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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
Describe: follicles
pale mounts of infiltrative cellular (lymphoid) with varying diameter, typically small but can be 5x larger than papillae (with trachoma from Chlamydia); avascular center
26
What layer of cornea is damaged in SPK?
epithelium (damage and breakdown) -- think: SPK is aka Punctate Epithelial Erosions
27
What are the potential etiologies for SPK?
dry eye, CL, drug toxicity, trauma, blepharitis, conj-itis
28
Parallelpiped is most effective at detecting which tissue lesions?
scars, abrasions, SPK, SEI, corneal guttae, corneal striae
29
What is direct illumination a poor choice to detect SEI?
direct's bright lght may "wash out" the SEI
30
When is an optic section the most useful?
determine depth & location of defects of cornea and lens
31
Which has a lucid interval at the limbus: arcus or limbal girdle of Vogt?
arcus
32
Dx: pt < 40 has bilateral gray, white, or yellow-ish circumferential deposits in the peripheral cornea. What is your concern?
Corneal arcus; concern of hyperlipoproteinemia and risk of cardiovasc disease
33
Pt has corneal edema -- what illumination technique is indicated?
Sclerotic Scatter
34
How is the pupil observed when performing sclerotic scatter?
naked eye -- at an angle directly opposite from light source
35
What are common indications for sclerotic scatter?
central corneal edema, central corneal clouding (from RGP wear or Fuch's Dystrophy(, orneal scar
36
T/F: A leukoma scar be seen w/o a slit lamp
True
37
What filter would you use to detect iron deposits in the K?
Cobalt blue
38
What are two findings that involve iron deposits in the K?
Hudson-Stahli line, Fleischer's ring
39
Hudson-Stahli line: in what K layer is the iron deposit found?
epith
40
Dx: horizontal dark line between lower pupil margin and inf limbus; more easily seen with cobalt blue
Hudson-stahli line
41
Dx: curved, pigmented line seen by the top , sort of seen by the bottom of cornea with cobalt blue filer and wide beam
Fleischer's Ring
42
What is the source of iron in Fleischer's Ring?
tear film
43
Where are the fine white lines of Vogt's (Corneal) Striae found? What is the best illumination for viewing?
deep in stroma or Descemet's membrane; parallelpiped with moderate mag
44
What are the expected SLEx finding for a pt with keratoconus
Fleischer's ring, Vogt's striae | opt. Munson's sign
45
T/F: Soft CL wearers can develop striae
T
46
PPM are remnants of what?
anterior portion of the tunica vasculosa lentis (what nourishes the lens in utero)
47
T/F: One of the PPM variations includes Iris to ciliary body
F
48
What are the 4 PPM variations
Iris to iris, Iris to free float, Iris to lens, Iris to cornea
49
T/F Peripheral PPM always inserts into iris crypts
False. True: Iris colarette
50
T/F: Iris melanocytes may be attached to strands of PPM and appear floating in the AC
T
51
T/F: PPM is present in > 33% of the population
F. True: 17-32%
52
What are the cells in Cells&Flare
usu WBC, can be RBC or pigment
53
What is the flare in cells&flare?
fibrinous exudate?
54
Breakdown of the blood aq barrier due to inflammation would cause what SLEx finding?
cells and flare?
55
What is hyphema assoc. with?
trauma, iris rubesis
56
Where do RBC pool in hyphema?
inferior AC
57
Examining AC, used the red-free filter, the dark cells disappear. What were they
RBC (they absorbed the green light)
58
Examining AC, used the red-free filter, the dark cells didn't disappear. What were they
pigment from iris`
59
When is the red-free filter most often used?
Posterior seg (ret)
60
T/F: Sclerotic scatter is an appropriate illumination technique to examine the lens
False
61
T/F: Mittendorf's dot and epicapsular stars are neither considered cataracts nor abnormal
True
62
A nasal spec is seen on the lens. With retroillumination, it appears black. With direct, it looks white. What is it?
Mittendorf's dot
63
T/F: PPM and Epicapsular stars are both remanants of the tunica vasculosa lentis?
T
64
T/F: Epicapsular stars are found on the anterior capsule of the lens
T
65
Dx: propellar-shaped cluster opacity in lens. No VA reduction. *What % of the population has this?
Anterior axial embryonic cat, 25%
66
Are cerulean congenital opacities found in the peripheral cortex? or are they nuclear?
peripheral cortex (ant and/or post)
67
What pigment causes the yellow hue of Nuclear Sclerosis?
urochrome
68
What cataract leads to a myopic shift?
Nuclear Sclerotic
69
Where do the first sign of changes occur of nuclear sclerosis?
embryonic nucleus -- it will appear hazy and less distinct
70
A yellow-orange NS cataract would have what expected BCVA?
20/50-20/60
71
What % of the lens is composed of water?
65%
72
T/F: The lens nucleus has less water content than the cortex
True
73
Where can vacuoles be found?
just under the lens capsule, in mid-cortex, near adult nucleus
74
T/F: lens vacuoles can turn into cortical cataracts
True
75
Grade this cortical cataract: 2 sectors seen undilated, 3 sectors seen dilated
2+
76
Where are the opacities found in posterior subcapsular cataracts?
along vis axis
77
What is the only illumination that can be used to view the epith cells of the posterior lens capsule?
spcular reflection
78
What are the common associations of PSC?
age, steroid therapy, diabetes
79
What are the conditions needed to grade PSC?
pt is dilated, retroillumination
80
What opacification is common post-cataract surgery?
posterior capsule opacification

PPO4 Lec 7-14 (4 decks)

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