Download MBBS Ophthalmology PPT 26 Cysts And Tumours Of Conjunctiva Lecture Notes

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Ophthalmology PPT 26 Cysts And Tumours Of Conjunctiva Lecture Notes

Cysts, tumors and degenerations of

conjunctiva

CONJUNCTIVAL CYSTS AND TUMOURS
Common cysts found in the conjunctiva are due to dilatation

of lymph spaces

Tumours

? Congenital- dermoids, dermolipoma
? Squamous Cell Carcinoma (Epithelioma)
? Basal Cell Carcinoma (Rodent Ulcer)
? Lymphomas
? Kaposi Sarcoma


CYSTS OF CONJUNCTIVA
1. Congenital cystic lesions.
2. Lymphatic cysts of conjunctiva.
3. Retention cysts.
4. Epithelial implantation cyst
5. Parasitic cysts
6. Aqueous cyst.

Treatment:
Wait and watch
Excision biopsy

TUMOURS OF THE CONJUNCTIVA
Classification
Non-pigmented tumours
I. Congenital: dermoid and lipodermoid (choristomas).
II. Benign: simple granuloma, papilloma, adenoma,
fibroma and angiomas.
III. Premalignant: intraepithelial epithelioma (Bowen's disease).
IV. Malignant: epithelioma or squamous cell carcinoma, basal

cell carcinoma.


Pigmented tumours
I. Benign: naevi or congenital moles.
II. Precancerous melanosis: superficial spreading melanoma

and lentigo maligna (Hutchinson's freckle).

III. Malignant: primary melanoma (malignant melanoma).

? Dermoids
? lenticular yellow tumours,
? At the corneal margin, most

commonly at the outer side

? Consist of epidermoid

epithelium with sebaceous

glands and hair

? Syndromic associations


Pigmented Tumours

Naevi or congenital mole
Precancerous melanosis
Malignant melanoma

Malignant melanoma


DEGENERATIVE CHANGES IN THE CONJUNCTIVA
Concretions (Lithiasis)
Pterygium
Pinguecula

Concretions (Lithiasis)
These occur as minute, hard, yellow spots in

the palpebral conjunctiva.

Concretions are formed due to the

accumulation of epithelial cells and

inspissated mucus in depressions called Henle

glands.

Foreign body sensation
Treatment: Remove with a sharp

needle.


Pterygium
Pterygium - a wing
It is a triangular encroachment of the vascularized granulation

tissue covered by conjunctiva in the interpalpebral area

Degenerative condition of the subconjunctival tissues
Often bilateral, usually present on the nasal side
Aetiopathogenesis
Dry sunny climates - Ultraviolet light
Degeneration of the subconjunctival tissues
Proliferates as avascularized granulation tissue encroaching

upon the cornea destroying the superficial layers of the

stroma and Bowman's membrane

Formation of dense fibrous tissue leads to the development of

corneal astigmatism

Clinical features
? Symptoms
? Foreign body sensation
? Watering
? Redness (inflamed)
? Blurring of vision due to induced astigmatism or

progression into the pupillary area of the cornea
Head
Body

Neck

Cap

Types
Progressive
Regressive
Atrophic


Various forms of pterygium, including simultaneous nasal and temporal pterygium (A),

quiescent nasal pterygium (B), inflammatory nasal pterygium (C) and inflammatory

temporal pterygium (D).

Pseudopterygium
Pinguecula
Limbal dermoid


Treatment
Observation in early stages
Surgical removal is the only satisfactory treatment
Recurrence

Excision with conjunctival autograft


Psuedopterygium

Pterygium-like lesion
Induced by cicatrizing conjunctival inflammatory overgrowth
Produced by trauma, thermo-chemical burn or chronic

conjunctivitis

chemical

Pterygium

Psuedopterygium

1. Degenerative process

? 1. Inflamatory process

2. Common in elderly

? 2. Can occur at any age

persons

3. Always situated in the

? 3. Can occur at any site

palpebral aperture

4. Progressive regressive or

? 4. Non progressive

stationery

5. Probe test negative

? 5. Probe test positive


Pinguecula
This is a triangular patch on the conjunctiva
Yellow in colour and looks like fat, hence the name (pinguis,

fat).

Found in elderly people, especially those exposed to strong

sunlight, dust, wind, etc.

Pterygium frequently follows a pinguecula.
It is due to hyaline infiltration and elastotic degeneration of

the sub-mucous tissue.

It requires no treatment.
Viral conjunctivitis

1.Acute serous conjunctivitis
2. Acute haemorrhagic conjunctivitis
3. Acute follicular conjunctivitis

ACUTE SEROUS CONJUNCTIVITIS
Etiology: Mild grade viral infection which does not give rise

to follicular response.

Clinical features.
Characterised by a minimal degree of congestion, a watery

discharge and a boggy swelling of the conjunctival mucosa.

Treatment.
Usually it is self-limiting
Broad spectrum antibiotic eye drops.
ACUTE HAEMORRHAGIC CONJUNCTIVITIS
Multiple conjunctival haemorrhages, conjunctival hyperaemia

and mild follicular hyperplasia.

Etiology: Enterovirus 70.
No specific effective treatment.
Broad spectrum antibiotic eye drops may be used to prevent
secondary bacterial infections.
Usually the disease has a self-limiting course of 5-7 days.

FOLLICULAR CONJUNCTIVITIS

1. Acute follicular conjunctivitis.
2. Chronic follicular conjunctivitis.
3. Specific type of conjunctivitis
1. Acute follicular conjunctivitis.
Adult inclusion conjunctivitis
Epidemic keratoconjunctivitis
Pharyngoconjunctival fever
Newcastle conjunctivitis
Acute herpetic conjunctivitis

Treament

Symptomatic
Prevention of secondary infection.