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SS Pathology > Eye > Flashcards

Eye Flashcards

1
Q

Mention clinical & microscopic finding of retinitis pigmentosa

A

Night blindness & constricted visual fields due to loss of rods. As cones are lost, central visual acuity may be affected; and may progress to complete blindness
Histologically, both rods & cones are lost by apoptosis with 2ry proliferation of retinal pigmented epithelium.

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2
Q

Visual effects of albinism are…….

A

Photophobia, nystagmus, amblyopia

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3
Q

Define hordeolum

A

Acute suppurative inflammation may be external in the sebaceous glands of Zeis, the apocrine glands of Moll and eyelash follicles or less commonly internal in Meibomian glands

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4
Q

Describe etiology and microscopic pic of chalazion

A

Chronic inflammatory inflammation of the Meibomian glands due to obstruction to the drainage of secretions. This begins with destructions of meibomian glands and duct and subsequently involves tarsal plate.
Histologically, chronic inflammatory granuloma located in the tarsus and contains fat globules in the center of the granulomas i.e. appearance of a lipogranuloma

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5
Q

Microscopic pic of conjunctivitis

A

In acute stage, there is corneal edema and infiltration by inflammatory cells, affecting the transparency of cornea. In chronic stage, there is proliferation if small bv in normally avascular cornea & infiltration by lymphocytes and plasma cells with dissolution of corneal stroma by collagenase

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6
Q

Pathogenesis of trachoma

A

Caused by chlamydia or TRIC agents. Trachoma is caused by C.trachomatis while inculsion conjunctivitis is caused by C.oculogenitalis

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7
Q

Microscopic pic of trachoma

A

In early stage, intracytoplasmic inclusion bodies formed by the proliferating microoganisms within the cells
Later conjunctiva thickens due to dense inflammatory cell infiltrate. The end result is extensive corneal & conjunctival scarring, eye lid distortion, abrasion of cornea, in-turned eyelashed and blindness.

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8
Q

Microscopic pic of sympathetic ophthalmia

A

Granulomatous uveal inflammation consisting of epithelioid cells, lymphocytes & eosinophils. No necrosis or neutrophils or plasma cells.

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9
Q

Endophthalmia is inflammation of……while pan-ophthalmitis is inflammation of….

A

Interior of eye involving vitreous humor
Interior of eye extends to retina, choroid & sclera

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10
Q

Mention 2 types of diabetic nephropathy

A

Background (non-proliferative) & proliferative (retinitis proliferans)

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11
Q

Enumerate features of diabetic background retinopathy

A
  1. BM is thickened
  2. Degeneration of pericytes & some endothelial cell loss
  3. Macular edema due to leaky circulation
  4. Capillary microaneurysms
  5. Waxy exudates around microaneurysms esp in elderly due to hyperlipidemia
  6. Dot & blot hemorrhages in deeper layers of retina due to extravasation of erythrocytes
  7. Cotton-wool spots on retina which are microinfarcts of nerve fiber layer
  8. Exudate in retinal outer plexiform layer
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12
Q

Mention features of proliferative retinopathy

A
  1. Neovascularization of the retina around optic disc
  2. Friability of newly formed vessels leading to vitreous hemorrhage
  3. Proliferation of astrocytes & fibrous tissue around new bv
  4. Fibrovascular & gliotic tissue contracts to cause retinal detachment & blindness
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13
Q

Mention effects of severe diabetes on eye

A
  1. Diabetic iridopathy may lead to adhesion of cornea & iris (ant synechiae) or iris & lens (post synechiae)
  2. Iris neovascularization with subsequent 2ry angle-closure glaucoma
  3. Cataract of lens at an earlier age than general population
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14
Q

Mention features of hypertensive retinopathy

A
  1. Variable degree of arteriolar narrowing due to arteriosclerosis
  2. Flame-shaped hemorrhages in retinal nerve fiber layer
  3. Macular star a sponge-like arrangement of exudate in the macula in malignant HTN — results from exudate accumulating obliquely in the outer plexiform layer of macula
  4. Cotton-wool spots & microaneurysms
  5. Arteriovenous nicking (resulting in occlusion of retinal vein branches)
  6. Exudate in retinal outer plexiform layer
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15
Q

Compare ischemic & nonischemic retinal vein occlusion

A

Ischemic: angiogenic factors are upregulated in retina leading to neovascularization of retina, surface of optic nerve & iris with subsequent angle-closure glaucoma
NonI: may be complicated by hemorrhages, exudates & macular edema

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16
Q

Cause of pinguecula & pterigium
What is the difference between them?

A

Due to actinic damage thus occurs in sun-exposed areas occurs in old age, more in males, associated with prolonged exposure to UV and alcohol consumption
-pinguecula is limited to bulbar conjunctiva, pterigium originates in conjunctiva astride the limbus and migrates towards cornea

17
Q

Histological characteristics of pterygium

A

There is fibrovascular CT that migrates from the conjunctiva to cornea, dissecting into plan of bowman layer this lewpads to fragmentation of it with variable acute and chronic inflammatory infiltrate.

18
Q

Compare “dry” & “wet” AMD

A

D, diffuse or discrete deposits in Bruch membrane (drusen) and geograpgic atrophy of RPE
W, choroidal neovascularization. The vessels may leak and exuded blood may be organized by RPE into macular scars. Occasionally these vessels give rise to diffuse vitreous hemorrhages

19
Q

Define retinal detachment

A

It is separation of neurosensory retina from RPE. It may occur spontaneously in persons older than 50 or may be 2ry to head/neck trauma.

20
Q

Compare Rhegmatogenous and nonR retinal detachment

A

R, associated with a full thickness retinal defect. This is due to pathological processes in vitreous or anterior segment, causing traction on points of abnormally strong adhesion to retinal internal limiting membrane.
NR, no retinal break: may be due to retinal vascular disorders associated with significant exudation and any condition that damges the RPE and permits fluid to leak from choroidal circulation under retina e.g. HTN. OR Choroidal tumors.

21
Q

Define phthisis bulbi and its histological characters

A

It is the end-stage of advanced degeneration and disorganizatiom of the entire eyeball inw which the IOP is inc and eyeball shrinks. The causes are trauma, glaucoma & intraocular inflammations.
Hist, marked atrophy & disorganization of all ocular structures, and the markedly thickened sclera. Even osseous metaplasia may occur.

22
Q

Enumerate causes of cataract

A
  1. Senility due to degeneration of lens protein
  2. Congenital (Dowm, rubella, galactosaemua)
  3. Traumatic
  4. Metabolic due to formation of abnormal opaque protiens
  5. Drugs, smoking & heavy alcohol consumption
23
Q

Histological features of cataract

A

Degeneration, fragmentation, liquefaction of lens fibers.

24
Q

Compare open and closed angle glaucoma (define)

A

O, result from an increased resistance to aqueous outflow in the open angle
C, peripheral zone of iris adheres to the trabecular meshwork and physically impedes the outflow of aqueous humor

25
Q

1ry closed angle glaucoma is common in individuals with…..

A

Hyperopia

26
Q

Compare 1ry & 2ry open angle glaucoma with respect cause

A

1ry, An insidious disease if the elderly and the condition may go un-noticed in the early stages. It is due to an abnormal resistance in the outflow system due to degenerative changes in trabecular meshwork & CT of canal of Schlemm.
2ry, deposition of fibrillar material of varying composition throughout the anterior segment such as inflammatory cells, tumor cells, red blood cells after trauma, or particulate matter from a degenerative lens cortex.

27
Q

Compare acute & chronic papilloedema

A

A, edema, congestion & hemorrhage at optic disc
C, degeneration of nerve fibers, gliosis, optic atrophy

28
Q

Describe triad of Sjögren

A

Keratoconjunctivitis sicca, xerostomia, rheumatoid arthritis

29
Q

Most frequent tumor of eyelid is…..

A

Basal cell carinoma

30
Q

BCC is seen in…while sebaceous carcinoma is seen in….

A

Lower eyelid
Upper eyelid

31
Q

Microscopic pic of sebaceous carcinoma

A

Tumor may show well-differentiated lobules of tumor cells with vacuolated cytoplasm (sebaceous differentiation) or may be poorly differentiated tumor requiring confirmation by special stains.

32
Q

Clinical presentation of child with retinoblastoma is…..

A

Leukocoria (white pupillary reflex)

33
Q

Describe gross and microscopic of retinoblastoma

A

G, appears as white mass within retina may be partly solid and partly necrotic. Tumor may be endophytic (into vitreous) or exophytic (towards subretinal)
M, tumor composed of undifferentiated retinal cells (small round cells with hyperchromatic nuclei) with tendency towards formation of differentiated photoreceptor elements. In better differentiated area, tumor cells are arranged is rosettes:
Flexner-Wintersteiner rosettes characterized by small tumor cells arranged around a lumen with nuclei away from lumen
Homer-Wright rosettes having radial arramgement of tumor cells around central neurofibrillary structure.

34
Q

Describe spread of retinoblastoma

A

Tumor can spread widely via hematogenous route as well. Prognosis is adbersely affected by extraocular extension and invasion along optic nerve and by choroidal invasion.

35
Q

Common site of metastasis to eye are…..
In men …..spread to eye while in women, it is…..
……also commonly spread to ocular tissues

A

Iris and choroid
Lung cancer, breast cancer
Leukemia/malignant lymphoma

SS Pathology (2 decks)

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