Pathology

Question 1

What is the main pathology of the lens?

Answer 1

Cataracts

No cancer

Question 2

What are cataracts?

Answer 2

Opacification within the lens

Question 3

What are the causes of cataracts?

Answer 3

Glaucoma 
UVB damage
Hypertension 
Post-op trauma 
Metabolic disorders
Genetic 
Diabetes

Question 4

Why does diabetes cause cataracts?

Answer 4

Change to osmotic pressure and altering of fluid content in the lens- damages epithelial clue and fibres

Increased sugar content in lens

Conversion of glucose to sorbitol

Altered osmotic gradients- swelling and fibre disruption

Question 5

What causes glaucoma?

Answer 5

Abnormal increase in pressure within the eye

Question 6

What is type 1 glaucoma?

Answer 6

Primary open angled glaucoma

• most common form
• poor drainage

Question 7

What is type 2 glaucoma?

Answer 7

Angle closure glaucoma

-drainage is fine, iris is closed to the lens

Question 8

Describe the onset of type 1 glaucoma

Answer 8

Slow, asymptomatic and screened for

Question 9

How is type 1 glaucoma therapy aimed?

Answer 9

Aimed at slowing progression by opening canal

Question 10

Describe onset of type 2 glaucoma?

Answer 10

1/3 medical emergency, visual loss with headache, acute red eye, nausea and vomitting

Question 11

Describe the therapy in type 2 glaucoma?

Answer 11

Zap a hole in the iris with a lazer

Question 12

How can raised intraocular pressure be observed?

Answer 12

Cupping

Question 13

What kind of glaucoma is seen in diabetes?

Answer 13

Rubeotic glaucoma

Neovascularisation forming an obstructing angle

Question 14

Describe conjuntivitis

Answer 14

Inflammation of conjunctiva

Swelling, redness, heat and pain

Viral in origin- can be bacterial or allergic

Question 15

Describe scleritis

Answer 15

More rare and severe

Associated with pain on movement and underlying pathology; SLE, HLA B27

Question 16

Describe episcleritis?

Answer 16

Superficial and self limiting- no clear cause

Question 17

Describe dry ARMD?

Answer 17

No significant vascular proliferation

Question 18

Describe wet ARMD?

Answer 18

Vascular proliferation (haemorrhage), for more progressive and associated with more visual loss

Question 19

Describe onset of wet ARMD

Answer 19

Neovascularisation in choroid

Mediated by VEGF

New vessels are small and fragile (leaky)

Question 20

How can wet ARMD be treated?

Answer 20

monoclonal antibodies to VEGF

Question 21

What is drusen?

Answer 21

Proteins and lipid and inflammatory mediators

Question 22

Describe an argyll robertson pupil

Answer 22

(Prostitues pupil) Accommodates but doesn’t react

Question 23

Describe retinopathy

Answer 23

• Complex- poor function of vessels
• Leaky vessels and small aneurysms
• New vessels
• macular oedema

Question 24

Which cancers can be found in the eye?

Answer 24

Basal Cell Carcinoma

Squamous cell carcinoma

Melanoma (retinal melanoma)

Question 25

Which vascular diseases are found in the eye?

Answer 25

Arterial occlusion and venous occlusion

• CRAO
• CRVO
• carotid and thromboembolic disease
• amaurosis fugax (TIA of retinal artery)
• vasculitis