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*BCSC deck > Cornea > Flashcards

Cornea Flashcards

1
Q

___ is seen in alkaptonuria.

A

Ochronosis is seen in alkaptonuria.

  • Alkapton (brown/black material) accumulates in body tissues, e.g. medial, lateral recti, cartilaginous tissues e.g. earlobes, nose, heart valves, tendons.
  • Urine turns dark after exposure to air.
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2
Q

What is appropriate adjunctive therapy for perilimbal conjunctival melanoma with suspected corneal epithelial involvement?

A

Absolute alcohol to adjacent corneal epithelium and scleral base

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3
Q

Corneal epithelial microtrauma resulting from the insertion and removal of soft contact lenses seems to play a role in the etiology of what disorder?

A

Infectious keratitis

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4
Q

Why is tissue from donors younger than 2 years generally not used in corneal transplantation?

A

The tissue is steeply curved and flaccid.

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5
Q

In immunocompetent individuals, what is the most common ocular presentation of chronic microsporidial infection? Treatment?

A

Stromal keratitis; topical fumagillin, PKP if severe stromal thinning

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6
Q

Causative organisms of acute purulent conjunctivitis:

  • Subconjunctival hemorrhage
  • Chronic with angular blepharitis
  • Hyperacute in sexually active adult
A

Subconjunctival hemorrhage: GNR Haemophilus influensa, GPC Streptococcus pneumoniae

Chronic with angular blepharitis: Gram-neg diplococci Moraxella catarrhalis

Hyperacute: Gram-neg diplococci Neisseria gonorrhoeae

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7
Q

Management of progressive corneal thinning in patient with Mooren ulcer

A

Limbal conjunctival excision, PKs if descemetocele or perforation

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8
Q

__% of patients with zoster of CN V1 develop ocular involvement. Diminished corneal sensation occurs in up to __% of patients.

A

70% of patients with zoster of CN V1 develop ocular involvement. Diminished corneal sensation occurs in up to 50% of patients.

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9
Q

Compare and contrast herpes zoster vs herpes simplex keratitis

A

The ends of herpes zoster dendritiform lesions are typically blunt, have little epithelial ulceration, stain poorly with fluorescein and bengal, and have more raised, plaque-like appearance. Herpes simplex dendritic lesions have terminal bulbs.

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10
Q

Chlamydia serotypes that cause:

  • trachoma
  • adult and neonatal inclusion conjunctivitis
  • lymphogranuloma venereum
A

Trachoma: A-C

Inclusion conjunctivitis: D-K

Lymphogranuloma venereum: L1, L2, L3

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11
Q

In the US, what is an acceptable donor cornea preservation time for corneal transplantation?

A

11-14 days

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12
Q

Rate of recurrence of conjunctival melanoma following excision

A

> 50%

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13
Q

When an inheritance pattern is present in Fuchs endothelial dystrophy, what type of pattern is most common?

A

Autosomal dominant

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14
Q

What should be done prior to removing sutures for PKs?

A

Identify steep axis, confirm axis and that astigmatism is regular with refraction and topography

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15
Q

What clinical feature of conjunctival melanoma increases the risk of regional lymph node metastasis?

A

Involvement of palpebral conjunctiva

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16
Q

Contraindications for corneal tissue transplantation

A
  • Death of unknown cause
  • Congenital rubella
  • Reye syndrome within the past 3 months
  • Neurodegenerative conditions including prion disease (eg, Creutzfeldt-Jakob, PML)
  • Infectious conditions (HIV, hepatitis, active bacterial/viral encephalitis or bacterial/fungal endocarditis, suspected rabies or history of being bitten within the past 6 months)
  • Down syndrome (PK, DALK)
  • Intrinsic eye disease including RB, malignant tumors of the anterior segment, or known adenocarcinoma in the eye of primary or metastatic origin, active ocular or intraocular inflammation, congenital or acquired disorders of the eye that would preclude a successful outcome
  • Leukemias
  • Active disseminated lymphomas
  • High-risk behavior (eg, intravenous drug use or incarceration in prison)
  • Prior refractive corneal surgery (except for EK)

**note posterior choroidal melanoma may be considered acceptable

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17
Q

Superior limbic keratoconjunctivitis causes a ___ conjunctival reaction.

A

Superior limbic keratoconjunctivitis causes a papillary conjunctival reaction.

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18
Q

Diagnosis of seasonal allergic conjunctivitis can be confirmed by finding a predominance of ___ in a conjunctival scraping.

A

Diagnosis of seasonal allergic conjunctivitis can be confirmed by finding a predominance of eosinophils in a conjunctival scraping.

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19
Q

Characteristics of blepharitis caused by:

  • staphylococcus
  • seborrheic etiology
  • Demodex
A

Staph: collarettes (hard brittle scales/crusts surrounding individual cilia)

Seborrheic: greasy scales along lashes

Demodex: cylindrical sleeves around lash base

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20
Q

Most common mechanism for vision loss in HZO?

A

Vasculitis (can lead to optic neuritis)

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21
Q

Long-term treatment of atopic dermatitis and associated keratoconjunctivitis uncontrolled by topical therapies

A

Oral cyclosporine

22
Q

What diagnosis should be considered in a young patient with bilateral, rapid-onset non-healing defects with ring infiltrates?

A

Anesthestic abuse

23
Q

How does ocular surface squamous cell carcinoma present?

A

White/yellowish pink lesion near limbus with possible leukoplakia

24
Q

How does amyloidosis of conjunctiva present?

A

Waxy yellowish localized lesion

25
Q

What risks are lower in DALK than PK?

A

CME, glaucoma, cataract, expulsive hemorrhage, RD, endophthalmitis

26
Q

Best slit lamp technique for:

  • corneal endothelium
  • edema
  • posterior capsule and corneal opacities
  • lesions and corneal foreign bodies
A

Endothelium: specular reflection

Edema: sclerotic scatter

Posterior capsule and corneal opacities: retroillumination

Lesions and corneal foreign bodies: proximal illumination

27
Q

How is CMV transmitted?

A

Sexual contact or through body fluids (saliva, breast milk)

28
Q

How is VZV transmitted?

A

Direct contact with skin lesions or respiratory droplets

29
Q

How are toxoplasmosis and toxocariasis transmitted?

A

Fecal-oral

30
Q

What treatment removes lashes for longest duration possible without collateral damage to eyelid?

A

Radiofrequency ablation/electrolysis

Epilation -> recurs in 3 weeks
Cryotherapy -> causes eyelid margin thinning, loss of adjacent lashes, depigmentation

31
Q

Preferred suture for surgical repair of the limbus portion of a corneoscleral laceration

A

10-0 Nylon

32
Q

Preferred suture for surgical repair of scleral wounds

A

9-0 Nylon or 8-0 silk

33
Q

What is the most common anatomical source of infection in microbial scleritis?

A

Local extension from adjacent cornea, usually Pseudomonas

34
Q

When treating a corneal alkali burn, oral administration of high-dose ___ ___ may reduce the risk of corneal perforation by acting as a cofactor in collagen synthesis. ___ ___ should be monitored when this therapy is initiated.

A

When treating a corneal alkali burn, oral administration of high-dose vitamin C (2 g per day) may reduce the risk of corneal perforation by acting as a cofactor in collagen synthesis. Renal function should be monitored when this therapy is initiated.

35
Q

What slit lamp finding is most suggestive of sterile contact lens-associated keratitis?

A

Peripheral corneal infiltrates with minimal to no fluorescein uptake

36
Q

What cardiac condition is associated with keratoconus?

A

Mitral valve prolapse

37
Q

Presentation and management of UV-induced keratitis

A

Eyelid edema, conjunctival hyperemia, diffuse punctate keratitis; treat with topical antibiotic ointment, cycloplegia, and patching to reduce discomfort from eyelid movement

38
Q

For patient with herpetic epithelial or stromal keratitis, oral acyclovir prophylaxis decreases the risk of recurrence by __%.

A

For patient with herpetic epithelial or stromal keratitis, oral acyclovir prophylaxis decreases the risk of recurrence by 50%. (HEDS decreased risk from 28% to 14%)

39
Q

How does iris atrophy differ between VZV and HSV?

A

VZV sectoral, HSV patchy

40
Q

What surgical option is recommended for unilateral chemical corneal burn with complete conjunctivalization of the cornea? Bilateral?

A

Unilateral: simple limbal epithelial transplantation (autograft of limbal epithelium from the fellow eye)

Bilateral: limbal stem cell allograft (living related donor) or keratolimbal allograft (eye bank donor cornea)

41
Q

Where are Hassall-Henle bodies found? What do they represent?

A

Peripheral Descemet membrane; overactive hyaline production/excrescences by endothelial cells

42
Q

Ocular medications that are contraindicated in neurotrophic keratopathy

A

Topical anesthetics, NSAIDs, beta blockers, CAIs, trifluridine, BAK-containing drops

Impair wound healing

43
Q

What is appropriate management of ruptured globe with extruded iris tissue and thin translucent membrane adherent to stromal surface?

A

Reposit prolapsed iris tissue with removal of the membrane (likely epithelialization from cornea or conjunctiva, increases risk of epithelial ingrowth)

44
Q

What vital dye is most likely to produce symptoms of ocular irritation?

A

Rose bengal

45
Q

Most common indication for PK in US and internationally?

A

Keratoconus, then repeat corneal transplant

46
Q

Most appropriate treatment of PAM without atypia

A

Careful follow-up every 6-12 months

47
Q

Where does HSV remain latent?

A

Sensory ganglia

48
Q

How is HSV transmitted?

A

Contact with oral secretions or infectious fluid from lesions containing virus, usually during childhood

49
Q

Management of large corneal perforations >2mm?

A

Corneal patch graft

50
Q

Mechanism of action of olopatadine

A

H1-antagonist / mast-cell inhibitor

*BCSC deck (10 decks)

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