Anterior Segment Examination

Question 1

The GRAY LINE represents the most superficial portion of the?

Answer 1

Orbicularis oculi (The muscle of Riolan)

Question 2

Acute infection of a sebaceous gland of the eyelid? Most common cause?

Answer 2

Hordeolum/Stye
S. aureus

Question 3

Define External Hordeolum

Answer 3

Acute inflammation of a Zeis gland in the anterior lamella of the eyelid

Question 4

Define internal hordeolum

Answer 4

Acute inflammation in a Meibomian gland of the posterior lamella of the eyelid

Question 5

Lipogranuloma within the eyelid from an obstructed sebaceous gland

Answer 5

Chalazion

Question 6

Eyelash Loss

Answer 6

Madarosis

Question 7

Causative agent of Demodetic blepharitis

Answer 7

Demodex folliculorum

Question 8

Affects mainly the medial or lateral cathal areas of the eyelids, which show eczematoid or ulcerative changes of the skin.

Answer 8

Angular Blepharitis
Moraxella, Staphylococcus

Question 9

Most common eyelid malignancy

Answer 9

Basal cell carcinoma

Question 10

Malignant tumor of the eyelid that present as a small translucent nodule with central depression, ulceration, rolled borders, and telangiectasias.

Answer 10

Basal cell carcinoma

Question 11

Malignant tumor of the eyelid that presents with nodular and plaquelike lesions with irregular edges, and chronic scarring.

Answer 11

Squamous cell carcinoma

Question 12

Neoplasm that arises from the sebaceous glands and can pre sent as a chronic unilateral blepharoconjunctivitis.

It should be considered in any el derly patient with unilateral bleph-
aritis, as it is a highly malignant and potentially lethal tumor.

Answer 12

Sebaceous Cell Carcinoma

Question 13

Dome-shaped nodules that cause the conjunctiva to have a bumpy
appearance.

Answer 13

Papillae

Question 14

Conjunctiva normally contains islands of subepithelial lymphoid tissue. When these enlarge to the extent that they are vis i ble, they are called?

Answer 14

Follicles

Question 15

Granulomatous conjunctivitis are caused by?

Answer 15

Bartonella henselae
Cat-scratch disease

Question 16

Material is seen as a white membranous deposit that is adherent to the conjunctiva and that obscures the under lying conjunctival blood.

Answer 16

Pseudomembrane (Transudation of Fibrin)

Question 17

Describe the lesion of Cat-scratch disease.

Answer 17

Conjunctival granuloma (large, polygonal lesion with central pallor) with adjacent follicles.

Question 18

Adhesion between the bulbar conjunctiva and the lower eyelid? Seen in?

Answer 18

Symblepharon
Ocular mucous membrane pemphigoid

Question 19

degenerating epithelial cells and proteinaceous secretions
from conjunctival glands

Answer 19

Conjunctival concretions

Question 20

cases of chronic allergic conjunctivitis, focal collections of degenerated eo-
sinophils and epithelial cells may be seen at the limbus

Answer 20

Horner- Trantas dots

Question 21

characteristic of vernal conjunctivitis.

Answer 21

Horner- Trantas dot

Question 22

Limbal follicles are common in trachoma; with healing, they leave round, often depressed, limbal scars known as?

Answer 22

Herbert pits

Question 23

Nodular inflammation of the conjunctiva or cornea secondary to a hypersensitivity reaction to an antigen, most commonly Staphylococcus aureus or Mycobacterium tuberculosis.

Answer 23

Phlyctenules

Question 24

Tear film layers

Answer 24

Anterior lipid layer - Meibomian
Middle aqueous layer - Lacrimal
Posterior mucin layer - Goblet

Question 25

used to evaluate tear production and is usually performed as part of the external examination

Answer 25

Schirmer testing

Question 26

5 Layers of the cornea; Describe

Answer 26

1. Epithelium and epithelial basement membrane (the most superficial layers of the cornea) 2. Bowman layer (the most superficial part of the corneal stroma) 3. Stroma (multiple lamellae of collagen fibers, which account for 90% of the cornea’s thickness) 4. Descemet membrane (the collagenous basement membrane of the corneal endothelium) 5. Endothelium (a single layer of endothelial cells that act as metabolic pumps to regulate corneal water content)

Question 27

Superficial corneal vascularization, usually with fibrosis,

Answer 27

pannus

Question 28

accounts for 90% of the corneal thickness.

Answer 28

Stroma

Question 29

Deposition of copper in peripheral Descemet membrane? It is usually beige to yellow- brown and occurs with?

Answer 29

Kayser- Fleischer ring Wilson disease.

Question 30

The SUN Working Group Grading System for Anterior Chamber Flare

Answer 30

0 None 1+ Faint 2+ Moderate (iris and lens details clear) 3+ Marked (iris and lens details hazy) 4+ Intense (fibrin or plasmoid aqueous)

Question 31

The SUN Working Group Grading System for Anterior Chamber Cells Grade

Answer 31

0 <1 0.5+ 1–5 1+ 6–15 2+ 16–25 3+ 26–50 4+ >50

Question 32

consists of a single layer of endothelial cells that act as metabolic pumps to regulate normal corneal water content.

Answer 32

Endothelium

Question 33

accumulations of inflammatory cells on the corneal endothelium that occur with intraocular inflammation

Answer 33

Keratic precipitates

Question 34

(1) are sequelae of inflammation; they are adhesions between the iris and the cornea (2) or between the iris and the crystalline lens (3).

Answer 34

Synechiae Anterior Synechiae Posterior Synechiae

Question 35

Posterior synechiae sometimes involve the entire circumference of the pupillary margin

Answer 35

Seclusio Pupillae

Question 36

Accumulation of aqueous behind the iris causes it to bow forward

Answer 36

Iris bombé

Question 37

Nodules at the pupillary margin are called

Answer 37

Koeppe nodules

Question 38

Nodules on the surface of the iris are called?

Answer 38

Busacca nodules

Question 39

Nodules on the angle

Answer 39

Berlin Nodules

Question 40

white spots on the peripheral iris seen in patients with Down syndrome

Answer 40

Brushfield Spots

Question 41

melanocytic nodules of the iris seen in neurofibromatosis

Answer 41

Lisch Nodules

Question 42

Quivering of the iris that can be seen with movements of the eye in patients who are aphakic (lacking a crystalline lens) or who have subluxated or luxated lenses. The condition occurs because of the lack of support of the iris by the lens and its zonular attachments.

Answer 42

Iridodonesis

Question 43

The lens is best examined after pupillary dilation, usually with the slitlamp in?

Answer 43

Optical Section

Question 44

Gray- white anterior cortical dots that appear after episodes of very high intraocular pressure. They usually indicate a prior acute angle- closure glaucoma attack.

Answer 44

Glaukomflecken

Question 45

Reflect light into the angle

Answer 45

Indirect Gonioscopy Goldmann 3 mirror Zeiss 4 mirror

Question 46

Refract light into the angle

Answer 46

Direct gonioscopy Koeppe Lens

Question 47

Peripheral termination of the Descemet membrane

Answer 47

Schwalbe line