ophtha-uvea Flashcards

0
Q

3 parts of uvea

A
  1. Choroid
  2. Ciliary body
  3. Iris
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1
Q

Pigmented vascular middle coat of the eye extending from optic disc to pupil

A

Uvea

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2
Q

Posterior uvea

A

Choroid

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3
Q

Anterior uvea

A

Iris and ciliary body

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4
Q

Choroid is supplied by

A

10-20 short ciliary a. (A branch of ophthalmic a)

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5
Q

Anterior uvea is supplied by

A

2 long ciliary a (branch of ophthalmic a)

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6
Q

Choroid layers of blood vessels

A
  1. Outer layer of large veins leading to vortex veins (haller)
  2. Middle layer of medium veins and some arterioles (sattler)
  3. Inner layer of choriocapillaries
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7
Q

The blood vessels layers are limited by 2 membranes, externally by ____ and internally by ____

A

Externally by suprachoroid

Internally by Bruch’s membrane

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8
Q

Anterior uvea has 2 circumferential arterial network

A
  1. Major arterial circle of ciliary body and part of ant choroid
  2. Minor arterial circle of iris
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9
Q

Embryological origin of uvea

A

Mesodermal in origin from tissues surrounding primary optic vesicle

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10
Q

Embryological origin of ciliary body and iris

A

Have Neuro ectodermal components

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11
Q

It provides nourishment for pigment epith and outer layer of retina

A

Choroid

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12
Q

Secretes aqueous humor and controls accommodation

A

Ciliary body

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13
Q

Regulates size of pupil

A

Iris

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14
Q

T/f: choroid has tendency to be isolated as well as macula

A

True. Because of segmental arrangement of choriocapillaries

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15
Q

Least severe inflammatory reaction

A

Iris.

Has limited bld supply and few stromal cells

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16
Q

More severe inflammatory reaction

A

Ciliary body.

Hs greater number of blood vessels and cells

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17
Q

Most severe inflammatory reaction

A

Choroid.

Has marked vascularity

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18
Q

Pigment proliferation depends on amt of pigment. What has least pigmentation and greatest pigmentation?

A

Iris has least pigmentation.
Ciliary body more.
Choroid most.

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19
Q

Purulent or non purulent inflammation: caused by bacteria or fungus

A

Purulent inflammation

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20
Q

Suppuration in uvea, retina and vitreous setting up

A

Endophthalmitis

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21
Q

Accumulation of leukocytes in anterior chamber

A

Hypopyon

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22
Q

Endo or exogenous type of purulent inflammation:

Initially vitreous opacities

A

Endogenous type

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23
Q

Endo or exogenous type of purulent inflammation:

Initially hypopyon

A

Exogenous type

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24
Q

When there is pain in purulent inflammation which occurs during the first week in endogenous type and much later in exogenous type

A

Glaucoma

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25
Q

In glaucoma, there is pain in purulent inflammation which occurs during ___ endogenous type and____ in exogenous type

A

In glaucoma, there is pain in purulent inflammation which occurs during 1st wk in endogenous type and much later in exogenous type

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26
Q

First sign in fungus purulent inflammation

A

Hypopyon

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27
Q

When infection extends to sclera and orbital struc producing proptosis, chemosis and limitation of ocular movement

A

Panophthalmitis

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28
Q

Panophthalmitis is characterized by

A

Proptosis
Chemosis
Limitation of ocular movement

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29
Q

Most common microorganism in bacterial purulent inflammation

A

Staph aureus
P. Aeruginosa
Proteus
Coli form bacillus

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30
Q

Most common microorganism in fungal purulent inflammation

A
Aspergillus
Candida
Sporotrichium
Cephalosporum
Cryptococcus 
Actinomyces
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31
Q

If condition in purulent inflammation does not improve in 4 days…

A

Vitrectomy (evacuation of vitreous)

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32
Q

Non purulent inflammation

A

Uveitis

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33
Q

S&s of uveitis

A
Ciliary injection
Fibrin in anterior chamber 
Small irreg pupil
Pupillary membrane 
Vitreous opacities
Choroids exudation
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34
Q

Signs seen in uveitis with the aid of magnifying loupe or bio microscope (slit lamp)

A

Keratic precipitate
Deposition of cells on post surface of cornea
Aqueous flare or trnaslucency caused by increased albumin, aqueous cells, Koeppe’s and Bussaca’s pseudonodules
Iris true nodule and stromal granuloma
Post synechiae or adhesion between iris and cataract cells

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35
Q

Adhesion between iris and cataract cells

A

Synechiae

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36
Q

Cause of uveitis common in Western Europe and America

A

Toxoplasmosis

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37
Q

Cause of uveitis common in Asia and Eastern Europe

A

TB

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38
Q

Cause of uveitis common in Middle East and japan

A

Viruses

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39
Q

Cause of uveitis common in central US

A

Histoplasmosis

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40
Q

T/f: uveitis by itself does not cause blindness

A

True

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41
Q

T/f. Uveitis is a recurring condition

A

True

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42
Q

Usual known cause of endogenous uveitis. Bacterial

A
TB
Leprosy
Syphilis 
Strep and staph
Klebsiella
Meningococcus
Gonococcus
Coliform bacilli
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43
Q

Usual known cause of endogenous uveitis. Viral

A
Herpes simplex
Herpes zoster 
Measles 
Mumps
Lymphogranuloma venerum
Cytomegalic inclusion bodies
44
Q

Usual known cause of endogenous uveitis. Fungal

A
Blastomyces
Monilia
Coccidiodomyces
Cryptococcus 
Histoplasma
45
Q

Usual known cause of endogenous uveitis. Protozoan

A

Amoeba

Toxoplasma

46
Q

Usual known cause of endogenous uveitis. Nematode

A

Hookworm

Ascaris

47
Q

Type of uveitis caused by introduction of inert substances, the composition of living organism, or whole dead organism into the eye

A

Non granulomatous uveitis

48
Q

Type of uveitis caused by live microorganism invading the eye

A

Granulomatous uveitis

49
Q

Non-granulomatous/granulomatous uveitis.

Onset

A

Non Granulomatous: acute

Granulomatous. Chronic

50
Q

Non-granulomatous/granulomatous uveitis.

Course

A

Non granulomatous. Self-limiting (1-2wks)

Granulomatous. Protracted with remission

51
Q

Non-granulomatous/granulomatous uveitis.

Ciliary injection

A

NG. Severe

G. Mild

52
Q

Non-granulomatous/granulomatous uveitis.

Pain

A

NG. Present

G. None

53
Q

Non-granulomatous/granulomatous uveitis.

Residual damage

A

NG. None or very slightly

G. Always and marked

54
Q

Non-granulomatous/granulomatous uveitis.

Keratin precipitates

A

NG. Small, pin-point

G. Big and greasy

55
Q

Non-granulomatous/granulomatous uveitis.

Aqueous

A

NG. Cells plenty

G. Cells few

56
Q

Non-granulomatous/granulomatous uveitis.

Nodules

A

NG. None

G. Frequent

57
Q

Non-granulomatous/granulomatous uveitis.

Posterior synechiae

A

NG. Very thin

G. Heavy and hard to break

58
Q

Non-granulomatous/granulomatous uveitis.

Vitreous opacities

A

NG. Thin with few cells

G. Heavy with plenty cells

59
Q

Non-granulomatous/granulomatous uveitis.

Retinal edema

A

NG. Generalized

G. Localized over choroid all exudates

60
Q

Non-granulomatous/granulomatous uveitis.

Choroidal exudates

A

NG. None

G. Large

61
Q

Non-granulomatous/granulomatous uveitis.

Pigmentation

A

NG. None

G. Prominent at borders of chordal exudates

62
Q

Reflex pupillary dilation

A

Mydriasis

63
Q

The principles of treatment of uveitis can be resolved into

A
  1. Mydriasis
  2. Anti-inflammation
  3. Specific therapy
64
Q

Beneficial effects of mydriasis

A
Breaks post synechiae (which is responsible for 75% of complications that end up in blindness)
Reduces volume of iris, consequently decongesting the iris mechanically (which diminishes the vascular exudation of inflammatory cells)
Reduces pain (cycloplegic effects)
65
Q

Mydriasis is done within ____ otherwise synechiae will remain permanent

A

Done within first 7-10 d

66
Q

Mydriasis solutions

A

Soln of atropine 1%
Phenylephrine 10%
Scopolamine 1%

For 1-3 times/d

67
Q

If there is consistent and prolonged Mydriasis, give

A

Sub conjunctival injection 0.5mL

68
Q

Anti-inflammation by locally applied steroid utilized in anterior uveitis. Local suspension, ointments , subconj, succinate ans subconj acetate is given every … To obtain adequate therapeutic level in aqueous.

A

Local suspension. 1-3 hrs
Ointment. 6-8 hrs
Subconj succinate. 3 d
Subconj acetate. 2 wks

69
Q

Specific type of uveitis that has protean manifestation.

A

TB uveitis

70
Q

TB uveitis affects both ant and post uvea?

A

Yes

71
Q

Charac by acute ant uveitis with greasy kp, and pseudo or true iris nodule or circumscribed irreg choroidal exudates

A

TB uveitis

72
Q

Does TB uveitis has tendency for recurrence?

A

Yes

73
Q

Usual form of foci of infection

A

Ant uveitis with fine kp and cells and post synechiae

74
Q

Most common org causing foci of infection

A

B-streptococcus hemolyticus

75
Q

Most common org causing foci of infection in Philippines

A

Alpha strep

76
Q

Specific type of uveitis charac with spontaneous or traumatic rupture of lens capsule

A

Lens-induced uveitis

77
Q

Specific type of uveitis with acute ant uveitis with greasy kp, and post granulomatous uveitis

A

Lens-induced uveitis

78
Q

Specific type of uveitis charac by acute ant uveitis with fibrin in anterior chamber I. Young asso with collagen disease

A

Rheumatoid disease

79
Q

Virus that cause ant non-granulomatous type

A

Herpes simplex
Herpes zoster
Mumps
Lymphogranuloma venerum

80
Q

Virus that cause posterior -granulomatous type

A

Cytomegalic inclusion body

81
Q

3 types of uveitis believed to be viral in etiology

A
  1. Behcet’s disease
  2. Harada’s disease
  3. Vogt-Koyanagi disease
82
Q

Behcet’s disease

A

Appearance of ant uveitis
Hypopyon
Aphthous ulcer on mouth, tongue and genitalia

83
Q

Bilat post uveitis with retinal detachment in young

A

Harada’s disease

84
Q

Similar with harada’s disease but ends up with an ant granulomatous uveitis with accompanying vitiligo, poliosis, alopecia, dysacusia

A

Vogt-kayanagi disease

85
Q

Special type of uveitis wc is an autoimmune disease with bilateral granulomatous uveitis which follows a perforating ocular injury affecting ciliary body in one eye.

A

Sympathetic ophthalmia.

86
Q

Special type of uveitis with post choroidal exudate

A

Toxoplasmosis

87
Q

To destroy cyst containing trophozoites which when released are responsible for recurrence

A

Photo coagulation

88
Q

Special type of uveitis confined to ant segment as granulomatous uveitis with whitish nodule in surface of iris

A

Leprosy

89
Q

Treatment for leprosy

A

Sulfone drugs (promin, promizole)

90
Q

Common cause of larvae migran syndrome

A

Larval hookworm and ascaris in dogs and cats

91
Q

Special type of uveitis with mild ant or post granulomatous uveitis and violent post uveitis with endophthalmitis

A

Larvae migran syndrome

92
Q

Endophthalmitis may end up into phthisis

A

Yes

93
Q

Special type of uveitis with ant granulomatous uveitis ans appears as macular edema

A

Amoeba

94
Q

Special type of uveitis charac by small peripheral exudates with hemorrhage that ends up as sharply demarcated punched-out scars

A

Histoplasmosis

95
Q

Special type of uveitis as acute ant granulomatous uveitis with gelatinous exudate and crystals in ant chamber

A

Gout

96
Q

Gout attack lasts for ____ leaving come residual post synechiae, pupillary membrane and and later in bans keratopathy

A

4-10 d

97
Q

Absence of iris

A

Aniridia

98
Q

In Aniridia, the structure behind the cornea is

A

Black

99
Q

In Aniridia, what is present behind the limbus

A

Iris tag

100
Q

Usual complaint in Aniridia

A

Photophobia

101
Q

Difference in color of iridis of 2 eyes

A

Heterochromia

102
Q

In hereditary type of heterochromia. the light/dark colored type is abnormal.

A

Light colored eye because if thinning of iris stroma

103
Q

In acquired type of heterochromia. the light/dark colored type is abnormal.

A

Darker eye because of pigment proliferation.

It usually follows uveal inflammation

104
Q

In heterochromia, when aging, these 3 appears

A

Glaucoma
Uveitis
Cataract

105
Q

Portions of iris, ciliary body, choroid or whole uvea is affected. It is charac by failure of optic cup to close completely during fetal life

A

COLOBOMA

106
Q

COLOBOMA is located inferiorly/superiorly

A

Inferiorly

107
Q

Accompanied by adjacent notching of lens and Astigmatic refractive errors

A

Ciliary body coloboma

108
Q

Choroidal absence which may be partial or total where only macula is left.
With bight blindness but central vision is retained.

A

Choroideremia