clinical pathology of the eye

Question 1

what are cataracts?

Answer 1

opacification within the lens

Question 2

what is the most common cause of cataracts?

Answer 2

increase in age

Question 3

what is the biggest pre disposing factor to cataracts?

Answer 3

-sun damage

Question 4

what are some causes of cataracts?

Answer 4

• increase in age
• hypertension
• smoking
• post op and trauma
• metabolic disorders
• genetic
• diabetes

Question 5

what is glaucoma?

Answer 5

-abnormal increase in pressure in the eye

Question 6

what is pressure in the eye related to?

Answer 6

-the amount of vitreous fluid and anteriorly aqueous humour

Question 7

where does fluid in the eye normally drain from?

Answer 7

-in the most anterior part of the eye in the trabecular meshwork and eventually into the Schlemm canal

Question 8

when does glaucoma occur?

Answer 8

-when there is a blockage in the drainage through the trabecular meshwork or in the canal of Schlemm

Question 9

what is the most common form of glaucoma?

Answer 9

-primary open angle glaucoma

Question 10

what is the biggest cause of blindness worldwide?

Answer 10

-primary open angle glaucoma

Question 11

what causes angle closure glaucoma?

Answer 11

• the drainage through the meshwork ect. is patent

- iris is essentially opposed to the anterior part of the eye and the fluid can’t get passed the meshwork

Question 12

what is the inset like for primary open angle glaucoma?

Answer 12

-slow onset

Question 13

how does primary open angle glaucoma typically present?

Answer 13

• gradual onset

- typically asymptomatic

Question 14

how does closed angle glaucoma present?

Answer 14

• 1/3 of cases are emergency
• acute red eye and visual loss with headache
• nausea and vomiting
• can lose site quickly

Question 15

what is the treatment for closed angle glaucoma?

Answer 15

-zap a hole in the iris with a laser

Question 16

what can raised intraocular pressure damage?

Answer 16

-optic disc and nerve

Question 17

how can you tell raised intra ocular pressure has occurred?

Answer 17

• often will witness ‘cupping’ of the disc

- essentially the edges of the disc become rolled up and the centre becomes depressed

Question 18

what is papilloedema?

Answer 18

-swelling of the optic nerve/disc

Question 19

what investigations are done for papilloedema?

Answer 19

-opthalmoscope used

Question 20

what is papilloedema related to?

Answer 20

-its a non specific finding related to increased intracranial pressure

Question 21

what is conjunctivitis?

Answer 21

-inflammation of the conjunctiva

Question 22

how does conjunctivitis present?

Answer 22

• swelling
• redness
• pain
• heat

Question 23

what causes conjunctivitis?

Answer 23

-usually it is viral but can be bacterial or allergic

Question 24

how does scleritis present?

Answer 24

• pain in eyes on movement

- may have blurry vision, unexplained tears or notice your eyes are especially sensitive to the light

Question 25

what other disease is scleritis associated with?

Answer 25

• RA
• lupus
• Sjogren’s syndrome
• scleroderma
• IBD
• Wegener’s granuloma

Question 26

what is episcleritis?

Answer 26

-inflammation of around the sclera (is superficial)

Question 27

is episcleritis self limiting?

Answer 27

yes

Question 28

what is ARMD?

Answer 28

• age related macular degeneration

- an acquired degeneration of the retina

Question 29

what causes age related macular degeneration (ARMD)?

Answer 29

• no clear cause

- age related and underlying inflammatory process

Question 30

how does diabetes affect the eye?

Answer 30

hyperglycaemia:

• cause changes to osmotic pressures in the anterior chamber of the eye in front of the lens
• this can cause blurred vision
• can have peripheral neuropathy causing Argyll Robertson Pupil (prostitute’s pupil)
• cataracts
• glaucoma (specifically robotic glaucoma due to new vessel formation in the eye)
• diabetic retinopathy