Trans 021 Ophthalmic Pathology

Question 1

• Painful red bump located at the base of the eyelash or inside the eyelid
• Acute infection of the oil glands of the eyelid that occurs after the glands have become clogged
• May arise from an infection.

Answer 1

Stye

Question 2

• Painless bump or nodule inside the upper or lower eyelid
• Result from healed internal styes that no longer are infectious
• Cyst-like nodules around an oil gland (meibomian) within the eyelid, resulting in red, swollen eyelids
• Contents include pus and blocked fatty secretions (lipids) that normally help lubricate the eye but can no longer drain out.

Answer 2

Chalazion

Question 3

is a sterile chronic granulomatous inflammatory lesion (lipogranuloma) of the meibomian, or sometimes Zeis, glands caused by retained sebaceous secretions. Histopathology shows a lipogranulomatous chronic inflammatory picture with extracellular fat deposits surrounded by lipid-laden epithelioid cells, multinucleated giant cells and lymphocytes. Blepharitis is commonly present; rosacea can be associated with multiple and recurrent chalazia. A recurrent chalazion should be biopsied to exclude malignancy.`

Answer 3

Chalazion

Question 4

what structure?nonkeratinizing stratified squamous epithelium

responds to inflammation by forming papillary folds

Answer 4

Palpebral conjunctiva

Question 5

pseudostratified columnar epithelium rich in goblet cell

-involved in viral conjunctivitis or lymphoid malignancy

Answer 5

Fornix conjunctiva

Question 6

nonkeratinizing stratified squamous epithelium

-covers the surface of the eye

Answer 6

Bulbar conjunctiva

Question 7

• Thin transparent layer of tissue that lines the inner surface of the eyelid and covers the white part of the eye
• Inflammation or swelling of the conjunctiva

Answer 7

Conjunctivitis

Question 8

conjunctivitis aused by sexually transmitted infections

Answer 8

Chlamydia conjunctivitis

Question 9

conjunctivitis Caused by chemicals such as chlorine (Swimming pool)

Answer 9

Reactive Conjunctivits

Question 10

Submucosal conjunctival elevations
• Common degenerative disease increasing with age
• Due to actinic damage to the collagen associated with the proliferation of sub-epithelial connective tissue of the bulbar conjunctiva

Answer 10

Pinguecula and pterygium

Question 11

• Does not invade the cornea

* Can affect tear film distribution resulting to focal dehydration with corneal depression

Answer 11

Pingeucula

Question 12

• Refers to growth of conjunctival mucosa and fibrovascular connective tissue originating in the limbus and invading the cornea
• Vision affected
• Resection performed due to irritation or cosmetic reasons

Answer 12

Pterygium

Question 13

• Sharply demarcated yellowish deposit of fat underneath the skin, usually on or around the eyelids
• May be associated with hyperlipidemia
• Dermal collection of lipid filled macrophages

Answer 13

Xanthelasma

Question 14

-most common tumor of conjunctiva; types similar to the skin lesions i.e., junctional, compound, and intradermal nevi

Answer 14

CONJUNCTIVAL MELANOCYTIC NEVI

Question 15

are usually in the dermal surface (intradermal navus), butif you see the nevi cells in the junction papilla you would call it junctional nevi.. or in both the junction and the dermal layer you call it compound nevi
 Intradermal is more common

Answer 15

Nevi Cells

Question 16

one of the most common sites for non-melanoma skin cancer

Answer 16

eyelid region

Question 17

• Most common malignant tumor involving skin of eyelids
• Sun damaged areas
• Locally invasive; does not metastasize
• Usually at the lower eyelids and medial canthi
 Pinaka mabait, pag natanggal yan without invations it will not reoccure, cause exposure to excessive sunlight

Answer 17

Basal Cell Carcinoma

Question 18

It most frequently arises from the lower eyelid, followed in relative frequency by the medial canthus, upper eyelid and lateral canthus. The tumour is slowly growing and locally invasive but non-metastasizing. Tumours located near the medial canthus are more prone to invade the orbit and sinuses, are more difficult to manage than those arising elsewhere and carry the greatest risk of recurrence. Tumours that recur following incomplete treatment tend to be more aggressive

Answer 18

BASAL CELL CARCINOMA

Question 19

Made up of basaloid cells, at the periphery you see a palisading of the basaloid cells which is one of the characteristics of

Answer 19

Basal cell carcinoma

Question 20

• 2nd most common eyelid malignancy
• Metastasizes to parotid and submandibular lymph nodes
• Exhibit intraepithelial pagetoid spread into the nasopharynx and lacrimal glands
• Mortality rate >20%

Answer 20

SEBACEOUS CARCINOMA

Question 21

• Tend to follow and indolent course; less than 5%
• Can be associated with HPV types 16 and 18
• Tends to occur at sun-damaged areas
• Ulcerations are common
• Invasive and metastasizes to preauricular and submandibular lymph nodes

Answer 21

Squamous cell carcinoma

Question 22

This is a well differentiated type of squamous cell carcinoma, because of the presence of _________-, this are horn cells and if you look at them individually each cell is connected by intercellular bridges. If you see this type of structure (intercellular bridges) in any part of the body basta may squamous cell lining siya and it becomes aberrant this will develop to keratin pearls. Look at the inflammatory reaction around these structures (mostly lymphocytes)

Answer 22

keratin pearls

Question 23

• Rare, unilateral; middle aged, fair
• <1% of all skin melanomas
• Results of DNA damage from exposure to UV light
• Risk factors: fair skin, the presence of dysplastic of congenital nevi, family history, and older age
• 25% mortality

Answer 23

Malignant Melanoma

Question 24

• Transparent, lacks blood vessels and lymphatics in the stroma
• Precise collagen alignment is necessary to maintain transparency
• Anterior: covered by epithelium overlying basement membrane and an acellular Bowman layer
• Posterior: bounded by corneal endothelium derived from neural crest, lies on basal lamina descement membrane

Answer 24

Cornea

Question 25

the most important refractive medium of the eye. This

Answer 25

Cornea

Question 26

* Inflammations of the cornea * Infectious caused by bacteria, viruses, fungi and parasites * Non-infectious keratitis caused by minor injury, wearing your contact lenses too long or other noninfectious diseases

Answer 26

Keratitis

Question 27

- Interruption of an intact corneal epithelium and/or abnormal tear permits entrance of microorganisms into the corneal stroma and cause ulcerations - Some bacteria can penetrate an intact corneal epithelium - Acute inflammatory cells surround the ulcer and cause necrosis of the stromal lamellae what pathology?

Answer 27

Keratits

Question 28

* Scarring clouding of the cornea due to trauma, inflammatory or ulcerative process, previous surgery, conjunctival disease * Porcelain-white color, blood vessels germinate into it eventually, fatty degeneration occurs, which becomes yellow shade color * Epithelial cell and stroma changes

Answer 28

Leukoma

Question 29

* Due to normal aging; harmless * Yellow-white, gray, or blue line at the corneal margin caused by lipid accumulation in between the corneal stromal lamella * Blood vessels in the eyes widen with age allowing more cholesterol and other fats to build up in the eye * Below 40 of age may be indicative of a hyper-lipoproteinemia (involving low-density lipoproteins) with elevated serum cholesterol * Lipid deposition occurs in the peripheral corneal stroma starting at the inferior and superior poles of the cornea * Late stages encircle the entire circumference

Answer 29

Arcus senilis

Question 30

is the most common peripheral corneal opacity; it frequently occurs without any predisposing systemic condition in elderly individuals, but may be associated with dyslipidemia in younger patients (arcus juvenilis)

Answer 30

Arcus senilis

Question 31

* Normally, cornea round shape, like a ping-pong ball * Structure of the cornea not strong enough to hold this round shape * Normal pressure inside the eye makes the cornea bulge outward like a cone, causing distorted vision * Thinning and fibrosis of cornea; numerous breaks in Bowman’s layer

Answer 31

KERATOCONUS

Question 32

- Epithelial: basement membrane fragmentation and scarring | Axial stromal: thinning and scarring breaks in folds close to the Descemet membrane result to acute hydrops

Answer 32

Keratoconus

Question 33

- Layer between the sclera and retina containing blood vessels, nerves, support cells and melanocytes o Divided into: Choroid (beneath the retina), ciliary body, iris

Answer 33

UVEA

Question 34

* Acutely painful, red, inflamed eyes * Causes inflection, injury, or an autoimmune or inflammatory disease * Many times, a cause can’t be identified * Complications: Glaucoma, Cataracts, Optic nerve damage, retinal detachment, permanent vision loss

Answer 34

Uveitis

Question 35

adult intraocular tumor in developed countries • Arises from the pigmented or potentially pigment producing cells of uvea, usually choroid, least commonly in iris • May cause retinal detachment • Spread occurs directly into the orbit or through the blood vessels • Associated with GNAQ and GNA11 mutations, both encoding G protein-coupled receptors that lead to enhanced proliferation through effects on MAP kinase pathway • Spread via hematogenous route and highly favor the liver • 5-yr survival rate” 80% • Mortality: 40% in 10 years, increasing 1% per year thereafter

Answer 35

Malignant melanoma in UVEA