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OD2 - Applied Clinical Training & Research Studies in Vision and Optometry > AED - Lumps and Bumps III - Week 3 > Flashcards

AED - Lumps and Bumps III - Week 3 Flashcards

1
Q

Can pigmented masses be found in the uvea?

A

Yesd

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2
Q

Where does colouration of pigmented masses come from? What two layers is this found in?

A

Melanocytes found in connective tissue and basal layer

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3
Q

Define naevus.

A

Benign acquired pigmentation

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4
Q

Define melanosis and provide an alternate name. Describe what it looks like and what structure it involves.

A

Complexion associated melanosis

Found in dark-skinned individuals, usually flat and involved the limbus

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5
Q

What does ocular melanocytosis look like and is it superficial or deep?

A

It is grey in the deep sclera

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6
Q

List the 5 classifications of ocular pigmented lesions.

A 
Naevus
Racial melanosis
Ocular melanocytosis
Primary acquired melanosis
Conjunctival melanoma
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7
Q

What does the classification of naevus follow?

A

Uses different terms in different tissue

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8
Q

What are conjunctival and skin naevus classified by? List them (3) and what theyre associated with.

A

By depth or cell type/appearance

  • junctional (epithelial basal layer/stroma junction)
  • intradermal (stromal)
  • compound (stromal and epithelial)
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9
Q

What is the most common conunctival tumour?

A

Naevus

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10
Q

Are naevus consistently coloured or can they be patchy?

A

Can be patchy

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11
Q

Are naevus mobile over the conjunctiva? What does this mean?

A

Yes, they havent ivaded below

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12
Q

When do naevus typically form?

A

Pubescent years, 10-20 years of age

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13
Q

Do naevus change with pregnancy?

A

They can

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14
Q

Are naevus fast or slow growing? What percentage become malignant?

A

Very slow

<1% become malignant

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15
Q

Are naevus flat or elevated?

A

Flat or minor elevation

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16
Q

What are naevus typically close to?

A

Limbus

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17
Q

Do naevus have a rich vascular supply?

A

No, 1-2 feeder vessels is common, its not rich

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18
Q

What is present in 70% of naevus?

A

Cysts

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19
Q

Can naevus be amelanotic?

A

Yes, complete or partial

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20
Q

In which two types of naevus are biopsies done?

A

Junctional or compound

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21
Q

What should you look out for with naevus (4)?

A

Sudden growth
Prominent feeders
Non-bulbar site
First noticed age 20+

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22
Q

Is congenital melanocytosis benign or malignant?

A

Benign

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23
Q

What is the cause of congenital melanocytosis?

A

Increased colour of deep tissue due to excess melanosomes

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24
Q

What is the difference between congenital melanocytosis and naevus of ota?

A

If the pigment is on the eyes alone, it is congenital melanocytosis
If it includes the eye and skin, it is naevus of ota

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25
Q

What appearance does congenital melanocytosis have? What percentage is associated with glaucoma? What percentage develops into melanoma?

A

Appears deep-bluish
10% can have associated glaucoma
2-4% develop melanoma

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26
Q

Does congenital melanocytosis involve the conjunctiva? Is it motile?

A

Doesnt involve the conjunctiva so it isnt motile

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27
Q

Does congenital melanocytosis change appearance or appear with puberty?

A

Can change or appear at puberty

28
Q

Is primary acquired melanosis benign or malignant?

A

Premalignant

29
Q

In what skin colour and age groups is primary acquired melanosis common?

A

Middle aged, fair skinned people

30
Q

Is primary acquired melanosis uni- or bilateral?

A

Unilateral

31
Q

Is the pigment of primary acquired melanosis dense or diffuse?

A

Diffuse

32
Q

Is primary acquired melanosis a birthmark?

A

No

33
Q

Where on the conjunctiva can primary acquired melanosis be found? Which regions especially?

A

Anywhere, especially the lid margins (evert lids)

34
Q

Is primary acquired melanosis flat or raised?

A

Flat, not usually raised

35
Q

What kind of proliferation is present in primary acquired melanosis? Is it mobile over the sclera? Does it have few or many feeder vessels?

A

Has lateral proliferation
Is mobile over the sclera
Has minimal feeder vessels

36
Q

Is primary acquired melanosis diffuse or localised?

A

Diffuse (localised would be a naevus)

37
Q

In what 3 cases is a biopsy indicated for a primary acquired melanosis?

A

Diffuse lesion found at the lid margin or the limbus with corneal involvement
Expansive diffuse lesion in one eye

38
Q

What is the chance of a future melanoma if there are pleomorphic cells in a primary acquired melanosis biopsy?

A

50%

39
Q

What percentage of melanoma comes from primary acquired melanosis?

A

75%

40
Q

Is melanoma invasive?

A

Yes

41
Q

Is melanoma fast-growing?

A

Yes

42
Q

Is the colouration of melanoma dense or diffuse?

A

Dense

43
Q

Do melanoma have regular or irregular borders? What else is seen and what is it?

A

Irregular border

Has a small halo which is the invasive region

44
Q

What appearance does a melanoma have in terms of its surface?

A

Raised and irregular surface like a cauliflower

45
Q

What can be seen on a biopsy of melanoma?

A

Invasive lesion with pleomorphism and anaplasia

46
Q

Is a cavernous sinus fistula acquired or congenital?

A

Acquired

47
Q

Is kaposi’s sarcoma benign or malignant?

A

Malignant

48
Q

What are the symptoms of kaposi’s sarcoma?

A

None

49
Q

List two signs of kaposi’s sarcoma and where it is usually found.

A

Bright red vascular mass, most often inferior fornix

May give sub-conjunctival haemorrhage

50
Q

In what percentage of AIDS patients does kaposi’s sarcoma occur?

A

25% due to immunocompromisation

51
Q

What is telangiectasia and is it acquired or congenital?

A

Is congenital

Dilated and tortuous blood vessels in the bulbar conjunctiva

52
Q

Is telangiectasia common in isolation?

A

Not uncommon

53
Q

List 7 important associations of telangiectasia.

A 
Fabry's disease
Bloom's syndrome
Diabetes
Ataxis telangiectasia
Sturge-Weber syndrome
Myeloid disorders
Anaemic disorders
54
Q

List 3 signs of sturge-weber syndrome.

A

Congenital conjunctival or episcleral haemangioma
Episcleral or conjunctival involvement (70%)
Cutaneous port wine stain along CNV

55
Q

What three things may someone with sturge-weber syndrome also have?

A

Choroidal haemangioma
Iris heterochromia
Glaucoma before 2yo

56
Q

What sign is classic of sturge-weber syndrome?

A

Port wine stain

57
Q

What are the four components to assessing sturge-weber syndrome?

A

SL with lid eversion
IOP
Gonioscopy
DFE

58
Q

What should be considered for sturge-weber syndrome and why?

A

Referral for assessment of neurological status (intracranial haemangioma)

59
Q

What does the presence of a choroidal haemangioma with sturge-weber syndrome predispose you to (2)?

A

Serous RD

Glaucoma

60
Q

List four symptoms of cavernous sinus fistula.

A

Weakness
Dizziness
Whooshing noise

61
Q

List 5 signs of cavernous sinus fistula.

A 
Generalised episcleral/conjunctival blood vessel dilation and tortuousity
Elevated IOP on that eye
Orbital bruit
Lid oedema
Retinal haemorrhage
62
Q

What happens with a cavernous sinus fistula? How can it happen (2)?

A

ICA blood fills the cavernous sinus

Can occur spontaneously or disease related (HT)

63
Q

When is cavernous sinus fistulas common (2)?

A

After trauma or surgery

64
Q

Should cavernous sinus fistulas be referred?

A

Yes urgently, for closure of fistula

65
Q

How is cavernous sinus fistula managed (by an optometrist)?

A

Manage their IOP

OD2 - Applied Clinical Training & Research Studies in Vision and Optometry (174 decks)

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