mock 2 Flashcards
Accomm Insufficiency is characterized by
A. reduced amplitude of accommodation
- reduce PRA
-high lag of accommodatio
- inability to clear minus moenses on monocular and binocular accomm facility test
accommodative excess is
- reduced NRA
- high amplitude of accommodation
- cant clear plus lense
-low lag or lead of accommodation
What is B lymphocytes?
-allow for specific humoral immunity
- secrete antibodies -> provide humoral immunity against specific antigen
What is the role of T lymphocytes?
- provide specific immune response against antigens w/in tissues
What is role of natural killer cells?
nonspecific - initial nonspecific reponse angainst antigen
the inner layer of the optic cups develops from ____, this includes?
develop from NEURAL RETINA
- PR, bipolar, amacrine, horizontal, Muller, ganglion cells
The RPE is derived from
the outer layer of the optic cup
What is Zonula Occludens?
- aka tight junction
- “belt” wraps around entire cell
- force particles to travel through cels rather then through cells
what is gluconeogensis?
production of glucose w/out the breakdown of glycogen
- occurs in Kiver -> provide to high oxygen tissues = retina
Whatis glycogenesis?
production glycogen, occurs in muscles and liver
what is glycogenolysis?
breakdown of glycogen in muscles and liver
which 2 lasers are MOST commonlu used for laser peripheral iridotomies?
Argon & Nd: YAG
What are Krypton laser used for?
Photocoagulation of retina
At what age does a child understand concept of reversibility?
stage 7-12yo
what 3 test measure the accuracy of accommodative?
FCC/BCC
MEM retinoscopy
Nott’s retinoscopy
What 3 test measures how much accommodation is present?
Minus lens test
push-up test
pull-away test
what is an inset?
dist from geometrical optical center to near optical center of bifocal segment
what are 3 physiological nystagmus?
- End - point (in extreme horizontal gaze)
- caloric (COWS - caloric testing of vestibular system)
- Optokinetic (maintains image of a moving obj on fovea when head is stationary)
what is latent nystagmus?
pathological nystagmus - one eye is occluded, associated w/ essential infantile esotropia and amblyopia
Accommodation reaches adult levels by
3 months
which of the following lenses will have the GREATEST amount of chromatic ?
Polycarbonate
What is an entrance pupil?
image of aperture stop formed by all lenses in front of it
- if no lenses = aperture stop = entrance pupil
Aperture stop
What is the exit pupil?
image of the aperture stop formed by all lenses BEHINH it
which drugs may cause anterior subcapsular deposits?
- chlorpromazine
- thioridazine
- amiodarone
- Miotics (pilocarpine)
Corticosteroids is associated w/ developement of _____ subcapsular cataracts
posterior
which types of scleritis is typically due to chronic rheumatoid arthritis?
Necrotizing w/OUT inflammation
- ex Scleromalacia perforans
- caused by chronic rheumatoid arthritis
S/S
- minimal symptoms
- minimal injection
- gray-blue patches of scleral thinning
accommodation reaches adult level by ___ mos
3
What is entrance pupil?
image of the aperture stop formed by all lenses in front of it
- if no lenses; aperture stop = entrance pupil
what is the exit pupil?
image of aperture stop formed by all lenses behind it
what are the water-soluble vitamins that are not stored by the body?
B1, B2, B3, B6, B12
C
what is aperture stop?
the physical entity that limits amount of light entering into an optical system
What is field stop?
the physical entity that limits the size of the object that can by viewed by an optical system
ex. Window
What are the FAT- soluble vitamins that are stored in the body (and can thus lead to toxicity)?
ADEK = (FAT- soluble)
Which color test can be used to distinguish btw anomalous trichromats and dichromats?
What can Ishihara plates detect?
Red-green defects
What can the HRR plates and Farnsworth D-15 detect?
red-green and blue-yellow defects
what 5 drugs may cause whorl keratopathy?
Chloroquine
Hydroxychloroquine
Amiodarone
Indomethacin
-
Tamoxifen
“CHAI-T”
what 2 drugs may cause pigmentation on corneal endothelium, crystalline lens pigmentation, & pigmentary retinopathy?
Chloropromazine
Promethazine
increasing water content in silicone hydrogel in CL will _____ oxygen transmission via silicone?
Decrease
- silicone = more permeable to oxygen > H20
- if H2O incrs = less silicone concentration = reduced oxygen transmission due to reduced silicone
A patient’s measured visual acuity reprsents which functions?
High spatial frequency cutoff on contrast sensitivity function
- occurs bc of optical limitations of visual system & density of photoreceptors
- ability to resolve details physically limited by spacing of photoreceptor
what is the Seg Inset?
major reference point (MRP) to center of bifocal segment
or
(dist PD - near PD)/2 for each eye
what is the total inset?
geometric center of lens to center of bifocal segment
or
(frame PD - near PD) / 2
What are the side effects associated w/ amiodarone?
- NAION: rare SE
- Whorl keratopathy: common at doses > 400 mg/day
- Anterior subcapsular lens deposits: doses > 600 mg/day after 6 mos tx
which 3 eye movements are associated w/ fixation?
- microsaccades (intentional conjugate eye movements that move fovea back on the object after microdrifts and microtremors
- microtremors (unintentional)
- microdrffts (unintentional)
maintain fixation on an object
which of the following. wavelength is the point of equal sensitivity of photopic and scotopic system?
650nm
scotopic system most sensitive to 507nm
photopic system most sensitive to 555nm
what is average refractive error in full term newborns?
+2.00D (+/- 0.75D)
emmetropization after birth -> losing 3D power to reach state of emmetropia or low hyperopia by age 1 yr
what type of aberration MOST likely to affect low-medium powered spectacle lens?
Radial astigmatism & Curvature of fiels - affect image quality of spec
- FIX: BC based on Tscherning ellipse
Spherical aberration & coma - small pupil size only allow paraxial rays into eye
Distortion - in high powered specs
what is the trichromatic theory?
color vision determined by trichromatic theory
- there are 3 diff cone photoreceptor w/ diff absorption spectra.
- color discrimination based on response to 3 cone PR to light w/ given wavelength & response is based on absorption spectra
hereditary color vision defects are often diagnosed in males due to ______ inheritance patterns?
X - linked recessive
- if mother are carrier of color defect, 50% chance make son will have color vision defect
What is Bloch’s law?
governs temporal summation & states that total number photons for stimulus below critical duration is constant
“Bloch’s likes to go to temple bc he is constant”
what is Ricco’s law?
govern spatial summation
” Ricco’s needs his Space”
what is Weber’s law and DeVries-Rose Law?
play role in light adaptation
what branches of ophthalmic artery supplies lacrimal sac?
Dorsal nasal artery
the lacrimal artery supplies…
lateral rectus + lac gland
what are the functions of RPE?
- Store & metabolized vit A
- absorption of light
- phagocytosis of PR outer segments
- transfer ions, water, metabolites btw choroid, and retina, absorbed light that is not absorbed by PR
- Production VEGF/ growth factors
- BRB
the ethmoid artery supplies
sphenoid, ethmoid, frontal sinuses
what is the abbe for CR-39?
CR- 39
- highest Abbe = 58
- least amount chromatic aberration
What is an ON-center bipolar cell ?
Inh by glutamate, depolarized when light is present
-hyperpolarized due to constant release glutamat
What is an Off-center bipolar cell ?
Excited by glutamate, hyper-polarized when light is present
which HA is associated w/
- red eyes
- nasal congestion
- transient ipsilateral Horner’s syndrom
Cluster HA
- men 30-50yo
-orbital or temporal pain - wake pt up in middle of night
- transient or permanent Horner’s syndrome on same side as cluster HA
What is a hydrop?
- sign in KCN
- tear in Descemet’s membrane -> corneal edema that ruptures corneal epithelium
What Antibiotics can treat MRSA?
” MRSA can be very difficult to tx”
- C – Clindamycin
B – Bactrim (sulfameth+trimethoprim)/ Besivance (topical)
Vancomycin
Doxy
TMP & Tobramycin (topical)
what antibiotic is effective against MSSA?
Dicloxacillin
which of the following meds MOST likely to cause corneal toxicity?
a. loteprednol
b. prednisolone acetate
c. diclofenac
d. difluprednate
C. diclofenac = topical NSAID
- SE: corneal toxicity
- corneal melt
which meds may be associated w/ NAION?
- erectile dysfx (sildenafil, verdenafil)
- sumatriptan & amiodarone
for every ___mm change in BC = __D change in power
0.1mm BC = 0.50D power
if flattened by 0.05mm = +0.25 D FAP
5 yo pt is 1.75 hyperopia, what RE is he MOST likely to have at age 14?
at 5 yo >1.50D hyperopia = hyperopic @ 14 yo
at 5 yo 0.50-1.25D hyperopia = emmetropic at 14 yo
at 5 yo < 0.50D hyperopia = myopic @ 14 yo
children can copy circle at ___ age?
3 yo
children can copy cross & square at ___ age?
4 yo
children can copy triangle at ___ age?
5 yo
The subcutaneous areolar layer contains
loose connective tissue
levator aponeurosis in upper eyelid
submuscular areolar layer contains
loss connective tissue
levator aponeurosis
palpebral portion of lacrimal gland in upper eyelid
the posterior muscular layer of superior eyelid contains
muller’s muscle
____ & ____ lens abberations can be minimized by selecting appropriate BC?
Curvature of field
Radial Astigmatism
which 3 ocular conditions can cause unilateral disc edema?
- Ischemia (NAION or AAION)
- CRVO, optic disc drusen, hypotony, uveitis
- Inflammatory (optic neuritis)
- Compressive (Grave’s opthalmopathy)
which 3 area of sclera contain elastin?
- Lamina fusca - innermost layer of sclera that is shared w/ chorioid
- Lamina cribosa
- Scleral spur - origin site of longitudinal ciliary muscle fibers
the classic clinical triad retinitis pigmentosa includes
- retinal bone-spicule pigmentation
- Arteriolar attenuation
- waxy optic disc pallor (bc orthograde degeneration)
- Cystoid mac edema
- optic disc drusen
- PSC cataracts
What are the signs associataed w/ ocular rosacea?
- papules on forehead and cheek, telangiectasia
- rhinophyma (sabaceous gland hyperplasia of nose)
- recurrent hordeola
facial flushing - associated w/ triggers (alcohol, exertion, spicy food, caffeine) - not spontaneous
3 meds that inhibit phospholipase A2 to decrs inflammation?
- triaminconoline
- hydroxychloroquine (tx Lupus, rheumatoid arthritis, anti-malarial)
- prednisone
what is MOA aspirin?
irreversibly inh Cox 1 and 3 enzymes - decrs production of prostaglandins & thromboxanes
what is MOA of indomethacine and naproxen sodium?
reversible inh of cox 1 and 2
which 2 types of refractive errors BEST corrected w/ spec ?
Axial myope
axial hyperope
Knapps law - minimize relative spec mag -
