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KMK Part 2 > General > Flashcards

General Flashcards

1
Q

What is the clinical triad for carotid-cavernous fistula?

A
  1. Chemosis
  2. Pulsatile exophthalmos
  3. Ocular bruit
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2
Q

What is the most common cause of unilateral or bilateral proptosis in young and middle aged patients?

A

Thyroid eye disease (TED)

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3
Q

How is CCF treated?

A

Balloon embolization of the internal carotid

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4
Q

What systemic symptoms are associated with TED?

A

Heart palpitation
Weight loss
Heat intolerance
Hair loss

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5
Q

What are the classic signs/symptoms of orbital cellulitis?

A 
Exophthalmos
Lid edema
Pain/restrictions on eye movement
Fever
Decreased VA
Conj injection and chemosis
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6
Q

What 3 meds can cause pseudotumor?

A

Tetracyclines
Accutane
Contraceptives

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7
Q

In CCF, on MRI and angio, what would suggest CCF?

A

Asymmetrically enlarged cavernous sinus, or superior ophthalmic vein

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8
Q

What tests can be run to evaluate for TED?

A 
Orbital CT (EOM enlargement w/o tendon involvement)
T3 and TSH testing (High T3, low TSH)
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9
Q

What other types of pathology can TED cause?

A

SLK
Exposure K
Optic neuropathy
Restrictive myopathy

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10
Q

How is optic neuropathy from TED treated?

A

Immediate oral steroids (Pred 100mg QD 2-14 days)
OR
Orbital decompression

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11
Q

What risk factor significantly increases the likelihood of ophthalmic findings in TED?

A

Smoking

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12
Q

What is the Tx for orbital cellulitis?

A

Hospitalization
IV ABx (ceftiraxone or nafcillin)
Followed by oral ABx (augmentin, ceclor, bactrim)
Topical bacitracin or erythromycin if conjunctivitis or exposure are present.

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13
Q

What causes molluscum contagiosum?

A

DNA pox virus

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14
Q

What ocular reaction does molluscum contagiosum cause?

A

Follicular conjunctivitis

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15
Q

What is the typical presentation of molluscum?

A

Waxy, dome-shaped papules with central umbilication

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16
Q

What is the classic presentation of seborrheic keratosis?

A

Elevated, “stuck-on”, crusty, greasy, or plaque like lesion

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17
Q

What is the typical age range for seborrheic keratosis?

A

Elderly

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18
Q

What is the typical presentation of a keratoacanthoma?

A

Small, dome-shaped tumor on sun exposed skin, the progress to large lesions with central ulceration

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19
Q

What causes papillomas?

A

HPV

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20
Q

Follicals are associated with what 3 things?

A

Viral
Chlamydia
Toxic

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21
Q

What is the classic presentation of basal cell carcinoma?

A

Firm, pearly nodule with superficial telangiectasia.

May progress to central ulceration “rodent ulcer”

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22
Q

What is the most common type of skin cancer?

A

Basal cell carcinoma

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23
Q

What is the 2nd most common type of skin cancer?

A

Squamous cell carcinoma

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24
Q

Which is more likely to metastasize: Basal cell or squamous cell?

A

Squamous cell

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25
Q

What is the typical presentation of a sebaceous gland carcinoma?

A

Yellow, hard tumor on the upper eyelid that causes madarosis and thickened lid margins

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26
Q

What is the most lethal type of skin cancer?

A

Malignant melanoma

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27
Q

What is the typical presentation of malignant melanoma?

A

Irregular borders with rapid growth and color changes

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28
Q

What is the common precursor to squamous cell carcinoma?

A

Actinic keratosis (elevated scaly, pink/red lesion)

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29
Q

A Fleischer ring is an indicator of what condition?

A

Keratoconus

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30
Q

What is a Fleischer ring made of?

A

Iron deposits

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31
Q

What are the late stage signs of keratoconus?

A

Vogt striae
Munson’s sign
Hydrops

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32
Q

What are Vogt’s striae?

A

Vertical lines in deep stroma

V for Vertical lines

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33
Q

What is the classic presentation of staph marginal keratitis?

A

Stromal infiltrates in the periphery secondary to chronic bleph, without epi defect

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34
Q

RCE occurs most commonly in pts with a history of what?

A 
Trauma (abrasions)
Corneal dystrophies (ABMD)
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35
Q

What is a corneal ulcer?

A

Epi defect with associated stromal infiltrate

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36
Q

What are the UCRAP (HLA-B27) conditions?

A 
Ulcerative colitis
Crohn's
Reactive arthritis
Ankylosing spondylitis
Psoriatic arthritis
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37
Q

What are the causes of granulomatous anterior uveitis?

A

Syphilis
Lyme
TB
Reactivated herp

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38
Q

What is the Tx for staph marginal keratitis?

A

ABx/roid combo Q4Hs

-Tobradex, zylet (lotepred, tobramy)

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39
Q

When using doxy for posterior bleph, what is the typical dosing?

A

100mg BID for 4 weeks, then QD for 3-6 months

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40
Q

What type of drug is natamycin?

A

Antifungal

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41
Q

What is the Tx for RCE?

A 
Debridement
Cyclo
ABx
Topical NSAID if needed
BCL
ATs
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42
Q

What Tx can be used to decrease recurrences of RCE?

A

Oral doxy 50mg BID x 2 months

Muro 128 ung QHS x 3 months

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43
Q

What is the classical presentation of fungal keratitis?

A

Gray-white corneal infiltrates with feathery edges and satellite infiltrates

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44
Q

What are 2 common topical antifungals?

A

Amphotericin B

Natacin

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45
Q

What are 2 systemic antifungals?

A

Ketoconazole

Itraconazole

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46
Q

What it the typical recall for staph marginal keratitis?

A

4 days

Then 3 weeks or so

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47
Q

What percent of newborns have congenital nasolacrimal duct obstruction?

A

5%

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48
Q

What is the typical presentation for dacryocystitis?

A

Epiphora
Edema over lac sac
Severe pain

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49
Q

What is the most common cause of an acquired nasolacrimal duct obstruction?

A

Idiopathic obstruction

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50
Q

What is the most common cause of congenital NLD obstruction?

A

Failure of the valve of Hasner to completely open by birth

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51
Q

What is the typical age of AKC?

A

Young to middle age

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52
Q

What are the common signs of AKC?

A

Corneal neo
Cataracts
Keratoconus
Milky edematous bulbar conj

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53
Q

VKC typically effects whom?

A

Young boys

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54
Q

What are the classic symptoms of VKC?

A 
Intense itching
Thick mucous
Lacrimation
Photophobia
FBS
Prominent papillae (cobble stone or Trantas dots)
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55
Q

Atopic dermatitis is what type of hypersensitivity reaction?

A

Type 1

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56
Q

What are the 2 cataracts associated with atopic dermatitis?

A

Shield cataract

PSC

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57
Q

What is the main cause of visual impairment in AKC?

A

SPK (interpalpebral)

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58
Q

What are the 3 mast cell stabilizers?

A

Alocril
Alomide
Alamast

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59
Q

When do mast cell stabilizers need to be used in order to be effective?

A

Prior to histamine release

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60
Q

What is the predominant area of ocular involvement in adult inclusion conjunctivitis?

A

Inferior

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61
Q

SLK is associated with what systemic condition?

A

Thyroid disease (50% of cases)

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62
Q

SLK can be cause secondary to what?

A

Contact lens wear

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63
Q

What is the typical presentation of SLK?

A

Thickened, red, sup bulbar conj
Velvety sup tarsal conj
Often bilateral, with adjacent SPK and filamentary keratitis

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64
Q

What is the most common cause of viral conjunctivitis?

A

Adenovirus

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65
Q

Viral conjunctivitis is more common in who, adults or kids?

A

Adults

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66
Q

Pharyngoconjunctival fever is cause by which serotypes of adenovirus?

A

3,4,5,7

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67
Q

What are the typical findings in pharyngoconjunctival fever?

A

Follicular conjunctivitis (occasionally hemorrhagic)
Low grade fever
Mild sore throat

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68
Q

What serotypes of adenovirus cause EKC?

A

8,19,37

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69
Q

What are the common findings of EKC?

A

+ PAN
SPK
SEKs in the 3rd week
Pseudomembranes

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70
Q

Are the majority of bacterial conjunctivitis cases cause by gram + or gram - bacteria?

A

Gram + (staph)

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71
Q

What gram - bacteria can cause bacterial conjunctivitis?

A

H. influenza

Moraxella catarrhalis

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72
Q

Which 2 bacteria are the most common causes of conjunctivitis in kids?

A

Strep pneumonia

H. influenzae

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73
Q

What are the common findings in gonococcal conjunctivitis?

A 
Hyperacute discharge
Conj chemosis w/pseudomembranes
Papillary reaction
Marked PAN
Pain on urination
Purulent urethral discharge
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74
Q

What is a possible severe consequence of conococcal conjunctivitis?

A

Corneal ulceration

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75
Q

What is another name for adult inclusion conjunctivitis?

A

Chlamydial conjunctivitis

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76
Q

What is the typical presentation of chlamydial conjunctivitis?

A

Unilateral giant follicals (limbal or palpebral), most concentrated in inferior fornices
Chronic red eye for weeks to months

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77
Q

What is the most common cause of preventable blindness worldwide?

A

Trachoma

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78
Q

What causes trachoma?

A

Chlamydia trachomatis serotypes A-C

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79
Q

What is the common presentation of trachoma?

A

Follicles in the form of Arlt lines (superior tarsal scarring) and Herbert’s pits
Follicular and papillary conjunctivitis of superior tarsal conj
Scaring of eyelids and ulceration from trichiasis

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80
Q

If you diagnose a non-CL wearer with SLK, what subsequent testing is warranted?

A

T3 and TSH

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81
Q

What is the frontline Tx for mild SLK?

A

ATs Q2Hrs

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82
Q

What is the additional Tx beyond ATs for mod/severe SLK?

A

Silver nitrate 0.5-1.0% applied to superior tarasal and bulbar conj, followed by irrigation and ABx ung

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83
Q

What is the Tx for filamentary keratitis?

A

Acetylcysteine 10% gtts, 3-5x/day

Mucomyst

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84
Q

What supportive measures can be taken for a pt with an adenovirus infection?

A

Cold compresses
Mild vasoconstrictors
ATs
IF SEVERE: mild steroid (lotemax) during first 1-2 weeks

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85
Q

What can be used to treat an adult with bacterial conjunctivitis?

A

5-7 days of QID of any of the following:

  1. Fluoroquinolones
  2. PolymyxinB/trimethoprim (polytrim)
  3. Tobramycin
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86
Q

What can be used to treat a child with bacterial conjunctivitis?

A

5-7 days QID of either:

  1. PolymyxinB/trimethoprim (polytrim)
  2. Bacitracin + polymyxin B (polysporin ung)
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87
Q

In cases of bacterial conjunctivitis with SPK, what medications are not recommended due to corneal toxicity?

A

Aminoglycosides (gentamicin, tobramycin)

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88
Q

What are the Tx options for chlamydial conjunctivitis?

A

1g azithromycin PO all at once

100mg doxycycline BID x 10 days

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89
Q

What is the Tx for a cornea involving gonococcal conjunctivitis?

A

Ceftriaxone IV (1g) 12-24hrs

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90
Q

What is the Tx for gonococcal conjunctivitis w/o corneal involvement?

A

1g ceftriaxone IM injection

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91
Q

What is the most common infectious cause of neonatal conjunctivitis?

A

Chlamydia

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92
Q

What is the Tx for Trachoma?

A 
"SAFE"
Surgery for trichiasis
Antibiotics
Facial hygiene
Environmental hygiene
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93
Q

Patients with what 2 conditions present with pain out of proportion to findings?

A

SLK

Acanthamoeba

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94
Q

A lipid tear film deficiency results from what?

A

Blepharaitis

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95
Q

An aqueous layer deficiency is termed what?

A

Keratoconjunctivitis sicca

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96
Q

During what part of the day are KSC symptoms worse?

A

End of day

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97
Q

During what part of the day are MGD symptoms worse?

A

Morning

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98
Q

What 3 drug classes/types are associated with KCS?

A

Beta blockers
Oral antihistamines
Hormone replacement therapies

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99
Q

Name 3 collagen vascular diseases that are associated with KCS?

A

Rheumatoid arthritis
Sjogren’s
Lupus

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100
Q

A deficiency in what causes bitot spots?

A

Vitamin A

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101
Q

What is the typical demographic for KCS?

A

Women over 50

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102
Q

What is the typical demographic for Salzmann’s?

A

Female over 50

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103
Q

Salzmann’s is typically associated with what conditions?

A

Trachoma
Phlyctenulosis
KCS

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104
Q

What is the classic appearance of Salzmann’s?

A

Smooth, opaque, elevated, blue-gray stromal opacities

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105
Q

What ocular manifestation is associated with gout?

A

Band K

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106
Q

What is the common demographic for SLE?

A

Female, teens-20’s

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107
Q

What ocular findings may be seen in SLE?

A

Disc edema
Dry eye
Photophobia
Malar rash

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108
Q

What is the typical Tx for mild Salzmann’s?

A

ATs

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109
Q

What Tx can be utilized for acne rosacea?

A 
Doxy 100mg BID with taper
Omega-3's
Metronidazole
Warm compresses
lid scrubs
Topical abx
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110
Q

When does posterior polymorphous dystrophy typically get identified?

A

30’s-50’s

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111
Q

What is the most common symptom of posterior polymorphous dystrophy?

A

Decreased vision from edema

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112
Q

What occurs in the endothelium in posterior polymorphous dystrophy?

A

Metaplasia and overgrowth of endo cells

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113
Q

What is the classic presentation of posterior polymorphous dystrophy?

A

Bilateral, asymmetric patches of vesicles

Band-like lesions and geographic gray hazy areas at Descemet’s membrane

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114
Q

What is the inheritance pattern of Fuch’s endothelial dystrophy?

A

AD

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115
Q

Fuch’s endothelial dystrophy is most common in what demographic?

A

Post-menopausal women

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116
Q

An endo cell count of less than what will typically lead to edema?

A

<500 cells/mm^2

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117
Q

Disciform keratitis most commonly occurs in what condition?

A

Herpes simplex keratitis

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118
Q

What is the typical presentation of disciform keratitis?

A

Round area of central/paracentral edema with a clear demarcation between involved and uninvolved cornea
Scatterek KP may be present

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119
Q

What is the inheritance of macular dystrophy?

A

AR

“macul-AR”

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120
Q

When does macular dystrophy occur?

A

In the first decade of life

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121
Q

What is the typical presentation of macular dystrophy?

A

Child with diffuse corneal haze and irregular gray-white spots (mucopolysaccharide deposits
Decreased VA
Possible corneal erosions

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122
Q

What is interstitial keratitis?

A

Stromal inflammation without primary involvement of the epi or endo

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123
Q

90% of interstitial keratitis cases are aquired how?

A

Congenital syphilis

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124
Q

What is the clinical appearance of interstitial keratitis?

A 
Salmon patch lesions (stromal neo)
Stromal edema
Conj injection
AC reaction
KPs
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125
Q

What is the clinical triad of congenital syphilis?

A
  1. Interstitial keratitis
  2. Hutchinson’s teeth
  3. Deafness
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126
Q

Papilledema and optic neuritis are found in which form of syphilis?

A

Tertiary

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127
Q

What are the Tx options for Fuch’s endothelial dystrophy?

A

NaCl 5% gtts QID or UNG

Glaucoma meds for IOP

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128
Q

What is the Tx for disciform keratitis?

A

Pred forte QID

Viroptic QID

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129
Q

What is the Tx for interstitial keratitis?

A

Topical steroieds

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130
Q

What medication can cause pigment deposition on the corneal endo?

A

Chlorpromazine

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131
Q

Malignant melanoma of the conj typically arise from what?

A

Primary acquired melanosis (PAM)

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132
Q

What is the most common conj malignancy in the US?

A

CIN

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133
Q

CIN gives rise to what malignant condition?

A

Squamous cell carcinoma

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134
Q

What is the typical presentation of CIN?

A

Elevated, gelatinous mass with neo

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135
Q

30% of primary acquired melanosis progresses to what?

A

Malignant melanoma

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136
Q

Primary acquired melanosis is caused by a proliferation of what?

A

Intraepithelial melanocytes

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137
Q

What is the typical presentation of a conj lymphoma?

A

Smooth, fleshy, subconj salmon-colored patch

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138
Q

What typically causes pyogenic granulomas?

A

Trauma

Surgery

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139
Q

What is the most important prognostic indicator of progression from PAM to malignant melanoma?

A

Thickness of the lesion

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140
Q

What 3 drugs can cause nystagmus?

A

Phenytoin (dilantin)
Phenobarbitol (luminal)
Salicylates

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141
Q

Which drug can cause blue/yellow color defects?

A

Digoxin

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142
Q

What type of cataracts can chlorpormazine cause?

A

Stellate cataracts

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143
Q

Amiodarone can cause deposits where?

A

Lens

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144
Q

What is the Tx for pyogenic granuloma?

A

ABx-steroid combo

tobradex, maxitrol

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145
Q

Pilocarpine can potentially cause what severe ocular side effect?

A

Retinal breaks

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146
Q

A history of cold sores and an increase in stress could lead to what ophthalmic condition?

A

Herpes simplex keratitis

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147
Q

Herpes simplex hides in which ganglion?

A

Trigeminal (gasserian)

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148
Q

What things may trigger recurrent HSK infections?

A 
Stress
Sun exposure
Fever
Trauma
Immunosuppression
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149
Q

Which herpes simplex virus is most commonly responsible for HSK, type 1 or type 2?

A

Type 1

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150
Q

What is the early acanthamoeba presentation?

A

Epi defects ranging from SPK to whorl-like defects, to pseudodendritic lesions
Pain > signs

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151
Q

If left to grow, what is the more advanced presentation of acanthamoeba?

A

Patcy anterior stromal infiltrates that become confluent to form a ring ulcer

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152
Q

What are the Tx options for an HSK dendrite?

A

Viroptic

Zirgan

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153
Q

Why might Zirgan be preferred to treat an HSK dendrite over Viroptic?

A

Thimerosol toxicity of Viroptic

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154
Q

What is the typical presentation of Thygeson’s?

A

Small, bilateral, multiple, asymmetric, gray-white crumb-like clusters, central lesions
White, quiet eye
Look like SEIs, but more superficial
Stain minimally with NaFl

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155
Q

What are the 4 forms of ocular herpes simplex infection?

A

Epithelial keratitis
Disciform keratitis
Blepharoconjunctivitis
Keratouveitis

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156
Q

What is the Tx for HSK?

A

Viroptic Q2H for 5-7 days, then 5x/day for 7 days

NO STEROIDS on HSK (will work for stromal keratitis, though)

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157
Q

What is the Tx for herpes simplex stromal keratitis?

A

Pred forte QID

Viroptic QID

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158
Q

For recurrent HSK, what oral med can be prescribed?

A

Acyclovir 400mg BID

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159
Q

What is the Tx for herpes zoster ophthalmicus?

A

Acyclovir 800mg 5x/day OR

Valacyclovir 1000mg TID

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160
Q

What is the Tx for Thygeson’s?

A

ATs for mild severity
Severe:
Mild steroids (FML, loteprednol QID x 1 week)
Bandage SCL

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161
Q

What is the most common anterior corneal dystrophy?

A

ABMD (AKA EBMD, map-dot-fingerprint, Cogan’s dystrophy)

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162
Q

ABMD is slightly more common in which gender?

A

Female

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163
Q

What things characterize Von Hippel-Lindau disease?

A

Retinal capillary hemangioblastomas

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164
Q

What are the 5 drugs that can cause whorl keratopathy?

A 
CHAI-T
Chloroquine
Hydroxychloroquine
Amiodarone
Indomethacin
Tamoxifen
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165
Q

A cortical cataract can cause what type of refractive shift?

A

Hyperopic

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166
Q

A nuclear cataract can cause what type of refractive shift?

A

Myopic

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167
Q

PSC can be caused by what 2 things?

A

Steroids

X-rays

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168
Q

Which systemic condition may result in “Christmas tree cataracts”?

A

Myotonic dystrophy

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169
Q

What are the characteristics of myotonic dystrophy?

A 
Miotic pupils
External ophthalmoplegia
Christmas tree cataracts
Pigmentary retinopathy
Muscle wasting and weakness
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170
Q

What is the inheritance of Wilson’s disease?

A

AR

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171
Q

Wilson’s disease results in an increased deposition of what?

A

Copper

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172
Q

In Wilson’s disease, where is copper most concentrated?

A

Liver
Brain
Cornea (Kayser-Fleisher Ring)

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173
Q

What signs/symptoms characterize Wilson’s disease?

A 
Wrist tremor (asterixis)
Basal ganglia degeneration
Cirrhosis
Corneal deposits
Cataracts
Carcinoma
Dementia
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174
Q

What is the most common cause of pre-senile cataracts?

A

Diabetes

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175
Q

Severe atopic dermatitis can result in which 2 cataracts?

A

Shield cataracts

PSC

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176
Q

What type of cataract forms due to acutely high blood sugar?

A

Snowflake cataracts

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177
Q

What type of cataract is found in Wilson’s disease?

A

Sunflower cataract

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178
Q

What would differentials for glare or halos be?

A

Cataracts
Angle closure
Corneal edema
Corneal haze

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179
Q

Sildenafil carries a slight risk of developing what ocular condition?

A

NAION

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180
Q

What ocular side affect may occur from Digoxin use?

A

Blue-yellow defect
Entoptic phenomena
Retrobulbar optic neuritis

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181
Q

What is the average axial length of the eye?

A

24mm

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182
Q

A 1mm change in axial length of the eye results in what dioptric power?

A

3D

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183
Q

How thick must the remaining “bed” be for LASIK?

A

250microns

184
Q

What is the formula for LASIK calculations?

A

Flap (120mu) + ablation (15mu per D) = >250mu (bed)

185
Q

How much cornea is ablated per diopter for LASIK?

A

15microns per 1 diopter

186
Q

What is the Tx for deep lamellar keratitis post LASIK?

A 
Topical steroids (Pred 1%)
If severe, flap needs to be lifted and irrigated
187
Q

How long after LASIK does DLK usually appear?

A

Days right after surgery

188
Q

How long after LASIK will epithelial ingrowth occur?

A

around 1 month post-op

189
Q

What is the preferred time period to wait before re-treating LASIK or PRK?

A

6 months - earliest is 3 months

190
Q

LASIK can cause a false high or low IOP?

A

False low

191
Q

Positive Seidel’s sign after cataract surgery puts a patient at risk for what 5 complications?

A 
Endophthalmitis
Hypotony
Iris prolapse
Choroidal detachment
Shallow A/C
192
Q

What are the typical signs and symptoms of endophthalmitis?

A 
Severe pain
Loss of vision
Corneal edema
Injection
Severe A/C reaction w/ possible hypopyon
Vitreous cells
Mucus discharge
193
Q

What is the management for endophthalmitis?

A

Immediate referral to surgeon for aggressive ABx treatment

194
Q

At what pressure does hypotony become a problem?

A

Under 6mmHg

195
Q

Why does a choroidal detachment occur with low IOP?

A

Fluid accumulates in the suprachoroidal space

196
Q

Why might diplopia occur after cataract surgery, and then resolve spontaneously?

A

Retrobulbar anesthesia

197
Q

How can you manage cataract post op bullae?

A

Bandage CL if epi is intact

198
Q

How long after cataract surgery does Irvine Gass typically set in?

A

3 months

199
Q

What causes Irvine Gass?

A

Anterior seg inflammation migrating to the posterior seg, leading to breakdown of the blood-retinal barrier, causing vessel leakage

200
Q

Where does fluid accumulate in Irvine Gass?

A

Outer plexiform layer

201
Q

If topical steroids and NSAIDs are not effective for Irvine Gass, what may be indicated?

A

Periorbital steroid injection

202
Q

ACIOLs have a higher risk of causing UGH syndrome. Why?

A

Haptic rubbing on iris causing hyphema and uveitis, clogging the TM

203
Q

Is scleritis a granulomatous or non-granulomatous inflammation?

A

Granulomatous

204
Q

50% of cases of scleritis are associated with what?

A

Underlying systemic disease - mostly collagen vascular disease (30%)

205
Q

What is the most benign form of Scleritis?

A

Non-necrotizing diffuse scleritis

206
Q

What is another name for necrotizing scleritis without inflammation?

A

Scleromalacia perforans

207
Q

Scleromalacia perforans is typically a result of chronic what?

A

Rheumatoid arthritis

208
Q

What is the worst form of scleritis?

A

Necrotizing with inflammation

209
Q

What are the conditions that cause non-granulomatous uveitis?

A 
UCRAP
Ulcerative colitis
Crohn's
Reactive arthritis
Ankylosing spondylitis
Psoriatic arthritis
210
Q

What lab will come back increased in Reiter’s syndrome?

A

Increased ESR

211
Q

What are the typical signs/symptoms of Reiter’s syndrome?

A

Urethritis
Polyarthritis
Conjunctivitis (with iritis)
Increased ESR

212
Q

What is the most common cause of uveitis in children?

A

Juvenile rheumatoid arthritis

213
Q

What is the most common cause of posterior uveitis in adults?

A

Toxoplasmosis

214
Q

What characterizes toxoplasmosis?

A

Unifocal yellow-white lesion obscured by overlying vitritis

“Headlights in the fog”

215
Q

What characterizes histoplasmosis?

A

Multifocal punched-out yellow-white lesions
Peripapillary atrophy
Maculopathy
Ohio-Mississippi river valley

216
Q

What are the typical signs of ocular sarcoidosis?

A

Granulomatous panuveitis
Retinal vasculitis
White, fluffy opacities of inverior vitreous

217
Q

Posterior uveitis occurs in which stage of syphilis?

A

Secondary syphilis

218
Q

What are the typical signs of secondary syphilis?

A

Acute multifocal chorioretinitis
Vitritis
Salt and pepper fundus
Flame hemes

219
Q

Which condition results in “snow banking”?

A

Pars planitis - intermediate uveitis

220
Q

Which test is used to see if a patient has ever had syphilis?

A

FTA-ABS

221
Q

What is the typical Tx for uveitis?

A

Pred 1% Q1Hr with slow taper

Cycloplegic BID

222
Q

What class of drug is brompheniramine?

A

Anti-histamine

223
Q

What is the classical presentation of an iris cyst?

A

Globular, dark-brown structure that transilluminates

-don’t typically grow

224
Q

What are Lisch nodules?

A

Small, round, lightly pigmented hamartomas of the iris

Typically bilateral and inferior

225
Q

95% of the time Lisch nodules are found in what condition?

A

Neurofibromatosis

226
Q

On what part of the iris are Koeppe nodules found?

A

Pupil margin

227
Q

Where are Busaca nodules found?

A

Iris surface

228
Q

In what condition might Koepe and Busaca nodules be found?

A

Granulomatous uveitis

229
Q

What systemic conditions can cause granulomatous uveitis?

A

Sarcoidosis
TB
Syphilis

230
Q

Episcleritis is usually idiopathic, but 40% of the time it is related to what?

A

Collagen vascular diseases

231
Q

What is the classical presentation of episcleritis?

A

Younger pt with unilateral sectoral injection

No to mild irritation

232
Q

Phlyctenular keratoconjunctivitis results from what type of hypersensitivity?

A

Type 4 - delayed

233
Q

What is the most common cause of phlyctenular keratoconjunctivitis? What is the second most common cause?

A

Staph from blepharitis

TB

234
Q

What simple test can be done to differentiate episcleritis from scleritis?

A

Phenylephrine 2.5% blanching

235
Q

What is the purpose of amiodarone?

A

Anti-arrhythmic

236
Q

At what dose of amiodarone is corneal verticillata inevitable?

A

400mg/day

237
Q

What 3 ocular side affects may be caused by amiodarone?

A

Verticillata/whorl K
Anterior subcapsular cataract
NAION

238
Q

What is the Tx for mild episcleritis?

A

ATs
Cold compresses
Topical decongestants if desired

239
Q

What is the Tx for moderate to severe episcleritis?

A

Topical steroid (lotemax) or oral NSAID for 5-10 days

240
Q

What is the Tx for pingueculitis?

A

Mild topical steroid (FML, lotemax, etc)

241
Q

What is the Tx for phlyctenular keratoconjunctivitis?

A

Mild: topical decongestants
Mod-Severe:
Topical steroids, or steroid/abx combo

242
Q

Addison’s disease is caused by what?

A

Too little corticosteroid in the system

243
Q

What 3 things do you need to know about your patient before prescribing oral steroids?

A

Pregnancy
Peptic ulcer
Diabetes

244
Q

What is the inheritance pattern of oculocutaneous albinism?

A

AR

245
Q

What is the inheritance pattern of ocular albinism?

A

X-linked

Less commonly AR

246
Q

What is ectropion uveae

A

Proliferation of iris posterior pigmented epithelium onto the surface of the iris

247
Q

What is the cause of ocular albinism?

A

Decreased number of melanosomes

248
Q

What typically causes the vision loss in ocular albinism?

A

Foveal hypopigmentation (hypoplasia)

249
Q

What is the most significant threat to vision in a patient with ectropion uveae?

A

Secondary angle closure glaucoma due to iris ectropion and/or high iris insertion

250
Q

Why should a patient with oculocutaneous albinism be referred to hmatology?

A

To rule out Chediak-Higashi and Hermansky-Pudlak syndromes, as they are potentially lethal

251
Q

What are the 4 TB drugs?

A 
RIPE
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
252
Q

What is a serious potential side effect of ethambutol?

A

Bilateral, retrobulbar optic neuritis

253
Q

Minocycline and corticosteroids have what potential ocular side effect in common?

A

Blue sclera

254
Q

What are the vision threatening complications of a retinal vein occlusion?

A

Macular ischemia and edema

Neovascularization - heme, glaucoma, RD

255
Q

What is the leading cause of vision loss in CRVOs?

A

Macular edema

256
Q

What is the clinical definition of an ischemic CRVO?

A

10DD or more of non-perfusion on FA

257
Q

90% of cases of CRVO present with what reduced acuity?

A

20/200 or worse

258
Q

What are the risk factors for CRVO?

A

Hypertension (61%)
Diabetes
CV disease
Open angle glaucoma

259
Q

What is the most common vascular cause of vision loss?

A

Diabetic retinopathy

260
Q

Which quadrant is most common for BRVOs?

A

Superior/temporal quad (60%)

261
Q

What is the clinical appearance of a retinal vein occlusion?

A

Hemes
CWS
Mac edema

262
Q

What are the risk factors for CRAO?

A

Hypertension (67%)
DM
Carotid disease
Cardiac valve disease

263
Q

CRAO may be preceded by what?

A

TIAs/amaurosis fugax

264
Q

90% of BRAOs are caused by what?

A

Emboli

265
Q

What are the 4 types of emboli?

A

Cholesterol
Calcium
Fibrin
Plateles

266
Q

What is the classic example of optic neuritis?

A 
Young female
Sudden vision loss
APD
Pain on EOM
Vision loss worsenes for 2 weeks, then stabilizes and improves
267
Q

What is the classical presentation of AAION?

A 
Sudden, unilateral vision loss
Disc edema
Over 55 years old
Temporal headache
Scalp tenderness
Jaw claudication
Malaise
268
Q

CRVOs and BRVOs result from what?

A

Compression of an artery on a vein leading to thrombus formation

269
Q

What most commonly causes a CRAO?

A

Calcific emboli from heart valves
OR
Hollenhorst plaque from carotid

270
Q

If a young patient presents with a CRVO, what might be the etiology?

A 
Oral contraceptives
Factor XII deficiency
Collagen vascular disease
AIDS
(among others)
271
Q

What is the most common cause of AAION?

A

GCA

272
Q

What is GCA?

A

Systemic vasculitis of medium and large blood vessels

273
Q

In AAION, what arteries become occluded?

A

SPCAs

274
Q

What is the typical final acuity after a CRVO?

A

Similar to what the acuity was on initial presentation

275
Q

When is PRP indicated after a CRVO?

A 
Any of the following:
Rubeosis is > 2 clock hours
Angle neo
Neo glaucoma
Any posterior seg neo
276
Q

How should mac edema after CRVO be treated?

A

Intravitreal steroids (according to SCORE study)

277
Q

How often should patients be followed after a CRVO? What procedures should be done?

A

Every 6 months
Gonioscopy
BP

278
Q

If neo arises after a BRVO, what is the Tx?

A

Sector laser of area of the occlusion

279
Q

What is the Tx for persistent mac edema after BRVO?

A

Focal laser of the macula

280
Q

How often should a patient be followed after BRVO?

A

1-2 months

Look for mac edema and neo

281
Q

What test should be run in an older patient presenting with a CRAO to rule out GCA?

A

ESR

282
Q

When should a PPV be considered after a non-clearing diabetic vit heme?

A

1 month

283
Q

What is the Tx for demyleniating optic neuritis?

A

IV steroids for 3 days

Followed by oral pred for 11 days

284
Q

What is the Tx for AAION?

A

High-dose steroid Tx

285
Q

What are the typical findings in retinitis pigmentosa?

A 
Waxy optic disc pallor
Midperipheral pigment clumping
Attenuated arterioles
Hyaline bodies of the optic nerve
PSC 
Keratoconus
286
Q

Which type of photoreceptor suffers more damage in RP, rods or cones?

A

Rods (think night blindness)

287
Q

What is the average age of diagnosis of RP?

A

9-19

288
Q

What is choroideremia?

A

Diffuse, progressive atrophy of the choriocapillaris and RPE

289
Q

What is the inheritance pattern of choroideremia?

A

X-linked recessive

290
Q

Choroideremia has similar symptoms to what condition, but with a different fundus appearance?

A

RP

291
Q

Fundus albipuncataus results in what symptoms?

A

Stationary night blindness

292
Q

What is the characteristic appearance of fundus albipuncataus?

A

Numerous small, yellow-white dotlike lesions of the RPE in the midperiphery (spare the macula)

293
Q

What macular changes may occur in RP that cause vision loss?

A

CME
ERMs
Atrophy

294
Q

Pigmentary retinopathy is a side effect of what 2 antipsychotics?

A

Thioridazine

Chlorpromazine

295
Q

Tamoxifen is known to have what ocular side effect?

A

Crystalline retinopathy

296
Q

Roughly what percentage of patients with an acute, symptomatic PVD with have a retinal break?

A

10-15%

297
Q

Where is the most common location for atrophic holes?

A

Temporal retina

sup>inf

298
Q

What is the most likely area for a tractional retinal tear?

A

Superior temporal

299
Q

What 2 things are defined as non-rhegmatogenous RDs?

A 
Exudative RD
Tractional RD (no retinal break)
300
Q

Which is a bigger risk factor for RD, white without pressure or lattice degeneration?

A

Lattice

301
Q

What is the most common cause of a tractional, non-rhegmatogenous RD?

A

Proliferative DM

302
Q

What type of cells are proliferating in an ERM?

A

Glial cells in ILM

303
Q

Who is the typical patient with CSR?

A

Male 20-50 with type A personality

304
Q

Who is more at risk of developing wet AMD, myopes, or hyperopes?

A

Myopes

305
Q

What is the end stage of dry AMD?

A

Geographic atrophy

306
Q

What are the 4 risk factors that increase the likelihood of progression to wet AMD?

A

Multiple soft drusen
Focal hyperpigmentation
Hypertension
Smoking

307
Q

What is a Lacquer crak?

A

Spontaneous, large linear break in Bruch’s membrane

308
Q

What is the 5 year risk for developing wet AMD in the fellow eye?

A

40-85%

309
Q

What is the change of CSR recurrence?

A

40%

310
Q

At what VA should an ERM be treated?

A

20/50 or worse (>20/40)

311
Q

What is the management for dry AMD?

A

Daily Amsler
High-dose antioxidants for cat 3-4 AMD
Low-dose antioxidants for cat 1-2 AMD
Smoking cessation

312
Q

What are the Tx options for wet AMD?

A

Thermal laser photocoagulation
Photodynamic therapy (PDT)
Anti-vegF (mainstream managment)

313
Q

What retinal findings are present in stage 3 HTN retinopathy?

A

CWS

Hard exudates

314
Q

Where are CWS typically found in HTN?

A

within 3DD of the nerve

315
Q

HTN retinopathy results from a breakdown of what?

A

Blood-retinal barrier

316
Q

A/V nicking would be given what HTN retinopathy grade?

A

Grade 2

317
Q

What retinal findings are seen in stage 4 HTN retinopathy?

A

CWS
Hard exudates
Nerve swelling

318
Q

What are Elschnig spots?

A

Focal areas of choroidal atrophy (white spot with black center)

319
Q

What causes Elschnig spots?

A

Past occurrences of acute HTN

320
Q

What is the main difference between diabetic retinopathy and hypertensive retinopathy?

A

Hypertensive usually presents with a “dry retina” - few hemorrhages, rare edema, but more CWS and vessel attenuation

321
Q

CMV retinitis is most common in patients with a CD4 count less that what?

A

50

322
Q

What is the classical presentation of CMV retinitis?

A

Hemorrhagic retinitis
Thick, white-yellow patches of necrotic retina
Vascular sheathing
Hemes and CWS

323
Q

In which retinal layer are flame hemes found?

A

NFL

324
Q

In which layer of the retina are hard exudates found?

A

Outer plexiform layer

325
Q

At what diastolic pressure should a pt be sent to the ER?

A

110-120

326
Q

What 3 drugs have NAION as a potential side effect?

A

Sildenafil (Viagra)
Sumatriptan (Imatrex)
Amiodarone (Codarone

327
Q

What are the common side effects of topical B-blockers?

A 
Dry eye
Depression
Impotence
Bradycardia
Bronchoconstriction
328
Q

What is the most common intraocular malignancy in children?

A

Retinoblastoma

329
Q

What is the most common intraocular malignancy in all age groups?

A

Malignant melanoma

330
Q

What is Coat’s disease and its presentation?

A 
Idiopathic peripheral vascular disease
Unilateral telangiectatic, dilated vessels (light-bulb appearance)
Marked hard exudates
Intraretinal hemes
Exudative detachment
Neovascular glaucoma
331
Q

Retinoblastoma arises due to a mutation of what gene?

A

Rb - retinoblastoma tumor suppressor gene

332
Q

What are the 3 most common presenting signs of retinoblastoma?

A

Leukocoria
Strab
Iris neo

333
Q

What finding in retinoblastoma increase the mortality rate?

A

Optic nerve invasion

334
Q

How are large retinoblastomas treated?

A

Chemotherapy and enucleation

335
Q

How are small retinoblastomas treated?

A

External beam radiotherapy
Laser photocoagulation
Brachytherapy
Cryotherapy

336
Q

Your patient presents with a focal, fluffy, yellow-white retinal lesion adjacent to an old scar with an overlying vitritis, what is the most likely Dx?

A

Toxoplasmosis

337
Q

What type of organism is toxoplasmosis gondii?

A

Intestinal parasite

338
Q

How is toxoplasmosis acquired?

A

Undercooked meet

Unpasteurized cheese

339
Q

What is the triad for congenital toxoplasmosis?

A

Convulsions
Cerebral calcifications
Chorioretinitis

340
Q

In Best’s disease, which test will be abnormal?

A

EOG

341
Q

What is the typical presentation of dominant (familial) drusen?

A

Scattered drusen throughout the posterior pole
First 3 decades of life
Bilateral and symmetric
Appear at macula and around optic nerve head
Pt is asymptomatic

342
Q

When is the typical onset of Stargardt’s?

A

Ages 6-10

343
Q

What is the most common hereditary macular dystrophy?

A

Stargardt’s

344
Q

What is the typical presentation of Stargardt’s?

A

Early stage: mild mottling and loss of FLR with VA decreased out of proportion to signs
Late stage: Fish tail shape of yellow flecks leading to beaten-bronze macular appearance (Bull’s eye maculopathy)
Possible salt and pepper in the periphery

345
Q

Which test is abnormal in later stages of Stargardts?

A

ERG

346
Q

What is the difference between fundus flavimaculaltus and Stargardt’s?

A

Fundus flavimaculatus doesn’t have the macular dystrophy, but the other signs are present
Patients are typically asymptomatic

347
Q

What is the Tx for toxoplasmosis?

A

Oral pyrimethamine
Systemic steroieds
Folinic acid
Sulfadiazine OR Clindamycin OR azithromycin

348
Q

Indomethacin is known for what ocular side effect?

A

Pigmentary retinopathy

349
Q

What are the 3 typical symptoms of ocular ischemic syndrome?

A

Gradual vision loss
Dull periorbital pain/headache
Amaurosis fugax

350
Q

What are the 4 typical signs of ocular ischemic syndrome?

A

Unilateral dot/bot hemes in midperiphery
Dilated, non-tortuous veins
Narrowed arteries
NVD and NVI

351
Q

What is venous stasis retinopathy?

A

OIS without anterior segment findings (rubeosis)

352
Q

What is the typical demographic for OIS?

A

Male, 50-70 years old

353
Q

Total cholesterol should be less than how much?

A

200

354
Q

What is the normal level of HDL?

A

40 or higher

355
Q

What is the normal level of LDL?

A

<100

356
Q

What is the normal triglyceride level?

A

<150

357
Q

What are the high risk characteristics in diabetic retinopathy?

A

Neo of the disc > 1/4 DD

Any NVD or NVE with a vit heme

358
Q

What is the leading cause of legal blindness in diabetes?

A

Macular edema

359
Q

What is the ETDRS definition of CSME?

A

Retinal thickening within 500um of the foveal center
Hard exudates within 500um of the foveal center
Retinal thickening of at least 1DD

360
Q

ETDRS recommends what Tx for CSME?

A

Focal argon laser

361
Q

Patients with severe NPDR have a 10-50% chance of progression within the next __months.

A

12 months

362
Q

What causes OIS?

A

Carotid or ophthalmic artery blockage >90%

363
Q

What is the Tx for OIS?

A

PRP if any neo is present

Carotid Doppler and endarterectomy if needed

364
Q

What is the prognosis for OIS?

A

Poor - Count fingers or worse after 1 year

365
Q

What percent of eyes with CRVO’s develop rubeoisis? When is it most likely to occur?

A

50%
2-4 months
(think 90 day glaucoma)

366
Q

What is Adie’s tonic pupil?

A

Acute, dilated pupil with possible ciliary body impairment

367
Q

What is the typical demographic for Adie’s tonic pupil?

A

Female 20-40

Possible complaints of light sensitivity and near blur

368
Q

Argyll Robertson and Horner’s pupils will demonstrate the most anisocoria in what lighting conditions?

A

Dark

369
Q

A pre-ganglionic Horner’s will dilate with what drug?

A

Cocaine

370
Q

IIH can present with what signs/symptoms?

A

Headache
CN 6 palsy
Transient visual obscurations
Enlarged blind spot

371
Q

What 4 things may possibly cause IIH?

A 
CANT
Contraceptives
Vitamin A
Naladixic acid
Tetracycline
372
Q

What are Tx options for IIH?

A

Oral acetazolamide

weight loss

373
Q

What is a potential serious side effect of oral acetazolamide?

A

Aplastic anemia

374
Q

Oral acetazolamide can cause what type of refractive shift?

A

Transient myopic shift

375
Q

What is the typical presentation of optic neuritis?

A

Young female
Sudden, unilateral vision loss (mild to severe)
APD
Pain on EOM (90%)
Visual field defect (usually central scotoma)
Uthoff’s sign

376
Q

What conditions can cause optic neuritis?

A 
MS
Syphilis
Cat-scratch disease
Lyme
Meningitis
Sarcoidosis
SLE
Devic's disease
377
Q

What is normal sed rate for a female?

A

(age + 10) / 2

378
Q

What is normal sed rate for a male?

A

age / 2

379
Q

What is the normal level of C-reactive protein?

A

0-1.0mg/dl

380
Q

How is Leber’s optic neuropathy inherited?

A

Mitochondrial DNA

381
Q

How does Grave’s disease cause vision loss?

A

Optic nerve compression from thickened EOMs

382
Q

What is the Tx for optic neuritis?

A

IV steroids and Interferon beta

383
Q

After an acute bout of optic neuritis, when does the vision generally return to normal?

A

2-3 months

384
Q

While vision will return to normal after acute optic neuritis, what are the lasting effects?

A

Reduced contrast sensitivity

Optic nerve head pallor

385
Q

What causes internuclear ophthalmoplegia?

A

Lesion of MLF

386
Q

What is the presentation of INO?

A

Adduction deficiency on affected side

Abduction deficit on contralateral side

387
Q

What is the typical demographic of Grave’s disease?

A

Middle aged to elderly female

388
Q

What are the classical signs of Grave’s?

A

Dry, red eyes
Conj injection
Proptosis
Diplopia

389
Q

What are the systemic symptoms of hyperthyroid?

A 
Weight loss
Nervousness
Heat intolerance
Heart palpitations
Increased bowel movements
Breathlessness
390
Q

What testing should be done for Grave’s disease?

A 
TSH, T3 and T4 levels
Orbital CT or MRI, looking for inflamed EOMs
Exophthalmometry
VF, looking for optic nerve compression
Forced ductions
391
Q

Brown’s syndrome will cause diplopia in what gaze?

A

Upgaze, especially in adducted upgaze

392
Q

In what order are the EOMs restricted in Grave’s?

A 
IMSLO
Inferior rectus
Medial rectus
Superior rectus
Lateral rectus
Obliques
393
Q

What is Kocher’s sign?

A

The stare appearance in Grave’s

394
Q

What is Gunn’s sign?

A

Retinal crossing changes, typically found in HTN retinopathy

395
Q

What is the primary Tx for early Grave’s?

A

Ocular lubricants

396
Q

What is the Tx for late stage Grave’s?

A

Orbital decompression, radiation, steroids (oral or IV)

397
Q

What are the signs of Grave’s disease, in order as they occur?

A 
NO SPECS
No signs/symptoms
Only signs of lid retraction/lag/stare
Soft tissue signs/symptoms (lid edema, lag, chemosis)
Proptosis
EOM enlargement
Corneal involvement
Sight loss - optic nerve compression
398
Q

What class of medication is Verapamil?

A

Ca channel blocker

399
Q

What conditions is verapamil indicated?

A

HTN
Angina
Arrhythmia

400
Q

What is the Tx for AAION?

A

IV or oral steroids long term, tapered over 3-6 months

401
Q

What are the classic signs/symptoms of AAION?

A 
Unilateral, profound vision loss
Swollen optic nerve
Jaw claudication
Scalp tenderness
Malaise
Anorexia
Temporal headache
402
Q

What is the typical demographic for AAION?

A

Over 55

403
Q

Which condition typically has a “disc at risk”, AAION or NAION?

A

NAION

404
Q

Sed rate and CRP will be normal in which condition, AAION or NAION

A

NAION

405
Q

What is the typical VF loss in NAION?

A

Altitudinal

406
Q

If GCA is not treated, what sequelae is most common?

A

Progression of vision loss to the other eye

407
Q

What are the potential side effects of oral steroids?

A 
Poor BS control
IOP spike
Cataract
Cushing's syndrome
Poor wound healing
Risk of secondary infections
408
Q

What demographic does ocular myasthenia typically effect?

A

Young women

Old men

409
Q

When are ocular MG symptoms the worst?

A

End of the day

410
Q

What are the ocular signs/symptoms of MG?

A

Diplopia (EOM involvement)

Ptosis (levator involvement)

411
Q

What are the potential systemic signs of MG?

A

Dysarthria (difficulty talking)
Dysphagia (difficulty eating)
Difficulty holding head upright
Respiratory failure

412
Q

What class of medications can make MG worse?

A

Beta-blockers

413
Q

Internuclear ophthalmoplegia is usually found in patients with what systemic condition?

A

MS

414
Q

If a patient has a superior oblique palsy, which way will their head be tilted?

A

Away from the affected side

415
Q

What test is done to confirm ocular MG?

A

Tensilon test

416
Q

What medication is used in the Tensilon test?

A

Edrophonium

417
Q

What is the antidote for the Tensilon test, should a patient have an adverse reaction?

A

IV atropine

418
Q

Why should thyroid testing be done in a patient with MG?

A

Thyroid disease occurs in about 5% of MG patients

419
Q

What class of medication is tamsulosin?

A

Alpha-1 blocker

420
Q

What is the Tx for MG?

A

Pyridostigmine and/or immunosuppressants

421
Q

A chiasmal lesion can result in what VF defect?

A

Bitemporal hemianopsia

can be inferior, superior, central, or complete

422
Q

Why does a chiasmal lesion typically cause bitemporal involvement?

A

Compression of nasal fibers

423
Q

What are the most common causes of chiasmal lesion?

A

Suprasellar meningiomas
Aneurysm of ICA
Craniopharyngioma
Glioma

424
Q

Where would a lesion be located that is causing a homonymous inferior quadrantonopsia?

A

Parietal lobe

425
Q

Where would a lesion be located that is causing homonymous superior quadrantanopsia?

A

Temporal lobe

426
Q

What VF defect would be expected in toxic/nutritional optic neuropathy?

A

Central or centrocecal

427
Q

If a patient has an occipital lobe lesion, what VF defect would you expect?

A

Homonymous and congruous

428
Q

What VF defect may be present due to tilted disc syndrome?

A

Pseudo-bitemporal hemianopsia that does NOT respect the midline

429
Q

What type of lesion will give a VF defect that respects the midline?

A

Chiasmal

430
Q

What lesion would cause a macula only homonymous VF defect?

A

Lesion at tip of occipital lobe

431
Q

What is the typical demographic for pigment dispersion syndrome?

A

20-45 year old myopic male

432
Q

What is the typical presentation of Posner Schlossman syndrome?

A

Open angle
Few cells
IOP >40

433
Q

What findings characterize Fuch’s heterochromic iridocyclitis?

A

Non-granulomatous, fine KPs

Low grade, asymptomatic chronic uveitis

434
Q

What is the MOA for prostaglandin analogs?

A

Increased uveoscleral outflow

435
Q

What is the MOA for Beta-blockers?

A

Decreased aqueous production

436
Q

What is the MOA for Alpha-agonists?

A

Decreased aqueous production

Increased uveoscleral outflow

437
Q

What is the MOA for Pilocarpine in glaucoma?

A

Increased TM outflow

438
Q

What is the MOA for CAIs ?

A

Decreased aqueous production

439
Q

Which glaucoma gtts should not be used in patients with a sulfa allergy?

A

CAIs

440
Q

How should pigmentary glaucoma be treated?

A

IOP lowering gtts - but may be harder to control, as the amount of pigment being disbursed varies
ALT is very effective

441
Q

What is the cause of glaucoma in pseudoexfoliation syndrome?

A

Deposits accumulating in the TM

442
Q

A patient with lung problems and glaucoma should not be given which class of IOP meds?

A

Beta-blocker

443
Q

What does a high PSD on VF indicate?

A

“lumpy” hill of vision with focal loss

444
Q

What is the default spot size in VF testing?

A

III

445
Q

After 5 years, what is the chance of progression from ocular hypertension to POAG?

A

9.6%

446
Q

Which has a larger treatment spot size, ALT or SLT?

A

SLT

447
Q

Drance hemes are typically associated with which type of glaucoma?

A

NTG

448
Q

What steroid is found in Maxitrol?

A

Dexamethasone

449
Q

Which cranial nerve is most susceptible to trauma?

A

CN 4

450
Q

What is the initial Tx of an orbital blow-out fracture on day 1?

A

Nasal decongestants (don’t blow nose!)

451
Q

What is absolute hyperopia?

A

The amount that can’t be overcome by accommodation

452
Q

Which of the topical steroids is ester based?

A

Lotoprednol

453
Q

How long does it typically take for a steroid response to occur?

A

30 days

454
Q

NTG can be associated with what type of headaches?

A

Migraines

455
Q

NTG is more common in persons of which decent?

A

Japanese

456
Q

Which class of IOP lowering drop is contraindicated in a patient with a history of HSK, CME, or complicated cataract surgery?

A

Prostaglandin analogs

KMK Part 2 (1 decks)

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