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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
Q

where does the Rb allele lie

A

chromosome 13

26
Q

visual field defects

floater

photopsia

A

uveal melanoma

27
Q

where does uveal melanoma originate

A

choroidal melanocytes with GMAQ or GMA11 oncogene mutations leading to upregulated MAP Kinase

28
Q

grey-yellow lesion with elevated edges near the temporal margin of the optic disc

A

fundoscopy characteristic of uveal melanoma

29
Q

describe the morphology of uveal melanoma

A

large cells with vesicular nucleus

prominent nucleolus with cytoplasmic melanin pigment

30
Q

causes of conjunctival carcinoma

A

HPV causes keratinizing squamous cell carcinoma

31
Q

what does conjunctival carcinoma look like

A

whitish bulging thickening of the epithelium with an irregular surface

32
Q

what is retinopathy of prematurity

A

premature babies with hyaline membrane disease, causing ischemia and upregulation of VEGF to cause retinal detachment when the neovascular membrane contracts

33
Q

associations of retinopathy of prematurity

A

ventilation or oxygen administration

blood transfusions

34
Q

what is retinal detachment

A

detachment of the inner layer of the retina from h retinal pigment epithelium

35
Q

associations of retinal detachment

A

trauma to the retina

pathologic myopia

retinitis

ocular disease

sickle

systemic disease

ocular neoplasms

family history

36
Q

difference in the presentation of anterior vs posterior uveitis

A

anterior: dull, progressive periocular pain, red eyes, photophobia, blurry vision, increased tearing, hypopyon

posterior: painless visual disturbance

37
Q

what areas are involved in anterior and posterior uveitis

A

anterior: iris and ciliary body

posterior: choroid, retina, vitreous body

38
Q

difference in the causes of anterior and posterior uveitis

A

anterior: most are idiopathic

posterior: usually infectous

39
Q

complications of anterior uveitis

A

cataracts

secondary glaucoma

synechia

40
Q

complications of posterior uveitis

A

visual field loss due to scarring

41
Q

associations of anterior uveitis

A

sarcoidosis

juvenile idiopathic arthritis

rheumatoid arthritis

42
Q

contrast the presentation of HTN and DM retinopathy

A

HTN:

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
Q

contrast the pathology of HTN and DM retinopathy

A

HTN:

atherosclerotic and HTN related changes to retinal vessels

DM:

autonomic neuropathy

44
Q

contrast the vessels of HTN and DM retinopathy

A

HTN= abnormal retinal arteries

DM= abnormal retinal veins and capillaries

45
Q

multiple cotton wool spots

flame shaped hemorrhages

A

HTN retinopathy

46
Q

multiple hemorrhages

extensive edema

multiple exudates

Most common cause of visual impairment and blindness in adults 25-74

A

DM Retinopathy

47
Q

contrast the presentation of central retinal artery and vein occlusions

A

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
Q

contrast the diagnostics of CRAO and CRVO

A

arteries: cherry-red spots at the fovea centralis

veins: flame-shaped hemorrhages, cotton wool spots, severe macular edema, papilledema

49
Q

contrast the associations of CRAO and CRVO

A

arteries: embolic occlusion of the retinal artery, atherosclerosis

veins: hypercoagulability, hyperviscosity, DM, Glaucoma, HTN

50
Q

what is a hypopyon

A

collection of pus in the anterior chamber

51
Q

contrast the diagnostics of granulomatous vs non-granulomatous uveitis

A

non-granulomatous: hypopyon on slit lamp

granulomatous: large keratic precipitates with mutton fat, candle wax drippings, and granulomatous inflammation

52
Q

what is glaucoma

A

optic neuropathy characterized by optic nerve damage and visual abnormalities and usually increased IOP

53
Q

contrast the presentation of open and closed glaucoma

A

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
Q

contrast the risk factors of open and closed glaucoma

A

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
Q

pathogenesis of glaucoma

A

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
Q

Most common association of closed angle glaucoma

57
Q

Which is the most common glaucoma

A

open-angle glaucoma

58
Q

causes of open-angle glaucoma

A

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
Q

compare and contrast the causes of ophthalmia neonatorum

60
Q

compare and contrast the causes of conjunctivits

61
Q

compare and contrast the causes of keratitis

62
Q

common cause of night blindness

A

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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