OPT 206A - A&P > The Ocular Surface 2 > Flashcards

The Ocular Surface 2 Flashcards

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1
Q

Three Reasons to Study Cornea

A
  1. disease
  2. contacts
  3. refractive surgery
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2
Q

5 Corneal Disease Categories

A
  1. injury
  2. dystrophies
  3. degenerations
  4. inflammation
  5. infection
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3
Q

4 Types of Corneal Injuries

A
  1. mechanical (scratch)
  2. chemical (acid/alkali)
  3. surgery
  4. radiation (UV, heat)
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4
Q

Corneal Dystrophies

A

inherited, spontaneous, bilateral (e.g Keratoconus)

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5
Q

Corneal Degenerations

A

aging, disease, injury, inflammation (band keratopathy, marginal degeneration)

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6
Q

How does corneal inflammation happen?

A

intent to help, healing

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7
Q

What does corneal inflammation involve?

A

activation of resident immune cells, changes to blood vessels

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8
Q

Why is inflammation problematic in the cornea?

A

vision loss, blood vessel ingrowth interfere with vision

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9
Q

What microbes can be involved in corneal infections?

A

bacteria, viruses, fungi, amoeba, parasites

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10
Q

Why are corneal infections problematic?

A

scarring, vision loss

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11
Q

PRK

A

no flap

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12
Q

LASIK

A

flap

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13
Q

Corneal optical properties

A
  1. refractive power (index)
  2. transparent (smooth)
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14
Q

The front surface of the cornea is _______.

A

elliptical

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15
Q

The back surface of the cornea is _____.

A

circular

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16
Q

Corneal Thickness

A

center thinner than periphery

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17
Q

Corneal Shape

A
  1. flattens towards periphery
  2. radius of curvature of back is less than front
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18
Q

5 Layers of the Cornea

A
  1. Epithelium
  2. Bowman’s Layer
  3. Stroma
  4. Descemet’s Membrane
  5. Endothelium
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19
Q

3 Layers of the Corneal Epithelium

A
  1. Superficial Surface Cells
  2. Wing Cells
  3. Basal Cells
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20
Q

Superficial Surface Cells

A

flat stratified (squamous), fingerlike projections (microvilli)

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21
Q

Basal Cells

A

columnar shaped (tall/narrow), produce and are anchored to a very thin basement membrane (basal lamina)

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22
Q

Textured Surface

A

antimicrobial

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23
Q

Exfoliation

A

surface cells slough and turn over regularly, cells move centrally and anteriorly (in/up)

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24
Q

Where does mitosis occur?

A

limbus

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25
Corneal Cell Regeneration Time
7 days
26
Corneal Epithelium Junctions
Tight Junctions -> barrier
27
Adherens
connect cells below tight junctions
28
Desmosomes
loosely connect cells, mostly in wing cell layer
29
Gap Junctions
participate in cell-cell communication
30
Hemidesmosomes
connect cells to the underlying basal lamina
31
Basal Lamina
basement membrane of the corneal epithelium, filter function, stops bacteria
32
Stroma
90% of corneal thickness, lamellae span entire diameter
33
Lamellae
thick collagen fibril layers, layered horizontal and vertically, adds strength
34
GAGs
glycosaminoglycans, attract water to maintain correct spacing between fibrils
35
Keratocytes
stromal cells, modified fibroblasts, reside between lamellae only, squashed flat, make/maintain fibrils/GAGs, phagocytes
36
Bowman's Layer
part of the anterior stroma, no cells, not a real membrane, irregular collagen, function unclear, only in primates
37
Corneal Endothelium
cells are upside down relative to corneal epithelium, single layer of hexagonal cells, very metabolically active, maintains hydration, do not regenerate, flattens with age
38
Descemet's Membrane
between endothelium and stroma, made by endothelial cells, filtration, thickens with age
39
Where do nutrients form the cornea come from?
aqueous humor (used as blood vessel)
40
Where do blood vessels stop?
limbus, clarity reasons
41
Neovascularization
abnormal vessel growth into cornea
42
Immune Privileged
immunologically inactive, cornea, clarity reasons, inflammation can damage tissue, immune cells are immature and less reactive
43
How do corneal cells amount a immune response?
1. Immature resident cells can mature 2. mature immune cells from elsewhere can be recruited
44
Parainflammation
in between state, found in contact lens wearers, some players involved in inflammation are there, but no actual inflammation
45
Does the cornea have nerves?
Yes, more sensory nerve endings than anywhere in human body, form an annular plexus at limbus, myelinated until they reach center of the cornea
46
How do nerves get into the epithelium?
pierce Bowman's layer and basal lamina
47
3 Types of Corneal Nerves
1. Simple 2. Ramifying 3. Complex
48
Corneal Nerve Relations
every epithelial cell touches at least one nerve, nerves supply factors to epithelium, corneal cells maintain intraepithelial nerves (prune)
49
Conjunctiva
mucous membrane, attached under lids and limbus, loosely wrapped around sclera, few nerves, very immune active
50
Conjunctival Layers
1. Epithelium (stratified squamous) 2. Stroma (loose collagenous)
51
Conjunctival Embedded Extras
1. tear producing glands 2. blood vessels 3. lymphatic vessels 4. melanocytes
52
Chemosis
fluid accumulation between conj and sclera
53
Hyperemia
red eye, many blood vessels
54
Edema
fluid leak from blood vessels
55
Papillae
red dots of varying size, fluid leakage from vessels (allergic/bacterial)
56
Follicles
avascular/white nodules, filled with lymphocytes (toxic/viral/Chlamydia)
57
GPC
giant papillary conjunctivitis (contact lens wear), mechanical/chemical stress
58
Vernal Conjunctivitis
severe allergy, scarring
59
Caruncle
corner of eye
60
Puncta
pump tears out of eye
61
Plica semilunaris
remnants of 3rd eyelid, understudied
62
Scleral Layers
1. Episclera 2. Scleral stroma 3. Lamina fusca
63
Episclera
under conjunctiva, loose connective tissue, blood vessels
64
Scleral stroma
translucent, collagen bundles
65
Lamina fusca
innermost layer, interface w underlying uveal tract, contains pigmented cells, absorbs stray light
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