Corneal Ectasias Flashcards

1
Q

which ectasia is a rare, progressive peripheral corneal thinning disorder

A

pellucid marginal degeneration

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2
Q

when is the onset of pellucid marginal degeneration

A

2nd-5th decade of life

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3
Q

these signs are indicative of which ectasia:

  • bilateral & slowly progressive band of corneal thinning from 4-8 o’clock
  • marked steepening just superior to the thinned zone
  • intact epithelium & no vascularization
  • severe astigmatism & steepening of inferior cornea
A

pellucid marginal degeneration

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4
Q

when corneal topography shows a “kissing-dove” pattern, what ectasia is this indicative of

A

pellucid marginal degeneration

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5
Q

how can you manage pellucid marginal degeneration

A
  • RGP CLs
  • collagen cross-linking (if progression in steepening)
  • surgery (if astigmatism can’t be corrected by other options)
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6
Q

which ectasia is an extremely rare condition that can be congenital or acquired

A

keratoglobus

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7
Q

if keratoglobus is congenital, what must you differentiate it from

A

congenital glaucoma

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8
Q

these signs are indicative of which ectasia:

  • cornea develops globular ectasia & corneal thinning is generalized
  • corneal hydrops are rare
  • cornea is prone to rupture from mild trauma
A

keratoglobus

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9
Q

these clinical findings are indicative of which ectasia:

  • irregular retinoscopy reflex
  • irregular astigmatism
  • globular protrusion of cornea
  • diffuse corneal thinning
  • normal corneal diameter
A

keratoglobus

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10
Q

how do you manage keratoglobus

A
  • protective eyewear (polycarbonate)
  • avoid contact spots
  • RGP CLs
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11
Q

if keratoglobus perforates, how do you manage it

A

surgery

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12
Q

which ectasia is a progressive disorder that begins during puberty, progresses into 3rd-4th decade of life, then stabilizes

A

keratoconus

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13
Q

what are the 3 syndromes keratoconus is associated with

A

down syndrome
Ehlers-Danlos
Marfan

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14
Q

pts with vernal keratoconjunctivitis or an atopic disease that causes persistent eye rubbing can be associated with which ectasia

A

keratoconus

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15
Q

these signs are indicative of which ectasia:

  • Charleaux oil drop reflex
  • irregular scissor reflex on ret
  • Vogt Striae
  • Fleischer ring
  • Munson’s sign
  • progressive corneal protrusion in a cone configuration w/ apical thinning
  • steep keratometry readings
A

keratoconus

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16
Q

these clinical findings are indicative of which ectasia:

  • stromal thinning in central/paracentral cornea
  • apical protrusion of cornea
  • high irregular astigmatism
A

keratoconus

17
Q

assessment of what can lead to an earlier diagnosis of keratoconus

A

posterior corneal curvature

18
Q

the keratoconus grading scale is based on what

A

the highest axis of corneal power on keratometry

19
Q

a mild keratoconus will have what keratometry reading

20
Q

a moderate keratoconus will have what keratometry reading

21
Q

a severe keratoconus will have what keratometry reading

22
Q

progression of keratoconus has a consistent change in at least two of what characteristics?

A
  • steepening of anterior corneal surface
  • steepening of posterior corneal surface
  • thinning &/or an increase in rate of corneal thickness change
23
Q

how can you optimize VA in keratoconus

A
  • spectacles in early stages
  • RGP CLs
  • scleral CLs
24
Q

what surgeries can be done to treat keratoconus

A
  • intrastromal corneal ring segment implantation
  • corneal crosslinking
  • corneal transplant in severe cases
25
which keratoconus surgery is more common & what does it do
corneal crosslinking → slows disease progression
26
what is contraindicated in pts w/ keratoconus
refractive surgery (LASIK)
27
what is the procedure for corneal crosslinking
riboflavin (vitamin B2) is combined with UV-A radiation
28
what does corneal crosslinking do
strengthens corneal tissue
29
how do intrastromal corneal ring segments work
- alter morphology of cornea | - alter refractive power of cornea
30
what is an acute break in Descemet's membrane
corneal hydrops
31
which ectasia occurs when fluid leaks into stroma, causing significant corneal swelling & opacification
corneal hydrops
32
these symptoms are indicative of which ectasia: - acute decreased VA - conjunctival hyperemia - significant pain - significant photophobia
corneal hydrops
33
these are all treatments for which ectasia: - cycloplegia - Muro 128 (hyperosmotic gel/drop that dehydrates stroma) - topical NSAID - bandage soft CLs
corneal hydrops
34
when ophthalmological intervention is needed for corneal hydrops, what do they do
anterior chamber gas bubble to speed up recovery