BAGIAN PATOLOGI ANATOMI

BAGIAN PATOLOGI ANATOMI FAKULTAS KEDOKTERAN USU – MEDAN 2007

NORMAL ANATOMY Palpebrae Conjunctiva Cornea Lens Uvea tract Retina Vitreous humor Nerve Gland Muscle Blood vessels

NORMAL ANATOMY A - Vitreous humor B - Lens C - Cornea D - Pupil E - Iris F - Sclera G - Optic Nerve H - Retina

CHOROID





CHOROID = MIDDLE LAYER EYE CONTAINS : • BLOOD VESSELS & • CONNECTIVE TISSUE

• SUPPLIES NUTRIENTS TO INNER PORTION OF EYE

CILIARY BODY





CILIARY BODY = ring of tissue  encircles the lens. Contains : • smooth muscle fibers (ciliary muscles) • control the shape of the lens.







Posterior surface lens (CILIARY PROCESSES) Contain : capillaries • Secrete fluid (vitreous humor)  into the anterior segment of the eyeball.

LACRIMAL SYSTEM LARGELY : SEROUS TYPE

MINOR MUCINOUS

DISORDER OF EYE






MICRO ORGANISMS * ANTIGEN * TOXIC CHEMICAL * SOLAR RADIATION * SYSTEMIC DISEASE * *  BLINDNESS

CONGENITAL ANOMALI


RARELY : - ANOPTHTHALMOS - EYE’S ((--) - MICROPHTHALMOS - MEDIAN EYE - HYPOPLASIA EYE’S - COLOBOMA - CONGENITAL CATARACTS - COLOR BLIND

COLOBOMA (Defect in iris)





Appear : black notch  pupil : irregular (shape) May be associated with : • Hereditary conditions • Trauma to the eye, or • Eye surgery

CONGENITAL CATARACTS


The number of people born with cataracts is low.




Possible causes : • • • • • • • • • • • •

Galactosemia Chondrodysplasia syndrome Congenital rubella syndrome Down syndrome (trisomy 21) Pierre Pierre--Robin syndrome Familial congenital cataracts Hallerman Hallerman--Streiff syndrome Lowe syndrome Trisomy 13 Conradi syndrome Ectodermal dysplasia syndrome Marinesco Marinesco--Sjogren syndrome

CONGENITAL CATARACTS

PIGMENTATION EXOGEN

IRON COPPER SILVER

ENDOGEN

MELANIN ALBUMIN  MELANOSIS

HEMOSIDERINE I.O.H

PIGMENTATION


KAYSER - FLEISCHER RING WILSON’S DISEASE (HEPATOLENTI CULAR DEGENERATION)

DEPIGMENTATION VITILIGO

PHYSICAL & CHEMICAL INJURIES







TRAUMA : ECCHYMOSIS SUP.FICIAL : • CONTACT LENS • FOREIGN BODIES • ULTRA VIOLET CAUSTIC CHEMICAL BLUNT TRAUMA  FRACTURE OF BONE

SKIN APPENDAGES OF EYELIDS 1.

2.

3.

SEBACEOUS GLANDS (ZEIS & MEIBOMIAN) APOCRINE GLANDS (MOLL) ECCRINE SWEAT GLANDS

MOLUSCUM CONTANGIOSUM



VIRAL INFECT  WART LIKE CENTRAL UMBILICAL  KERATIN

CYSTIC LESSION





SUDORIFERA SEBACEA MEIBOMIAN DERMOID

HORDEOLUM ( = STYE )








ZEIS GLAND (SEBACEOUS GLANDS)  EXTERNAL HORDEOLUM MEIBOMIAN GLANDS  INTERNAL HORDEOLUM FOLICLE  INFECTION STAPHYLLOCOCUS  CELLULITIS

HORDEOLUM

EXTERNAL

INTERNAL

CHALAZION (MEIBOMIAN GLAND LIPOGRANULOMA)








A PAINLESS GRANULOMA OF THE MEIBOMIAN GLANDS MEIBOMIAN GLAND  OCCLUTION CHRONIC  GRANULATION

MICROSCOPIC MULTIPLE FOCI OF GRANULOMATOUS INFLAMMATION

XANTHELASMA


SHARPLY DEMARCATED YELLOWISH (COLLECTION CHOLESTEROL) UNDERNEATH SKIN




USUALLY : ON / AROUND EYELIDS




ASSOCIATIONS : • • • •

CHOLESTEROL ↑ (FAMILIAL HYPERCHOL) PRIMARY BILIARY CIRRHOSIS MENOPAUSE DIABETES

EXOPTHALMUS ( = PROPTOSIS ) PROTUSION (EYEBALL) BILATERAL THYROID DISEASE EARLY ADULT LIFE (WOMEN), 4/1 + EDEMA (EYELID, CHEMOSIS)

EXOPTHALMUS ( = PROPTOSIS )





PATHOLOGY: • ORBITAL WATER >> • EXT.OCULAR MUSCLE >> ( + LYMPHOCYTES & MN ) CLINIC : • EXPOSURE CONJ’TIVA  BLIDING, ULCERATION, OPTIC NERVE COMPRESSION

CONJUNCTIVA DISORDER









HYPEREMIA HEMORRHAGE INFLAMATION THRACHOMA CHLAMYDIAL INFECTION OPHTHALMIA NEONATORUM DRY--EYE SYNDROME DRY PINGUECULA & PTERYGIUM

HYPEREMIA - CONJUCTIVA








DILATASI BLOOD VESEL CONJUNCTIVITIS CORNEA DISEASE IRIDOCYCLITIS CORNEA DEFECT GLAUCOMA IRITIS

HEMORRHAGE CONJUNCTIVA






TRAUMA ANOXIA SEVERE COUCHING  SPONTANEUS

SUBCONJUNCTIVAL HEMORRHAGE


Causes : • Minor eye trauma • Spontaneously (venous press ↑) • Streneuous Exercising • Coughing • Touching/widening eyes • Sneezing • Vomiting (bulimia nervosa) • Severe alcohol intoxication,  blood press ↑ • Severe hypertension

CONJUNCTIVITIS





MICRO--ORG  CONJUNCTIVITIS MICRO  KERATITIS  CORNEAL ULCER HEMATOGEN  IATROGENIC INFECTION  SURGICAL :
CATARACT
CORNEAL GRAFT
PROSTHETIC LENS

CONJUNCTIVITIS


EXUDATE/DISCHARGE : - PURULENT  CLOSE - FIBRINOUS - SEROUS - HEMORRHAGIC

CONJUNCTIVITIS

TRACHOMA






INF.CHRONIC (CLAMYDIA TRACHOMATIS) = SWIMMING POOL CONJUNCTIVITIS OCULAR, GENITAL, SYST’MIC  BLIND




CHILD  REMISION (SP)




ADULT  PROGRESSIVE




BILATERAL, SUP > INF







NEW BORN : PURULENT CONJUNC. (BLENORRHOE) ADULT : • • • •

CHRONIC FOLLICLE CONJ. LYMPHOCYTE (+) HYPERPLASIA  GERM. CENTRE NECROTIC TRACHOMATOUS PANNUS

(EPIT – BOWMANN ZONE) • FIBROSIS (CONJ. & EYELIDS)


 DISTORS EYELIDS PATHOLOGY : • LOWER TARSAL CONJUNTIVA • SCAR & NECROTIC ((-) • KERATITIS ((-)

TRACHOMA (CHLAMYDIAL CONJUNCTIVITIS)

OPHTHALMIA NEONATORUM





ACUTE  SEVERE CONJUNCTIVITIS COPIUS PURULENT DISCHARGE GO  GOGO-NEONATORUM ULC.CORNEA, PERFORATION  SCAR & PANOPH’ITIS  BLIND PREVENT  SILVER NITRAT (PNC)

OPTHALMIA NEONATORIUM








Microbial Agent : Neisseria gonorrhoeae Mode of Transmission: From mother to newborn Classic Feature: purulent destructive eye disease

DRY EYE SYNDROME


Common condition




Tear production