Chapter 29-The Eye Flashcards by Michael Dennis

What is the most common cause of irreversible visual loss

Age related macular degeneration

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Diseases of the orbit tend to push the eye in which direction

Forward, known as proptosis

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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

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What direction is the eye pushed in the case of masses in the horizontal rectus muscles

Straight forward

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What are the two most common primary tumors of the optic nerve

Glioma

Meningioma

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What direction is the eye pushed in the cause of primary tumors of the optic nerve

Axial proptosis

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Graves’ disease proptosis is due to changes in which eye structure

Orbit

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What is proptosis due to Graves’ disease caused by

Accumulation of EC matrix proteins and fibrosis in the rectus muscles

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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

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What is idiopathic orbital inflammation

Aka orbital inflammatory pseudo tumor

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Necrosis and degenerating collagen accompanied by vasculitis of the orbit should lead to which diagnosis

Wagner granulomatosis

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What is the general nature of neoplasms of the orbit

Vascular in origin

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What are the common tumors of the orbit

capillary hemangioma
lymphangioma
cavernous hemangioma

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Primary orbital malignancies may arise from which orbital layer

Any of the them

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What is the most common malignancy fo the eyelid

Basal cell carcinoma

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How common are malignancies of the eyelid

Very rare

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What are the common locations of basal cell carcinomas of the eyelid

Lower eyelid and medial canthus

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Which condition can sebaceous carcinomas mimic

Chalazion

Paget disease

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Sebaceous carcinomas typically spread to which LN first

Submandibular and parotid

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Karposi sarcoma may occur in the eyelid in which individuals

AIDs

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What color is the Kaposi sarcoma lesion in the eyelid

Purple because lesion is in the debris

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What color is the Karposi sarcoma lesion in mucous membrane of the conjunctiva

Bright red

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Primary lymphoma of the conjunctive is most likely to occur in which portion

Fornix

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Infection with which organism is able to produce significant scarring

Chlamydia trachomatis

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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

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