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NMSP > Eye Pathology part 1 > Flashcards

Eye Pathology part 1 Flashcards

1
Q

Define Proptosis

A

Increased ORBITAL contents so the eye is displaced and the eyelid cannot cover it

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2
Q

If the eye is inferior and medially displaced due to Proptosis, where is the issue?

A

Lacrimal gland

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3
Q

If the eye is axially (straight forward) displaced due to Proptosis, where is the issue?

A

Optic Nerve

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4
Q

What is the most common cause of Proptosis?

A

Thyroid Disease = Graves

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5
Q

With Thyroid Disease (Graves), what is enlarged in order to cause Proptosis?

A

Enlargement of the extra-ocular muscles ONLY

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6
Q

With Thyroid Disease (Graves), what molecule is increased with the enlargement of the extra-ocular muscles that is causing proptosis?

A

Increased Glycosaminoglycans

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7
Q

Another cause of Proptosis is Idiopathic Orbital Inflammation (pseudotumor). What cells infiltrate the orbit?

A

Inflammatory cells + Eosinophils!

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8
Q

Another cause of Proptosis is Idiopathic Orbital Inflammation (pseudotumor). What does fibrosis replace in the orbit that differentiates it from Graves Disease?

A

Fibrosis replaces the orbital fat and tendons!!

– Graves disease only affects the extra-ocular muscles!

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9
Q

Sarcoid can also affect the orbit. It involves what type of inflammation and what 2 items on an opthalmic exam?

A

Granulomatous inflammation

  1. Mutton fat
  2. Candlewax drippings
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10
Q

Neoplasms of the orbit are mostly of ____ origin. List 2 and the age group that they affect.

A

Vascular origin

  1. Capillary Hemangioma = KIDS
  2. Cavernous Hemangioma = ADULTS
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11
Q

Chronic inflammation of the eyelid?

A

Blepharitis

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12
Q

What is a Chalazion and what part of the eye does it affect?

A

Lipogranuloma (lipid into the tissue)

– Affects the EYELID

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13
Q

What are the 2 most common neoplasms that affect the EYELID?

A
  1. Basal Cell Carcinoma

2. Sebaceous Carcinoma

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14
Q

What is the most common malignancy of the eyelid?

A

Basal Cell Carcinoma

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15
Q

Basal Cell Carcinomas often affect younger individuals with sun-exposed skin. What location of the eyelid is affected and what are the attributes of the carcinoma?

A

Lower eyelid

  • Pearly nodule
  • Telangiectasia
  • Central ulcer
  • Rolled edges
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16
Q

A pearly nodule with telangiectasia, a central ulcer and rolled edges is likely what neoplasm on the eyelid?

A

Basal Cell Carcinoma

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17
Q

What do the cells of a Basal Cell Carcinoma show histologically?

A

Peripheral Palisading

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18
Q

If a Chalazion returns after treatment on the eyelid, what is the likely neoplasm?

A

Sebaceous Carcinoma

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19
Q

Sebaceous Carcinomas commonly occur on what location of the eyelid and what type of spread do they have?

A

Upper eyelid

- Pagetoid spread = intraepithelial spread

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20
Q

With Sebaceous Carcinomas of the eyelid, the nuclei are more atypical than a BCC. What stain do you need and what attribute is detectable in the cytoplasm?

A

Oil red O stain

– Vacuolization of the cytoplasm

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21
Q

Where do Sebaceous Carcinomas of the eyelid often spread?

A

Regional lymph nodes

= Parotid and Submandibular nodes

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22
Q

What cell type is very abundant in the Conjunctiva?

A

Goblet cells

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23
Q

What infection can produce significant scarring of the Conjunctiva?

A

Chlamydia Trachomatis

24
Q

Dry eye affects the conjunctiva. Describe how it arises.

A
  • Conjunctival scarring decreases the number of Goblet cells
  • Decreased Goblet cells = Decreased mucin
  • Decreased mucin = Decreased adherence of aqueous tear film
25
Q

What are 2 unique lesions that can affect the conjunctiva after sun damage?

A

Pinguecula

Pterygium

26
Q

How do Pinguecula and Pterygium lesions look on the Conjunctiva?

A

Small, yellowish submucosal elevations

27
Q

On the conjunctiva, where do Pingueculas usually arise?

A

At the limbus

28
Q

What type of growth differentiates a Pterygium from a Pinguecula on the conjunctiva?

A

Pterygium encroaches onto the cornea in a wing-like fashion

29
Q

A small, yellowish submucosal elevation of the conjunctiva that is encroaching onto the cornea in a wing-like fashion is likely a?

A

Pterygium

30
Q

Due to Pterygiums encroaching onto the cornea, what symptom will be present with them that is not present with Pingueculas?

A

Visual impairment

31
Q

What are 2 common neoplasms that affect the conjunctiva?

A

Squamous Cell Carcinoma – HPV 16/18

Melanoma

32
Q

Melanoma on the Conjunctiva usually involves what mutations?

A

BRAF v600 mutations

33
Q

Nevi (moles) can affect the Conjunctiva. Describe Junctional, Compound, and Intradermal Nevi.

A

Junctional - epidermal melanocyte nests along dermoepidermal junction
Compound - melanocyte nests in dermis and epidermis
Intradermal - melanocyte nests only in dermis

34
Q

What can compound nevi of the conjunctiva contain?

A

Cysts

35
Q

Immature superficial nevi grow how? Mature deeper nevi grow how?

A

Immature superficial = nests

Mature deeper = cords

36
Q

What are the layers of the Cornea?

A
  • Bowman layer
  • Stroma
  • Descemet Membrane
37
Q

What is unique about the stroma layer of the cornea?

A

NO blood vessels/lymphatics

– Transparent but hard to repair

38
Q

If copper deposits occur in the eye with Wilson’s disease, where do they get deposited?

A

Descemet membrane of the cornea

39
Q

With a corneal transplant, what is there a lack of and why?

A

Lack of rejection!

– Stroma lacks blood vessels

40
Q

If exudate leaks from the iris/ciliary body into the anterior chamber, what is that called? – cornea affected

A

Hypopyon

41
Q

Acanthamoeba can affect the Cornea. What symptom will occur and in what patients?

A

Permanent visual impairment

= contact lens wearers with poor hygiene of lenses and hands

42
Q

What infection may occur in the cornea of contact lens wearers with bad hygiene?

A

Acanthamoeba

43
Q

Herpes Simplex Virus Keratitis can also affect the Cornea. What type of pattern is the opacification and swelling of the cornea? If chronic, what reaction will take place and where?

A

Dendrite-linear pattern

– Granulomatous reaction at the Descemet’s membrane

44
Q

What causes corneal degenerations?

A

Inflammation

45
Q

What are 3 types of Corneal Degenerations?

A
  1. Calcific band keratopathy
  2. Actinic band keratopathy
  3. Keratoconus
46
Q

Calcific Band Keratopathy of the Cornea

A

(Corneal degeneration)

- Calcium is deposited in Bowman layer of the cornea

47
Q

Actinic Band Keratopathy of the Cornea

A

(Corneal degeneration)

- Collagen becomes yellow due to UV light exposure

48
Q

Keratoconus of the Cornea

A

(Corneal degeneration)

- Bilateral central thinning and anterior protrusion

49
Q

Keratoconus results in what type of vision and what is the treatment?

A

Irregular astigmatism

– Rigid contact lenses is the treatment

50
Q

Bilateral central thinning of the cornea with anterior protrusion

A

Keratoconus

Corneal degeneration

51
Q

With Keratoconus, where are the breaks in the cornea?

A

Bowman layer

52
Q

What causes Corneal Dystrophies and how do they occur?

A

Deposition of abnormal material

– FAMILIAL occurrence

53
Q

What is a type of Corneal Dystrophy?

A

Fuchs Dystrophy

54
Q

Fuchs Dystrophy of the Cornea

A

Descemet’s membrane is thickened with guttata (drop-like) material protruding into anterior chamber

55
Q

Descemet’s membrane is thickened with drop-like material protruding into the anterior chamber of the eye

A

Fuchs Dystrophy (corneal)

NMSP (28 decks)

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