Ocular Anatomy and Allergic Eye Diseases
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Questions and Answers

What type of allergic eye disease is characterized by minimal changes and mainly symptoms from mast cell mediators?

  • Atopic keratoconjunctivitis
  • Contact dermatitis
  • Allergic conjunctivitis (correct)
  • Vernal keratoconjunctivitis

    • Which form of allergic eye disease is known for demonstrating more persistent symptoms?

  • Vernal keratoconjunctivitis (correct)
  • Seasonal allergic rhinitis
  • Mast cell activation syndrome
  • Allergic conjunctivitis

    • Which structures of the eye are mainly affected in allergic and immunologic diseases?

  • Ocular adnexa and bony orbit (correct)
  • Choroid and vitreous body
  • Iris and sclera
  • Retina and cornea

    • What is the thinnest portion of the bony orbit located medially associated with?

    <p>Medial rectus muscle</p> Signup and view all the answers

    Which allergic eye disease demonstrates the highest severity and chronicity?

    <p>Atopic keratoconjunctivitis</p> Signup and view all the answers

    What is the primary mediator involved in the symptoms of allergic conjunctivitis?

    <p>Mast cell mediators</p> Signup and view all the answers

    What is suggested about the connection of the eye to the central nervous system?

    <p>It has a direct connection.</p> Signup and view all the answers

    Which cell type is primarily involved in the allergic response within the eye?

    <p>Mast cells</p> Signup and view all the answers

    What is the primary source of mucin in the tear film?

    <p>Goblet cells</p> Signup and view all the answers

    Which of the following statements is true regarding the lipid portion of the tear film?

    <p>It is secreted from meibomian glands.</p> Signup and view all the answers

    How much tear volume does the surface of the eye typically have?

    <p>2.6 to 7.4 microliters</p> Signup and view all the answers

    What is the normal turnover rate of tears on the ocular surface?

    <p>12% to 16% per minute</p> Signup and view all the answers

    Which cellular structures contribute to the composition of the tear film?

    <p>Goblet cells, epithelial cells, and meibomian glands</p> Signup and view all the answers

    Which part of the eye is known for having an avascular and optically clear design?

    <p>Cornea</p> Signup and view all the answers

    What condition can alter the volume or composition of the tear film?

    <p>Inflammatory conditions</p> Signup and view all the answers

    Immunoglobulins diffuse into which part of the eye from the limbus?

    <p>Cornea</p> Signup and view all the answers

    What are the main components that constitute allergic eye disease?

    <p>Defined entities with an immunologic basis</p> Signup and view all the answers

    Which steroid administration schedule is considered beneficial for controlling symptoms?

    <p>Eight times per day for 7 to 10 days</p> Signup and view all the answers

    What potential side effects must be monitored during steroid use?

    <p>Cataract and glaucoma</p> Signup and view all the answers

    How often should topical mast cell stabilizers be administered in patients with perennial symptoms?

    <p>One to four times daily</p> Signup and view all the answers

    What should be done if an exacerbation occurs in a patient not using a mast cell stabilizer?

    <p>Initiate mast cell stabilizers and add topical steroids</p> Signup and view all the answers

    Which of the following is NOT a nonsteroid medication mentioned for symptom relief?

    <p>Prednisolone acetate</p> Signup and view all the answers

    What is the frequency of use recommended for topical steroids in an acute situation?

    <p>Eight times per day for 7 to 10 days</p> Signup and view all the answers

    Mast cell stabilizers have been shown to be effective for which symptoms?

    <p>Itching, tearing, and photophobia</p> Signup and view all the answers

    Which medication would be classified as a mast cell stabilizer?

    <p>Cromolyn</p> Signup and view all the answers

    How should the use of steroids be characterized in relation to chronic disease?

    <p>Transient and closely monitored</p> Signup and view all the answers

    Which of the following statements regarding mast cell stabilizers is true?

    <p>They can help with perennial symptoms.</p> Signup and view all the answers

    What is the most useful diagnostic tool for evidence of contact sensitivity of the eye?

    <p>Patch testing</p> Signup and view all the answers

    What is increased in the inflammatory cell infiltrate of the substantia propria in OCP?

    <p>Mast cell and fibroblast numbers</p> Signup and view all the answers

    What finding was demonstrated in electron microscopy studies of tissue specimens associated with OCP?

    <p>Basement membrane zone fragmentation and duplication</p> Signup and view all the answers

    Which treatment approach is recommended for OCP when possible?

    <p>Avoidance of offending agents and nonirritating medication substitution</p> Signup and view all the answers

    In treating OCP, what type of cream is preferred over ointment and why?

    <p>Low-potency steroid cream to reduce irritation</p> Signup and view all the answers

    What is the percentage of mast cells in the substantia propria that contain fibroblast growth factor (β-FGF)?

    <p>46%</p> Signup and view all the answers

    Which type of lymphocytes have been isolated from biopsy specimens of VKC tarsal conjunctiva?

    <p>CD4+ T cells</p> Signup and view all the answers

    What potential issue may arise from the use of antiviral agents for herpes simplex virus (HSV) infection?

    <p>Sustained epithelial toxicity</p> Signup and view all the answers

    What is a potential treatment consideration for recurrent episodes of epithelial HSV keratitis?

    <p>Oral acyclovir</p> Signup and view all the answers

    What inflammatory marker is expressed in T cell lines generated from VKC biopsy specimens?

    <p>IL-4</p> Signup and view all the answers

    In VKC, which substances are found associated with inflammatory cells in the substantia propria?

    <p>Various growth factors including PDGF and TGF-β</p> Signup and view all the answers

    What cells are increased in number in the substantia propria compared to normal tissue in conditions like VKC?

    <p>Eosinophils and basophils</p> Signup and view all the answers

    What happens to the corneal epithelial defects despite adequate control of signs and symptoms of AKC?

    <p>Reepithelization may be difficult to achieve</p> Signup and view all the answers

    What role does eosinophil major basic protein deposition play in VKC?

    <p>Stimulates fibroblast production</p> Signup and view all the answers

    What is the recommended use of artificial tears in relation to corneal punctate staining in AKC?

    <p>To aid in avoiding corneal epithelial defects</p> Signup and view all the answers

    Study Notes

    Introduction

    • The eye is a complex organ with diverse tissue types and direct connections to the central nervous system.
    • Allergic eye diseases exhibit varying severity, with conditions like allergic conjunctivitis (AC) showing minimal changes primarily due to mast cell mediators.

    Anatomy and Physiology of the Eye

    • Ocular anatomy includes the bony orbit, where the thinnest section is located medially.
    • Tear film components: mucin from goblet and epithelial cells, lipid from meibomian glands; normal tear volume ranges from 2.6 to 7.4 microliters.
    • Tear turnover rate is 12% to 16% per minute, essential for maintaining ocular surface health.

    Allergic Diseases of the Eye

    • Persistent forms of allergic conditions include atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC) which may lead to chronic symptoms.
    • Treatment strategies involve the use of topical steroids, which should be closely monitored to prevent side effects like cataract and glaucoma.
    • Nonsteroidal medications effectively alleviate symptoms such as itching and tearing.

    Treatment Approaches

    • Topical mast cell stabilizers are recommended year-round for perennial symptoms.
    • In acute exacerbations, mast cell stabilizers should be combined with a short course of topical steroids.
    • Corneal punctate staining may necessitate the use of artificial tears to prevent epithelial defects.

    Immunologic Implications

    • Eosinophils and basophils are significantly increased in VKC compared to normal tissue, along with a unique lymphocyte profile.
    • CD4+ T cells in VKC support IgE synthesis, indicating a localized immune response within the eye.
    • Increased fibroblast activity and collagen deposition mark significant inflammatory responses in conditions like AKC.

    Other Immunologic Diseases of the Eye

    • Contact dermatitis involves patch testing to identify irritants and sensitivities affecting the eye.
    • Treatment for ocular cicatricial pemphigoid (OCP) should involve a multidisciplinary approach to consider systemic involvement and collaborative management strategies.

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    Related Documents

    Allergic and Immunologic Diseases of the Eye PDF

    Description

    Test your knowledge on the anatomy and physiology of the eye, as well as various allergic eye diseases like allergic conjunctivitis and atopic keratoconjunctivitis. Understand the tear film components, their turnover rate, and treatment strategies. This quiz will assess your comprehension of complex ocular conditions.

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