UIC 2015 Flashcards
Lens capsule thickest?
Just anterior and posterior to equator
Dimensions of the lens?
9mm equatorially and 5mm a-p
Greatest mitotic activity of lens at?
Equatorial epithelial cells
Carbohydrate metabolism of lens is mostly?
Anaerobic glycolysis
What % of peters get glaucoma? Are bilateral?
Glaucoma 50% and bilateral 80%
Most common type of congenital cataract?
Lamellar
Normal aging lens index of refraction does what?
Decrease from decreasing presence of insoluble proteins
Cause of snowflake cataracts?
Diabetes
Cataracts in downs?
Cerulean
When does A constant in Len equation increase?
More posterior placement of IOL
Indications for ICCE?
Poor zonule integrity
Which piggyback IOL leads to most inter lenticular opacification?
2 acrylic
CTR contraindications?
Radial capsular tears, PC rupture, zonular weakness progression
Duty cycle?
Amount of time phaco power is being delivered
Brown McLean?
Peripheral corneal edema with central guttata
Urretz-Zavalia?
Fixed dilated pupil with iris atrophy
Fabry’s enzyme and substance that accumulates?
Alpha galactosidase and ceramide trihexoside
How many SPCA and LPCA are there?
7 and 2
Height of tarsus?
11mm upper lid and 4mm lower lid
Nasociliary nerve innervates what?
Tip of nose, medial canthus, long ciliary nerves - cornea and cilia body, short ciliary nerves - globe sensation
Dorsal ophthalmic artery becomes?
Ophthalmic artery, temporal LPCA, spca, CRA
Ventral ophthalmic artery becomes?
Nasal LPCA
3 waves of cornea neural crest migration?
1 corneal endothelium
2 cornea stroma
3 iris stroma
Aqueous outflow?
AC, uveal mesh work, corneoscleral meshwork, juxtacanalicular tissue, schlemm canal, collector channels, aqueous veins, episcleral veins, superior orbital vein
What valve is blocked in congenital NLDO?
Hasner
What marker do orbital fibroblasts express uniquely?
CD40
What type of flow on Doppler do capillary hemangioma shows?
High flow
Management of adenoid cystic carcinomas?
Incisional biopsy, radical eye teraflop +/- radiation, intra-arterial cytotoxic time chemotherapy
Where is location of lymphoma with highest risk of systemic lymphoma?
Eyelid, then orbit, then conjunctiva
Craniosynostosis strabismus pattern?
V exotropia
Gene for Crouzon? Saethre-chotzen?
FGFR2 and TWIST
Tool for cultures? Viral?
Metal spatula or calcium alginate swab. Viral use Dacron swab
Iris finding in JXG?
Heterochromia
Eye findings in NF2?
Cataracts (PSC and wedge), retinal hamartoma, combined retina and RPE hamartoma, nevi, myelinated NFL
Systemic findings in tuberous?
Cardiac rhabdomyoma and renal angiomyolipoma
How does congenital nystagmus change with fixation and convergence?
Worsens with fixation and improves with convergence. Inverted OKN response, always horizontal uniplanar
What % of primary congenital glaucoma is bilateral?
2/3, more in males
Morning glory disc - at risk for? Associations? Testing?
Serous RD, Moyamoya and basal encephalocele, mri and mra
What is 1mm change by hirschberg in PD and degrees?
15PD and 7 degrees
What is inheritance of lowe? What % get glaucoma?
X recessive, 50-70%
ACA ratio?
PD+ (near deviation - distance deviation)/(diopters of accommodation)
Describe horner’s pharmacological testing
Cocaine fails to dilate horner’s pupil. Hydroxyamphetamine fails to dilate 3 horner’s pupil. Apraclonidine causes reversal of anisocoria in horner’s
What visual field defect does infarct of LGN cause?
Sectoranopia
What localized to temporal lobe?
Formed visual hallucinations, agnosia, proposagnosia (recognize faces)
What localizes to parietal lobe?
Simultagnosia, optic ataxia
What localizes to frontal lobe?
Slow initiation of saccades, ocular motor apraxia, square wave jerks
Majority of optic neuritis is where?
2/3 retrobulbar 1/3 optic disc swelling
Main treatment for optic nerve meningioma?
Radiation
Screen dominant optic atrophy for what?
Hearing loss
Describe disc findings in Lebers
Vascular tortuosity, circumpapillary telangiectatic microangiopathy, disk pseudoedema (no leakage on FA)
Each increase in VCD raises risk of glaucomatous change by how much?
32%
Describe CCT effect on risk of developing POAG
Each 40 microns thinner leads to 81% increase in relative risk for developing POAG
What % of population is steroid responders?
1/3
Avoid pilocarpine in what glaucoma?
Uveitic (increases breakdown of blood aqueous barrier)
Which beta blocker is selective?
Betaxolol
Which beta blocker has intrinsic sympathomimetic activity?
Carteolol
Which beta blocker is reported to be associated with iritis?
Metipranolol
What factors five falsely high iop?
Thick cornea, too much fluorescein, ATR astigmatism, forceful lid eversion, tight collar or tie
What factors give falsely lower IOP?
Thin corneas, LASIK, corneal edema, not enough fluorescein, WTR astigmatism
Treatment of FHIC?
Steroids not effective, control pressure
Angle recession associated with glaucoma in fellow eye?
Yes 50%
What are risks for steroid induced glaucoma?
Family history of POAG, myopia, diabetes
MOA of brimonidine?
Alpha 2 agonist
Risks of mitomycin C?
Hypotony and Bleb leaks and infections
What uveitic disease is associated with intra-iris hemorrhage?
HSV
What lab is elevated in TINU?
Urinary beta 2 microglobulin
What % of scleritis is necrotizing? Bilateral?
2/3 and 50%
What toxo med should be avoided in pregnant or lactating women?
Pyrimethamine
What factor is responsible for splitting eye field?
Sonic hedgehog
RPE cells are what type?
Cuboidal
When do rods and cones shed discs?
Rods at dawn and cones at dusk
Light leads to what changes in RPE?
Drop in K in the subretinal space and hyper polarization of RPE (6mV, C wave of ERG)
What is peak absorption of rhodopsin?
510nm green
Where is highest concentration of rods?
20 degrees from fixation
Which are light adapted responses on ERG?
Single flash cone response and 30 Hz flicker
What do waves of ERG represent?
A photoreceptors
B bipolar and Müller cells
C RPE
Multifocal erg tests what?
Central 25 degrees of fixation
EOG tests what? What is abnormal?
Standing potential of RPE, light dark (Arden) ratio below 1.85 abnormal
VEP measure primarily what?
Macular response
What is wavelength of light used in PDT?
689 mm
Where is the hemorrhage in valsalva retinopathy?
Sub-ILM space
What is stage 4 sickle retinopathy?
Vitreous hemorrhage
What refractive error increases risk of AMD?
Hyperopia
Developmental precursors to retinal breaks?
Enclosed Ora bays, Meridional folds and complexes, cystic retinal tufts, zonular traction tufts
Buckle indications?
Dialysis in young, absence of PVD, inferior breaks, phakic RD from atrophic holes in young myopes
Vitrectomy indications?
PVR and vitreous hemorrhage
Indications for pneumatic Retinopexy?
Breaks within superior 8 clock hours, break within 1 clock area, absence of PVR
What is best indicator for progression to threshold ROP diseases?
Zone
Gene for FEVR?
FZD4, 55% no family history
What is wavelength of ROP laser?
810nm. Regular is 532nm
What cytology suggests lymphoma?
IL-10/IL-6 > 1
What is associated with SLK?
Thyroid disease
Signs of limbal stem cell deficiency?
Recurrent epi defect, conjunctivalization, superficial Neovascularization, corneal ulcer and scarring, late staining fluorescein, loss of palisades of Vogt
Causes of limbal stem cell deficiency?
Congenital - aniridia, ectodermal Dysplasia
Inflammatory - Pemphigoid, SJS, AKC, GVHD
Toxic - CL, SLK, MMC, injury
Meesman - gene? Distribution? Pathology?
KRT3 (cytoskeletal proteins), limbus to limbus, peculiar substance in vesicles
What is gene in Fuchs?
COL8A2
Consider PK for Fuchs if endo counts and pachy are what?
Below 1000/mm2 or > 650 um
Causes of Salzmann nodular degeneration?
Phlyctenules, IK, trachoma, CL, staph hypersensitivity
When do SEI develop in EKC?
14-20 days
What are contraindications to DALK?
Endothelial dysfunction - edema or posterior dystrophy
epithelial dysfunction - LSCD, chronic surface disease
severe Ectasias
Best way to isolate rods?
Blue light
What cellular reactions happen when light strikes a photoreceptor?
Decreased cGMP and closed sodium channel
How many more times sensitive are rods vs cones?
1000 times
What binds with opsin to make rodopsin?
11-cis-retinal
Colorblind 20/200 va, normal retina, poor cone function on erg. What is Dx and inheritance and mutation?
Rod monochromatism (achromatopsia), AR, cGMP mutations
Child with Reduced B wave on erg, nystagmus, poor vision, nyctalopia. Disease?
CSNB, will see macular carotenoids (unlike albinism)
Acquired nyctalopia, reduced color vision, reduced b wave on erg. Rule out what?
Cancer (melanoma)
What drugs can reduce b wave and give optic atrophy?
Methanol and quinine
Which gene in LCA is in a clinical trial with promising results?
RPE65
Bulls eye, optic pallor, bright ILM reflex?
Battens disease
How to diagnose juvenile x-linked Retinoschisis? Treatment?
Reduced b wave on ERG, CAI drops