) if the cause is INFLAMMATORY --> steroid-antibiotic combo

Front 52

Tx for severe staining?

Back 52

1) if cause is INFECTIONS --> Tx the infxn b4 adding a steroid later
2) other causes --> protect the cornea (use prophylactic antibiotic) until it is healed enough to use a combo or a steroid

Front 53

what is chemosis?

Back 53

conjunctival swelling (see w/ a variety of diseases and disorders)

Front 54

is chemosis a specific or non-specific response?

Back 54

non-specific

Front 55

A/C rxn refers to ____ w/in the anterior chamber/aqueous

Back 55

inflammation

Front 56

what is A/C rxn associated with?

Back 56

1) any moderate to severe insult to the eye (trauma, severe infxn, postsurgery)
2) systemic infxns
3) autoimmune diseases

Front 57

hallmark features of A/C rxn?

Back 57

cells (WBC) and flare (proteins) in the AC from leaking blood vessels in the uveal tract

Front 58

what does PAN signify?

Back 58

signifies acute or severe inflammation

Front 59

______ is a swollen, palpable, and/or tender area just in front of the ear

Back 59

PAN (preauricular lymph node)

Front 60

what is PAN associated with?

Back 60

1) viral eye diseases
2) severe bacterial eye diseases

Front 61

examples of severe bacterial eye diseases that PAN is associated with?

Back 61

severe internal hordeolum/preseptal cellulitis

gonococcal hyperacute conjunctivitis

Front 62

PAN is located just anterior to the ___

Back 62

flap covering the ear opening

Front 63

if there is severe eye infxn, ____ glands are involved as well.These are the swollen glands that are often present during a cold or upper respiratory tract infxn (URTI)

Back 63

submandibular

Front 64

manifestations of corneal edema?

Back 64

1) ground glass or vaguely opaque appearance in the stroma
2) epithelial microcysts
3) stromal striae
4) gross clouding of the entire cornea
5) bullous keratopathy

Front 65

what do epithelial microcysts indicate?

Back 65

corneal edema

Front 66

what do stromal striae indicate?

Back 66

corneal edema

Front 67

what does bullous keratopathy indicate?

Back 67

corneal edema

Front 68

what is the best way to see corneal edema?

Back 68

with a very thin, sharply focused optic section

Front 69

what is corneal edema associated with?

Back 69

a variety of degenerative, dystrophic, inflammatory, and infectious conditions

Front 70

what contributes to eyelid swelling?

Back 70

increased vascular permeability and vessel dilation

Front 71

what is protective ptosis?

Back 71

when the upper eyelid partially closes to protect the cornea

Front 72

SEI =

Back 72

subepithelial infiltrates

CORNEAL infiltrates

Front 73

SEI occur in what part of the eye?

Back 73

the superficial corneal stroma, just beneath the epithelium

Front 74

how do SEI look like?

Back 74

gray-white

Front 75

what is the histopathological definition of SEI?

Back 75

infiltration of WBCs out of the limbal BVs into the subepithelial space in response to some insult (infxn, inflammation)

Front 76

____ often form as sequelae to PEK, producing a more intense epithelial-subepithelial involvement

Back 76

infiltrates

Front 77

Often, the epithelium will heal 1st, leaving the ______

Back 77

subepithelial infiltrates

Front 78

what is a sterile ulcer

Back 78

- INFILTRATE
-epithelial erosion that is caused by any process OTHER THAN AN INFXN

Front 79

infiltration in CONJUNCTIVAL stroma=

Back 79

papilla

Front 80

infiltration in CORNEAL stroma =

Back 80

SEI

Front 81

1) small areas of epithelial loss =

2) larger, geographical areas (not pinpoint) areas of epithelial loss =

Back 81

1) PEK

2) ulcer

Front 82

what is a true ulcer?

Back 82

when the SURFACE of a tissue or organ has been eroded or otherwise damaged, in a measurable area

Front 83

describe the types of ulcers

Back 83

1) sterile = non-infectious
2) infectious = bacterial, fungal, viral, or protozoan

Front 84

what is the most common type of sterile ulcer? describe it

Back 84

shield ulcer - large areas of corneal epithelium removed by scraping from giant papilla on upper lids

Front 85

infections that cause corneal ulcers are collectively called ______

Back 85

microbial keratitis

Front 86

typically, a corneal ulcer refers to __________

Back 86

an infectious process

Front 87

most common cause of corneal ulcer?

Back 87

bacterial keratitis

Front 88

another name for petechial hemorrhages?

Back 88

punctate hemorrhages

Front 89

what are petechial hemorrhages?

Back 89

pinpoint or splotchhy hemorrhages

Front 90

petechial hemorrhages are usually found in what part of the eye?

Back 90

superficial palpebral or bulbar conj

Front 91

what are petechial hemorrhages associated with?

Back 91

associated w/ any moderate to sever inflammation or infxn

Front 92

____ are sometimes seen in scuba divers after a deep dive

Back 92

petechial hemorrhages

Front 93

____ are sometimes seen after a bout of crying/eye rubbing OR in patients w/ poor sleep habits

Back 93

petechial hemorrhages

Front 94

what are the 2 things that the word 'filament' refers to

Back 94

1) mucus strands in the tear film
2) filaments associated w/ filamentary keratitis (result of aberrant epithelial healing from any epithelial disorder)

Front 95

what is a pseudomembrane?

Back 95

conjunctival epithelial hyperplasia

Front 96

causes of pseudomembrane?

Back 96

severe infxn or inflammation

Front 97

what are true membranes?

Back 97

fibrin cellular debris

Front 98

which indicate an even MORE severe inflammatory response, pseudo or true membranes?

Back 98

true membranes

Front 99

which cause significant bleeding when peeled from the conj, pseudo or true membranes?

Back 99

true membranes

Front 100

what is the end result of a wide variety of severe inflammations?

Back 100

conjunctival scarring

Front 101

name some of the things that conjunctival scarring can cause

Back 101

1) entropian
2) trichiasis
3) dry eye
4) symblepharon

Front 102

what is a symblepharon?

Back 102

adhesions b/w the conj of the lids and the globe

(forms after trauma, burns, infxins, etc)