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Opthalmology > 3 - Optho > Flashcards

3 - Optho Flashcards

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1
Q

Foreign bodies may present as

A

Bump on the cornea

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2
Q

How do you treat foreign body

A

Remove after administering topical anesthesia

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3
Q

What do you remove a foreign body with on the eye

A

Hydropulsion or very fine forceps

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4
Q

Keratoconjuctivitis sicca

A

Disease resulting in keratitis and conjunctivitis caused by a lack of aqueous tear production

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5
Q

Are seen with stain Superficial ulcers

A

May not be visible

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6
Q

Signs of superficial ulcers

A

Blepharospams, epiphora, discharge, pain, conjectural hypermedia

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7
Q

Superficial ulcer

A

You just lost the epithelium

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8
Q

How are superficial ulcers treated

A

Triple antibiotics and atropine

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9
Q

Who shows more pain in superficial ulcers

A

Long nosed dogs

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10
Q

Stromal ulcer

A

Any ulcer that extends into the stroma

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11
Q

Stromal ulcers result in

A

Divor that makes the corneal contour uneven

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12
Q

Many stromal ulcers are

A

Infected

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13
Q

Stroma ulcer have what type of appearance

A

Gelatinous appearance MMPs

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14
Q

Treatment of stromal ulcer is dependent on

A

Presence or absence of infection, melting, and predisposing cause

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15
Q

Descemetocele

A

Very deep ulcer that extends all the way through the stroma to descements membrane

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16
Q

What will take up stain with decemtocele

A

Walls will take up stain, not the floor of ulcers

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17
Q

What should be done with descemetocele

A

Surgery!

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18
Q

Perforation / iris prolapse occurs with

A

Trauma or worsening of a deep ulcer to the point of a hole developing in the cornea

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19
Q

Within minutes of perforation / iris prolapse, the hole becomes

A

Plugged with fibrin or iris

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20
Q

What will fluorescenin stain show with perforation / iris prolapse

A

Aqueous leakage

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21
Q

What should u look for with perforation / iris prolapse

A

Collapsed anterior chamber, fibrin plug, MBIO tic pupil, hypopyon

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22
Q

What should be done with perforation / iris prolapse e

A

Cultured and have surgery

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23
Q

Facet

A

Divot in the corneal stroma that has intact overlying epithelium

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24
Q

With a facet, it takes some time for the keratoconjuctivitis to

A

Secrete enough collagen to fill in stromal defect

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25
If re - epithelializaiton occurs prior to to complement filling then
A facet will be present
26
Melting ulcer etiology
Stromal ulcer complicated by the release of proteases and collagenase that cause rapid progressive stromal dissolution
27
Collagenase that cause rapid progressive stromal dissolution I are also called
Matrix mellatoproteinases
28
Matrix metalloproteinases are family of enzymes that have what type of activity
Proteolytic activity
29
Collagenase is also an
MMP
30
If MMP activity is present in a case of corneal ulceration, what will happen
Stroma will rapidly degrade and appear soft and malacic
31
What is used to counteract melting from MMP
Topical serum
32
Where do MMP come from
Cornea, invading leukocytes, microorganism
33
MMP are normal present in the
Cornea
34
MMP serve the function of what in the cornea
Cleaning up necrotic debris in cases of stromal ulceration
35
The overactive expression of corneal MMP seem more common in
Eyes of Brachycephalics
36
Another cause of stimulation of MMP
Topical corticosteroids
37
Steroids are strictly contraindicated in
Corneal ulceration
38
PMN is
Leukocytes
39
Pros of PMN
Necessary to keep infection at bay
40
Cons of PMN
Liberate large quantities of proteolytic enzymes including MMP
41
How do steroids affect PMN
Inhibit the influx of PMN
42
What pathogens are the best MMP secretors
Pseudomonas and B hemolytic Streptococcus
43
3 etiologies of ulcers with stromal loss
Bacterial infection, fungal infection , chronic unrelenting imitation
44
Ulcer with stromal los are most infected with
Pseudomonas, streptococcus’s or staph
45
Ulcers with stromal los caused by fungal infections are usually what color
Brown
46
What is teh medical treatment of deep ulcers
Topical AB every 2 hours, serum every 2 hours , atropine, e collar
47
What is the topical antibiotics used in standard medical treatment
TObramycin and Cefazolin
48
When do you use serum for medical treatment
If melting or infected
49
After 24 hour treatment of deep ulcer what do you do if there is improvement
Antibiotics and serum are dropped to every 4 hours
50
Conjunctival pedicle graft
Strip of bulbar conjunctivitis is sutured over the corneal ulcer
51
The conjunctival pedicle graft gives the compromised cornea
Structural support
52
Why is the blood supply important in conjunctival pedicle graft
The serum contain a couple of compounds that inhibit MMP activity
53
What is in the serum that inhibit MMP activity
A2 macrogolbulin and a 1 anti trypsin
54
Products that are collagen sheets that are available for conjuctivial pedicle graft
BioSy and A-Cell
55
Biosys is made from
Porcine small intestinal submucosa
56
A cell is made from
Urinary bladder
57
Indolent ulcers
Chronic superficial non healing ulcer with loose edge of epithelium
58
Physio of indolent ulcer
Lack of functional basal epithelial hemidesmosomes
59
What are some hypothesis on why indolent ulcers occur
Primary corneal dystrophy, over active level of protease in teh tear film which degrade the fibroneciton network onto the basal epithelial cells migrate, and presence of a cellular zone in the anterior stroma
60
Overactive level of protease in teh tear film cause what
Degrade the fibronectin network onto which the basal epithelial cells migrate
61
The presence of an acellular zone in the anterior stroma will prevent
Attachment of overlying epithelium
62
The fluorscein stain in indolent ulcer often migrate
Under the loose edge of the epithelium
63
Indolent ulcer are ALWAYS
Superficial
64
Treatment of indolecent ulcer
Debride, grid keratotomy, antibiotics
65
What antibiotics do u use for indolecent ulcer
Oxytetractyline
66
Recheck after tx of indolecent ulcer
2 weeks and repeat debridement
67
Additional therapies of indolecent ulcer
Contact lens, remend, topical morphine sulfate eye drops, cyanoacrylate, e collar, lamellar keratotomy
68
What will contact lens do for indolecent ulcer
Protect any new formed epithelium from being wiped away
69
What therapy is reserved for indolecent ulcer that haven’t healed after 6 - 8 weeks
Lamellar keratectomy or conjuctivial pedicle graft
70
Corneal lacerations are caused by
Trauma
71
If corneal laceration is less than 1/2 thickness can treat
Medically
72
If corneal laceration is > 2/3 thickness need to
Primary closure
73
Pigmentary keratitis
Non specific change that develops with long sanding Trauma/ irrigation to the cornea
74
Pigmentary keratitis manifests as
Corneal pigmentation
75
Pannus is aka
Chronic superficial keratitis
76
Panus
often bilateral immune mediated vascularized pigment lesion of the cornea
77
Pannus begins as
Red vascularized conjunctival lesion
78
Pannus initially invade the
Temporal or inferior temporal limbus
79
Pannus can turn into
Fleshy lesion causing blindness
80
Etiology of Pannus
Immune mediated, genetic, UV radiation
81
What breed is predisposed to Panus
German Sheperds
82
Pannus is usually controllable but not
Curable
83
Begin treatment of Pannus with
Dxamethasone or prednisone TID - QID
84
How long might it take for Panus to respond to treatment
3 - 4 weeks
85
What can be used for maintenance of Pannus
Cyclosporine or tacrolimus
86
How do you monitory if Pannus lesion is quiescent or active
Vasculariaztion
87
What can be used as TX in severe Pannus
Strontium radiation
88
Scars - fibrosis
Result from abnormal alignment of corneal stromal lamellar
89
Scars - fibrosis usually secondary to
Ulceration or other chronic disease
90
Appearance of scars - fibrosis
Grey irregular opacity +/- vessels and pigment
91
How do you DX scars - fibrosis
Fluorescein negative, white or pigmented opacity
92
Corneal dystrophy
Primary, axial llcaoted, bilateral, inherited disorder of teh cornea that is not accompanied by corneal inflammation or systemic disease
93
Corneal dystrophy typically results from
Deposition of lipid in the cornea

Opthalmology (8 decks)

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