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opthalmology > thee lens > Flashcards

thee lens Flashcards

1
Q

what is cataract ?

A

clearing of the normally clear lens

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2
Q

what is the cause of blurry vision in cataract ?

A

cloudiness of the lens doesn’t allow for the focusing of light on the retina - leading to blurry vision

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2
Q

what are the different types of cataract ?

A

congenital
acquired
secondary
traumatic

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3
Q

what are the causes of acquired cataract ?

A

either due to aging
or due to systemic or local causes

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4
Q

what are the different types of cataract maturity ?

A

immature - partially opaque
mature - totally opaque
hyper mature -shrunken and wrinkled anterior capsule due to leakage of water out of the lens

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5
Q

what are the types of age related cataract ?

A

subcapsular cataract
nuclear cataract
cortical cataract

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6
Q

what is the pathology in sub capsular cataract ?

A

lies directly underneath the capsule whether anterior or posterior
due to fibrous metaplasia of the lens epithelium
posterior sub capsular has a profound effect on vision

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7
Q

what is the pathology in nuclear cataract ?

A

nuclear sclerotic cataract is considered an exaggerated aging process
deposition of urochrome pigments giving it a yellow hue

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8
Q

what is the second sight of age phenomenon ?

A

nuclear cataract is associated with myopia due to the increased refractive index of the nucleus resulting in some elderly patients being able to read again without spectacles

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9
Q

what is the pathology associated with cortical cataract ?

A

opacities start as clefts between fibres of the lens then opacification occurs due to cortical hyddration

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10
Q

what is the typical image of opacities in cortical cataract ?

A

typical wedge shaped
or
radial spoke like opacities

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11
Q

what cause of congenital cataract is associated with cortical cataract ?

A

Lowe’s syndrome

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12
Q

what cause of congenital cataract is associated with radial spoke like arrangements of opacities in the posterior lens cortex ?

A

mannosidosis

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13
Q

what are the systemic diseases associated with cataract ?

A

Diabetes
Myotonic dystrophy: Beckers and Duchenne
Neurofibromatosisi type 2
Atopic dermatitis

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14
Q

what is the pathology in cataract associated with diabetes ?

A

glucose is metabolized into sorbitol
sorbitol accumulates inside the lens
becomes osmotic due to over hydration

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15
Q

fluctuations in sight in diabetes ?

A

hyperglycaemia - inc RI - myopia
hypoglycaemia - dec RI - hypermetropia

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16
Q

what does classical diabetic cataract look like ?

A

snowflake cortical appearance
but rare

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17
Q

what type of cataract forms in myotonic dystrophies
?

A

wedge shaped cortical opacities with a star configuration

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18
Q

what type of cataract is associated with atopic dermatitis ?

A

cataracts are Shield-like dense anterior subcapsular plaque that wrinkles the anterior capsule

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19
Q

what is the type of cataract associated with neurofibromatosis type 2 ?

A

posterior subcapsular
capsular
cortical
or mixed

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20
Q

what are the local diseases of the eye associated with cataract ?

A

chronic anterior uveitis
acute congestive glaucoma
high myopia
hereditary fundus dystrophy
or secondary to mediications

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21
Q

what is the most common cause of secondary cataract ?

A

chronic anterior uveitis
related to duration and intensity of inflammation

22
Q

what does the cataract look like associated with acute congestive glaucoma ?

A

anterior grey white capsular opacities in the pupillary area
glaukomflecken

23
Q

what is thee association between high myopia andd cataract ?

A

associated with posterior subcapsular lens opacitty
and early onset nuclear sclerosis

24
Q

what are the hereditary fundus dystrophies ?

A

retinitis pigmentosa
leber congenital amaurosis
Stickler syndrome

25
Q

what is the type of cataract associated with steroids whether topical or systemic ?

A

posterior sub capsular

26
Q

what is the most common cause of unilateral cataract in young individuals ?

A

traumatic cataract

27
Q

what other ocular injuries are associated with traumatic cataract ?

A

iridiodialysis
seperation of the iris from its insertion on the ciliary body

28
Q

what are the symptoms of cataract ?

A

blurry vision - cloudy
photophobia glare - halos around light especially at night
changes of glasses prescription ( including sudden near sightedness )
need for brighter light to read
difficulty seeing at night

29
Q

what are the indications of surgery in age related cataract ?

A

visual improvement - most important indication
cataract affecting health of the eye

30
Q

what is the concept in cataract surgery ?

A

removal of the clouded lens
insertion of thee IOL

31
Q

what is the difference between ICCE and ECCE surgery ?

A

ICCE - removal of thee whole lens including the capsule
ECCE - lens is reemoved capsule is left for thee IOL

32
Q

when is ECC indicated ?

A

in patients with very hard cataract

33
Q

what is phaeoemulsification ?

A

emulsification of the contents of the lens using ultrasonic vibrations
aspirating the emulsified cataract
new IOL implants
conventional surgery nowadays

34
Q

what are the ophthalmic pre operative assessments ?

A

visual acuity
cover test - to seen if there is any amblyopia
pupillary reflex - as cataract doesn’t cause RAPD
Cornea examination
Anterior chamber depth
lens
Fundus exam
current refractive status
informed consent
biometry

35
Q

what are thee operative complications associated with cataract surgery ?

A

post op endophthalmitis
rupture of the posterior capsule of the lens
loss of some lens fragments in the vitreous
dislocation of the IOL
suprachoroidal hge

36
Q

what is ectopia lentis ?

A

displacement of the lens from its place

37
Q

what are the types of ectopia lentis ?

A

hereditary
acquired

38
Q

what are the 2 possible presentations of ectopic lentis ?

A

luxated - making the eye essentially aphakic
subluxated - partial displacement

39
Q

what is the clinical presentation of the early stages of subluxation ?

A

phacodenesis - vibration of the lens with eye movement

40
Q

what are the acquired causes of ectopia lentis ?

A

Hypermature cataract
Inflammatory - chronic uveitis
Trauma
Large eye - bupthalmous , high myopia
A - anterior uveal tumors

41
Q

what are the hereditary causes of ectopica lentis ?

A

with no systemic association :
ectopia lentis et pupillae
familial ectopic lentis

with systemic associations :
Marfans syndrome
homocystinurea
Weill-Marchesani Syndrome

42
Q

what is thee mode of inheritance of
ectopica lentis et pupillae
familial ectopica lentis

A

ectopica lentis et pupilla : AR
familial ectopica lentis : AD

43
Q

what is the presentation of ectopica lentis et pupillae ?

A

congenital bilateral affection where thee pupil and the lens are displaced in the opposite direction
asymmetric and eccentric
oval pupils dilate poorly

44
Q

what is the presentation of familial ectopica lentis ?

A

symmetrical
supertemporal dislocation of thee lens

45
Q

what are the features of marfan’s syndrome ?

A

superotemporal subluxatiioin
high-arched plate
long fingers andd toes

46
Q

what are the ocular features associated with marfan’s syndrome ?

A

superotemporal lens dislocation
glaucoma
retinal detachement
strabismus

47
Q

what are the systemic features of weill-marchesani syndrome ?

A

short fingers
short stature
learning difficulties

48
Q

what are the ocular manifestations of weill-marchesani syndrome ?

A

ectopica lentis subluxation is in the inferior direction
microspherophakia

49
Q

what is a common ocular compliicattion associated with weill-marchhesani synddrome ?

A

acute angle closure glaucoma

50
Q

what are the systemic features of homocystinuria ?

A

coarse blonde hair
blue irises
malar flush

51
Q

what are the ocular manifestations associated with homocystinuria ?

A

zonules are lax
so lack of accomodation
ectopia lentis is infero nasal

52
Q

what is the treatment for homocystinuria ?

A

oral pyridoxine
folic acid
vitamin b12

opthalmology (14 decks)

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