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HEENT CABS > Eye pathology > Flashcards

Eye pathology Flashcards

1
Q

Why are corneal abrasions so painful

A

The cornea is higher innervated

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2
Q

roughly how long will is take for a corneal abrasion to heal

A

24-48 hours

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3
Q

Where does regeneration of the cornea occur

A

the limbus

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4
Q

What is the most common pathogen in corneal ulcers

A

S. pneumoniae
pseudomonas
s. aureus

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5
Q

What is keratitis

A

Surrounding inflammation and disease process of the cornea. Typically associated with corneal ulcers

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6
Q

What is the most common type of conjunctivitis

A

Viral

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7
Q

What is viral conjunctivitis most commonly associated with

A

adenovirus

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8
Q

What may be seen on a slit lamp exam with viral conjunctivitis

A

follicles

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9
Q

What type of conjunctivitis is caused from herpes simplex / zoster

A

Keratoconjunctivits

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10
Q

What is the typical cause for bacterial conjunctivitis

A

If contacts: pseudomonas

Otherwise: S. Aureus, S. Pneumoniae, H. Flu, Moraxella Catarrhalis

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11
Q

What causes hyper acute bacterial conjunctivitis and how fast does it come on

A

Rapid onset of less than 12 hours

m/c associated with Gonorrhea

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12
Q

What is pterygium

A

Proliferative disorder hallmarked by the abnormal growth of fibrovascular conjunctival tissue

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13
Q

Where is pterygium seen in the eye

A

Along the nasal aspect and reaches toward the cornea

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14
Q

What is generally the cause of pterygium

A

UV light exposure
*causes changes in DNA and RNA

Also associated with HPV infections

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15
Q

What is the pathophys of pterygium

A

Light induced alterations of the limbus causes increased angiogenesis and abnormal tumor suppressor P53 and HLA expression

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16
Q

What is the cause of dacrocystitis

A

Infection (m/c Staph pneumoniae)
*generally s/p viral URI

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17
Q

If dacrosytitis is not treated, what can occur

A

periorbital or orbital cellulitis

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18
Q

What makes up the lens of the eye

A

crystalline proteins

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19
Q

What is occurring with cataracts

A

The crystalline proteins that make up the lens will lose their transparency over time

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20
Q

What are non-age related causes of cataracts

A

Trauma
uveitis
scleritis
radiation
medications

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21
Q

What are the common side effects of cataracts

A

Difficulty seeing at night
nearsightedness
frank opacification of the lens
*generally bilateral

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22
Q

What are the risk factors for cataracts

A

Age
Sunlight
Smoking / ETOH
malnutrition
metabolic syndromes
DM
HIV
high dose steroids

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23
Q

What is entropion

A

Internal folding of the lower lid

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24
Q

What can cause entropion

A

Post infectious (trachoma)
blepharospasm

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25
Q

What is trachoma

A

Chronic conjunctivitis d/t chlamydia trachomatis, leading to neovascularization and scarring of the lid

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26
Q

What is ectropion

A

eversion of the lower lid

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27
Q

What is the cause of ectropion

A

Age (tissue begins to relax)
*will present with tearing and dry eyes

28
Q

What is a chalazion

A

non-infectious occlusion of the meibomian gland

29
Q

What is a hordeolum

A

infection of the meibomian gland

30
Q

What is orbital cellulitis

A

Infection of the orbit
*can be life threatening

31
Q

What is the presentation of orbital cellulitis

A

Pain with eye movement
fever
normal visual acuity
proptosis
**does NOT involve the globe

32
Q

What is a rare complication of orbital cellulitis

A

bacterial rhino sinusitis
*gains access from ethmoid sinus via the lamina papyracea

33
Q

What is optic neuritis associated with clinically

A

MS

34
Q

What is optic neuritis

A

inflammatory disease with demyelination of the optic nerve

*myelin breaks down secondary to an immune mediated reaction
-systemic T cell activation and then B cell activation against myelin

35
Q

What is afferent pupillary defect associated with

A

pathology of the optic nerve

36
Q

How do you test for afferent pupillary defect

A

swinging flashlight test (effect of the light will not get through to the CNS)
* if not present -> rule out optic neuritis

37
Q

What causes glaucoma

A

Increased IOP due to the blockage of the canal of schlemm

38
Q

What is normal IOP

A

12-22mmHg

39
Q

What is occurring with glaucoma

A

Increased IOP will cause optic neuropathy and decreased visual flow to the retina

40
Q

What are the types of glaucoma

A

Closed angle
open angle

41
Q

What is acute closed angle glaucoma

A

Lens or peripheral iris blocks the meshwork/canal (m/c in people with shallow ant. chambers)

42
Q

What are the symptoms of acute closed angle glaucoma

A

Monocular eye pain
blurry vision/vision loss
headache
conjunctival injection & cloudy cornea

43
Q

What will the IOP be in someone with closed angle glaucoma

A

> 40mmHg

44
Q

What is pipilledema

A

Edematous head of optic nerve bilateral from increased ICP

45
Q

What will be seen on a fundoycopic exam with papilledema

A

Blurred disc margins
nerve head elevation
vascular congestion

46
Q

What is macular degeneration

A

degenerative disease of the central aspect of the retina
*can be monocular or binocular

Progressive-> generally starts as dry and turns wet

47
Q

How will a patient with macular degeneration present

A

with central vision loss

48
Q

What increases a persons risk for macular degeneration

A

age
smoking
CV disease
HTN
obesity
sun exposure

49
Q

What is atrophic macular degeneration

A

Dry
Generally will be mild and asymptomatic

50
Q

How can you test for atrophic macular degeneration

A

Noticed on eye exam from the presence of druses

51
Q

What is druse

A

yellow deposits made up of lipid and proteins in the macula

52
Q

What is neovascular/exudative macular degeneration

A

Wet
Increased druses causes an inflammatory response. Pigmentation of macula increases and angiogenesis begins

these vessels are ‘leaky’ and the extra fluid can form pockets which distort typical anatomy of the eye = distorted vision

53
Q

What is a retinal detachment

A

detachment between neurosensory retina from the retinal pigment epithelial layer/choroid

54
Q

In what part of the eye is a retinal detachment most likely to progress

A

If it is along the superior aspect
if initially a larger size
if patient moves their head/eyes too much

55
Q

What is the most common cause of retinal detachment

A

Vitreous detachment (posterior eye)

the vitreous mobility leads to cobweb floaters that are visualized by the patient

56
Q

When is retinal detachment vision threatening

A

If it involves the central retina

57
Q

Why can retinal detachment threaten vision

A

the separation leaves the neuronal layer avascular which causes photoreceptor degeneration

58
Q

What is the most common type of retinal detachment

A

Rhegmatogenous tear

59
Q

What is a rhegmatogenous retinal tear

A

A hole/tear in the inner neuronal later

*fluid accumulated between retinal layers

60
Q

What is a tractional tear

A

Vitreous fibrous band pulls the retina away (no actual tearing)
-typically chronic and more likely to be asymptomatic

61
Q

What is an exudative retinal tear

A

Fluid/blood from a retinal vessel leak, pushing the retina away from its typical anatomic position
*typically infection / inflammatory

62
Q

What are black spots associated with in retinal detachment

A

vitreous hemorrhage

63
Q

What does a patient have if they complain of feeling like their is a curtain coming over their vision

A

Retinal detachment

64
Q

Where does retinal vascular occlusion occur

A

the first branch of the internal carotid (ophthalmic artery)
- if becomes occluded= retinal infarction

65
Q

If a cherry red spot is seen on a fundoycopic exam with a pale retina, what is the likely diagnosis

A

retinal artery occlusion

66
Q

What happens to the retina as it slowly infarcts from arterial occlusion

A

becomes pale
translucent
edematous

67
Q

What are the signs and symptoms of retinal artery occlusion

A

Sudden, painless, monocular vision loss
*may have amaurosis fugax

HEENT CABS (6 decks)

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