Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ocular Disease > Lens > Flashcards

Lens Flashcards

1
Q

what are some causes of cataracts?

A

BMI, diabetes, hypertension, sunlight/irradiation, smoking (3x increase in NSC), age/education and myopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the 6 congenital or infantile cataracts?

A

anterior polar, coralliform, lamellar, cerulean, sutural and mittendorf’s dot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what does it mean when a congenital cataract is unilateral vs. bilateral?

A

unilateral = trauma or intrauterine infection (syphilis, rubella, measles) bilateral = inherited and associated with other diseases (60%) (hypoglycemia, trisomy, infectious disease and prematurity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is an anterior polar cataract?

A

congenital - caused by imperfect seperation, epithelial damage or incomplete vascular re-absorption as lens develops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is a coralliform cataract?

A

congenital - autosomal dominant: round/oblong opacities that appear coral-like and have a variable affect on vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is a lamellar cataract?

A

congenital - common, bilateral and symmetrical: round, gray opacities that surround the nucleus (inherited or metabolic/inflammatory cause)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is a cerulean cataract?

A

congenital - bilateral, non-progressive, small bluish dots scattered through lens (no affect on vision)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is a sutural cataract?

A

congenital - dominantly inherited bluish dots or a dense, chalky band around the Y-sutures (if posterior it can affect vision)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is Mittendorf’s dot?

A

embryological remnant of hyaloid artery on posterior surface of lens (inferior nasal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the 3 types of age-related cataracts?

A

nuclear sclerotic, cortical, and posterior subcapsular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are nuclear sclerotic cataracts caused by?

A

an alteration in lens metabolism which increases the concentration of insoluble proteins (amino acid residue = color change)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are some symptoms of a nuclear sclerotic cataract?

A

as nucleus becomes more dense - changes refractive index and patient can have a myopic shift, can also have glare (halos/glare at night)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what causes a cortical cataract?

A

an imbalance of electrolytes that leads to an over-hydration of the lens = liquification of lens fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are some signs and symptoms of cortical cataracts?

A

vacuoles, clefts, wedges (spoke pattern in periphery) or lamellar separations, swelling/edema, decreased night vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what causes posterior subcapsular cataracts?

A

a loss of lens fiber nuclei and replacement by aberrantly migrating epithelial cells (cells cluster and breakdown adjacent cells) - seen in uveitis, RP and trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the symptoms of posterior subcapsular cataracts?

A

more day symptoms (more glare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the 2 types of advanced cataracts?

A

mature/intumescent and hypermature/morgagnian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are mature/intumescent cataracts?

A

dense and white (20/200), complete opacification and lens starts to swell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are hypermature/morgagnian cataracts?

A

complete liquification of cortex, lens my sink/float, and need immediate surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the causes of anterior/posterior subcapsular secondary cataracts?

A

trauma, electric shock, glass blower, uveitis, RP, RD, degenerative myopia, diabetes, galactosemia, wilson’s disease, atopic dermatitis, steroids, miotics, chloroquine and amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the causes for nuclear secondary cataracts?

A

rubella, degenerative myopia, anterior segment ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the causes for cortical secondary cataracts?

A

UV exposure, ciliary body tumors, Fabry’s, and dystrophia myotonica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are 3 lens-induced ocular diseases that are indications for cataract surgery?

A

phacolytic glaucoma, lens-particle glaucoma, and phacoanaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are 3 indications for cataract surgery?

A

improvement of daily life, lens-induced ocular diseases, and prevention of sight threatening conditions (diabetic patients)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are some contraindications for cataract surgery?

A

no improvement to daily living, bad systemic health/mental status, significant ocular health concerns (NVG, chronic uveitis, blind eye, decreased endothelial cell count)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are 2 ways to check potential acuity prior to cataract surgery?

A

interferometry (laser/white light) and potential acuity meter (PAM) *dilated for both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how do you test glare prior to cataract surgery?

A

brightness acuity meter (BAT) *not dilated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

which existing condition can a patient have before cataract surgery that can lead to endophthalmitis?

A

blepharitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are two additional pre-surgery tests used for advanced cataracts?

A

macular/retinal function (entopic images) with maddox rod and B-scans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

why should you perform an endothelial cell count test before cataract surgery?

A

performed on patients with significant corneal edema or corneal guttata = poor candidate if less than 800 cells/mm^2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what would a 0.3mm error in an A-scan result in for cataract surgery?

A

a 1D error in refractive component

32
Q

what is intracapsular cataract surgery (ICCE)?

A

entire lens is removed (mainly 3rd world countries) - more prone to complications (vitreous prolapse, CME, RD)

33
Q

what is extracapsular cataract surgery (ECCE)?

A

the posterior capsule is left in place - has two types: planned ECCE and phacoemulsification

34
Q

what happens during planned ECCE?

A

limbal incision is made at sclera, nucleus is expressed out, PCIOL is implanted in capsular bag

35
Q

what happens during phacoemulsification?

A

involves ultrasound which vibrates at a high frequency and fragments the lens material - corneal incision (smaller incision, foldable IOL, quicker recovery)

36
Q

what is a complication of phacoemulsificaiton?

A

may cause endothelial cell damage

37
Q

which procedure is more common: planned ECCE and phacoemulsification?

A

phacoemulsification

38
Q

what is an iris clip/iris fixated IOL?

A

it is clipped onto the iris or sutured into place **do not dilate these patients

39
Q

what is the most common type of IOL?

A

posterior chamber IOL

40
Q

what are some complications of an anterior chamber IOL?

A

uveitis/glaucoma/hyphema = UGH syndrome and can cause corneal damage to endothelium

41
Q

what are the 3 types of multifocal IOL’s?

A

apodized diffractive IOL, ReZoom multifocal and crystalens

42
Q

which multifocal IOL is designed to mimic the eye’s natural ability to focus on all distances?

A

Crystalens

43
Q

what are some contraindications of multifocal IOLs?

A

extreme perfectionists, anyone whose job requires excellent night vision, and high amounts of astigmatism

44
Q

what is performed at a 1 day post-op appointment?

A

history/cc, clean wound site, VA’s, SLE, GAT, and DO

45
Q

what drops are a 1 day post-op patient using?

A

(shield), steroid/antibiotic combo q2-4h, NSAID?, analgesic prn, and restricted physical acivity

46
Q

what treatment changes are made at 1 week post-op visit?

A

discontinue the shield and discontinue antibiotic drops - begin tapering steroid, still on NSAID

47
Q

what are the treatment changes at the 2-4 week post-op visit?

A

tapering steroid and still on NSAID (perform DFE if <20/100)

48
Q

what happens at the 6-8 week post-op appointment?

A

final refraction, possible DFE, discontinue all drops

49
Q

what are 2 early post-op conjunctiva complications?

A

injection and sub-conjunctival hemorrhage

50
Q

what are some early post-op corneal complications?

A

edema (common), descemet’s layer folds or descemet’s detachment (rare)

51
Q

what are some early IOP post-op complications?

A

transient rise in IOP, pupillary block glaucoma, hypotony/flat AC

52
Q

what are 2 early post-op complications in the anterior chamber?

A

hyphema and endophthalmitis (2-3 days post-op)

53
Q

what is the common organism that causes endophthalmitis and what are the sources?

A

staph. epidermidis and aureus normal flora, instruments, contaminated IOLs/solutions

54
Q

what are the signs and symptoms of endophthalmitis?

A

pain, redness, reduced VA inflammation, hypopyon, corneal edema, AC reaction and viritis

55
Q

what is the treatment for endophthalmitis?

A

IV/topical antibiotics (may need to be cultured)

56
Q

what is an early post-op complication of the iris?

A

iris atrophy or prolapse (may cause peaked pupil/distorted)

57
Q

what is a late complication of the cornea from cataract surgery?

A

bullous keratopathy - see striae, stromal folds, microcysts and bullae

58
Q

what is the treatment for bullous keratopathy?

A

hypertonics and PKP

59
Q

what late complication can occur if the steroids are not properly tapered?

A

rebound iritis and inflammation

60
Q

when does posterior capsular opacification occur following cataract surgery? What is the treatment?

A

occurs in 50% of ECCE patients - 6 months to 5 years after treatment = neodymium - YAG laser

61
Q

what is the late complication windshield wiper syndrome?

A

due to zonular weakness (PXF, trauma) and capsular bag isn’t stable

62
Q

which type of cataract surgery is CME more common in?

A

more common in ICCE than ECCE - can occur up to 1 year post-op (cause is unclear)

63
Q

how do you diagnose CME and what is the treatment?

A

diagnose = fluorescein angiogram or OCT treatment = oral and topical NSAIDs or steroids

64
Q

when is a retinal detachment following cataract surgery most likely going to occur?

A

in first 3 years after surgery - more often in ICCE due to loss or compromise to capsular bag - shift in anterior vitreous

65
Q
A

Seidel’s Sign

66
Q
A

Nuclear Sclerotic

67
Q
A

Cortical

68
Q
A

Posterior subcapsular

69
Q

What are 3 types of cataracts in this photo?

A

NSC, PSC, cortical

70
Q
A

Congenital - Anterior Polar

71
Q
A

Congenital - Coralliform

72
Q
A

Congenital - lamellar

73
Q
A

Congenital - Cerulean

74
Q
A

Congential - sutural

75
Q
A

Congenital - Mittendorf’s dot

Ocular Disease (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions