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Ophtho > Cornea > Flashcards

Cornea Flashcards

1
Q

What r examples of type I, II, III, and IV hypersentivities? What is mechanism of each?

A

I: anaphylactic or atopic
- allergic conjunctivitis

II: cytotoxic

  • Foreign ag –> complement
  • OCP

III: immune complex
- SJS

IV: delayed hyper

  • pre sensitized immune cells
  • allergic contact dermatitis
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2
Q

Child with recurrent dendrites

A

Tyrosinemia
Defect in tyrosine aminotransferase
Autosomal recessive
Restrict dietary tyrosine and phenylalanine (to decrease retardation)

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3
Q

Limbus definitions:
Anatomist
Pathologist
Surgeon

A

Anatomist- termination of descemets and bowmans

Pathologist-

  • anterior limbus= termin of bowman and descemets
  • posterior = line btw iris root and schlemms canal

Surgeon

  • anterior blue zone (1 mm) and posterior white zone
  • perpendicular incision thru conj insertion enters AC thru desc
  • perpendicular incision thru posterior aspect of limbus enters AC thru TM
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4
Q

HEDS

Tx of stromal HSV keratitis?

A

Topical trifluridine and topic steroid

  • -adding oral acyclovir to this did NOT help
  • -anti viral used to prevent epithelial HSV
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5
Q

What is epi LASIK?

A

Blunt microkeratome to remove epithelium then ablate stromal bed. Plane of separation btw bowmans and basement membrane

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6
Q

What is LASEK?

A

Put alcohol on epithelium to remove it then laser bed. Then replace epithelium

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7
Q

What findings make dx of ppmd?
How does it differ from ICE?
What % get glaucoma?

A 
AD
Cluster or linear vesicles in posterior cornea surrounded by gray haze. 
Iris atrophy
Corectopia 
Iridocorneal adhesions

Differs: ppmd bilateral, ICE uni

Glaucoma 15% in ppmd

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8
Q

What r cutoffs for post op power of cornea after LASIK?

How do u predict postop power?

A

Keep between 34 and 50D

If correcting myopia remove 0.8 D for every D of ablation
For hyperopia it’s 1D increase for every D of treatment

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9
Q

Diff etiologies of dry eye syndromes and examples

A 
Aqueous deficiency
-lac gland dysfunction, infiltration (tumor), anti histamine, inflammation (sjogren)
Lipid def
-blepharitis, rosacea
Mucin def
-goblet cell dysfunction 
-OCP, SJS, vit a def, alkali burn
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10
Q

Most common muscle affected by thyroid eye disease

A

Inf rectus

Spare tendon

IMSLO - Most to least common
Inf rec, med, sup rec, lat then obliques

Mimics position of BCC
-lower lid then med canthus, upper lid then lay canthup

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11
Q

What determines prognosis of orbital lymphoma?

A

Location
Eyelid worst (67% systemic dz)
Orbit (35%)
Conjunctiva (20%)

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12
Q

Most common benign orbital tumor in adults? Children?

A

Benign adult- cavernous hemangioma

Benign kids- capillary hemangioma

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13
Q

What is diff btw external and internal hordeolum?

A

External- Zeiss gland obstructed

Internal- meibomian

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14
Q

What bacteria assoc w angular blepharitis

A

Moraxella

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15
Q

Multiple Sebaceous tumors and keratoacanthomas

What else might the pt have?

A

Visceral tumors (esp GI)

Muir-torre syndrome

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16
Q

Phlyctenule -
What’s the mechanism?
What is most common etiology?
What r others?

A

Type 4 hyper sens

Staph= most

TB is classic
Also hsv candida coccidiomycosis, LGV (chlamydia)

17
Q

At what age do atopic keratoconjunctivitis pt present?

What r other eye associations?

A

30-50 yr

Keratoconus, pellucid marg
Subscapsular cats (Maltese cross)
Bilateral hsv keratitis

18
Q

If u see pt w fbs and staining of superior limbus, what testing should u get?
What’s treatment?

A 
SLK
Assoc w thyroid dysfunction in 50%
Females 
30-55 yr
Tx: nor steroids
-bcl, pressure patch, silver nitrate, cauterize
19
Q

Which strains assoc w EKC?

What about pharyngoconjunctival fever?

A

EKC- 8, 19, 37

PCF- 3, 4,5,7

20
Q

Interstitial keratitis ddx?
What if assoc w tinnitus, vertigo or hearing loss?
What’s treatment

A

Large ddx includes syph (classic), hsv most common, etc

Cogans syndrome

  • IK and CN8
  • likely autoimmune
  • 80% progress to deafness without systemic steroids!!
21
Q

Woody palpebral conjunctiva
Dx?
What’s defect?

A

Ligneous conjunctivitis
Type 1 plasminogen deficiency
Tx: excise and use Mmc or amniotic membrane

22
Q

Corneal stromal dystrophy w highest recurrence rate after PK

A

Reis buckler then Lattice
Then granular then macular
“rude little green men keep coming back”

23
Q

Most common of stromal k dystrophy

A

Gran> lattice > Mac

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Ophtho (9 decks)

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