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II. Anterior Segment Disease > Cornea (M2) > Flashcards

Cornea (M2) Flashcards

1
Q

What are the layers of the cornea?

A
  1. epithelium
  2. Bowman’s layer
  3. Stroma
  4. Descemet’s membrane
  5. edothelium
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2
Q

What percentage of the corneal thickness is stroma?

A

90%

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3
Q

What percentage of the refractive power of the eye is due to the cornea?

A

75%

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4
Q

What is the average thickness of the cornea?

A

540 microns

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5
Q

How long does it take to heal the Bowman’s membrane?

A

6 weeks

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6
Q

What layer of the cornea holds mucin and keeps the cornea hydrated?

A

glycocalyx layer (Slime layer)

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7
Q

What hold the basal corneal cells together?

A

zonal occludens

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8
Q

What holds the basal corneal cells to the basement membrane?

A

hemidesmosomes

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9
Q

How many cells/mm does a normal adult endothelium have? 1. At what number of cells does edema occur? 2

A
  1. 3,000

2. 500 cells/mm

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10
Q

What are the gram positive bacteria that make up the normal flora of the cornea?

A
  1. Staph. aureus (common)
  2. Staph. epidermidis (common)
  3. Diphtheroids
  4. Propionibacterium acnes
  5. Strep. pneumonia
  6. Strep. viridans
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11
Q

What are the gram negative bacteria that make up the normal flora of the cornea?

A
  1. E. coli
  2. Klebsiella
  3. Proteus
  4. Moraxella
  5. Pseudomonas (rare)
  6. Haempjilus influenzae (rare)
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12
Q

What are the fungi that make up the normal flora of the cornea?

A

candida (less common)

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13
Q

What is the enzyme on the cornea that breaks down bacterial cell walls?

A

lysozymes

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14
Q

What is the metal chelating protein found on the cornea?

A

lactoferrin

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15
Q

What is the antibody the prevents bacterial adherence on the cornea?

A

IgA

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16
Q

What are the risk factors for microbial keratitis?

A
  1. CL wearer
  2. Trauma
  3. topical corticosteroids
  4. chronic corneal surface disease
  5. ocular surgery
  6. ocular adnexal conditions
  7. systemic disease
  8. smoking
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17
Q

What are the bacteria capable of corneal penetration without epithelial compromise?

A
  1. Neisseria gonorrhea
  2. Neisseria meningitidis
  3. Hemophilus influenzae
  4. Corynebacteria diphtheria
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18
Q

What is required for the infection to be an infectious corneal ulcer?

A
  1. eroded epithelium

2. underlying stromal infiltrate

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19
Q

What are the proper times to culture a kerititis?

A
  1. non-responsive lesion
  2. extensive infiltration of cornea
  3. lesion >1.0mm that is central or paracentral
  4. post-surgical infection
  5. monocular patient
  6. immunocompromised patient
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20
Q

What does the prescription abbreviation “ad lib.” mean?

A

freely, as needed

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21
Q

What does the prescription abbreviation “a.c.” mean?

A

before meals

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22
Q

What does the prescription abbreviation “b.i.d.” mean?

A

twice a day capsule

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23
Q

What does the prescription abbreviation “gtt.” mean?

A

drops

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24
Q

What does the prescription abbreviation “h.s.” mean?

A

at bedtime

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25
Q

What does the prescription abbreviation “p.c.” mean?

A

after meals

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26
Q

What does the prescription abbreviation “p.o.” mean?

A

by mouth

27
Q

What does the prescription abbreviation “p.r.n.” mean?

A

as needed

28
Q

What does the prescription abbreviation “oint” mean?

A

ointment

29
Q

What does the prescription abbreviation “qAM” mean?

A

every morning

30
Q

What does the prescription abbreviation “q.4.h.” mean?

A

every four hours

31
Q

What does the prescription abbreviation “q.d.” mean?

A

daily

32
Q

What does the prescription abbreviation “q.h.s.” mean?

A

at bedtime

33
Q

What does the prescription abbreviation “q.i.d.” mean?

A

four times a day

34
Q

What does the prescription abbreviation “q.o.d.” mean?

A

every other day

35
Q

What does the prescription abbreviation “sol” mean?

A

solution

36
Q

What does the prescription abbreviation “susp” mean?

A

suspension

37
Q

What does the prescription abbreviation “t.i.d.” mean?

A

three times a day

38
Q

What does the prescription abbreviation “top” mean?

A

topically

39
Q

What does the prescription abbreviation “ung” mean?

A

ointment

40
Q

What does the prescription abbreviation “Ut dict. or UD” mean?

A

as directed

41
Q

How many days should you wait to apply a steroid when dealing with gram + bacteria? 1. Gram -? 2

A
  1. at least 2 days

2. at least 3 days

42
Q

What is it called when fluid from the anterior chamber is coming through the cornea?

A

Positive Seidel sign

43
Q

Where do HSV1 infections take place on the body? 1. HSV2? 2

A
  1. above the waist

2. below the waist

44
Q

What are two methods for determining corneal sensitivity?

A
  1. corneal cotton tip wisp test

2. corneal anesthesiometer

45
Q

What type of anti-viral medication used to treat HSV kills DNA non-specifically?

A

Trifluoridine

46
Q

What type of anti-viral medication used to treat HSV kills DNA specifically?

A

Zirgan

47
Q

What are the causes of pseudo-dendrites?

A
  1. Herpes Zoster
  2. healing corneal abrasions
  3. Acanthamoeba
  4. corneal epithelium graft injection
  5. Tyrosinemia type2
  6. CTL
  7. toxic Keatopathy as a result of topical meds
48
Q

What were the major findings from the Herpetic Eye Disease Study I (HEDS I)?

A
  1. epi disease not make future recurrences more likely but stroma disease does
  2. stromal disease can occur w/o epi involvement
  3. Oral acyclovir dec reoccurrence
  4. steroids effective in managing stromal infections
  5. oral acyclovir beneficial in tx of HSV uveitis
49
Q

What were the major findings from the Herpetic Eye Disease Study II (HEDS II)?

A

oral acyclovir reduce recurrence of any form of ocular herpes (epi and stromal)

50
Q

What neurological palsies can be impacted by Herpes Zoster?

A

III, IV, or VI

51
Q

What are the possible triggers of interstitial keratitis?

A
  1. syphilis
  2. TB
  3. HSV and HZV
  4. Sarcoid
  5. Cogan
52
Q

What is lipid accumulation in the cornea called? 1. What is it secondary to? 2. What is a possible treatment? 3

A
  1. lipid keratopathy
  2. interstitial keratitis
  3. lasering of BV’s
53
Q

What are the peripheral acting analgesics given to treat pain associated with keratitis?

A
  1. topical anesthetics

2. topical NSAIDs

54
Q

What are the central acting analgesics given to treat pain associated with keratitis?

A
  1. Vicodin (A+H)
  2. Percocet (A+O)
  3. Tylenol 2 or 3 (A+C)
55
Q

Which level of drug has the highest potential for abuse?

A

level I

56
Q

What level of drug is vicodin and percocet?

A

level II

57
Q

What are areas of corneal thinning as a result of poor wetting? 1. What is the treatment? 2

A
  1. Dellen

2. Aggressive corneal lubrication

58
Q

What are the therapeutic uses of contact lenses?

A
  1. restoring optical clarity
  2. promoting epithelial healing
  3. pain relief
  4. preservation of corneal integrity
  5. future: drug delivery
59
Q

What is a corneal side effect of the heart medication Amiodarone?

A

Corneal Verticillata (Vortex Keratopathy)

60
Q

What is a corneal side effect of antidepressants, oral contraceptives, and anti-acne medications?

A

dry eye

61
Q

What is it called when something that is purposefully put in the eye damages the eye?

A

corneal medicamentosa

62
Q

What side effect in the cornea do older antiviral meds cause?

A

PEK

63
Q

What side effect in the cornea do topical anesthesia meds cause?

A

Sloughing of epithelial cells

64
Q

What side effect in the cornea does recreational drug use (meth and crack) cause?

A

epithelial sloughing

II. Anterior Segment Disease (11 decks)

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