Lens Flashcards
Smoking increases the formation of which type of cataract?
Nuclear sclerotic cataract (NSC)
What is the biggest factor in developing cataract?
age
NSC can induce _______.
myopia
What are the common congenital/infantile cataracts?
- anterior polar
- coralliform
- lamellar
- cerulean
- sutural
- mittendorf’s dot
Mittendorf’s Dot congenital cataract is associated with the embryological remnant of the _______ artery on the posterior surface of the lens.
hyaloid
Which congenital cataract is associated with bluish dots scattered throughout the lens?
Cerulean
T/F posterior subcapsular is caused by the loss of lens fiber nuclei and replacement by aberrantly migrating epithelial cells.
True
Posterior subcapsular cause more glare during the day or night?
day because the pupil is constricted
What is another name for mature cataract?
Intumescent
What is another name for hypermature cataract?
Morgagnian
In which stage of cataract does the lens start to swell?
mature/intumescent stage
In which stage of cataract does the lens have complete liquifaction of the cortex?
hypermature/morgagnian
Uveitis, retinitis pigmentosa and trauma is commonly associated with which type of cataract?
Posterior subcapsular
Myopia is associated with which cataracts but not the other?
associated with anterior/posterior subcapsular and nuclear. not with cortical
Steroids, diabetes, galactosemia, wilson’s disease atopic dermatitis, miotics, chloroquine and amiodarone are associated with ________ cataract.
anterior/posterior subcapsular
What are you looking for when evaluating advance cataract?
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).
Patient is a poor candidate for cataract surgery if their corneal endothelium is _______cells/mm2.
<800
When evaluating the patient’s cornea before cataract surgery, you see corneal edema or corneal guttata, what would you do?
let the surgeon know
The Avg length of the human eye is ______mm.
22-25
1D error = _____mm
0.3
What are the types of cataract surgeries?
- Intracapsular Cataract Extraction (ICCE) - entire lens removed. 3rd world countries do this.
- Extracapsular Cataract Extraction (ECCE)
a. planned ECCE
b. Phacoemulsification - best one
Which IOL implant location is the most common?
Post chamber
What are the types of IOL?
- Apodized Diffractive IOL (ReStor)
- Multifocal IOL (ReZoom)
- Crystalens
ReZoom multifocal IOL have _____ focusing zones.
5
T/F Apodized Dffractive IOL is only able to focus light onto the retina for images at one distance.
False. at different distances
Which IOL mimic the eyes natural ability to focus on distance, intermediate and near objects?
Crystalens
Which IOL is not good for someone who needs excellent night vision?
Multifocal IOL
Multifocal IOL gives high amount of ___________.
astigmatism
During which time after post-op cataract surgery would you give the final SRx to the patient?
6-8weeks of follow up
How often do you have to schedule the patient back to your office for a follow up after post-op cataract surgery?
1 day 1 week 1 month 2 month (give final SRx) 6 month 1 year
What medications you can steroid and antibiotic med prescript to patients during the 1st day after post-op cataract surgery?
- TobraDex (combination of antibiotics and steroids)
2. Vigamox(Flouroquinolone antibiotics) with predisolone.
What is the management for us optometrists during the 1st day of post-op cataract surgery?
- Shield- metal patch
- Steroid/Antibiotic combo
- NSAID’s
- Analgesics
- Restrict physical activity
What is the management for us optometrists during the 1 week of post-op cataract surgery?
- Take off metal patch and stop antibiotic
- taper steroid
- prescript NSAIDs - Prolensa or llevro
What is the VA have to be during your 2-4 week post-op visit in order to dilate your patient’s eyes?
<20/100
What are some early post-op complications?
corneal edema and descemet’s detachment.
What should you do if you see your patient with endophthalmitis post-op surgery?
IV/topical antibiotics and call the surgeon ASAP. “you don’t want them in your chair”.
What are the organisms that cause endophthalmitis in post-op patients?
Staph. Epidermis and Staph Aureus.
What are some late complications of post-op surgery?
- Bullous Keratophathy
- Rebound Iritis
- Posterior Capsular Opacification
- Windshield wiper syndrome - zonular weakness
- Uveitis-glaucoma-hyphema syndrome
- Cystoid macular edema (CME)
- Retinal detachment (RD)
Cystoid Macular Edema is more common with _______ than with _______ cataract surgery.
ICCE, ECCE
