eye immunology

Question 1

innate immune system of eye:
physical barrier? 
commensals?
chemical agents? 
cells?
solutions?

Answer 1

no
yes
yes
yes

blink, properties of surface, exposure limitation

Question 2

layers infront of cornea

Answer 2

mucin layer
aqueous layer
lipid layer

these 3 make up the tear film

Question 3

adaptive immune ssytem consists of 3

Answer 3

antigen presenters -dendritics, B’s, macrophages
lymph drainage
effector cells
- CD4/8+ Ts, Bs

Question 4

which cell links annate and adaptive

Answer 4

macrophages

Question 5

langerhans cells are located in the __ eye, rich in Class _ MHC molecules, and most abundant at ___-__ limbus

Answer 5

external
II
corneo-scleral

Question 6

conjunctiva is the only part of eye with __ drainage, due to specialised endothelial venules. they contain dendritics, MALTs ( __ __ __ __) also found in GI tract, macrophages, langerhans , macrophaes and commensal bacteria

Answer 6

lympohatic

mucosa associated lymphoid tissue

Question 7

lacrimal gland contains more plasma cells (__) and CD__ T cells compared to conjunctiva.
t cells found where?
the lacrimal drainage systtem contains diffuse __ tissue and ___ in mucosa (MALT)

Answer 7

IgA
8+
lymphoid
follicles

Question 8

there is a lack of APCs in the __, ___ and retina

Answer 8

vitreous

choroid

Question 9

the eye has immune privilege, what is this

Answer 9

intro of antigens with no inflam response

also in brain, testes, and placenta/foetus

Separation + Inhibition + Regulation

Question 10

anterior chamber associated immune deviation (ACAID) is found in eye, what is this

Answer 10

antigens produce tolerance to foreign antigens

‘peripheral tolerance’ to ocular antigens

Question 11

hallmarks of ACAID

Answer 11

CD4+ T and B - non-compliment fixing ABs

inhibition of delayed-type hypersen and bs that secrete complement-fixing ABs

Question 12

sympathetic opthalmia is a bilateral ___ uveitis due to trauma or surgery.
is 1 or 2 eyes inflicted upon?

Answer 12

granulomatous
1 eye
-injured eye = excited, other=sympathising

Question 13

clinical appearance of sympathetic opthalmia

Answer 13

both appear same

Question 14

sympathetic opthalmia -trauma to one eye results in the released of sequestered intraocular protein ___, these are carried to lymph nodes and activates __ cells, these effector cells reutrn via __ and encounter antigens in both eyes

Answer 14

antigns
T
bloodstream

Question 15

chemosis, what is it, how is this descirbed by patient

Answer 15

oedema of the conjunctiva

itchy, painful, swollen eyes

Question 16

give an example of a type 2 hypersensitivity disease

Answer 16

ocular cicatricial pehphigoid

Question 17

ocular cicatricial pehphigoid causes blistering and scarring of __. the upper lid is swollen causing it to stay __, it is well vascularised, over-exposed. treatment?

Answer 17

conjunctiva
open
steroids

Question 18

specific to the eye, give an example of a type 3 hypersensitvity reaction

Answer 18

corneal melting

Question 19

corneal melting is a type 3, what is a possible complication

Answer 19

outer layer melts -> inner layer bulges forward

possible perforation

Question 20

example of optic type 4 reaction

Answer 20

corneal graft rejection

Question 21

s/e of steroids affecting the eyes

Answer 21

cataracts

steroid–induced glaucoma (rise in pressure)