Eye and Ear Disorders Flashcards
Arcus senilis/lipoides
- Elderly or HLD+smoking pts
- Gray-opaque ring at corneal margin
- Cholesterol deposits in corneal stroma
Ophthalmia neonatorum
- Conj in newborn
* Neisseria gonorrhoeae or Chlamydia trachomatis
Bacterial conjunctivitis
- Purulent conjunctivitis WITHOUT blurry vision
* Staph aureus, Strep pneumoniae, H. influenzae
Viral conjunctivitis
- Watery exudates
- Adenovirus: pinkeye
- HSV1: keratoconjunctivitis w/ dendritic ulcers
Acanthamoeba infection
Severe keratoconjunctivitis in pts who don’t clean contacts
Chalazion
Granulomatous inflammation of meibomian gland
Pterygium
- Exposure to wind, sun, sand
* Raised, triangular encroachment of thickened conjunctiva on nasal side
Pinguecula
Yellow-white conj degeneration at jxn of cornea and sclera on temporal side; sun-damaged tissue
Optic neuritis
- Blurry or lost vision, may cause optic atrophy
* MS, methanol poisoning
Central retinal artery occlusion
- Embolization from carotid or ophthalmic artery; giant cell temporal arteritis
- Sudden, painless, unilateral loss of vision
- Pallor or optic disk, “boxcar” segmentation of blood in retinal veins, cherry-red macula
Central retinal vein occlusion
- Caused by hypercoagulable state
- Sudden, painless, unilateral loss of vision
- Swollen optic disk, engorged retinal veins, “blood and thunder” appeareance
Glaucoma
- Increased IOP
- Chronic open-angle: decreased rate of aqueous outflow in severely myopic people; cupping of optic disks; night blindness, tunnel vision
- Acute angle-closure: precipitated by mydriatic agent, uveitis, lens dislocation; red eye w/ steamy cornea; pupil fixed, nonreactive
Uveitis
- Inflammation of iris, ciliary body, choroid
- Sarcoidosis, ulcerative colitis, ankylosing spondylitis
- Pain w/ vlurry vision, miotic pupil, normal IOP, adhesions b/w iris and anterior lens capsule
- When chronic: may cause calcific band keratopathy
Macular degeneration
- Elderly
- Disruption of Bruch membrane in retina
- Dry type: thinning of retina, deposits called drusen
- Wet type: vessels under retina hemorrhage, cells die —> blind spots or distorted central vision
CMV retinitis
- Usually painless, unlike VZV retinitis
- AIDS pts
- Cotton-woll exudates, retinal hemorrhages
Cataracts
- Lens opacity
* Advanced age, DM, congenital infection, corticosteroids, intraocular disease
Meniere disease
- 40-60 y/o
- Inner ear: increased endolymph, loss of cochlear hairs
- Dizziness, tinnitis, hearing loss
Weber test
- Sensorineural: contralateral ear affected
* Conduction: lateral ear affected
Otosclerosis
- Elderly
* Fusion of middle ear ossicles
Malignant external otitis
- DM patients
- Mastoiditis, oteomyelitis, meningitis, etc.
- MCC: Pseudomonas aeruginosa
Relapsing polychondritis
- Autoimmune disease, Abs to connective tissue
* Inflammation that destroys cartilage, including ear
Chronic serous otitis media
- Goblet cell metaplasia in middle ear
* Hemorrhage, with erythrocyte destruction and cholesterol liberation —> cholesterol granuloma
Cholesteatoma
- Mass of accumulated keratin and squamous mucosa in middle ear
- Growth of squamous epithelium from external ear thru perforated TM
Jugulotympanic paraganglioma
- MC benign tumor of middle ear
- Lobules of richly vascular connective tissue
- Neural crest origin; contain catecholamines
Chlamydia-associated eye disease
- Upper conjunctiva: trachoma
* Lower conjunctiva: inclusion conjunctivitis
Onchoceriasis
- Helminth of Africa and Central America
* Corneal opacification and visual impairment (“river blindness”)
Phacoanaphylactic endophthalmitis
- Traumatized or cataractous lens
* Autoimmune rxn to lens proteins
Sympathetic ophthalmitis
- Arrestin acts as antigen
- Granulomatous inflammation of other eye 4-8 weeks after uveitis
- Dalen-Fuchs nodules b/w Bruch membrane and retinal pigment epithelium
Retinal hemorrhage
- HTN, DM, trauma, bleeding disorders
- Flame-shamed: nerve fiber layer
- Round: deeper
Retinal detachment
- Sensory retina separates from retinal pigment epithelium
* Happens after eye trauma/surgery
Retinitis pigmentosa
- May have RHO or PDE mutation
- Destruction of rods, then cones; attenuation of vessels
- Night blindness, peripheral vision defects
Retinopathy of prematurity (retrolental fibroplasia)
- Results from high levels of inspired O2 in premature infants
- Developing retinal vessels are obliterated
- Deluge of angiogenesis when returned to ambient air may cause blindness
Phthisis bulbi
Intraocular ossification after trauma or inflammation
Retinoblastoma
- Young children
- Malignant tumor of immature neurons
- May have densely packed cells, rosettes, or fleurettes
- Disseminate via optic nerve to brain or via choroid to blood
- White pupil, strabismus, spontaneous hyphema, painful eye, cat’s eye reflex, glaucoma
