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Flashcards in Cornea Deck (155):
0

Whats Avelino dys?

Gran + lattice
LGA airport (lattice granular avellino all same family)

1

K verticilata
Facts in

Fabrys
Amio
Chloroquine
Tamoxifen
Subconj gent
Ibupofen
Naproxen

2

Whats meretoja sx

Lattice and systemic amyloid
Masked facies and cranial n palsies

3

Stumped

Sclerocornea
Trauma (foreceps)
Ulcer
Metabolic conditions
Peters
Endothel dystrophy
Dermoid

4

What % of peters will be bilateral?

60

5

Which dystrophies are tgfb1?

Large (5 letters = chrom. 5)
Lattice
Avellino
Reis bucklers
Granular
Empty

6

What does a pt w schnyders k dysrophy c/o?

Decr vision during day when pupil small bc cant get thru central cholest plaquea

7

Whats the eye finding in goldenhars

Dermoids

Preaur skin tag
Bellybutton tag

8

Name 8 causes of spontaineous hyphema

1. Retinoblastoma
2. Von willinbrand
3. Leukemia
4. Juv xanthogran (tuton)
5. Nvi
6. Hemophilia
7. Iris melanoma
8. Zoster uveitis

9

Refractive power of the cornea

43.25

11

What syndrome is keratoglobus ass w?

Ehlera danlos
Can have deafness

12

short stature, short stubby fingers, microspherophakia, extopia lentis

weill-marchessani

13

whats the surgical risk in a pt w nanophthalmos?

spontaneous choroidal hemorrhage

14

microphthalmos

small screwed up eye

15

what causes keratoglobus?

high IOP pushes against ectatic cornea causing thinning and K readings in the 60s

16

name 3 syndrome associated with keratoglobus

1) LCA
2) Ehlers-danlos
3) Rubenstein-Taybi syndrome

17

what syndrome is limbal dermoid associated with?

Goldenhaar

18

Name the 3 indications for corneal surgery

1) center of K has opacity and cant see through it
2) opacity NEAR visual axis causing astigmatism that cant be corrected with glasses
3) pain/redness failed medical treatment

19

name 2 causes of massive telangiectasias of the conj

1) ataxia-telangiectasia (aka Louis bar- AR)
2) osler-weber-rendu syndrome (plt disorder w renal compromise)

20

name 5 causes of follicular conjunctivitis

adeno hardly happens to careful nuns
adenovirus
herpes
hemorrhagic conjunctivitis (picornavirus)
chlamydia
newcastles disease (a bird virus)

21

what causes ligneous conjunctivitis?

type 1 plasminogen deficiency

22

whats the finding in CIN

"fimbriated blood vessels" grows rapidly in immunocompromise

23

how do you treat CIN?

Excisional biopsy with surrounding cryo

24

where does SCC of conj usually appear?

by limbus and may be white bc its growing faster than the eye can lubricate it so it keratinizes itself

25

when do you biopsy PAM?

>1 cm in diameter

26

whats the w/u for conj malignant melanoma?

full body scan and LFTs

27

whats the surgical management of sebaceous cell ca

full-thickness lid biopsy--send fresh for oil red o staining
don't forget its pagetoid spread (spreads from deep to superficial)

28

what causes episcleritis and how do you treat it?

its just irritation, lubricate

29

whats the symptoms of scleritis?

deep pain

30

whats the workup for scleritis?

infectious, collagen vascular dz
rf, ana, anca,lyme, syphilis, tb

31

how do you treat scleritis?

NSAIDS

32

Whats posterior embryotoxon?

anteriorly displaced prominent schwalbes line

33

whats the abnormality in peters?

no K endo or decemets

34

Whats the abnormal finding in chandlers syndrome

clinically iris looks normal but there is "reversal" on the specular microscopy- cells look black w white borders

35

whats zirgan?

ganciclovir ointment

36

how do you treat acanthomeba?

biguanide (PHMB) or chlorhexadine

37

what was the variable in HEDS1?

Everyone on viroptic but...did steroid help treat stroma keratitis?

38

2 findings of heds1

1) use steroid for stromal keratitis
2) use oral acyclovir 400tid for iridocyclitits

39

finding of heds2

acyclovir 400bid x 1 yr reduced recurrence by 41%

40

whats the ring you see in herpes?

Wesley immune ring

41

post-lasik pt with stroma keratitis..cause?

atypical mycobacteria- had an outbreak bc of reusable blades. Treat with amikacin

42

which mucopolysaccaride does not involve the cornea?

sanfillipo and hunters
"sam the hunter must see to shoot"

43

whats the finding in thygessons

bilateral in boys white eyes, white deposits, negative staining

44

cogan syndrome

interstitial keratitis with defness

45

whats the treatment of fungal keratitis?

topical natamycin 5%

46

ddx of enlarged K nerve MARKING L cornea

MEN2B
Acanthomeba
Riley day/refsums dz
Keratoconus
Icthyosis
NF1
Grafts (failed)
Leprosy

47

4 drugs that cause K verticilata

1) amiodorone
2)indomethacin
3) chloroquine
4)hydroxychloroquine

48

corneal graft rejection sign

khohodust line (inflammatory cells on K endo)

49

how could prostate cancer cause blepharitis?

anti-androgen treatment causes decr meibomian gland fxn

50

how does early acanthomeba present

PERINEURITIS in the cornea with pain- culture on non-nutrient agar w e coli overlay

51

which herpes are associated with cin?

HHV 16 AND 18 (HHV 6 and 11 is conj papilloma)

52

how do you manage terriens marginal degeneration

rx for glasses to account for any astigmatism and counsel the pt that the astig may get worse with time

53

what are salzmanns nodules (looks like clear lump on surface)?

post-inflammatory thing when bowmans get replaced by fibrillar material. Treat with superficial keratectomy

54

what is type 2 lattice dystrophy?

meretoja syndrome- get recur erosions from lattice and systemic amyloid deposition, can have cn7 palsy

55

terriens marginal degen
1) bilat v unilat
2) red eye or white eye?
3) location of thinning?
4) young or old?
5) treatment?

bilateral
white
limbus, esp sup-temp, with lipid bc of bridging blood vessels
young
rx for astigmatism caused by the thinning- usually steep at 180 bc thins at 90

56

moorens
1) unilat v bilt
2) red eye or white eye?
3) old or young pts?
4) epi defect or no epi defect?
5) rx?

unilateral
red eye
older pts
+epi defect
steroids!!!! bc its an immunologic resp possibly to hepatitis

57

PUK
1) unilater or bilat?
2) cause?
3) w/u?
4) rx?

unilateral
infectious or autoimmune
cbc, ana, anca, syphilis, ace, ppd
doxy or conj recession to move inflammatory mediators away from cornea

58

whats the difference between moorens and PUK?

look the same but in PUK theres a known autoimmune or inflammatory cause

59

what causes phlectunule? where in cornea occur? how to treat?

type-4 t cell mediated inflammation
post-allergy
fleshy nodule at limbus
rx with steroids

60

what serotypes of chlamydia causes trachoma

serotypes A-C

61

Whats the treatment of trachoma?

1) topical erythro
2) oral erythro x2 weeks for concomitant pneumonitis

62

what causes SLK?

mechanical rubbing of lid on conj eg in thyroid. can rx by trimming conj

63

atopic conjunctivitis
1) kids or older pple?
2) whats the usual pmhx include?
3) finding
4) rx?

older pple
eczema/atopy
GPC
steroids

64

Vernal conjunctivitis
1) kids or older pple?
2) name 2 findings
3) rx

kids, seasonal
horner trantas dots/GPC/eosinophilia
steroids

65

whats the histologic finding in band K?

calcium hydroxyapetite in bowmans

66

where is keyser Fleischer ring located?

decemets

67

IRON LINES
Hudson stahli line
stocker
fleicher
ferry
warring

Hudson stahli line- bleb
stocker- PTG
fleicher-KCN
ferry- bleb
warring- RK

68

what hereditary dz is associated with K verticilatta?

Fabrys disease (alpha galactosidase deficiency)

69

what does salzmanns look like?

clear bump

70

1) whats the cause of salzmanns
2) how to treat salzmanns?

1) post inflammatory fibrillar material at level of bowmans
2) lubricate or superficial keratectomy

71

whats inside the dots in meesmans dystrophy and what stains it?

"peculiar substance" PAS+

72

What the electron microscopy finding in reiss bucklers?

rod-shaped (R for Reiss buckler)

73

whats the electron microscopy finding in theil benke?

curly fibers
has honey-comb appearance in central K only
recurrent erosions due to path at level of bowmans

74

which is the only AR corneal dystrophy?

macular

75

whats the typical CCT in Fuchs?

>650

76

what CCT foreshadows bad outcome in CE?

>625

77

What type of abnormal collagen is found in fuchs?

fetal banded type 8 collagen

78

is PPMD visually signif?
whats the clinical finding?

NO
Snail tracks

79

which dystrophy recurs the most in PK?

Reiss bucklers

80

whats "irregular astigmatism?

no bowtie pattern!

81

who gets keratoglobus?
how steep is the k?

1)ehlers-danlos or collagen disorders
2) >50 also thin all over

82

what ideal cell count in a donor cornea

>2500

83

whats the wavelength of the excimer laser?

193nm

84

whats an epikeratoplasty? and who gets it?

sew an extra K on top of your K. Used for aphakic pts

85

whats an abnormal TBUT?

<10secs

86

how do you do a schirmers I?

no anesthetic- measure tears with paper- <10mm is abnormal

87

how is rose Bengal and lissamine green different from fluorescein?

rose Bengal and lissamine stain dead/sick cells
fluorescein stains erosion

88

whats the optical principle behind keratometry?

"optical doubling"

89

name 3 causes of mucin deficiency

1) SJS
2)OCP
3) linear IgA deficiency

90

what are 2 drugs you can use for MGD?

1) Doxy
2) Azasite (topical azithromycin)

91

whats the ddx for any inflammation in the eye?
or vasculitis

TB
Sarcoid
lyme
Syphillis
Wegeners
Lupus

92

OCP and SJS what type of hypersens rxn?

type 2 (direct ab vs. tissue)

93

what do you do immunofluorescence for (3 things)?

SJS
OCP
Linear IgA deficiency

94

how do you treat OCP systemically?

dapsone- but not if have G6PD deficiency

95

what meds can cause symblepharon?

1) ecothiophate
2) BAK

96

How does muro help EBMD?

Helps create adhesions between epithelial cells

97

staph- clusters or chains?

clusters
("the staff clusters around the water cooler")

98

who gets filamentary dry eye?

severe dry eye (mucus adheres to eroded area)

99

whats the potassium content of the lens?

HIGH! pumps K INTO lens

100

whats the metabolism pathway in the lens?

anaerobic unless high glucose then shifts to HMP shunt

101

whats the direction of subluxation in homocystinurea?

down and in

102

atopic dermatitis- what type of cataract?

anterior subcapsulr

103

3 risk factors for psc cataracts?

1) smoking
2) dm2
3) steroid use

104

when do you get "oil droplet cataract" that you see on retroillumination

galactosemia

105

what's the minimum ecc for a k donor graft

2000

106

how long after CE does CME tend to appear?

6-10 weeks

107

what type of hpv casues
- sessile squam papilloma
- peduculated squam papilloma

sessile- hpv 16, 18 (sex-ile- teenage yrs 16, 18)
peduculated hpv 6, 16

108

what do you see in bietti corneal dystrophy?

AR (dirty dozen type thing)
crystals in k periphery
nyctalopia from retinal degenration

109

what does the schimflug (pentacam) measure?

anterior and posterior K curvature, CCT and ACD

110

Besides hep c, what else can moorans be associated with?

flukes

111

whats the mutation in meesmans

KRT12

112

name ecc
at birth
young adult
65 yo

4000
3000
2500

113

recurrence in grafts of dystrophies
Really? Lets graft more

reis bucklers
lattice
granular
macular

114

age of presentation of stromal dystrophies
"might like to grow"

macular
lattice
granular

115

what are shield ulcers ass with?

vernal conjuctivitis

116

whats GPC associated with?

cl wear
vernal conjunct
atopic conjunct

117

how does doxy effect the cornea?

inhibits martix metalloproteinase

118

does scleromalacia perforans have inflammation?

NO

119

What alpha hemolytic strep?

strep viridens

120

at what CCT does epi edema typically appear

>700

121

what are cowdry bodies associated with?

hsv and vzv

122

how does the K get neurtrophils and lysozyme?

tears (NOT limbal blood vessels)

123

snow blindness and welding injury can damage what layer of the K?

Epithelium

124

PUK involves the sclera but ....... does not

moorens (K only)

125

what bugs can invade intact epitelium? CHANLS

corneybacterium
haemophilus
aegyptus
Neisseria
listeria
shigella

126

what type of crystallins are the most in the lens
which are largest

Beta is the most common
alpha are the largest w highest molecular weight

127

what contributes to anterior capsular phimosis?

any dz with loose zonules--> the capsule can contract more

128

which type of icthyosis has K changes?

X LINKED

129

What bug causes chronic angular blepharoconjunctivitis?

Moraxella lacunata

130

which map measures central corneal power?

axial map

131

which map measures peripheral corneal power?

instantaneous map

132

what kind of K changes do you see with aniridia?

progressive opacification

133

what causes thygessons? how do you treat?

dry eye and mgd, occurs in boys usually bilateral
lubricate +/- lotemax or fml

134

whats lisch epithelial dystrophy?

x-linked epi dystrophy
similar to meesmans
has clear intervening spaces between the cysts

135

what finding on exam indicates that post-op K edema may resolve

clear cornea periphery

136

what contributes the refractive power of the K. The air/tear interface or the tear/cornea interface?

air/tear!!!!!

137

in which case would you consider doing a running suture in a pk?

KCN

kids, thin K, vasc K- do interupteds

138

what part of the K is effected wit "fleck" dystrophy?

stroma

139

what are filaments made of and how do you treat?

epi with mucus core
10% N-acetylcystine

140

at what ECC will you start getting K edema?

500 cells

141

which mucopolysaccaridoses actually causes clouded corneas?

hunters
hurlers
schies
sanfillipos

142

what can you look for on an ELISA in macular K dystrophy

sulfated keratin sulate

143

how do you treat hydrops?

observe
or possible muro +bcl

144

UBIAD1 gene causes which dystrophy?

schnyders

145

besides apple green birefringence, lattice can stain with what?

crystal violet metachromasia

146

you see a "wavelike" K epi irregularity, what dz are you thinking?

limbal stem cell deficieny staining pattern is 2/2 conjunctivization of the K

147

which drop is ineffective for ice?

pilo
drugs of choice are aq suppressants like b-block and cai

148

In the hav recurrence trial, what was found to cause recurrences?

None!
Stress, sunlight, menatruation and cl wear were not proven to be triggers for outbreaks

149

Which type of adenovirus causes ekc?

Type 8

150

what level of the K does crocodile shagreen effect?

deep stroma

151

is crocodile shagreen visually significant?

no

152

whats the biggest difference between crocodile shagreen and central cloudy dystrophy of francois?

crocodile- 2/2 old age
francois- AD inherited disorder

153

TGFB1 - LARGE dystrophies- what locus is fucked up

5q31

154

whats the thinnest part of the cornea?

temporal to center

155

at what level of the K, is K verticilatta?

epi