Eye Path

Question 1

limbus

Answer 1

where cornea and sclera fuse

Question 2

retinal a occlusion

Answer 2

usually d/t:

• atheromatous emboli from i/l internal carotid stenosis
• stenosis from HTN or DM
• vasculitis

Question 3

TIA of retinal a

Answer 3

amaurosis fugax- browing out or loss of vision from one wyw for about 10 min
usually caused by i/l internal a stenosis

Question 4

anterior ischemic optic neuropathy

Answer 4

short post ciliary aa -> supply ant optic n
occulsion results in sudden vision loss in one eye
classic onset is upon wakening
sometimes seen in temporal arteritis

Question 5

what are the layers covering eye

Answer 5

lipid/oil layer
aqueous/water layer
mucin layer- adheres tears to eye

Question 6

meibomain glands

Answer 6

create the lipid layer of tear film

blockage can lead to evaporative dry eye

Question 7

Stye

Answer 7

acute inflammation of gland of Zeis and/or orifice of meibomian gland
usually staph
usually clears in 7 days
very painful

Question 8

chalazion

Answer 8

aka meibomian gland lipogranuloma
lipogranulomataous inflammatory rxn to sebum in tissues (foreign body rxn)
secondary to obstruction of gland
subacture to chronic
painless 
weeks-months
surgical, abx if infected

Question 9

xanthelasma palpebratum

Answer 9

soft of sligthly raided yellow papulfes and plauqes
in inner canthus
seen in hyperlipemic and normolipemic pts
foamy lipid-laden histiocytes in dermis
surgery

Question 10

nevi

Answer 10

congenital or acquired (most)

spilt nevus-rare congenital form on eyelids

Question 11

junctional nevus

Answer 11

at interface of epi and dermis

Question 12

compound nevus

Answer 12

dermis and epi

Question 13

dermal nevus

Answer 13

confined to dermis

Question 14

basal cell carcinoma

Answer 14

most common eyelid malignancy

lower lid >medial canthus> upper lid > outer canthus

Question 15

sebaceous carcinoma

Answer 15

elderly
F>M
asians
can mimic chalazion or chronic belpharoconjunctivitis
malignant cells with foamy, lipid-laden cytoplasm, necrosis, pagetoid invasion

Question 16

pinguecula

Answer 16

asmptomatic, small, yellowish submucosal nodule at limbus
adults and older, but seen in young with lots of sun exposure
typical in tropical locations
conjuntival sequivalent of solar elastosis of skin
no Tx needed

Question 17

pterygium

Answer 17

submucosal growth of CT that migrates into cornea
resutls from UV, dust, and wind damage
removed
examine histo to check for CA

Question 18

viral ulcerative keratitis

Answer 18

herpes simplex most common cuase of central corneal ulver (dendritic shape)
herpes zoster

Question 19

bacterial ulcerative keratitis

Answer 19

psudomonas and S. aureus

associated with cosmetics or contacts

Question 20

mycotic ulcerative keratitis

Answer 20

aspergillosis
candida
fusarium

Question 21

parasitic ulcerative keratitis

Answer 21

microsporidia

Question 22

amebic keratitis

Answer 22

hot tubs, contacts, fresh water exposure
often presents as an irregular dendritiform epithelial keratitis
often mis-diagnosied as herpes simplex
later progresses to a ring ulcer 
calcoflour white staining for Dx

Question 23

karatoconus

Answer 23

degenerative deformation of corneal curvature
irregular myopic astigmatism
usually b/l
progressive visual distortion
corrective lenses, lasik, cornela transplant

Question 24

munsosn sign

Answer 24

when pt looks down the cones in each eye cause the lower lids to bulge in keratoconus

Question 25

lenticonus

Answer 25

should not be confused with keratoconus

its is a deformity of the lens that occurs in alports disease

Question 26

age related macular degeneration

Answer 26

loss of central vision
>75
dry or wet

Question 27

dry degeneration

Answer 27

by far most common type
no neogenesis
deposits in Brush membrane and atrophy of retinal pigmented epi
no available Tx

Question 28

wet degeneration

Answer 28

linked to C’ factor H
neogenesis with proliferation of capillaries in choroidal membranes all the way into photoreceptors
can be Tx with anti-neogenesis agents

Question 29

retinoblastoma

Answer 29

most common intraocular tumor of childhood
90% Dx <3yrs of age
30-40% b/l and associated with germ line mutations
retinoblastoma gene Chr 13

Question 30

Tx of retinoblastoma

Answer 30

enucleation
photocoagulative ablation and hyperthermia
cyrotherapy
chemoreduction
external beam radiation
plaque radiotherapy

Question 31

prognosis of retinoblastoma

Answer 31

survival 95%

most important risk factor is extraocular extension of tumor thru ON or sclera

Question 32

sympathetic opthalmia

Answer 32

non-infection inflammation of uvea b/l
can result from trauma
retinal Ags visible to immune system delayed hypersensatively rxn weeks to years after injury

Question 33

uveal melanoma

Answer 33

larger the tumor, ant location, extraocular extension all indicate poor prognosis
mets usually 2-4 yrs after Dx and give <6months to live

Question 34

Tx of uveal melanoma

Answer 34

chemo
charge partical therapy
enucleation

Question 35

cataracts

Answer 35

clouding of lens inside eye decreasing vision

Question 36

open-angle glaucoma

Answer 36

aqueous humor has complete physical access to drain, but there is still increases IOP
mutations in MYOC associated with juvenile cases
mutations in OPTN associated with adult cases
more difficult to Tx

Question 37

closed-angle glaucoma

Answer 37

physical blockage of aqueous humor drainage