Lens

Question 1

Smoking increases the formation of which type of cataract?

Answer 1

Nuclear sclerotic cataract (NSC)

Question 2

What is the biggest factor in developing cataract?

Answer 2

age

Question 3

NSC can induce _______.

Answer 3

myopia

Question 4

What are the common congenital/infantile cataracts?

Answer 4

1. anterior polar
2. coralliform
3. lamellar
4. cerulean
5. sutural
6. mittendorf’s dot

Question 5

Mittendorf’s Dot congenital cataract is associated with the embryological remnant of the _______ artery on the posterior surface of the lens.

Answer 5

hyaloid

Question 6

Which congenital cataract is associated with bluish dots scattered throughout the lens?

Answer 6

Cerulean

Question 7

T/F posterior subcapsular is caused by the loss of lens fiber nuclei and replacement by aberrantly migrating epithelial cells.

Answer 7

True

Question 8

Posterior subcapsular cause more glare during the day or night?

Answer 8

day because the pupil is constricted

Question 9

What is another name for mature cataract?

Answer 9

Intumescent

Question 10

What is another name for hypermature cataract?

Answer 10

Morgagnian

Question 11

In which stage of cataract does the lens start to swell?

Answer 11

mature/intumescent stage

Question 12

In which stage of cataract does the lens have complete liquifaction of the cortex?

Answer 12

hypermature/morgagnian

Question 13

Uveitis, retinitis pigmentosa and trauma is commonly associated with which type of cataract?

Answer 13

Posterior subcapsular

Question 14

Myopia is associated with which cataracts but not the other?

Answer 14

associated with anterior/posterior subcapsular and nuclear. not with cortical

Question 15

Steroids, diabetes, galactosemia, wilson’s disease atopic dermatitis, miotics, chloroquine and amiodarone are associated with ________ cataract.

Answer 15

anterior/posterior subcapsular

Question 16

What are you looking for when evaluating advance cataract?

Answer 16

you want to look at the macula and retina to see if there’s macula edema(Entoptic image or maddox rod) or retina detachement (B scan).

Question 17

Patient is a poor candidate for cataract surgery if their corneal endothelium is _______cells/mm2.

Answer 17

<800

Question 18

When evaluating the patient’s cornea before cataract surgery, you see corneal edema or corneal guttata, what would you do?

Answer 18

let the surgeon know

Question 19

The Avg length of the human eye is ______mm.

Answer 19

22-25

Question 20

1D error = _____mm

Answer 20

0.3

Question 21

What are the types of cataract surgeries?

Answer 21

1. Intracapsular Cataract Extraction (ICCE) - entire lens removed. 3rd world countries do this.
2. Extracapsular Cataract Extraction (ECCE)
   a. planned ECCE
   b. Phacoemulsification - best one

Question 22

Which IOL implant location is the most common?

Answer 22

Post chamber

Question 23

What are the types of IOL?

Answer 23

1. Apodized Diffractive IOL (ReStor)
2. Multifocal IOL (ReZoom)
3. Crystalens

Question 24

ReZoom multifocal IOL have _____ focusing zones.

Answer 24

5

Question 25

T/F Apodized Dffractive IOL is only able to focus light onto the retina for images at one distance.

Answer 25

False. at different distances

Question 26

Which IOL mimic the eyes natural ability to focus on distance, intermediate and near objects?

Answer 26

Crystalens

Question 27

Which IOL is not good for someone who needs excellent night vision?

Answer 27

Multifocal IOL

Question 28

Multifocal IOL gives high amount of ___________.

Answer 28

astigmatism

Question 29

During which time after post-op cataract surgery would you give the final SRx to the patient?

Answer 29

6-8weeks of follow up

Question 30

How often do you have to schedule the patient back to your office for a follow up after post-op cataract surgery?

Answer 30

``` 1 day 1 week 1 month 2 month (give final SRx) 6 month 1 year ```

Question 31

What medications you can steroid and antibiotic med prescript to patients during the 1st day after post-op cataract surgery?

Answer 31

1. TobraDex (combination of antibiotics and steroids) | 2. Vigamox(Flouroquinolone antibiotics) with predisolone.

Question 32

What is the management for us optometrists during the 1st day of post-op cataract surgery?

Answer 32

1. Shield- metal patch 2. Steroid/Antibiotic combo 3. NSAID's 4. Analgesics 5. Restrict physical activity

Question 33

What is the management for us optometrists during the 1 week of post-op cataract surgery?

Answer 33

1. Take off metal patch and stop antibiotic 2. taper steroid 3. prescript NSAIDs - Prolensa or llevro

Question 34

What is the VA have to be during your 2-4 week post-op visit in order to dilate your patient's eyes?

Answer 34

<20/100

Question 35

What are some early post-op complications?

Answer 35

corneal edema and descemet's detachment.

Question 36

What should you do if you see your patient with endophthalmitis post-op surgery?

Answer 36

IV/topical antibiotics and call the surgeon ASAP. "you don't want them in your chair".

Question 37

What are the organisms that cause endophthalmitis in post-op patients?

Answer 37

Staph. Epidermis and Staph Aureus.

Question 38

What are some late complications of post-op surgery?

Answer 38

1. Bullous Keratophathy 2. Rebound Iritis 3. Posterior Capsular Opacification 4. Windshield wiper syndrome - zonular weakness 5. Uveitis-glaucoma-hyphema syndrome 6. Cystoid macular edema (CME) 7. Retinal detachment (RD)

Question 39

Cystoid Macular Edema is more common with _______ than with _______ cataract surgery.

Answer 39

ICCE, ECCE