Pathology (Mike) Flashcards
Gram stain is able to stain what types of organisms?
bacteria and fungi

Gemsia stain is used to test for which organisms?
Acanthamoeba, fungi, and cytology; best for intranuclear inclusion bodies

Acid fast (Ziehl-Neelsen) stain is used to test for which organisms?
Mycobacterium, Nocardia

Periodic acid-Schiff (PAS) stain is used to test for which organisms?
fungi

Gomori’s methenamine silver stain is used to test for which organisms?
fungi

Calcofluor white stain is used to test for which organisms?
fungi and Acanthamoeba

How does Calcofluor white stain bind to fungi and what is used to view this stain?
fungi and Acanthamoeba (binds to cell wall, visible with fluorescent microscopy
KOH stain is used to test for which organisms?
fungi

Blood agar is used to grow which organisms? Which grows best?
most bacteria; very good for atypical Mycobacterium

Blood agar in 5–10% carbon dioxide is used to grow which organisms?
Moraxella
Chocolate agar is used to grow which organisms?
Haemophilus, Neisseria

Which important substrates does chocolate agar contain?
contains hemin and nicotinamide adenine dinucleotide [NAD]
Thioglycolate broth is used to grow which organisms?
anaerobes

Sabouraud’s agar is used to grow which organisms?
fungi

Löwenstein-Jensen medium is used to grow which organisms?
Mycobacterium tuberculosis, Nocardia

Loeffler’s medium is used to grow which organisms?
Corynebacteria

Non-nutrient agar with E. coli overgrowth is used to grow which organisms?
Acanthamoeba

Intracytoplasmic basophilic inclusions using Giemsa stain are seen in which organisms?
Chlamydia

Intranuclear eosinophilic inclusions using Papanicolaou stain (Tzanck smear) are seen in which organisms?
herpes

Hematoxylin and eosin (H&E) satins which colors?
Pink and Blue

Hematoxylin is specific for which biomolecule?
specific for nucleic acids within nuclei and stains blue (basophilic)
Eosin is specific for which intracellular structures?
specific for most cytoplasmic organelles (such as mitochondria) and stains pink (eosinophilic)
What does PAS stain for? which color does it stain?
stains basement membrane material Magenta

Which intraocular structures are PAS positive?
- Descemet’s
- lens capsule
- Bruch’s membrane
- ILM
- gutattae
- drusen
Which organisms stain PAS positive?
fungi
How is PAS stain useful in differentiating corneal and conjunctival epithelium?
stains conjunctival goblets cells
Which metabolic substrate is PAS positive?
glycogen

What colors are seen in Masson trichrome stain? What tissues are stained by Masson trichrome?
Collagen- blue
Hyaline- red

What condition is Masson trichrome stain used to identify?
granular dystrophy

Congo red stains which tissue? what color does it stain?
stains amyloid orange

What condition is Congo red stain used to identify?
Lattice dystrophy

Crystal violet stains which tissue? what color does it stain?
stains amyloid red-purple

Alcian Blue stains which tissue? what color does it stain?
stains acid mucopolysaccharide blue

What condition is Alcian blue stain used to identify?
macular dystrophy

Colloidal iron stains which tissue? what color does it stain?
stains acid mucopolysaccharide blue

What condition is Colloidal iron stain used to identify?
macular dystrophy

Oil red O stains which tissue?
What color does it stain?
How does the tissue have to be prepared?
stains neutral lipids red-orange in frozen section
Must be applied to fresh tissue because formalin leaches out lipid

Sudan Black stains which tissue?
Waht neurologic tissue is this useful for?
stains phospholipids
myelin in ON

Luxol fast blue stains which tissues?
How can you tell if there is tissue pathology present?
stains myelin blue
demyelinated plaques lose affinity for stain

Bodian stain is used to stain which tissues?
stains nerve fibers black

Mucicarmine stains which tissue? what color does it stain?
stains mucus pink/red

Which tumors can be identified with Mucicarmine?
mucus-secreting adenocarcinomas (i.e. GI, breast)

Verhoeff Van Gieson stains which tissue? what color does it stain?
stains elastic tissue black

Which pathologic state is Verhoeff Van Gieson stain used for?
used for elastotic degeneration
Movat’s pentachrome stains which tissue? what color does it stain?
stains elastic tissue black

Wilder stain is used on which tissue? what color does it stain?
stains reticulin fibers black

Alizarin red stains which substance? what color does it stain?
stains calcium red-orange

von Kossa stains which substance? what color does it stain?
stains calcium black

What ocular condition is von Kossa stain used to diagnose?
used for band keratopathy
Prussian blue stains which stubstance? what color does it stain?
stains iron (hemosiderin, ferric ions) blue

Fontana-Masson stains which stubstance? what color does it stain?
stains melanin black

What ocular condition is Fontana-Masson stain used to diagnose?
used for amelanotic melanoma

What lesions can be identified with the S-100 protein?
stains
- nevi
- melanomas
- schwannomas
- neurofibromas
- other heterologous cell lines

What can polarizing filters be used to identify?
for evaluating structures or deposits that have a regular molecular structure (amyloid, calcium oxalate crystals), as well as suture granulomas and vegetable foreign bodies
When grossing a specimen, how does one orient the globe?
identify superior oblique (SO) (tendinous insertion) and inferior oblique (IO) (muscular insertion) muscles
What is the most commone embedding process for histologic examination?
Parrafin embedding
Briefly how does parafin embedding work?
- water is removed
- organic solvents leach out lipids
- PMMA is dissolved completely
- to preserve lipids, fresh or frozen tissue specimens are used
- paraffin must be removed before different stains are applied
What chemical is necessary to use for electron microscopy?
Glutaraldehyde
Formalin and Bouin’s fixative is used for which tissue viewing method?
for light microscopy
Briefly, describe how Formalin and Bouin’s fixative works-
10% buffered formalin (formalin = 40% solution of formaldehyde in water); formalin stabilizes protein, lipid, and carbohydrates, and prevents postmortem enzymatic destruction of tissue
Cyctology require which chemical to be used?
Ethyl alcohol
What is shown in the picture below?

Lange’s fold
What is a Lange’s fold?
fold at ora serrata in newborn eyes probably caused by unequal shrinkage of retinociliary tissues during fixation
What is the finding seen in the picture below?

Artifactual RD:
common histologic finding, differentiated from true retinal detachment by:
- lack of subretinal fluid
- preservation of photoreceptors
- pigment attached to outer surface of rods and cones
What is seen in the picture below?

True RD with material in the subretinal space and degeneration of the outer retinal layers
Do clefts in corneal stroma increase or decrease in corneal edema?
obliterated in corneal edema
What is a Type 1 Hypersensitivity Reaction?
anaphylactic/immediate hypersensitivity
What molecule mediates a Type 1 hypersensitivity reaction?
IgE

Name examples of Type 1 hypersensitivty reactions
- hay fever
- vernal, atopic, giant papillary conjunctivitis (GPC)
What is a Type II Hypersensitivity reaction?
cytotoxic hypersensitivity
What molecule mediates a Type II Hypersensitivity reaction?
compliment mediated

Name 2 examples of Type II Hypersensitivity Reactions
- OCP
- Mooren’s ulcer
What is a Type III Hypersensitivity Reaction?
Immune Complex Deposition
What molecules mediate at Type III hypersensitivity reaction?
Ag-Ab Complex

Name at least 4 of the 8 ocular examples of a Type III hypersensitivity reaction
- Stevens-Johnson
- marginal infiltrates
- disciform keratitis
- subepithelial infiltrates
- Wessely ring
- scleritis
- retinal vasculitis
- phacoanyphlaxis
What is a Type IV hypersensitivity reaction?
Delayed Hypersensitivity
What mediates a Type IV hypersensitivity reaction?
Cell mediated (CD4 lymphocytes)

Name 4 of the 7 ocular examples of Type IV Hypersensitivity Reactionsphlyctenule, graft reaction, contact dermatitis, interstitial keratitis, granulomatous disease (TB, syphilis, leprosy), sympathetic ophthalmia, Vogt-Koyanagi-Harada (VKH) syndrome
- phlyctenule
- graft reaction
- contact dermatitis
- interstitial keratitis
- granulomatous disease (TB, syphilis, leprosy)
- sympathetic ophthalmia
- Vogt-Koyanagi-Harada (VKH) syndrome
What is a Type V Hypersensitivity Reaction?
stimulating antibody
Name 2 ocular examples of Type V Hypersensitivty Reactions
- Graves’ disease
- myasthenia gravis
Which is the most abundant immunoglobulin?
IgG
Which immunoglobulin is able to cross the placenta?
IgG
To what molecule does IgG bind?
complement
What is the second most abundant immunoglobulin?
IgA
What is the structure of IgA?
monomeric or joined by J chain
Where is IgA found?
mucous secretions
What type of infections are IgA particularly important?
important against viral infection
What is the largest immunoglobulin?
IgM
What does IgM bind to?
complement
What is IgM important for?
important in primary immune response
Which immunoglobulin is present in newborns?
IgD
Which is the only immunoglobulin not found in the tear film?
IgD
What is teh role of IgE?
sensitizes mast cells and tissue leukocytes
Which immunoglobin is involved in atopy?
IgE
In humans, which molecules are HLA molecules?
MHC proteins
Where are MHC proteins found?
the surfaces of all nucleated cells
Where are the gene loci for MHC proteins found?
located on chromosome 6
Class I MHC proteins perform which function?
antigen presentation to cytotoxic T cells (CD8 positive)
Where are the genes for Class I MHC proteins found?
loci A, B, C
Class II MHC proteins perform which function?
antigen presentation to helper T cells (CD4 positive)
Where are the genes located for class II MHC proteins?
loci DR, DP, DQ
HLA A29 is associated with which disease?
Birdshot retinochoroidopathy (90%)
HLA B7, DR2 are associated with which disease?
Presumed ocular histoplasmosis syndrome (80%)
HLA B8, B13 are associated with which disease?
Sarcoidosis
Intermediate Uveitis is associated with whcih 4 HLA comlplexes?
HLA B8, B51, DR2, DR15
HLA B 27 is associated with which 5 ocular conditions?
- Adult iridocyclitis (usually unilateral)
- Reiter’s syndrome (75%)
- ankylosing spondylitis (90%)
- inflammatory bowel disease (90%)
- psoriatic arthritis, juvenile rheumatoid arthritis (JRA) (subtype V)
What percentage of the population is HLA B27 positive?
1-5% of the population
HLA B51 is associated with which disease?
Behçet’s disease (70%)
HLA DR4 is associated with which 2 ocular diseases?
- Sympathetic ophthalmia
- Vogt-Koyanagi-Harada syndrome
HLA DR15 is associated with which disease?
Pars planitis
HLA DQ7 is associated with which disease?
Acute retinal necrosis (50%)
Which HLA complexes are associated with HSV keratitis?
B5
DR3
DR4
Which HLA complexes are associated with Sjögren’s syndrome?
B8
DR3
HLA B12 is associated with which disease?
Ocular cicatricial pemphigoid
HLA B15 is associated with which disease?
Scleritis
HLA DR3 is associated with which disease?
Thygeson’s superficial punctate keratitis (SPK)
Which HLA complexes are associated with Myasthenia gravis?
A1
B8
DR3
Which HLA complexes are associated with Multiple sclerosis?
B7
DR2
HLA DR3 is associated with which ocualr disease?
Grave’s disease
What is the definition of inflammation?
Tissue infiltration by inflammatory cells
What is the primary cell of acute inflammation?
Neutrophils (PMNs)
Name the immune cell type–

PMN- multilobed nucleus
What is a focal collection of PMNs called?
an abcess
What is it called when PMNs are combined with tissue necrosis?
pus
What kind of immune reactions are associated with eosinophils?
Allergic and parasite-related reactions
(‘worms, wheezes, weird diseases’)
What is the role of eosinophils in the immune response?
modulation of mast cell reactions, phagocytosis of Ag–Ab complexes
Name the below immune cell type–

Eosinophil-Bilobed nucleus, granular cytoplasm
Which cell type are tissue basophils?
mast cells
What molecule is bound to the surface of mast cells?
IgE
What is released when a antigen binds to a mast cell?
degranulation with release of histamine and heparin
What is an example of mast cell degranulation?
anaphylaxis, allergic conjunctivitis
Name the below immune cell–
Mast cell- looks like plasma cell

What is the main cell in humoral and cell-mediated immune reactions?
Lymphocytes
What are the different types of lymphocytes?
- B cells
- T cells (helper, suppressor, cytotoxic, killer, null cells)
Name the below immune cell type:

Lymphocyte- scanty cytoplasm
What is a plasma cell?
activated B cells
What is the role of a plasma cell?
Synthesis and secretion of antibodies
Name the following cell type-

Plasma cell- Eccentric ‘cartwheel’ nucleus, basophilic cytoplasm
Name the cell type

Plasmacytoid cell: granular eosinophilic cytoplasm
Name the inclusions inside these plasma cells

Russell body: immunoglobulin crystals
What are the two different types of macrophages?
histiocytes
monocytes
What is the primary phagocytic cell in the body- the second line of defense?
phagocytosis
Name the immune cell type:
Macrophage- kidney shaped nucleus

How do macrophages work?
regulation of lymphocytes
(via Ag presentation and monokine production)
What cell types do macrophages transform into?
epithelioid histiocytes and giant cells

Name the below cell type
epitheliod histiocyte

What is an epitheliod histiocyte?
activated macrophage with vesicular nucleus and eosinophilic cytoplasm
resembles epithelium

What is the hallmark of granulomatous inflammation?
Epithelioid histiocyte
What forms when epithelioid histiocytes fuse?
they form giant cells
How many different types of Giant cells are there?
3 types:
- Langhans’ cell
- Foreign Body
- Touton

Name the cell type: How can you tell?
Langhans’ giant cell: nuclei arranged around periphery in ring/horseshoe pattern

What is an example of 2 diseases where you might see Langhan’s giant cells
- TB
- sarcoidosis
Name the cell type:
How can you tell?
Touton:
- midperipheral ring of nuclei
- central eosinophilic cytoplasm
- nuclei are surrounded by clear zone of foamy lipid
In what ocular condition would Touton giant cells be seen?
juvenile xanthogranuloma (JXG)
Name the cell type: what can you tell?

Name the 2 types of Acute inflammation
- Suppurative
- Nonsuppurative
Which cell types are seen in acute inflammation?
- Suppurative: neutrophils
- Nonsuppurative: lymphocytes
Name the 4 types of chronic inflammation
- Nongranulomatous
- Granulomatous
- Endophthalmitis
- Panophthalmitis
WHat cell types are involved in nongranulomatous inflammation?
lymphocytes and plasma cells
During which phase is granulation tissue seen in nonrganulomatous inflammation?
reparative phase
What forms when there is an exuberant nongranulomatous response?
pyogenic granuloma

What cell is seen in Granulomatous inflammation?
epithelioid histiocytes
What are the 3 patterns of granulomatous inflammation?
- Diffuse
- Discrete
- Zonal
Name the pattern of granulomatous inflammation:

Diffuse: epithelioid cells distributed randomly against background of lymphocytes and plasma cells
Name 4 ocular conditions in which diffuse grnulomatous inflammation can be seen?
- sympathetic ophthalmia
- fungal infection
- JXG
- lepromatous leprosy
name the pattern of granulomatous inflammation:

DISCRETE: epithelioid cells form nodules with giant cells, surrounded by rim of lymphocytes and plasma cells
Name 3 ocular conditions in which discrete granulomatous inflammation can be seen-
- sarcoidosis
- miliary TB
- tuberculoid leprosy
Name the pattern of granulomatous inflammation-

ZONAL: palisaded giant cells surround central nidus
What are 3 conditions is which zonal granulomatous inflammation is can be seen-
- phacoantigenic endophthalmitis
- rheumatoid scleritis (nidus = scleral collagen)
- chalazion
Is phcotoxic uveitis granulomatous or nongranulomatous?
nongranulomatous
What is the definition of endophthalmitis? (lee is unsatisfied with this definition)
Endophthalmitis: inflammation involving at least one ocular coat and adjacent cavity, sclera is not involved
What is the difference between Endophthalmitis and Panophthalmitis?
Panophthalmitis is suppurative endophthalmitis that also involves the sclera and orbit
What happens chronically when inflammation occurs in the cornea?
scarring:
- Band Keratopathy
- Inflammatory pannus
- degenerative pannus
Name the ocular inflammatory condition:

Calcific band keratopathy
What is the pathologic finding present in band keratopathy?
basophilic granules in Bowman’s membrane

Name this type of corneal scarring:

Corneal inflammatory pannus
What pathology is seen in an inflammatory corneal pannus?
subepithelial fibrovascular and inflammatory ingrowth with destruction of Bowman’s membrane

In which condition is an inflammtory pannus seen?
Trachoma
Name the type of corneal scarring

Degenerative pannus
What is the pathology seen in degenerative corneal pannus?

What is an example of a degenerative pannus?
chronic corneal edema

What are the 2 ways inflammation can occur in the anterior chamber?
- hypopyon
- retrocorneal fibrous membranes (PAS)
What is it called if PAS is completely scarred down 360 degrees?
seclusio pupillae
What is a complete fibrovascular membrane across the pupil?
occlusio pupillae
Name the type of cataract in the picture:

Anterior subcapsular cataract:
fibrous plaque beneath folded anterior capsule, secreted by irritated metaplastic anterior epithelial cells
What is the underlying cause of the cataract in the picture?

Posterior subcapsular cataract: bladder cells adjacent to capsule
What is is cyclitic membrane?
retrolental collagenous membrane attached to the ciliary body
what happens when a cyclitic membrane contracts?
detachment of the pars plana
What causes a cyclitic membrane?
- due to organization and scarring of vitreous
- metaplastic ciliary epithelium
- organized inflammatory residua
What cell type is swollen in CME?
retinal vascular leakage or Müller cell edema
Why can phthisical eyes appear square at times?
rectus muscle traction on hypotonous globe causes squared-off appearance
What are 3 signs of phthisis?
- thickened sclera
- high incidence of retinal detachment and disorganization
- calcareous degeneration of lens
What is the name of the eyelid epithelial changes that result in thickening of the keratin layer?
Hyperkeratosis
What is it called when hyperkeratosis appears white and flaky?
Leukoplakia
What is the eyelid change called when thickening of the keratin layer with retention of nuclei occurs?
Parakeratosis
What does parakeratosis indicate?
indicates shortened epidermal regeneration time; granular layer is thin or absent
What is the eyelid epithelial change called when there is keratin formation within the basal cell layer or deeper?
Dyskeratosis
What is the eyelid epithelial change called when there is thickening of the squamous cell layer due to proliferation of prickle cells?
Acanthosis
What is the eyelid epithelial change called when there is loss of cohesion between epidermal cells with breakdown of intercellular junctions, creating spaces within the epidermis?
Acantholysis
What disease is acantholysis present in? What forms when acantholysis occurs?
occurs in pemphigus and produces intraepithelial bullae
What is the eyelid epithelial change called when there is disorderly maturation of epithelium with loss of polarity, cytologic atypia, and mitotic figures found above the basilar layer?
Dysplasia
What is the difference between mild and moderate dysplasia?
Mild: <50% epidermal thickness involved
Severe: >50% involved
What is the eyelid epithelial change called when there is full-thickness replacement of epithelium by malignant cells without invasion through the basement membrane?
Carcinoma in situ (CIN)
What is it called when malignant epithelial cells invade below basement membrane?
Squamous cell carcinoma
What is it called when cytologic malignancy with pleomorphism, anisocytosis, abnormal nuclei, and mitotic figuresare present?
Anaplasia
What is it called when there is a proliferation of dermal papillae, causing surface undulation of the skin?
Papillomatosis
What is an inflammatory response with hyperplasia of epithelium, which mimics carcinoma?
Pseudoepitheliomatous hyperplasia
acanthosis with protrusion of broad tongues of benign epidermis into the dermis
Name the skin changes seen in the picture below:

Elastosis
actinic damage; seen as blue staining (normally pink) of superficial dermal collagen with H&E stain; damaged collagen stains with elastic tissue stains but is not susceptible to digestion with elastase
What are the age related changes seen in the corneal periphery:

Hassal-Henle warts (excrescences and thickenings of Descemet’s membrane in corneal periphery) look like peripheral guttae
What age related changed occur in the pars plana and plicata over time?
clear (teardrop) cysts

What age related changes occur in the retina over time?
- loss of retinal cells and replacement with glial tissue
- chorioretinal adhesions and pigmentary lesions in periphery
What is the eponym called when peripheral retinal microcystoid degeneration occurs?
Blessig-Iwanoff cysts
In which layer are Blessig-Iwanoff cysts located?
located in outer plexiform layer
Which cell type line Blessig-Iwanoff cysts?
What is contained within Blessig-Iwanoff cysts?
mucopolysacharides
If there are no blood vessels in the cornea, how does wound healing occur?
- stromal healing is avascular
- healing can result in fibrosis
- neutrophils arrive via tears in 2–6 hours
- wound edges swell and glycosaminoglycans (keratan sulfate, chondroitin sulfate) disintegrate at edge of wound
- activated fibroblasts migrate across wound and produce
How long does it take for full cornea thickness after injury?
4-6 weeks
How does Descemet’s membrane regenerate?
endothelium migrates and regenerates Descemet’s membrane
How does the sclera heal?
does not heal itself; it is avascular and acellular; ingrowth of granulation tissue from episclera and choroid
How does the iris heal a wound?
It doesn’t no healing
Scars formed from healing response in the retina are produced by what cell type?
glial cells rather than fibroblasts
Name the wound complication seen in the photo:

epithelial ingrowth
What is epithelial ingrowth?
- sheet of multilayered nonkeratinized squamous epithelium over any intraocular surface
- may form cyst (free-floating or attached to iris);
- implanted cells tend to be 2–4 cell layers thick and have conjunctival characteristics (more than corneal)
Name the wound healing complication in the photo:

Fibrous downgrowth
What is fibrous downgrowth?
- proliferating fibroblasts originate from episcleral or corneal stroma; contraction can occur
- can occur with a puncture wound if there is a break in Descemet’s membrane
Name the wound healing complication in the photo:

Corneal blood staining
What is corneal blood staining?
hemoglobin (Hgb) breakdown products are forced through endothelial cells by increased intraocular pressure (IOP)
How are Hgb cells removed from the cornea?
Hgb molecules are removed by phagocytic and biochemical processes. Clears centripitally
What is Hemosiderosis bulbi?
Deposition of hemoglobin on an intraocular structure due to longstanding intraocular hemorrhage.
- hemosiderin contains iron
- can damage essential intracellular enzyme systems
What is an ochre membrane?
hemorrhage that accumulates on posterior surface of detached vitreous
Name the wound healing complication seen in the photo:

Synchysis scintillans
What is Synchysis scintillans?
accumulation of cholesterol within vitreous following breakdown of red blood cell (RBC) membranes; angular, birefringent, flat crystalline particles with golden hue located in dependent portions of globe
What are the white spaces seen in the photo?

Cholesterol clefts
cholesterol dissolves during preparation of tissues in paraffin; cholesterol clefts are negative image of cholesterol crystals, surrounded by tissue
What is the differentail diagnsosis for intraocular calcification?
- Retinoblastoma
- Choroidal osteoma
- Choroidal hemangioma
- Phthisis
- Osseous choristoma
What is the differential diagnosis for intraocular cartilage?
- PHPV (retrolental plaque)
- Medulloepithelioma
- Teratoma
- Trisomy 13 (seen in photo)
- Complex choristoma of conjunctiva

Where is Type 1 collagen found in the eye?
- normal corneal stroma
- Bowman’s membrane (highly disorganized type 1, basal lamina has type 4)
Where is Type 2 collagen found in the eye?
vitreous (two is in the goo)
Where is type 3 collagen found?
stromal wound healing
Where is type 4 collagen found?
basement membranes
Name the locations of the 4 most likely areas of the sclera to rupture during blunt force trauma?
- Limbus (on opposite side from trauma)
- Posterior to rectus muscle insertions
- Equator
- Lamina cribrosa (ON)
At which 3 locations is the uveal tract connected to the sclera?
- scleral spur
- Internal ostia of vortex veins
- Peripapillary tissue
Name and describe the ocular disorder seen in the photo:

cyclodialysis cleft
disinsertion of longitudinal fibers of ciliary muscle from scleral spur
Name and describe the ocular disorder seen in the photo:

Iridodialysis
disinsertion of iris root from ciliary body
Name and describe the ocualr pathology seen in the photo:

angle recession:
rupture of face of ciliary body
plane of relative weakness at ciliary body face extending posteriorly between longitudinal fibers and more central oblique and circular fibers; oblique and circular muscles atrophy, changing cross-sectional shape of ciliary body from triangular to fusiform
Name and describe the ocular pathology seen in the photo:

Vossius ring
compression and rupture of IPE cells against anterior surface of lens deposit ring of melanin concentric to pupil

Lens capsule rupture
cataract can form immediately; epithelium may be stimulated by trauma to form anterior lenticular fibrous plaque
Where is the lens capsule thinnest?
capsule is thinnest at posterior pole
Name a describe the ocular trauma pathology seen in the photo:

Descemet’s rupture
causes acute edema (hydrops); due to minor trauma (keratoconus) or major trauma (forceps injury)
Name a describe the ocular trauma pathology seen in the photo:

Choroidal rupture
often concentric to optic disc; risk of CNV
Name a describe the ocular trauma pathology seen in the photo:

Sclopoteria:
choroidal rupture with overlying necrosis of retina
Name a describe the ocular trauma pathology seen in the photo:

Retinal dialysis
circumferential tear of retina at point of attachment of ora or immediately posterior to vitreous base attachment
Where is the attachment site of the retina anteriorly?
retina anchored anteriorly to nonpigmented epithelium of pars plana and reinforced by vitreous base, which straddles the ora serrata;
Name a describe the ocular trauma pathology seen in the photo:

Commotio retinae
temporary loss of retinal transparency; due to disruption of photoreceptor elements, not true retinal edema
What is the difference between penetrating ocular injury vs Perforating ocular injury?
- Penetration- partial-thickness wound (into)
- Perforation- full-thickness wound (through)
- (globe penetration is due to perforation of the cornea or sclera; globe perforation is a double penetrating injury)
Name the 3 types of Phthisis bulbi
- Atrophia bulbi without shrinkage
- Atrophia bulbi with shrinkage
- Atrophia bulbi with disorganization
Describe Atrophia bulbi without shrinkage-
- initially, size and shape of eye are maintained
- with loss of nutrition: cataract develops, retina atrophies and separates from RPE by serous fluid accumulation, synechiae cause increased IOP
Describe Atrophia bulbi with shrinkage:
- eye becomes soft owing to ciliary body dysfunction
- internal structures are atrophic but histologically recognizable
- globe becomes smaller with squared-off shape (because of tension of rectus muscles); anterior chamber (AC) collapses; corneal endothelial cell damage leads to corneal edema and opacification
Describe Atrophia bulbi with disorganization (true phthisis bulbi)
- globe shrinks to average diameter of 16–19 mm
- most ocular contents are disorganized
- calcification of Bowman’s layer, lens, retina, and drusen
- bone formation in uveal tract
What 2 bad things can happen when copper gets inside the eye?
- ≥85%: noninfectious suppurative endophthalmitis
- <85% chalcosis
What is chalcosis and b=name 3 ways it can present in the eye
copper deposits in basement membranes
- Kayser-Fleisher ring
- sunflower cataract
- retinal degeneration
What haooens when steel gets into the eye?
Steel contains Iron:
siderosis bulbi

How can you follow siderosis bulbi clnically?
- follow with electroretinogram (ERG)
- (early increased a wave, normal b wave
- later decreased b wave leading to extinguished
What kind of response is seen to getting organic vegetable matter into the eye?
severe granulomatous foreign body response
Describe what an acidic chemical injury does to the proteins in the eye-
precipitates proteins
zone of coagulative necrosis acts as barrier to deeper penetration
Describe what an alkali chemical injury does to the proteins in the eye-
denatures proteins and lyses cell membranes
- Liquificative necrosis: no effective barrier is created – therefore deeper penetration; vascular occlusion, ischemia, corneal damage during healing phase owing to collagenase released by regenerating tissue
- limbal bleaching in severe cases (if limbal stem cells are depleted the corneal surface is repopulated with conjunctival cells)
Name two types of radiation that can damage the eye:
- Nonionizing- depends on wavelength
- Ionizing
How does non-ionizing microwave radiation effect the eye?
cataract formation
How does non-ionizing INFRARED radiation effect the eye?
true exfoliation of lens capsule (glassblower’s cataract)

How does non-ionizing UV radiation effect the eye?
keratitis (welder’s flash)
Name some of the ways that ionizing raditation can damage the eye:
- tissue damage is direct (actively reproducing cells) or indirect (blood vessels
- epithelial atrophy and ulceration
- dermatitis of eyelids
- dysfunction of adnexa
- destructive ocular surface disease with keratinization
- cataract
- retinal necrosis, ischemia, neovascularization
- (retina is relatively radioresistant, but retinal blood vessels are vulnerable)
- optic atrophy
Name the two most commonly seen pathogens in Acute postoperative endophthalmitis (<6 weeks)
- Coagulase-negative Staphylococcus
- Staphylococcus aureus
Name the two most commonly seen pathogens in delayed endophthalmitis (>6 weeks)
- Propionibacterium acnes
- coagulase-negative Staphylococcus
Name the three most commonly seen pathogens in filtering bleb associated endophthalmitis.
- Streptococcus pneumoniae
- Staphylococcus
- Haemophilus influenzae
Name the three most commonly seen pathogens in post traumatic endophthalmitis.
- Staphylococcus species
- Bacillus cereus
- Gram-negative organisms
Name the most commonly seen pathogens in endogenous endophthalmitis.
Candida
Name the two most commonly seen pathogens in Dacryocystitis

- S. pneumoniae
- Staphylococcus
Name the most commonly seen pathogens in Dacryoadenitis

Staphylococcus
Name the most commonly seen pathogen in canaliculitis

Actinomyces
Name the most commonly seen pathogen in orbital cellulitis (children)
S. aureus
Name the most commonly seen pathogen in pre-septal cellulitis
S. aureus
Name the most commonly seen pathogen in angular blepharitis
Staphylococcus, Moraxella
What is a hamartoma?
tumor composed of tissues normally found in that area
Name this type of ocular hamartoma

hemangioma
What is a choristoma?
tumor composed of tissues not normally found in that area
Name this ocular choristoma

choroidal osteoma
What is the Most common primary malignant intraocular tumor in adults?
uveal melanoma

What is the Second most common primary malignant intraocular tumor in adults?
lymphoma

What is the Most common primary malignant intraocular tumor in children?
retinoblastoma

What is the Second most common primary malignant intraocular tumor in children?
medulloepithelioma

What is the Most common malignant lacrimal gland tumor?
adenocystic carcinoma

What is the Most common benign orbital tumor in adults?
cavernous hemangioma

What is the Most common benign orbital tumor in children?
capillary hemangioma

What is the Most common primary malignant orbital tumor in children?
rhabdomyosarcoma

What is the Most common metastasis to orbit in children?
neuroblastoma
