Path Spring 11 Eye

Front 1

enucleation

Back 1

removal of eye

Front 2

what components make up the vascular coat of the eye

Back 2

choroid, cilliary body, iris

Front 3

definitions

1. myopia
2. hyperopia
3. presbyopia
4. strambismus
5. miosis
6. midriasis

Back 3

1. myopia- nearsighted
2. hyperopia- farsighted
3. presbyopia- loss of accomidation when you get older, point of focus receds
4. strambismus- cross eye, squint
5. miosis- pupil contraction
6. midriasis- pupil dilation

Front 4

whats proptosis

Back 4

forward displacement of the eye,

caused by:
lacrimal gland lesion
sarcoid
neoplasm
optic N tumor, glioma/meningioma
thyroid- graves

Front 5

what causes proptosis

Back 5

lacrimal gland lesion: sarcoid, CA
optic N tumor: glioma, meningioma
Thyroid: graves disease
Inflammatory: cellulitis, mucormycosis, wegener granulomatosis

Front 6

what are the orbital CA

Back 6

1. hemangiomas: most fommon primary

2. Pleomorphic adenoma- CA of the lacrimal gland

3. Malignant Lymphoma

4. Mets to eye from neuroblastoma

Hint 6

w

Front 7

whats an orbital pseudotumor?
whats on the ddx

Back 7

inflammation, fibrosis of lacrimal gland.

it causes a proptosis so all of the things that cause proptosis are on ddx
cellulitis
mucormycoses
wegner- c ANCA
graves
lacrimal gland lesion, sarcoid

Front 8

wegners granulomatosis does what to the eye

Back 8

proptosis

cANCA

Front 9

what is... whats the cause

1. Blepharitis/blepharoconjunctivitis

2. Hordeolum

3. Chalazion

4. wen

Back 9

1. blepharitis: inflammation of eyelid skin
blepharoconjunctivitis: eyelids and conjunctiva are inflammed

2. hordeolum- stye. staph is common, infected hair follicle

3. chalazion- painless, gramulomatous inflammation of meibomian glands

4. wen- epidermal inclusion and dermoid cysts

Front 10

what is inflammation of the eyelid called?
what is it called if it is caused by s aureus in the hair follicle

Back 10

blepharitis- the inflammation of eye

stye- hordeolum,

recall the chalazion is the granulomatous inflammation that causes a painless nodule of the eyelid

Front 11

chalazeon

Back 11

painless nodule that is granulomatous

Front 12

what are the 3 malignant eyelid tumors

Back 12

1. basal cell: MUST KNOW PIC. basal cells give rise to neoplasm, very dark cells, white picket fence. most common

2. Sebacous: 2 most common. can be a tumor like growth or pagents like growth with thick eyelid. mets to parotid/submandibular

3. sq cell

Front 13

what is syringoma

Back 13

eecrine tumor of lower eyelid, benign

Front 14

what ist he eye CA that mets to parotid and submandibular

Back 14

sebaceous

Front 15

what are causes of conjunctival scarring

Back 15

scarring can be the result of:
1. chlamydia
2. alkali
3. pemphigoid
4. drugs
5. surgery

Front 16

whats pinguecula
whats ptergium

Back 16

pinguecula: raised yellow edematous area with vascular proliforation, caused by solar damage/trauma. does NOT involve cornea, its a conjunctival lesion

petergium: wing like proliforation of fibrovascular tissue that extends into the cornea. it can cause astigmatism, wont cross midline, related to sun exposure. BL

Front 17

which conjunctival lesion is related to sun exposure and will enter hte cornea

which one is related to sun exposure and WONT enter conjunctive

Back 17

pterygium: will enter cornea


pingecula: wont enter cornea

Front 18

what are the conjunctival neoplasms

Back 18

1. sq papilloma- low risk HPV, CIN- conjunctival intraepithelial neoplasia. all the way to the invasive

2. Mucoepidermoid carcinoma- RARE, aggressive

3. Melanocytic: conjunctival nevi, malignant nevi
**the neoplasms you can get in the conjunctiva are the same as the ones you can get in the skin

Front 19

the list of conjunctival neoplasms is the same as neoplasms where

Back 19

in the skin

Front 20

what are hte melanocytic neoplasms of the conjunctive

Back 20

1. Moles- conjunctival nevi, common

2. Malignant melanoma- UL, fair caucasions are at risk. precursor is 1 acquired melanosis with atypia. spreads to parotid and submandibular first (the sebaceous carcinoma of the eyelid also mets to the parotid and submandibular glands

Front 21

what eye CA mets to parotid and submandibular

Back 21

1. sebaceous carcinoma of eyelid

2. malignant melanoma of the conjunctiva

Front 22

what is more worrisome in the eye a flat brown marking or a raised one

Back 22

raised

the flat is just a nevi

Front 23

does the sclera of the eye heal well

Back 23

nope, poorly vascularized

Front 24

blue sclera is associated with what

Back 24

osteogenesis imperfectica -AD problem with type 1 collagen

also can be pigmented conjunctival nevus beneath the surface- nevus of ota, common in darker skinned ppl

Front 25

whats a nevus of ota

Back 25

its a big old nevus on teh face, its increased melanocytes on the skin and in the eye. causes blue sclera

Front 26

do corneal transplants elicit an immune response

Back 26

nope, non immunological site

Front 27

what is kayser fleischer ring, where is it

Back 27

ita Cu accumulation in the cornea from wilsons (AR)

Front 28

whats keratitis

Back 28

kerato- is the prefix for cornea

keratitis is corneal inflammation

corneal ulcers are common with opprotunistic infections

Front 29

what causes keratitis

Back 29

abrasian- contacts
debiliation
immune compromise

Front 30

whats the most common cause of corneal ulcer, what does it look like?

Back 30

herpetic lesion!!!

its a dendritic ulcer seen with flourescin dye

can lead to corneal scar or vision loss

Front 31

what are hte consequences of keratitis and corneal ulcers

Back 31

blindness

Front 32

can syphilitic interstitial keratitis be treated

Back 32

you bet! pen G

**can get syphalis in the cornea bc of tertiary or congenital syphilis

Front 33

43 y/o woman presents with sudden loss of
vision in her left eye.
• She has a history of syphilis 4 years ago that
was incompletely treated
• There is markedly decreased visual acuity in
the left eye with deep cornea edema
• Labs:
FTA IgM and IgG both 4+ positive
T. pallidum hemagglutination titer 1:640
What is the diagnosis?

Back 33

syphilitic keratitis, after tx its normal visual acuity

Front 34

describe band keratopathy adn list the causes of both types

Back 34

opaque horizontal bands across the cornea
there are 2 types
1. Calcific Keratophathy- and cause of hypercalcemia (hyperparathyroid)
2. Chronic Actinic Keratopathy: UV light, yellow band

Front 35

what are causes of keratoconus

Back 35

1. DS- superoxide dismutse
2. Marfan syndrome

Bl, thinning of cornea. causes irregular astigmatism.

tx with rigid contacts or transplant

Front 36

we know band keratopathy is when there are bands across the cornea. what are 2 ways the bands can look

Back 36

1. Calcific- seen in anything that increases Ca, JRA

2. Chronic actinic keratopahty- UV light damage leads to YELLOW bands

Front 37

a child with juvelina RA can develop what eye lesion

Back 37

band shaped keratopathy- it will have a horizontal calcific band along cornea

Front 38

marfans and DS have this eye lesion in common

Back 38

keratoconus

Front 39

fuchs endothelial dystrophy is what

Back 39

hereditary corneal dystropthy.
AD
middle age get blurring of vision bc the cornea cant pump water out

looks liek bullea, and stromal edema and drop like deposits called guttata

Front 40

what is it called when you get water like drops in the cornea bc of a failure to pump water out

Back 40

fuchs endothelial dystrophy

Front 41

what is the stromal corneal dystrophy

Back 41

its a macular corneal dystrophy that is AR inherited, blind by 30. keratin is deposited in stroma

b keratoepithelim types

Front 42

keratin gets deposited in teh stroma in what diseases

Back 42

hurlers, fabrays

**its a hereditary corneal dystrophy- stromal dystrophy

Front 43

why do ppl get blinder as they get older

Back 43

epithelium infoliates the lens with age

Front 44

what are hte neoplasms of the lens

Back 44

NONE

Front 45

whats cataracts, what are hte causes and what is the significance

Back 45

Cataract- clouding of lens- this scatteres the light

Caused: congenital, age, UV light, DM, wilsons, radiation, trauma, corticosteroids

leads to blindness nad glaucoma

Front 46

can corticosteroid use lead to caratacts

Back 46

you bet

often cataracts is the result of old age but can be DM, wilsons, congeital, UV light, rubella, ocular diseases

Front 47

can uveitis cause cataracts

Back 47

you bet!

will see poor pupillary dilation and the white lens

Front 48

your old woman pt has some brown coloration (her blue dress looks funny) and she sees halos when she drives, whats the deal

Back 48

cataracts


**nuclear sclerosis is common

Front 49

does your eye get red nad painful with cataracts

Back 49

nope, just impaired night vision, halos around light (scattered light through cloudy lens) and distortion of blues

Front 50

if cataracts is not treated what can develop

Back 50

glaucoma- collection of disease characterized by loss of visual filed and optic cup changes

**glaucoma causes cataracts and cataracts causes glaucoma

Front 51

what makes eye fluid

Back 51

cilliary body

Front 52

what is the collection of diseases that is characterized by visual filed loss and optic cup changes

Back 52

glaucoma

**can be caused by cataracts, or glaucoma can cause cataracts

**most glaucoma is associated with increased intraocular pressure. normal or low tension glaucoma can occur

Front 53

what is glaucoma

what are the 2 types

Back 53

open angle- aq humor can access trabecular meshwork, resistance to outflow is present

closed angle: edge of iris contacts the trabecular meshwork, this is problem with dilation- BLOCKED

Front 54

what is the cause of 1 and 2 glaucoma (list for both open adn closed glaucoma)

Back 54

open:
primary- most common
secondary- trabecular meshwork is clogged by junk, associated with sturge weber

closed angle
primary- most common in asians (common in eyes with shallow anterior chamber)
pupillary block- iris in opposition to lens when lens is dilated

secondary- due to neuvascular glaucoma

Front 55

how does glaucoma present

Back 55

ASX!!! make sure you are getting your eyes checked!!!

progressive vision loss, decreased peripheral visual field


**closed angle is PAINFUL
**progressive loss of vision
**cupped optic disk
- can be seen in a kid with chronic uveitis bc of JRA

Front 56

whats sturge weber syndrome

Back 56

associated with secondary open angle glaucoma bc junk gets clogged in the trabecular meshwork

dilated BV

Front 57

whats the primary closed angle glaucoma

Back 57

the iris comes and blocks the aq humor from circulating. increased post chamber pressure

pupillary block

Front 58

neovascular glaucoma is what

Back 58

secondary closed angle glaucoma

**contraction of membranes cover the trabecular network

Front 59

which type of glaucoma is painful

Back 59

closed angle

**glaucoma is typically asx

Front 60

what disease is characterized by changes in the optic cup

Back 60

glaucoma

**first there is an increased diameter, then there is cupping of the disc. can cause cataracts
**the retina thins

Front 61

whats opthalmitis

Back 61

inflammation of the eye bc of trauma, infection, inflammation,

can lead to claucoma,

Front 62

endophthalmitis

Back 62

eye inflammation that includes vitreous

Front 63

what is panopthalamitis

Back 63

involves retina, choroid, sclera

extends into orbit and causes orbital cellulitis and proptosis

Front 64

can you get glaucoma as a result of scarring

Back 64

yep

a scar is called synechia

Front 65

whats uveitis, what causes it.

Back 65

inflammation of one or more components of the uveal tract

iris, ciliary body, paneveitis

**can be local or systemic (JRA)

Front 66

what are sx of uveitis

Back 66

PAINFUL red, (not like the asx glaucoma)
photophobia, blurred vision, mild miosis
pericorneal halo

can progress to glaucoma bc of adhesions

Front 67

whats on teh ddx for granulomatous uveitis

Back 67

sarcoidosis
sympathetic opthalmitis (opthalmoplegia)
TB

sx of uveitis is pain, red, photophobia

Front 68

your pt has red painful eyes with photophobia and ciliary flush whats the deal

Back 68

uveitis

**anything that is blood born can get into the eye and cause uvitis

Front 69

what eye lesions are seen in sarcoidosis

Back 69

granulomatous uveitis
calcific band keratopathy
mutton fat
candle wax dripping on retina

eye is involved in sarcoidosis 1/3 of time

Front 70

your pt has granulomatous uveitis (short ddx) along with calcific band keratopathy on cornea and mutton fat nad candle wax drippings on retina. whats the deal

Back 70

sarcoidosis of the eye

Front 71

mutton fat ppt is associated with what

Back 71

sarcoidosis

Front 72

candle wax drippings is associated with what

Back 72

sarcoidosis

Front 73

what is the pathogenesis and clinical of SYMPATHETIC ophthalmitis

Back 73

RARE complication of ocular trauma. when one eye is damaged the OTHER eye sympathizes and you get granulomatous inflammation in BOTH eyes.

pathogenesis: autosensitivity to exposed pigment AG shared by uveal melanocytes retinal epithelial cells and neuroal cells

Front 74

what are hte 2 AI diseases that affect the eyes

Back 74

sarcoid
sympathetic opthalmous

Front 75

what is the pathogenesis of sympathetic opthalmitis

Back 75

its when one eye is injured nad so teh other eye sympathizes adn then BOTH eyes get granulomatous inflammation (short ddx for granulomatous)

its caused by an autosensitivitiy to exposed pigment AG shared by uveal melanocytes, retinal epithelium and neural cells

Front 76

when do you see sx in sympathetic opthalmia

Back 76

about liek 2 weeks

sx in the BL eye are:
loss of accomadation, blurred vision, photophobia.

tx w/removal of blind eye and long term immuno suppression

Front 77

what happens in the sympathetic eye in sympathetic opthalmia

Back 77

loss of accomidation
blurred vision
photophobia

**this is the disease where one eye is injured and then like 2 weeks later the other eye has this problem. then BOTH eyes get granulomatous inflammation bc of exposure to pigment AG. tx with eye removal and long term immunosuppression

Front 78

what melanocytic neoplasm occurs in teh uvea

Back 78

malignant melanoma

**this occurs in the iris, ciliary body, and chorodi

S100+

Front 79

what are the clinical features, prognosis, and mets of malignant melanoma in the eye

Back 79

clinical: can be iris, ciliary body. slit lamp will be CURVED line. clilary causes loss of accomidation

pale lesion, contrast to the
nevi which is really dark brown

METS: liver

Front 80

whats the most common occular malignancy in adults

Back 80

mets to choroid

**the most common PRIMARY is malignant melanoma

Front 81

are benign choroid nevi premalignant

Back 81

nope

Front 82

is a dark brown large lesion or a paler raised lesion in the eye more concerning

Back 82

the pale bumpy one- melanoma is likely

Front 83

does occular CA mets to lung, brain, liver, bone

Back 83

liver

Front 84

melanoma is what shape

Back 84

spindle, goes with neuro ectoderm