{"id":6679,"date":"2021-09-13T21:43:57","date_gmt":"2021-09-13T19:43:57","guid":{"rendered":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/respiratory-system\/eye\/"},"modified":"2023-05-25T15:42:40","modified_gmt":"2023-05-25T13:42:40","slug":"eye","status":"publish","type":"page","link":"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/nervous-system\/eye\/","title":{"rendered":"Eye"},"content":{"rendered":"<span class=\"block-heading\" id=\"header_1\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Eyelid<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_1\">\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Ptosis<\/strong>\n<ul class=\"wp-block-list\">\n<li>Drooping of the eyelid<\/li>\n\n\n\n<li>Seen in Horner syndrome, Mysanthia Gravis among others<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Stye (Hordeolum)<\/strong>\n<ul class=\"wp-block-list\">\n<li>Acute, suppurative inflammation of the various glands of the eyelash\n<ul class=\"wp-block-list\">\n<li>External hordeolum\n<ul class=\"wp-block-list\">\n<li>Zeis, glands of Moll<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Internal hordeolum\n<ul class=\"wp-block-list\">\n<li>Tarsal (Meibomian) glands<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Very common<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Chalazion<\/strong>\n<ul class=\"wp-block-list\">\n<li>Chronic inflammation of the Tarsal glands, resulting in their destruction<\/li>\n\n\n\n<li>Due to obstruction of the drainage<\/li>\n\n\n\n<li>Histologically &#8212; Appears as a lipogranuloma (fatty tissue granuloma)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_2\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Orbit<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_2\">\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Exopthalmos<\/strong>\n<ul class=\"wp-block-list\">\n<li>Protrusion of the eyes forward\n<ul class=\"wp-block-list\">\n<li>Sometimes known as proptosis &#8212; Which is the general germ for any type of protrusion, while exopthalmos refers to the eyes specifically<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Can be due to increased IcP or inflammation (Grave&#8217;s disease)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Keratitis<\/strong>\n<ul class=\"wp-block-list\">\n<li>Inflammation of the cornea<\/li>\n\n\n\n<li>Usually associated with ulceration<\/li>\n\n\n\n<li>Usually caused by microbes and viruses (especially herpes)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Pinguecula and Pterygium<\/strong>\n<ul class=\"wp-block-list\">\n<li>Benign fibromuscular submucosal elevations found within the conjunctiva<\/li>\n\n\n\n<li>Appear due to sun damage<\/li>\n\n\n\n<li>Both lesions extend from the corneoscleral junction (limbus region) and do not affect the vision<\/li>\n\n\n\n<li><strong>Pinguecula<\/strong>\n<ul class=\"wp-block-list\">\n<li>Small, often yellowish and elevated (uneven surface, can harm tear-film formation)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Pterygium<\/strong>\n<ul class=\"wp-block-list\">\n<li>Larger, whitish, and flatter<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Endophthalmitis-Panophthalmitis<\/strong>\n<ul class=\"wp-block-list\">\n<li>Intraocular inflammation, from a pathogen that reaches the eye via a wound or through the bloodstream (hematogenous)<\/li>\n\n\n\n<li>The ciliary body and iris become leaky, resulting in suppurative exudate that accumulates within the anterior chamber<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Synechiae&#8211; Adhesions of the iris to the adjacent structures<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Anterior &#8212; To the cornea<\/li>\n\n\n\n<li>Posterior &#8212; To the lens<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conjunctivitis and Keratoconjunctivitis<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Inflammation of the conjunctiva alone (conjunctivitis), or the conjunctiva and cornea (keratoconjunctivitis)<\/li>\n\n\n\n<li>May affect the transparency of the cornea (keratoconjunctivitis)\n<ul class=\"wp-block-list\">\n<li>In recurrent and chronic states, granulation tissue formation will ensure (blood vessel formation (<em>recall that the cornea is avascular<\/em>), and infiltration of lymphocytes)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Trachoma and&nbsp;<\/strong><strong>inclusion conjunctivitis<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Caused by Chlamydia\n<ul class=\"wp-block-list\">\n<li>Trachoma is caused by C. trachomatis\n<ul class=\"wp-block-list\">\n<li>Much more severe,&nbsp;and can cause thickening of the conjunctiva resulting in blindness<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Inclusion conjunctivitis is caused by C. oculogenitalis\n<ul class=\"wp-block-list\">\n<li>Less severe, and causes mild inflammation<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_3\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Uveal tract<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_3\">\n\n\n<ul class=\"wp-block-list\">\n<li>The uveal tract consists of the choroid, ciliary body, and iris\n<ul class=\"wp-block-list\">\n<li>The most vascularized tissue of the eye<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Granulomatous uveitis<\/strong>\n<ul class=\"wp-block-list\">\n<li>Formation of granulomas in the uveal tract<\/li>\n\n\n\n<li>Due to infection<\/li>\n\n\n\n<li>Common in&nbsp;sarcoidosis<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Pupils<\/strong>\n<ul class=\"wp-block-list\">\n<li>The pupil is the orifice in the middle of the iris. Its size is controlled by the extent of the constriction and dilation controlled by the autonomic nervous system.<\/li>\n\n\n\n<li><strong>Miosis<\/strong>\n<ul class=\"wp-block-list\">\n<li>Constricted pupils<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Mydriasis<\/strong>\n<ul class=\"wp-block-list\">\n<li>Dilated pupils<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Anisocoria<\/strong>\n<ul class=\"wp-block-list\">\n<li>Pupils are not in the same size<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_4\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Tumors<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_4\">\n\n\n<p class=\"wp-block-paragraph\">The various tissues of the eye can develop neoplasias of a benign or malignant origin, the same as with other parts of the body:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Benign\n<ul class=\"wp-block-list\">\n<li>Squamous\/basal cell papillomas<\/li>\n\n\n\n<li>Adenomas<\/li>\n\n\n\n<li>Hemangiomas<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Malignant\n<ul class=\"wp-block-list\">\n<li>Squamous\/basal cell carcinomas<\/li>\n\n\n\n<li>Adenocarcinomas<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Metastatic tumors<\/strong>\n<ul class=\"wp-block-list\">\n<li>More common than primary malignant tumors<\/li>\n\n\n\n<li>Common metastasizing tumors:\n<ul class=\"wp-block-list\">\n<li>Breast in women<\/li>\n\n\n\n<li>Lung in men<\/li>\n\n\n\n<li>Leukemia and lymphoma<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Basal cell carcinoma of the eyelid<\/strong>\n<ul class=\"wp-block-list\">\n<li>Most&nbsp;frequent tumor of the eyelid<\/li>\n\n\n\n<li>Mostly in the lower eyelid<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Sebaceous carcinoma of the eyelid<\/strong>\n<ul class=\"wp-block-list\">\n<li>Second-most frequent tumor of the eyelid<\/li>\n\n\n\n<li>Sebaceous carcinoma is very rare anywhere else in the body<\/li>\n\n\n\n<li>Usually arises from the Tarsal glands or Zeis&#8217; glands, mostly in the upper eyelid<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Malignant melanoma<\/strong>\n<ul class=\"wp-block-list\">\n<li>Arise from the melanocytes, usually the pigmented epithelium of the uvea\n<ul class=\"wp-block-list\">\n<li>Most commonly in the posterior choroid<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Slow-growing and late-metastasizing\n<ul class=\"wp-block-list\">\n<li>Usually, to the liver<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Better prognosis than melanoma of the skin<\/li>\n\n\n\n<li>Classification:\n<ul class=\"wp-block-list\">\n<li>Spindle A melanoma (best prognosis)<\/li>\n\n\n\n<li>Spindle B melanoma<\/li>\n\n\n\n<li>Mixed-cell type melanoma<\/li>\n\n\n\n<li>Epithelioid melanoma (worst prognosis)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Treatment involves enucleation of the eye<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Retinoblastoma<\/strong>\n<ul class=\"wp-block-list\">\n<li>Described separately under Retinopathies<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_5\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Retinopathies<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_5\">\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Retinal detachment (ablation)<\/strong>\n<ul class=\"wp-block-list\">\n<li>Separation of the neural retina from the pigmented retinal layer<\/li>\n\n\n\n<li>Types:\n<ul class=\"wp-block-list\">\n<li><strong>Rhegmatogenous retinal detachment<\/strong> &#8212; A tear in the retina leaking vitreous gel underneath the retina, forming a &#8220;water under a wallpaper&#8221; detachment.<\/li>\n\n\n\n<li><strong>Non-rhegmatogenous:<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Exudative retinal detachment <\/strong>&#8212; A fluid collects under the neural retina leading to its detachment, but without any physical dear in the retina.<\/li>\n\n\n\n<li><strong>Tractional retinal detachment&nbsp;<\/strong>&#8212; Fibrosis of the retina leading to its pulling (traction) and detachment, usually seen in DM.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Retrolental fibroplasia (retinopathy of prematurity)<\/strong>\n<ul class=\"wp-block-list\">\n<li>Initially, not all of the retinal vessels are formed; the more distal vessels develop after birth<\/li>\n\n\n\n<li>Retinal vessels are extremely sensitive to oxygen; in high levels of oxygen, VEGF is suppressed, leading to decreased angiogenesis<\/li>\n\n\n\n<li>Exposure of retinal capillaries to high levels of oxygen initially, resulting in the obliteration of blood vessels, and fibrosis in the distal part of the retina\n<ul class=\"wp-block-list\">\n<li>Occurs in premature infants given oxygen-therapy<\/li>\n\n\n\n<li>The fibrosis will lead to fusion with the lens and retina (=fibroplasia)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Retinitis pigmentosa<\/strong>\n<ul class=\"wp-block-list\">\n<li>Degeneration of retinal pigment epithelium or the rods and cons<\/li>\n\n\n\n<li>Early symptoms include night-blindness and may progress to complete blindness<\/li>\n\n\n\n<li>Genetically inherited, with unknown etiology<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Age-related macular degeneration<\/strong>\n<ul class=\"wp-block-list\">\n<li>Damage to the macula (required for central vision)<\/li>\n\n\n\n<li>Affects older adults<\/li>\n\n\n\n<li>Can be &#8220;wet&#8221; (neovascularization) or &#8220;dry&#8221; (no neovascularization)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Diabetic retinopathy<\/strong>\n<ul class=\"wp-block-list\">\n<li>Proliferative<\/li>\n\n\n\n<li>Non-proliferative<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n<\/span><span class=\"block-heading\" id=\"header_6\">\n<h4 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title2\">Retinoblastoma<\/h4>\n<\/span><span class=\"block-content\" id=\"contents_6\">\n\n\n<ul class=\"wp-block-list\">\n<li>Malignant tumor of the retina<\/li>\n\n\n\n<li>Most common primary intraocular malignancy in children<\/li>\n\n\n\n<li>Composed of immature cells resembling the fetal cells<\/li>\n\n\n\n<li>Caused by a mutation in the retinoblastoma (Rb) gene which is a\u00a0<strong>tumor suppressor gene<\/strong>\n<ul class=\"wp-block-list\">\n<li>Rb gene encodes a protein that regulates gene expression (allowing cell division when phosphorylated)<\/li>\n\n\n\n<li>As with other tumor suppressors, both copies have to be mutated for the gene to inactivate<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>40% of cases are familial, 60% are sporadic\n<ul class=\"wp-block-list\">\n<li>Familial cases start as a germline mutation of a single copy of the Rb gene\n<ul class=\"wp-block-list\">\n<li>Since one copy was mutated from birth, all it takes is another &#8220;hit&#8221; on the second copy to deactivate the gene completely (hence, only&nbsp;<strong>&#8220;one hit&#8221;&nbsp;<\/strong>is required)<\/li>\n\n\n\n<li>Usually, the tumors develop on both sides (bilateral)<\/li>\n\n\n\n<li>Inherited in an <strong>autosomal dominant<\/strong> manner<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Sporadic cases are involved with somatic mutations\n<ul class=\"wp-block-list\">\n<li>Both copies of the gene must be mutated sporadically (hence,&nbsp;<strong>&#8220;two hits&#8221;<\/strong> are required)<\/li>\n\n\n\n<li>Usually, a single tumor develops in one side (unifocal, unilateral)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Symptoms include:\n<ul class=\"wp-block-list\">\n<li>Poor vision<\/li>\n\n\n\n<li>Cross-eyeing<\/li>\n\n\n\n<li>A shiny hue of the pupil (&#8220;cat&#8217;s eye reflex&#8221;)<\/li>\n\n\n\n<li>Pain and tenderness of the eye<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Histologically:\n<ul class=\"wp-block-list\">\n<li>Undifferentiated tumor cells are round, with a large round nucleus<\/li>\n\n\n\n<li>Differentiated tumors contain<strong> Flexner-Wintersteiner rosettes<\/strong>\n<ul class=\"wp-block-list\">\n<li>Short, columnar tumor cells with an oval nucleus surrounding a lumen (unlike neuroblastoma where a lumen is absent<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Other rosettes &#8212; Homer Wright<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Patients surviving retinoblastoma are at risk of developing osteosarcomas<\/li>\n\n\n\n<li>Tumor cells may metastasize beyond the retina<\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter\"><a href=\"https:\/\/meddists.com\/wp-content\/uploads\/2019\/02\/Screenshot_25.png\" target=\"_blank\" title=\"Eye\"><img decoding=\"async\" src=\"https:\/\/meddists.com\/wp-content\/uploads\/2019\/02\/Screenshot_25.png\" alt=\"\" class=\"wp-image-9217\"\/><\/a><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><strong>A Flexner-Wintersteiner rosette<\/strong> &#8212; Public domain<\/p>\n\n\n<\/span><span class=\"block-heading\" id=\"header_7\">\n<h3 class=\"wp-block-heading\" class=\"wp-block-heading\" class=\"title_collection title1\">Diabetes and ophthalmic pathology<\/h3>\n<\/span><span class=\"block-content\" id=\"contents_7\">\n\n\n<p class=\"wp-block-paragraph\">Long-standing diabetes is tightly linked with ophthalmic pathologies. The involvement can be in the form of cataract formation (opacification of the lens), retinopathies, or glaucoma.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Glaucoma<\/strong>\n<ul class=\"wp-block-list\">\n<li>Increased intraocular pressure leading to degeneration and damage of the optic nerve and retina<\/li>\n\n\n\n<li>Due to the impaired outflow of aqueous humor (mostly obstruction)<\/li>\n\n\n\n<li>Can be congenital, primary or secondary<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/span><div id=\"the_titles\" style=\"display:none;\"><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Eyelid<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Orbit<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Uveal tract<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Tumors<\/h3><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Retinopathies<\/h3><h4 class=\"wp-block-heading\" class=\"wp-block-heading\">Retinoblastoma<\/h4><h3 class=\"wp-block-heading\" class=\"wp-block-heading\">Diabetes and ophthalmic pathology<\/h3><\/div>","protected":false},"excerpt":{"rendered":"<p>Eyelid Orbit Synechiae&#8211; Adhesions of the iris to the adjacent structures Conjunctivitis and Keratoconjunctivitis Trachoma and&nbsp;inclusion conjunctivitis Uveal tract Tumors The various tissues of the eye can develop neoplasias of a benign or malignant origin, the same as with other parts of the body: Retinopathies Retinoblastoma A Flexner-Wintersteiner rosette &#8212; Public domain Diabetes and ophthalmic [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":6651,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-6679","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Eye &#8211; Meddists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/meddists.com\/learn\/pre-clinical\/pathology\/nervous-system\/eye\/\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/nervous-system\\\/eye\\\/\",\"url\":\"https:\\\/\\\/meddists.com\\\/learn\\\/pre-clinical\\\/pathology\\\/nervous-system\\\/eye\\\/\",\"name\":\"Eye &#8211; 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