Quiz (Corneal Dystrophies, Keratokonus, Lens and Cataracts, and Refractive Surgery) Flashcards
What are traits that nearly all corneal dystrophies follow?
- non-inflammatory
- bilateral
- hereditary
- central corneal involvement
What is the procedure that uses a needle to puncture the cornea, allowing for a new basement membrane formation?
anterior stromal puncture
What is the keratoplastic surgery in which all 5 layers are removed? 1. What is the one in which only some are removed? 2
- penetrating keratoplasty
2. lamellar keratoplasty
What is the procedure used to transplant an endothelium?
DSEAK (Descemet Stripping automated endothelial keratoplasty)
What are the complications of DSEAK? 1. What are the advantages? 2
- posterior graft dislocation
2. less post-op astigmatism, faster recovery
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?
Vogt’s striae
What is the sign that is a V shaped lower lid conformation when the patient looks in downgaze?
Munson sign
What is the keratoconus sign that has an oil droplet appearance with retroillumination?
Charleaux sign
What is the treatment for keratoconus where half circles of PMMA are place into the midstroma for better vision?
Intacs
What is done to the cornea in corneal cross linking?
- some epithelium removed
- Riboflavin added
- UVA rays applied
- increase in collagen cross linking
What are the requirements in Germany to perform cross linking?
- > 17yo
- keratoconus or ectasia
- progression in last year
- > 400um corneal thickness
- keratometry readings
What is the procedure for keratoconus in which the opaque scarred cornea is replaced with clear donor cornea?
penetrating keratoplasty
In penetrating keratoplasty what is used to cut the donor button?
trephine
What are the possible side effects of penetrating keratoplasty?
- persistent epithelial defects
- wound leak
- shallow anterior chamber
- iris prolapse
- uveitis
- inc IOP
- Infection
- Graft rejection
What is seen when there is a graft rejection following a penetrating keratoplasty?
Khodadoust line
What is a removal of the epithelium and anterior stroma called?
lamellar keratoplasty
What is a removal of the eopithelium and all stromal tissue called?
deep lamellar keratoplasty
What do high blood sugar levels do to the vision of a diabetic patient? 1. Low sugar? 2
- inc myopia
2. inc hyperopia
What is the leading cause of blindness worldwide?
cataracts
What are the prevalence percentages for each of these age groups: 1. 52-64? 2. 65-74? 3. 75-85?
- 42%
- 60%
- 91%
What types of cataracts are found to be in more african americans?
cortical/nuclear
Are men or women more likely to have a cataract?
women
What are the medical risk factors associated with cataracts?
- diabetes
- family history
- medications
What nutritional addition can help lower prevalence of cataracts?
B vitamins
What are the possible causes of a traumatic cataract?
- concussion
- ionizing radiation
- electric shock
- lightning
What are the different types of cataracts that can occur from a concussion?
- Vossius ring from iris
- flower-shaped
- penetrating
What wavelengths do yellow cataract absorb?
low wavelengths so violet and blue
What are the medical reasons where cataract surgery must be done and is not just if the patient wants to?
- reina not visible in a diabetic
- morgagnian
- hypermature cataracts
What are the things that should be done in all pre-operative cataract surgery appointments?
- symptoms
- best corrected VA (lights on and off)
- Amsler grid
- SLE, IOP, fundus evaluation
- Optical coherence (OCT)
- Glare (BAT)
- IOL power calculation
- macular integrity
What is used to test the affect of glare on VAs?
Brightness acuity test (BAT)
What is done to measure the macular integrity?
- potential acuity meter (PAM)
- Laser interferometer
- blue field entoptoscope
- Amsler grid
What does biometry test?
- axial length
- keratometry
- thickness of IOL
What are the relative contraindications when considering cataract surgery?
- blepharitis
- high IOP
- systemic problems
What procedure is an anterior chamber IOL usually used with?
ICCE
What are the different types of posterior chamber IOLs?
- spherical
- toric
- multifocal
- accomodative
What are the different types of anesthesia methods given during cataract surgery?
- topical
- intracameral
- retrobulbar
What are the operative complications associated with cataract surgery?
- tear/rupture of posterior capsule
- dislocation of nucleus fragments
- bleeding
- pupil constriction
- tear anterior capsule
- wound leak
What is the common steroid drop given post-cataract surgery?
Pred Forte
What is the worst case scenario for post-op cataract surgery involving bacterial infection called?
endophthalmitis
What is the treatment for endophthalmitis?
- vitrectomy
- antibiotics
- steroids
