Term
|
Definition
| Disinsertion of the iris root from the ciliary body. Induced by trauma and looks like two pupils. |
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Term
|
Definition
| Radial tears around the pupil causing a traumatic dilation of the pupil. |
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Term
|
Definition
| Jiggling of the iris often in aphakic patients where the motion of the vitreous transfers to the iris. Focal iridodenesis is traumatic and may result from iridodyalisis |
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Term
|
Definition
| Settled blood in the anterior chamber. Graded by the portion of the anterior chamber that is filled with blood. Grade 4 is known as a blackball or 8-ball hyphema. |
|
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Term
|
Definition
| Red blood cells leaking into the anterior chamber |
|
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Term
|
Definition
| A staining of the cornea as a result of long standing hyphema. Initially presents with yellow crystals in the stroma. Can impede vision. |
|
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Term
|
Definition
| Dehydration of the limbal cornea causing thinning and formation of little divots. May be associated with pterygia, pingueculae, or chemosis |
|
|
Term
| Superficial punctate keratitis |
|
Definition
| Epithelial inflammation with intraepithelial infiltrates. May cause FBS and photophobia. Often related to dry eye and allergies. |
|
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Term
| Superior limbic keratoconjunctivitis |
|
Definition
| Inflammation and injection of the superior limbal area. |
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Term
|
Definition
| Fungal infection of the corneal. Often presents with fuzzy borders and satellite lesions. May also be gelatinous or have immune rings. Very hard to treat. Aspergillus is the most common cause |
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Term
|
Definition
| May also be called disciform keratitis. It is stromal inflammation. May present with deep vascularization of the stroma and hemes and the vessels may resolve into ghost vessels which look a lot like prominent corneal nerves. Most common cause is herpes simplex. |
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Term
|
Definition
| Defined by interstitial keratitis and hearing loss |
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Term
|
Definition
| Protozoan infection of the cornea. Most commonly caused by acanthamoeba. Present with a stromal ring, pain, +PAN,injection, follicles, cells and flare and sometimes follicles, hypopyon and prominent corneal nerves. Treat with brolene, PHMB/chlorhexidine, miconazole or ketoconazole and pentamidine |
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Term
|
Definition
| Relatively rare. bacterial infection of the cornea resulting in ulceration. Mostly caused by s. aureus, s. pneumoniae, and pseudomonas. Typically treated with 4th gen fluoroquinolone |
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Term
|
Definition
| antigen-antibody infiltrates in the peripheral cornea. May coalesce into arcs. Often a result of staph hypersentivity. |
|
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Term
|
Definition
| Focal areas of anterior stromal inflammation and accumulation of leukocytes and debris. May be hypersentivity reaction or related to a virus, bacteria, fungus or protozoan. Tend to be multiple, small, mild to no staining, and more peripheral. |
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Term
|
Definition
| large ulcers associated with damage to the trigeminal innervation of the cornea. Typically have gray, rolled borders. May be caused by herpes, diabetes or other neurological conditions or surgery. May also be related to abuse of topical anesthetics or Riley Day syndrome. |
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Term
|
Definition
| cornea becomes dry and inflamed from environmental exposure. Can be related to lagophthalmos, parkinsons and proptosis among other things. |
|
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Term
| infectious crystalline keratitis |
|
Definition
| Complication of long term steroid use. Results in an infiltration of s. viridans which make crystal like lesions in the cornea. These present with intact epithelium and the appearance of star like infiltrates. |
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Term
|
Definition
| common bilateral keratitis in females. Has multiple, pinpoint, granular, elevated intra-epithelial lesions. So it looks like large SPK with a crushed chalk like appearance. treat with steroids. |
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Term
|
Definition
| gelatinous mucin strangs that adhere to the corneal epithelium. Often caused by the lid not being able to rewet the cornea with tears. Will present with FBS and SPK that looks like band keratopathy. You can remove these filaments with forceps or just treat with a bandage CL and steroid |
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Term
|
Definition
| aqueous deficiency dry eye associated with vitamin A deficiency. Complain of night blindness and may have a bitot spot, keratomalacia or loss/change of epithelial cells and goblet cells |
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Term
|
Definition
| blister like edema on the cornea in the epithelium. Can distort vision and cause pain and erosion. Can happen after phaco, particularly in those with prior guttata. Can also happen in patients with prolonged high IOP due to endothelial damage. |
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Term
|
Definition
| epithelial infiltrates at the edges of sutures. May or may not be a sign of rejection. |
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Term
|
Definition
| stromal infiltrates that look like infiltrates related to adenovirus. a sign of graft rejection |
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Term
|
Definition
| lines of inflammation and precipitates in the endothelium. a sign of graft rejection. |
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Term
|
Definition
| chronic autoimmune disease causing drying of mucous membranes and destruction of exocrine glands. Way more common in women. Related to the "sicca complex" or xerostomia (dry mouth), xerophthalmia (dry eyes), and exocrine gland infiltration. May look like jowls of a dog. May also be associated with increase risk of lymphoma. Secondary form often due to rheumatoid arthritis |
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Term
| herpes simplex 1 primary infection |
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Definition
| initial infection has seropurulent vesicles on the lids/adnexa and conjunctival effects. Will also have +PAN and possibly a recent URI fever or FBS. mostly occurs in children |
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Term
| herpes simplex virus epithelial keratitis |
|
Definition
| HSV1 recurrence. Usually unilateral. hallmark sign is a dendritic ulcer but may look like linear SPK that won't heal. Can progress to geographic erosions or become stromal. Can cause non-granulomatous uveitis with associated trabeculitis and iritis atrophy |
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Term
| herpes simplex virus stromal keratitis |
|
Definition
| herpes simplex 1 recurrence, usually after long standing epithelial involvement. this is immune mediated and inflammatory which causes an immune ring (Wessely). The stromal inflammation is called interstitial keratitis and can lead to thinning and neovascularization which can progress to ghost vessels. Can lead to neurotrophic ulcers, edema, opacification, endothelial folds etc. Put a steroid on it for a LONG time. |
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Term
|
Definition
| herpes 3. can reactivate and cause shingles. If shingles affects the tip of the nose (hutchinsons sign) there is a good chance it is affecting the cornea because both are innervated by the nasociliary branch of CN5. Presents with vesicular lesions, bleph, ptosis, keratitis, scleral thinning and inflammation in other tissues like the uveal tract (non-granulomatous) or optic nerve.May also cause CN palsys. Very painful. Keratitis looks like pseudo-dendrites with tapered ends. They are actually elongated infiltrates and not ulcers and are plaque like. Will progress to deep stromal keratitis. May also have nummular keratitis (granular subepithelial infiltrates surrounded by stromal haze). |
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Term
|
Definition
| white stripe looking things in the cornea. related to endocrine neoplasias, keratoconus, neurofibromatosis, fuchs', refsum's syndrome, trauma, congenital glaucoma, graft failure, and inflammation |
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Term
|
Definition
| fibrovascular intraepithelial growth around the cornea. three types. pannus crassus: thick with lots of vessels and very dense. pannus ciccus: dry glossy surface. pannus tenuis: thin with few vessels and light opacity. |
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Term
|
Definition
| occurs in the iris or pars plicata or both (ie iritis or iridocyclitis). iridocyclitis is the most common type of uveitis in herpes patients |
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Term
|
Definition
| inflammation of just the pars plana with signs in the vitreous |
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Term
|
Definition
| inflammation of the posterior segment such as chorioretinitis |
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Term
|
Definition
| inflammation of pretty much the whole globe |
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Term
|
Definition
| Uveitis, glaucoma, and hyphema syndrome. caused by an IOL rotating out of position. |
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Term
|
Definition
| inflammation of the uveal tract. presents with cells and flare, ciliary flush, photophobia, pain, miosis, PAS, decreased VA, keratic precipitates (fine or mutton fat and may coalesce into arlt's triangle), iris nodules, iris atrophy or dilated iris vessels, and IOP changes |
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Term
|
Definition
| nodules at the pupil border of the iris. associated with uveitis |
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Term
|
Definition
| nodules on the iris away from the pupil border associated with uveitis |
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Term
|
Definition
| uveitis caused by low lying retinal detachments |
|
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Term
|
Definition
| accumulations of vitreous white cells in the inferior vitreous just before the retina. May be referred to as snow banking if it occurs near the pars plana |
|
|
Term
| posner-schlossman syndrome |
|
Definition
| Also known as glaucomatocyclitic crisis. trabeculitis caused by cataract surgery. low grade uveitis that is unilateral and more common in men. Also have corneal edema, IOP spikes, and small/fine keratic precipitate. |
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Term
|
Definition
| complete posterior synechia 360 causing pupillary block (seclusiopupillae) and a buildup of pressure causing a protrusion of the iris. |
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Term
|
Definition
| HLA-B27 positive disorder that occurs in young adult males. Causes sacroiliac fusino (fusion of the vertebral column) which causing an arched spine and lower back pain. can cause bilateral uveitis with tons of flare to the point of plasmoid aqueous |
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|
Term
| inflammatory bowel disease |
|
Definition
| chronic intermittent diarrhea alternating with constipation. causes acute uveitis |
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Term
|
Definition
| can't see (bilateral uveitis and keratitis or mucopurulent conjunctivitis) can't pee (urethritis) can't climb a tree (polyarthritis). Also HLA-B27 positive and in young men. |
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Term
|
Definition
| Uveitis (usually iritis) occuring in people who have both psoriasis and arthritis. |
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Term
|
Definition
| leaking of lens material causes an immune response. happens in incomplete cataract surgery or hypermature cataracts |
|
|
Term
| juvenile-rheumatoid arthritis |
|
Definition
| occurs mostly in young females and causes a bilateral chronic non-granulomatous iritis. The iritis can present before arthritis symptoms. Present as asymptomatic (no ciliary flush!). May also have band keratopathy. Three types (pauciarticular=most common mostly girls ANA +, polyarticular=mostly girls, more joints affected, ANA+, still's disease=rarest, systemic, equal M/F, fever, ANA- and no associated uveitis) |
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|
Term
| fuch's heterochromiciridocyclitis (fuch's uveitis syndrome) |
|
Definition
| chronic unilateral non-granulomatous uveitis (iritis) where stroma of one iris thins and causes transillumination defect (lighter iris). Iris will also have blunt (flat) features. Tend to have fine stellate keratic precipitates that distribute diffusely across the endothelium. may also have glaucoma, cataracts, or vitreal opacities. may also have bleeding in the angle (amsler sign) |
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Term
|
Definition
| sexually transmitted disease. presents in the secondary stage with maculopapular rash on the palms/soles of feet and other symptoms that bring them to us. have iris roseola (vascular papules on the iris that look pink). also has interstitial keratitis and ghost vessels. causes chronic granulomatous uveitis (either panuveitis or iritis both severe). the panuveitis has salt and pepper fundus appearance, flame hemes, vascular sheating, and chorioretinitis. they also can't feel their feet on the group (tabesdorsalis) |
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Term
|
Definition
| causes a chronic granulomatous uveitis (usually iritis). may also cause phylectenules, conj. nodules, interstitial k, scleritis. often feel weak, have night sweats and cough up blood :/ |
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Term
|
Definition
| masquerades as a posterior uveitis that doesn't respond to treatment |
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Term
|
Definition
| masquerades as a bilateral uveitis that doesn't respond to treatment. confirm with CBC. May also have heterochromia, hyphema and glaucoma. |
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Term
|
Definition
| uveitis secondary to scleritis |
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Term
|
Definition
| fungal infection that causes unilateral panuveitis. most common infectious retinitis cause in the immunocompetant!looks like headlights in the fog (dense yellow lesion seen through clouded vitreous). Presents usually around age 25 test with sabin-feldman dye test |
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Term
|
Definition
| infection transmitted by dogs that presents between ages 2-9 usually and causes a white pupil. can cause uveitis. |
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Term
|
Definition
| unilateral granulomatous uveitis with associated vitritis. (if bilateral called BARN). associated with herpes simplex and zoster |
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Term
|
Definition
| triad of symptoms: bilateral iritis (maybe affecting posterior segment), apthous stomatitis (ulcer of the oral mucous), and genital ulcers. Have a +pathergy test |
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Term
|
Definition
| a treponemal infection transmitted by ticks that can cause acute non-granulomatous uveitis. has a +FTA-ABS test. show a target skin rash and may also have optic neuritis, meningitis, or encephalitis |
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Term
|
Definition
| systemic granulomatous disorder affecting mostly young black men or old while women. bilateral chronic granulomatous uveitis which typically causes dense posterior synechiae. can also form granulomas in the lungs and lymph nodes. often present with mutton fat precipitates and busacca nodules. may also have vascular sheating that look like candle wax dripping, vitreous snowballing, bilateral hilar lymphadenopathy (swollen chest lymph nodes), and lupus pernio (purple "lupus" which is swelling of extremitis) |
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Term
|
Definition
| t-cell mediated melanocyte issue. causes severe bilateral granulomatous panuveitis that can become a smoldering low grade uveitis over time. have vitiligo, polisos, deafness, and multiple serous retinal detachments. (if skin signs and uveitis only, just VK. If only neurological stuff just Harada syndrome) |
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Term
|
Definition
| local inflammation of the episcleral vessels. differentiate from conjunctival injection by using phenyl. may be idiopathic or related to TB, syphilis, RA or other collagen vascular diseases. Can be simple (diffuse or sectoral) or nodular |
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Term
|
Definition
| Inflammation of the deeper scleral vessels. More associated with systemic conditions (like RA) Looks similar to episcleritis but presents with pain, typically which radiates to the jaw. Upon resorption can cause scleral thinning. Can be anterior (diffuse,nodular, or necrotizing(vaso-occlusive, granulomatous,surgically induced)) or posterior |
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Term
|
Definition
| Necrotizing scleritis without inflammation. In elderly female patients with RA. Usually appears superiorly.Painless, rarely perforating, and can cause choroidal protrusion and large sections of scleral thinning |
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Term
|
Definition
| Idiopathic multisystem granulomatous disorder with small vessel vasculitis. Affects respiratory system/kidneys. Associated with necrotizing progressive granulomatous scleritis. May affect eye without systemic complications. |
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Term
|
Definition
| Idiopathic condition with small vessel vasculitis involving cartilage. Cause of intractable scleritis (necrotizing or non) |
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Term
|
Definition
| Collagen vascular disorder that affects medium sized and small arteries and causes aneurysms. Ocular involvement (scleritis) can precede systemic symptoms. |
|
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Term
|
Definition
| Dark gray areas over the muscle insertions. Normal finding in the elderly. |
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Term
|
Definition
| Anteriorly rotated ciliary processes which cause a protrusion of the base of the iris root crowding the angle. Appears as a narrow angle on van herick and demonstrates double hump sign on gonio. |
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Term
|
Definition
| Uneven pupil sizes. If aniso is bigger in bright light, the large pupil is the problem. If aniso worse in dim light the small pupil is the problem. Can be physiologic (same dim/bright), pharmacologic, mechanical (surgery/trauma and pathology) |
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Term
|
Definition
| Classic triad: meiosis(anisocoria where miotic pupil is the issue so worse in dim light), ptosis (including a reverse ptosis), anydrosis (if 1/2 order). May also have heterochromia. Problem with sympathetic innervation to face and eye. Diagnose with 10% cocaine or apraclonidine. Find lesion location with 1% hydroxyamphetamine. 1st order caused by brainstem issues (trauma, demylination, vascular), neck trauma, and spinal chord tumors. Second order caused by pancoast tumor, aortic dissection, and neck lesions (granular, trauma, post-surgical). Third order caused by internal carotid dissection, fistula, migraine, HZO, or otitis media. |
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Term
|
Definition
| Distortion of the pupil that is transient lasting less than a few minutes and occurring several times in a day or for weeks at a time. Caused by iris dilator spasm. Related to horner's, adie's and migraine. |
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Term
|
Definition
|
|
Term
|
Definition
| Usually in younger females. Pupil that is dilated (iridoplegia) in bright light and no or slow reaction to light but a slow reaction to accommodation which may be vermiform in nature. Caused by denervation of sympathetic supply to the sphincter muscle and ciliary muscle. Bilateral can occur but very rare (rule our perinauds which has restricted upgaze with nystagmus). Diagnose with 1/8 pilocarpine. Constriction is (+). Ass't with herpes infection, DM, and guillain-barre. Also related to diminished deep knee tendon reflex (Holmes-Aide's syndrome) |
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Term
|
Definition
| Small pupil reacts poorly/not at all to light but normal to convergence. Does not dilate well. Related to tertiary syphilis though DM and long standing aide's can mimic it. |
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Term
|
Definition
| Eye is down and out, pupil dilated, severe ptosis. Sudden and painful is usually caused by aneurysm of the posterior communicating artery. Potential of rupture and fatal hemorrhage into subarachnoid space! |
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Term
|
Definition
| Absolute afferent pupil defect.Blind eye due to optic nerve lesion, completely unresponsive directly. Pupil dilates when seeing eye occluded, but appears normal with both eyes open due to consensual response. |
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Term
|
Definition
| AkA marcus gun pupil. Incomplete optic nerve lesion or retinal disease diminishes pupil response to light directly. Mostly caused by different neuropathies and neuritis or a CRAO. |
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Term
|
Definition
| Posterior synchiae 360 (iris bombe) |
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Term
|
Definition
| A fibrotic membrane that covers the pupil (often due to long standing uveitis and plasmoid aqueous) |
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Term
|
Definition
| White pupil. Can be due to cataracts, retinoblastoma, ROP and others. |
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Term
|
Definition
| Neovascularization of the iris and angle. Associated with DM CRVO and ocular ischemic syndrome. Can lead to glaucoma and hyphema. If covering entire pupil its called Florid neo. |
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|
Term
| Pigment dispersion syndrome |
|
Definition
| Most common in myopic males. Posterior iris rubs against lens zonules which causes pigment to be removed which accumulates on the posterior cornea as a kruckenberg spindle. May have ITI, posterior bowing of iris (reverse bombe), pigmented AC cells and other pigment accumulations in the angle and on the lens . Can cause glaucoma (50%) |
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Term
|
Definition
| Can be the full iris (iridum) or just one iris with 2 colors (iridis). Can be congenital (if hypo=horner's, waardenberg,idiopathic. if hyper=nevus of ota, hemartoma) or acquired (hyper=tumor, siderosis. hypo=fuch's heterochromic iridocyclitis or acquired horners) |
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Term
|
Definition
| Darker pigment spots on iris |
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Term
|
Definition
| May look like an iris nevus but closer to an involving the pupil border. Often will drag the pupil, have intrinsic vascularity and color changes. May be amelanotic.May have multiple lesions (called tapioca appearance) More common in light eyes. |
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Term
|
Definition
| Circular white/gray nodules usually in an arc formation associated with Down's. |
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Term
|
Definition
| White/gray nodules in an arc formation that occur idiopathically |
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Term
|
Definition
| Lightly pigmented (brown) gelatinous melanocytic hamartomas on the iris (nodules). In 94% of NF1, typically found in inferior half of iris. |
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Term
|
Definition
| Dilated vein on the iris can lead to heme |
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Term
|
Definition
| Changes in the lens nucleus causing a yellowing an opacity. Grade 1 defined as the beginning of optical separation with or without yellowing. Grade 4 is brunescent (yellow/brown). Can have white NS which is white in color but very dense, typically are familial and progress more rapidly and are harder to remove. |
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Term
|
Definition
| Cataract changes in the lens cortex. Begin as water clefting and progress usually to a spoke or wedge like pattern. Often ass't with DM |
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|
Term
| Posterior subcapsular cataract |
|
Definition
| Glossy/spotty and highly reflective changes just beneath the posterior capsule. Affect near acuity more than distance. Can occur in DM, trauma or with steroid use. |
|
|
Term
| Anterior subcapsular cataract |
|
Definition
| Rare. May present with atopic dermatitis patients. Opacity under the anterior lens capsule |
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Term
|
Definition
| Typical DM cataract. Caused by acute blood sugar changes. Look like flecks of snow. |
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Term
|
Definition
| Multicolored, unilateral, reflective, in the deep cortex or nucleus. Ass't with myotonic dystrophy |
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|
Term
|
Definition
| Any cataract type where the lens is completely opaque |
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|
Term
|
Definition
| Cataract that has shrunken and wrinkled the anterior capsule and is losing water |
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Term
|
Definition
| Hypermature cataract that has a completely liquified cortex and a sunken nucleus (setting sun). Risk of immune response |
|
|
Term
| Anterior polar/pyramidal cataract |
|
Definition
| dense circular and well defined cataract on the anterior pole of lens. May protrude. Has reduplication. |
|
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Term
|
Definition
| Dense circular well defined opacity on posterior pole of lens. Has reduplication and can affect near acuity. |
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|
Term
|
Definition
| Bluish spot like cataract on posterior cortex. Ass't with coronary cataracts and other types and can be sectoral. |
|
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Term
|
Definition
| Multiple finger or bowling pin shaped opacities making a ring in the posterior cortex. |
|
|
Term
| Pulverulent/powder cataract |
|
Definition
| Hollow sphere with a central opacity involving fetal nucleus |
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Term
|
Definition
| Opacity of y suture. If congenital it is very well defined. If occurred later it is more stellate |
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Term
|
Definition
| Luminescent opacities between embryonic nucleus and anterior Y suture. Small dots or propellar shaped. Occur in 25% of people. |
|
|
Term
| zonular/lamellar cataract |
|
Definition
| U-shaped "riders" of opacity that surround the edge of the nucleus. |
|
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Term
|
Definition
| Opacity, typically on the anterior capsule, that looks like opacities in the following layers. Usually anterior to nucleus and caused by intrauterine or post-natal injury |
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Term
|
Definition
| antioer subcapular cataract that form a star like pattern. Side effect of long term use of an antipsychotic |
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|
Term
|
Definition
| Cataract caused by trauma. A feathery rounded opacity with central suture lines. can be early (occuring within weeks to months of the trauma) or later (occuring years later). Early ones tend to be more anterior whereas the late ones are usually direcly on top of the nucleus |
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Term
|
Definition
| Traumatic lens defect caused by the pigmented part of the iris pushing against the anterior lens. Leaves a circular pigment ring. |
|
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Term
|
Definition
| Small light brown, reflective, star shaped deposites on the anterior capsule. Remnants of the tunica vasculosa lentis |
|
|
Term
| Posterior capsular opacification |
|
Definition
| Aka prosterior capsular fibrosis. Opacification of the posterior capsule after cataract surgery. |
|
|
Term
|
Definition
| Remaining epithelium after cararact surgery that begins to proliferate and form pearl like opacities which can coalesce and impede vision |
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|
Term
|
Definition
| Infection inside the eyeball. BAD. Be on the lookout after surgeries for any hypopyon since this is a classic indicator. Refer out immediates for intavitreal antibiotics or vitrectomy |
|
|
Term
| Anterior capsular contraction |
|
Definition
| Post cataract surgery when the capsular rhexis (hole in the remaining anterior capsule) shrinks and opacifies |
|
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Term
|
Definition
| True versions are rare. Occurs when the lens delaminates as a result of intense infrared radiation. Results in the anterior capsule thickening and splitting into two, appearing to float |
|
|
Term
| Pseudoexfoliation syndrome |
|
Definition
| A result of systemic basement membrane disorder where the anterior lens capsule begins to deposit in flaky sheet like formations. Where the iris contacts the lens it will peel and where it doesn't will be clear (target pattern). Has a glaucoma risk. May have transillumination defects |
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|
Term
|
Definition
| Palsy of CN 7 due to inflammation, possibly viral related. Diagnosis of exlcusion. Differentiate from a space occupying lesion (cerebellopontine tumor). May have dry eye |
|
|
Term
|
Definition
| Eyelid muscle twitching (mueller's or ciliary portion of orbicularis oculi). If involving the superior oblique (SOM) will have diplopia, vertical nystagmus, oscillopsia. If myokymia accompanies a facial twitch they may have a brainstem disease or aneurysm |
|
|
Term
| Benign essential blepharospasm |
|
Definition
| Involuntary tonic spasm of the obicularis oculi. Can render patients functionally blind for a period of time. Varients = meige's (BEB with focal motor prob in the mouth) and breughel (BEB with mandibular and neck muscle involvement) |
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