Aseg exam 1 Facts

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Aseg exam 1 Facts
2012-01-31 23:50:34
Aseg exam Facts

Aseg exam 1 Facts
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  1. Microblepharon Facts
    vertical lid shortening (upper and lower)cause nocturnal lagophthalmus
  2. Congenital Entropion Fact and Location and Management
    • Fact: lid turns inward
    • Location/cause: Upper - microphthalmos; Lower - malformed retractor muscle
    • Management: Holtz
  3. BPES Facts and Types
    • Facts: narrowing of palpebral fissure vertically and horizontally
    • Type 1: female only, ovarian failure
    • Type 2: male and female
  4. Eyelid Coloboma Location
    Junction of middle and Upper middle 1/3 of lidSuperior: nasal and unilateral (Goldenhar syndrome)Inferior: lateral and bilateral (system abnormality, Treacher Collins, Amniotic bands)
  5. Congenital Upper Lid Eversion Facts
    • Present at birth
    • African Amercian
    • Down Syndrome
  6. Ctypthophthalmus Types
    • Complete: most common
    • Incomplete: usually remains fused medially
    • Symblepharon: usually remains used superiorly
  7. Ectropion Types
    • Involutional: Due to age (Most common cause in adults) (Laxity/sagging)(Usually lower lid)
    • cicatricial: Due to burns, trauma, or chronic inflammation; Associated with rosacea, chronic blepharitis
    • congenital: 2ndary to vertical shortening of skin
    • inflammatory: Atopic dermatitis; Herpes Zoster; Rosacea
    • mechanical: 2ndary to edema, lid tumors
    • paralytic: CNVII; Bell’s Palsy
  8. Entropion Types
    • congenital: Dysgenesis of the lower eyelid retractors orstructural defects in the tarsal plate; Tarsal Kink Syndrome; Upper lid
    • Acute Spastic Entropion: Spastic closure of the eyelids allows the orbicularis oculi muscle to overcome the lower lid retractors
    • Involutional: Involution of the posterior lid retractors; Similar to spastic; Digital eversion of the lid is easy; Involution of the soft tissues of the orbit may lead to involutional enophthalmos and the entropion
    • Cicatrical: scar tissue of the conjunctiva; digital eversion of the lid is difficult; results from - trauma, chemical burns, Stevens-Johnson's sydrome, ocular cicatrical pemphigoid (OCP), infections, topical medication
  9. Microphthalmos Types
    • Simple: no other malformations
    • Complex: associated coloboma
    • With cyst: optical stalk closure failure leading to orbital cyst with associated cleft syndromes
    • Posterior: decreased TAL, but normal corneal diameter (hyeropia)
  10. Crouzon Facts
    • coronal and sagittal sutures fuse early
    • brachycephaly and mandibular prognathism -> broad and concave appearance
  11. Pfeiffer System signs
    • underdeveloped midface
    • webbed fingers
    • dental problems
    • hearing loss (50%)
  12. Apert Systemic signs
    • oxycephaly
    • midfacial hypoplasia
    • Cleft palate
    • syndactyly
  13. Goldenhar Facts
    • congenital
    • from fetal vascularaccident with anomalous branchial arch dvlpment
  14. Treachear Collins Facts
    • Mandibulofacial dystosis
    • Zygomatic bone fails to fuse with maxilla, frontal and temporal bones
    • small lower jaw
  15. Anterior Megalophthalmos Facts
    • megalocornea with enlarged lens
    • CB band wider than TM and SS on gonio
  16. Anterior Megalophthalmos Signs
    • Iris stretching
    • lens zonule stretchin
    • gpigment dispersion
    • lens subluxation
    • ectopia lentis
    • glaucoma
    • excessive mesenchymal tissue in angle
  17. Keratolenticular Dysgenesis Facts
    lens vesicle separates, but doesn't form correctly
  18. Sclerocornea Facts
    • nonprogressive
    • sceralization of the cornea
    • opaque collagen bundles
    • no inflammatory vascularization
  19. Posterior Keratoconus Facts
    • Steeper post corneal curvature
    • normal anterior corneal curvature
    • generally good vision
    • variation of Peter's anomaly
    • nonprogressive
    • no relation to keratoconus
  20. Posterior Keratoconus Types
    • Generalized
    • Circumscribed
  21. Congenital Anterior Staphyloma Facts
    • opaque cornea protroduces thru eyelids due to intrauterine keratitis
    • poor vision
  22. Anterior Lenticonus Facts
    • anterior conical protrusion of the center of the lens surface up to 3-4 mm
    • due to thin anterior capsule and fragile basement membrane
    • spontaneous rupture can occur
  23. Microspherophakia Facts
    • Lens is small and relatively spherical
    • increased antero-posterior thickness
  24. Lens coloboma Facts
    • not a true coloboma (no missing tissue)
    • segmental agenesis
    • lens shape chnges b.c of zonule attach
    • mentinferior flattening b.c CB colobom
    • acaused by cysts and/or tumors of CB
  25. Posterior Embryotoxon Facts
    Thickened, anteriorly displaced SL
  26. Alagille's Syndrome Facts
    • Axenfeld's + pigmentary retinopathy
    • has abnormal EOG and ERG
  27. Alagille's Syndrome Signs
    • Corectopia
    • Esotropia
    • Absent deep tendon reflexes
    • Post embryotoxon
  28. Rieger's Anomaly Facts
    • Axenfeld's anomaly + iris atrophy + corectopia +ectropion uvea
    • iris atrophy varies from mild to marked thinning
  29. Rieger's Sydrome Facts
    • Rieger's anomlay + dental, facial, cranial and skeletal abnormalities
    • mental retardation
  30. Peter's Anomaly Facts
    • development abnormalities of central anterior segment
    • iris strands may extend from collarette to the corneal scar
  31. Peter's Anomaly Signs
    • central corneal scar
    • absent or defective posterior stroma, descemet's and endothlium
    • corneal leukoma
  32. Peter's Anomaly Types
    • Type 1: no lens involvement (iris adhesion)
    • Type 2: lens involvement (cataract, abnormal lens position, corneo-lenticular adhesion)
  33. Mittendorf Dot Facts
    anterior remnant of the hyaloid artery as it joins the tunica vasculosa lentis
  34. Aniridia Facts
    • Congenital absence of the iris (can be partial)
    • total absence rare. stump often present
  35. Chalazion Facts
    • sterile granulomatous lesions caused by retained sebaceous secretion from meibomian glands
    • typically progression from hordeolum
    • may casue WTR astigmatism
    • may cause mechianical ptsosis
  36. Comedones Facts
    plug of keratin and sebum within dialted orifice of a hair follicle (black head and white heads)
  37. Epidermoid Cyst Facts
    • Proliferation of epidermal cells
    • any age, but most common in 30s-40s
    • discharge foul smelling
  38. Epidermoid Cyst Signs
    • firm, round, mobile, flesh-colored
    • superficial or subcutaneous
    • keratinized: most opaque of the cysts
  39. Cyst of Moll (apocrine hidrocystoma) Facts
    • abnormal proliferation of apocrine secretory sweat gland
    • mostly solitary
    • no seasonal changes
    • not more symptomatic in hot weather typically larger then eccrine
  40. Cyst of Moll Signs
    most translucent of the cysts
  41. Eccrine Hidrocystoma Facts
    • cystic lesions with a lining resembling that of the eccrine sweat gland
    • typically smaller than appocrine
    • increased prevalence in female
    • worsens in hot/humid weather
  42. Eccrine Hidrocystoma Types
    • Smith: single
    • Robinson: multiple
  43. Syringoma Facts
    • proliferation of intra-epidermal duct eccrine sweat gland epithelium
    • usually appears at puberty
  44. Cyst of Zeiss Facts
    blocked zeiss lash follicle gland
  45. Cyst of Zeiss Signs
    • non-translucent (may be sebaceous)
    • Keratin, degenerated epithelial cells, granulates of fat and cholesterin in CT sac
  46. Milia Facts
    • caused by occlusion of polosebaceous units
    • results in retention of keratin
    • tiny epidermoid cysts
  47. Squamous Cell Papilloma Facts
    • Most common benign eyelid growth
    • benign hyerplasia of the squamous epi
    • if cancerous it will change color, size, or show irregular margins
    • generic germ for any papilloma of non-viral origin
    • "papilloma" means benign epi lesion of skin or mucosa
    • usually in older patients (30-40)
    • de novo
    • also called Acrochordan (skin tag)
  48. Actinic Keratosis Facts
    • keratotic growth surrounds errythema
    • scaly appearance, red underneath
    • most common precancerous skin lesion
    • 25% develop squamous cell carcinoma
    • due to chronic sun exposure
  49. Seborrheic Keratosis (basal cell papilloma, senile veruca) facts
    • composed of basal intraepithelial cells
    • found in old pple
    • can be found all over body
  50. Viral Papillom (verruca vulgaris) facts
    • fibrovascular tissue
    • risk of malignancy
    • may resolve spontaneously
    • can be spread by contact or with excision
    • usually young pple, and pedunculated
  51. Inverted Follicular Keratosis Facts
    • non-pigmented papillomatous lesion
    • zones of squamous cells arranged in whrols
    • may grow rapidly
    • inflammatory variant of seborrheic keratosis
    • may be viral. not certain
    • mostly in males and old pple
  52. Keratocanthoma (molluscum sebaceum) facts
    • form of pseudoepitheliumatous hyperplasia
    • some classify as squamous carcinoma
    • appear in sun exposed areas
    • may resolve spontaneously
  53. Acquired Melanocytic Nevus Types
    • Blue Nevi: derived from dermal melanocytes, nevus cells located deep in dermis. uncommon
    • Compound: derived from epidermal melanocytes. nevus cells from epidermis into dermis. middle aged pts
    • Junctional Nevi: derived from epidermal melanocytes, cells at epidermal/dermal junction. younger ppl
    • Intradermal: dervied from epidermal malanocytes; cells confined to dermis only. older pple. MOST COMMON NEVI. papillomatous with little/no pigment. no malignant potential
  54. Congenital Melanocytic Nevus Facts
    • "kissing" or "split" nevus
    • very rare
  55. Nevus of Ota facts
    • ispilateral melanocytosis of sclera and uveal tract
    • can also be conjunctiva
    • usually CNV (V1 or V2)
    • low risk of malignancy
  56. Neurofibroma Types
    • Plexiform: kids wtih Neurofibromatosis 1
    • Solitary: adults, 25% with NF1
  57. Ephelias Fact
    • freckles
    • focal areas of cutaneous melanocytic over activity
    • no malignant potential
    • common with light complexions in sun-exposed areas
  58. Xanthelesma Facts
    • flat or slightly elevated, creamy yellow plaques composed of lipid histocytes and inflammation
    • most pple have normal lipid levels
    • if age 30 wth arcus and xanthelesma suspect Hyperlipidemia
  59. Port Wine Stain (venus flammeus) Facts
    • congenital, subcutaneous venular formation (dilated, blood filled space)
    • follows dermatomes
    • always present at birth
    • does not blanch
    • risk of glaucoma
  60. capillary hemangioma facts
    • hamartomatous growth of capillary blood vessels
    • proliferation of vascular channels in dermis and subcutaneous tissue
    • most common pediatric eyelid/orbital tumor (but still rare)
    • appears witin 1mo of age
    • rapid growth in 2 phases (peak 3-8mo)
    • may spontaneously involute after 1yr
    • "strawberry nevus"
    • females 3x more likely
    • blanches with pressure
    • may swell with crying
    • can have extraconal elements (muscle)
    • involvement of conj common
  61. Pyogenic Granuloma Facts
    • Red mass at site of chronic inflammation
    • collection capillaries
    • Bleeds readily
    • Hemorrhagic pyogenic granuloma (very red)
    • not pyogenic or granulomatous
  62. Basal Cell Carcinoma Facts
    • central ulceration
    • firm, pearly in color
    • nodular or flatter presentation
    • most common malignant eye tumor (90%)
    • locally invasive, rarely metastatic
    • typicall in males, older pple
  63. Basal Cell Carcinoma Location
    LL>UL>M canthus> L canthus
  64. Basal Cell Carcinoma Types
    • Nodular: "rodent ulcer" (most common)
    • Morpheaform: sclerosing (most invasive)
  65. Squamous Cell Carcinoma Facts
    • scaly, ulcerated
    • more of an erythematous plaque
    • often arise from actinic keratosis
    • less common than basal cell carcinoma
    • more aggressive than basal cell carcinoma
    • less than %5 of malignant eyelid tumors
    • 2nd most common tumor
    • low risk of metastasis
    • spreads through lymph noes (20%)
  66. Lentigo Maligna Facts
    • Hutchinson Freckle
    • uncommon (10% of cases)
    • old ppl, sun damaged skin infiltrates dermis and becomes malignant
  67. Sebaceous Cell Carcinoma Facts
    • very rare
    • highly malignant
    • most common age 50-70, mostly in females
    • pagetoid spread (uneven)
  68. Malignant Melanoma Facts
    • very rare (<1%)
    • rapid growth with color change
  69. Kaposi Sarcoma Fact
    • soft tissue sarcoma
    • vascular tumor
    • biolaceous nodule
    • nontender
    • very malignant if immunocompromised
  70. Trichiasis Cause
    • entropion (pseudo-trichaisis)
    • cicatrical eye disease: Steven-Johnson and ocular cicatrical pemphigoid where lid is scarred
    • Chronic blepharitis
    • inflammation
    • idiopathic
  71. Eyelash Ptosis Fact
    Upper lid lashes sag downward
  72. Distichiasis Facts
    • double row of lashes
    • ectopic lashes that grow posterior to or out of meibomian glands
    • normally softer, shorter and finer
  73. Distichaisis Congenital
    • rare
    • primary epithelial germ cell destined to differentiate into a specialized sebaceous gland of the tarsus develops into a complete pilosebaceous unit
    • distichiasis lymphadenopathy syndrome
  74. Distichiasis Acquired
    • Metaplasia and dedifferentiation of the meibomian glands to become hair follicles
    • most important cause = late stage cicatrizing conunctivitis associated with chemical injury, Steven-Johnson, and ocular cicatrical pemphigoid
  75. Trichomegaly Facts
    Excessive lash growth
  76. Trichomegaly Causes
    • AIDS
    • hypothyroidism
    • Latisse (Allergan)
    • Cyclosporin (restasis)
    • Prostaglandin Analog (glaucoma med)
    • Oculocutaneous albinism type 1
  77. Madarosis Facts
    loss of lashes, brow, or both
  78. Madarosis Causes
    • chronic blepharitis
    • sebaceous cell carcinoma
    • burn
    • trauma
    • trichotillomania
    • hypothyroidism
    • psoriasis
    • seborrheic dermatitis (assoc dry skin)
    • chemo
    • CT disease
    • malnutrition
    • Alopecia (hair loss)
  79. Poliosis Facts
    total absent of melanin in hair follicle of lash or brow