1 Flashcards
(146 cards)
1
Q
peripheral corneal edema
A
Brown-McLean syndrome
2
Q
basal tear secretion rate
A
2 ul/min
3
Q
adult diameter
A
11-12 mm H. 10-11 mm V
4
Q
Diameter at birth
A
9.5-10mm H.
5
Q
Radius of curvature average
A
ant 7.8mm. post 6.2-6.8mm
6
Q
Power
A
ant 49.0D ant. -6D post. 43D total
7
Q
Refractive index overall (keratometry)
A
1.3375
8
Q
Keratometry measures
A
2 points 3 mm apart
9
Q
cornea innervation
A
70-80 branches of long posterior ciliary nerves
10
Q
collagen type IV
A
epi secretes, basal lamina, Descemet
11
Q
collagen type I
A
Bowman’s membrane, stroma (V i VI also), sclera
12
Q
collagen type III
A
wound repair
13
Q
Stroma collagen
A
I, V, VI
14
Q
Bowman collagen
A
I
15
Q
wound repair collagen
A
III
16
Q
Descemet collagen
A
IV
17
Q
basal lamina collagen
A
IV
18
Q
sclera collagen
A
I
19
Q
Enlarged corneal nerves
A
NFL map. Neurofibromatosis, Familial Dysautotnomia (Riley-Day), Leprosy, MENIIB, Acanthamoeba, Phytanic acid deficiency (Refsum)
20
Q
More visible corneal nerves
A
CCKIF. Corneal edema. Congenital glaucoma. Keratoconus. Ichthyosis. Fuchs
21
Q
Verticillata - where
A
FACCI. Fabry, Amiodarone, Chlorouine, Chloropromazine, Indomethacin (Nsaids)
22
Q
What penetrate intact epithelium
A
SCHLN. Shigella, Corynebactrium diphtheriae, Haemophilus aegyptus, Listeria monocytogenes, Neisseria
23
Q
Culturing Acanthamoeba
A
nonnutreint agar with E.Coli or E. Aerogenes
24
Q
Histo staining for Acanthamoeba
A
H&E, PAS, calcofluor white, acridine orange, Gridley, Giemsa
25
Average tear volume
7-10 microliters
26
basic secretion test
with anesthetic. abnormal <3mm, equivocal 3-10mm
27
Schirmer I test
no anesthetic (both basic and reflex). abnormal <5.5mm
28
Schirmer II test
anesthetic + nasal mucosa stimulated with cotton-tipped applicator (only reflex secretion). abnormal <15mm at 2 minutes
29
dry eye - change in proteins
decreased lysozyme and lactoferrin levels
30
c-ANCA
Granulomatosis with polyangiitis
31
ANA
lupus
32
immunocompromised + Valacyclovir
thrombotic thrombocytopenic purpura or hemolytic uremia syndrome
33
Treatment of non-necrotizing diffuse anterior scleritis
oral NSAIDS
34
post-refractive surgery keratitis - what and when
atypical mycobacteria, >20days after surgery
35
I-S values in keratoconus
>1.4
36
Acute hydrops - treatment
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.
37
Porphyria cutanea tarda
scarring and vesicles in sun exposed areas of the skin, conjunctiva and cornea. similar to bullous pemphigoid
38
ophthalmomyiasis
fly maggots (larva)
39
Leishmania
severe granulomatous inflammation of the eyelid
40
Unilateral arcus senilis
contralateral carotid artery disease --> carotid Doppler ultrasound
41
Arcus senilis <40 yo
hyperlipoproteinemia
42
Fleischer ring
iron line deposited at the base of the cone. Provides landmark of the peripheral edge of the cone
43
Vogt lines
fine opaque parallel lines in the deep stroma of keratoconus. Disappear on digital pressure
44
Most common indication for corneal transplant in children
Peters anomaly
45
Cloudy corneal at birth
STUMPED. Sclerocornea, Trauma, Ulcer, Mucopolysaccharidoses, Peters anomaly, Endothelial (CHED), Dermoid
46
Peters - genetics
sporadically. Type 1 - FOXC1, CYP1B1, PITX2, PAX6. Type 2 - FOXE3
47
Herpes zoster ophthalmicus - Iris
Sectoral iris atrophy
48
HZO - treatment immunocompetent
oral Valacyclovir 1 gram 3x or Acyclovir 800mg 5x/day or Famciclovir 500 mg 3x 7-10 day course
49
HZO - treatment immunocompromised
i.v. Acyclovir (10 mg/kg twice daily)
50
Most commonly involved branch in HZO
Frontal
51
HZO - branch that confers higher risk of ocular involvement
Nasociliary
52
Iron lines
"tear star". Epithelial iron deposition in areas with pooling of tears - 80% patients after radial keratotomy
53
Ferry's line
at the leading edge of a filtering bleb
54
Stocker's line
at the leading edge of a pterygium
55
Hudson-Stahli line
at the upper border of the normal tear layer (elderly)
56
Kayser-Fleischer ring
Wilson. peripehral corneal. at the level of Descemet's membrane
57
Salzmann nodular degeneration - what and where
hyaline material deposited in Bowman's layer. chronic irritation of the cornea, rarely CL
58
Batten disease
neurodegenerative lipofuscinosis. accumulation of lipopigments in lysozymes, also conjunctiva
59
peripheral endothelial guttae that develop with normal aging
Hassall-Henle bodies
60
Hassall-Henle bodies
peripheral endothelial guttae that develop with normal aging
61
Spheroidal degeneration - where, when, other names
golden-brown in superficial stroma, bilateral interpalpebral zone, old males. climatic droplet keratopathy/Labrador keratopathy
62
golden-brown in superficial stroma, bilateral interpalpebral zone, old males. climatic droplet keratopathy/Labrador keratopathy
Spheroidal degeneration
63
Cowdry bodies
eosinophilic nuclear inclusions (composed of nucleic acid and protein) in cells with HSV, VZV, CMV
64
eosinophilic nuclear inclusions (composed of nucleic acid and protein) in cells with HSV, VZV, CMV
Cowdry bodies
65
Streptococcus viridans - what group of bacteria
alpha-hemolytic streptoccus
66
Conjunctival flap (Gundersen) - indications
persistent epithelial defect in a poor visual potential eye
67
Early findings of LSCD
loss of palisades of Vogt, peripheral pannus formation, late staining of the epithelium ("wavelike" irregularity)
68
LSCD - hallmark
presence of conjunctival goblet cells in the corneal epithelium - impression cytology
69
Keratoglobus
present at birth, generalized thinning, thins paracentrally
70
Pellucid marginal degeneration - where is the thinning
inferior thinning with protrusion above the thinning (corneal apex is above the area of thinning)
71
Congenital keloids - syndromes
Lowe, ACL (acromegaly, cutis gyrata, leukoma), Rubinstein-Taybi
72
defective enzyme in Fabry disease
alpha galactosidase A
73
Fabry disease - characteristics
renal failure, peripheral neuropathy, cornea verticillata
74
Multiple myeloma, Waldenstrom macroglobulinemia, benign monoclonal gammapathy
corneal crystals in all layers of the cornea
75
corneal crystals in all layers of the cornea
Multiple myeloma, Waldenstrom macroglobulinemia, benign monoclonal gammapathy
76
Mooren-like PUK - association
Hep C
77
PUK - associations
Rheumatoid arthritis, Wegener, SLE, PAN, HSV, VZV, TB, gonorrhea, syphilis, AIDS
78
"beer belly"
ectatic pattern of PMD
79
After how many days doues rebleeding generally occur after a traumatic hyphema?
2-7 days
80
Band keratopathy - what and where in cornea
Calcium (also urate - then brown) mainly in Bowman layer but also in the anterior stroma
81
Which technique highest rate of pterygium recurrence
bare sclera
82
stromal keratitis, vertigo and hearing loss
Cogan syndrome
83
Cogan syndrome
stromal keratitis, vertigo and hearing loss. Topical and oral steroids.
84
child with recurrent pseudodendrites
Tyrosinemia - AR
85
Tyrosinemia
child with recurrent pseudodendrites. AR
86
Cystinosis
anterior stroma crystals, patchy depigmentation of the RPE, renal impairment. AR. No loss of vision
87
anterior stroma crystals, patchy depigmentation of the RPE, renal impairment. AR. No loss of vision
Cystinosis
88
Alkaptonuria
pigmented material near the medial and lateral muscle insertions
89
pigmented material near the medial and lateral muscle insertions
Alkaptonuria
90
Salzmann nodular degeneration - when
chronic keratitis, phlyctenulosis, trachoma, interstitial keratitis. middle-aged and older women
91
toxic ulcerative keratopathy
BAK, topical anesthetics, NSAIDs, TRIFLUORIDINE, B-blockers, carbonic anhydrase inhibitors
92
keratoconjunctivitis with needle-like calcium oxalate crystals
Dieffenbachia plant
93
Dieffenbachia plant
keratoconjunctivitis with needle-like calcium oxalate crystals
94
Crystals
Dieffenbachia plant, Macular Lattice Granular Bietti Schnyders dystrophies. Ciloxan depostis, S. viridans, cystinosis, multiple myeloma, monoclonal gammapathy
95
Mikulicz syndrome
lacrimal gland enlargement, salivary gland enlargement, keratoconjunctivitis sicca. Risk of lymphomas
96
lacrimal gland enlargement, salivary gland enlargement, keratoconjunctivitis sicca.
Mikulicz syndrome
97
Band keratopathy - disturbances in serum
elevated phosphorus, elevated calcium, decreased potassium
98
Terrien marignal degeneration
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
Microphthalmos
small disorganized globe. Associations: Trisomy 13, mr, dwarfism
100
Small disorganized globe
Microphthalmos
101
Small normal eye
Nanophthalmos
102
Riley-Day syndrome - other name
Familial Dysautonomia
103
Familial Dysautonomia - other name
Riley-Day syndrome
104
Riley-Day syndrome
neurotrophic keratopathy, Asheknazi, skin blotching, decreased tearing when crying
105
Primary LSCD
congenital aniridia, ectodermal dysplasia, sclerocornea, KID syndrome, congenital erythrokeratodermia
106
Epibulbar dermoid - location
inferotemporally ( dermoid cyst - superotemporally)
107
Epibulbar dermoid - what astigmatism
induced plus astigmatism 90 degress away
108
When to perform AC washout to remove a hyphema
IOP >60 for 2 days, >35 for 7 days, >25 for 1 day in a patient with sickle cell disease
109
Unknown cause of band keratopathy - what to assess
serum calcium, phosphorus, uric acid, blood urea nitrogen, creatine, parathyroid hormone, ACE, urinanalysis
110
Natamycin 5% for
Fusarium infections
111
Amphotericin B for
Candida and Aspergillus
112
Candida and Aspergillus - treatment
Amphotericin B or Voriconazol
113
Fusarium - treatment
Natamycin 5%
114
p-ANCA
polyarteritis nodosa, inflammatory bowel disorder
115
Megalocornea - definition, genetics
horizontal cornea diameter >=13 mm, NORMAL axial length, XLR, may be in Marfan's
116
Associations of Keratoglobus
perforation and rupture. Ehlers-Danlos type VI, blue sclera, flexible joints, bone fractures, deafness
117
Antibodies in Sjogres syndrome
ANA, SS-A, SS-B
118
Aqueous components of the tears is produced by
Krause, Wolfring glands. lacrimal glands
119
Difference between PUK and Mooren's
PUK involved both cornea and sclera. Mooren's only cornea.
120
Single eye drop - volume
50ul
121
Maximum volume of conjunctival sac
20ul
122
Microsporidiosis - treatment
fumagilin
123
Microcornea - definition
Clear, normal thickness. Horizontal diameter less than 10mm.
124
Microcornea - genetics
AD
125
Microcornea - associations
hyperopia, angle closure glaucoma, 20% open angle glaucoma
126
Condition that mimics Terrien marginal degeneration but is seen in children
Fuchs superficial marginal keratitis
127
What is the most common manifestiation of Congenital Rubella Syndrome
salt-and-pepper pigmentary retinopathy
128
What si the most common systemic manifestation of Congenital Rubella Syndrome
deafness
129
Nanophthalmos - associations
chronic angle closure, elevated episcleral venous pressure, hyperopia (7-15), short axial length (15-20mm), STRABISMUS
130
Which branch of the trigeminal nerve is most commonly involved in HZO?
Frontal (of the ophthalmic division CN V1)
131
Involvement of which branch of trigeminal nerve confers a higher risk of ocualr involvement
Nasociliary (of the ophthalmic division CN V1)
132
Senile furrow degeneration
slight thinning of the cornea in the lucid area between the limbus and the start of arcus. Induces astigmatism
133
Cogan syndrome - systemic association
stromal keratitis, vertigo and hearing loss. Poliarteritis nodosa
134
Which organism is associated with an acute fulminant endophthalmitis following an open globe injury contaminated with soil?
Bacillus cereus (25% of cases of traumatic endophthalmitis)
135
Vascular ingrowth in lipid keratopathy - treatment
argon laser to limbal feeding vessels
136
Lipid line occurs at the edge of the pannus
Terrien's marginal degeneration
137
Pattern of clearance of corneal blood staining
Centripetally (periphery first, then to the center)
138
Mechanism of blood staining
RBC --> release hemoglobin --> posterior corneal stroma --> kertocytes absorb --> hemosiderin
139
EBV most commonly presents with
multifocal corneal infiltrates
140
when to perform limbal stem cell transplantation in no improving severe alkali corneal burn
after 2 weeks
141
Sign of primary HSV infection
enlarged preauricular lymph node
142
What layers of the cornea are absent with a delle?
none are absent
143
Cornea plana
flat, central corneal power <43D. Curvature similar to the adjacent sclera. in Finnish, in Ehlers-Danlos.
144
HSV epithelial dendrite
terminal bulbs (+)Rose Bengal, (+)Fluo. patchy iris atrophy
145
VZV epithelial dendrite
tapered ends. sectoral iris atrophy
146
Negative staining
VZV mucous plaque lesions
