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Cornea > 1 > Flashcards

1 Flashcards

1
Q

peripheral corneal edema

A

Brown-McLean syndrome

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2
Q

basal tear secretion rate

A

2 ul/min

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3
Q

adult diameter

A

11-12 mm H. 10-11 mm V

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4
Q

Diameter at birth

A

9.5-10mm H.

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5
Q

Radius of curvature average

A

ant 7.8mm. post 6.2-6.8mm

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6
Q

Power

A

ant 49.0D ant. -6D post. 43D total

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7
Q

Refractive index overall (keratometry)

A

1.3375

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8
Q

Keratometry measures

A

2 points 3 mm apart

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9
Q

cornea innervation

A

70-80 branches of long posterior ciliary nerves

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10
Q

collagen type IV

A

epi secretes, basal lamina, Descemet

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11
Q

collagen type I

A

Bowman’s membrane, stroma (V i VI also), sclera

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12
Q

collagen type III

A

wound repair

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13
Q

Stroma collagen

A

I, V, VI

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14
Q

Bowman collagen

A

I

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15
Q

wound repair collagen

A

III

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16
Q

Descemet collagen

A

IV

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17
Q

basal lamina collagen

A

IV

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18
Q

sclera collagen

A

I

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19
Q

Enlarged corneal nerves

A

NFL map. Neurofibromatosis, Familial Dysautotnomia (Riley-Day), Leprosy, MENIIB, Acanthamoeba, Phytanic acid deficiency (Refsum)

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20
Q

More visible corneal nerves

A

CCKIF. Corneal edema. Congenital glaucoma. Keratoconus. Ichthyosis. Fuchs

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21
Q

Verticillata - where

A

FACCI. Fabry, Amiodarone, Chlorouine, Chloropromazine, Indomethacin (Nsaids)

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22
Q

What penetrate intact epithelium

A

SCHLN. Shigella, Corynebactrium diphtheriae, Haemophilus aegyptus, Listeria monocytogenes, Neisseria

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23
Q

Culturing Acanthamoeba

A

nonnutreint agar with E.Coli or E. Aerogenes

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24
Q

Histo staining for Acanthamoeba

A

H&E, PAS, calcofluor white, acridine orange, Gridley, Giemsa

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25
Q

Average tear volume

A

7-10 microliters

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26
Q

basic secretion test

A

with anesthetic. abnormal <3mm, equivocal 3-10mm

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27
Q

Schirmer I test

A

no anesthetic (both basic and reflex). abnormal <5.5mm

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28
Q

Schirmer II test

A

anesthetic + nasal mucosa stimulated with cotton-tipped applicator (only reflex secretion). abnormal <15mm at 2 minutes

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29
Q

dry eye - change in proteins

A

decreased lysozyme and lactoferrin levels

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30
Q

c-ANCA

A

Granulomatosis with polyangiitis

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31
Q

ANA

A

lupus

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32
Q

immunocompromised + Valacyclovir

A

thrombotic thrombocytopenic purpura or hemolytic uremia syndrome

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33
Q

Treatment of non-necrotizing diffuse anterior scleritis

A

oral NSAIDS

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34
Q

post-refractive surgery keratitis - what and when

A

atypical mycobacteria, >20days after surgery

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35
Q

I-S values in keratoconus

A

> 1.4

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36
Q

Acute hydrops - treatment

A

hypertonic saline drops, patching, cycloplegia, aqueous suppressants, bandage soft contact lens. Pneumatic descemetopexy (injection of air or gas e.g. C3F8, SF6) into the AC.

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37
Q

Porphyria cutanea tarda

A

scarring and vesicles in sun exposed areas of the skin, conjunctiva and cornea. similar to bullous pemphigoid

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38
Q

ophthalmomyiasis

A

fly maggots (larva)

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39
Q

Leishmania

A

severe granulomatous inflammation of the eyelid

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40
Q

Unilateral arcus senilis

A

contralateral carotid artery disease –> carotid Doppler ultrasound

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41
Q

Arcus senilis <40 yo

A

hyperlipoproteinemia

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42
Q

Fleischer ring

A

iron line deposited at the base of the cone. Provides landmark of the peripheral edge of the cone

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43
Q

Vogt lines

A

fine opaque parallel lines in the deep stroma of keratoconus. Disappear on digital pressure

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44
Q

Most common indication for corneal transplant in children

A

Peters anomaly

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45
Q

Cloudy corneal at birth

A

STUMPED. Sclerocornea, Trauma, Ulcer, Mucopolysaccharidoses, Peters anomaly, Endothelial (CHED), Dermoid

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46
Q

Peters - genetics

A

sporadically. Type 1 - FOXC1, CYP1B1, PITX2, PAX6. Type 2 - FOXE3

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47
Q

Herpes zoster ophthalmicus - Iris

A

Sectoral iris atrophy

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48
Q

HZO - treatment immunocompetent

A

oral Valacyclovir 1 gram 3x or Acyclovir 800mg 5x/day or Famciclovir 500 mg 3x 7-10 day course

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49
Q

HZO - treatment immunocompromised

A

i.v. Acyclovir (10 mg/kg twice daily)

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50
Q

Most commonly involved branch in HZO

A

Frontal

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51
Q

HZO - branch that confers higher risk of ocular involvement

A

Nasociliary

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52
Q

Iron lines

A

“tear star”. Epithelial iron deposition in areas with pooling of tears - 80% patients after radial keratotomy

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53
Q

Ferry’s line

A

at the leading edge of a filtering bleb

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54
Q

Stocker’s line

A

at the leading edge of a pterygium

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55
Q

Hudson-Stahli line

A

at the upper border of the normal tear layer (elderly)

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56
Q

Kayser-Fleischer ring

A

Wilson. peripehral corneal. at the level of Descemet’s membrane

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57
Q

Salzmann nodular degeneration - what and where

A

hyaline material deposited in Bowman’s layer. chronic irritation of the cornea, rarely CL

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58
Q

Batten disease

A

neurodegenerative lipofuscinosis. accumulation of lipopigments in lysozymes, also conjunctiva

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59
Q

peripheral endothelial guttae that develop with normal aging

A

Hassall-Henle bodies

60
Q

Hassall-Henle bodies

A

peripheral endothelial guttae that develop with normal aging

61
Q

Spheroidal degeneration - where, when, other names

A

golden-brown in superficial stroma, bilateral interpalpebral zone, old males. climatic droplet keratopathy/Labrador keratopathy

62
Q

golden-brown in superficial stroma, bilateral interpalpebral zone, old males. climatic droplet keratopathy/Labrador keratopathy

A

Spheroidal degeneration

63
Q

Cowdry bodies

A

eosinophilic nuclear inclusions (composed of nucleic acid and protein) in cells with HSV, VZV, CMV

64
Q

eosinophilic nuclear inclusions (composed of nucleic acid and protein) in cells with HSV, VZV, CMV

A

Cowdry bodies

65
Q

Streptococcus viridans - what group of bacteria

A

alpha-hemolytic streptoccus

66
Q

Conjunctival flap (Gundersen) - indications

A

persistent epithelial defect in a poor visual potential eye

67
Q

Early findings of LSCD

A

loss of palisades of Vogt, peripheral pannus formation, late staining of the epithelium (“wavelike” irregularity)

68
Q

LSCD - hallmark

A

presence of conjunctival goblet cells in the corneal epithelium - impression cytology

69
Q

Keratoglobus

A

present at birth, generalized thinning, thins paracentrally

70
Q

Pellucid marginal degeneration - where is the thinning

A

inferior thinning with protrusion above the thinning (corneal apex is above the area of thinning)

71
Q

Congenital keloids - syndromes

A

Lowe, ACL (acromegaly, cutis gyrata, leukoma), Rubinstein-Taybi

72
Q

defective enzyme in Fabry disease

A

alpha galactosidase A

73
Q

Fabry disease - characteristics

A

renal failure, peripheral neuropathy, cornea verticillata

74
Q

Multiple myeloma, Waldenstrom macroglobulinemia, benign monoclonal gammapathy

A

corneal crystals in all layers of the cornea

75
Q

corneal crystals in all layers of the cornea

A

Multiple myeloma, Waldenstrom macroglobulinemia, benign monoclonal gammapathy

76
Q

Mooren-like PUK - association

77
Q

PUK - associations

A

Rheumatoid arthritis, Wegener, SLE, PAN, HSV, VZV, TB, gonorrhea, syphilis, AIDS

78
Q

“beer belly”

A

ectatic pattern of PMD

79
Q

After how many days doues rebleeding generally occur after a traumatic hyphema?

80
Q

Band keratopathy - what and where in cornea

A

Calcium (also urate - then brown) mainly in Bowman layer but also in the anterior stroma

81
Q

Which technique highest rate of pterygium recurrence

A

bare sclera

82
Q

stromal keratitis, vertigo and hearing loss

A

Cogan syndrome

83
Q

Cogan syndrome

A

stromal keratitis, vertigo and hearing loss. Topical and oral steroids.

84
Q

child with recurrent pseudodendrites

A

Tyrosinemia - AR

85
Q

Tyrosinemia

A

child with recurrent pseudodendrites. AR

86
Q

Cystinosis

A

anterior stroma crystals, patchy depigmentation of the RPE, renal impairment. AR. No loss of vision

87
Q

anterior stroma crystals, patchy depigmentation of the RPE, renal impairment. AR. No loss of vision

A

Cystinosis

88
Q

Alkaptonuria

A

pigmented material near the medial and lateral muscle insertions

89
Q

pigmented material near the medial and lateral muscle insertions

A

Alkaptonuria

90
Q

Salzmann nodular degeneration - when

A

chronic keratitis, phlyctenulosis, trachoma, interstitial keratitis. middle-aged and older women

91
Q

toxic ulcerative keratopathy

A

BAK, topical anesthetics, NSAIDs, TRIFLUORIDINE, B-blockers, carbonic anhydrase inhibitors

92
Q

keratoconjunctivitis with needle-like calcium oxalate crystals

A

Dieffenbachia plant

93
Q

Dieffenbachia plant

A

keratoconjunctivitis with needle-like calcium oxalate crystals

94
Q

Crystals

A

Dieffenbachia plant, Macular Lattice Granular Bietti Schnyders dystrophies. Ciloxan depostis, S. viridans, cystinosis, multiple myeloma, monoclonal gammapathy

95
Q

Mikulicz syndrome

A

lacrimal gland enlargement, salivary gland enlargement, keratoconjunctivitis sicca. Risk of lymphomas

96
Q

lacrimal gland enlargement, salivary gland enlargement, keratoconjunctivitis sicca.

A

Mikulicz syndrome

97
Q

Band keratopathy - disturbances in serum

A

elevated phosphorus, elevated calcium, decreased potassium

98
Q

Terrien marignal degeneration

A

TMD. TTTTT Thinning, Top (superior), Transversing pannus over area of thinning, Thirties, Transplantation (crescent shaped lamellar). M-Male3:1. D-deposition of lipid. Intact epi (no pain), steepening 90 st. away (against-the-rule)

99
Q

Microphthalmos

A

small disorganized globe. Associations: Trisomy 13, mr, dwarfism

100
Q

Small disorganized globe

A

Microphthalmos

101
Q

Small normal eye

A

Nanophthalmos

102
Q

Riley-Day syndrome - other name

A

Familial Dysautonomia

103
Q

Familial Dysautonomia - other name

A

Riley-Day syndrome

104
Q

Riley-Day syndrome

A

neurotrophic keratopathy, Asheknazi, skin blotching, decreased tearing when crying

105
Q

Primary LSCD

A

congenital aniridia, ectodermal dysplasia, sclerocornea, KID syndrome, congenital erythrokeratodermia

106
Q

Epibulbar dermoid - location

A

inferotemporally ( dermoid cyst - superotemporally)

107
Q

Epibulbar dermoid - what astigmatism

A

induced plus astigmatism 90 degress away

108
Q

When to perform AC washout to remove a hyphema

A

IOP >60 for 2 days, >35 for 7 days, >25 for 1 day in a patient with sickle cell disease

109
Q

Unknown cause of band keratopathy - what to assess

A

serum calcium, phosphorus, uric acid, blood urea nitrogen, creatine, parathyroid hormone, ACE, urinanalysis

110
Q

Natamycin 5% for

A

Fusarium infections

111
Q

Amphotericin B for

A

Candida and Aspergillus

112
Q

Candida and Aspergillus - treatment

A

Amphotericin B or Voriconazol

113
Q

Fusarium - treatment

A

Natamycin 5%

114
Q

p-ANCA

A

polyarteritis nodosa, inflammatory bowel disorder

115
Q

Megalocornea - definition, genetics

A

horizontal cornea diameter >=13 mm, NORMAL axial length, XLR, may be in Marfan’s

116
Q

Associations of Keratoglobus

A

perforation and rupture. Ehlers-Danlos type VI, blue sclera, flexible joints, bone fractures, deafness

117
Q

Antibodies in Sjogres syndrome

A

ANA, SS-A, SS-B

118
Q

Aqueous components of the tears is produced by

A

Krause, Wolfring glands. lacrimal glands

119
Q

Difference between PUK and Mooren’s

A

PUK involved both cornea and sclera. Mooren’s only cornea.

120
Q

Single eye drop - volume

121
Q

Maximum volume of conjunctival sac

122
Q

Microsporidiosis - treatment

123
Q

Microcornea - definition

A

Clear, normal thickness. Horizontal diameter less than 10mm.

124
Q

Microcornea - genetics

125
Q

Microcornea - associations

A

hyperopia, angle closure glaucoma, 20% open angle glaucoma

126
Q

Condition that mimics Terrien marginal degeneration but is seen in children

A

Fuchs superficial marginal keratitis

127
Q

What is the most common manifestiation of Congenital Rubella Syndrome

A

salt-and-pepper pigmentary retinopathy

128
Q

What si the most common systemic manifestation of Congenital Rubella Syndrome

129
Q

Nanophthalmos - associations

A

chronic angle closure, elevated episcleral venous pressure, hyperopia (7-15), short axial length (15-20mm), STRABISMUS

130
Q

Which branch of the trigeminal nerve is most commonly involved in HZO?

A

Frontal (of the ophthalmic division CN V1)

131
Q

Involvement of which branch of trigeminal nerve confers a higher risk of ocualr involvement

A

Nasociliary (of the ophthalmic division CN V1)

132
Q

Senile furrow degeneration

A

slight thinning of the cornea in the lucid area between the limbus and the start of arcus. Induces astigmatism

133
Q

Cogan syndrome - systemic association

A

stromal keratitis, vertigo and hearing loss. Poliarteritis nodosa

134
Q

Which organism is associated with an acute fulminant endophthalmitis following an open globe injury contaminated with soil?

A

Bacillus cereus (25% of cases of traumatic endophthalmitis)

135
Q

Vascular ingrowth in lipid keratopathy - treatment

A

argon laser to limbal feeding vessels

136
Q

Lipid line occurs at the edge of the pannus

A

Terrien’s marginal degeneration

137
Q

Pattern of clearance of corneal blood staining

A

Centripetally (periphery first, then to the center)

138
Q

Mechanism of blood staining

A

RBC –> release hemoglobin –> posterior corneal stroma –> kertocytes absorb –> hemosiderin

139
Q

EBV most commonly presents with

A

multifocal corneal infiltrates

140
Q

when to perform limbal stem cell transplantation in no improving severe alkali corneal burn

A

after 2 weeks

141
Q

Sign of primary HSV infection

A

enlarged preauricular lymph node

142
Q

What layers of the cornea are absent with a delle?

A

none are absent

143
Q

Cornea plana

A

flat, central corneal power <43D. Curvature similar to the adjacent sclera. in Finnish, in Ehlers-Danlos.

144
Q

HSV epithelial dendrite

A

terminal bulbs (+)Rose Bengal, (+)Fluo. patchy iris atrophy

145
Q

VZV epithelial dendrite

A

tapered ends. sectoral iris atrophy

146
Q

Negative staining

A

VZV mucous plaque lesions

Cornea (10 decks)

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