Eye Dr. Martin Flashcards
proptosis
increased orbital contents displaces eye
= eyelid cant cover all of it —-> ulcers and infection
cause for inferior + medial proptosis
Lacrima gland problem (sarcoidosis, lymphoma, pleomeorphic adenoma, adenoid cystic carcinoma
causes for axial proptosis
optic nerve problem (glioma, meningioma)
graves disease causes what kind of orbitopathy
- extraocular muscles are non-granulamatous inflammed
- HIGH Glycosaminoglycans
- NOT ADIPOSE OR TENDONS inflammation
graves disease orbitopathy complications
- visual loss
2. cornea complications
Idiopathic orbital inflammation is what and causes and what needs to be excluded
= psudotumor
- eosinophils in fat and tendons —-> inflammation and fibrosis
- only in lacrimal gland
- IgG related disease can look like this and needs to be excluded
other orbital inflammation diseases besides psudotumor and graves
- Wagner
- Sinus infection
- sarcoid —> granulomatous uveitis + Mutton Fat + Candle wax dippling
sarcoid causing orbital inflammation gives what 2 PE findings
- Mutton fat = keratic debri on cornea
2. Candle wax dripping : privascular inflammation of retina
most common neoplasm of the eye
- capillary hemangioma = children , infants
- cavernous hemangioma = adults
- non-hodkins lymphoma (B-cell lymphomas only)
- lacrimal gland adenoma
Blepharitis
eyelid inflammation , chronic
chalazion is what and can look just like what
lipid into the tissue —> granulamatous response = lipogranuloma
= Sebaceous carcinom**
neoplams to look for on eyelid in AIDS and can look like what
Karposi sarcoma can be in conjunctiva also, purple lesion in dermis
= can look like subconjunctival hemorrhage due to redness
most common tumor of all on eyelid and looks like
BCC (lower eyelid, inner canthus, upperlid)
= pearly nodules, telengiectasia vessels, **
= central rodent ulcer , rolled edges **
= can eat away anything
= peripheral palisading ***
BCC looks like what color on histology that is important to see
BLUE
1. peripheral palisading = nucleus stand up vertically (like a flower)
SCC looks like what and histologic things to see
PINK
1. keratin pearls
Sebaceous Carcinoma can be found how, spreads how, and histology + stain needed
- reoccuring chalazion that is removed and comes back
- Pagetoid spread : intraperipheral spread (through epidermis)
- Vacuolization of cytoplasm **, Oil Red O STAIN ** only stain that works
Sebaceous Carcinoma metastasizes first where and is associated with what syndrome
- parotid + subandibular LN, lung, liver, brain, skull
2. Muir- Torre Syndrome (lynch syndrome where internal tumors cause sebaceous gland skin tumors)
you see many goblet cells with nonkeratinizing squamous epithelium what area is this
conjunctiva
conjunctiva
- palpebral
- fornix
- bulbar
- limbus
- palpebral = allergies and bacterial infection
- fornix = lacrimal gland + LN is here
- bulbar = non-K SS Epi covers the eye
- limbus = transition from sclera to cornea
what can cause conjunctiva scarring
- chlamydia trachomatis or autoimmune ocular cicatrical pemphigoid
- can cause a type of dry eye
what happens in the conjunctiva scarring that causes dry eye
goblet cells decrease = less mucin made = needed for adherence of aqueous part in tears (so even if you give artificial tears it will not adhere to the cornea)
Pinguecula vs pterygium
Pinguecula : limbus, small yellow elevation from sun exposure + CAN become SCC OR MELANOMA fragmented collagen (elastase stain VVG)
Pterygium : can impair vision, winging onto cornea
freckle vs lentigo
freckle = melanin is higher due to enlarges melanocytes lentigo = melanin increases due to linear melanocyte hyperplasia
nevus vs melanoma seen how
NEVUS : melanocytes grow round and grow in aggregates of nests (LARGE to small as you go down vertically)
MELANOMA : stays LARGE all the layers down
conjunctival melanoma what happens and gene
- primary acquired melanosis not tx completely
- BRAF V600
= 25% fatal
blue scleral means what and due to what 3 things can this happen
from thinning of sclera
- increased intraocular P = staphyloma
- osteogenesis imperfecta
- congenital melanosis oculi
normal cornea layers
- Bowman layer : prevent cancer, and injuries
- stroma = NO BVs, Lymph, hard to repair
- ednothelium : no vasculature
- Decemet membrane : increase thickness with age (gets Kayser-Fleischer Wilson ring = copper deposits)
Cornea Transplant of stroma is done how
LOW rejection due to low BVs and lymph
as long as there is no cornea vascularization
what can prevent cornea vascularization
VEGF antagonist
corneal infections
- hypopyon:
- bacteria most common
- exudate that layes on bottom of cornea like a boat
2. staph Aureus, strep pneumo, psudo aeruginosa, enterobacteriaceae
acanthamoeba can do what and how and most common way of getting this
blindness, parasite
= acanthamoebic keratitis —> cornea ulcer –> blindess
= contact lenses (wash hands)
Acanthamoeba tx and what can happen in immunocompromised pts
transplant cornea
GAE (Granulomatous amoebic encephalitis) = enters by open wound and goes to brain
Herpes Simplex Virus Keratitis
- chronic stromal keratits = ulcer and scarring**
2. granulamtous reaction at Descemets membrane
corneal degeneration vs dystrophy
Degeneration : unilateral , asymmetric, peripheral caused inflammation
Dystrophy : familial, several corneal layers, NO inflammation, deposition of abnormal material
Calcific Band Keratopahty what happens and what usually causes this and looks like
Bowman Membrane CALCIUM depostis
from
1. chronic uveitis (juvenile rheumatoid arthritis)
2. white/grey band across cornea
Actinic Band Keratopathy (climatic droplet keratopathy)
is what and caused by what and looks like
- high UV light (solar elastosis in superficial cornea= horizontal band)
- yellow oil droplet keratopathy on the cornea (from damaged collagen)
Keratoconus is what and risk of getting
- BILATERAL thinning of cornea + Bowman breaks causing edema = anterior protrusion of cornea when looking down (RIGID CONTACTS CAN HELP)**
- infantile glaucoma = HIGH Intraoccular P
Keratoconus is associated with what dzs and PE sig nto test for this
- Marfans, Downs, Atopic Disorders, forcepts used at birth
2. MUNSON SIGN (look down and lower lids bulge out
Fuchs Dystrophy is what and how does a pt get this and can cause what risk
- Descemets membrane thickened + ANVIL SHAPED excrescents of BM (GUTTATA*) material in it
- more in women, inherited
- Psudophakic bullous Keratopathy
Fuchs Dystrophy looks like what on PE
cornea is hazy and like bluish ground glass, distorted light reflex,
= blurred vision
= beaten metal appearance in fundus reflex
