Chapter 29-The Eye Flashcards
What is the most common cause of irreversible visual loss
Age related macular degeneration
Diseases of the orbit tend to push the eye in which direction
Forward, known as proptosis
Which direction is the eye pushed in the cause of inflammation of the or neoplasm of the lacrimal gland
Proptosis in the inferior and medial direction
What direction is the eye pushed in the case of masses in the horizontal rectus muscles
Straight forward
What are the two most common primary tumors of the optic nerve
Glioma
Meningioma
What direction is the eye pushed in the cause of primary tumors of the optic nerve
Axial proptosis
Graves’ disease proptosis is due to changes in which eye structure
Orbit
What is proptosis due to Graves’ disease caused by
Accumulation of EC matrix proteins and fibrosis in the rectus muscles
In immunosuppressed, diabetic ketoacidosis patients what can occur in the eye following a sinus infection
Infection of the ethmoid sinus can spread to the eye
What is idiopathic orbital inflammation
Aka orbital inflammatory pseudo tumor
Necrosis and degenerating collagen accompanied by vasculitis of the orbit should lead to which diagnosis
Wagner granulomatosis
What is the general nature of neoplasms of the orbit
Vascular in origin
What are the common tumors of the orbit
- capillary hemangioma
- lymphangioma
- cavernous hemangioma
Primary orbital malignancies may arise from which orbital layer
Any of the them
What is the most common malignancy fo the eyelid
Basal cell carcinoma
How common are malignancies of the eyelid
Very rare
What are the common locations of basal cell carcinomas of the eyelid
Lower eyelid and medial canthus
Which condition can sebaceous carcinomas mimic
Chalazion
Paget disease
Sebaceous carcinomas typically spread to which LN first
Submandibular and parotid
Karposi sarcoma may occur in the eyelid in which individuals
AIDs
What color is the Kaposi sarcoma lesion in the eyelid
Purple because lesion is in the debris
What color is the Karposi sarcoma lesion in mucous membrane of the conjunctiva
Bright red
Primary lymphoma of the conjunctive is most likely to occur in which portion
Fornix
Infection with which organism is able to produce significant scarring
Chlamydia trachomatis
Where does pterygium typically originate
Conjunctive astride the limbus
Pterygium is formed by what
Submucosal growth of Fibrous secular connective tissue that migrates onto the cornea
What threat does a pterygium have on vision loss
Not a threat as it does not cross the pupillary axis
Why should pyerygium be removed if they are benign
Can occasionally included squamous cell carcinoma and melanoma
What can develop as a result of a pinguecula
A delle (saucer shaped depression due to focal dehydration)
Neoplasms of the conjunctiva tend to develop in which location
Limbus
Squamous papillomas and conjunctival intraepithelial neoplasia are associated with which pathogen
HPV 16 and 18
What is the carcinoma of the conjunctivitis that follows an aggressive course
Mucoepidermoid carcinoma
Pigmentations in which areas are usually melanomas or their precursors
Cornea, fornix, or palpebral fissure
A condition with immune complex deposition such as rheumatoid arthritis may cause what condition to the sclera
Necrotizing scleritis
When well the urea appear a blue color
Aka typical Tyndall effect seen following episodes of scleritis
What may occur in individuals with high intraocular pressure with regards to the uvea
May thin the sclera, resulting in a lesion known as staphyloma, which appears blue.
What is responsible for the majority of refraction of the eye
Cornea
What is the association with Bowmans layer and malignancy
Bowmans layer is able to serve as a barrier against penetration of malignancies
Under which conditions can corneal vascularization occur
Chronic corneal, edema, inflammation and scarring
What is the location that Kayser Fleisher rings form
Descemet membrane
What are the pathogens that can cause corneal ulceration
Acanthomebia, herpes simples, herpes zoster, bacteria and fungi
What are the general characteristics of corneal degenerations
Unilateral or bilateral and are nonfamilial
What are the general characteristics of dystrophies
Bilateral and familial
What are the two common corneal degenerations
Calcification band keratopathy
Actinic band keratopathy
Which keratopathy is associated with calcium in Bowmans layer
Calcific band keratopathy
Which condition may increase the risk of calcific band keratopathy
RA
Which corneal condition develops due to high amounts of UV light
Actinic band keratinopathy
Which condition is characterized by solar elastosis, yellow hue to the point is looks like oil drops
Actinic band keratopathy
What is occuring in Keratoconus
Thinking of the extasia of the cornea without inflammation or vascularization, resulting in a conical shape rather than spherical
What is a conditions seen commonly in keratoconus
Corneal hydrops
Which conditions are assoacited with Keratoconus
Down syndrome, Marfans, atopic disorders
What is occurring in Fuchs endothelial dystrophy
Loss of endothelial cells resulting in edema and thickening of the stroma
Which condition is characterized by guttata (abnormal droplike deposits, and the stoma tacking a ground glass appearance with blurred vision
Fuchs endothelial dystrophy
When does pseudophakic bolls keratopathy occur
Endothelial cell reduction following cataract surgery
What are the common causes for a corneal transplant
- Fuchs endothelial (principal indicator)
- pseudophakic bullous keratopathy
What do stromal dystrophies usually result in
Opacities in the cornea leading to vision compromise (usually painful as well)
What is a gene seen commonly in stromal dystrophies
TGFB1
Which diseases are associated with increased risk for cataracts
Systemic diseases(galactosemia, DM, Wilsons, atopic dermatitis), corticosteroids, radiation, trauma
What are cataracts
Lenticular opacities of the lens
What condition distorts the perception of blue hues
Accumulation of urochrome pigmentation
What is the most common form of glaucoma
Primary open angle glaucoma which is resistance to aqueous outflow
Which gene mutations are comonly associated with open angle glaucoma
MYOC and OPTN
Which gene mutation is associated with secondary open angle glaucoma
LOX1 gene
Granulomatous uveitis is commonly a complication of which condition
Sarcoidosis
The opthalmic sign of candle wax dripping is characteristic of which condition
Granulomatous inflammation and subsequent sarcoidosis
What is the most common intraocular malignancy in adults
Metastasis to the uvea, or choroid
What is the prognosis of metastasis of the eye
Short survival, any treatment is palliative
What are the common gene mutations in uvea melanomas
GNAQ and GNA11
What is the common location that a uveal melanomas will spread
Liver
What is the prognosis of choroidal and ciliary body melanomas related to
Lateralization
Cell type
Proliferative index
How does the retina respond to injury
Gliosis
What is the cause of findings in the eye exam such as each night spots (focal choroidal spots), and macular star
Malignant hypertension
What is the cause of a eye exam finding of “cotton wool spots”
Nerve fiber infarct
Premature birth is associated with the increased risk of which event in the eye
Retinal detachment
During a cessation of blood supply to the retina, what color is the fundus
White, because the retinal opacity blocks the view
A cherry red spot is indicative of which condition regarding vasculature
Central retinal artery occlusion
What is the difference between the wet and dry forms of age related macula degeneration
Wet- presence of angiogenesis
Dry- no angiogenesis
What is dry AMD characterized by
Diffuse or discrete deposits of Bruch membrane and atrophy of RPE
What is wet AMD characterized by
Choroidal neovascularization
Which gene is mutated in AMD
CFH and other complement proteins increased
What can predispose an individual to AMD
Smoking cigarettes and intense light exposure
