Upgrade to remove ads
Sclera and Episclera
Terms in this set (89)
It is more common for scleral/episcleral pigmentation to occur in what patient population?
common to see a cuff of pigment around blood vessels: _ _ _, where they exit from the _ near the limbus
anterior ciliary artery
Pigmentation of the sclera/episclera occurs via
1. _ channels
2. migration of uveal _
The most commonly seen type of congenital ocular melanocytosis is: _ _
- involves both
skin and eye
Oculodermal melanocytosis is also commonly called: _ _ _
Nevus of Ota
Congenital ocular melanocytosis only involving the skin:
congenital ocular melanocytosis, least common, involves only the eye: _ _
Condition of hyperpigmentation of the
- sclera or deep episcleral
-multifocal, patchy bluish gray coloration with associated dark brown iris (unilateral) and a darker appearing ipsilateral fundus: _ _ _
Congenital Melanosis oculi
Congenital melanosis oculi
is most common in what population?
The major increase in pigmentation that occurs in
congenital melanosis oculi
occurs at what age?
Is there a treatment for congenital melanosis oculi?
If a Caucasian patient is found to have congenital melanosis oculi, what should be done?
risk for _ _ of choroid and for _ _
is 30 times more common in patient with: _ _
- long posterior ciliary nerve that partially or completely perforates the sclera, then returns to the inner surface of the sclera
- nerve accompanied by blood vessel
- appear as a pigmented blue-black dot
_ _ _ _ _
Intrascleral nerve loop of Axenfield
Scleral thinning translucency or "blue sclera" is usually a _____________ (benign/malignant) finding.
What is the pathophysiology of scleral thinning translucency?
_, _, and _ of the collagen structure
Scleral thinning translucency that occurs due to age and exposes the uvea is called: _ _ _
Senile Hyaline Plaque
Where on the eye are
Senile Hyaline Plaques
most likely to occur?
between either _ or _ _ and the _
lateral or medial recti
Condition of stretching or distention of only the sclera without involvement of the uveal tissue: _ _
- bulging of the sclera lined with uveal tissue
- dark blue appearance
Are anterior or posterior scleral staphylomas more common?
Posterior scleral staphylomas most often occur in patients who are: _ _
Tumors of the sclera occur when: _ _ _
Sclera may be secondarily affected by tumors of other structures.
Do not occur
Because scleral wounds heal slowly, scleral wounds should be _ early and securely covered by _ and _
Which is more
: scleritis or episcleritis?
Is Episcleritis malignant or benign?
Which is more painful: scleritis or episcleritis?
Which is more likely to be associated with systemic disease: scleritis or episcleritis?
Episcleritis usually self-limits to 1-7 days, but is often: _
Which patient population is most commonly affected by episcleritis? _
What decade of life? _
Which diseases/conditions are most commonly associated with Episcleritis?
- spontaneous/acute onset of redness
- pinkish flush - to - bright firey red
- mild discomfort
- mild photophobia
- tenderness on palpation
- watery w/o discharge
- no pain
80% of Episcleritis cases are of the _ variety and are frequently _
What type of episcleritis has these S&S:
- non-specific irritation (hot/pin-pricking)
- tenderness on direct palpation
- mild photophobia
- rarely involves entire globe
A) usually apex toward limbus & interpalpebral
B) anterior chamber rx rare
C) cornea unaffected usually
D) Vision normal
E) Episcleral edema (no scleral edema)
The injection pattern seen in episcleritis is usually:
In ________________________ (scleritis/episcleritis), the inflamed blood vessels move with the conjunctival blood vessels.
Treatment for Episcleritis:
- usually _ _
- OTC topical _
- more severe uses topical _ or oral _
- recommended _
20% of Episcleritis cases are _
- less common
- more severe
_ Episcleritis is more likely associated with systemic disease than _ Episcleritis.
This type of episcleritis: _
- round/ oval
- white (2-6 mm)
Signs of: _ episcleritis:
- injection may expand up to 180 degrees
- more resistant to treatment
- cornea not involved except
- scleral transparency
_ :part of cornea, thinned out, tears don't coat that spot well.
differential diagnosis for nodular episcleritis
treatment for nodular scleritis
- same as episcleritis
- rarely need to use NSAIDS or steroids
an episcleritis won't develop into a _ but a scleritis will have any overlying _
How to differentiate whether a pt has nodular episcleritis or pingueculitis:
- concurrent eye dz common
Look at pt's past exam records- did they have a pinguecula before?
Underlying systemic disease is associated with approximately _______% of episcleritis cases.
system associations with episcleritis: _
Gout & Episcleritis:
- 10% recurrent cases of episcleritis with -
- may have attacks of _
- control of _ acids levels may help
Take home message with episcleritis:
- looks worse than it is
- use _ for blanching conj/episclera
- r/o _
- if severe/recurrent/nodular/persistant: r/o systemic dz
Which patient population is most commonly affected by Scleritis?
Females, 4th-6th decades
Scleritis is bilateral in _ % of cases.
and associated with system disease _ % of the time
_ : composed of collagen + elastic fibers. subject to range of dz processes that affect CT elsewhere in the body; hence it's association with chronic joint dz
- inflammation of the sclera
- may result in severe destruction of ocular tissue
- loss of vision/paint/perforation of globe/loss of eye
_ _ :common cause of
and accounts for approximately 20-33% of all cases.
Which diseases/conditions are most commonly associated with Scleritis?
Hallmark system of
2. severe _
4. decreased _
_ _ makes up 98% of scleritis cases.
What are the 3 main subtypes of Anterior Scleritis?
Necrotizing (with and without inflammation)
The most common subtype (85%) of anterior scleritis is:
type of anterior scleritis is:
- gradual onset
- widespread inflammation
- BV's large/deep/dilated/tortuous/beaded
bluish-red, purple tinge
- BV's do not move with a cotton swab
do not blanch with 2.5% phenylephrine
what does the patient most likely have? _ _ _
Diffuse Anterior Scleritis
Diffuse Anterior Scleritis
- aggressive Tx necessary to avoid complications
- oral _
- topical _ : may provide relief but won't affect underlying dz
- systemic _ : if no responds with topical steroids & oral NSAIDs (40-80 mg daily), slowly taper
The most painful form of scleritis is: _ _ _
Nodular anterior scleritis
Nodular Anterior Scleritis
- _ color, firm nodule that
- sclera becomes _
Treatment of Nodular Anterior Scleritis:
1. _ _
2. _ _
3. _ _
Same as diffuse anterior scleritis:
Oral steroids if necessary
The most severe form of scleritis: _ _ _ _ _
Necrotizing anterior scleritis with inflammation
Symptoms of necrotizing anterior scleritis with inflammation:
- incapacitating _ that radiates
- 75% of cases develop _ impairment
- 25% of patients _
Most patients with necrotizing scleritis with inflammation are:
Females with longstanding history of rheumatoid arthritis
necrotizing anterior scleritis
- BV's appear _ or _
- Avascular _ _ appear
- bluish areas of underlying _ tissue, spreading around the globe
- Associated anterior _
severe vision threatening complications may develop
Treatment for necrotizing anterior scleritis with inflammation:
co-manage with internist/rheumatologist!!
Oral steroids (possibly IV)
Cycloplegic if pt has anterior uveitis
Necrotizing anterior scleritis without inflammation is also called: _ _
Which subtype of scleritis is 100% associated with systemic disease?
Necrotizing anterior scleritis without inflammation
Signs/symptoms of necrotizing anterior scleritis without inflammation:
No inflammation or pain
Initial sign= yellow necrotic scleral patch
Thinning, melting, and loss of sclera due to occlusion of deep vascular network.
Exposure of underlying uveal tissue
May form staphyloma if IOP is elevated
Treatment for necrotizing anterior scleritis without inflammation:
No effective treatment
Ocular complications of necrotizing anterior scleritis without inflammation:
Scleral thinning- possible staphyloma formation
ocular complications 60%
_ complications are seen in 37% of necrotizing anterior scleritis without inflammation cases.
corneal complications w/ necrotizing anterior scleritis w/o inflammation:
1. acute _ _ : opacities
2. limbal _ : thick & grey
3. sclerosing _: corneal thinning
4. peripheral _ _: corneal melting
- patient has a considerable amount of ocular
with no visible signs and rapid onset of hyperopia, you should suspect: _ _
About 85% of patients with posterior scleritis develop: _ _ _
Permanent visual loss
symptoms of posterior scleritis.
external signs of posterior scleritis
1. eyelid _
3. _ of _ _
4. _ _
restriction of eye movements
Fundus signs of a posterior scleritis:
Exudative retinal detachment
B-scan ultrasonography of the posterior segment in a patient with posterior scleritis will show:
CT: shows posterior _
Thickening of posterior sclera with fluid in Tenon's space
Differential Diagnosis for scleritis:
All scleritis patients should be referred for:
In all cases of episcleritis and scleritis, you should consider the underlying cause to be due to _ _ until proven otherwise.
all classes of microbial organisms can cause: _ _
These condition can increase risk:
- surgical procedures
- CL wear
- recurrent herpes simplex/zoster
THIS SET IS OFTEN IN FOLDERS WITH...
Assessment of Head & Neck Part 1: Intro to Dermato…
Assessment of head and neck part II
Assessment of Head & Neck part III
YOU MIGHT ALSO LIKE...
Pathology of the Eye
perio quiz 11/30
Ocular Disease Exam II
DHY 1410 Oral Pathology Chapter 2
OTHER SETS BY THIS CREATOR
PA: Critical Values
5. Peripheral Retinal Disorders
3. Non-Diabetic Retinal Vascular Disease
1. Diabetic Retinopathy