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Cornea & Lens and Cataract > Cataract > Flashcards

Cataract Flashcards

1
Q

What are the 5 enzymes that protect against free radicals or oxygen damage?

A
  1. Glutathione peroxidase
  2. Catalase
  3. Superoxide dismutase
  4. VITAMIN E
  5. ASORBIC ACID
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2
Q

What are the 3 ways which glucose is metabolized by the lens and which provides the most high-energy phosphate bonds required for lens metabolism?

A
  1. Anaerobic (78%)
  2. Hexose Monophosphate Shunt (5%)
  3. Sorbitol (5% - when no hexokinase is used)
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3
Q

Which cataract has disruption of water and electrolyte balance?

A

Cortical cataracts (NOT NUCLEAR)

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4
Q

Is Na or K high in the lens?

A

K (Na high in aqueous and vitreous)

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5
Q

Is Ca higher inside or outside the len?

A

Inside

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6
Q

How does glucose enter the lens?

A
  1. Simple Diffusion

2. Facilitated diffusion

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7
Q

Sympathetic or parasympathtic control accommodation?

A

Parasympathetic

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8
Q

What lens changes are seen in Peter’s Anomaly?

A

Microspherophakia

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9
Q

Microspherophakia makes the eye hyperopic or myopic?

A

Highly myopic - b/c increased refractive power of the spherical shape of the lens.

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10
Q

Name the 6 conditions you can see microspheophakia?

A
  1. Peters
  2. Marfans
  3. Alports
  4. Lowes syndrome
  5. Congenital rubella
  6. WEILL-MARCHESANI
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11
Q

What is the most common congenital cataract?

A

Lamellar or zonular cataracts

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12
Q

What is the first sign of cortical cataracts?

A

Vacuoles and water clefts in the anterior and posterior cortex

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13
Q

How is classic galactosemia confirmed?

A

Non-glucose reducing substance galactose in the URINE

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14
Q

“Oil” droplet cataracts are seen in what d/o?

A

Galactosemia - AR

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15
Q

HYPER OR HYPO calcemia causes cataracts?

A

Hypocalcemia - from parathyroid surgery causes punctate iridescent opacities in the anterior and posterior cortex

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16
Q

What type of cataract do you see with atopic dermatitis and when?

A

B/L Anterior subcapsular opacites in 2nd or 3rd decade.

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17
Q

Normal enothelial counts are?

A

> 2400 cells/mm2

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18
Q

Phacoantigenic Uveitis occurs when and causes what type of inflammation?

A

Lens protein released through a ruptured lens capsule and cortical material remains in the eye. ZONAL GRANULOMATOUS inflm.

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19
Q

What are late complications to phacoanaphylactic Uveitis?

A

Cyclitic membrance, hypotony, and phthisis bulbi

20
Q

What type of cataract causes Phacolytic GL?

A

Mature or hypermature - proteins leak through an INTACT lens capsule where MACROPHAGES ingest lens proteins

21
Q

Ischemic ocular conditions (Takayasu arteritis, thromboangitis obliterates, anterior segment necrosis) cause what type of cataract?

A

PSC

22
Q

Retrobulbar anesthesia causes which two problems?

A
  1. Inadvertent INTRAVENOUS injection a/w CARDIAC ARRHYTHMIAS

2. Inadvertent intraDURAL injections a/w seizures, repiratory arrest, and brain stem anesthesia.

23
Q

Astigmatic Keratotomy is used for what range of astigmatism and how is it performed?

A

Incisions are made 100% of the thinnest paracentral pachymetry, or 0.6 mm for a 7 mm optical zone.

24
Q

LRIs are used for what range of astigmatism and how is it performed?

A

0.5-3.0 D; a diamond blade is set to a 0.6mm depth and an incision is made at the limbus for a distance of 6-8 mm along the steep axis.

25
Q

How are vacuum rise time related to aspiration flow rate?

A

Inversely proportional

26
Q

Which vacuum rise time has a direct relationship with vacuum level and time?

A

Venturi

27
Q

When is a cohesive agent useful and give an example?

A

When space needs to be maintained, such as during capsulrrhexis; Healon, Provisc, Amvisc

28
Q

What is a dispersive agent useful and give an example?

A

Posterior capsular rent; Viscoat

29
Q

What is the name of the syndrome with corneal edema starting inferiorly and progresses circumferentially bust spares the central cornea?

A

Brown-McLean Syndrome (usually after intracapsular surgery)

30
Q

When is the peak incidence of post-operative CME?

A

6-10 weeks after surgery

31
Q

It infants with B/L cataracts when should the cataracts be taken out and how long between the two?

A

ASAP after diagnosis and seperated by 2 weeks for children under the age of 2 years and by 1 month for children over the age of 2 years.

32
Q

When should a U/L cataract be taken out?

A

before 6 weeks.

33
Q

When is the cornea the thickest?

A

The morning

34
Q

Which food can decrease the risk of cataract development?

A

Leutin

35
Q

What is a soemmering ring?

A

After cataract surgery the residual epithelial cells may proliferate in the closed space between the anterior and posterior capsule

36
Q

Which of the following IOLs forms a PCO the most?

A

PMMA>silicone>acrylic

37
Q

Which is the main scavenger of free radical in the lens?

A

Glutahione

38
Q

If an Ascan is performed on staphalyoumatous eye, what type of refraction will the patient have?

A

Hyperopic surprise because the lens is too weak.

39
Q

Stellate contusion cataracts occur where?

A

Posteriorly

40
Q

Sunlight is a/w what type of cataract?

A

Cortical - UV radiation

41
Q

What are the dimensions of the lens at birth and as and adult?

A

6.4mm/3.5mm; 9mm/5mm

42
Q

What is a U/L white cataract with pigmentary retinopathy ?

A

Rubella

43
Q

What has deafness, hematuria?

A

Alports

44
Q

How do u treat homocysteine and what r the risks of having it?

A

Treat with low methanine diet and high cysteine and vit b6

Risk of thromboembolic episodes esp during general anesthesia

45
Q

During Ascan if u press too hard on cornea u get a shorter axial length and what type of refraction?

A

Unexpected myopia

Cornea & Lens and Cataract (11 decks)

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