Red Eye and Adnexal Oncology Flashcards
if there is non/ mild pain with pericorneal redness, minimal discharge and blurred vision what is the most likely diagnosis?
uveitis
describe symptoms and signs in bacterial conjunctivitis
> no pain/itch
peripheral/diffuse redness
yellow discharge
normal vision
what type of conjunctivitis would cause watery discharge?
viral conjunctivitis
describe what sort of discharge you would expect allergic conjunctivitis to produce
mucousy
what would the most likely diagnosis me for: > severe/boring pain > sectoral/diffuse redness > no discharge > normal vision
scleritis
what would the most likely diagnosis be for: > severe pain/headache > pericorneal redness > can be discharge > loss of vision
acute glaucoma
describe symptoms that would be seen in keratitis/corneal ulcer
> severe pain/eye closing (?)
pericorneal redness
can be discharge
loss of vision
describe symptoms that would be seen in orbital cellulitis
> severe/periocular pain
no redness
can be discharge
normal vision
what does anterior uveitis affect?
the iris
what does intermediate uveitis affect?
the ciliary body and vitreous
what does posterior uveitis affect?
> retina
choroid
blood vessels
name the different types of uveitis
> anterior
intermediate
posterior
panuveitis
what systemic diseases in uveitis associated with?
> ankylosing spondylitis > behcets disease > sarcoidosis > wegners > systemic lupus erythematosis
what infections are associated with uveitis?
> TB > syphilis > toxoplasma > herpes simplex > lymes disease > CMV
what are the treatment options for uveitis?
> topical anti-inflammatories
systemic steroids
systemic immunosuppressant’s in steroids not an option
what are the symptoms seen in acute angle glaucoma?
> severe pain
vomiting
fixed dilated pupil
what are the features of preseptal cellulitis?
> pain
redness
lid swelling
systemically unwell
what are some common causes for preseptal cellulitis?
> lid cyst
> insect bite
what are some of the features of orbital cellulitis?
> pain > redness > lid swelling > systemically unwell > double vision > conjunctivitis > exophthalmos > blurred vision
what are some common causes for orbital cellulitis?
> sinusitis
dental infections
haematological spread
name some inherited conditions that can have ophthalmic presentations
> albinism > ehlers-danlos > marfans > myotonic dystrophy > neurofibromatosis
what ratio of orbital tumours are benign?
2/3
what cells are carcinomas derived from?
epithelial cells
what cell type are sarcomas derived from?
connective tissue
what cell type are lymphomas derived from?
haemopoietic cells maturing in the lymphatic tissue
what cell type do leukaemias develop from?
haemopoietic cells maturing in the blood
what are blastomas derived from?
cancers derived from immature precursor cells or embryonic cells
name some common benign eyelid tumours
> squamous cell papilloma
basal cell papilloma
melanocytic naevus
name some rarer eyelid tumours
> actinic keratosis > pyogenic granuloma > keratoacanthoma > capillary haemangioma > cavernous haemangioma
what is the most common malignant eyelid tumour type?
basal cell carcinoma
describe a squamous cell papilloma
> benign eyelid tumour
pedunculated or sessile
raspberry texture
usually viral
what is the management for a squamous cell papilloma?
excision or laser ablation
describe basal cell papilloma
> benign eyelid tumour
greasy, brown, flat and oval
unrelated to sun exposure
what is the treatment for basal cell papilloma (seborrheic keratosis)?
excision
what is melanocytic naevus composed of?
atypical melanocytes
what colour and what level would a junctional melanocytic naevus be?
black and epidermis level
what does the location of the melanocytes in melanocytic naevus influence?
clinical appearance and potential for malignant transformation
what type of melanocytic naevus is brown and in the deep epidermis?
compound melanocytic naevus
what type of melanocytic naevus is grey and in the papillary dermis?
intradermal
what are some of the early signs of malignant transformation in melanocytic naevus?
> asymmetry > irregular border > variegated colour > diameter > 6mm > growth
what are some concerning features of melanocytic naevus suggesting nodular malignancy?
> elevated
firm to touch
growing
describe a pyogenic granuloma
> benign eyelid tumour > fast growing > highly vascularised granuloma > may follow surgery, infection, trauma > erythematous pedunculated mass
what is the management for pyogenic granuloma?
excision
describe actinic keratosis
> common premalignant condition > rare in eyelids > flat > scaly > hyperkeratotic skin > can form cutaneous horn > related to sun exposure
what is the treatment from actinic keratosis?
> excision
> medical treatment
describe keratoacanthoma
> rare squamous cell carcinoma is situ
rapidly growing in other wise healthy skin
pink papule, hyperkeratonic crater
what can cause keratoacanthoma?
> sun exposure
> immunosuppression
what is the treatment for keratoacanthoma?
excision
describe capillary haemangioma
> commonest tumour in infancy
predilection upper lip (with/without orbital extension)
astigmatism
what is the management for capillary haemoangioma?
> beta blockers
intralesion steroid
surgery
describe a cavernous haeangioma
> rare
congenital
well demarcated pink patch
darkens with age-does not involute
what is the treatment for cavernous haemangioma?
laser
what is the most commonest cancer world wide?
basal cell carcinoma
what are basal cell carcinomas associated with?
pale skin and sun exposure
what features are suggestive of a basal cell carcinoma?
> slow growth over months > non-pigmented, elevated, ulcerated > pearly, rolled, irregular border > telangiectasia > lack of tenderness
name the clinical subtypes of basal cells carcinomas
> nodular
ulcerative
morpheaform/infiltrative
describe ulcerative basal cell carcinoma
> common
can progress from nodular
cycles of crusting and bleeding
what is the management for basal cell carcinoma?
> standard excision
mohs surgery
non-surgical treatment
describe the non-surgical treatment for basal cell carcinoma
> topical > chemotherapy > cryotherapy > radiotherapy > photodynamic therapy
describe squamous cell carcinoma
> malignant eye tumour
sun damaged skin
scaly surface over thick plaque
growth over weeks
what is the management for squamous cell carcinoma?
excision
describe sebaceous gland carcinoma
> malignant eyelid carcinoma > recurrent chalazion > nodular indurated lid margin > yellowish discolouration > pagetoid spread along conjunctiva
what is the management form sebaceous gland carcinoma?
excision
what are the three types of cutaneous malignant melanoma?
> lentigo maliga
superficial spreading
nodular
describe lentigo maligna CMM
> flat
> variably pigmented
describe superficial spreading CMM
slightly raised pigmented plaque
describe nodular CMM
vertically invasive
name some benign orbital tumours
> capillary haemangioma
cavernous haemangioma
pleomorphic adenoma
optic nerve glioma
name some malignant orbital tumours
> lymphoma > rhabdomyosarcoma > lacrimal gland carcinoma > osteocarcinoma > liposarcoma > primary melanoma
