Term
| What are the coats of the eye? |
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Definition
outer: fibrous exoskeletion (cornea & sclera)
middle: pigmented vasc layer (uiris, ciliary body, choroids)
inner: neuroectodermal layer, neurosensory retina |
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Term
| Where are the anterior and posterior aqueous compartments? |
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Definition
anterior: between cornea & iris
posterior: between back of iris & lens |
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Term
| Explain the flow of aqueous fluid through the eye. |
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Definition
| drains into the angle between the iris & the cornea>trabecular meshwork>canal of Schlemm>venous system |
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Term
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Definition
nourishes the retina
largest capillary network in the body
acts as a heat pump to dissipate heat |
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Term
| What are the inflamm lesions of the eyelid? |
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Definition
acute hordeolums (styes): staph infection of the lash follicles or acute meibomiantis
Chalazion: chronic granulomatous reaction to lipid material |
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Term
| what are benign lesions of the eyelid? |
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Definition
| nevi, papillomas, skin tags, warts |
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Term
| What are the tumors of the eyelid? |
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Definition
basal cell carcinoma: elevated, pearly margin w/ulcerated center; most common on lower lid; upper lid does not metastasize
sebaceous carcinoma (of Meibomian glands): 23% mortality; may masquerade as chalazion |
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Term
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Definition
| acute or chronic infection of the lacrimal drainage system |
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Term
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Definition
| covers inner surface of eyelid and white part of eyeball |
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Term
| How is an epithelial abrasion diagnosed? |
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Definition
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Term
| What is keratitis, and why shouldn't you treat it with steriods? |
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Definition
inflammation of the cornea ie Herpes simplex keratitis
steroids promotes stromal invasion, which can cause chronic debilitating disease i.e. glaucoma |
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Term
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Definition
#1 surgical procedure in US
optically dysfunctional or opaque lens
filters out blue
diagnosed clinically |
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Term
| What are the causes of cataracts? |
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Definition
cong/developmental
cortical: degen of lens cortex
nuclear: nuclear sclerosis as a result of continued growth of the lens throughout life combined w/inward sequestration makes lens self destruct
post subcapsular
ant subscap: abn epithel prolife caused by noxious stimuli
toxic or drug related
metabolic cataract (ie DM) |
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Term
| sympathetic uveitis (opthalmia) |
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Definition
occurs 2 weeks - many years after penetrating ocular injury
"safe period": if injured eye is removed within 2 weeks of injury, the uninjured eye is protected
bilateral, diffuse, t-cell mediated granulomatous uveitis |
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Term
| explain the pathology of sympathetic uveitis |
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Definition
thought to be AI to uvueal pigment
sparing of choriocapillaries
pigment phagocytosis by epitheliod cells
Dalen-Fuchs nodules: small granulomas between chroiocapillaries and RPE |
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Term
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Definition
seen in sympathetic uveitis
small granulomas between choriocapillaries and RPE |
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Term
| Which is worse, uveal melanoma in the iris, or cilliary body/choroid? |
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Definition
| uvueal melanoma in the cilliary body/choroid is worse |
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Term
| What are some risk factors for developing ciliary body or choroidal uveal melanoma? |
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Definition
mean age: 55
race: white
pre-existing choroidal nevus
light irises (blue or green)
^ exposure to UV light |
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Term
| How does ciliary body or choroidal uveal melanoma present? |
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Definition
mass found on routine exam
episcleral injection
glaucoma
decreased vision (retinal detachment, macular edema, vitrous hemorrhage) |
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Term
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Definition
chronic ocular inflammation
red eye & constricted pupil
types: granulomatous or non-granulomatous
sigs: pain, photobia, injection, ciliary flush, miotic pupil, protein & inflamm cells in ant chamber on slit lamp exam, keratic precipitates
sequelae: adhesions between iris and lens and iris and post. cornea |
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Term
| diffuse granulomatous uveitis |
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Definition
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Term
| acute narrow angle glaucoma |
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Definition
a medical emergency
occurs in eyes with anatomic predisposition: smal hyperopic eyes w/shallow anterior chamber; peripherally iris functionally blocks the trabecular meshwork causing a sudden increase in intraocular pressure (can be precipitated by dilating drops)
symptoms: severe pain, decreased vision, N/V, dilated pupil, red eye |
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Term
| What is the most common type of primary glaucoma? |
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Definition
open angle: poorly understood
Symptoms: NO pain, insidious onset of peripheral vision loss
Diagnosed by tonomtery or detection of optic nerve cupping & visual field loss |
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Term
| What are the difference in symptoms between narrow angle and open angle glaucoma? |
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Definition
| open angle does not have any pain, and an insidious loss of periph vision |
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Term
| secondary closed-angle glaucoma |
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Definition
permanent adhesions between iris and posterior cornea block aqueous outflow
causes: iris neovascularization in DM or following retinal vein occlusion |
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Term
| What can increased intraocular pressure cause? |
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Definition
glaucomatous retinal atrophy: loss of ganglion cells & nerve fibers
glaucomatous optic atrophy: loss of axons, gliosis, excavation or cupping of nerve head |
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Term
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Definition
| fluid collects in potential space formed by invag of optic vesicle during embryonic development and separates the neural retina from underlying retinal pigment epithelium |
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Term
| What are the types of retinal detachment? |
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Definition
rhegmatogenous: caused by holes in neural retina
exudative
tractional: scar tissue pulls the retina off i.e. diabetes
solid: tumors of choroids |
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Term
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Definition
| yellow spot @ limbus, seen nasally: a degenerative lesions secondary to actinic damage or substantia propria |
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Term
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Definition
bilateral, hereditary diseases which generally lead to pacification
rare |
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Term
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Definition
| inflammation of the cornea |
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Term
| What are the types of acute ocular inflammation? |
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Definition
endopthalmitis: 2 ocular coats + adjacent cavities
panopthalmitis: all 3 ocular coats, adjacent cavities and ocasionally the orbit |
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Term
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Definition
a major cause of blindness
retinal and iris neovasc (stimulated by retinal hypoxia), vitreous hemorrhage, tractional retinal detachment, neovascular glaucoma
types:
background retinopathy: microaneurysms, hemorrhages, and exudates; retinal edema common in adult onset DM
proilferative diabetic retinopathy (usually in juvenile or insulin-dependent diabetics) |
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Term
| Which type of diabetic retinopathy is most common in adult onset DM? juvenile or insulin-dependent? |
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Definition
adult onset: background retinopathy
insulin-dependent: prolif diabetic retinopathy |
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Term
| How can macular edema and prolif diabetic retinopathy? |
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Definition
| panretinal photocoagulation and vitrectomy |
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Term
| When do you see a edematous retina w/macular "cherry red spot" |
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Definition
central renal artery occlusion: narrowed empty arterioles, white, opacified
histo: coag necrosis of inner retinal layers |
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Term
| What is a common sequel of central vein occlusion? |
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Definition
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Term
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Definition
nerve fiber layer: flame or splinter
middle retinal layers: blot & dot
preretinal: scaphoid or boat-shaped w/fluid level
sub-RPE: dark colord, may mimic tumor
viterous: may be massive and blinding |
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Term
| soft exudates (cotton wool spots "cytoid bodies") |
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Definition
| microinfarcts of nerve fiber layer |
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Term
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Definition
| pools of proteinaceous fluid in OPL watershed zone of retina |
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Term
| From what cells do the most common ocular neoplasms arise? |
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Definition
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Term
| What are some prognostic factors of malignant melanoma of the choroids or ciliary body? |
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Definition
histological cell type: spindle cell tumors>mixed>pure epithelioid
size
extraocular extensions
mitoses
metastasizes later
liver involvement common
iris: usually benign/excellent prognosis |
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Term
| What is the most common intraocular tumor of childhood? |
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Definition
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Term
| What is the only human cancer inherited as an autosomal dominant? |
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Definition
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Term
| How does retinoblastoma present? |
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Definition
white papillary reflex (leukokoria)
may be bilateral and multicentric
gross-white encephaloid appearance
Flexner-Wintersteiner rosettes, fleurettes, tumor necrosis and calcification, optic nerve invasion (related to prognosis) |
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Term
| What are causes of leukokoria? |
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Definition
retinoblastoma
congenintal cataract, persistent hyperplastic primary vitreous, retinopathy of prematurity, Coats' disease, toxocara canis endopthalmitis |
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Term
| What is the hallmark of orbital disease? |
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Definition
| exophthalmos: anterior displacement of the eyeball |
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Term
| What is the most common cause of unilateral or bilateral exophthalmos? |
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Definition
graves disease
massive enlargement of extraocularm uscles may be detected on CT or MIR scans |
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Term
| What is the most common malignant orbital tumor of childhood? |
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Definition
rhabdomyosarcoma
embryonal form= most common
65% cure rate w/radio/chemotherapy |
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Term
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Definition
epithelial tumor in the orbit
often fatal |
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Term
| Flexner-Wintersteiner Rosettes |
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Definition
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Term
| retinopathy of prematurity |
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Definition
vessels don't grow all the way to the retina
association between severity/incidence and arterial PO2>80 |
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Term
| age-related macular degeneration |
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Definition
dry-drusen
wet-drusen: bleeds and forms scars
can hemorrhage, causing central vision to become grey |
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Term
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Definition
usually secondary to strabismus
to avoid double vision, one eye suppresses the macular image, causing unequal signals from each eye to the brain
Tx: patch over good eye before age 10, otherwise you have permanent vision loss |
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