Final - Ocular Pathology Flashcards
Conjunctivitis
Inflammation of the surface tissue of the glove & inner surface of eyelid.
3 zones
- Palpebral: conjunctiva covers inner surface of lids to the tarsus. Non-keratinized stratified squamous
- Bulbar: conjunctiva covers suface of the globe. Non-keratinized stratified squamous.
- Fornix: conjunctiva is accessory lacrimal tissue and ductules of lacrimal gland. Pseudostratified columnar epithelium w/goblet cells.
Keratoconjuctivitis, Sicca
Dry eyes lead to scarring.
Also Trachoma infection, causic agents, epithelial conditions (pemphigoid), drugs & surgery can cause scarring.
Conjunctival neoplasms
- Tend to arise near the limbus
- Mostly squamous & melanocytic
- Squamous progress similarly to epithelial neoplasm elsewhere
- conjuctival intraepithelial neo. may be assoc. w/HPV 16 & 18
- Mucoepidermoid carcinoma of conjunctiva tends to be more aggressive.
Conjunctival Melanoma
- Unilateral, in fair skinned, middle-aged people.
- Intraepithelial phase - “primary acquired malanosis with atypic” **50-90% of these develop melanoma if incompletely treated.
- Metastasis goes to parotid & submandibular lymph tissue
- Mortality 25%
Uveitis
Affects middle layer of eye (uvea, between retina & sclera). = Iris & ciliary body @ front of eye, choroid in back of eye. * BV that nourish the retina.
Pterygium vs Pinguecula
Pinguecula does NOT cross the iris.
Pterygium T-transfers across the iris - it DOES cross.
Sclera
CT that voters the choroid, deep to bulbar conjunctiva
- white of the eye
- Inflammation is “scleritis” ***MUCH more dangerous than conjunctivitis!
- -May indicate inflammation of urea
- -May result from systemic dz like RA, RA can cause necrotizing scleritis
Usually scleritis is noninfectious, ~5% are. Suspect this in pts w/recent hx of infectious keratitis or ocular surgery -> pterygium removal or scleral bucket placement.
-risk also goes up in contact lens wearers.
Blue Sclera
- Osteogensis imperfecta = congenital bone & CT disorder
- Congenital nevus of the urea -> congenital melanosis oculi
- Nevus of Ota is the combination of this lesion w/periocular pigmentation
Keratitis
= inflammation of the cornea
- caused by infectious, inflammation, systemic dz (RA), physical/chemical insults. (herpes simplex, and zoster)
- dissolution of corneal stroma often accompanies
- activation of collagenases may accelerate
- inflammatory infiltrates & cells from the iris & ciliary body may be visible in enterior chamber!
Ulceration
= full thickness erosion of the cornea
- most commonly from physical trauma, chemical insults, or infection
- HSV, HZV, Acanthamoeba, and other virus/bacteria/fungi
Cornea
= tissue covering the pupil & anterior chamber
- **responsible for majority of refractive power of the eye
- 3 layers: superficial epithelial (24-48), bowman layer (acellular), corneal stroma (lacks blood & lymphatics)
Cataract
= opacities of the lens of the eye!
- congenital or acquired
- assoc. w/diabetes, atopic dermatitis, Wilsons dz, galactosemia, intraocular disorders, raiation, trauma, drugs (corticosteroids)
- age related cataract typically affects the lens NUCLEUS
- urochrome accumulation turns the nucleus brown. (may distort their perception of blue)
Morgagnian cataract
- Hypermature cataract - from liquefaction of lens cortex
- leaking proteins through lens capsule is phacolysis
- phacolytic proteins mau caues secondary open angle glaucoma
Anterior Chamber
- filled w/aqueous humor = ultra filtrate of the blood , provides nutrition & immune stuff
- AH created by ciliary body, drained through Cana of Schlemm
- Increased production or decreased drainage can cause build up of aqueous humor and increased pressure in anterior chamber -> glaucoma -> blindness from damage to the optic n.
Glaucoma
Conditions that change visual field & the optic cup.
- usu. come w/elevated intraocular pressure (normal tension glaucoma)
- In the optic n. -> diffuse loss of ganglion cells and thinning of retinal nerve fiber layer
- > optic n. cupping & atrophy
