Quiz (Corneal Dystrophies, Keratokonus, Lens and Cataracts, and Refractive Surgery)

Question 1

What are traits that nearly all corneal dystrophies follow?

Answer 1

1. non-inflammatory
2. bilateral
3. hereditary
4. central corneal involvement

Question 2

What is the procedure that uses a needle to puncture the cornea, allowing for a new basement membrane formation?

Answer 2

anterior stromal puncture

Question 3

What is the keratoplastic surgery in which all 5 layers are removed? 1. What is the one in which only some are removed? 2

Answer 3

1. penetrating keratoplasty

2. lamellar keratoplasty

Question 4

What is the procedure used to transplant an endothelium?

Answer 4

DSEAK (Descemet Stripping automated endothelial keratoplasty)

Question 5

What are the complications of DSEAK? 1. What are the advantages? 2

Answer 5

1. posterior graft dislocation

2. less post-op astigmatism, faster recovery

Question 6

What are parallel lines that are deep in the posterior stroma that run parallel with the axis of the cone and disappear with pressure called?

Answer 6

Vogt’s striae

Question 7

What is the sign that is a V shaped lower lid conformation when the patient looks in downgaze?

Answer 7

Munson sign

Question 8

What is the keratoconus sign that has an oil droplet appearance with retroillumination?

Answer 8

Charleaux sign

Question 9

What is the treatment for keratoconus where half circles of PMMA are place into the midstroma for better vision?

Answer 9

Intacs

Question 10

What is done to the cornea in corneal cross linking?

Answer 10

1. some epithelium removed
2. Riboflavin added
3. UVA rays applied
4. increase in collagen cross linking

Question 11

What are the requirements in Germany to perform cross linking?

Answer 11

1. > 17yo
2. keratoconus or ectasia
3. progression in last year
4. > 400um corneal thickness
5. keratometry readings

Question 12

What is the procedure for keratoconus in which the opaque scarred cornea is replaced with clear donor cornea?

Answer 12

penetrating keratoplasty

Question 13

In penetrating keratoplasty what is used to cut the donor button?

Answer 13

trephine

Question 14

What are the possible side effects of penetrating keratoplasty?

Answer 14

1. persistent epithelial defects
2. wound leak
3. shallow anterior chamber
4. iris prolapse
5. uveitis
6. inc IOP
7. Infection
8. Graft rejection

Question 15

What is seen when there is a graft rejection following a penetrating keratoplasty?

Answer 15

Khodadoust line

Question 16

What is a removal of the epithelium and anterior stroma called?

Answer 16

lamellar keratoplasty

Question 17

What is a removal of the eopithelium and all stromal tissue called?

Answer 17

deep lamellar keratoplasty

Question 18

What do high blood sugar levels do to the vision of a diabetic patient? 1. Low sugar? 2

Answer 18

1. inc myopia

2. inc hyperopia

Question 19

What is the leading cause of blindness worldwide?

Answer 19

cataracts

Question 20

What are the prevalence percentages for each of these age groups: 1. 52-64? 2. 65-74? 3. 75-85?

Answer 20

1. 42%
2. 60%
3. 91%

Question 21

What types of cataracts are found to be in more african americans?

Answer 21

cortical/nuclear

Question 22

Are men or women more likely to have a cataract?

Answer 22

women

Question 23

What are the medical risk factors associated with cataracts?

Answer 23

1. diabetes
2. family history
3. medications

Question 24

What nutritional addition can help lower prevalence of cataracts?

Answer 24

B vitamins

Question 25

What are the possible causes of a traumatic cataract?

Answer 25

1. concussion
2. ionizing radiation
3. electric shock
4. lightning

Question 26

What are the different types of cataracts that can occur from a concussion?

Answer 26

1. Vossius ring from iris
2. flower-shaped
3. penetrating

Question 27

What wavelengths do yellow cataract absorb?

Answer 27

low wavelengths so violet and blue

Question 28

What are the medical reasons where cataract surgery must be done and is not just if the patient wants to?

Answer 28

1. reina not visible in a diabetic
2. morgagnian
3. hypermature cataracts

Question 29

What are the things that should be done in all pre-operative cataract surgery appointments?

Answer 29

1. symptoms
2. best corrected VA (lights on and off)
3. Amsler grid
4. SLE, IOP, fundus evaluation
5. Optical coherence (OCT)
6. Glare (BAT)
7. IOL power calculation
8. macular integrity

Question 30

What is used to test the affect of glare on VAs?

Answer 30

Brightness acuity test (BAT)

Question 31

What is done to measure the macular integrity?

Answer 31

1. potential acuity meter (PAM)
2. Laser interferometer
3. blue field entoptoscope
4. Amsler grid

Question 32

What does biometry test?

Answer 32

1. axial length
2. keratometry
3. thickness of IOL

Question 33

What are the relative contraindications when considering cataract surgery?

Answer 33

1. blepharitis
2. high IOP
3. systemic problems

Question 34

What procedure is an anterior chamber IOL usually used with?

Answer 34

ICCE

Question 35

What are the different types of posterior chamber IOLs?

Answer 35

1. spherical
2. toric
3. multifocal
4. accomodative

Question 36

What are the different types of anesthesia methods given during cataract surgery?

Answer 36

1. topical
2. intracameral
3. retrobulbar

Question 37

What are the operative complications associated with cataract surgery?

Answer 37

1. tear/rupture of posterior capsule
2. dislocation of nucleus fragments
3. bleeding
4. pupil constriction
5. tear anterior capsule
6. wound leak

Question 38

What is the common steroid drop given post-cataract surgery?

Answer 38

Pred Forte

Question 39

What is the worst case scenario for post-op cataract surgery involving bacterial infection called?

Answer 39

endophthalmitis

Question 40

What is the treatment for endophthalmitis?

Answer 40

1. vitrectomy
2. antibiotics
3. steroids