Exam findings of cornea, iris, lens, AC

Question 1

Transillumination defects can only be seen with ____ illumination. Guttata is best seen with _____, and sub epithelial infiltrates are best seen with ____ illumination.

Answer 1

retro; specular reflection; indirect

Question 2

_____ refers to corneal surface disorder, There is breakdown and damage to the epithelium. It stains with NaFl.

Answer 2

superficial punctate keratitis

Question 3

What is SPK associated with

Answer 3

dry gritty feeling of there is something in my eye; photophobia; due to dry eyes, contacts, drug toxicity, trauma, blepharitis or conjuntivitis

Question 4

Subepithelial infiltrates refers to an accumulation of ____ that leave the limbal area and go to the cornea

Answer 4

WBC

Question 5

What is EKC

Answer 5

Epidemic Keratoconjunctivitis; refers to follicles + subepithelial infiltrates. It is highly contagious

Question 6

____ precipitates refer to inflammatory WBC deposits on the corneal endothelium. It is associated with intraocular inflammation due to iritis, ____, or post opt cataract or LPI surgery

Answer 6

Keratic; uveitis

Question 7

What refers to white/bluish ring around the limbus? what if its brown around the limbus?

Answer 7

arcus - due to cholesterol leaking out and invading the cornea; melanosis

Question 8

____ ____ of Vogt refers to

It has a chalky look

Answer 8

Limbal Girdle

Question 9

What are the different reasons we use sclerotic scatter

Answer 9

1. identify central corneal edema
2. Central corneal clouding
3. Fuch’s dystrophy
4. determine the extent of corneal scars

Question 10

What are the 3 different types of corneal opacities (scars)

Answer 10

NO MORE LIGHT

1. Nebular; Viewed with SL; no effect on VA
2. Macular: Viewed with SL; VA can be effected
3. Leukoma; Naked eye; Significantly reduced VA

Question 11

when is cobalt blue filter used

Answer 11

for dry eye eval, GPC, and RGP contacts. Also aids in detection of iron deposits in the K

Question 12

What is the dark line typically between the lower pupil margin and inferior limbus, where lower lid margin meets the cornea

Answer 12

Hudson Stahli line; iron deposition line in the corneal epithelium

Question 13

_____ ring is a curved pigmented line seen near the top/bottom of parallelepiped beam. It forms around around the base of the “cone” in keratoconus

Answer 13

Fleisher’s ring

Question 14

What is corneal striae aka vogts striae

Answer 14

fine white lines deep in storm or DM seen in keratinous.

Question 15

Patients who wear soft contact lenses can also develop _____. IT begins at ____ % of edema

Answer 15

striae; 7

Question 16

_____ _____ ____are the remnants of the anterior portion of the tunica vasculosa lentis which is the vascular structure that nourishes the crystalline lens in utero

Answer 16

Persistent pupillary membranes

Question 17

What are the four variations of PPM

Answer 17

1. Iris to iris
2. one end attached to iris, other not attached and is free floating
3. iris to lens
4. iris to cornea (rare)

• The peripheral portion always inserts into the iris colarette.
• Typically does not affect vision
• Present in 17-32% of population

Question 18

The transparent medium of the eye exhibits the ____ phenomenon, that is submicroscopic particles become visible in a bright beam of light. Conical beam uses this phenomenon .

Answer 18

tyndall

Question 19

Trace grade would have about ____ cells and no flare. Grade ____ would have about 26-50 cells and iris detail would be hazy

Answer 19

1-5; 3+

Question 20

What is a severe intraocular infection…where pus develops in Anterior chamber

Answer 20

Hypopyon

Question 21

What is hyphema

Answer 21

when RBC pooled and settle inferiorly in the AC. Associated with trauma or rebuses of iris

Question 22

the red green filter is used most often for the ____ segment to evaluate the retina

Answer 22

posterior

Question 23

This type of cataract begins closer to 40 and is characterized by a yellow hue. Leads to a myopic shift in refractive error

Answer 23

Nuclear Sclerosis

Question 24

Where does the first sign of change occur with nuclear sclerosis

Answer 24

embryonic nucleus

Question 25

what is the va of a grade 1 NS

Answer 25

20/25 - 30

Question 26

what is the va of a grade 2 NS

Answer 26

20/30 - 40

Question 27

What is the VA of a grade 3 NS

Answer 27

20.50 - 60

Question 28

what is the VA of a grade 4 NS

Answer 28

20/80 and worse

Question 29

The lens is ____% water with the nucleus less water content than the cortex. One of the early signs of change occurs in the _____

Answer 29

65; cortex

Question 30

Where are the different regions that cortical cataracts can be found

Answer 30

anterior, posterior, or equatorial positions of the lens cortex

Question 31

What leads us to what we see as water clefts seen as dark areas within cortical cataracts

Answer 31

lamellar separation of lens

Question 32

How are you supposed to grade cortical cataracts

Answer 32

based on what you see dilated and undilated. Use both direct and retro illumination of the lens

Question 33

Posterior subcapsular cataracts appear granular with specular reflection. Opacities are along the _____ ____. Puts complain of decreaed VA with near often worse and will complain of glare

Answer 33

visual axis

Question 34

What is the only way to view epithelial cells of the posterior lens capsule and helps to view the “shagreen” on the anterior capsule.

Answer 34

specular reflection

Question 35

what are common associations of PSC

Answer 35

age related, steroid therapy, or diabetes

Question 36

What is PSC grading based on

Answer 36

density of amount seen in retroillumination while pupil is dilated

Question 37

which cataract is due to trauma

Answer 37

rosette cataract

Question 38

What is posterior capsular opacification

Answer 38

proliferation of equatorial lens epithelial cells along the posterior capsular surface AFTER cataract surgery. “elschnig pearls”