Eye Pathology

Question 1

What is palpebral conjunctiva?

Answer 1

Tightly tethered to tarsus; papillary folds with allergic and bacterial conjunctivitis

Question 2

What is the fornix?

Answer 2

Contains accessory lacrimal tissue and lymphoid tissue; pseudostratified columnar epithelium rich in goblet cells

Question 3

What is bulbar conjunctiva?

Answer 3

Covers the surface of the eye; non keratinizing stratified squamous epithelium

Question 4

What is the limbus?

Answer 4

Intersection between sclera and cornea; transition from conjunctiva to cornea epithelium

Question 5

What is a freckle?

Answer 5

Increased melanin within basal keratinocyte, melanocytes normal in # but may be slightly enlarged

Question 6

What is a lentigo?

Answer 6

Linear (non nested) melanocytes hyperplasia restricted to basal cell layer

Question 7

What is a junctional nevus?

Answer 7

Epidermal nests along the dermoepidermal junction

Question 8

What is a compound nevi?

Answer 8

Junctional grows into underlying dermis at nests or cords

Question 9

What is an intradermal nevi?

Answer 9

Epidermal nests lost completely

Question 10

What is a conjunctival nevus?

Answer 10

Nevus in the conjunctiva that is benign

Question 11

What is a compound cystic nevus?

Answer 11

Compound nevi of the conjunctiva characteristically contain subepithelial cysts lined by surface epithelium

Question 12

What does sclera consist of?

Answer 12

Mainly of collagen and contains few blood vessels and fibroblasts; hence wounds and surgical incisions tend to heal poorly

Question 13

What is necrotizing scleritis?

Answer 13

Immune complex deposits (i.e. RA)

Question 14

Which conditions can cause a blue sclera?

Answer 14

Scleritis thins sclera, increased intraocular pressure thins sclera —> blue = staphylomm, osteogenesis imperfecta, congenital melons is oculi (when accompanied by periocular cutaneous pigmentation called a nevus of Ota)

Question 15

What is the Bowman layer of the cornea?

Answer 15

Acellular barrier that prevents malignant cells from penetrating from the epithelium to the stroma

Question 16

What is the stroma of the cornea?

Answer 16

Lacks of blood vessels and lymphatics thus transparent but difficult to repair

Question 17

Corneal vascularization may be caused by what?

Answer 17

Trauma, inflammation, edema, scarring all which lead to opacification of the cornea; VEGF antagonists could be used to tx

Question 18

Describe the endothelium of the cornea

Answer 18

Derived from neural crest not vascular endothelium; malfunction —> stromal edema, bullous keratopathy

Question 19

Describe the Descemet membrane of the cornea

Answer 19

Thickness increases with age; site of Kayser-Fleischer ring in Wilson’s dz; copper deposits here

Question 20

What is the flow of aqueous humor?

Answer 20

Ciliary body produces it —> travels from the posterior chamber through the pupil and into the anterior chamber —>drains thru the trabecular meshwork

Question 21

What is uveitis?

Answer 21

Any type of inflammation involving uvea (consists of iris, choroid and ciliary body)

Question 22

What is posterior segment uveitis?

Answer 22

Frequently involves retinal pathology; infection (pneumocystis crinii), idiopathic (sarcoid), autoimmune (sympathetic ophthalmia)

Question 23

What is granulomatous uveitis?

Answer 23

Complication of sarcoidosis; candle wax drippings; conjunctival bx detects granulomatous inflammation, confirm dx by ocular sarcoid

Question 24

What is sympathetic ophthalmia?

Answer 24

A rare bilateral granulomatous uveitis that occurs after either surgical or accidental trauma to one eye

Question 25

What are some infections that can cause uveitis?

Answer 25

Retinal toxoplasmosis with uveitis and scleritis; AIDS pts: CMV retinitis, uveal pneumocystis, mycobacterial choroiditis

Question 26

What is radial growth?

Answer 26

Horizontal growth of melanoma

Question 27

What is vertical growth?

Answer 27

Characteristics determine biological behavior of melanoma

Question 28

Melanoma cells in the skin contain what?

Answer 28

Large nuclei with irregular contours, peripherally clumped chromatin, and prominent red (eosinophilic) nucleoli

Question 29

What is Clark’s level?

Answer 29

Anatomic level of invasion (melanoma)

Question 30

What is Breslow thickness?

Answer 30

Thickness of the tumor (melanoma)

Question 31

What is the retinal pigment epithelium?

Answer 31

Derived embryologically from primary optic vesicle (an outpouching of the brain)

Question 32

What is retinal detachment?

Answer 32

Separation of neurosensory retina from RPE

Question 33

What is retinitis pigmentosa?

Answer 33

Hereditary (X linked, AR, or AD) retinal degeneration; age of onset correlates with inheritance pattern (AD later in life); affects rods and cones of RPE

Question 34

Describe vitreous humor of the retina

Answer 34

Avascular; persistent fetal vasculature (incomplete regression —> retrolental mass); hemorrhage and neovasculature —> opacification of vitreous);

Question 35

What causes floaters?

Answer 35

With age, vitreous humor of the retina liquefies and collapses causing floaters

Question 36

What is posterior vitreous detachment?

Answer 36

Posterior hyaloid (vitreous) separates from neurosensory retina due to aging (vitreous fluid liquefies)

Question 37

What is phthisis bulbi?

Answer 37

Soft, shrunken, shapeless, sightless, structureless, squared and sore eyeball

Question 38

What can cause phthisis bulbi?

Answer 38

Trauma, intraocular inflammation, chronic retinal detachment, and many other conditions can give rise to an eye that is both small (atrophic) and internally disorganized