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QUESTIONS Flashcards

1
Q

How do you treat post op pupillary block

A

cycloplegia, LPI

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2
Q

How do you treat post op ciliary block?

A

cycloplegia, LPI (to r/o pupillary block), aqueous suppression

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3
Q

patients with elevated IOP from ICE syndrome…what is best therapy?

A

tube shunt vs trabeculectomy. laser angle surgery doesn’t work due to angle abnl

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4
Q

What serologic markers are most associated with uveitis in JIA patients?

A

postive ANA with negative RF

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5
Q

First line treatment for fungal keratitis?

A

natamycin–only available topical anti fungal in US

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6
Q

When should you consider giving steroids in EKC?

A

SEIs or pseudomembranes

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7
Q

prostaglandin ocular side effects?

A

macular edema, uveitis

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8
Q

topical carbonic anhydrase ocular side effects?

A

K edema

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9
Q

laser trabeculoplasty is good for patients for what kind of angle structure?

A

open angles such as in pseudo exfoliation syndrome

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10
Q

what is Kasabach Merritt syndrome?

A

infantile hemangioma on organs leading to thrombocytopenia due to sequestration

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11
Q

anterioposterior width of lens at birth and in adult?

A

3.5 mm and 5 mm in adults

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12
Q

what’s the width of a phase tip?

A

1.6mm

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13
Q

what optic disc features are seen in NTG?

A

larger CDR, sloping, PPA, disc hemorrhage

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14
Q

what is scleromalacia perforans?

A

necrotizing scleritis WITHOUT inflammation. Associated with RA and is painless. High mortality–manage with a rheumatologist

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15
Q

redundant periumbilical fold is associated with what condition?

A

axenfeld rieger

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16
Q

interrupted PKP sutures are best for what kind of patients?

A

inflamed K, children, thin cornea, and vascularized corneas.

allows sutures to be removed individually if needed

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17
Q

rubella infection of second trimester is associated with what?

A

retinopathy

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18
Q

rubella of first trimester is associated with sequestration of virus in lens leading to cataracts… what other association is almost never seen at the same time with cataracts in these patients

A

congenital glaucoma

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19
Q

myasthenia gravis is also associated with what comorbid condition?

A

Graves and thymoma

Get TSH and CT chest/neck

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20
Q

salt pepper fundus

A

congenital rubella mostly associated with second trimester infection

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21
Q

describe Lisch Epithelial Corneal Dystrophy?

A

X link dominant condition with micro cysts in epithelium forming whirl like pattern. Similar to Meesman’s

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22
Q

definition and width of perifovea

A

1.5 mm, area of the very peripheral macula

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23
Q

width of parafovea

A

0.5mm, area surrounding fovea. It is where ganglion cells are the thickest

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24
Q

foveola definition. width of foveola?

A

area where there’s only cones.

250 microns

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25
Q

where is foveola in relations to optic nerve?

A

0.4mm temporal, and 0.8mm inferiorly

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26
Q

What is the width of fovea?

A

1.5mm–aka 1 disc diameter

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27
Q

thickness of K epithelium?

A

50 microns

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28
Q

thickness of Bowman’s layer?

A

8-14 microns

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29
Q

Thickness of decedent’s membrane?

A

3 microns at birth —increases to 10 microns in adulthood

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30
Q

nevus of Ota is associated with what condition?

A

glaucoma in 10% pts

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31
Q

Feldenstrucktur muscle is at what NMJs for what movements

A

at En grappe NMJs for smooth pursuits

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32
Q

Fibrillenstruktur muscle is at what NMJs for what movements

A

en plaque NMJs for saccades

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33
Q

Cidofovir ocular side effect?

A

uveitis, hypotony

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34
Q

what conditions are associated with enlarged K nerves/

A

neurofibromatosis 2
MENIIB
leprosy

MeN2 large k nerves

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35
Q

how many % of melanomas come from PAM (with atypic)? de novo? nvus?

A

70% from PAM. de novo 20% rest from nevus

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36
Q

dieffenbachia plant exposure causes what?

A

corneal calcium oxalate crystals called raphides

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37
Q

treatment for toxo?

A

oral: pyrimethamine, sulfadiazine, folic acid…(triple therapy)… then later on prednisone

or IV of clindamycin and dexamethasone

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38
Q

LASIK. what organisms are common infections in <10 days post op? what about >10 days post op?

A

Gram + <10 days

Fungal or atypical mycobacteria >10 days

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39
Q

Lens capsule is thickest where?

A

posterior pre equatorial 23 microns

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40
Q

anterior lens capsule thickness?

A

14microns

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41
Q

direct eye lid closure is used for what size of eye lid defects?

A

<33%

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42
Q

how do you close lid defect 33-50%?

A

lateral canthotomy then rotate flap (Tenzel flap)

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43
Q

what is Cutler-Beard procedure?

A

for UPPER lid defects of >50% by using lower lid as flap

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44
Q

What is the modified Hughes procedure?

A

to fix lower lid defects >50% with upper eyelid flap to construct posterior lamella

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45
Q

what is echothiophate?

A

indirect Miotics. Do NOT give succinylcholine with it as it may prolong paralysis

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46
Q

What is central cloudy dystrophy of Francois?

A

exactly the same appearance as crocodile shagreen. Except for crocodile shagreen develops over time and central cloudy dystrophy of Francois is from birth (it’s a dystrophy)

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47
Q

what are the two flattest quadrants of the cornea?

A

superior and nasal

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48
Q

fovea size

A

1.5mm same as ON

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49
Q

microscopic breaks in bowman’s layer is associated with early stages of what condition?

A

Keratoconus

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50
Q

What is the difference between CHED and CHSD?

A

CHSD is extremely rare –there is no corneal edema, but there’s thickening with flaky stromal lesions.

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51
Q

what is astigmatism keratotomy?

A

parallel corneal incisions about 1mm from apex in order to flatten steep meridian and steepen the flat meridian (coupling)

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52
Q

what effect do radial incisions on the cornea have on the curvature?

A

radial incisions flatten both the meridian at hand as well as 90 degrees from it

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53
Q

Cidofovir is used for CMV retinitis. what are its side effects?

A

anterior uveitis.
hypotony
renal toxicity

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54
Q

what is the only medicine proven to reduce rebleed s/p traumatic hyphema?

A

aminocaproic acid

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55
Q

christmas tree cataract are associate with what two conditions?

A

myotonic dystrophy

hypoparathyroidism

56
Q

what kind of collagen is associated with decemet’s membrane

A

type IV

57
Q

corneal power total? anterior? posterior?

A

total is 43. anterior is 48, posterior is -6

58
Q

sudden vision loss with disc edema/peripapillary telangiectasia. waht condition? pattern of inheritance?

A

Leber hereditary optic neuropathy. mitochondrial

59
Q

symptomatic patients and what % of carotid occlusive disease should get CEA? what’s the periop risk of stroke in CEA? how does stenting compare?

A

70-99%. Periop risk of stroke for CEA is 6%. vs higher with stenting

60
Q

ONTT. how many % of patients with optic neuritis had pain with EOM?

A

92%

61
Q

square wave jerks. associated with what condition? it’s nystamoid movement but not nystagmus because?

A

parkinson’s and cerebellar/pontine disease.

It is saccdic intrusion and does not have fast/slow phase.

62
Q

How many posterior short ciliary arteries enter the globe around the optic nerve? how many posterior short ciliary nerves?

A

20 arteries

10 nerves

63
Q

what’s the length of intraorbital portion of optic nerve?
what’s the length of intrascleral portion of optic nerve?
what’s the length of intra canal portion of optic nerve?

A

24mm
1mm
10mm

64
Q

whats the difference between prolapsed orbital fat and lipodermoid

A

lipodermoid is choristoma present at birth vs prolapse happen with age

65
Q

rate of aqueous production

A

2 microliters/min

66
Q

what substances are at increased concentration in Aqueous than blood

A

vit C, hydrogen, chloride

67
Q

type 2 parafoveal telangiectasia is associated with what lab test finding?

A

impaired glucose tolerance

68
Q

Duane type 1. preferred surgical procedure?

A

medial rectus recession

69
Q

Duane type 2. preferred surgical procedure?

A

lateral rectus resection

70
Q

the orbits are separated by how many mm?

A

25

71
Q

light induced scotoma that improves with laying down. dx? diagnostic studies?

A

ocular ischemic syndrome. also could present as hypotony and mid-peripheral DBH

can do FA, CTA, MRA, carotid doppler–carotid endarterectomy

72
Q

volume of vitreous cavity

A

5ml

73
Q

volume of AC

A

200 microliters

74
Q

which immunemodulator is associated with drug induced lupus?

A

infliximab

75
Q

vitrectomy induces what kind of cataract?

A

nuclear

76
Q

silicon oil induces what kind of cataract

A

PSC

77
Q

average power of the lens is how many diopters?

A

20

78
Q

ectopia lentis et pupilae. mode of inheritance

A

autosomal recessive

79
Q

what is the most common cause of congenital unilateral cataract?

A

persisting fetal vasculature (PFV)

80
Q

how often is Rb bilateral

A

1/3 of the time

81
Q

beer belly cornea, crab claw on keratometry. Dx?

A

pellucid marginal degeneration

82
Q

what is snowflake degeneration?

A

degenerative changes to PMMA IOLs.

83
Q

IOL calcifications happen with what kind of IOL material?

A

hydrogel

84
Q

glistening occur with what kind of IOL material

A

hydrophobic

85
Q

encephaloceles are associated with what two optic nerve abnormalities?

A

morning glory nerve

optic nerve hypoplasia

86
Q

what is Heerford syndrome?

A

It’s uveitis, parotidis, and fever (uveoparotid fever)

can be a presentation of sarcoid

87
Q

What is Lofgren’s syndrome?

A

erythema nodosum, hilarious LAD, and arthritis

88
Q

what are the signs of intraoperative suprachoroidal hemorrhage?

A

tense eye, shallowing AC, loss of red reflex.

89
Q

What do you do in the case of intraoperative suprachoroidal hemorrhage.

A

close wound with suture

90
Q

the two oblique muscles are at how many degrees from visual axis?

A

51 degrees

91
Q

the superior and inferior rectus muscles are at how many degrees from visual axis?

A

23 degrees

92
Q

What is spherical aberration?

A

4th order aberration. Due to stronger focusing at peripheral corneal vs central. Risk factors: young, large pupil, myopic corneal ablation
night myopia is a side effect

93
Q

What is coma?

A

coma and trefoil are 3rd order aberrations.

Coma is due to eccentric light focusing causing light to look like a comet

94
Q

what are second order aberrations?

A

myopia (positive defocus) and hyperopia (negative defocus)

95
Q

What are first order aberrations?

A

prisms.

96
Q

What are ophthalmoplegic migraines?

A

intermittent 3rd nerve palsy. Almost always in Peds.

Always a diagnosis of exclusion (lymphomas, sarcoid..etc). enhancement on MRI is seen

97
Q

what are the three FA patterns seen with central serous chorioretinopathy— in order of most common to least common?

A

expansile dot pattern, smoke stack (10%), diffuse

98
Q

CN with the longest intracranial course?

A

CN 4

99
Q

which sub nuclei of CN III are fused (and thus supplies both eyes)?

A

levator palpebrae

100
Q

which EO muscle receives innervation from both ipsilateral and contralateral nerve fibers?

A

Superior rectus… from both CNIII fibers

101
Q

Saltzmann’s nodules are in what layer of the K?

A

Bowman’s.

Middle age women–trachoma/interstitial keratitis/phlyctenules

102
Q

most common hormone deficiency in de Morsier syndrome?

A

growth hormone

103
Q

what is a contraindication to azathioprine?

A

hx of treatment with alkylating drug or hx of allergy

104
Q

What is Foster-Kennedy Syndrome vs Pseudo Foster-Kennedy Syndrome? How do you distinguish?

A

Foster Kennedy syndrome: mass compression induced optic neuropathy/atrophy. Then compression of CSF flow results in unilateral papilledema in other eye.

PSeudo Foster Kennedy syndrome: sequential NAION at least 6 weeks apart. One nerve is atrophic already and one is swollen.

Both have one atrophic and one swollen nerve
distinguished by VF defect of the swollen side–> pseudo Foster Kennedy will have altitudinal or arcuate defect like NAION. Pseudo FK will have only enlarged blind spot

105
Q

latent nystagmus is associated with what kind of deviation? when does it occur?

A

congenital estropia with fast beats AWAY from viewing eye.

Occurs when binocularity is disrupted.

106
Q

What settings of PRP increase chance of choroidal neovascular membrane?

A

higher power, longer duration, and SMALLER spot size (breaks through Bruch’s membrane)

107
Q

what’s the magnification of a simple magnifier equation?

A

Msimple magnifier=D x distance

108
Q

what is oscillopsia?

A

subjective sensation that environment is moving in patients with nystagmus or nystamtoid eye disorders

109
Q

what are some drugs that causes uveitis?

A

rifabutin, bisphosphonates, sulfonamides, OCPs

110
Q

What meds are associated with uveitis

A

metoprolol, travaprost.

111
Q

proliferative sickle cell retinopathy should be treated how?

A

low intensity PRP to ischemic regions

112
Q

benefits of YAG contact lens?

A

stabilizes eye, reduces depth of field, and magnifies image.

113
Q

Bacterias that can penetrate intact K epitheliuM?

A

No Hard or Soft Contact Lenses

Neisseria (both), Haemophilis aegyptus, Shigella, Corynebacterium, Listeria

114
Q

What is Sherrington’s law? what condition violates Sherrington’s law?

A

When one rectus muscle contracts the opposite muscle relaxes. Duane’s violates Sherrington’s thus the globe retracts

115
Q

What is Herring’s law?what condition violates this?

A

The two eyes are yolked together. so refixation of a hyperopic eye should result in corresponding downward movement of the other eye. Dissociative vertical deviation (DVD) violates this

116
Q

What is the lens maker’s equation?

A

Power (D)= (n’-n)/r

n’=index of refraction of lens. n=index of refraction of air. R is focal length

117
Q

how many degrees do you treat when doing CPC?

A

270 –so that 90 degrees are spared–decreases anterior segment necrosis risk.

118
Q

Plateau iris is diagnosed s/p doing LPI and pressure is still elevated. What should you do to treat plateau iris?

A

ALT

119
Q

Touton giant cells are associated with what condition?

A

Erdheim-Chester (two tons of chest nuts)
Associated with early cardiac disease
Skin findings of Juvenile Xanthogranuloma (little red bumps)
yellow iris lesions

120
Q

Unilateral ischemic eye disease with mid periphery retinal hemorrhage seen on exam. What condition is this? what’s the work up?

A

Ocular ischemic syndrome.

You need to do carotid US

121
Q

Neuroblastoma associations in children?

A

periorbital ecchymosis

Horner’s syndrome

122
Q

Forster Fuch’s spots. what are they. what condition do you seen them in?

A

RPE changes/hyperpig spots. In high myopia

123
Q

Dalen Fuch’s spots. What conditions do you see them in?

A

Sympathetic ophthamia

VKH

124
Q

neuroretinitis with macular star and papilledema. What’s the organism that causes this?

A

Bartonella

125
Q

magnification of image with a lens is calculated how?

A

Mag=power of eye/power of lens

126
Q

Bird shot chorioretinitis is characterized by what HLA marker

A

HLA A29

best tested with ERG and VF

127
Q

Young child who has bilateral ptosis and cannot look up.

A

congenital fibrosis extra ocular muscle syndrome 1. autosomal dominant hesitance of muscle fibrosis.

128
Q

chandler’s

A

iris atrophy, k edema

129
Q

energy pathway of the lens? (glucose)

A

anerobic glycolysis

130
Q

what is pseudoxanthalasma elasticuma?

A

xanthalasmas on skin

Fundus has angio streaks and peau d’orange appearance. These eyes are prone to CNVM, choroidal hemorrhage.

131
Q

how do retinoblastoma escape the eye and disseminate?

A

via optic nerve

132
Q

what is bilateral diffuse uveal melanocytes proliferation (BDUMP)

A

leopard spots withOUT leakage on FA. associated with lung cancer.

133
Q

uveal effusion syndrome

A

leopard spots WITH. leakage on FA

not associated with lung cancer

134
Q

uncontrolled IIH with progressive vision loss–tx? uncontrolled HA–tx?

A

optic nerve fenestration for vision loss.

lumboperitoneal shunt for headache

135
Q

When you do surgery on the inferior rectus the lower eye lid tend to go in the direction where you move it. Recession –> lower lid retraction, Resection –>lower lid elevation

A
136
Q

dieffenbachia house plants can cause what complication?

A

corneal crystals. painful

ChM (59 decks)

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