Red Eye and Adnexal Oncology Flashcards
What type of infection would be seen with yellow discharge ?
- bacterial
- viral
- allergic
bacterial
What type of infection would be seen with watery discharge ?
- bacterial
- viral
- allergic
viral
What type of infection would be seen with mucous discharge ?
- bacterial
- viral
- allergic
allergic
what is uveitis ?
inflammation of the eye
what is inflamed with anterior uveitis ?
iris
what is inflamed with intermediate uveitis ?
ciliary body
vitreous
what is inflamed with posterior uveitis ?
retina
choroid
blood vessels
what is panuveitis?
inflammation of all the eye
What systemic diseases are uveitis associated with?
Ankylosing spondylitis Behcet’s disease Sarcoidosis Wegener’s Systemic lupus erythematosis
can leukaemia cause uveitis?
yes
what is the treatment for uveitis ?
Topical anti-inflammatories for front of eye infections
Systemic steroid
Systemic immunosuppressants for back of eye infections
is there any discharge with uveitis ?
no
is there any discharge with conjunctivitis ?
yes
how bad is the pain with conjunctivitis ?
no pain
- just itching
what is Episcleritis & Scleritis?
inflammation of the sclera
is there any discharge with scleritis ?
no
is vision blurred or normal with uveitis?
blurred
is vision blurred or normal with conjunctivitis?
normal
is vision blurred or normal with scleritis?
normal
is vision blurred or normal with glaucoma?
blurred/lost
how painful is scleritis ?
very painful
what are the symptoms of acute angle closure glaucoma
severe pain
vomiting
head ache
what should the pupil look like during acute angle closure glaucoma ?
fixed mid dilated pupil
non-responsive to light
can contact lens cause corneal ulcer?
yes
what is the treatment for a corneal abrasion?
self limiting
- give pain killers
state the clinical features of preseptal cellulitis
- pain
- redness
- lid swelling
- systematic well
what is a common cause for preseptal cellulitis ?
lid cyst
what are the clinical features of orbital cellulitis ?
- pain
- redness
- lid swelling
- systematic unwell
- blurred vision
- protruding of eye
what is the main difference between preseptal and orbital cellulitis ?
preseptal doesn’t make you systmatically unwell
is eye movement affected with orbital cellulitis ?
yes
is vision affected with the following ?
- preseptal cellulitis
- orbital cellulitis
- no
2. yes
is orbital cellulitis more common in children or adults?
in children
what are the common causes of orbital cellulitis ?
- sinusitis
- dental infections
- haematological spread
what is a serious complication of orbital cellulitis ?
meningitis
state 7 aetiological causes of ophthalmic diseases?
- diabetes
- HT
- Autoimmune
- inflammation
- infection
- haematological
- inherited/genetic
what are some clinical signs of thyroid eye disease ?
Proptosis
Retraction of the upper eye lid
what are the three types of adnexal oncology tumours
eye lid tumour
lacrimal drainage tumours
orbital tumours
what is a benign tumour?
abnormal number of normal cells
define tumour
abnormal proliferation of tissue
what cells form carcinomas?
epithelial cells
what tissue forms sarcomas ?
connective tissue
what cells form lymphoma ?
haemopoietic cells maturing in the blood
what cells form blastoma ?
immature “precursor” or embryonic cells
what are the 2 most common benign eye lid tumours?
squamous cell papillomas
basal cell papilloma
what are the 2 most common malignant eye lid tumours?
basal cell carcinoma
squamous cell carcinoma
what texture do Squamous Cell Papilloma usually have?
Raspberry texture
what texture do basal Cell Papilloma usually have?
Raspberry texture
what do basal cell papilloma look like?
greasy
brown
flat
round/oval
what is the treatment for squamous and basal cell papillomas, keratoacanthoma and pyogenic granuloma?
excision
what is melanocytic naevus composed of?
atypical melanocytes
what is the rarest colour of melanocytic naevi and where is it usually found?
black
- in the epidermis
does a melanocytic naevus have the potential for malignant transformation?
yes
what is the ABCDE signs of malignant transformation ?
Asymmetry Border (irregular) Colour Diameter (>6mm) Evolving (growing)
what is a pyogenic granuloma ?
Fast growing, highly vascularised granuloma
what is a granuloma?
a mass of granulation tissue
what are some causes of pyogenic granuloma ?
post surgery
infection
trauma
what causes actinic keratosis?
sun exposure
what is the appearance of actinic keratosis ?
Flat
Scaly
Hyperkeratotic skin
Occasional forms cutaneous horn
is actinic keratosis common or rare on the eye lid?
rare
what is the treatment for actinic keratosis ?
excision or topical chemo
what is the appearance of keratocanthoma ?
pink papule with a hyperkeratotic crater
what is the main cause of keratocanthoma?
sun exposure
immunosuppression
where does capillary haemanioma usually occur?
on the upper eye lid but can extend to the orbital
what are the two symptoms of capillary haemanioma ?
amblyopia
astigmatism
what are the three treatment options for capillary haemanioma ?
- b blockers
- intra lesion steroid
- surgery
is capillary haemanioma benign or malignant?
benign
what is the appearance of Cavernous haemangioma
?
well demarcated pink patch
does the Cavernous haemangioma disappear with age?
no it gets darker with age
what is the treatment for Cavernous haemangioma
?
dermal laser
what is the most common malignant eye lid cancer ?
basal cell carcinoma
what are the risk factors for basal cell carcinoma ?
pale skin
sun exposure
is the risk of metastasis with basal cell carcinoma high or low?
very low
what is the appearance of a basal cell carcinoma ?
non-pigmented, elevated, ulcerated, pearly, rolled, irregular border, telangiectasia (can see vessels)
does a basal cell carcinoma cause pain?
no
what are the three sub types of basal cell carcinoma ?
nodular
ulcerative
morpheaform (less common)
out of the three subtypes of basal cell carcinoma which one is most likely yo bleed?
ulcerative
where is the most common location on the eye lid to get a basal cell carcinoma ?
lower eye lid
what are the two types of surgery which can be preformed for basal cell carcinoma ?
standard excision
Mohs surgery
what is the advantage of using Mohs surgery ?
Mohs surgery has close communication with histology
- therefore the margins of cutting can be smaller as the surgeon knows where the cancer has spread to
- increases the chance of removing all the cancer
If a patient with basal cell carcinoma can’t tolerate surgery. what other treatment options are there?
Topical (imiquimod, efudex) Chemotherapy (vismodegib) - Gorlin, Muir-Torre Cryotherapy Radiotherapy Photodynamic therapy
what are the disadvantages of not using surgery to treat basal cell carcinoma ?
there is a higher chance of recurrence
what is the appearance of squamous cell carcinoma ?
scaly surface over a thick plaque
what is the surgical treatment for squamous cell carcinoma ?
excision
what is the metastatic risk of squamous cell carcinoma?
3-10%
what is the appearance of a sebaceous gland carcinoma ?
Nodular, indurated lid margin Yellowish discolouration (due to lipid content)
what is the surgical treatment for sebaceous gland carcinoma ?
excision - if there is spread to the orbit then the eye must be removed
what are the three types of cutaneous malignant melanomas?
lentigo maligna
superficial spreading
nodular
are cutaneous malignant melanomas common or rare?
very rare
what is the most common benign orbital tumour ?
capillary haemangioma
what is the most common malignant orbital tumour ?
lymphoma