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Clinical Manifestation of Eye Disease

Pain : - many different types

- conjunctival / corneal : associated with itching, burning +photophobia

- >> : glaucoma

Visual Disturbances- decreased visual aquity (amblyopia)

- spots / halos : cataract / glaucoma- diplopia : eye muscle disfunction

Discharge- increasing tearing ( eg. : allergic)

- microscopic : inflam.cells / viral or chlamydial inclusions

Change in Appearance :

strabismus (muscle imbalance), hemorrhage, congestion, jaundice,

swelling, displacement (eg.proptosis), tumors

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The Eye Lid

Blepharitis : low grade inflammation

Hordeolum- acute suppurative inflam. of hair folicle : + sebaceous glands (Zeis) +

+ apocrine glands ( Moll)

- caused by Staph. aureus

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Chalazion

- involving meibomian glands

- cause by duct obstruction :- leading to retention of secretions

infection

chronic inflam.

( macrophages,

lymphocyte,

plasma cells)

- produces mass :

mistaken for a neoplasm

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The Conjunctiva & Cornea

Keratoconjunctivitis-inflam. of conjunctiva : conj.tis

-Inflam.of the cornea : keratitis

-frequently both involve : keratoconj.tis

Acute Bacterial Conj.tis- pain, hyperemia (vascular injection) :red eye,

- discharge (neutrophils)

- common : Neisseria, pneumococcus, Haemophilus aegyptus

- severe cases : ulceration, involves cornea : visual impairment

Opthalmia Neonatorum : infection of the fetus w/ N. gonorrhoeaeduring delivery through the birth canal

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Red eye ; OS>OD

Crusting on the lashes

Conjunctival injection with a follicular

conjunctivitis.

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Ciliary flush along the corneal limbus.

Follicles on the palpebral conjunctivae

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Viral Conj.tis: adenoviruses / herpes simplex virus

Inclusion Conj.tis- swimming pool conj.tis

- acute inflam. With pain, red eye, discharge

- histologically : accum.of lymphocyte in conj.

- caused by Chlamydiae : cytoplasmic inclusions in infected cells

in the exudate

- transmited : contaminated hands, shared towels, fetus by infected

birth canal

- self-limited : after few days

Corneal scar by recurent

herpes simplex keratitis

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Trachoma- serious Chlamydial infection

- long term destruction of the cornea

- non early treated : blindness

- acute inflam. progress to chronicepithelial hyperplasia + lymphocytic infiltration

+ pannus formation inflammed mass of granulation tissue

replaced superficial layers of the cornea blindness

Acanthamoeba Keratoconj.tis- caused by amoeba :Acanthamoeba, contaminated lens cleaning fluids

Allergic Conj.tis- vernal / spring conj.tis

- typically seasonal- + hay fever

- hstpl : goblet cell hyperplasia, lymphocyte and eosinophils infiltration

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PhlyctenularConj.tis

- delayed hypersensitivity response to Ag bacteria ( M.tuberculosis, S.aureus)

- elevated, hard, red triangular plaque at the limbus ulcerate

heals

( 2 weeks)

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The Eye Ball

Bacterial Infection- pyogenic bacteria (staph) :entry the eye ball by :

> penetrating injuries

> orbital cellulitis

> blood stream

- endophtalmitis or panophtalmitis

Toxoplasma Chorioretinitis

- Toxoplasma gondii choroid and retina

- Congenital or Acquired- hstpl : focal coagulative necrosis of retina / choroid + granulamatous

inflam. + fibrosis

Toxoplasma : crescent-shapes trophozoites / larger pseudocyst

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