Cornea & Conjunctiva

Question 1

RTC for recurrent corneal erosions

Answer 1

1 day, RTC every 1-2 days to ensure healing

Question 2

Treatment of RCE

Answer 2

Erythromycin ung QID
lubricating tears q2h
Bandage CL if erosion is large

Question 3

Cause of RCE?

Answer 3

Secondary to trauma that causes initial corneal abrasion (fingernail or tree branch)

Question 4

What is this corneal finding?

Answer 4

Mutton-fat (granulomatous) keratic precipitates
*associated with granulomatous anterior uveitis (aka iritis)

Question 5

Which organisms can penetrate an intact corneal epithelium?

Answer 5

Corynebacterium diptheriae
Haemophilus
Listeria
Neisseria gonorrhoea

Question 6

Bacterial conjunctivitis in kids is caused by?

Answer 6

Haemophilus influenzae

Question 7

Bacterial conjunctivitis in adults is caused by?

Answer 7

S. Aureus

Question 8

True or false
Preauricular lymphadenopathy is present in bacterial conjunctivitis

Answer 8

FLASE

Question 9

RTC for giant papillary conjunctivitis

Answer 9

2 to 4 weeks

Question 10

Treatment for corneal abrasion in patients who wear CL

Answer 10

AB that protects against pseudomonas (fluoroquinolone or tobramycin QID)

Question 11

If patient with corneal abrasion is extremely photophobia what can you prescribe them?

Answer 11

Cyclopes agent such as homatropine

Question 12

RTC for small corneal abrasion

Answer 12

2 to 5 days later and FU until healed

Question 13

RTC 1 day for what kind of corneal abrasion?

Answer 13

Defect large, within visual axis, CL wearer or if patient was patched

Question 14

True or False
Patching is recommended for CL wearers or corneal abrasion caused by vegetative or organic matter

Answer 14

FLASE
* do NOT patch these patients

Question 15

Treatment for corneal abrasion for non-CL wearer

Answer 15

Antibiotic ointment Q2H or Q4H
Or
Antibiotic drops to ensure sterility
(Fluoroquniolone QID)

Question 16

Patient presents with unilateral arcus. What should you do next?

Answer 16

Refer for carotid artery doppler contralateral to the eye with arcus to check for potential artery occlusion

Question 17

Corneal arcus initially appears where on the peripheral cornea?

Answer 17

Inferior
Superior
Then coalesces circumferentially

Question 18

Cholesterol deposits in which layer of the cornea in Corneal Arcus?

Answer 18

Stromal periphery

Question 19

Punctual atresia is asymptomatic when the absence of puncta is located where?

Answer 19

Upper eyelid

Question 20

What is punctual atresia?

Answer 20

Congenital absence of puncta

Question 21

Treatment for punctal atresia

Answer 21

Cannulation with placement of silicone tubes

Question 22

Tx for endophthalmitis

Answer 22

Immediate referral to OMD for Intravitreal antibiotic injection of vancomycin and ceftazidime

Question 23

What is the most likely causative organism of acute post operative endophthalmitis?

Answer 23

Staphylococcus epidermidis

Question 24

Iron pigment line on pterygium

Answer 24

Stocker line
* sign of stability

Question 25

Hudson-stahli line

Answer 25

Observed in inferior mid-peripheral region of corneas of patients with advanced age

Question 26

Fleischer ring

Answer 26

At base of the cone in patients with keratoconus

Question 27

If a rust ring is present with a metallic foreign body, how should I be removed?

Answer 27

Alger brush
* ophthalmic drill
* stop spinning if pushed to deep, can’t go to bowman’s layer