Eye Pathology - Fremont-Smith

Question 1

hyaloid canal

Answer 1

remnant of fetal central retinal artery

Question 2

retinal artery occlusion

Answer 2

atheromatous emboli from I/L internal carotid stenosis

HTN diabetes

temporal arteritis

Question 3

TIA of retinal artery

Answer 3

amaurosis fugax

browin out
loss of vision one eye 10 minutes

I/L internal carotid artery stenosis

Question 4

anterior ischemic optic neuropathy

Answer 4

short ciliary arteries

supply optic nerve

vision loss one eye - upon awakening**

Question 5

papilledema

Answer 5

with increased ICP

venous stasis
and compression of optic nerve

Question 6

infection of eyelid

Answer 6

staph

Question 7

meibomian gland

Answer 7

eyelid

Question 8

external stye

Answer 8

hair follicle

Question 9

internal stye

Answer 9

meibomian gland

Question 10

hordeolum

Answer 10

stye

Question 11

stye

Answer 11

acute inflammation gland of zeis

or meibomian gland

Question 12

stye infection

Answer 12

staph

clears 7 days

Question 13

chalazion

Answer 13

meibomian gland lipogranuloma

inflammation to rupture of gland

secondary to obstruction

granuloma - giant cells around lipid vacoles

Question 14

chalazion prognosis

Answer 14

lasts weeks to months

Question 15

xanthelasma palpebratum

Answer 15

soft, flat, raised yellow papules or plaques

hyper and normo-lipemic patients

foamy, lipid-laden histiocytes in dermis

cosmetic surgery

Question 16

split nevus

Answer 16

congenital of eyelid
-rare

follow for changes

Question 17

compound nevus

Answer 17

dermis and epidermis

Question 18

only dermis

Answer 18

dermal nevus

Question 19

most common eyelid malignancy

Answer 19

BCC

often lower eyelid

nodular, cystic, or diffuse

possible ulceration

lical invade - rare mets

Question 20

mohs surgery

Answer 20

slice by slice removal of BCC of eyelid

Question 21

shallow ulcer surrounded by wide, elevated, and indurate border on lower eyelid

Answer 21

SCC

potential for mets

polygonal cells with pink eosinophilic cytoplasm nuclear atypia, infiltrating cords into dermis, dyskeratotic cells, keratin pearls

Question 22

sebaceous carcinoma

Answer 22

elderly asian female

majority upper lip

meibomian, zeis (lash follicle), or caruncle gland

malignant**

foamy, lipid laden cytoplasm, necorsis, pagetoid invasion of skin

15% mortality

Question 23

mets of sebaceous carcinoma

Answer 23

lung, liver, brain, skull

Question 24

solar elastosis of conjunctiva

Answer 24

pinguecula

small yellow submucosal nodule at limbus

Question 25

pinguecula

Answer 25

with sun exposure

no therapy

follow - may go to SCC

Question 26

pterygium

Answer 26

submucosal growth of CT - migrates into cornea

UV damage, dust, wind

removed for cosmetic reasons

B9, but need to rule out squamous neoplasia

Question 27

central corneal ulcer

Answer 27

herpes simplex virus

Question 28

ulcerative keratitis

Answer 28

pseudomonas aeruginosa
staphylococcus aureus

cosmetics or contact lenses

Question 29

ulcerative keratosis fungal

Answer 29

aspergillosis
candida
fusarium

Question 30

parasite to ulcerative keratitis

Answer 30

microsporidia

Question 31

dendritic ulcer of cornea

Answer 31

herpes simplex keratitis

Question 32

hot tub, pond, contact lense

Answer 32

amebic keratitis

acanthamoeba

progresses to ring ulcer

Question 33

calcoflour white stain

Answer 33

diagnosis of amebic keratitis

confirmed by culture

Question 34

keratoconus

Answer 34

degenerative degeneration of corneal curve

astigmatism

usually B/L

progressive visual distortion

Question 35

alport syndrome

Answer 35

lens bulge - collagen defect

Question 36

major refractive surface of eye

Answer 36

cornea

• keratoconus
• distort vision - irregular astigmatism

Question 37

munson sign

Answer 37

patient look down - lower lid bulges

positive in keratoconus

Question 38

loss of central vision

Answer 38

macular degeneration

age-related

dry and wet

Question 39

dry macular degeneration

Answer 39

no neoangiogenesis

deposit in brush membrane and atrophy of retinal pigmented epithleium

no tx

Question 40

wet macular degeneration

Answer 40

yes neoangiogenesis

tx - VEGF antagonist injection to vitreous

Question 41

associated with smoking

Answer 41

wet macular degeneration

Question 42

intraocular tumor of child

Answer 42

retinoblastoma

Question 43

retinoblastoma

Answer 43

leukocoria (white pupil)

also strabismus, red and painful eye, poor vision

Question 44

retinoblastoma gene

Answer 44

Chromosome 13

Question 45

prognosis of retinoblastoma

Answer 45

95%

make sure no invasion (extraocular extension)

Question 46

sympathetic opthalmia

Answer 46

non-infectious granulomatous inflammation of uvea of both eyes

retinal antigens visible to immune system

delayed hypersensitivity rxn to other eye

after uvea injury

Question 47

uveal melanoma

Answer 47

aka choroidal melanoma

risk fx for mortality - large size, anterior location, extraocular extension

Question 48

early metastasis

Answer 48

uveal melanoma

often to liver

bad prognosis

Question 49

cataract

Answer 49

disorganization of corneal stroma in lens of eye

Question 50

open angle glaucoma

Answer 50

increased resistance to aqueous outflow in open angle

mutations in myocilin - juvenile and adult primary

optineurin mutation - subset of adults

Question 51

angle-closure glaucoma

Answer 51

iris adheres to trabecular meshwork

Question 52

cupping

Answer 52

result of increased intraocular pressure

-with glaucoma