125. Emergency Ophthalmic Surgery Questions

Question 1

What is the preferred suture material for closing the muscle and fibrous layers in full-thickness eyelid lacerations? a) 3-0 Nylon b) 5-0 or 6-0 Polyglactin 910 c) 4-0 Polydioxanone d) 7-0 Polypropylene

Answer 1

b) 5-0 or 6-0 Polyglactin 910

Question 2

The primary goal in treating eyelid lacerations is to: a) Remove necrotic tissue b) Prevent scar formation c) Achieve anatomic reapposition d) Promote granulation tissue

Answer 2

c) Achieve anatomic reapposition

Question 3

The figure of eight suture technique is preferred for: a) Corneal laceration repair b) Nasolacrimal duct laceration c) Eyelid margin closure d) Third eyelid lacerations

Answer 3

c) Eyelid margin closure

Question 4

Damage to the nasolacrimal puncta in medial canthal lacerations may lead to: a) Chronic epiphora b) Corneal ulceration c) Conjunctivitis d) Keratoconjunctivitis sicca

Answer 4

a) Chronic epiphora

Question 5

The most common autograft used in corneal reconstruction in veterinary ophthalmology is: a) Lamellar keratoplasty b) Bulbar conjunctival graft c) Corneal allograft d) Biosynthetic graft

Answer 5

b) Bulbar conjunctival graft

Question 6

The primary indication for performing a conjunctival pedicle graft is: a) Lens luxation b) Superficial corneal ulcer c) Deepening corneal ulcer d) Retinal detachment

Answer 6

c) Deepening corneal ulcer

Question 7

When performing a rotational conjunctival pedicle graft, the incision begins: a) 2 mm proximal to the limbus b) 1 mm temporal to the limbus c) At the nasal limbus d) At the center of the ulcer

Answer 7

b) 1 mm temporal to the limbus

Question 8

Which suture pattern is preferred for securing a corneal allograft? a) Cruciate b) Simple continuous c) Horizontal mattress d) Simple interrupted

Answer 8

d) Simple interrupted

Question 9

The most common site of scleral rupture in dogs following blunt trauma is: a) The limbus b) The posterior pole c) The equator d) The optic nerve head

Answer 9

b) The posterior pole

Question 10

Corneal foreign bodies are typically: a) Metallic fragments b) Organic plant material c) Synthetic fibers d) Bone splinters

Answer 10

b) Organic plant material

Question 11

An anterior lens luxation is considered an emergency because it can lead to: a) Cataract formation b) Severe anterior uveitis c) Conjunctivitis d) Corneal dystrophy

Answer 11

b) Severe anterior uveitis

Question 12

The optimal treatment for a proptosed eye with minimal extraocular muscle damage is: a) Enucleation b) Temporary tarsorrhaphy c) Orbital exenteration d) Topical corticosteroids

Answer 12

b) Temporary tarsorrhaphy

Question 13

In cases of traumatic proptosis, which muscle is most commonly torn? a) Lateral rectus b) Medial rectus c) Dorsal oblique d) Ventral oblique

Answer 13

b) Medial rectus

Question 14

During a temporary keratostomy, which gauge needle is typically used? a) 18 gauge b) 21 gauge c) 25 gauge d) 30 gauge

Answer 14

d) 30 gauge

Question 15

Which of the following techniques is most commonly used for emergency extraction of a luxated lens? a) Cryoextraction b) Phacoemulsification c) Intracapsular cataract extraction d) Lens loop extraction

Answer 15

a) Cryoextraction

Question 16

The preferred orientation for the conjunctival pedicle arm in relation to blinking action is: a) Horizontal b) Vertical c) Oblique d) Circular

Answer 16

b) Vertical

Question 17

For corneal reconstruction, extracellular matrix grafts are typically derived from: a) Bovine skin b) Porcine small intestinal submucosa c) Equine pericardium d) Canine cartilage

Answer 17

b) Porcine small intestinal submucosa

Question 18

The most important predictor of successful corneal allograft adherence is: a) The use of antibiotics b) Removal of the epithelium c) Size of the graft d) Suturing technique

Answer 18

b) Removal of the epithelium

Question 19

What is the most common long-term complication following temporary tarsorrhaphy? a) Corneal ulceration b) Glaucoma c) Orbital cellulitis d) Retinal detachment

Answer 19

a) Corneal ulceration

Question 20

A conjunctival graft should ideally be left in place for: a) 2-3 weeks b) 4-5 weeks c) 6-8 weeks d) 9-10 weeks

Answer 20

c) 6-8 weeks

Question 21

Eyelid lacerations in dogs and cats generally heal poorly due to poor vascular supply. (True/False)

Answer 21

False

Question 22

Conjunctival pedicle grafts maintain their own blood supply, which aids in corneal ulcer healing. (True/False)

Answer 22

True

Question 23

In cases of traumatic proptosis, enucleation is always required. (True/False)

Answer 23

False

Question 24

Anterior lens luxation is an emergency due to the risk of severe anterior uveitis. (True/False)

Answer 24

True

Question 25

A figure of eight suture pattern is commonly used for securing a conjunctival graft. (True/False)

Answer 25

False

Question 26

Damage to the nasolacrimal duct in medial canthal injuries can lead to chronic epiphora. (True/False)

Answer 26

True

Question 27

Bulbar conjunctival grafts are only suitable for superficial corneal ulcers. (True/False)

Answer 27

False

Question 28

A corneoconjunctival transposition can be used for axial lesions larger than 6 mm in diameter. (True/False)

Answer 28

False

Question 29

Phacoemulsification is a technique used to remove a luxated lens. (True/False)

Answer 29

True

Question 30

Corneal allografts can be stored in frozen conditions for months with no loss of endothelial cell viability. (True/False)

Answer 30

False

Question 31

Iris tissue herniating through a corneal laceration should always be sutured back into the eye. (True/False)

Answer 31

False

Question 32

Latanoprost is used to constrict the pupil and maintain the position of a luxated lens. (True/False)

Answer 32

True

Question 33

Blunt trauma is more likely to cause posterior scleral ruptures in dogs than in cats. (True/False)

Answer 33

False

Question 34

Conjunctival grafts should remain in place for 6 to 8 weeks to ensure proper incorporation. (True/False)

Answer 34

True

Question 35

Temporary keratostomy involves inserting a 30 gauge needle to relieve intraocular pressure. (True/False)

Answer 35

True

Question 36

Silicone stents used for nasolacrimal duct repair should remain in place for 6 to 8 weeks. (True/False)

Answer 36

False

Question 37

Intraocular pressure must reach approximately 7000 mm Hg for scleral rupture to occur. (True/False)

Answer 37

True

Question 38

A horizontal mattress suture pattern is preferred for closing corneal lacerations. (True/False)

Answer 38

False

Question 39

Corneal endothelial damage is more likely with frozen allografts compared to fresh ones. (True/False)

Answer 39

True

Question 40

Topical corticosteroids are contraindicated in cases of corneal ulceration. (True/False)

Answer 40

True

Question 41

The optimal suture size for repairing conjunctival lacerations in small animals is: a) 3-0 b) 4-0 c) 5-0 d) 6-0

Answer 41

d) 6-0

Question 42

What type of foreign bodies most commonly cause corneal perforation in dogs? a) Glass fragments b) Plant material c) Metallic splinters d) Plastic debris

Answer 42

b) Plant material

Question 43

The most effective treatment for rapidly deepening corneal ulcers is: a) Topical antibiotics b) Conjunctival graft c) Corneal debridement d) Systemic corticosteroids

Answer 43

b) Conjunctival graft

Question 44

The term 'Gundersons graft' refers to: a) A scleral graft b) A free skin graft c) A bulbar conjunctival graft d) A lamellar corneal graft

Answer 44

c) A bulbar conjunctival graft

Question 45

In corneal reconstruction, which layer is primarily targeted to enhance tectonic stability? a) Epithelium b) Endothelium c) Stroma d) Descemet’s membrane

Answer 45

c) Stroma

Question 46

What is the preferred suture pattern for closing deep corneal lacerations? a) Cruciate b) Horizontal mattress c) Simple continuous d) Simple interrupted

Answer 46

d) Simple interrupted

Question 47

If iris tissue is herniated through a corneal laceration and contaminated, it should be: a) Sutured back in place b) Reduced into the eye c) Resected d) Left untreated

Answer 47

c) Resected

Question 48

In a conjunctival pedicle graft, what is the purpose of dissecting Tenon’s capsule from the graft? a) Improve blood supply b) Reduce tension c) Increase graft thickness d) Facilitate suturing

Answer 48

b) Reduce tension

Question 49

Which technique is used to remove a retro-third eyelid foreign body? a) Cryoextraction b) Lateral canthotomy c) Topical anesthetic and forceps d) Intravitreal injection

Answer 49

c) Topical anesthetic and forceps

Question 50

Which of the following is NOT a typical indication for corneoconjunctival transposition? a) Superficial corneal ulcers b) Deep corneal ulcers c) Perforated corneas d) Axial lesions <5mm

Answer 50

a) Superficial corneal ulcers

Question 51

What is the most significant complication associated with full-thickness corneal grafts? a) Persistent ulceration b) Corneal edema c) Conjunctivitis d) Lens damage

Answer 51

b) Corneal edema

Question 52

Corneal endothelial cell death is commonly associated with: a) Fresh corneal grafts b) Freezing corneal tissue c) Lamellar keratoplasty d) Topical antibiotic therapy

Answer 52

b) Freezing corneal tissue

Question 53

Which medication is commonly used to constrict the pupil and keep a posteriorly luxated lens in place? a) Timolol b) Latanoprost c) Atropine d) Pilocarpine

Answer 53

b) Latanoprost

Question 54

Which procedure is typically performed for a luxated lens that cannot be surgically removed immediately? a) Lens repositioning b) Phacoemulsification c) Anterior chamber washout d) Enucleation

Answer 54

a) Lens repositioning

Question 55

In traumatic proptosis, the most critical step in successful reduction is: a) Application of topical corticosteroids b) Identification and stabilization of eyelid margins c) Orbital decompression d) Use of systemic antibiotics

Answer 55

b) Identification and stabilization of eyelid margins

Question 56

What technique is used to manage a large scleral rupture with macerated edges? a) Cryotherapy b) Phacoemulsification c) Scleral patch graft d) Air tamponade

Answer 56

c) Scleral patch graft

Question 57

Which instrument is commonly used for blunt dissection of Tenons capsule during a pedicle graft? a) Scalpel b) Strabismus scissors c) Beaver blade d) Needle driver

Answer 57

b) Strabismus scissors

Question 58

The ideal time frame for keeping a silicone stent in place when repairing nasolacrimal canaliculi is: a) 1-2 weeks b) 3-4 weeks c) 2-4 months d) 6 months

Answer 58

c) 2-4 months

Question 59

After lens extraction, which procedure helps reduce the risk of retinal detachment? a) Intravitreal injection b) Anterior vitrectomy c) Posterior capsulotomy d) Scleral reinforcement

Answer 59

b) Anterior vitrectomy

Question 60

Which of the following is an absolute contraindication for attempting to reduce a proptosed globe? a) Severe hyphema b) Lateral strabismus c) Complete loss of extraocular muscles d) Intact conjunctiva

Answer 60

c) Complete loss of extraocular muscles