Key points 17 Flashcards
The most common cause of vitreous haemorrhage in the United Kingdom adult population is:
Diabetic retinopathy accounts for 40-55% of cases of vitreous haemorrhage.
Surgery on which rectus muscle is MOST likely to lead to lid malposition postoperatively:
Inferior rectus surgery nearly always involves manipulation of the lid retractors.
The most common postoperative complication of enucleation is:
Superior sulcus deformity occurs due to inadequate volume replacement when the eye is removed from the orbit.
What are some intraop complications during enucleation?
Removal of the wrong eye
Damage to or loss of extraocular muscles
Hemorrhage
What are some postop complications during enucleation?
Infection
Hemorrhage
Wound dehiscence
Extrusion of the conformer
Contraction of the fornices
Exposure of the implant
Extrusion of the implant
Migration of the implant
Ptosis
Ectropion
Entropion
Hollow or deep superior sulcus
Poorly fitting prosthesis
Enophthalmos
Socket contracture
Why is Moh’s surgery inappropriate for sebacious cell carcinoma?
multicentric foci with skip areas, and negative margins do not necessarily imply complete excision of the tumour.
What is the Harada Ito procedure?
increases the force vector for incyclotorsion by moving the antero-lateral half of the insertion of the paretic muscle. It has no effect on vertical eye movement or fusion.
What condition is associated with HLADR 15
MS is associated with HLA-DR15
What are some causes of Intermediate uveitis?
Idiopathic pars planitis (most common, diagnosis of exclusion)
Sarcoid
MS
Lyme
Elevation of which structure to its previous anatomic position is often used to perform mid-face rejuvenation?
Sub-orbicularis oculi fat elevation provides a youthful midface appearance. It is usually accessed through a transconjunctival or sub-ciliary approach.
Which complication is most likely after central retinal artery occlusion?
Rubeosis iridis occurs in 15%-20% of cases of CRAO. Neovascularisation of the retina and disc can occur but is much less common.
What is the MOST frequent indication for penetrating keratoplasty in children?
Peters’ anomaly is the most frequent indication for penetrating keratoplasty in children.
What drops can be good for pigmentary glaucoma to lower IOP
Pilocarpine miotics
What are some causes for posterior subcapsular cataracts?
oral, topical, inhaled steroids (oral more frequent than others)
uveitis
penetrating surgery (e.g. vitrectomy)
retinal dystrophies (e.g. RP, Usher’s, gyrate atrophy)
degenerative myopia
chloroquine
busulfan
diabetes
Iridocorneal endothelial (ICE) syndrome glaucoma is caused by:
ICE syndrome is caused by an abnormal corneal endothelial cell layer which proliferates and migrates across the angle and onto the iris. Glaucoma occurs in about 50% of cases, due to synechial angle closure secondary to contraction of this abnormal tissue. PCR suggests a possible herpes simplex viral origin to the disease process.
What is the most common childhood exotropia?
Intermittent exotropia is the most common form of childhood exotropia. It usually presents between 2-5 yrs of age.
What is the general rule with patching in amblyopia?
The duration of full-time occlusion must not exceed 1 week per year of age in order to prevent occlusion (deprivation) amblyopia.
What are the facial features of stickler syndrome?
mid-face hypoplasia, flat nasal bridge, long philtrum and micrognathia
Which landmark study demonstrated that blood sugar levels controlled to less than 7 mmol and blood pressure controlled to less than 140/80 mmHg reduced retinopathy by one quarter and nephropathy by one third in Type 2 diabetic patients?
UKPDS
The most sensitive area of the eye to examine and detect features of ocular cicatricial pemphigoid is the:
inferior fornix
What are the commonest complications seen in JIA?
band keratopathy (40%)
cataract (30%)
secondary glaucoma (15%)
What are the features of CHED?
autosomal dominant inheritance
presents at birth
a central, anterior stromal feathery opacity
the corneal periphery may be clear
opacification may involve the entire cornea
opacification may be static or slowly progressive
normal IOP, normal (or slightly increased) corneal thickness, no pain, no photophobia, no tearing (as opposed to congenital glaucoma where these are features)
In statistics the p-value is:
The p value is the probability of obtaining a test statistic result at least as extreme as the one that was actually observed, assuming that the null hypothesis is true.
Spontaneous regression of retinopathy of prematurity (ROP) occurs in approximately what percentage of affected eyes?
Approximately 85% of ROP cases spontaneously regress.
While undergoing retinal examination, a patient claims to see his retinal vessels. This is an example of:
The Purkinje tree is a physiological entoptic phenomenon. It can be seen by shining a beam of a small bright penlight through the pupil from the periphery
Which clinical trial showed that candesartan resulted in a 34% regression in retinopathy in Type 2 diabetics over a period of 5 years?
The DIRECT study showed no statistically significant difference in progression of established retinopathy in Type 1 diabetes by candesartan, but in Type 2 there was statistically greater regression, especially in the mild retinopathy group.
What is the mechanism of IOP-lowering by pilocarpine in open-angle glaucoma?
it increases aqueous outflow via the trabecular meshwork
A patient with corneal epithelial deposits, hepatosplenomegaly and bone pain is MOST likely to have:
Gaucher disease
Which of the following statements most accurately describes the conclusion reached by the DRVS study:
early vitrectomy is recommended for vitreous haemorrhage in Type 1 DM
What is the most common posterior segment opportunistic infection in patients with AIDS?
Cytomegalovirus retinitis is by far the most common posterior segment opportunistic infection in patients with AIDS. Toxoplasma retinochoroiditis may be a distant second. Patients with cytomegalovirus retinitis often present with floaters and peripheral visual field loss. Patients with cytomegalovirus retinitis and AIDS uniformly have CD4 counts of less than 50.
What does the Jones 1 positive test mean?
dye can be visualized within the nasal cavity.
What does the Jones 2 positive test mean?
a method for determining if dye has entered the lacrimal sac. A positive Jones II indicates dye is in the nasal cavity after lacrimal irrigation.
What does the Jones 3 positive test mean?
useful when assessing the functioning of a surgical osteotomy site. A positive Jones III means dye is found in the nasal cavity of a post DCR patient.
