Pathology Flashcards
What is cataracts?
Opacification of the lens
What is the general pathology behind cataracts?
Epithelium of the lens matures
Cell contents alter
Cell de-nucleates
Cell becomes fibrous and more opaque
What external factor is most most linked with developing cataracts?
UVB exposure
List some external factors which increase the risk of cataracts.
Hypertension Smoking Post operative Trauma Metabolic disorders Genes Infection
What is glaucoma?
Abnormal increase intra orbital pressure.
Where does the fluid within the eye generally drain out of?
Within anterior chamber through the trabecular.
Where does blockage occur to inhibit fluid drainage?
Generally within the trabecular or in the canal of schlemm.
What happens in Primary Opened Angled Glaucoma?
Blockage of the drainage
Normal fluid production
What happens in Angle Closure Glaucoma?
Normal fluid production
Normal drainage
Blockage elsewhere within the system.
In Angle Closure Glaucoma where does the blockage occur?
Lens shifts and blocks the iris preventing fluid entering the anterior chamber.
How does someone with an open angled glaucoma present?
Slow onset and often asymptomatic
What is the treatment for a primary opened angled glaucoma?
Pharmacologically aimed at widening the drainage trabecular.
How does someone present with an angled closure glaucoma?
Medical emergency - vision loss isn't uncommon Acute red eye Visual loss Severe pain Headache N+V
In a glaucoma what should you look for with a fundoscopy?
Cupping of the optic nerve
Depression in the centre and rolled edges
Looks widened
What is papilloedema?
Non specific symptom of a raised ICP
Swelling of the optic disc
What is conjunctivitis?
Inflammation of the conjunctiva
How does someone with conjunctivitis present?
Eye and orbit looks swollen inflamed
Excess discharge and gunk
Red eye
What is the aetiology of conjunctivitis?
Usually viral
Occasionally bacterial
If bilateral its generally allergic
How does someone with scleritis present?
Pain on movement of they eye
Inflamed sclera
What autoimmune conditions should be associated with scleritis?
SLE
BLA B27 “ankylosing spondylitis
What is BLA 27 associated with?
Ankylosing spondylitis
What is the aetiology behind Episcleritis?
Generally no known cause
What are the differences between Episcleritis and Scleritis?
Scleritis - Rarer and more severe
Episcleritis -Superficial and self limiting
What types of macular degeneration are there?
Age Related
Dry
Wet
What is seen on fundoscopy for someone with age related macular degeneration?
Accumulation of lipids, proteins and inflammatory mediators.
What is the name given to the accumulation of lipids proteins and inflammatory mediators?
Drusen
What alongside age is related to Age Related Macular Degeneration?
Underlying inflammatory process
What is the difference between wet and dry macular degeneration?
In wet there is vascular proliferation
What regulates the vascular proliferation in wet macular degeneration?
VEGF
Vascular Epidermal Growth Factor
Why does the vascular proliferation lead to increased intra retinal haemorrhages?
The new vessel are leaky with poorly formed vessel walls.
What is the treatment for someone with wet macular degeneration?
Monoclonal antibodies for VEGF
Why does hyperglycaemia cause visual disturbances?
Alters the osmotic pressure within the anterior chamber.
What visual conditions are all linked to diabetes?
Peripheral neuropathy Argyll Roberson Pupil
Cataracts
Diabetic retinopathy
Rubertic glaucome
How does does diabetes increase the risk of cataracts?
Increased sugar content within the cells and the conversion of glucose in to sorbitol.
What does retinopathy look like in fundoscopy?
Haemorrhage
New leaky vessels
Small aneurysms
Oedema
What is rubertic glaucoma?
New vessels formation obstructing the trabecular
What does Central Retinal Artery Occulsion look like on fundoscopy?
Pale washed out retina
Cherry red spot within the optic disc
What does Central Retinal Vein Occlusion look like on fundoscopy?
Bulging vessels
Cloudy
Haemorrhage
What is Commotio Retinae?
Bruised retinae
Self resolving
Can cause visual disturbances if big enough
What is Hyphema ?
Blood within the anterior chamber look for fluid level
What does retinal detachment look like on fundoscopy?
Crumpled appearance in the veins and throughout the retina.
