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40 Cards in this Set

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  • Back
What tissue that is part of the neural plate develops ino the eye?
Ocular primordia.
When the neural plate folds, what does it form?
Neural tube
When the neural tube closes, what forms?
Optic pits
When the optic pits invaginate, what do they form?
Optic vesicles
Optic vesicles enlarge and come into contact with what surface?
Ectoderm.
Optic vesicles induce surface ectoderm to thicken and the vesicles invaginate to form what?
Optic cups.
Ectoderm continues to invaginate and eventually separates forming what?
Primitive lens.
What types of cells form most tissues of the eye and orbit?
Neural crest cells.
Where are most eye complications seen?
Embryonic fissue, which is located inferiorly.
-Part of eyelid is missing, and it is usually the upper lid.
-Caused by a failure of the tissues to regress, often the eyelid can still be connected to cornea.
-Usually the patient has normal visual acuity
-Can require plastic surgery if eye is completely closed to prevent amblyopia (lazy eye).
WHAT DOES PATIENT HAVE?
Lid Coloboma
If the eyelid has not fully developed and remains shut, what is this called?
Cryptothalmos
-Well encapsulated lesion, usually near the lacrimal gland area.
-Sometimes they occur right on the globe usually at the limbus, where the cornea meets the sclera.
-The cyst is often composed of skin appendages, sweat glands, hair follicles (usually of ectodermal origin)
-Does NOT affect vision
-Often associated with systemic diseases, including cervical spine and auricular abnormalities.
WHAT DOES THE PATIENT HAVE?
Dermoid cyst
What syndrome is often associated with bilateral dermoid cysts? This syndrome is characterized by incomplete development of the ear, nose, soft palate, lip and mandible.
Goldenhar's Syndrome
-Absence of the eye and ocular tissues
-Results as a failure of the optic cup to develop normally
-Usually a remnant of the eye is still present
-Often associated with other CNS abnormalities
WHAT DOES THE PATIENT HAVE?
Anophthalmos
-Cornea looks smaller in diameter.
-Eye has inductive effect on orbit, if the eye is smaller than normal-->smaller orbit
-May be associated with other ocular or systemic abnormalities
WHAT DOES THE PATIENT HAVE?
Micropthalmia
-Cone shaped cornea
-When patient looks down, you get an out-pouching of the lower eyelid
-Fairly common
-->In the past, the typical patient suffered from gradual blurriness and became increasingly nearsighted.
-->Recent advances in refractive surgery (LASIX) has increased pre-operative testing, allowing us to detect subclinical anomalies before they have progressed beyond repair.
-->Subtle anomalies are easily seen using a topography imaging method-->often is it in the lower part of the cornea where the abnormal curve is.
WHAT DOES THE PATIENT HAVE?
Keratoconus
-Big, baggy basketball shaped cornea.
-This condition is not compatible with normal vision and will require a corneal transplant.
-WHAT DOES THE PATIENT HAVE?
Keratoglobus
-The embryonic fissure closes inferiorly last, so defects in the eye are usually inferior
-When the cornea is viewed under a slit lamp, one can see a notch in the iris
-WHAT DOES THE PATIENT HAVE?
Iris coloboma
-Presents as a "cobweb" covering the pupil
-During embryonic development, this fibrovascular covering usually regresses.
-Can use a laser to get rid of the membrane and increase vision.
-WHAT DOES THE PATIENT HAVE?
Persistent iridopupillary membrane
-NO iris present
-Chromosomal abnormality
-Ocular and systemic problems often present together so do a systemic workup!
-Bilateral condition
-is often associated with Wilm's tumor.
WHAT DOES THE PATIENT HAVE?
Aniridia
-Caused by a localized defect in pigmentation
-Inherited condition
-Neural crest cells form most of the pigmented tissues of the eye
-When we shine light in the pupil-->light bounces off the reting. This is an ABNORMAL response. Normally one does NOT see reflected light b/c the iris will block it from bouncing back.
-Can see choroidal bld vessels b/c they are not blocked by retinal pigmented epithelium
-No retinal pigmented epithelium-->therefore have a blonde fundus
-Usually have a defect in their macula and central vision is not very good
WHAT DOES THE PATIENT HAVE?
Albinism
-Iris is fused to cornea
-Caused by a failure of the iris, cornea, and eyelid tissues to regress
-Associated with dental abnormalities
-Always do a systemic workup with ocular abnormalities!
WHAT DOES THE PATIENT HAVE?
Peter's anomaly
-Little moles on the iris
-Look for systemic disease
-Neurofibromatosis patients usually have multiple nevi on their iris
WHAT DOES THE PAIENT HAVE?
Iris nevi
Abnormal pigment layer, increased pigmentation found around the lens.
WHAT DOES THE PATIENT HAVE?
Ectropian uveae
-Lens fibers are cloudy
-The lens normally grows with age, although slowly
-New lens fibers are continuously laid down
-Usually caused by an inutero insult: either by infection or chemical cause
-Vision is not usually impaired, although it can sometimes cause blurred vision.
WHAT DOES THE PATIENT HAVE?
Fetal nuclear cataract
If you see a dislocated lens in which the zonules are frayed and broken-->lens is dislocated upward....WHAT SYNDROME IS INVOLVED?
Marfan's Syndrome
-Tuft of tissue found on back of lens
-The hyaloid artery or other vessel has not fully regressed and remains attached to the back of the lens
WHAT DOES THE PATIENT HAVE?
Mittendorf dot
-Tuft of tissue on optic nerve
-Sometimes incorrectly diagnosed as a swollen optic nerve
WHAT DOES THE PATIENT HAVE?
Bergmeister's papillae
What are the 2 causes of leukocoria?
-Retinoblastoma
-Persistent hyperplasia of the primary vitreous (PHPV)
-Abnormality where the vitreous doesn't devleop properly. Rather than the vascular tissue in the vitreous progressing, it proliferates and forms a big white scar on the eye, causes the retina to opacify, causes lens to opacify-->looks like a white pupil!
WHAT DOES THIS PATIENT HAVE?
Leukocoria due to Persistne hyperplasia of the primary vitreous (PHPV)
-Normally, retinal fibers lose their myelination as to not obstruct vision
-In these patients, they have NOT lost the myelination on the optic nerve fibers
-->It is fairly common
-->Often misdiagnosed as a swelling of the optic nerve
-->The optic nerve has a feathery white appearance
-->The myelinated fibers cover retinal blood vessels so the vasculature of the eye is difficult to see.
WHAT DOES THE PATIENT HAVE?
Myelinated nerve fibers
-Bone spicule pigmentation
-Retina has a mottled colored appearance
-Optic nerve is pale yellow
-Vision is usually impaired
WHAT DOES THE PATIENT HAVE?
Retinitis pigmentosa
-Bilatareal tumors, almost always inherited
-pt. has leukocoria
-this disease can be life-threatening
-->The tumor can travel to the brain via the optic nerve and cause serious and permanent damage
-->The tumor has a cottage cheese appearance
-->Patients will need immediate radiation or sometimes anucleation of the eye to save their life
WHAT DOES THE PATIENT HAVE?
Retinoblastoma

KNOW THIS!
-Can be a sign of systemic disease
-Retinal epithelium has not fully developed inferiorly-the embryonic fissure fuses last on the inferior aspect
-Vision usually is not very good but it depends on how much of the optic nerve is affected
WHAT DOES THE PATIENT HAVE?
Optic nerve coloboma
-Angiogram: Dye is administered and circulates in retinal blood vessels
-In this case, the dye leaked out through the optic nerve under the retina, which may affect the macula and cause blurred or distorted vision
WHAT DOES THE PATIENT HAVE?
Optic pit: localized coloboma
-Calcifications on optic nerve
-Look at fundus and see irregular surface with a white calcified look
-->The optic disk has a marbled mulberry appearance
-Usually compatible with good vision
-Dominantly inherited
WHAT DOES THE PATIENT HAVE?
Disk drusen
-Small, pale optic nerves
-If this disease presents bilaterally, it usually indicates brain abnormality
WHAT DOES THE PATIENT HAVE?
Optic nerve hypoplasia
-Child is irritable, crying, eyes are red, and corneas are huge!
-Children are often light sensitive (photophobic)
-Anterior angle does not develop normally
-Aqueous humor does not drain properly
-The eye expands and causes scarring of cornea due to tears and breaks-->the ability of the eye to expand preserves the optic nerve
WHAT DOES THE PATIENT HAVE?
Congenital glaucoma
What is the difference b/w adults and glaucoma and babies with glaucoma?
Adults: Intraorbital pressure increases
Babies: Eye expands and causes scarring of cornea due to tears and breaks-->the ability of the eye to expand preserves the optic nerve
What numbered diopter should be used to see the cornea, iris, and lens better?
+8 diopter (+8 in black)