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The Nervous System: The eye > The Red Eye & Adnexal Oncology > Flashcards

The Red Eye & Adnexal Oncology Flashcards

1
Q

What is Uveitis

A

inflammation of the middle layer of the eye, called the uvea or uveal tract

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2
Q

What is involved in the uveal tract

A

The uveal tract includes the iris, the ciliary body, choroid, retina and blood vessels

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3
Q

What is a serious inflammation of the uveal tract called

A

Panuveitis

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4
Q

What is the presentation of uveitis

A

Pain - none/mild

Redness- pericorneal/none

Discharge - minimal/no

Vision - blurred

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5
Q

What is the causes of uveitis

A

Idiopathic

Associated with systemic disease

Infection

Masquerade
o Intraocular lymphoma
o Leukaemia

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6
Q

What systemic disease is uveitis associated with

A

Ankylosing spondylitis

Behcet’s disease

Sarcoidosis

Wegener’s

Systemic lupus erythematosis

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7
Q

What infections is uveitis associated with

A

TB

Syphilis

Toxoplasma

Heres simplex

Lyme’s disease

CMV

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8
Q

What is the treatment for uveitits

A

Treat infection

Topical anti inflammatories

Systemic steroids

Systemic immunisuppressants

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9
Q

What is the symptoms of acute angle closure glaucoma

A

Severe pain

Vomiting

Fixed, dilated pupil

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10
Q

What is the presentation of acute angle closure glaucoma

A

Pain: Severe/headache

Redness: Pericorneal

Discharge: Yes/no

Vision: Lost

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11
Q

What is the cause of acute angle closure glaucoma

A

caused by a rapid or sudden increase in intraocular pressure (IOP)

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12
Q

What is the signs of acute angle closure glaucoma

A

Mid- dilates pupil
Non responsive to light
Hard eye

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13
Q

What is the presentation of Bacterial conjunctivitis

A

Pain: None/itch

Redness: Peripheral/diffuse

Discharge: Yes/yellow

Vision: Blurred

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14
Q

What is the presentation of Bacterial conjunctivitis

A

Pain: None/itch

Redness: Peripheral/diffuse

Discharge: Yes/yellow

Vision: normal

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15
Q

What is the presentation of viral conjunctivitis

A

Pain: None/itch

Redness: Peripheral/diffuse

Discharge: Yes/watery

Vision: normal

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16
Q

What is the presentation of allergic conjunctivitis

A

Pain: None/itch

Redness: Peripheral/diffuse

Discharge: Yes/mucous

Vision: normal

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17
Q

What is the presentation of scleritis

A

Pain: Severe/boring

Redness: Sectoral/diffuse

Discharge: No

Vision: Normal

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18
Q

What occurs in scleritis

A

serious inflammatory disease that affects the white outer coating of the eye, known as the sclera.

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19
Q

What is the presentation of corneal ulcer (open sore on the cornea)

A

Pain: severe

Redness: Pericorneal

Discharge: yes/no

Vision: lost

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20
Q

What is symptoms and signs of preseptal cellulitis

A

Pain
Redness
Lid swelling
Systemically unwell

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21
Q

What is common causes of perceptual cellulitis

A

Lid cyst

Insect bite

22
Q

What is the signs of orbital cellulitis

A

Pain, redness, lid swelling

Systemically unwell

Double vision

Conjunctivitis

Exophthalmos

Blurred vision

23
Q

What is the common causes for orbital cellulitis

A
  • Sinusitis
  • Dental infections
  • Haematological spread
24
Q

What is orbital cellulitis

A

is inflammation of eye tissues behind the orbital septum

25
Q

What are systemic diseases than can have ophthalmic presentations

A

Diabetes

Hypertension

Autoimmune

  • Graves disease
  • rheumatoid arthritis
  • myaesthenia gravis

Inflammatory

  • Ankylosing spondylitis
  • Crohn’s disease
  • Juvenile idiopathic arthritis
  • Sarcoidosis

Infection

Heamatological

Inherited/genetic

  • Albinism
  • Marfan’s
  • Myotonic dystrophy
  • Neurofibromatosis

Thyroid eye disease

26
Q

Name eight benign eyelid tumours

A 
Squamous cell papilloma (commonest)
				       Basal cell papilloma
					     (seborrhoeic keratosis)
				       Melanocytic naevus
				       Actinic keratosis
				       Pyogenic granuloma
				       Keratoacanthoma
				       Capillary haemangioma
				       Cavernous haemangioma
(rarest)
27
Q

Name six malignant eyelid tumours

A

Basal cell carcinoma (90-95%)
Squamous cell carcinoma (2-5%)
Sebaceous gland carcinoma (1-2%)
Melanoma (<1%)
Kaposi sarcoma (<1%)
Merkel cell carcinoma (<1%)

28
Q

What is the presentation of sqaumaous cell papilloma

A

Pedunculated or sessile (broad-based)

Characteristic ‘raspberry’ texture

Usually viral

29
Q

How are squamous cell papilloma benign eyelid tumours treated

A

Excision or laser ablation

30
Q

What is the presentation of basal cell papilloma

A

Greasy, brown, flat, round/oval

Similar texture to squamous cell papilloma

‘Stuck on’ appearance

(Unrelated to sun exposure)

31
Q

How is basal cell papilloma treated

A

Excision

32
Q

What is the presentation of mealoncytic naveus benign eye lid tumours

A

Composed of atypical melanocytes

Location of these melanocytes influences
clinical appearance and potential for malignant transformation

33
Q

What is early signs of malignant transformation in melanocytic naves

A 
A	Asymmetry
    B	Border (irregular)
    C	Colour (variegated)
    D	Diameter (>6mm)
    E	Evolving (growing)

Concerning (suggesting nodular MM)
E Elevated
F Firm to touch
G Growing

34
Q

What is the presentation of pyogenic granuloma benign eyelid tumour

A

Fast growing, highly vascularised granuloma

May follow surgery, infection, trauma

Erythematous pedunculated mass

Treat - excision

35
Q

What is the presentation of actinic keratosis

A

Common pre-malignant condition, though relatively rare on eyelids

Flat, scaly, hyperkeratotic skin, occasional forms cutaneous horn

Related to sun exposure

Treatment - excision or medical treatment

36
Q

What is the presentation of keratocanthoma benign eyelid tumour

A

Rare, ‘squamous cell carcinoma in-situ’

Rapidly growing in otherwise healthy skin

Pink papule, hyperkeratotic crater

Sun exposure, immunosuppression

Often spontaneous involution after 2-3/12

Treatment excision

37
Q

What is the presentation of capillary haemangioma benign eye lid tutor

A

Although rare, one of the commonest
tumours of infancy

Predilection upper lid +/- orbital extension

Amblyopia (dim vision), astigmatism

treatment

  • B blockers
  • intralesion steroid
  • surgery
38
Q

What is the presentation of cavernous haemangioma

A

Rare, congenital

Well demarcated pink patch

Darkens with age, does not involute

Treatment - Rx Laser

39
Q

What is the presentation of basal cell carcinoma malignant eyelid tumour

A

Commonest cancer worldwide

Pale skin and sun exposure

Locally invasive, risk of metastasis

treat - Excision (2-3mm)

40
Q

What are the features suggesting basal cell carcinoma

A

Slow, inexorable growth over months

Usually non-pigmented, elevated, ulcerated

Pearly, rolled, irregular border

Telangiectasia

Lack of tenderness

41
Q

What is the 3 clinical subtypes of basal cell carcinoma

A

Nodular

  • Common
  • Classic firm pearly nodule

Ulcerative

  • Common
  • May progress from nodular
  • Cycles of crusting and bleeding

Morpheaform/infiltrative

  • Less common,
  • Indurated plaques
42
Q

What is the management of basal cel carcinoma

A

Standard excision (3mm margin)

Mohs surgery

Non-surgical

  • Topical
  • Chemotherapy
  • Cryotherapy
  • Radiotherapy
  • Photodynamic therapy
43
Q

What is the presentation of squamous cell carcinoma

A

Sun damaged skin and pre-existing AK

Scaly surface over a thick plaque

Growth over weeks rather than months

Metastatic risk of 3-10%

treatment - excision (4mm margin)

44
Q

What is the presentation of sebaceous gland carcinoma

A

Nodular, indurated lid margin

Yellowish discolouration (lipid content)

Pagetoid spread along conjunctiva,

Treat - Excision (5-10mm)

45
Q

What is the presentation of malignant melanoma

A

Rare on the eyelids

3 types of cutaneous MM

Treat -excision (10-30mm)

46
Q

What is the three types of malignant melanoma and there presentations

A

Letingo maligna
- Flat variably pigmented macule

  • Superficial spreading
  • Slightly raised pigmented plaque

Nodular
- Vertically invasive

47
Q

For what malignant eyelid tumours should you consider sentinel node biopsy

A

Sebaceous gland carcinoma

Malignnat melanoma

48
Q

What should aslo be considered with squamous cell carcinoma

A

MRI

Abdomina Ultrasound

49
Q

Name four benign orbital tumours

A

Capillary haemangioma

Cavernous haemangioma

Pleimorphic adenoma

Optic nerve glioma

50
Q

Name seven malignant orbital tumours

A

Lymphoma

Metatatis

Phabdomysarcoma

Lacrimal gland sarcoma

Osterosarcoma

Liposarcoma

Primary melanoma

51
Q

Where also can a rare tumour occur in the eye

A

Lacrimal drainage tumours

52
Q

Are the majority of orbital tumours benign or malignant

A

2/3 benign

1/3 malignant

The Nervous System: The eye (11 decks)

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