4.1.1 Eye Pathology I and II Flashcards
What is the most common cause of irreversible blindness in the US?
Age-related macular degeneration (ARMD)
What is the normal range of corneal refractive power? Lenticular refractive power?
Corneal: 39-48 diopters
Lenticular: 15-24
What type of fracture may give rise to “racoon” eyes?
Basilar skull fracture
Though still very rare, what is the most common type of neoplasm in the orbit?
Hemangioma
Name this eye pathology? What condition is it often secondary to?
Exopthalmos; Graves dz
What causes the exopthalmos in graves disease?
The extraocular muscles are greatly distended. Note that the tendons are spared
Name condition: acute inflammation of the eyelids caused by allergens, mild trauma, etc
Blepharitis
Name condition: caused by acute folliculitis of the Meibomian or Zeis glands. How do you treat this condtion?
Hordeolum (sty); hot compresses will usually cause the sty to “point” and drain
Name this condition
Sty (Hordeolum)
What is the most common malignancy of the eyelid?
Basal cell carcinoma (predilection for lower eyelid and medial canthus)
What type of conjunctival issue is usually caused by minimal trauma (coughing)?
Conjuctival emorrhage
What is the leading cause of blindness worldwide?
Chlamydia trachomitis
What are the five types of conjunctivitis?
Allergic, Bacterial, Viral, Chlamydial, Gonococcal (opthalmia neonatorum)
Which two bacteria most commonly cause bacterial conjunctivitis (pink eye)?
H. influenzae and Strep pneumoniae
Condition?
Hemophilus Conjunctivitis. Yellow “matting” in the morning
What is the treatment for conjunctivitis?
What are two common causes of drying and scarring of the cornea?
Sjogren syndrome - dry eyes and mouth
Idiopathic - Common in older women, can over in pregnant women (treated with artificial tears)
What condition? What is the pathogenesis and treatment?
Pterygium; vascularized conjuctival tissue which may grow over the iris, common in elderly, treated by surgical excision
What is true about the rate at which the cornea heals?
Corneal eptihelium heals faster than any other tissue in the body (Corneal BM (Descemet’s membrane) does not regenerate following injury)
Name the condition: pt believes there is something in the eye, physical exam reveals only conjunctivitis? How are you going to treat the pt?
Corneal abrasion; patch affected eye for 24-48 hrs w/ possible pain management
Name the condition. What is the offending organism? What treatment should be avoided?
Corneal ulcer; HSV; avoid STEROIDS
“Chinese character” aspect of Herpes simplex keratitis
Name this condition being shown under UV light?
HSK - herpes simplex keratitis (corneal ulcer)
What is going on with this pt’s cornea? How are you going treat it, Future Dr. Batts?
Huge corneal ulcer; treat with corneal transplant b/c BM is affected
What is being shown in these two images?
Fungus growing into the anterior chamber after being prescribed STEROIDS
This is a case to simply illustrate how corticosteroids can be dangerous. I never use them. Let an ophthalmologist make that decision (they have better malpractice coverage).
Date these two transplant images
Top: Day 1
Bottom: Day 3
What is the difference b/t corneal degenerations and corneal dystrophies?
Corneal degenerations: Unilateral or bilateral, typically non-familial
Corneal dystrophies: typically bilateral and hereditary
What is the leading cause of corneal transplant in the US?
Fuch’s (familial) dystrophy
What is cataracts?
The term cataract describes lenticular opacities that may be congenital or acquired. Systemic diseases (e.g., galactosemia, diabetes mellitus, Wilson disease, and atopic dermatitis), drugs (especially corticosteroids), radiation, trauma, and many intraocular disorders are associated with cataract. Age-related cataract typically results from opacification of the lens nucleus (nuclear sclerosis). The accumulation of urochrome pigment may render the lens nucleus brown, thus distorting the individual’s perception of blue color (the predominance of yellow hues in Rembrandt’s paintings later in life might have been a consequence of nuclear sclerotic cataracts).
What is this an image of?
Cataract of the eye
What is this an image of?
More advanced cataract
What is this an image of?
Lens cataract
What is glaucoma?
Optic disc atrophy with characteristic cupping, usually accompanied with increased Intraocular pressure and progressive visual field loss if left untreated
What is the difference between open and closed angle glaucoma?
- In open-angle glaucoma the aqueous humor has complete physical access to the trabecular meshwork, and the elevation in intraocular pressure results from an increased resistance to aqueous outflow in the open angle.
- In angle-closure glaucoma the peripheral zone of the iris adheres to the trabecular meshwork and physically impedes the egress of aqueous humor from the eye blocking the canal of schlem.
Primary closed angle glaucoma is thought to be?
A medical emergency
What are these images of?
Glaucoma
What is this an image of?
Retina and optic nerve in glaucoma
Glaucoma might well be the only condition in which optic atrophy is accompanied by cupping (thus guaranteeing it will be on the Boards- Fish)
What are the characteristics of hypertensive retinopathy?
Normally, the thin walls of retinal arterioles permit a direct visualization of the circulating blood by ophthalmoscopy. In retinal arteriolosclerosis the thickened arteriolar wall changes the ophthalmic perception of circulating blood: vessels may appear narrowed, and the color of the blood column may change from bright red to copper and to silver depending on the degree of vascular wall thickness
What is this an image of?
Temporal Arteritis
The vessel lumen has been completely occluded by granulomatous inflammation, so-called temporal or “giant cell” arteritis (referring to the granulomatous nature of the inflammation). Common in older adults, keep in mind that retinal arteries may also be affected, causing retinal infarction.
What is this an image of?
Hypertensive Retinopathy
What are the characteristics of proliferative diabetic retinopathy?
What are the characteristics of non-proliferative retinopathy?
What is this an image of?
Proliferative retinopathy
What are the characteristics of retinopathy of prematurity?
What are the two types of retinal detachment?
What is age-related macular degeneration (AMRD)?
Degeneration of macula - causes distortion and eventual loss of central vison
Classified as wet or dry
What is the difference between wet and dry ARMD?
Dry - deposition of yellowish extracellular material in and between Bruch membrane and retinal pigment epithelium with gradual decrease in vison
Wet - rapid loss of vision due to bleeding secondary to choroidal neovascularization
What is a retinal detachment?
Separation of neurosensory layer of retina from the outer most pigmented epithelium. Leads to degeneration of photoreceptors and eventually vision loss.
What is this an image of?
Dry AMRD
What is this an image of?
Wet AMRD
What is this an image of and what are the characteristics?
Papilledema
Optic disc swelling due to increased ICP
NEED TO RULE THIS OUT BEFORE DOING SPINAL TAP
Edema of the head of the optic nerve may develop as a consequence of compression of the nerve (as in a primary neoplasm of the optic nerve) or from elevations of cerebrospinal fluid pressure surrounding the nerve, e.g, from a large brain tumor).
What are the characteristics of retinoblastoma?
Mutation of the Rb gene
What is this an image of?
Retinoblastoma
What is this an image of?
Retinoblastoma
What are the characteristics of a uveal tract melanoma?
What is this an image of?
Melanoma of the eye
What must be known about the orbit of the eye?
What must be known about the eyelid?
What must be known about the conjunctiva?
What must be known about the cornea?
What must be understood about the anterior segement of the eye?
What is endophtalmitis?
What must be understood about the uveal tract?
What must be known about the retina?
What must be known about the optic nerve?
