-
Epicanthal Folds Associations
- Down Syndrome
- Ehlers-Danlos
- Fetal Alcohol Syndrome
- Cri du Chat
- Klinefelter
- Turner's
- Congenital ptosis
-
Epicanthal Folds Differentiation
Pseudoesoptropia - use Hirshburg test
-
-
Epiblepharon Differentiation
Entropion
-
Microblepharon Association
anopthalmus
-
Ablepharon Association
- syndactyly
- mental retardation
- cleft lip
- meningoencephalocele
- developmental abnormalities
- special association:
- Ablepharon-Macrostomia Syndrome (AMS) - fish mouth and underdeveloped ears
-
Euryblepharon Associations
- malpositioned lateral canthi
- lateral ectropion
- blepharophimosis
- lagophthalmus -> exposure keratitis
- laterally displaced lacrimal system
- double row of meibomian glands
- telecanthus
- strabismus
-
Telecanthus Associations
- Waardenburg's syndrome
- Fetal alcohol syndrome
- blepharophimosis
-
Telecanthus Differentiation
Hypertelorism
-
Blepharophimosis Association
- ocular:
- ptosis
- epicanthus inversus
- no levator fold
- lateral ectropion
- hypoplasia of superior orbital rim
- telecanthus
- inverted medial canthus fold
- lacrimal abnormalities
- depreivation ambylopia (50%)
- Other:
- low nasal bridge
- mental retardation
- infertility
-
Blepharophimosis Differentiation
essential blepharospasm - treat with botox
-
Eyelid Coloboma Associations
- lens coloboma
- iris coloboma
- retina coloboma
- Treacher Collins
- Cryptophalmus
- Fraser Syndrome
- Goldenhar Syndrome (most common) - upper lid coloboma epibulbar dermoid, preoricular skin tag
- Leukocoria
-
Congenital Upper Lid Eversion Association
Down Syndrome
-
Cryptophthalmus Association
- Fraser's Syndrome
- Cryptophthalmos-syndactyly syndrome
-
Cryptophalmus Differentiation
Total ankyloblepharon (pseudocrytophthalmus) - eye forms, but lids don't separate
-
Entropion Association
- Tarsal Kink Syndrome
- Stevens-Johnson Syndrome
-
Anopthalmus Associations
- If bilateral: absence of optic chaism; corpus collosum disruption
- microblepharon
-
Microphthalmos Association
- Cleft syndromes
- Microcornea
-
Crouzon Syndrome (Craniosynostoses) Associations
- Exophthalmus
- Hypertelerism
- Apert Syndrome (closely related)
- Shortened Femur and humerus
- Acanthosis Nigrican (dark streaks)
- Partial syndactyly (if Type 2)
- V-type exotropia
- Blue sclera
- Aniridia
- Cataract
- Glaucoma
- Coloboma
- Megalocornea
- Optic Nerve Hypoplasia
- Ectopic lens
-
Goldenhar Syndrome Association
- Ocular:
- epibulbar dermoid
- upper lid coloboma
- microphthalmus
- microcornea
- disc coloboma (with leucocoria)
- strabismus
-
Treacher Collins Syndrome Association
Lateral lower lid coloboma
-
Microcornea Association
- microphthalmus
- Iris Coloboma
- Shallow anterior chamber angle
- Glaucoma (closed 1st, then open 2nd)
- Congenital cataracts
- Riger anomaly
- microphakia
- optic nerve hypoplasia
- aniridia
- Axenfeld syndrome
- Corectopia
- Nystagmus
- Papillary membrane
- Retinopathy of Prematurity (ROP)
- Leukoma
- Cornea plana (poss hyperopia)
- Weill-Marchesani syndrome
- Waardenburg
- Fetal Alcohol
- Ehler-Danlos
- Rubella
- Trisomy 21
-
Microcornea Differentiation
Sclerocornea
-
Megalocornea Associations
- WTR astigmatism
- Pigmentary Dispersion Syndrome - Krukenburg Spindle; Iris red light reflex on ITI
- Neuhauser Syndrome - megalocornea; mentral retardation
- Down syndrome
- Ehler-Danlos
- Alport
-
Megalocornea Differentiation
- Buphthalmos: elevated IOP; englarged globe and cornea
- Congenital Glaucoma: elevated IOP; Haab's Striae; bupthalmos; 1st year of life; unilateral or bilateral; progressive
-
Anterior Megalophthalmos Differentiation
Congenital glaucoma
-
Keratolenticular Dysgenesis Association
- Scherlocornea
- Disruption of iris and lens
-
Sclerocornea Association
- Ocular:
- Cornea plana (bilateral)
- Angle closure glaucoma
- Narrow angle glaucoma
- Open angle glaucoma
- Aniridia
- Arcus juvenilis
- Blue Sclera
- Cataract
- Ectopia lentis
- Microcornea
- Microphthalmos
- Peripheral anterior synechiae
- Retinal aplasia
- Retinal/uveal coloboma
- Systemic:
- Cranial dystrophies
- Cerebellar and ear abnormalities
- Osteogenesis imperfecta
- Hallerman-Streiff
- Hurler's
- Maroteaux-Lamy
- Polydactyly
- Unbalance Translocation
-
Sclerocornea Differentiation
Pannus -> fribrovascular net
-
Posterior Keratoconus Associations
- Corneal haze
- endothelial pigment
- Guttata (3 things: posterior keratoconus, endothelial dystrophy, Fuch’s (Hassell-Henle bodies due to old age have peripheral guttata))
- Hypertelorism
- Corneal nebulae from acute hydrops
- endothelial precipatetes
- aniridia
- iris atrophy
- mesodermal tissue in angle
- Choroid/retinal sclerosis
-
Posterior keratoconus Differentiation
Peter's Anomaly
-
Congenital Anterior Staphyloma Association
Uveal tissue lines posterior to cornea
-
Keratectasia Association
- Caused by Lasik or Keratoconus
- no uveal ring posteriorly
-
Anterior Lenticonus Associations
- Irregular lenticular astigmatism
- Alport's Syndrome (90%)
- Spherophakia
- Anterior polar cataract
- Posterior Cortical cataract
- Fundus lesions (drusen)
- Neobascularization
- Posterior polymorphous dystrophy
- Sensorineural deafness
- Hearing loss in later childhood
- Renal involvement (with hearing loss)
- Hematuria (most common and earliest Alport's manifestation; all men and 95%F)
- Dot-Fleck retinpathy (most common ocular finding in Alports 85%M)
-
Posterior Lenticonus Association
- no systemic manifestations
- Post capsule wrinkles
-
Lentiglobus Associations
Posterior polar lens opacity
-
Microspherophakia Associations
- Ocular:
- Glaucoma (angle closure)
- Peter's Anomaly
- Lenticular Myopia
- Familial ectopia lentis et pupilae (AR)
- Systemic:
- AD type - no systemic defects
- Marfan's
- Congenital Rubella
- Posterior Synechiae
- Glaucomflecken
- Weill-Marchesani (collagen ds) - short staure; skeletal malformation, brachycephaly, limited joint mobility, ectropion lentis, lenticular myopia, glaucomflecken
-
Microphakia Associations
- Lowe's Syndrome - lens is small and disk like
- Lowe's diagnosis triad: 1. congenital cataract 2. neonatal/infantile hypotonia with subsequent mental impairment 3. renal tubular dysfunction
- Lowe's have glaucoma (w/ or w/out buphthalmos in 50-60% of boys w Lowe's) - usually bilateral, usually diagnosed in the 1st year of life
-
Lens Coloboma Association
- Optic nerve, retina, iris coloboma
- Microphthalmia
- Marfan's Syndrome
- Morning Glory
-
Posterior Embryotoxin Association
- 10% - no ocular anomalies or glaucoma
- Axenfeld-Reiger Syndrome
- Alagille's Syndrome
-
Posterior Embryoptoxon Differentiation
- Limbal Girdle Vogt
- Arcus
- Pannus
-
Axenfeld's Anomaly/Syndrome Association
glacoma develops in 50% of anomaly
-
Axenfeld's Anomaly/Syndrome Differentiation
Alagille's Syndrome -> do EOG/ERG (abnormal)
-
Alagille's Syndrome Associations
- Neonatoral jaundice (70%)
- Borad forehead
- POinted chin
- Elongated nose
- Cardiac murmurs and stenose
-
Alagille's Syndrome Differentiation
Axenfeld's Syndrome -> do EOG/ERG (normal)
-
Reiger's Anomaly/Syndrome Associations
- Glacoma in 50%
- Corectopia
- Polycoria
- Ectropion uvea
-
Peter's Anomaly Association
- Glacoma (50%)
- Congenital cardiac defects
- Cleft lip or palate
- Craniofacial dysplasia
- Skeletal abnormalities
-
Mittendorf Dot Associations
- Posterior lenticonus
- Lentiglobus
- Microspherophakia
-
Aniridia Association
- AN2 - Wilm's Tumor (renal); WAGR complex (Wilm's tumor, Aniridia, Genitourinary malformations, Retardation); Miller's Syndrome (Wilm's tumor + aniridia)
- AN3 - Gillespie's Syndrome (mental retardation, cerebellar ataxia)
-
Chalazion Differentiation
- Hordeolum -> timing, pain, infection
- Ocular leishmaniasis with lid involvement - ask about Middle Eastern travel
- Cellulitis
- Pyogenic granuloma
- Sebaceous cell carcinoma
- Sarcoid
-
Comedones Associations
Acne vulgaris
-
Eccrine Hidrocystoma Association
Graves (b.c hyerhidrosis in heat)
-
Eccrine Hidrocystoma Differentiation
Apocrine cyst (doesn't worsen in heat)
-
-
Squamous Cell Papilloma Differentiation
- Viral Wart
- Seborrheic keratosis
- Intradermal nevus
- Carcinoma
- Viral Papilloma -> young pts, pedunculated, associated wtih HPV
-
Actinic Keratosis Assocaitions
Occasionally cutaneous horns
-
Seborrheic Keratosis Associations
Lesser-Trelat: multiple eruptive seborrheic keratoses with internal malignancy (typically adenocarcinoma of GI tract)
-
Seborrheic Keratosis Differentiation
- Pigmented basal cell carcinoma
- Nevus
- Melanoma
-
Viral Papilloma Associations
HPV 6, 11, 16
-
Viral Papilloma Differentiation
Squamous Cell Papilloma
-
Keratoacanthoma Associations
Furguson-Smith Syndrome: AD, multiple lesion keratoacanthoma
-
Keratoacanthoma Differentiation
- Squamous Cell Carcinoma
- Basal Cell Carcinoma
-
Acquired Melanocystic Nevus Associations
Atypical Mole Syndrome - multiple dysplastic nevi, increases chance of conjunctival and uveal nevi and melanoma
-
Port Wine Stain Associations
- Sturge-Weber Syndrome:
- 1. Cerebellar arterial/venular malformations
- 2. Port Wine Stain - CNV capillary abundance
- 3. Choroidal Hemangioma
-
Port Wine Stain Differentiation
Capillary Hemangioma will blanch
-
Capillary Hemangioma Associations
- High ouput heart failure
- Kasaback-Merritt: thrombocytopenia, anemia, low coagulation factor levels
- Maffuci Syndrome: skin hamangiomas, enchondromata of hands, feet, long bones (which may bow)
-
Capillary Hemangioma Differentiation
Nevus - will not blanch
-
Pyogenic Granuloma Differentiations
- Conjunctival Melanoma: scleral pigment abnorm in Caucasians; PAM if not born with pigment and deefer vessels present
- Squamous Cell Carcinoma: feeder vessels & lobulated appearance; PG not lobulated (onr or two humps only)
- Conjunctival Nevus: No feeder vessels
- Lymphoma: larger and present all around limbus; firm
- Papilloma: "just looks different"
- Kaposi's Sarcoma: immunocompromised pt; lesion more purple
- Sarcoid Granuloma: Granulomas all over body, even lung
-
Squamous Cell Carcinoma Associations
- Actinic Keratosis
- Bowen's Disease: conjunctival intraepithelial neoplasia then can involve lids
-
Squamous Cell Carcinoma Differentiation
Keratoacanthoma
-
Sebaceous Cell Carcinoma Associations
Muir-Torre Syndrome
-
Sebaceous Cell Carcinoma Differentiation
- Chronic unilateral blepharitis (no such thing)
- Recurrent chalazion
-
Karposi Sarcoma Associations
- Entropion with misdirected lashes
- AIDS
- Herpes Virus #8 (Karposi virus)
-
Eyelash Ptosis Association
- Floppy eyelid syndrome
- dermatochalasis
- CN7 Bell's Palsy
-
Distichiasis Associations
- Stevens-Johnson Syndrome
- Ocular cicatricial pemphigoid
-
Madarosis Association
- Ehler-Danlos
- Lupus
- Both are CT diseases
-
Madarosis Differentiations
chronic blepharitis with recurrent chalazion could be sebaceous cell carcinoma
-
Poliosis Associations
- VKH
- TS (tuberous Sclerosis)
- Irradiation
- SO (sympathetic Ophthalmia)
- Waardenburg's Syndrome
- Chroquine and Hydroxychroroquine (plaquenile) - antimalarial and RA, cause whorl keratopathy in cornea, cause bull's eye maculopathy
|
|