8. Phthiriasispalpebrarum Infestation of lashes by pubic crab louse and its ova (nits) Typically affects children in poor hygenic conditions
9. Staphylococcal blepharitis Chronic irritation worse in mornings Hyperaemia and telangiectasia of anterior lid margin Scarring and hypertrophy if longstanding Scales around base of lashes (collarettes)
10. Complications of staphylococcal blepharitis poliosis madarosis trichiasis Recurrent styes Marginal keratitis Tear film instability
29. Molluscumcontagiosum Painless, waxy, umbilicated nodule May be multiple in AIDS patients Chronic follicular conjunctivitis Occasionally superficial keratitis
30. Xanthelasma Common in elderly or those withhypercholesterolaemia Yellowish, subcutaneous plaques containing cholesterol and lipid Usually bilateral and located medially
31. Eyelid cysts Cyst of Moll Translucent On anterior lid margin Cyst of Zeis Opaque On anterior lid margin
32. Viral wart (squamous cell papilloma) Most common benign lid tumour Raspberry-like surface
33. Keratoses Seborrhoeic Actinic Common in elderly Affects elderly, fair-skinned individuals Discrete, greasy, brown lesion Most common pre-malignant skin lesion Flat ‘stuck-on’ appearance Rare on eyelids Flat, scaly, hyperkeratotic lesion
34. Keratoacanthoma Uncommon, fast growing nodule Acquires rolled edges and keratin-filled crater Involutes spontaneously within 1 year
35. Naevi Elevated Flat, well-circumscribed Has both intradermal and junctional components May be non-pigmented Pigmented No malignant potential Low malignant potential
37. Basal Cell Carcinoma - Important Facts 1. Most common human malignancy 2. Usually affects the elderly 3. Slow-growing, locally invasive 4. Does not metastasize 5. 90% occur on head and neck 6. Of these 10% involve eyelids 7. Accounts for 90% of eyelid malignancies
38. Nodular basal cell carcinoma Shiny, indurated nodule Slow progression Surface vascularization May destroy large portion of eyelid
40. Sclerosing basal cell carcinoma Indurated plaque with loss of lashes Spreads radially beneath normal epidermis May mimic chronic blepharitis
41. Squamous cell carcinoma Nodular Ulcerative Less common but more aggressive than BCC No surface vascularization
42. Meibomian gland carcinoma Hard nodule; may mimic chalazion Very large tumour Diffuse thickening of lid margin and loss of lashes Conjunctival invasion; may mimic chronic conjunctivitis
43. Melanoma Plaque with irregular outline Blue-black nodule with normal surrounding skin May be non-pigmented Variable pigmentation
44. Kaposi sarcoma Vascular tumour occurring in patients with AIDS Usually associated with advanced disease Very sensitive to radiotherapy
73. Conjunctival melanoma From naevus Primary From PAM with atypia Very rare Most common type Solitary nodule Sudden appearance of nodules in PAM Frequently juxtalimbal but may be anywhere Sudden increase in size or pigmentation
96. Fungal keratitis Frequently preceded by ocular trauma with organic matter Greyish-white ulcer which may be surrounded by feathery infiltrates Slow progression and occasionally hypopyon
97.
98. Symptoms worse than signsPerineuralinfiltrates (radial keratoneuritis) Small, patchy Anteriorstromal infiltrates Ulceration, ring abscess& small, satellite lesions Stromal opacification Treatment
99.
100. Usually associated with long-term topical steroid use
103. Herpes zoster keratitis Nummular keratitis Acute epithelial keratitis Develops in about 50% within 2 days of rash Develops in about 30% within 10 days of rash Small, dendritic or stellate epithelial lesions Multiple, fine, granular deposits just beneath Bowman membrane Tapered ends without bulbs Halo of stromal haze May become chronic Resolves within a few days
112. Vogt white limbal girdle Innocuous and very common in elderly Bilateral White, crescentic line along nasal and temporal limbus Type 1 - separated from limbus by clear zone Type 2 - not separated by clear zone
113.
114. Usually bilateralPolygonal stromal opacities separated by clear space Most frequently involve anterior stroma (anterior crocodile shagreen) Occasionally involve posterior stroma (posterior crocodile shagreen)
115.
116. Rarely progression to Fuchs dystrophyTiny dark spots on central endothelium
117. Lipid keratopathy Primary Secondary Common, secondary to previous disciformkeratitis Rare, occurs spontaneously in avascular cornea Unilateral stromal deposits with vascularization Usually unilateral stromal deposits without vascularization
132. Grey in direct illuminationTreatment- not required
133. Schnyder dystrophy Onset - second decade with visual impairment Subepithelial ‘crystalline’ opacities Treatment- excimer laser keratectomy
134. Lattice dystrophy type I Onset - late first decade with recurrent corneal erosions Progression Fine, spidery, branching lines within stroma Later general haze may submerge lesions Treatment - penetrating keratoplasty if severe
135. Granular dystrophy type I Onset - first decade with recurrent corneal erosions Progression Eventual confluence Initial superficial and central crumb-like opacities Later deeper and peripheral spread but limbus spared Treatment - penetrating keratoplasty if severe
136. Fuchs endothelial dystrophy Onset - old age Progression Eventually bullous keratopathy Later central stromal oedema Gradual increase in cornea guttata with peripheral spread Treatment- penetrating keratoplasty if advanced
156. Iris Melanoma 1. Very rare - 8% of uveal melanomas 2. Presentation - fifth to sixth decades 3. Very slow growth 4. Low malignancy 5. Excellent prognosis
157. Iris melanoma Usually pigmented nodule at least 3 mm in diameter Invariably in inferior half of iris Occasionally non-pigmented Surface vascularization Angle involvement may causeglaucoma Pupillarydistortion, ectropion uveaeand cataract
158. Differential diagnosis of iris melanoma Adenoma of pigment epithelium Large iris naevus distorting pupil Leiomyoma Ciliary body melanoma eroding iris root Metastasis to iris Primary iris cyst
208. Ocular features of Marfan syndrome Upward subluxation Lattice degeneration Axial myopia Zonuleusually intact Angle anomaly and glaucoma Blue sclera Cornea plana
209. Weill-Marchesani syndrome Ocular features Systemic features Short stature Microspherophakia Short stubby fingers (brachydactyly) Usually anterior lens subluxation Mental handicap Angle anomaly and glaucoma
