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Pathology Unit 3 > Chapter 29: The Eye > Flashcards

Chapter 29: The Eye Flashcards

1
Q

Physical Injuries
Blunt trauma to the eye can momentarily increases intraorbital pressure causing the bones in the orbit floor to fracture (1_______) and inferior rectus entrapment (2______)
Retinal degeneration and discoloration of occular tissue due to iron on a foreign object (3)

A
  1. Blowout fracture
  2. Enopthalmosis
  3. Siderosis bulbi
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2
Q

Causes exopthalmosis due to extra-ocular muscle swelling. Increased sympathetic tone can cause upper eyelid retraction and characteristic stare.

Name the main complication and a paradox with treatment

A

Grave’s Disease
Complication: Blindness (due to corneal exposure, ulceration, or optic nerve compression)
Paradox: thyroidectomy can increase exopthalmosis severity

Fun Fact: Proptosis=unilateral; Exopthalmosis=bilateral

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3
Q

Almost everyone has this viral/bacterial disease characterized by hyperemic blood vessels (pink eye), and an inflammatory exudate that commonly crusts. What is a common complaint in the morning? What is the more seasonal form of this condition

A

Infectious Conjuctivitis
Crusting of eyes causes them to stick closed in the morning
Seasonal: Allergic conjuctivitis

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4
Q

This disease is the most common cause of blindness in the world, leading to fibrosing keratoconjunctivitis and may spontaneously heal in children
The lymphocytic infiltrate that invades the superior portion of the cornea is known as a ____ ____?
Characteristic large macrophages with nuclear fragments?

A

Trachoma: C. trachomatis (serovars A,B,C)
Infiltrate: Trachomatous pannus
M0: Leber Cells

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5
Q

Purulent conjunctivitis of Chlamydia in newborns?
Less severe Chlamydia of eye in adults/children?
Organism most commonly causing severe acute conjunctivitis in newborn (Ophthalmia Neonatorum)?

A

Neonate: Inclusion blennorrhea
Less severe: Inclusion conjunctivitis
Organism: Neisseria gonorrhoeae

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6
Q

Yellowish conjunctival lump usually located nasal to the corneoscleral limbus: sun-damaged connective tissue?
Fold of vascularized conjunctiva grows horizontally onto cornea (insect shape/recurs after excision)?

A
  1. Pinguecula

2. Pterygium

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7
Q

This disease causes keratitis that normally will heal w/o ulcers. Commonly accompanied by systemic infection/fever. Lesions may coalesce to form linear branching fissures/ulcers. Is the primary or reactivating infection more likely to cause ulcers?

A

Herpes Simplex Type 1
Reactivating infection more likely to cause ulcers (also form central disc-shaped corneal opacity called Disciform Keratitis)
HSV2 can be passed to child’s eyes during vaginal delivery but otherwise uncommon

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8
Q

Most common helminthic infection of the eye in which the damage is caused by inflammatory response to the dead bug and can lead to blindness?

A

Onchocerciasis

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9
Q

Xerostomia and xerophthalmia are present, lacrimal gland enlarged bilaterally. Name that disease!
What is the cellular infiltrate?

A

Sjogren Syndrome

CD4 Lymphocytes

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10
Q

Noninflammatory Genetic Corneal Disorders:
Epithelial and Stromal Dystrophies
Describe the two

A

E: Microcysts-> faulty desmosomes cause layers to seperate; faulty hemidesmosomes can cause painful/recurrent erosions (Ex: Posterior polymorphous corneal dystrophy)
S: Metabolic disorders cause substances like GAGs and amyloid to accumulate

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11
Q

Common causes include advancing age, diabetes, nutritional deficiency, toxins, drugs, or physical agents. Degeneration of this organ involved causes it to swell and increases intra-ocular pressure leading to open angled glaucoma (phacolytic glaucoma). Name the disease and organ involved

A

Cataracks

The lens: degenerates then swells to obstruct the pupil and opacify

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12
Q

Loss of lens accommodation due to aging?

Granulomatous reaction to lens proteins?

A

Presbyopia

Phacoanaphylactic Endophthalmitis

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13
Q

Some facts about the Uvea?

What is peripheral anterior synechiae and posterior synechiae?

A

Common site of primary melanoma proliferation
Commonly inflamed (uveitis)
Sympathetic Ophthalmitis=Autoimmune Uveitis
(granulomatous) (due to arrestin)
Sarcoidosis: can present as Granulomatous Uveitis
PAS: adhesion of iris and anterior camber angle
PS: adhesion between iris and lens

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14
Q

Causes include hypertension, diabetes mellitus, central retinal vein occlusion, bleeding diatheses, and trauma, and shaken baby syndrome.

A

Retinal Hemorrhage
Flame-shaped appearance in nerve fiber layer
Round shape in deep retinal hemorrhages
When between retinal pigment epithelium and Bruch membrane: Dark Mass like Melanoma

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15
Q

Aggregates of swollen axons, frequently due to retinal ischemia

A

Cotton-wool spots (reversible if circulation returned)

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16
Q

Two causes of cherry-red spot at the macula that stand out due to pallor of the retina. What is that cause of retinal pallor in each disease?

A

Central Retinal Artery Occlusion: ischemia causes neuronal impairment and edema, causing the pallor
Permanent blindness tends to follow( Amaurosis fugax=unilateral blurred vision of a few min)
Lysosomal Storage Disease: lysosomes of ganglion cell filled with gangliosides, causing pallor

17
Q

Occlusion leading to flame-shaped hemorrhage in nerve fiber layer due to high intravascular pressure. Can cause what type of glaucoma as a result due to peripheral anterior synechiae due to neovascularization of iris?

A

Central Retinal Vein Occlusion
Flame-shape can look like melanoma
Can cause closed-angle glaucoma

18
Q

Name the features of Hypertensive Retinopathy

A

Arteriolar narrowing
Venular wall thickening
Flame-shaped hemorrhages
Exudates causing Macular Star
*Numerous cotton-wool spots due to ischemia
Microaneurysms
Kinking/tortuous vessels (arteriovenous nicking)
*Decreased lumen of retinal vessels make it look orange (copper wiring)
Retinal arterioles appear as parallel white lines (arterial sheathing)
Sclerotic vessels appear as threads (silver wiring)

19
Q

Disease in which severity correlates with the ability to control glycemic index.
Name some features
Name the two disease stages and describe them.

A

Diabetic Retinopathy causes retinal ischemia
Cotton-wool spots, **capillary closure, *numerous microaneurysm, retinal neovascularization (due to VEGF), decreased pericytes
Phases:
Background (nonproliferative): engorged retinal veins, sausage-shaped distentions, small hemorrhages, waxy exudates (numerous in elderly)
Proliferative: Delicate new blood vessels form (due to angiogenic factor of avascular tissue) that frequently bleed due to friability (hemorrhages can obsure vision)

20
Q

Diabetic Retinopathy can lead to

A

Irreversible blindness, Open ended glaucoma; iris neovascularization (rubeosis iridis)–>secondary glaucoma

21
Q

Glucose alcohol that builds-up in the eye causing snowflake cataracts

A

Sorbitol

22
Q

Common complication of intra-ocular hemorrhage after trauma or complications after operations such as cataract extractions? Leads too?
3 types?

A

Retinal Detachment: separates sensory retina from pigment epithelium–>cause photoreceptor degeneration and cysts appear
3 types?: Rhegmatogenous (tear), Tractional (pulled toward center of eye), Exudate (fluid accumulation in space)

23
Q

Destruction of rods and later cones causes loss of peripheral vision and night blindness is called?
What accumulates within the retina? What follows macular involvement?

A

Retinitis pigmentosa
Melanin pigment appears in retina
Family history is common (x-linked more common)
Macular involvement->blindness

24
Q

Very common in elderly, has a dry and wet form, other risk factors are advanced age, smoking, cardiovascular disease and high cholesterol.
Accumulation of extracellular material that build up as a result?

A 
Macular degeneration (wet variety has subretinal fibrovascular tissue and bleeding into subretinal space)
Laser photocoagulation is helpful in wet variety
Genetic and environment factors

Drusen

25
Q

Retinopathy of prematurity:
Caused by administering?
What happens to blood vessels?
Can they revascularize? Buttt?

A

Admin: oxygen
Vessels: obliterate, retina doesn’t vascularized
Vascularize: Yes, but 25% of the time, this can progress to scarring, retinal detachment, and blindness

26
Q

Optic nerve head edema often reflecting increased intracranial pressure

A

Papilledema; blurred margin and frequently can hemorrhage with exudate and cotton-wool spots
Few visual symptoms

27
Q

Can cause cupping due to loss of optic axons (optic atrophy). Commonly due to obstruction of what?

A

Glaucoma! Obstruction of drainage of aqueous humor via trabecular meshwork and canal of Schlemm. One of most common causes of preventable blindness

28
Q

Yellow plaque of lipid-containing MACROPHAGES not always due to high serum cholesterol/triglycerides
What is a Blepharitis, Hordeolum (sty), and Chalazion

A

Xanthelasma
B: inflamed eyelid
H: infection obstructs oil glands (Zeis more common); painful
C: lipogranulous inflammation around glands (Meibomian more common); chronic and painless

29
Q

Types of Glaucoma?

A

Congenital/buphthalmos: development abnormal (due to pliable young eye, pressure doesn’t increase as much until age 3)
Open-angle: most frequent, angle of anterior chamber is open but aqueous humor to anterior chamber is blocked (COMMON IN DIABETES AND MYOPIA)
Closed: when pupil dilates, iris obstructs drainage in anterior chamber to canal of Schlemm (EMERGENCY! TREAT THAT PATIENT WITH OCULAR HYPOTENSIVES)
Low tension: like open but without increased pressure
Secondary: due to underlying disease and unilateral

30
Q

Caused by the eye being longer than usual, leading to the focal point being in front of the retina

A

Myopia (childhood can adjust axial length with development (emmetropization))
Fibrillin, collagen, and perlecan disorders increases risk

31
Q

Phthisis Bulbi

A

End-stage eye that is disorganized and atrophic (can even get intra-ocular bone formation)

32
Q

Disease due to Rb gene (chrom13) mutation, leukocoria (white pupil), poor vision, red and painful eye with strabismus (squinting)

A

Retinoblastoma due to immature retinal neurons (Can form Flexner-Wintersteiner rosettes: surround photoreceptors)
Endophytic (grow toward vitreous body); Exophytic (between sensory retina and pigment to detach retina); Diffuse (No mass, spread along retina)
Secondary glaucoma is frequent complication

33
Q

Lets talk about primary malignant melanoma!

A

Most common primary neoplasm, arise from eye melanocytes in (CHOROID MOST COMMON in UVEA (retina unlikely to proliferate excessively))
Can metastasize via blood vessels (death in 5 years) without eye enucleation/radiotherapy/excision

Pathology Unit 3 (14 decks)

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