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PPO4 Lec 7-14 > Lec 7 > Flashcards

Lec 7 Flashcards

1
Q

Illumination technique for Transillumination Defect

A

Iris retro

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2
Q

Best ilumination technique for guttata

A

Specular reflection

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3
Q

Best illumination technique for sub-epi infiltrate

A

indirect

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4
Q

Unilateral proliferation of melanocytes following CN V branches 1&2 describes

A

Nevus of Ota

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5
Q

Melanocytes of the nevus of ota follow what nerve?

A

CN V1 and V2

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6
Q

Describe: Cogan’s senile plaque (aka Senile Hyaline Plaque)

A

benign in elderly (pt >60yo), bilat, N&T, no clinical signif

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7
Q

What causes senile plaque of sclera

A

constant stress & strain on scleral fibers by horiz rectus muscles
(so they’re found N&T)

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8
Q

Describe: Conjunctivochalasis

A

redundant, loose, non-edematous conj that creates conj folds that go over the lid margin
Typically involves InfraTemp conj

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9
Q

What does a pinguecula typically look like

A

N&T (interpalpebral), yellow-white bulba conj thickening adjacent to limbus

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10
Q

What stimulates a pterygium

A

UV exposure and/oor climate

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11
Q

Describe: pterygium

A

thick, fleshy trianglar tissue mass onto NASAL cornea, usu bilateral

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12
Q

What is: brown discoloration of conj

A

melanosis

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13
Q

What are typical ab-normal findings of the palpebral conj

A

retention cysts, concretions, papillae, follices

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14
Q

Describe: retention cyst

A

inferior palpebral conj, thin-walled with clear fluid, in gland of Krause

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15
Q

Etiology of concretions

A

idiopathic or result of chronic inflamm

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16
Q

Describe: concretions

A

small, yellow-white, hard on palpebral conj

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17
Q

When do concretions become symptomatic?

A

larger, numerous, calcific

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18
Q

What is the key feature of papillae?

A

single vessel growth in the middle

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19
Q

What is papillae assoc with?

A

allergic rxn, bac infxn

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20
Q

Where are papillae best seen?

A

Sup conj

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21
Q

Where can papillae be found in chronic allergic conj-its?

A

inf. conj

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22
Q

Where would follicle presentation be abnormal?

A

inf or sup palpebral conj in adults or children

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23
Q

Follicles are most common with what type of infection?

A

Viral (or drug toxicity to topical Rx)

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24
Q

When would follicle presentation be normal?

A

in children with lower cul-de-sac, quiet eyes

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25
Q

Describe: follicles

A

pale mounts of infiltrative cellular (lymphoid) with varying diameter, typically small but can be 5x larger than papillae (with trachoma from Chlamydia); avascular center

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26
Q

What layer of cornea is damaged in SPK?

A

epithelium (damage and breakdown) – think: SPK is aka Punctate Epithelial Erosions

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27
Q

What are the potential etiologies for SPK?

A

dry eye, CL, drug toxicity, trauma, blepharitis, conj-itis

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28
Q

Parallelpiped is most effective at detecting which tissue lesions?

A

scars, abrasions, SPK, SEI, corneal guttae, corneal striae

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29
Q

What is direct illumination a poor choice to detect SEI?

A

direct’s bright lght may “wash out” the SEI

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30
Q

When is an optic section the most useful?

A

determine depth & location of defects of cornea and lens

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31
Q

Which has a lucid interval at the limbus: arcus or limbal girdle of Vogt?

A

arcus

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32
Q

Dx: pt < 40 has bilateral gray, white, or yellow-ish circumferential deposits in the peripheral cornea. What is your concern?

A

Corneal arcus; concern of hyperlipoproteinemia and risk of cardiovasc disease

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33
Q

Pt has corneal edema – what illumination technique is indicated?

A

Sclerotic Scatter

34
Q

How is the pupil observed when performing sclerotic scatter?

A

naked eye – at an angle directly opposite from light source

35
Q

What are common indications for sclerotic scatter?

A

central corneal edema, central corneal clouding (from RGP wear or Fuch’s Dystrophy(, orneal scar

36
Q

T/F: A leukoma scar be seen w/o a slit lamp

A

True

37
Q

What filter would you use to detect iron deposits in the K?

A

Cobalt blue

38
Q

What are two findings that involve iron deposits in the K?

A

Hudson-Stahli line, Fleischer’s ring

39
Q

Hudson-Stahli line: in what K layer is the iron deposit found?

A

epith

40
Q

Dx: horizontal dark line between lower pupil margin and inf limbus; more easily seen with cobalt blue

A

Hudson-stahli line

41
Q

Dx: curved, pigmented line seen by the top , sort of seen by the bottom of cornea with cobalt blue filer and wide beam

A

Fleischer’s Ring

42
Q

What is the source of iron in Fleischer’s Ring?

A

tear film

43
Q

Where are the fine white lines of Vogt’s (Corneal) Striae found? What is the best illumination for viewing?

A

deep in stroma or Descemet’s membrane; parallelpiped with moderate mag

44
Q

What are the expected SLEx finding for a pt with keratoconus

A

Fleischer’s ring, Vogt’s striae

opt. Munson’s sign

45
Q

T/F: Soft CL wearers can develop striae

A

T

46
Q

PPM are remnants of what?

A

anterior portion of the tunica vasculosa lentis (what nourishes the lens in utero)

47
Q

T/F: One of the PPM variations includes Iris to ciliary body

A

F

48
Q

What are the 4 PPM variations

A

Iris to iris, Iris to free float, Iris to lens, Iris to cornea

49
Q

T/F Peripheral PPM always inserts into iris crypts

A

False. True: Iris colarette

50
Q

T/F: Iris melanocytes may be attached to strands of PPM and appear floating in the AC

A

T

51
Q

T/F: PPM is present in > 33% of the population

A

F. True: 17-32%

52
Q

What are the cells in Cells&Flare

A

usu WBC, can be RBC or pigment

53
Q

What is the flare in cells&flare?

A

fibrinous exudate?

54
Q

Breakdown of the blood aq barrier due to inflammation would cause what SLEx finding?

A

cells and flare?

55
Q

What is hyphema assoc. with?

A

trauma, iris rubesis

56
Q

Where do RBC pool in hyphema?

A

inferior AC

57
Q

Examining AC, used the red-free filter, the dark cells disappear. What were they

A

RBC (they absorbed the green light)

58
Q

Examining AC, used the red-free filter, the dark cells didn’t disappear. What were they

A

pigment from iris`

59
Q

When is the red-free filter most often used?

A

Posterior seg (ret)

60
Q

T/F: Sclerotic scatter is an appropriate illumination technique to examine the lens

A

False

61
Q

T/F: Mittendorf’s dot and epicapsular stars are neither considered cataracts nor abnormal

A

True

62
Q

A nasal spec is seen on the lens. With retroillumination, it appears black. With direct, it looks white. What is it?

A

Mittendorf’s dot

63
Q

T/F: PPM and Epicapsular stars are both remanants of the tunica vasculosa lentis?

A

T

64
Q

T/F: Epicapsular stars are found on the anterior capsule of the lens

A

T

65
Q

Dx: propellar-shaped cluster opacity in lens. No VA reduction. *What % of the population has this?

A

Anterior axial embryonic cat, 25%

66
Q

Are cerulean congenital opacities found in the peripheral cortex? or are they nuclear?

A

peripheral cortex (ant and/or post)

67
Q

What pigment causes the yellow hue of Nuclear Sclerosis?

A

urochrome

68
Q

What cataract leads to a myopic shift?

A

Nuclear Sclerotic

69
Q

Where do the first sign of changes occur of nuclear sclerosis?

A

embryonic nucleus – it will appear hazy and less distinct

70
Q

A yellow-orange NS cataract would have what expected BCVA?

A

20/50-20/60

71
Q

What % of the lens is composed of water?

A

65%

72
Q

T/F: The lens nucleus has less water content than the cortex

A

True

73
Q

Where can vacuoles be found?

A

just under the lens capsule, in mid-cortex, near adult nucleus

74
Q

T/F: lens vacuoles can turn into cortical cataracts

A

True

75
Q

Grade this cortical cataract: 2 sectors seen undilated, 3 sectors seen dilated

A

2+

76
Q

Where are the opacities found in posterior subcapsular cataracts?

A

along vis axis

77
Q

What is the only illumination that can be used to view the epith cells of the posterior lens capsule?

A

spcular reflection

78
Q

What are the common associations of PSC?

A

age, steroid therapy, diabetes

79
Q

What are the conditions needed to grade PSC?

A

pt is dilated, retroillumination

80
Q

What opacification is common post-cataract surgery?

A

posterior capsule opacification

PPO4 Lec 7-14 (4 decks)

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