,
pain
and physiology of sense organs)
Table of contents :
,
physiology
of tongue,
and diseases
of tongue),
physiology
of nose,
and diseases
of nose))
of the eye
: an encapsulated, circumscribed mass. The tumor is built up of fusiform
and spindle-shaped cells containing black pigmentation, with very few mitoses
and without necrosis.
: a distinctive, chronic inflammatory reaction in the orbital tissues of
the eye, of unknown etiology, that may closely resemble a neoplasm and
often becomes bilateral. Symptoms include exophthalmos
and congestion of the lids with edema. When limitation of ocular motility
also occurs, it is sometimes called orbital myositis
in children
(before age 5)
may develop
(vaccinophthalmia)of
the eyelidref
results from the interruption of the sympathetic supply to Muller’s smooth
eyelid muscle
: it innervates the levator palpebrae superioris.
on other skin areas
on other skin areas
on other skin areas
of the eyelid that usually occurs in groups
superciliorum : difference in color of the hairs of the 2 eyebrows.
: pilocarpine
eyewash
sometimes combined to vasoconstrictors
ophthalmic emulsion 0.05%
(xerosis parenchymatosa)
=> restrictive syndrome),
and occasionally accompanied by mental deficiency
(Graves' ophthalmopathy or orbitopathy) (90%)
(5%);
GR
agonists;
decompression => muscular surgery is required if compression of optic nerve
or corneal ulcers occur
(it innervates the levator palpebrae superioris muscle)
poisoningthey
are a.k.a. Frenzel eyeglasses). Look for nystagmus in median and
both lateral deviations (< 45° to prevent end-position
nystagmus / pseudonystagmus).
If it doesn't worse it probably has central origin.
and marked by impaired lateral conjugate gaze.
(30%)
(gonorrheal ophthalmia) (14%)
(10%) (also chronic catarrhal conjunctivitis)
(also acute membranous conjunctivitis)
=> acute mucopurulentous, pseudomembranous (in immunocompromised hosts)
or subacute catharral conjunctivitis
=> chronic catarrhal conjunctivitis=>
angular
conjunctivitis with surrounding dermatitis and fissuration
=> acute membranous conjunctivitis (hemorrhages at detachment)
=> acute membranous conjunctivitis in immunocompromised hosts
(leptotrichosis conjunctivae)
(scrofulous ophthalmia).
The acute phase of EKC is usually over within 2 weeks, but corneal opacities
may remain for months or even years.
,
800 mg antibacterials every 4 hrs (topical => systemic if severe keratitis),
lymphadenopathy
)ref1,
ref2
infection : with subconjunctival haemorrhage and periorbital ecchymosisref
(acute hemorrhagic conjunctivitis)ref1,
ref2refrefref.
and may progress to xerophthalmia and keratomalacia
and osteosclerosis)
or a bacterial infection but sometimes is idiopathic
deficiency, generally associated with uveitis, and characterized by minute
gray epithelial flecks.
and marked by extensive denudation of the corneal epithelium,
sometimes leading to ulceration
(photokeratitis / actinic keratitis)
(in children under age 15)
(trachoma / Egyptian ophthalmia / granular ophthalmia / trachomatous
keratitis / pannus trachomatosus)
rejection.
(herpes zoster ophthalmicus
(HZO); keratoconjunctivitis accompanied by iridocyclitis)
(vaccinial
keratitis)
(aspergillus keratitis)
(Acanthamoeba keratitis; it is usually associated with soft
contact lens wear, particularly overnight wear)).
(ulcus serpens corneae / pneumococcus ulcer / Saemisch's ulcer / serpiginous
corneal ulcer : an ulcer of the cornea; a creeping central suppurative
ulcer of the cornea)
(29.4%)
(23.5%)
preserving Descemet's membrane and endothelium of recipient's cornea in
young patients.
(a type of nonsyphilitic interstitial keratitis)
(relapses occur)
.
It begins with xerotic spots (Bitôt's spots)
on the conjunctiva, while the cornea becomes xerotic and insensitive (xerotic
keratitis); as the condition progresses, the haze increases until finally
the entire cornea becomes soft, and colliquative necrosis occursref.
The partial response to hydroxyamphetamine in the two cases presented may
reflect trans-synaptic degeneration of the postganglionic neuron. A reduction
in trophic influences on iris melanocytes may have contributed to the observed
heterochromiaref
of the iris, occurring in neurofibromatosis
(rubeosis iridis diabetica)
: ACh
(used only during eye surgery as normally it is hydrolyzed before arriving
in anterior chamber), pilocarpine,
clonidine,
cholinergic drugs, ...
(organophosphates), opiates, phenothiazines
: guanethidine, timolol,
sedatives and hypnotics) cause flaccid paralysis of iris dilator
: phenylephrine,
adrenalin,
cocaine,
amphetamines,
ephedrine,
...) cause spastic paralysis of iris dilator
(60-75%; circular portion > longitudinal portion), M2
(5-10%; circular portion > longitudinal portion), M4
(5-10%), and M1
(7%), and M5
(5%; longitudinal portion > circular portion) antagonists) cause flaccid
paralysis of iris sphincter
(60-75%), M2
(5-10%), and M4
(5-10%) antagonists) : these drugs also cause cycloplegia
(iridocycloplegia) by inducing flaccid paralysis of ciliary muscles
=> loss of visual acuity in hypermetropic patients|
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cycloplegia | mydriasis | cycloplegia | ||||
| atropine / dimethyl
scopolamine |
multi-dose eye-drops 0.5%, 1%
Single-dose eye-drops 1% Eye ointment 1% Mydricaine injection * |
9.8 | 30–40 minutes | 1 day | 7–10 days | 2 weeks | anterior uveitis
cycloplegic refraction suppression amblyopia |
| cyclopentolate |
multi-dose eye-drops 0.5%, 1%
Single-dose eye-drops 0.5%, 1% |
8.4 | 15–30 minutes | 15–30 minutes | 24 hours | 24 hours | anterior uveitis
cycloplegic refraction fundus photography and ophthalmoscopy |
| homatropine |
multi-dose eye-drops 1%, 2%
Single-dose eye drops 2% |
9.9 | 30–60 minutes | 30–60 minutes | 1–2 days | 1–2 days | anterior uveitis |
| tropicamide | multi-dose eye-drops 0.5%, 1%
Single-dose eye-drops 0.5%, 1% |
5.4 | 15–30 minutes | 25 minutes | 4–6 hours | 6 hours | ophthalmoscopy and fundus photography |
(accompanied by herpes keratitis)
(Förster's uveitis; pseudohypopyon)
(nodular iritis => tubercolomas)
(chronic granulomatous iridocyclitis).
The minimum follow-up was 10 years. The presenting findings were cyclitis
in 3 of the patients and heterochromia iridis associated with blepharoptosis
in the other 2ref
(chorioretinitis and choroid
coloboma)
(chorioretinitis in immunocompromised hosts)
(miliary choroiditis, disseminated choroiditis)
(toxoplasmic chorioretinitis or retinochoroiditis / ocular toxoplasmosis
: a unilateral or bilateral condition)
(ocular histoplasmosis
syndrome (OHS)) : macular hemorrhagic choroiditis of the young adultref
(asymptomatic focal chorioretinitis)
=> exudative choroiditis : that which is characterized by scattered
patches of an exudate
(rubella cataract)
or nuclear radiations
or IR rays
(assessed with biometry) implantation (=> pseudoaphakia)
: .
Postcapsular
fold is treated with laser lysis
=> increased [Glc]aqueous humor => swelling
(diabetic cataract) : rare, usually
bilateral, opacity shaped like a snowflake, affecting the anterior and
posterior cortices of young diabetics. Sometimes it can be reversed when
the blood glucose is brought under control, but in most cases it progresses
rapidly to a mature cataract.
(galactosemic cataract) : increased
sorbitol => opacities look like oil droplets, are bilateral, and are zonular
or nuclear.
(hypocalcemic cataract) : punctate,
sometimes cerulean, opacities, initially subcapsular, becoming lamellar
(sunflower cataract) : a brightly
colored, usually red anterior capsular opacity with a sunflower pattern;
it has little effect on vision and clears after treatment with penicillamine.
and in ethanol
addicted
(atopic cataract)
(mongoloid myopia)
(sunflower cataract)
(heat cataract / thermal cataract / glassblowers' cataract).
Tyrosinase
acts as a modifier gene.
often causes rejection and lymphomas.
.
After 6 weeks of use 40% experience ocular hypertension (corticosteroid
responders : 5% > 31 mmHg, 35% between 22 and 30 mmHg)
(except macula)
,
headache,
folds in Descemet's membrane ; conjunctival and perikeratic injection
: tonometric curve : measurement of intraocular pressure (IOP) at
11-13 and 21-23 => ocular hypertension (intraocular pressure
(IOP) > 21 mmHg).
inhibit mydriasis and production of aqueous humor
(side effets : asthma, bundle branch block)
(side effects : uveitis)
(side effects : cataract)
(side effects : hypokalemia)
(20% of lymphomas : compared with PIOL, metastatic systemic lymphomas have
a much lower prevalence, better prognosis, and are less likely to create
a diagnostic dilemma), breast
carcinoma
and lung carcinoma
for women and lung
carcinoma
and gastrointestinal carcinoma
for men most commonly metastasize to the eye and orbit. The short-term
prognosis for vision is usually good after an individualized therapeutic
approach (chemotherapy, hormonal therapy, external
beam radiotherapy (EBRT),
or plaque radiotherapy), but the systemic prognosis is poor.
(removal of the eyeball),
patent
ductus arteriosus (PDA),
and other congenital cardiac anomalies.
of the central artery of the retina => amaurosis
fugax
+ antiaggregants
+ GR
agonists
(high PO2 in incubators for premature
infants)
by PlGF-1
is a selective strategy for preventing oxygen-induced retinal ischemia
without provoking retinal neovascularization. ROP is different from other
pathologies of abnormal vessel regression in that the vessels eliminated
are immature and hence VEGF dependent
=>
infection; it is manifested by transient cotton-wool
spots, and occasionally hemorrhages, microaneurysms, and other lesions
of the microvasculature
(copper-wire arterioles),HIV-associated
retinopathy, and numerous other conditions => hard exudate
,
with paleness of the fundus resulting from infiltration of the retina and
choroid with leukocytes, and swelling of the disk with blurring of its
margin
(prevalence = 100% of all DM patients since > 20years; 80% in type I DM
(incidence = 25% within 5 years, 80% withihn 15 years), 60% in type II
DM)
is contraindicated to avoid damaging of remaining normal blood vessels
therapy.
to the centre of circinate exudate (corresponding to leaking vessels),
sparing interpapillomacular tractref.
The development and progression of DR is related to blood glucose concentration
and is slowed by intensive glycemic controlref1,
ref2.
The mechanisms by which elevated blood glucose concentrations cause DR
and DME remain incompletely understood. Substantial evidence suggests that
hyperglycemia-induced synthesis of diacylglycerol results in the activation
of PKC, which plays a central role in mediating diabetes complications
in the eye and elsewhere in the bodyref.
PKC is a family of ~13 enzymesref,
of which the b-isoform has been most closely
linked to the development of diabetic microvascular complicationsref.
Diabetes-induced activation of PKCb appears
to mediate increases in retinal vascular permeability and neovascularization
in animal modelsref1,
ref2,
ref3
and changes in retinal blood flow in diabetic patients. PKC activation
is important in the intracellular signaling of VEGF, which is hypothesized
to be a principal mediator of retinal neovascularization and permeability
in diabetesref1,ref2,
ref3.
Ruboxistaurin (RBX) is a PKCb isozyme-selective
inhibitor that is orally bioavailable and has been shown to ameliorate
the adverse effects of high glucose in a number of animal models of diabetic
microvascular complications, including DR, DME, diabetic peripheral neuropathy,
and diabetic nephropathyref1,
ref2,
ref3,
ref4,
ref5,
ref6.
Early safety studies indicated that RBX was well tolerated in individuals
with diabetes and reached the retina in bioeffective concentrations as
evidenced by an amelioration of diabetes-induced retinal blood flow abnormalities.
The Protein Kinase Cb Inhibitor Diabetic Retinopathy
Study (PKC-DRS) reported here was a randomized clinical trial that evaluated
the effect of three orally administered doses of RBX on DR progression.
=> preretinal neovascularization starting from temporal archs, becoming
fibrous (and hence with hematoretinal barrier detected at angiography)
with time; the optic disk may project into the vitreous
(rubeosis retinae diabetica), and usually leading to tractional
retinal detachment
with probes via pars plana
and leukemia.-associated
retinopathy (MAR) is thought to affect bipolar cell function
(1q25-31, the ARMD1 locus) that binds heparin and C-reactive protein (1q25-31,
the ARMD1 locus), leading to excessive inflammation that ultimately destroys
cells in the macula and causes blindness, could explain 43- 50% of the
variation between people who develop AMD and those who don't (RR = 2.7
in heterozygous, 7.4 in homozygous; OR = 2.45-5.57)ref1,
ref2,
ref3
(also burns normal retina) only if the neovascular membrane doesn't involve
fovea
3-4 times a year
(abundant in the vitreous of PVR patients) is believed to play a pivotal
role in progression of PVR through stimulation of ECM production, contraction
of cellular membrane, and induction of inflammation. PVR is characterized
by formation of fibrovascular membranes within the vitreous cavity
above and beneath the retina. These membranes cause subsequent tractional
retinal detachement, resulting in
serious vision problems.
if bilateral
+ cryotherapy)
and deafness developing later
procedures / scleral buckle : biological or synthetic belt-shaped exoplants
are inserted in the orbit and tightened around the globe's equator to inwardly
depress the sclera until its inner layers contact the retina
: laser beam is directed into the eye through the pupil onto the fundus
where the heat resulting from the absorbed laser light coagulates the retinal
tissue. This thermally damaged region is highly scattering and appears
as a white disk.
retinopathy
retinopathyref
(20%; bilateral if from temporal arteritis (33%); 30% develop unilateral
blindness, 20% bilateral blindness, and 15% ophthalmoplegia)
of internal carotid artery, ophthalmic artery of posterior ciliary arteries
(75%),
diabetes
mellitus,
panarteritis
nodosa,
systemic
lupus erythematosus (SLE)
(5%).
in nonarteritic PION, soon after the onset of visual loss, resulted in
significant visual improvement compared to the untreated cases, but not
in arteritic and surgical PION.
(Graves' ophthalmopathy) causes fibrosis of extraocular muscles (expecially
inferior rectus muscle), preventing retraction,
accommodation failure requires lenses that cause exotropia
,
...,
dry or irritated eyes, excess tearing
(only if visual axis is parallel to optic axis, hence low sensitivity)
with rotating bars
with bars on a white background
with the Nd:YAG laser
Copyright © 2001-2005 Daniele Focosi.
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