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X Kanski synopsis for Duke > lens > Flashcards

lens Flashcards

1
Q

acquired ectopia lentis causes

A

trauma
large eye
anterior uveal tumor
hypermature cataract

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2
Q

hereditary ectopia lentis causes

A 
familial ectopia lentis 
ectopia lentis et pupillae
marfan syndrome
weill-marchesani syndrome
homocystinuria
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3
Q

hereditary ectopia lentis RARER causes

A 
aniridia
stickler syndrome
ehlers danlos
hyperlysinaemia
sulphite oxidase deficiency
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4
Q

familial ectopia lentis

A

AD
bilateral
symmetrical
superotemporal

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5
Q

ectopia lentis et pupillae

A

AR

bilateral ectopia of lens and pupil but in different directions

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6
Q

marfan syndrome ectopia lentis

A 
AD
bilateral
symmetrical
superotemporal
Intact zonules
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7
Q

weill-marchesani syndrome ectopia lentis

A

AD or AR
bilateral
inferior

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8
Q

homocystinuria ectopia lentis

A

AR
inferonasal
disintegration of zonules

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9
Q

ectopia lentis complications

A 
refractive error
optical distortion
glaucoma
cataract
endothelial damage
lens induced uveitis
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10
Q

ectopia lentis tx

A

spectacles for astigmatism/ aphakic correction

surgery for cataract, glaucoma, uveitis, endothelial touch

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11
Q

coloboma

A

notching or segmental agenesis at inferior equator

absence of zonular fibres

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12
Q

lenticonus

A

conoid curvature + thinning of capsule

ant = Alports

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13
Q

lentiglobus

A

spherical curvature + thinning of capsule

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14
Q

microspherophakia
def
causes

A

spherical lens with a small diameter

familial AD
Marfan
weill-marchesani syndrome
hyperlysinaemia
congenital rubella
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15
Q

microspherophakia
complications

ocular associations

A

lenticular myopia
subluxation
dislocation into ant chamber

Peters anomaly
Familial ectopia lentis et pupillae

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16
Q

congenital cataract

types

A 
nuclear
lamellar
sutural
ant polar
post polar
coronary/ supranuclear
blue dot
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17
Q

congenital cataract inheritance

A

AD

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18
Q

congenital cataract

metabolic causes

A 
Galactosemia oil droplet
galactokinase def
lowe syndrome
hypocalcemia
hypo/hyperglycemia
mannosidosis
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19
Q

congenital cataract
infectious causes
TORCH

A

toxo
rubella
CMV
HSV

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20
Q

congenital cataract

chromosomal abnormalities

A

Trisomy 21, 13, 18
turner
cri du chat

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21
Q

complications of cataract surgery

A 
rupture of post capsule
post loss of lens material
post dislocation of IOL
Suprachoroidal haem
endophthalmitis acute/ delayed
capsular opacification
decentration of IOL
Retinal detachment
CMO
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22
Q

rupture of post capsule
problems

tx

A

vitreous loss
post loss of lens material

remove lens material
clear vitreous from ant chamber

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23
Q

long term comp of vitreous loss

A 
updrawn pupil
chronic uveitis
endothelial vitreous touch
retinal detachment
CMO
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24
Q

post loss of lens material
COMP

Tx

A

glaucoma
chronic uveitis
retinal detachment
CMO

remove nuclear fragments by pars plana vitrectomy

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25
Q

post dislocation of IOL
COMP

Tx

A

vitreous haem
uveitis
retinal detachment
CMO

pars plana vitrectomy
remove IOL

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26
Q

Suprachoroidal haem
Predisposing

Tx

A 
elderly
glaucoma
increased axial length
systemic CV disease
vitreous loss

immediately close incision
U/S
Pars plana vitrectomy 7-14 days later

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27
Q

endophthalmitis acute

pathogen

A

staph epidermidis coag-neg
Staph aureus GP
Pseudomonas, Proteus GN

28
Q

endophthalmitis acute

prevention

A

tx blepharitis, conjunctivitis, dacryocystitis
pre-op povidone-iodine
meticulous draping
prophylactic ABX - drops, irrigation, subconj injection

29
Q

endophthalmitis acute

Dx severe

A 
2-7 days post op
pain
large hypopyon
poor VA
no red reflex
cant see fundus
30
Q

endophthalmitis acute

Dx moderate

A

mild/ absent pain
mild/ absent hypopyon
partial red reflex
partial view of fundus

31
Q

endophthalmitis acute

micro Dx, get

A

0.1ml of acqeous on tuberculin syringe

32
Q

endophthalmitis acute tx

A

vancomycin
bethamethasone
vitrectomy

33
Q

endophthalmitis delayed

pathogens

A

propionibacterium acnes
staph epidermidis
actinomyces israelii
corynebacterium

34
Q

endophthalmitis delayed

presentation when

A

4 wks - 1 yr

most 9 months post op

35
Q

endophthalmitis delayed

signs

A

low grade uveitis mutton fat precipitates

white capsular plaque = pseudomonas

36
Q

endophthalmitis delayed

clinical course

A

initial good response to topical steroids

recurrence fails to respond

37
Q

endophthalmitis delayed

tx

A

steroids + abx
intravitreal vancomycin +-vitrectomy
remove capsular bag, residual cortex, IOL

38
Q

capsular opacification SIGNS

A

Elschnig pearls on posterior capsule
post capsular fibrosis
ant fibrosis –> capsulophimosis

39
Q

comp of YAG laser capsulotomy

A 
damage to IOL = pitting
IOL sublux
increase IOP transient
chronic CMO
Rhegmatogenous retinal detachment - myopics
40
Q

decentration of IOL
causes

tx

A

operative malplacement
post op trauma, capsular contraction

mild - constrict pupil w/ miotics
severe - replace IOL

41
Q

Retinal detachment

risk factors

A

lattice deg/ retinal breaks
high myopia

post capsule rupture
vitreous loss

YAG laser capsulotomy

42
Q

CMO risk factors

A

post capsule rupture

vitreous prolapse

43
Q

Density of congenital cataract

A

red reflex quality
fundus view quality
portable slit lamp

44
Q

Congenital cataract

ASSOCIATED PATHOLOGY IN ANT SEGMENT

A

keratopathy
microphthalmos
glaucoma
persisitent hyperplastic primary vitreous

45
Q

Congenital cataract

ASSOCIATED PATHOLOGY IN POST SEGMENT

A

chorioretinitis
leber amaurosis
rubella retinopathy
foveal/ optic nerve hypoplasia

46
Q

Congenital cataract

signs of severe visual impairment

A

absence of central fixation
nystagmus
strabismus

47
Q

Congenital cataract

special tests

A

forced choice preferntial lookig

visually evoked potentials

48
Q

Congenital cataract

serological investigations

A

anti-rubella IgM, IgG
ELISA for toxo
Anti-CMV

49
Q

Congenital cataract

URINALYSIS

A

Galactosemia

Lowe syndrome

50
Q

Congenital cataract

other investigations

A

fasting blood glucose
serum calcium, phosphorus
RBC transferase, galactokinase
Chromosome analysis

51
Q

timing of surgery

bilateral congenital cataracts

A

dense - within 6 wks

partial - later, if at all

52
Q

timing of surgery

unilateral congenital cataracts

A

dense - urgent within days

partial - pupillary dilatation/ contralateral occlusion

53
Q

congenital cataracts surgical techniques

A

lens aspiration w/ vitreous cutter/ Sicoe cannula
post capsulorrhexis
limited ant vitrectomy

54
Q

congenital cataracts

visual rehab

A

spectacles/ contact lens for aphakia

IOL implantation

55
Q

Morgagnian cataract

A

hypermature

nucleus has sunk inf

56
Q

causes of presenile cataract

A

DM
Myotonic dystrophy
Atopic dermatitis

steroids
chlorpromazine/ amiodarone

57
Q

DM cataract

A

snowflake

58
Q

Myotonic dystrophy cataract

A

stellate post subcapsular

59
Q

Atopic dermatitis cataract

A

shield like

60
Q

steroids cataract

A

post subcapsular
then
ant subcapsular

61
Q

chlorpromazine/ amiodarone cataract

A

stellate, yellowish brown granules on ant lens capsule

62
Q

secondary cataract causes

A 
chronic ant uveitis
acute congestive angle closure glaucoma
high myopia
trauma
hereditary fundus dystrophies
63
Q

anaesthesia for cataract surgery

A

general
local - retrobulbar/ peribulbar/ sub-Tenon
topical-intracameral

64
Q

for cataract surgery

IOL positioning

A

post chamber w/ capsular fixation

ant chamber w/ angle fixation

65
Q

IOL design

A

rigid IOLs PMMA 5-6.6mm incision

flexible IOLs silicone, acrylic, hydrogel, collamer, 2.5-3mm incision

X Kanski synopsis for Duke (2 decks)

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