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OPT 631 > Exam 1 -- Corneal Dystrophies > Flashcards

Exam 1 -- Corneal Dystrophies Flashcards

1
Q

Epithelial Basement Membrane Dystrophy (EBMD)

Subjective findings

A 
• Mild
   - Asymptomatic
   - Irritation when waking up
•Moderate
   - Irritation may wake them up
   - Transient visual fluctuations
   - Photophobia, glare
• Severe
   - History of spontaneous recurrent corneal erosions
   - Reduction in VA
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2
Q

Epithelial Basement Membrane Dystrophy (EBMD)

Objective findings

A
  • TBUT instantaneous
  • Maps: gray, geographic patterns, 1-3mm
  • Dots: gray/clear round spots, clustered,
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3
Q

Epithelial Basement Membrane Dystrophy (EBMD)

Treatment

A
  • Chronic, no cure, treat symptoms
  • Mild: hypertonic ointment at night, lubrication
  • Moderate: hypertonic solution and ointment, bandage CL, antibiotic, homatropine, diclofenac, lid hygiene
  • Severe: anesthetic, bandage CL, hypertonic solution, antibiotic
  • Surgical: anterior stromal puncture, lamellar keratectomy, phototherapeutic keratectomy
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4
Q

Meesman’s Juvenile Epithelial Dystrophy

Subjective findings

A

•Only slight decrease in VA

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5
Q

Meesman’s Juvenile Epithelial Dystrophy

Objective findings

A
  • Intraepithelial cysts / veicles
  • Irregular astigmatism
  • Onset: early childhood to 2 years
  • May have epithelial erosions after age 40
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6
Q

Meesman’s Juvenile Epithelial Dystrophy

Treatment

A

• Treat symptoms

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7
Q

Reis-Buckler’s Dystrophy

Subjective findings

A
  • Painful RCE

* Decrease in VAs by age 20-30

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8
Q

Reis-Buckler’s Dystrophy

Objective findings

A
  • Grey-white irregular opaque pattern in Bowman’s, may project into epithelium
  • Mottled fish-net appearance
  • Causes anterior stromal opacification
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9
Q

Reis-Buckler’s Dystrophy

Treatment

A
  • Treat erosions

* Keratoplasty

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10
Q

Anterior Mosaic Dystrophy

Subjective findings

A

• VA not affected

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11
Q

Anterior Mosaic Dystrophy

Objective findings

A
  • Gray polygonal opacities

* True dystrophy or age-related process?

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12
Q

Granular dystrophy

Subjective findings

A

• VA gradually drops by age 60

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13
Q

Granular dystrophy

Objective findings

A
  • Before age 10
  • Round oval white spots
  • Increase, enlarge, and coalesce
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14
Q

Granular dystrophy

Treatment

A

• Keratoplasty

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15
Q

Lattice dystrophy

Subjective findings

A

• VA good early on

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16
Q

Lattice dystrophy

Objective findings

A
  • Anterior stromal lines
  • Dots, flakes, stellate opacities between lines
  • Thickens and creates stromal haze
  • Can have RCE
17
Q

Lattice dystrophy

Treatment

A
  • Treat erosions

* Keratoplasty usually by age 40

18
Q

Crystalline dystrophy

Subjective findings

A

• VA not affected

19
Q

Crystalline dystrophy

Objective findings

A
  • White/yellow crystals form a ring
  • Cholesterol crystals
  • Dense arcus by 30-40
  • May see xanthelasma
  • Assoicated with hypercholesterolemia
20
Q

Crystalline dystrophy

Treatment

A

• Referral for CV workup

21
Q

Macular dystrophy

Subjective findings

A

• VA drops substantially by age 30

22
Q

Macular dystrophy

Objective findings

A
  • Stroma invaded by mucopolysaccharide
  • Diffuse corneal clouding by age 5-9, involves full thickness by teens
  • Gluttata possible
23
Q

Macular dystrophy

Treatment

A

• Keratoplasty

24
Q

Keratoconus

Subjective findings

A
  • Slow reduction of VA
  • Starts age 15-25, progresses 5-6 years
  • Glare, photophobia
  • Diplopia
25
Q

Keratoconus

Objective findings

A
  • Frequent Rx changes
  • Scissors reflex on ret, oil drop reflex with o-scope
  • Steeper K’s, mires distorted
  • Better VA with contacts
  • Inferior central thinning
  • Topogrophy shows steep inferior central cornea
  • Munson’s sign
  • Fleisher’s ring
  • Vogt’s striae
  • Perforation and hydrops
26
Q

Keratoconus

Treatment

A
  • RGP and specialty CL
  • Treat edema
  • Keratoplasty
27
Q

Which of the corneal dystrophies affect the epithelium?

A

Epithelial Basement Membrane Dystrophy (EBMD)

Meesman’s Juvenile Epithelial Dystrophy

28
Q

Which of the corneal dystrophies affect Bowman’s layer?

A

Reis-Buckler’s Dystrophy

Anterior Mosaic Dystrophy

29
Q

Which of the corneal dystrophies affect the stroma?

A

Anterior Stromal:

  • Granular Dystrophy
  • Lattice Dystrophy
  • Crystalline Dystrophy

Full thickness stromal:
-Macular Dystrophy

30
Q

Which corneal condition is considered ectatic?

A

Keratoconus

OPT 631 (5 decks)

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