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Opthalmology > Immunology > Flashcards

Immunology Flashcards

1
Q

Describe innate immunity

A

First line response - fast

Includes physical barriers, commensals, chemical agents and cells

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2
Q

Describe adaptive immunity

A

Acquired immunity - learned
Slower response
Specific

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3
Q

List components of the innate immune system of the eye

A

Blink reflex
Flushing of the eye
Chemical defences - in tears
Some immune cells are present

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4
Q

What chemical defences are found in tears

A 
Lysozyme 
Lacto and transferrin 
Tear lipids 
Angiogenin 
Secretory IgA 
Complement 
Interleukins
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5
Q

Which immune cells are found in the eye

A

Neutrophils
Macrophages
Conjunctival mast cells

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6
Q

How do Langerhans cells work in the eye

A 
Main antigen presenting cells for external eye 
Have lots of MHC class 2 molecules 
Abundant in the corneal/scleral area
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7
Q

What is the only part of the eye with lymphatic drainage

A

the conjunctiva

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8
Q

Describe the immune defences of the conjunctiva

A 
Has special venules for migration of lymphoid cells 
Lymphocyte populations present 
Dendritic cells work as APC's 
MALT 
Commensal bacteria
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9
Q

Describe the immune defences of the cornea and sclera

A

Avascular and no lymphoid tissue
Relative lack of APCs Langerhans cells only present in peripheral cornea
It is a downregulated immune environment

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10
Q

Describe the immune defences of the lacrimal system

A

Glands: has more plasma cells and CD8 T cells

Drainage system: has lymphoid tissue (MALT)

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11
Q

Describe the immune defences of the vitreous, choroid retina

A

Blood ocular barrier - created by tight junctions
Relative lack of APCs
Downregulated immune environment

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12
Q

What are immune privilege sites

A

Places in the body where antigen introduction is tolerated and doesn’t elicit the inflammatory response

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13
Q

Which sites in the body have immune privilege

A

Brain
Testes
Placenta/foetus
EYES - cornea, anterior chamber, lens, vitreous cavity

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14
Q

What is ACAID

A

Anterior chamber associated immune deviation
Introducing a foreign antigen into the eye can induce a form of tolerance
It protects the eye from damage from an immune response by suppressing it

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15
Q

What are the hallmarks of ACAID

A

Generation of primed CD4 T cells and B cells

Inhibition of delayed-type hypersensitivity

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16
Q

How is ocular immune privilege established

A

Separation (immune ignorance) - cornea lacks blood and lymph vessels and decreased MHC expression
Inhibitions - local factors supress the immune response
Regulation (tolerance) - ACAID

17
Q

What can occur immunologically if there is trauma to the eye

A

Can lead to an exaggerated immune response as it disrupts the carefully balanced system

18
Q

What is sympathetic ophthalmia

A

Rare, bilateral, granulomatous uveitis due to trauma or surgery
Injury of one eye leads to inflammation in both
Elevated immune response may be cause - T cells are the main mediators

19
Q

In sympathetic ophthalmia what is the exciting eye

A

The one that sustained the injury

The other eye is called the sympathising eye

20
Q

List some hazards of the immune system

A 
Recurrent infections
Inadvertent injury to normal host tissues
Allergy
Hypersensitivity reactions
Autoimmune disease
Cancer
Transplant/graft rejection
21
Q

List some ocular autoimmune diseases

A

Autoimmune uveoretinitis - inflamed uvea and retina
Keratoconjunctivitis sicca (‘dry eyes’)
Lens-induced uveitis
Sympathetic ophthalmia

22
Q

Give an example of a type 1 hypersensitivity reaction in the eye

A

Acute allergic conjunctivitis

23
Q

Give an example of a type 2 hypersensitivity reaction in the eye

A

Ocular cicatricial pemphigoid

24
Q

Describe the presentation of acute allergic conjunctivitis

A

Red, puffy and swollen eye
Very inflamed
Chemosis= classic sign
Itchy watery eye with jelly-like appearance

25
Q

Describe the presentation of ocular cicatricial pemphigoid

A

Lid is held open
Blisters form on surface of the eye
Can lead to scarring - destroys eye structure
Cornea becomes hazy

26
Q

How do you treat ocular cicatricial pemphigoid

A

Steroids

27
Q

Give an example of a type 3 hypersensitivity reaction in the eye

A

Autoimmune corneal melting

treat with steroids

28
Q

Give an example of a type 4 hypersensitivity reaction in the eye

A

Corneal graft rejection
Not common
Can occur when tissue becomes vascularised

29
Q

What side effects of steroids can affect the eye

A

Can lead to cataract

Steroid-induced glaucoma

Opthalmology (9 decks)

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