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Ch29-Eye - Pathology of the Eye Eye John R Minarcik M.D...

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Pathology of the Pathology of the Eye Eye John R. Minarcik, M.D. John R. Minarcik, M.D.
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Outline and Introduction SECTIONS 1. Orbit 2. Eyelid 3. Conjunctiva 4. Cornea 5. Uvea 6. Lens 7. Retina/Vitreous 8. Optic Nerve/Glaucoma
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Intro - Basic Anatomy
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THE ORBIT Anatomy Thyroid Orbitopathy Tumors Inflammation/Infection Trauma
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Orbit - Anatomy Bones of the orbit Sphenoid Maxillary Ethmoid Lacrimal Zygoma Palatine Frontal
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Orbit - Osteology
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Orbit – Posterior Contents The ANNULUS OF ZINN is the tendon- ring that encircles the ON and acts as an origin for the muscles.
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Orbit – Anterior Boundary The ORBITAL SEPTUM is the anterior fascial boundary to the orbit
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Thyroid-Related Orbitopathy (Graves’ Disease) Autoimmune condition, triggered by TSH-R Antibodies, with lymphocytic infiltration, FIBROSIS, and ENLARGEMENT of extraocular muscles. Proptosis, strabismus/muscle-restriction, exposure problems (dry-eye), and compressive optic neuropathy. Treated with steroids, radiation therapy, or surgical decompression (opening the orbital walls into the sinuses)
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Orbit – Thyroid-Related Orbitopathy
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Orbit - Tumors Wide variety of lacrimal, lymphoid, neural, vascular, meningeal origin tumors, and metastatic tumors Children –rhabdomyosarcoma is the most common primary malignancy of orbit . neuroblastoma is most common metastatic tumor
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Orbit - Inflammation Orbital Cellulits frequently extends from adjacent sinus infections, or periocular trauma. A life and sight threatening emergency! Can extend into the cavernous sinus, and brain. “Pre-Septal” vs. “Post-Septal” can be distinguished by involvement of intraorbital structures
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Orbit - Inflammation
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Orbit - Trauma “Blow–out” fractures occur when blunt trauma to the eye causes the orbit to rupture Orbital Floor fractures can cause restricted upgaze if there is muscle entrapment
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LIDS - Anatomy LAYERS: Skin Orbicularis Tarsal plate Meibomian glands Palpebral conjunctiva
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LIDS - Histology
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LIDS - Tumors Malignant Basal cell carcinoma - most common Squamous Melanoma Sebaceous cell carcinoma Benign Chalazion vs. Hordeolum Papillomas/Verrucae Epidermal inclusion cysts Many others…
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LIDS - Tumors Chalazion – a cyst of the meibomian gland Hordeolum – an inflammed cyst of the MG (foreign body granuloma)
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Conjunctiva Thin, non-keratinized skin covering the sclera (bulbar) or the inner surface of the lid (palpebral) Rich in goblet cells, which secret the mucinous components of the tear film
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Conjunctiva The bulbar layer is continous with the palpebral layer
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