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Part 2/TMOD Prep > Neda's typed out notes > Flashcards

Neda's typed out notes Flashcards

1
Q

What is the initial glaucomatous damage seen on VFT?

A

Paracentral scotoma

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2
Q

What conditions are contraindicated for PG drugs for glaucoma?

A
  1. History of Uveitis
  2. CME
  3. HSK
  4. Complicated cataract surgery
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3
Q

What is the known ocular complication of a topical beta blocker?

A

Narrow Angles.

Pt’s who have a low BPM (Bradycardia), which ultimately should be avoided.

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4
Q

What are the 2 contraindications of CAI usage in glaucomatous pt’s?

A

Corneal endothelial compromise (Fuch’s dystrophy) and Sulfonamide allergy.

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5
Q

What are the 2 systemic side effect relative contraindication in patient taking what certain medications?

A

MAO inhibitors and Bradycardia

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6
Q

When should you assess the efficacy of a topical drop in a glaucomatous patients?

A

4 to 6 weeks

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7
Q

When should be the follow up for a pt who has achieved their target IOP?

A

3 to 6 months

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8
Q

Signs: Recurrent attacks of unilateral acute raised IOP (Usually 40 to 60mmHg) associated with mild anterior uveitis?

A

Posner Schlossman Syndrome

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9
Q

What is the “speculated” cause of Posner Schlossman syndrome?

A

Acute Trabeculitis ; possibly by CMV or H. Pylori

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10
Q

What is the treatment for Posner Schlossman syndrome?

A
  1. IOP controlling meds (Timolol 0.5% BID
  2. Short course (1 week) steroids (Prednisolone Acetate 1% QID)
  3. If significantly high, use Oral CAI
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11
Q

True or False, synchiae are formed during Posner Schlossman syndrome?

A

False. Synechiae and optic nerve damage is not seen. However, corneal edema is.

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12
Q

Which two layers of the angle will you see black pigment with a pt who has Pseudo-exfoliation syndrome?

A

Trabecular meshwork and Anterior to Schwalbe’s line (Sampaolesi line)

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13
Q

When is IOP the highest?

A

Night time

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14
Q

When is Aq humor production the lowest?

A

12am to 6 am

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15
Q

When Aq humor production the greatest?

A

In the morning

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16
Q

What is the fastest peak glaucoma drug?

A

Beta blocker

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17
Q

When does a drance heme go away?

A

1 to 3 months

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18
Q

What is the most common location for a drance heme?

A

Inferior Temporal

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19
Q

Which condition likely occurs due to elevated IOP following retinal vascular conditions?

A

CRVO

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20
Q

What is the IOP target when to treat for precautionary measure to avoid CRVO?

A

30 mmHg and above

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21
Q

How long does it take for a “steroid” to cause an increase in IOP?

A

4 weeks

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22
Q

How would you taper steroids?

A

Start by prescribing QID x 5 days, then tapers to BID x 5 days and then qd x 5 days.

Note: Longer the treatment period or frequent dosage, the longer the taper will be.

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23
Q

What is the most commonly encountered form of infantile glaucoma?

A

Primary Congenital glaucoma

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24
Q

What are the signs of Primary congenital glaucoma?

A 
Male
75% Bilateral
Before 1st birthday
Sporadic orgin
Abnormal angle (either flat iris insertion or a concave iris insertion)
No systemic condition
No inheritance pattern
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25
Q

What are the symptoms of Primary congenital glaucoma?

A

Photophobia, epiphora and blepharospasm

Note: Corneal appear cloudy due to corneal edema.

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26
Q

Which layer of the cornea will result in a tear when a pt has Primary congenital glaucoma?

A

Descemet’s

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27
Q

If the glove enlarges and the structures stretch with a pt suffering from primary congenital glaucoma is called?

A

Buphthalmos

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28
Q

What are horizontal breaks called when associated with congenital glaucoma? Which layer does this occur?

A

Haab’s striae and ruptures in Descemet’s membrane

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29
Q

What is the preferred procdeure for Congenital glaucoma?

A

Goniotomy (TM is incised)

Note: Trabeculectomy is used as a last resort when the cornea is not transparent and Schlemm’s canal cannot be located.

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30
Q

What occurs to the cupping observed earlier in congenital glaucoma?

A

Reverses back to normality due to increased elasticity of connective tissue

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31
Q

When should a pt return with POAG?

A

1 month

The reason is to get various IOP readings throughout the day’s time frame and to establish a baseline and to re-measure IOP.

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32
Q

What test would aid in the diagnosis of OHTN?

A

VF Test; Should be within normal limits for OHTN pt’s.

This was the criteria in the Ocular Hypertension Treatment study (OHTS)

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33
Q

What is the first line of drug for the treatment of open angle glaucoma and ocular hypertension?

A

PG’s. It lowers the most amongst all classes of glaucoma medications.

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34
Q

What is the second line of choice for glaucomatous patients’?

A

Beta Blockers ; if no heart rate or asthma issues.

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35
Q

What is the typical clinical presentation of a pt with plateau iris?

A

Female
30 to 50’s
Myopic Refractive error

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36
Q

What is the common sign seen with indentation gonioscopy is preformed on a plateau iris?

A

Double hump sign

Note: LPI should be considered as a first line of treatment to counter act pupillary block

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37
Q

What is the treatment for PDS?

A

Miotic agent is the first line of treatment (Pilocarpine 4% gel qhs)

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38
Q

What is stage 1 in neovascular glaucoma?

A

Rubeosis iridis

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39
Q

What is stage 2 in neovascular glaucoma?

A

Open angled neovascular glaucoma

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40
Q

What is stage 3 in neovascular glaucoma?

A

Angle closure neovascular glaucoma

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41
Q

Where does iris neovascularization occurs?

A

Pupillary margin

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42
Q

What is the firstline of treatment for neovascular glaucoma?

A

Panretinal photocoagulation

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43
Q

Where do the newly formed abnormal vessels from iris neovacularization originates from?

A

Capillaries of the Minor Arterial Circle of the Iris

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44
Q

What 2 ocular procedures increases the risk of developing neovascular glaucoma in an eye with iris neovascularization?

A

Cataract surgery and Vitrectomy

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45
Q

What are 2 side-effects are most frequently associated with Topamax?

A

Myopic shift and Angle closure

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46
Q

What is the angle closure treatment?

A

1 gtt timolol 0.5%
1 gtt pilocarpine 2%
1 gtt apraclonidine 1%
Acetazolamide 500mg PO

Measure IOP every 15 to 30 mins

If the IOP does not reduce in 1 hour; add hyperosmotic like glycerin or isosorbide for diabetic pts

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47
Q

Who are the most common individuals who get angle closure glaucoma?

A

South-East Asian, Eskimo or Chinese descent.

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48
Q

What common oral antihistamine can cause angle closure?

A

Benadryl

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49
Q

What is the term when it refers to the duty of an optometrist to avoid acts that could potentially harm a patient?

A

Non-maleficence

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50
Q

Who governs CTL’s?

A

FDA

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51
Q

Which type of contact lens, hydrogel or silicon, has higher incidence of lipid deposit?

A

Silicon

Note: Hydrogen has protein deposit

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52
Q

Which was is the filter oriented in Polarized glasses?

A

Vertically

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53
Q

In which meridian does flexure cause OR cylinder?

A

Same meridian of the corneal toricity

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54
Q

How much center thickness should be increased for each prism diopter?

A

1.0mm for each PD

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55
Q

What happens when you increase the Dk in gas permeable lenses?

A

Increase oxygen and wettability decreases

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56
Q

What is the etiology of dimple veiling?

A

Poor tear exchange under the GP lens and CO2 gas from the cornea, when wearing a GP lens and causing the cornea to have indentations

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57
Q

How do you get rid of dimple veiling?

A

Removing the CTL for several hours will typically allow for resolution of dimple veiling.

Long term: Decrease the OVD and Flatten the base curve

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58
Q

What is the treatment of choice for getting rid of dimple veiling?

A

Decrease the diameter of the OZD.

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59
Q

Which types of CTL’s are more prone to jelly bumps?

A

Hydrophillic

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60
Q

Which non silicone hydrogel soft lenses will have more protein deposits?

A

Group 4

LHLH -NNII

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61
Q

Which type of lenses tend to attract more proteins?

A

Ionic compounds

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62
Q

Which populations has the highest predilection for refractive error of myopia?

A

Japanese, Chinese, Jewish and Arab.

Rare in African Americans

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63
Q

You have an african american pt who has had there 3rd hypema in few years, what should you do next?

A

Screen for Sickle Cell

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64
Q

What is the treatment for Hyphema?

A

Atropine 1% BID to TID (Scopolamine)

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65
Q

What is the f/u for hyphema?

A

1 day ; do GONIO in 4 weeks.

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66
Q

What is the elevated element when a pt has Band Keratopathy?

A

Calcium

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67
Q

What is the treament for mild band keratopathy?

A

AT’s 4 to 6 times a day w/wo bandage CTL

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68
Q

What is the treatment for severe band keratopathy?

A

EDTA, however if there is stromal haze, PTK can be used to improve vision.

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69
Q

Posterior embrytoxon is an anteriorly displaced Schwalbe’s line, which type of inheritance is it?

A

Dominant trait

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70
Q

What is the difference between Axenfeld anomaly vs. Rieger anomaly?

A

Axenfeld anomaly (Posterior Embryotxon) is when the scwalbe’s line is anteriorly displaced. Rieger anomaly is Axenfeld anomaly and correctopia as well.

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71
Q

What is Peter’s Anomaly?

A

Rare but bilateral Axenfeld-Reiger anomaly and central corneal opacity.

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72
Q

What seasons does VKC generally occur?

A

Spring and Summer

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73
Q

What is the treatment for VKC?

A

Loteprednol etabonate 0.2% 1gtt OU QID

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74
Q

What is the follow up for VKC?

A

1 week –> Check IOP even though Alrex is a soft steroid

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75
Q

What is good for a 2yo who has allergic conjunctivitis?

A

Pataday

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76
Q

What is the treatment for Molluscum Contagiosum?

A

Excision of the lesion or removal via laser

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77
Q

What is a common associated sign with Molluscum Contagiosum?

A

Unilateral folliculitis located on the same side of the lesion

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78
Q

What are the 5 major findings when associated with Trachoma?

A 
Mucopurulent discharge
Lymphadenopathy
Red eye
Superior tarsal follicles
Superior pannus
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79
Q

Treatment for Trachoma

A

Oral doxycycline, Tetracycline, Azithromycin or Erythromycin

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80
Q

What is the category for refractive surgery with CK?

A

+0.75 to +3.00 D and less than 0.75 D of astigmatism

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81
Q

How long does Epithelial ingrowth occur after lasik?

A

Several days to weeks

Monitor pt for 2 weeks.

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82
Q

What is another name for DLK?

A

Sands of Sahara

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83
Q

How long after does DLK occur after Lasik?

A

2 to 5 days.

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84
Q

Contrast sensitivity and visual acuity are decreased for how long status post Lasik?

A

3 months

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85
Q

Which staining agent is the best to use for HZV?

A

Rose Bengal

Some studies have shown that NaFl poorly stains

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86
Q

What is the treatment for HZV?

A

Acyclovir, Famciclovir or Valcyclovir should be initiated within 72 hours of the onset of skin lesions.

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87
Q

What is the follow up for HZV?

A

1 to 7 days of the initiation of treatment.

Follow up 1 to 4 weeks

then 3 to 6 months as relapse may occur

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88
Q

What are the signs of HSV?

A

a) Unilateral follicular reaction
b) Lymphadenopathy
c) Tearing
d) Ocular irritation
e) Photophobia
f) Blurry vision
g) Decreased corneal sensation
h) Crops of skin vesicles

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89
Q

What is the treatment for HSV?

A

Triflurdine (Viroptic), Vidaradine (Vira-A) and Ganciclovir (Zirgan) Ointment

q2h

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90
Q

F/U for HSV?

A

2 to 7 days, stain with FLC and Rose bengal

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91
Q

What is the prophylaxis treatment to prevent epithelial keratitis caused by HSV?

A

400 mg of Acyclovir BID for 1 year

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92
Q

What is an early sign of Acanthamoeba Keratitis?

A

Epithelial mottling (Psuedodendrite)

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93
Q

Where is the break in Polymorphous dystrophy?

A

Descemet’s Membrane

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94
Q

What layer does PTK remove?

A

Epithelium and superficial stroma

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95
Q

What layer does DALK transplant?

A

Stromal

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96
Q

What layers are replaced in DMEK?

A

Descemet’s and Endothelium, however host stroma is still used.

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97
Q

What layers are transplanted in DSEK?

A

Descemet’s and Endothelium, while a donor stroma is also used.

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98
Q

What are the 2 major demographics Terrien’s Marginal Degeneration are predisposed to?

A

Men

2nd to 4th decade

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99
Q

What is the F/U for a pt with Terrien’s Marginal Degeneration?

A

6 to 12 months

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100
Q

What is the predilection for Salzmann’s?

A

Females and >50 YO

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101
Q

What are the nodules in Salzmann made of and what layer do they impact?

A

Hyaline and Bowman’s

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102
Q

What is the management of Salzmann’s?

A

Lubricants, Steroids (if inflammed), Bandage CL.

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103
Q

What is the reason for refractive error to change during pregnancy?

A

Increase in central corneal thickness, possibly due to edema and fluid retention.

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104
Q

What type of refractive error occurs during pregnancy?

A

Myopic shift

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105
Q

What are two major decreases that occur during pregnancy, in regards to the eye?

A

Decrease in corneal sensitivity and decrase in IOP

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106
Q

What is Siderosis?

A

FB which dislayed intraocular involvment

Usually due to Iron will lead to enzymal toxicity

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107
Q

What is the agic number in endothelial loss in Fuch’s endothelial dystophy?

A

1800 cells/mm2 (Normal is 2400 cells/mm2)

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108
Q

Fuch’s is predominantly occurs more so in women, is there an inheritance pattern?

A

Yes, Autosomal Dominant

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109
Q

The same patien returns one year later with a further reduction in acuity and ishes to undergo cataract surgery. You notice that she has Fuch’s dystrophy. This finding puts him most at risk for which post-operative complications?

A

Pseudophakic Bullous Keratopathy

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110
Q

What would you give a pt that has a corneal abrasion from vegetative matter?

A

Gatifloxacin (Zymar) QID

We are worried about Pseudomonas.

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111
Q

What is a pt with a corneal abrasion is in pain?

A

Rx Ketorolac Oph solution QID. A topical NSAID maybe prescribed.

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112
Q

What is the normal protocol for treating EKC?

A

AT’s and Vasoconstrictor

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113
Q

What is the most common etiology of Filmentary Keratitis?

A

Keratoconjunctivitis Sicca

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114
Q

What is the treatment for Filamentary Keratitis?

A

Mechanical debridement and removal of corneal filaments.

Acetylsycteine (Mucomyst) when applied will help alleviate the attachment.

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115
Q

FDA requires soft CTL wearer to be out of contacts for how long prior to surgery?

A

2 weeks

RGP’s are 1 month

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116
Q

When does Keratoconus generally start in an individuals life?

A

Starts at Puberty but stablizes in 3rd and 4th decades of life

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117
Q

Which layer does Fleischer’s ring occur?

A

Bowman’s layer and must be seen with a Cobalt Blue filter due to Iron deposition.

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118
Q

Which layer do Vogt’s Striae occur in?

A

Stroma

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119
Q

What is the percentage of pts who develop corneal hydrops from Keratoconus?

A

5%; usually ocur in Descemet’s membrane

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120
Q

What is the topography presentation in Keratoconus?

A

Inferior steeping or a “sagging bowtie”

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121
Q

What type of topography is noticed on forme fruste keratoconus?

A

Central or Paracentral irregular astigmatism

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122
Q

Should a pt be recommended for Lasik if they have Forme Fruste Keratoconus?

A

No, as this could progress into a serious ectasia such as Keratoconus.

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123
Q

What IOP measuring tool is best used for individuals with Fuch’s Endothelial dystrophy?

A

ORA (Ocular Response Analyzer); eliminates corneal hysteresis

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124
Q

What is the treatment for arc welder’s flash?

A

AT’s (preservative free) every 2 hours and Vigamox QID

Prognosis is good due to good if treatment started, if not high chance for infectious keratitis to occur due to epithelial barrier has died.

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125
Q

What is the usage of Acular?

A

Decrease Conjunctival
Post Cataract inflammation
CME
Seasonal Allergic Conjunctivitis

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126
Q

What are the 3 major side effects of a Topical AH/Mast cell stabalizers?

A

Stinging upon instillation, Headaches and Adverse taste (Use punctual occlusion)

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127
Q

What is the immediate thought process of a unilateral arcus?

A

Contralateral Carotid Artery disease of potential occlusion.

The reason why this is due to the fact that the contralateral artery is blocked thus the lipid deposition is not making to the non-arcus eye.

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128
Q

Which topical steroid needs to be shaken?

A

FML, since its a suspension

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129
Q

What are the only 3 anti-histamine/mast cell stabilizer?

A
  1. Lastacraft QD
  2. Patanol BID
  3. Zaditor BID
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130
Q

How often is Cromolyn Sodium (Mast cell stabilizer) should be used?

A

4 to 6 times/day

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131
Q

Which systemic anti-depressant is commonly associated with suicidal thoughts?

A

Wellbutrin

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132
Q

What is the MOA of Warfarin?

A

Inhibits the activation of clotting factors that depend on vitamin K for synthesis

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133
Q

What is the MOA of Heparing?

A

Inhibits the conversion of prothrombin to thrombin

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134
Q

What is the MOA of Aspiring?

A

Irreversible inhibition of platlet cycloxygenase

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135
Q

What is the function of Biguanides (Glyburide or Metformin)?

A

Act by increasing insulin sensitivity; molecular target is the AMP dependent protein kinase (AMPPK)

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136
Q

Biguanides are associated with lowering of serum lipis and decrease weight, however it is useful against what systemic condition aswell?

A

Polycycstic Ovarion Syndrome (PCOS)

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137
Q

What is the MOA of Thiazolidinediones (-glitazone)?

A

Enhance the action of insulin at target tissues

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138
Q

What is the MOA of Sulfonylureas (Glipizide, Glyburide and Glimepiride)?

A

Stimulate secretion of insulin from pancreatic cells increasing the level of circulating insulin

May cause Hypoglycemia

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139
Q

Which common medication causes tinnitus?

A

Aspirin

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140
Q

Phenlyephrine is what type of dilation medication?

A

Sympathomimetics

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141
Q

Cholinergic antagonist (ASHCT), inhibit which cholinergic receptors in the iris sphincter?

A

Muscarinic

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142
Q

Which 4 of the following medication have been linked to cataract formation?

A
  1. Amiodarone (Anterior sub-capsular lens deposits)
  2. Steroids (Posterior subcapsular opacification)
  3. Allopurinol (longer than 3 years are at greatest risk)
  4. Chlorpromazine, Phenothiazines, gold and busulfan (cataract formation)
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143
Q

Whats the treatment for syphilis?

A

3 to 4 million units of IV Penicillin G q4h 10 to 15 days

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144
Q

What are the two commonly used medications for gonorrhea?

A

Ceftriaxone and Azithromycin

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145
Q

What is the common medication for the treatment for Chlamydia?

A

Doxycycline

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146
Q

What is the best treatment for anterior uveitis?

A

Prednisolone Acetate 1% q1h and Cyclopentalate 1% BID with a follow up in 1 day.

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147
Q

Which of the following is an absolute contraindication of using 10% Topical Phenylephrine?

A

TCA’s such as Amytriptyline

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148
Q

What is an ocular side effect of Dilantin?

A

Nystagmus

Phenytoin blocks voltage-sensitive Na+ channels in neurons, resulting in reduced repetitive firing and thereby helping to treat most seizure disorders.

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149
Q

What is the most common side effect of subcutaneous injection of Kenalog?

A

Depigmentation at the injection site

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150
Q

Which drugs can cause a myopic shift?

A

Isotretinoin, BCP’s, Topamax and Diuretics

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151
Q

What is the MOA for Zoloft?

A

SSRI

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152
Q

Which NSAID is known to increase the risk of stroke, Myocardial Infarction and Thrombosis?

A

Indomethacin

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153
Q

Which drops are used with caution in pigment dispersion syndrome?

A

2.5% Phenylephrine and Pupil mydriasis

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154
Q

What is the treatment for an ulcer in the periphery that is 1mm in size and minimal anterior chamber reaction?

A

Ciproflocacin every 2 to 4 hours

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155
Q

Ulcer 1.5mm and higher should be treated with?

A

Fortified Tobramycin or Gentamycin, alternated with fortified cefazolin or vancomycin every 30 mins. If not available, then FLQ 1gtt every 5 minutes for 25 minutes, then every 15 minutes for 45 minutes , then every half hour for 1 day.

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156
Q

How long does it take Pseudomons Aeruginosa to liquify the cornea?

A

1 to 2 days.

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157
Q

What condition is associated with HLA-A29?

A

Birdshot Retinopathy

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158
Q

HLA DR4 is associaed with what condition?

A

Vogt-Koyanagi Harada syndrome

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159
Q

HLA B51 is commonly associated with what condition?

A

Behcet’s disease

160
Q

What is the offending agent in toxocaris?

A

Nematode

161
Q

What is the offending agent in Toxoplasmosis?

A

Protozoan

162
Q

Which condition is associated with “headlights in the fog”?

A

Toxoplasmosis ; Vitritis is associated with the overlying the chorioretinal lesions.

163
Q

What is the treatment of an active lesion of Toxoplasmosis?

A

Oral Pyrimethamine 200 mg; then 25 mg 2x day for 3 to 6 weeks.Oral Folnic 10 mg acid and Oral sulfadiazine 2g followed by 1g 4x day for 3 to 6 weeks.

164
Q

What is the offending agent in Histoplasmosis?

A

Fungus

165
Q

Which condition is associated with Ohio-Missippi river valley region?

A

Histoplamosis

166
Q

What is the triad for Histoplasmosis?

A
  1. Histo spots; which appear small (1mm in size)
  2. Peripapillary atrophy
  3. CNVM
167
Q

Which condition has vitiritis?

A

Toxoplasmosis; Histoplasmosis never does.

168
Q

What is the inheritance pattern for FAP?

A

Dominant; will usually have atypical CHRPE’s at birth

169
Q

Which population is common with being impacted by Idiopathic polypoidal choroidal vasculopathy?

A

Asian. 50% of cases resolve spontaneously.

170
Q

Which systemic condition is associated with IPPC?

A

HTN

171
Q

What is the grading of Mild NPDR?

A

Either one of hard exudates, microaneurysms and/or dot/blot hemorrhages.

172
Q

What is the grading of Moderate NPDR?

A

More hemes, venous beading or CWS with the possible presence of IRMA

173
Q

What is the grading of Severe NPDR?

A

4-2-1 rule

174
Q

In the early stages of DM2, what are of the retina was mostly likely to have been affected first?

A

Mid periphery

175
Q

What are the 3 criteria for CSME?

A
  1. Retinal thickening within 500 microns
  2. Hard exudates within 500 microns of the center of the fovea, if associated with adjacent retinal thickening
  3. Thickening of the retina with a size greater than 1 disc area, part of which is within 1 DD of the foveal center.
176
Q

What is the criteria for High-Risk PDR?

A
  1. NVD with a size greater 1/4 to 1/3 of the ONH
  2. Any degree of NVD if an associated or vitreous hemorrhage is present
  3. NVE associated with a preretinal or vitreous hemorrhage
177
Q

What is the criteria for the diagnosis of diabetes?

A
  1. HbA1c >6.5%
  2. FBS >126 mg/dL (7.0mmol/L). Fasting is defined as no caloric intake for atleast 8 hours.
  3. 2 hour plasma glucose >200mg/dL (11.1 mmol/L) during an oral glucose tolerance test (OGTT).
178
Q

What is the etiology of Coat’s disease?

A

Breakdown of the blood-retinal-barrier

179
Q

What is the etiology of Choroideremia?

A

Progressive, and diffuse atrophy of the choroid, RPE and retinal photoreceptors.

180
Q

What are the 5 stages of ROP?

A

Stage 1: Presence of myopia in addition to minimal peripheral retinal pigmentary disturbances

Stage 2: Appearance of temporal vitreoretinal fibrosis with dragging of the ON and posterior retinal

Stage 3: More severe peripheral fibrosis with contracture and the formation of falciform retinal fold

Stage 4: Partial ring of the retrolental fibrovascular tissue with the presence of a partial retinal detachment

Stage 5: Complete ring of retrolental fibrovascular tissue with total RD

181
Q

Wis the gestational age and birth weight risk factor for ROP?

A

32 weeks and 1500g

182
Q

What age does retinal vasculature reach the nasal and temporal periphery?

A

6 months for nasal and 1 month after birth for temporal

183
Q

What are the 3 zones for describing ROP?

A

Zone 1: Posterior pole (2x the distance from the disc to the macula)

Zone 2: From zone 1 to nasal ora serrata, temporally equidistant to the disc

Zone 3: The remaining temporal periphery

184
Q

What 2 conditions are children at a higher chance with a low birth weight and those treated with ROP?

A

Strabismus and Myopia

185
Q

Which measurement is over-exagerated when dragging of the macula occurs temporally?

A

Angle Kappa, looks larger than it is.

186
Q

Dilated tortuous retinal vessels in the posterior pole of children diagnosed with ROP, is called what condition?

A

Plus disease

187
Q

What is the genetic predisposition of Choroidermia?

A

X-linked disorder

Males in 2nd to 3rd decade of life

188
Q

What is the early sign of Choroidermia?

A

Night blindness

189
Q

What would be the ERG and EOG findings in Choroidermia?

A

Abnormal ERG and EOG

190
Q

Treatment for Choroidermia?

A

Specific gene therapy

191
Q

Which two layers of the retina are impacted by CME?

A

OPL and INL

192
Q

When should YAG capsulotomy be preformed after cataract surgery?

A

6 months, to reduce the chances of CME

193
Q

Chronic CME can leased to what condition?

A

Lamellar Macular Hole

194
Q

What is the treament for CME?

A

Ketorolac 0.5% QID for 3 months

195
Q

What is the peak period of Irvine Gass syndrome to occur?

A

following cataract surgery of 6 weeks to 3 months.

196
Q

When does CSCR spotaneously resolve?

A

6 months.

197
Q

What type of field loss is seen in BRAO?

A

Sectoral visual field loss

198
Q

What is the follow up for a BRAO?

A

3 to 6 months

199
Q

What will be the VA for a CRAO?

A

Counting fingers to Light preception

200
Q

CRAO f/u time?

A

1 to 4 weeks; check for neo

201
Q

What is the final VA for CRAO?

A

20/400; this will be permanent

202
Q

What type of FA will be noticed with a BRVO?

A

Early phase hypofluorescence and during the late phase of FA.

203
Q

What are the 5 stage of Best’s disease?

A
  1. Previtelliform - abnormal EOG, normal fundus and no symptoms
  2. Vitelliform - egg yolk
  3. Pseudohypopion - absorbed lesion, no effect on VA
  4. Vitelliruptive - scrambled egg, mild visual loss
  5. End stage - CNVM and macular scarring, mod to severe VA loss
204
Q

What substance is being deposited into the retina/sub-retinal space in the above condition?

A

Lipofuscin-like material

205
Q

What is the condition when the posterior pole becomes littered with white-yellow flecks?

A

Fundus Flavimaculatus

VA tends to be fairly good.

206
Q

EOG measures which portion of the eye?

A

Bruch’s membrane, RPE and cornea

207
Q

What are the wave’s that corresspond to their anatomy of the eye based on ERG?

A

A wave - PR
B wave - BP and Muller cells
C wave - RPE
D wave - off BP cell

208
Q

What is the predilection genetic disorder based on Gyrate ATrophy?

A

AR

209
Q

What is the amino acid that is deficient in Gyrate Atrophy?

A

Hyperornithinemia

210
Q

What are the tests needed to diagnose Lyme Disease?

A

Elisa, Western Blot and PCR

211
Q

What CN is impacted with Lyme disease?

A

CN 7

212
Q

At around which week of gestation does incomplete closure of the embryonic fissure?

A

Week 6

213
Q

Which part of the retina is impacted in a chorioretinal coloboma?

A

Inferior retina

214
Q

What is the most common increase risk in development, when a pt has a chorioretinal coloboma?

A

Rhematogenous Retinal Detachment

215
Q

Iris coloboma is impacted in what portion of the Iris?

A

Inferior nasal

216
Q

Where is lattice degeneration the most common?

A

Superior temporal

217
Q

What is the precentage of individuals who have lattice degeneration?

A

8%

218
Q

In Reticular pigmentary changes are noted in which quadrant of the retina?

A

Nasal equator; no intervention is needed

219
Q

Which gender is most likely to have Leber’s Hereditary Optic Atrophy?

A

Male’s due to malformation in maternal mitochondrial DNA

220
Q

Which imaging technique allows for the BEST diagnostic evaluation of abnormal choroidal vasculature lesions?

A

ICG (Indocyanine green angiography)

221
Q

Where is the most common area for white without pressure to occur?

A

Inferior temporal. Most common race is African American

222
Q

What is the formula to gauge normal ESR for males?

A

age/2

223
Q

What is the formula to gauge normal ESR for women?

A

age + 10 / 2

224
Q

What is the immediate treatment for GCA?

A

IV Methylprednisolone for 3 days in addition to oral prednisolone. Usually they need to take steroids for 1 to 2 years. Fellow eye maybe affected even if treatment is successful

225
Q

Best treatment for a RD?

A

Focal laser photocoagulation

226
Q

Once a CRVO has occurred, how long after for NVE or NVD occur?

A

3 years from incident but generally develop 6 to 12 months after acute phase of the CRVO.

227
Q

When is the follow up for NVI and why should you be concerned about it when someone has suffered a CRVO?

A

90 Day Glaucoma. Usually 2 to 4 months period from the initial presentation.

228
Q

Follow up for a pt with VA of 20/40 or better with a CRVO?

A

1 to 2 months for 6 months.

229
Q

Folow up for a pt with a VA of 20/200 or worse with a CRVO?

A

Every month for 6 months.

230
Q

What is the FA finding in a pt with a Commotio Retinae?

A

Early transmission defect corressponding to the lesion

231
Q

What is the genetic predilection of Familial Drusen?

A

Autosomal Dominant

232
Q

What would the OCT look like for a pt with Familial Drusen?

A

Thickening of the RPE-Bruch’s Membrane but the Photoreceptor layer is intact

233
Q

What would be the ERG and EOG findings in Familial Drusen?

A

Normal ERG but subnormal EOG

234
Q

Which decade does Stargardt’s disease is noticed?

A

1st to 2nd decade

235
Q

What are the 3 major findings in Oculocutaneous Albinism?

A

Transillumination defect, Nystagmus and Reduced VA

236
Q

What is the most likely cause of reduced VA in Oculocutaneous Albinism?

A

Foveal Hypoplasia

237
Q

F/U for Fuch’s Endotheial Dystrophy?

A

4 months (3 to 12 months is the variance) check for rise in IOP and evaluate corneal edema

238
Q

What is the CD4 count when CMV is evident?

A

50 cells/mm3

239
Q

What is the treatment for CMV?

A

Intravitreal Ganciclovir implant

240
Q

What is the genetic disposition of Juvenile Retinoschisis?

A

X linked recessive

241
Q

What is the treatment for Juvenile Retinoschisis?

A

Nothing

242
Q

What is the follow up for a Choroidal Melanoma?

A

6 months

243
Q

What causes Valsalve retinopathy?

A

Forcible exhalation that occurs against a closed glottis and creates a sudden increase in intrathoracic or intraabdominal pressure.

244
Q

Which area does the hemorrhage occur in Valsalve Retinopathy?

A

ILM and Sub-hyaloid region

245
Q

What type of ocular deviation is noted with Posterior Staphyloma?

A

Large Exophoria

246
Q

What is the condition called when the fellow eye is involved, when the impeding eye had a NAION?

A

Pseudo-Foster Kennedy Syndrome (Optic atrophy in one eye and optic nerve edema in the other)

247
Q

What is a good medication to prevent the fellow eye being involved in NAION?

A

81mg Aspirin

248
Q

When does the disc swelling decrease in NAION?

A

4 to 8 weeks

249
Q

What is the most common visual field defect in NAION?

A

Altitudinal

250
Q

Buried drusen is what type of material?

A

Hyaline

251
Q

What is the FU for buried drusen?

A

6 months

252
Q

Which layer of the choroid is impacted by Lacquer cracks?

A

Bruch’s membrane

253
Q

What is the genetic deposition of Usher’s syndrome?

A

Autosomal Recessive

254
Q

What is the triad of Retinitis Pigmentosa?

A
  1. Arteriolar Attenuation
  2. Retinal Bone Spicule pigmentation
  3. Waxy optic disc pallor
255
Q

Pt with the age >45, has a SO palsy. What is the etiology?

A

Microvasculature Infarction

256
Q

What is the most common etiology of a 3rd nerve palsy?

A

Aneurysm

257
Q

Pupil sparing 3rd nerve palsy is usually caused by?

A

Ischemic Vascular Disease, usually diabetic in nature

258
Q

What is the FU period of a CN palsy?

A

Observation daily for the first 7 days after the onset.

259
Q

Once the first 7 days of observation has been completed, what is the next step for follow ups?

A

Every 4 to 6 weeks. Function should return within 3 months. If the pupil does not go to its normal state, an Urgent MRI/MRA should be done.

260
Q

Which pupillary condition has a normal near response?

A

Adies Tonic

261
Q

A dilated pupil is noticed and you place 0.125% pilocarpine and miosis occurs. What condition can you consider?

A

Adies Tonic.

If it does not become miotic, it will be CN 3 palsy.

262
Q

What type of visual field defect is seen in tilted disc ?

A

Superior temporal

263
Q

Formula for calculating magnifcation of your eye?

A

60D/4

264
Q

What are 2 major findings associated with Oculoglandular syndrome?

A

Unilateral Follicular conjunctivitis and Lymphadenopathy

265
Q

What are the signs of CPEO?

A

After the age of 20 and bilateral ptosis.

266
Q

What is the FU with someone with CPEO?

A

6 months

267
Q

What is the treatment for CPEO?

A

Nothing. Only treat the exposure keratopathy

268
Q

What is the inheritance pattern of CPEO?

A

Mitochondrial

269
Q

What is Kearns-Sayre Syndrome?

A

Similar to CPEO, degeneration of retinal pigment, heart block and sudden death

270
Q

What is the most common visual field loss based on a stroke?

A

Homonymous Hemianopsia

271
Q

If there is a congruous homonymous visual field defect, where would you suspect the etiology to be?

A

Occiptal lobe

272
Q

Superior quadrant - congrous visual field defect would be suspected in which etiology?

A

Inferior calcarine cortex

273
Q

What is the affect of cocaine drops on Horner’s?

A

Nothing, won’t dilate

274
Q

Aproclonidine will have what affect on a horner’s pupil?

A

Pupil will dilate with horners

275
Q

What medication tells you if the horners is pre or post ganglionic?

A

1% hydroxyamphetamine; Pre-ganglionic lesion will dilate

276
Q

What will occur if light is shining in a Argyl Robertson Pupil?

A

No response to light, pupil respond to near stimulus

277
Q

How do you distinguish between the CN 3 and Adies Tonic?

A

0.125% Pilocarpine ; constriction will occur in Adies pupil

1% is too much

278
Q

What is the criteria for Malignant HTN?

A

200/140

279
Q

Which vasculature in the eye have autoregulation?

A

Retinal Arterioles and Capillaries

280
Q

How long does it take a CWS disappear?

A

3 to 6 weeks

281
Q

When do intraretinal periarteriolar transudates resolve?

A

2 to 3 weeks

282
Q

What is the most common etiology of isolated 3rd nerve palsy?

A

Damage of the nerve fibers in the area of the subarachnoid space

283
Q

What is the etiology of a cortical blindness?

A

Ischemia of the occipital lobe

284
Q

What type of VF loss is associated with Alcholism?

A

Temporal Disc Pallor

285
Q

What is the age for doing DEM?

A

6 to 13

286
Q

Which parts of the DEM test, works on Automaticity?

A

A and B test

287
Q

What part of the test of DEM works on oculomotor?

A

Test C

288
Q

How do you adjust the horizontal time?

A

(Raw score x 80)/(80-Additions + Omissions)

289
Q

How do you calculate the Ratio score?

A

Horizontal time / Vertical time

290
Q

How do you distinguish to diagnosis a oculomotor dysfunction?

A

Low Ratio score and High Error ; Therefore high horizontal portion and the vertical portion is normal. Ratio will be high

291
Q

How do you diagnose Poor automaticity?

A

Horizontal and Vertical components are high. Ratio will be normal

292
Q

What are the findings with both an oculomotor dysfunction and poor automaticity?

A

High ratio = High error

High test times for both horizontal and vertical components in addition to an increaed ratio

293
Q

What is the normal percentile in DEM?

A

31% and above

294
Q

What would a 16% to 31% percentile in DEM score mean?

A

Suspect; anything below would be highly suspect

295
Q

What is the best way to notice subtle receeded NPC?

A

Use R/G glasses; control binocularity

296
Q

What is the training vergence program?

A

SILO (Small In and Large Out)

297
Q

Findings for DI

A

Esophoria at distance>near,
Low AC/A Ratio
Decreased NFV at distance

298
Q

Treatment for DI?

A

BO Prism

299
Q

Findings for DE

A

High exophoria at distance,

High AC/A ratio, decreased DFV

300
Q

What VT training is good for DE?

A

Brewster stereoscope

301
Q

Findings in CE

A

High Esophoria at near, reduced NFV, High AC/A, Lowe PRA and failes -2.00 Binocular accommodative facility testing

302
Q

What is the most common binocular problems seen in clinical practice?

A

CE ; approx 6%

303
Q

Formula to calculate AC/A?

A

PD(cm) + near distance (m) x (near phoria - distance phoria)

Exo = - and Eso = +

304
Q

If a pt has poor vergence, how will the disparity curve look?

A

Narrow curve

305
Q

Sheard’s criterion

A

2/3phoria - 1/3compensating fusional vergence

306
Q

What is the amount for normal values of phenol red test?

A

9 to 20 mm

307
Q

What is the treatment for Phthirasis?

A

Mechanical removal of all nits and lice with jeweler’s forceps and placing into alcohol.

Rx. Bacitracin TID

308
Q

How often do are the eggs laid in Phthirasis?

A

7 to 10 days

309
Q

What are the follow up for pt with Phthirasis?

A

Everyday.

310
Q

What will you communicate to the PCP with Phthirasis?

A

Check for STD and treat sexual partner too.

311
Q

What is the etiology of Interstitia Keratitis?

A

Secondary to an immune reaction caused by exposure to infectious agents triggering the deployment of T cells to the stroma.

312
Q

What is the most common cause of Interstitial Keratitis?

A

Congenital Syphilis

313
Q

What is the treatment for Interstitial Keratitis?

A

Topical Steroids 1 to 6 hours.

Prednisolone Acetate 1% q2h, Homatropine 2% TID and Valtrex 1 gram PO BID.

314
Q

What is the FU for Interstitial Keratitis?

A

3 to 7 days

315
Q

What are the 3 major meds that can cause Contact Dermatitis?

A

Neomycin, Dorzolamide and Chloramphenicol

316
Q

What is the treatment of Contact Dermatitis?

A

Cool compresses 4 to 6 /days. Preservative free AT’s 6 to 8 times/day. If skin is scaly and crusty, Dexamethasone 0.05% BID to TID for 5 days. Oral Histamine such as Benadryl can be added.

317
Q

What is the FU for Contact Dermatitis?

A

1 week

318
Q

How long does acute angioedema last for?

A

7 to 21 days

319
Q

What condition is Kaposi sarcoma associated with ?

A

AIDS

320
Q

What is blephamide consist of?

A

Sulfacetamide and Prednisolone

321
Q

Chronic Blepharitis is usually what etiology?

A

Staphylococcus

322
Q

Mucopurulent discharge, that seals the eyelids shut by the morning. Crusting of eyelashes and conjunctival injection which is unlateral and corneal SPK. Which condition?

A

Bacterial Conjunctivitis

323
Q

Follow up for conjunctival nevi?

A

6 to 12 months

324
Q

What is the description with a pt has Primary Aquired Melanosis?

A

Middle aged (usually after 45), Caucasian

325
Q

Which layer of the conjunctiva is impacted by PAM?

A

Basal layer

326
Q

A brown lesion that is immobile and slow growing, would indicate which condition?

A

Melanocytoma

327
Q

What is the condition called when there is an absence of the punctal opening?

A

Punctal Artesia

328
Q

What is the treatment for Punctal Artesia?

A

Cannulation with silicone tubes

329
Q

What is punctal stenosis?

A

Narrowing

330
Q

HTN retinopathy FU

A

2 to 3 months

331
Q

Which condition is associated with Epiblepharon ?

A

Grave’s disease

332
Q

What is the treatment for Epiblepharon?

A

Lower lid Blepharoplasty

333
Q

Treatment for Dacryocystitis

A

Augmentin or Keflec PO. Warm compresses.

If febrile give IV antibiotics

334
Q

FU for Dacryocystitis?

A

1 day

335
Q

When is there a FU for Hordeolum?

A

Not nessecary unless it becomes enlarged

336
Q

What is the treatment for a Chalazia?

A

Hot soaks are always mandatory and digital massage.

337
Q

Treatment for Dacryocystitis?

A

Augmentin or Keflex

338
Q

What is the treatment for Canaliculitis?

A

Canaliclotomy

339
Q

When evaluating the function of the leavtor muscle, it is important to negate the action of which facial muscle?

A

Frontalis

340
Q

Increasing pantoscoptic tilt will result what type of astigmatism?

A

At the 180 degree meridian

341
Q

Abbe value of Polycarbonate?

A

30

342
Q

Abbe value of Trivex?

A

43 to 45

343
Q

What is the abbe value of CR39?

A

58

344
Q

What is the abbe value for Crown Glass?

A

58

345
Q

Which type of lens material possess the most amount of reflection?

A

Polycarbonate

346
Q

What product on lenses will decrease glare and halos?

A

Anti-reflective coating

347
Q

Pt reports that when she first picked up her glasses, everything appeared to be stretched vertically. What is the most likely etiology of this observation?

A

Her Rx contains a correction for Against-the-rule astigatism (minus cylinder with an axis of 090)

348
Q

CNS cells that coats axons in a myelin sheath?

A

Oligodendrocytes

349
Q

Stages of Proliferative retinopathy associated with Sickle cell disease

A

Stage 1: Occlusion of the peripheral arterioles

Stage 2: Peripheral Arteriovenous Anastomoses

Stage 3: Neovascularization of the anastomoses resulting in a “sea fan” appearance

Stage 4: Vitreous Hemorrhage

Stage 5: Proliferation of fibrovascular tissue and RDD

350
Q

Signs of a cluster headache

A

Extreme intense and severe unilateral pain, Most intense they have ever endured, feels like behind one eye, lasts from 15 to 18 minutes and several times per day

351
Q

What is the most common type of headache?

A

Tension

352
Q

How long do common headaches last?

A

4 to 6 hours

353
Q

How long does a migraine last for?

A

2 to 72 hours

354
Q

What are the signs and symptoms associated with a Migraine headache?

A

Unilateral pain, pulsating, nausea, vomitting, photophobia and phonophobia

355
Q

Which type of headache is associated with a visual aura?

A

Classical migraine

356
Q

What type of VF defect would you notice when a pt complains of visual disturbances?

A

Homonymous Hemianopia

357
Q

What are the signs of a sinus headache?

A

Constant pain in the location of the cheek bones

358
Q

What is the treatment for cluster HA?

A

Oxygen therapy

359
Q

What test do you order for Talc retinopathy?

A

Chest X-Ray

360
Q

What is the biggest risk factor for COPD?

A

Smoking Cigarettes

361
Q

What levels are decreased in COPD?

A

Alpha-1 Antitrypsin levels

362
Q

What is the most common ocular presentation associated with Behcet’s disease?

A

Bilateral, non-granulomatous panuveitis

363
Q

Which test determines if the pt has or has not had systemic syphilis?

A

FTA-ABS

364
Q

What test determines if Syphillis is currently active?

A

RPR-VDRL

365
Q

What is the causative organism of syphilis?

A

Spirochete - Treponema Pallidum

366
Q

What is the treatment for Syphilis?

A

3 to 4 million units of IV Penicillin G q4h for 10 to 15 days

367
Q

What is the triad for congenital syphilis?

A

Interstitial Keratitis, Widely spaced incisors and deafness

368
Q

What is the most common ocular complication related to Psoriatic Arthritis?

A

Anterior Uveitis

369
Q

What is a pathognomonic sign for psoriasis?

A

Nail pitting

370
Q

What is the most prevalent form of color discrimination deficiency amount males and females?

A

Deuteranomaly

371
Q

What did the COMET study find?

A

Slowing down of juvenile onset of myopia with the use of PAL’s

372
Q

What type of visual defect is seen with Retinoschisis?

A

Absolute VF defect

373
Q

What type of visual defect is seen with retinal deteachment?

A

Relative defect

374
Q

What is the age of emmetropization?

A

9 to 18 months

375
Q

You have latent hyperopia, and would like to prescribe based on cycloplegic refraction. Will you give the full rx or cut it, what would you do?

A

Cut the Rx by -1.00D to -1.50D, however keeping the anisometropia the same difference is needed.

376
Q

What is the FU after prescribing glasses?

A

6 to 8 weeks

377
Q

What type of degree of fusion is Worth 4 Dot?

A

Second degree (Biocular)

378
Q

What are the Amblyogenic refractive error with Anisometropia?

A

M - 3.00D
H - 1.00D
A - 1.50D

379
Q

What are the Amblyogenic refractive error with Isometropia?

A

M - 8.00D
H - 5.00D
A - 2.50D

380
Q

BO Vergence ranges

A

Distance 9/19/10

Near 17/21/11

381
Q

BI Vergence ranges

A

Distance -/7/4

Near 13/21/13

382
Q

What type opacification is associated with Elscnig pearls?

A

Posterior opacification of the IOL

383
Q

What is the term when you have bilateral subluxation of the lenses?

A

Ectopia Lentis

384
Q

Pt’s with Marfan’s syndrome have what common development?

A

Aortic aneurysms and Aortic dissection

385
Q

What is the most common ocular issue with marfan’s syndrome?

A

Retinal Detachment

386
Q

What type of subluxation occurs due to homocystinuria?

A

Inferior nasal

387
Q

Which layers are impacted in Lamellar Cataract?

A

Between Nucleus and the Cortex

388
Q

What layers are impacted in a NSC?

A

Fetal or Embryonic nucleus

389
Q

What is the most common cause of acute post-operative endophthalmitis?

A

S. Epidermidis

390
Q

What is the most common delayed post operative endophthalmitis?

A

Propionibacterium acnes

391
Q

What systemic condition is associated with Episcleritis?

A

Rheumatoid Arthritis

392
Q

Treatment for Episcleritis?

A

Topial steroids (FML QID)

393
Q

How to treat Diffuse Scleritis?

A

Oral NSAID’s (Indomethacin 25mg TID)

394
Q

FU for Diffuse Scleritis?

A

1 week or less

395
Q

US legal blindness?

A

20/200 or worse in the better seeing eye with glasses on.

Peripheral vision worse than 20 degrees OU

Part 2/TMOD Prep (4 decks)

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