Iris Flashcards
Iris is contribute to depth of _____.
focus
Long ciliary nerves-branches of trigeminal of the sympathetic system innervate which muscle in the eye?
dilator muscle
Short ciliary nerve from the ciliary ganglion from Edinger-Westphal of the parasympathetic system innervate which muscle of the eye?
sphincter muscle
What is neovascularization of the iris called?
Rubeosis iridis
How does neovascularization of the iris happen?
It’s from retinal ischemia where it causes the release of angiogenesis factor which diffuse into the aqueous humor, interacting with the anterior segment, which then causing blood vessels to grow in the iris.
What are some conditions that can cause retinal ischemia?
Diabetes Mellitus, central vein occlusion, central artery occlusion, ocular ischemic syndrome, intraocular tumors, chronic retinal detachments.
Who do you refer to if you see NVI on a patient?
To Pan-retinal photocoagulation (PRP)
What kind of masses you can find in the iris?
Nevus, melanoma or neurofibromatosis
T/F Iris nevus is malignant neoplasms composed of melanocytes.
False. it’s benign. usually flat, less than 3mm and they don’t grow.
What should you do if you see Iris nevus on a patient?
monitor it for growth
Is Iris melanoma malignant?
malignancy is low
How do you evaluate a Iris melanoma?
Use a slit-lamp to document the size and location. Draw pic and document size and characteristics of it. Do an ultrasound as well
Who do you refer to after you have diagnosed the patient with iris melanoma?
Refer them for a surgical evaluation.
Iris melanoma composed of _______ cells.
spindle
Neurofibromatosis is a ________ disorder.
hereditary
T/F Neurofibromatosis affects cells growth of neural tissues.
True
Which neurofibromatosis is more common. 1 or 2?
1 is more common than 2 and it has more ocular involvements also
What is another name for neurofibromatosis 1?
Von Rechlinhausen disease
Which neurofibromatosis will you find Cafe au lait spots?
neurofibromatosis 1. you will see it on the skin and face
Will you find fibroma molluscum (pigmented nodules of the skin) with neurofibromatosis 1 patients? What about neurofibromatosis 2 patients?
Yes, only in neurofibromatosis 1 patients
What do you see in a neurofibromatosis 1 patient’s eye?
You can see Lisch nodules, chroidal nevus, retinal astrocytoma, optic nerve glioma (tumor) and the patient can have glaucoma
Is there treatment for Lisch nodules?
No.
What do you see in the eyes of a neurofibromatosis 2 patient?
- Cataract is common with patients before 30.
- Fundus lesion
- EOM defects
Albinism is deficient in enzyme ________.
tyrosinase (convert tyrosine to melanin)
T/F Most people with albinism doesn’t have nystagmus.
False
How is the EOM in Aniridia (no iris) patient?
Nystagmus
What can alpha 1 blockers affect the iris?
Can cause flobby iris mostly in older man. talk to the surgeon before they do cataract surgery if the patient is on alpha 1 blocker.
What is Iridodialysis?
tearing of the iris away from the ciliary body.
T/F Iridodialysis is symptomatic.
False. Asymptomatic
What are the symptoms you can get from pigment dispersion glaucoma?
Blur, eye pain, eyepain/halos after exercising.
What is Iridocorneal endothelial syndrome (ICE)?
Abnormal corneal endothelial cells that can migrate to the surface of the iris. Atrophy of the iris.
T/F Iridocorneal endothelial syndrome (ICE) can cause edema to the cornea.
True
What would you do if you suspect a patient with ICE?
Check their cornea for edema, look at the optic nerve, check IOP and glaucoma workup
What are some symptoms of angle closure glaucoma?
Pain, blurred vision, halos, headache, nausea and vomiting
What do you do if you suspect a patient with angle closure glaucoma?
- try to lower their IOP asap with topical and/or oral anti-gluacoma meds
- refer them to get a peripheral iridotomy (PI) ASAP
Progressive iris atrophy-ICE patients can develop _________ synechiae.
peripheral anterior
What are the syndromes you see in ICE?
- Progressive iris atrophy
- Cogan Reese (iris nevus)
- Chandler
Which ICE causes Iris stromal atrophy and the development of peripheral anterior synechia?
Progressive iris atrophy
Which ICE causes diffuse iris nevus and pigmented nodules on iris?
Cogan-Reese
Which ICE causes the most corneal changes and it’s 50% of all the different ICE?
Chandler
