Sample Qs 4 Flashcards
What is Leber’s congential amaeurosis
Autosomal recessive
eye poking, hypermetropia, sluggish pupil, macular dysplasia but normal fundal appearance
What is vitreomacular adhesion
Normal PVD process is complicated by incomplete separation of the vitreous from the retina combined with an abnormally strong adherence of the posterior hyaloid to the ILM
What are subclassifications of vitreomacular adhesion?
Focal (<= 1500 microns)
Broad (>1500microns)
Isolated or concurrent
What are subclassifications of vitreomacular traction?
Focal (<= 1500 microns)
Broad (>1500microns)
Isolated or concurrent
What are subclassifications of FTMH
Small ( < = 250microns)
Medium (250 - 400 microns)
Large >400microns
With or without VMT
Primary or secondary
Macular hole epidemiology
2:1 women
1/10000 per year
Onset by 65
Gass Stages for macular hole
1 - no sensory retinal defect
a: small yellow foveolar spot, loss of foveal contour
b: yellow foveolar ring
2 - small (100-400microns) full thickness sensory retinal defect
3 - larger (>401 microns) full thickness sensory retinal defect with cuff of SRF and yellow deposits in base of hole
4 - complete vitreous separation
What would be seen on FFA
Window defect
When can medical management be used for macular hole?
enzymatic vitreolysis with ocriplasmin
Can relieve VMT and close stage 1/2 holes
What are causes of macular holes?
Idiopathic
Trauma
CMO
ERM VMT
RRD
Laser injury
Pathological myopia
HTN
DR
What is polypoidal choroidal vaculopathy?
A variant of wet AMD with polypoidal dilatation fo the choroidal vasculature with serosanguinous PED
Most common in Asian or African
What is the management for macular hole
ILM peel and gas
Facedown posturing for larger holes >400microns or recurrent holes
What are complications of macular hole repair
cataract
Retinal tear/detachment
Failure of closure
Late reopening of hole
Endophthalmitis
Which drug for preventing post-op endophthalmitis
Intracameral cefuroxime
complication of cataract surgery in patients who have had lasik for myopia
Hypermetropic refractive surprise as underpowered lens is used
What is used for intraoperative reverse pupil block
Second instrument to lift iris forward and allow flow to posterior and anterior chambers
What is Fuch’s ED
AD or sporadic
Women 4:1
Increasing age
Primary endothelial dysfunction with NAKATPase pump failure
Accumulation of fluid
Collagen COL8a2 gene
SLC4A11
What are clinical features of FED
GRadually reducing VA
Stage 1: Corneal guttata - centrally
Hassal Henle bodies)
BEaten metal appearance
Pigement on endothelium
Stage 2: stromal oedema, DM folds, epithelial bullae
Stage 3: Recurrent corneal erosions - vascular pannus, stromal haze
What is seen on specular microscopy in FED
Reduced endothelial cell count
Increased average cell diameter
Reduced hexagons
Increased variation in cell size.
Pachymetry - Increased CCT
What is treatment for FED
RElieve oedema - 5% NaCL, Treat OHT, Warm air blown on eyes, BCL for Bullous change
DMEK
If scarring PK
What is preferred if there is OHT/glaucoma in FED
Topical beta blocker
Topical carbonic anhydrase inhibitors may induce endothelial failure
what is CHED
Congenital hereditary endothelial dystrophy
Bilateral corneal oedema in healthy term neonates
AR CHED2 is more severe, severe reduced VA, amblyopia, nystagmus
AD form CHED1 - mild
Treated with PK
What is PPCD
Posterior polymorphous corneal dystrophy
AD
Asymptomatic
Clusters of lines of vesicles
Diffuse haze of posterio cornea
Iridocorneal adhesion
corectopia
Glaucoma
What is the most common conditions associated with PUK
Rheumatoid arthritis
