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Eye disorders Flashcards

1
Q

what is a chalazion

A

benign, self-limiting focal granulomatous swelling of the sebaceous glands without necrosis

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2
Q

presentation of a chalazion

A

chronic slow-growing firm rubbery nodule on the eyelid causing heaviness

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3
Q

how do you get a chalazion

A

obstruction of the meibomian glands

due to:

poor eyelid hygiene

stress

immunodeficiency

TB

rosacea

seborrheic dermatitis

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4
Q

what is a hordeolum

A

stye caused by acute inflammation of the eyelash follicles at the zeis or meibomian glands

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5
Q

how does a hordeolum typically present

A

painful erythematous tender pus-filled nodule with subsequent spontaneous perforation and purulent discharge

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6
Q

what causes a hordeolum

A

S. aureus

acne Vulgaris

DM

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7
Q

what is a pinguecula

A

small yellowish submucosal elevation due to protein and lipid deposits that do not invade the cornea

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8
Q

what is a pterygium

A

fan-shaped fibrovascular connective tissue that migrates into the cornea but doesn’t cover the pupil

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9
Q

how do pterygiums normally present

A

as mild astigmatism

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10
Q

highest risk factor for pingueculas and pterygiums

A

chronic sun exposure

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11
Q

what is keratoconus

A

non-inflammatory corneal condition that thins the cornea into a cone shape, causing it to bulge forward

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12
Q

how does keratoconus present

A

altered refractive surfaces

astigmatism

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13
Q

what is a complication of keratoconus

A

corneal hydrops

rupture of the descemet membrane, allowing the aqueous humor to gain access to the corneal stroma

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14
Q

what are cataracts and how do they present

A

clouding of the lens, causing light distortion, visual impairment, glaring and opacities within the red reflex

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15
Q

congenital causes of cataracts

A

hereditary congenital cataracts

galactosemia

congenital infections

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16
Q

acquires causes cataracts

A

age-related nucleus sclerosis- opacification of the lens nucleus

DM

prolonged glucocorticoid use

trauma

excessive sunlight

smoking

Wilson disease

Down syndrome

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17
Q

what is age-related macular degeneration and what causes it

A

painless central impairment and blind spots caused by progressive degenerative changes in the macula of the retina

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18
Q

what is the difference in wet and dry age-related macular degeneration

A

dry:

nonexudative, retinal pigment epithelium atrophy or hypertrophy with deposition of yellow-whitish material in and under the retinal pigment epithelium
wet:

exudative grey/green retinal discoloration with serous detachment of the retina and the retinal pigment epithelium

shows choroidal neovascularization between the retinal pigment epithelium and Brusch’s membrane

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19
Q

presentation of optic neuritis

A

impair vision with retrobulbar pain worse on eye movement

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20
Q

diagnostics and associations of optic neuritis

A

Diagnostics: the presence of poorly defined papilla, hyperemia, hemorrhage at the border of the papilla

Associations: MS, syphilis

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21
Q

what is sympathetic ophthalmia and how does it present

A

bilateral granulomatous panuveitis usually occurring after unilateral penetrating injury

floating spots, reduced injury, pain in both eyes, increased sensitivity to light

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22
Q

explain the pathogenesis of sympathetic ophthalmia and its morphology

A

T cell-mediated autoimmune response to retinal pathogens

usually absent plasma cells, but may have eosinophils in the infiltrate

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23
Q

cats’s eye pupil (leukocoria)

strabismus

progressive sudden loss of vision in children

A

retinoblastoma

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24
Q

morphology of retinoblastoma

A

small blue cells with scant cytoplasm

Flexner-Wintersteiner rosettes and fleurette necrosis with a viable tumor around blood vessels

dystrophic calcification

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25
where does the Rb allele lie
chromosome 13
26
visual field defects floater photopsia
uveal melanoma
27
where does uveal melanoma originate
choroidal melanocytes with GMAQ or GMA11 oncogene mutations leading to upregulated MAP Kinase
28
grey-yellow lesion with elevated edges near the temporal margin of the optic disc
fundoscopy characteristic of uveal melanoma
29
describe the morphology of uveal melanoma
large cells with vesicular nucleus prominent nucleolus with cytoplasmic melanin pigment
30
causes of conjunctival carcinoma
HPV causes keratinizing squamous cell carcinoma
31
what does conjunctival carcinoma look like
whitish bulging thickening of the epithelium with an irregular surface
32
what is retinopathy of prematurity
premature babies with hyaline membrane disease, causing ischemia and upregulation of VEGF to cause retinal detachment when the neovascular membrane contracts
33
associations of retinopathy of prematurity
ventilation or oxygen administration blood transfusions
34
what is retinal detachment
detachment of the inner layer of the retina from h retinal pigment epithelium
35
associations of retinal detachment
trauma to the retina pathologic myopia retinitis ocular disease sickle systemic disease ocular neoplasms family history
36
difference in the presentation of anterior vs posterior uveitis
**anterior**: dull, progressive periocular pain, red eyes, photophobia, blurry vision, increased tearing, hypopyon **posterior**: painless visual disturbance
37
what areas are involved in anterior and posterior uveitis
**anterior**: iris and ciliary body **posterior**: choroid, retina, vitreous body
38
difference in the causes of anterior and posterior uveitis
**anterior**: most are idiopathic **posterior**: usually infectous
39
complications of anterior uveitis
cataracts secondary glaucoma synechia
40
complications of posterior uveitis
visual field loss due to scarring
41
associations of anterior uveitis
sarcoidosis juvenile idiopathic arthritis rheumatoid arthritis
42
contrast the presentation of HTN and DM retinopathy
**HTN**: ## Footnote **usually asymptomatic**, gradual reduction in vision with normal lens and cornea, wiring of the retina, presence of exudates, AV nicking and **papilledema** **DM:** gradual painless vision loss, leading to blindness
43
contrast the pathology of HTN and DM retinopathy
**HTN**: ## Footnote atherosclerotic and HTN related changes to retinal vessels **DM**: autonomic neuropathy
44
contrast the vessels of HTN and DM retinopathy
HTN= abnormal retinal arteries DM= abnormal retinal veins and capillaries
45
multiple cotton wool spots flame shaped hemorrhages
HTN retinopathy
46
multiple hemorrhages extensive edema multiple exudates Most common cause of visual impairment and blindness in adults 25-74
DM Retinopathy
47
contrast the presentation of central retinal artery and vein occlusions
**arteries**: sudden, painless vision in one eye with afferent pupillary defects and thrombosis of the retinal vessels **veins**: severe loss of vision in the affected eye, with or without afferent pupillary defects
48
contrast the diagnostics of CRAO and CRVO
**arteries**: cherry-red spots at the fovea centralis **veins**: flame-shaped hemorrhages, cotton wool spots, severe macular edema, papilledema
49
contrast the associations of CRAO and CRVO
**arteries**: embolic occlusion of the retinal artery, atherosclerosis **veins**: hypercoagulability, hyperviscosity, DM, Glaucoma, HTN
50
what is a hypopyon
collection of pus in the anterior chamber
51
contrast the diagnostics of granulomatous vs non-granulomatous uveitis
non-granulomatous: hypopyon on slit lamp granulomatous: large keratic precipitates with mutton fat, candle wax drippings, and granulomatous inflammation
52
what is glaucoma
optic neuropathy characterized by optic nerve damage and visual abnormalities and usually increased IOP
53
contrast the presentation of open and closed glaucoma
**open**: often asymptomatic or generalized bilateral progressive visual field loss from the periphery to the center, halos around light, mild HA, impaired adaptation to darkness **closed**: sudden onset of acute vision loss with a unilaterally inflamed, reddened and severely painful eye, frontal HA with N/V, blurred vision with halos around light
54
contrast the risk factors of open and closed glaucoma
**open**: \>40 y/o, increased IOP, African descent, DM, myopia, steroid use, family hx **closed**: advanced age, females, Inuit/ Asians, eye injuries with scarring and adhesions, mydriasis
55
pathogenesis of glaucoma
reduced aqueous flow increased IOP, which compresses the retinal supply and contributes to loss of retinal ganglion cells also causes optic disc atrophy with cupping, leading to vision loss
56
Most common association of closed angle glaucoma
DM
57
Which is the most common glaucoma
open-angle glaucoma
58
causes of open-angle glaucoma
**secondary clogging** due to: inflammatory cells(uveitis), RBCs (vitreous hemorrhage, material from retinal detachment in aqueous humor reduced drainage of aqueous humor due to: increased episcleral pressure and damaged trabecular, meshwork after a chemical injury
59
compare and contrast the causes of ophthalmia neonatorum
60
compare and contrast the causes of conjunctivits
61
compare and contrast the causes of keratitis
62
common cause of night blindness
Vitamin A deficiency: component of rhodopsin and other visual pigments and causes epithelial metaplasia and keratinization Look for dry eye, keratomalacia and Bitot spots

Neuro (13 decks)

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