Ординатура / Офтальмология / Английские материалы / Ocular Differential Diagnosis 7th edition_Roy_2002

Fraunfelder FT, Fraunfelder FW. Drug-induced ocular side effects. Woburn, MA: Butterworth-Heinemann, 2001.

Fraunfelder FT, Roy FH. Current ocular therapy, 5th ed. Philadelphia: WB Saunders, 2000.

Hegab SM, et al. Conjunctival ulcer in patients with Crohn's disease. Ophthalmic Surg Lasers 1994;25:638â??639.

Jordan DR, et al. Wegener's granulomatosis: eyelid and conjunctival manifestations as the presenting feature in two individuals. Ophthalmology 1994;101:602â??607.Bibliographic Links

Phlyctenular Keratoconjunctivitis

This condition involves a localized conjunctival, limbal, or corneal nodule measuring about 1 to 3 mm.

1. *Delayed hypersensitivity to bacterial protein, particularly tuberculoprotein and staphylococci; lymphopathia venereum and coccidioidomycosis may also be allergens

2. Malnutrition

3. Secondary infection of the conjunctiva, especially from S. aureus, pneumococcus, and Kochâ??Weeks bacillus

4. Systemic infection

A.Bang disease (brucellosis)

B.Candidiasis

C.Neurodermatitis

5. Foreign substances such as silver (argyrosis), iron (siderosis), copper (chalcosis), arsenic (arsenic melanosis), gold (chrysiasis), aluminum, quinones, aniline dyes, and eye cosmetics containing carbon black

6. *Benign melanosisâ??overactivity of melanocytes

A.Epithelialâ??congenital or acquired, for example., following radiation or use of P.216

chemicals (arsenic); in Addison disease; because of chronic conjunctivitis (trachoma, vernal conjunctivitis, onchocerciasis, keratomalacia)

B. Subepithelialâ??congenital or in association with melanosis oculi or nevus of Ota 7. Neoplasms

A.*Nevusâ??most common in children, localized stationary, elevated, cystic, may or may not have pigmentation

B.*Malignant melanoma arising from preexisting nevus, apparently normal conjunctiva, or from an area of acquired pigmentation (intraepithelial melanoma); occurs primarily in middle age; diffuse, flat, pigmentation; progressive; no cysts

C.Secondary melanotic tumors

D.Incidentally pigmented tumors, such as a melanocarcinoma

E.Secondary metastatic tumors from lung or breast

8. Ocular causes, including the following:

A.Apocrine adenocarcinomas

B.Foreign bodies

C.Hematic cysts

D.Moll gland cystadenomas

E.Staphylomas

F.Subconjunctival hematomas

Cheskes J, et al. Ocular manifestations of alkaptonuric ochronosis. Arch Ophthalmol 2000;118:724â??727.Bibliographic Links

Fraunfelder FT, Fraunfelder FW. Drug-induced ocular side effects. Woburn, MA: Butterworth-Heinemann, 2001.

Linebarger EJ, et al. Conjunctival aluminum deposition following pneumatic cryopexy. Arch Ophthalmol 1999;117:692.Bibliographic Links

Roy FH. Ocular syndromes and systemic diseases, 3rd ed. Philadelphia: Lippincott Williams & Wilkins, 2002.

Seregard S. Conjunctival melanoma. Surv Ophthalmol 1998;42:321â??350.Bibliographic Links

Discoloration of Conjunctiva

1. Red

A.Subconjunctival hemorrhage 2. Yellow

A.Bilirubinemiaâ??obstructive or hemorrhagic jaundice

B.Picric acid

C.Leptospirosis

D.Brucellosis (Barg disease or Mediterranean fever)

E.Aromatic nitro and amino compounds

F.Conjunctival fatâ??occurs primarily in older and black patients

G.Blood pigment tinge of malaria, blackwater fever, and yellow fever

3. Gray (black)

A.*Argyrosis (silver)

B.Drugs, including the following:

atabrine

nitrochlorobenzene

C.Chrysiasis (gold)â??grayish green effect

D.Arsenicalsâ??ash white

E.Mascara

4. Brown

A.Subconjunctival hemorrhageâ??fine brown spots P.217

B.Pigmentary limbal ring associated with senile, traumatic, or diseased conditions

C.*Benign melanosisâ??overactivity of melanocytes

1. Epithelialâ??congenital or acquired, following radiation or use of chemicals (arsenic); in Addison disease (adrenal cortical insufficiency); because of chronic conjunctivitis (trachoma, vernal conjunctivitis, onchocerciasis, keratomalacia)

2. Subepithelialâ??congenital or in association with melanosis oculi or nevus of Ota

D.Neoplasms

1. *Nevusâ??most common in children, localized, stationary, elevated, cystic, may or may not have pigmentation

2. *Malignant melanoma arising from preexisting nevus, apparently normal conjunctiva, or from an area of acquired pigmentation (intraepithelial melanoma); occurs primarily in middle age; diffuse, flat, pigmentation; progressive; no cysts

E.Drugs, including the following:

4. Long-standing acute inflammation

A.Pemphigus (Cazenave disease)

B.Stevensâ??Johnson disease (dermatostomatitis)

5. Congenital

6. Associated with cyanoacrylate tissue adhesive

7. Epidemic keratoconjunctivitis

Fraunfelder FT, Fraunfelder FW. Drug-induced ocular side effects. Woburn, MA: Butterworth-Heinemann, 2001.

Leahey AB, Gottsch JD. Symblepharon associated with cyanoacrylate tissue adhesive. Am J Ophthalmol 1993;115:46â??49.

Meyer SJ, et al. Conjunctival involvement in paraneoplastic pemphigus. Am J Ophthalmol 1992;114:621â??624.Bibliographic Links

Conjunctival Concretions

Conjunctival concretions are small yellow spots that are most common in tarsal conjunctiva.

1. Chronic inflammatory conditions, including atopic keratoconjunctivitis, vernal conjunctivitis, and posttrachomatous degenerations

2. Elderly

3. Calcium deposits in patients with chronic renal failure treated with maintenance hemodialysis

Chin GN, et al. Ultrastructural and histochemical studies of conjunctival concretions. Arch Ophthalmol 1980;98:720.Bibliographic Links

Pahor D, et al. Conjunctival and corneal changes in chronic renal failure patients treated with maintenance hemodialysis. Ophthalmologica 1995;209:14â??16.Bibliographic Links

Lesions of Caruncle

1. Apocrine hydrocystoma

2. *Basal cell carcinoma

3. Capillary hemangioma

4. Chronic inflammation

5. Dermoid

6. Ectopic lacrimal gland

7. Epithelial inclusion cyst

8. Foreign-body granuloma

9. Granular cell myeloblastoma

10. Histiocytic lymphoma P.219

11. Lipogranuloma

12. Lymphangiectasis

13. Malignant melanoma

14. Nevus

15. Normal caruncle

16. *Oncocytoma

17. Papilloma

18. Pilar cyst

19. Plasmacytoma

20. Pyogenic granuloma

21. Reactive lymphoid hyperplasia

22. Sebaceous gland hyperplasia

23. *Sebaceous gland adenoma

24. Seborrheic keratosis

25. Squamous cell carcinoma

Rennie IG. Oncocytomas of the lacrimal caruncle. Br J Ophthalmol 1980;64:935.Bibliographic Links

Shields CL, et al. Types and frequency of lesions of the caruncle. Am J Ophthalmol 1986;102:771â??778.Bibliographic Links

Shields CL, Shields JA. Tumors of the caruncle. Int Ophthalmol Clin 1993;33:31â??36.Buy NowBibliographic Links

6

Globe

Microphthalmia (Small Globe)

1. Microphthalmia associated with the following:

A.Cataractâ??dominant inheritance

B.Colobomaâ??dominant and sex-linked inheritance

C.Congenital spastic diplegiaâ??x-linked

D.Ectopic pupilsâ??dominant inheritance

E.Glaucomaâ??recessive inheritance

F.Harelip and cleft palateâ??autosomal recessive

G.High hypermetropiaâ??recessive inheritance

H.Malformation of hands and feetâ??autosomal recessive

I.Polydactylyâ??autosomal recessive

J.Retinitis pigmentosa and glaucomaâ??dominant inheritance

2. Colobomatous microphthalmia

A.X-linked

1. Aicardi syndrome

2. Blochâ??Sulzberger syndrome (incontinentia pigmenti)

3. Goltz syndrome (focal dermal hypoplasia)

4. Lenz microphthalmia syndrome

B.Autosomal recessive

1. Cohen syndrome

2. Ellisâ??van Creveld syndrome

3. Hepatic fibrosis, polycystic kidneys, colobomas, and encephalopathy

4. Humeroradial synostosis

5. Kartagener syndrome

P.221

6. Laurenceâ??Moonâ??Biedl syndrome

7. Marinescoâ??Sjögren syndrome

8. Meckel syndrome

9. Micro syndrome

10. Sjögrenâ??Larsson syndrome

11. Warburg syndrome

i.Autosomal dominant

1. Basal cell nevus syndrome