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Cornea Flashcards

(43 cards)

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1
Q

What is keratometry?

What are keratometric mires?

A

Measurement of corneal curvature.
Normal=42-46
Image is seen in the form of keratometric mires.
-minus sign btw vertical mires overlap
-plus sign btw horizontal mires overlap

Mires-horizontally oval=with the rule astigmatism
-vertically oval=against the rule “
PULSATING=Keratoconus

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2
Q

What is pachymetry?

What is esthesiometry?

A

Measurement of corneal thickness…..500-600u

Eliciting corneal sensation…..by Cochet Bonnet esthesiometer

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3
Q

Specular microscopy?

Confocal microscopy?

A

To visualise count endothelial cells

To visualise any layer of cornea
Also corneal nerves,Fungal hyphae,Acanthamoeba cysts*****

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4
Q

Corneal topography nd instruments?

Uses of Gonioscopy?

A

To assess surf elevation
Measured by 1.Placebo disc
2.Orb scan(th+curv)
3.Pentacam(5)

Visualise angle structures-schwalbe’s line nd very early KF ring

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5
Q

Dyes used in staining corneal ulcers?

A
  1. Fluorescein dye- base or floor
  2. Rose Bengal dye- margins
  3. Alicante blue dye-Mucin nd filaments
  4. Lissamine green-not healthy surface
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6
Q

Other uses of fluorescein dye?

A
  1. Goldman’s AT in glaucoma
  2. Dx of Dry eye
  3. Jones dye test- for lacrimation assessment
  4. Seidel’s test- detect leakage thr perforation
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7
Q

Staining nd culture for diff organisms?

A
  1. Bacterial- Grams stain- Blood/chocolate agar
  2. Fungi- 10%KOH- SDA
  3. Acanthamoeba= Gomori’s methamine silver stain- Non nutrient agar with E-coli overlay
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8
Q

Mcc in the world?

Mcc in India/Mcc of hypopyon CU

Mcc in contact lens user/fast spreading/Mcc of perforation

Mcc in post keratoplasty pts

A

Staphylococcus aureus

Streptococcus pneumoniae

Pseudomonas aeruginosa(green discharge)

Atypical mycobacterium

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9
Q

Bacteria that penetrate intact epithelium

A
  1. N.g, N.m
  2. C.d
  3. H.aegypticus
  4. Listeria
  5. Shigella
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10
Q

Symptoms in bacterial CU

A
  1. Defective vision
  2. Photophobia
  3. Lacrimation
  4. Redness
  5. Pain nd FBS
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11
Q

Hypopyon CU

A

By streptococcus pneumoniae

Etio = Chronic dacrocystitis

Serpenginous ulcer nd violent iridocyclitis nd 2” glaucoma

Sterile,mobile

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12
Q

Complications of bacterial CU

A
  1. Toxic iridocyclitis
  2. 2” glaucoma
  3. Descematocele
  4. Perforation = iris prolapse,Ant capsular cataract,end/panophth,phthisis
  5. Scarring
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13
Q

Treatment of uncomplicated bacterial CU

A

Topical fortified antibiotics
1.Cefazolin5% + Tobramycin1%
Or
2.Vancomycin 5% + FQs(cipro 0.3% or moxi 0.5%)

Every 5min for 30min…..every 15min for 2hrs…..1hrly for 2 days….4-6hrly till healed

Cycloplegics(A=dec pain nd prevent synechae nd inc BF)
Analgesics(paracetamol,ibuprofen)
Vitamins

Dark goggles,hot fomentation

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14
Q

Wreath pattern or Pin head ulcer is caused by?

A

Nocardia

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15
Q

Signs are out of proportion in which ulcer?

Symptoms are out of proportion in which ulcer?

A

Fungal keratitis(vegetable,animal trauma)

Acanthamoeba keratitis(unhygienic contact lens users)

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16
Q

Signs of fungal corneal ulcer

A
  1. Dry looking
  2. Feathery margins
  3. Satellite lesions
  4. Sterile immune ring of WESLEY
  5. Hypopyon= not sterile,immobile
  6. Endothelial plaque
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17
Q

DOC in fungal keratitis

A

For Aspergillus fumigatus= 5% NATAMYCIN

For Candida albicans= 0.15% Amphotericin B

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18
Q

Symptoms of Acanthamoeba keratitis

Signs seen in “

Study These Flashcards
A
  1. Pain d/t Radial Perineuritis nd Radial keratoneuritis
  2. Blepharospasm
  3. FBS,watering
  4. Epith=Radial keratoneuritis nd Psuedodendrites
  5. Limbal=limbitis
  6. Stromal=RING infiltrate nd Ring abscess
19
Q

Fungal hyphae nd Acanthamoeba cysts can be seen with?

Study These Flashcards
A

Confocal microscopy

20
Q

Treatment of Acanthamoeba keratitis

Study These Flashcards
A

DOC= PHMB(poly hexamethyl Biguanide) topical

  1. PHMB+ propamidine/Hexamidine
  2. Chlorhexidine+ neo/paromycin

3-4 months for early epith nd 6-12 months for stromal lesions

Unresponsive cases=Penetrating keratoplasty

21
Q

Mcc of viral keratitis

22
Q

Epithelial keratitis signs nd treatment

Study These Flashcards
A
  1. Punctate epith k
  2. Dendritic ulcer…..decreased sensations
  3. Geographic ulcer/Amoeboid ulcer

Acyclovir 3% 5times/day for 14-21 days
Other-Ganciclovir,Vidarabine

Mech debridement for resistant cases

Oral acyclovir 400mg bid for 14-21 days in recurrent cases

23
Q

Treatment for stromal keratitis

Study These Flashcards
A

Topical steroid drops
+
Acyclovir

24
Q

Disciform keratitis

Study These Flashcards
A

Disc shaped stromal edema d/t Endothelitis(TYPE IV Hsn)

2”OAG occurs

25
Herpes zoster ophthalmicus is caused by?
Reactivation of VZV in the gasserian ganglion
26
Mc involved nerve in HZO? MC nerve palsy nd least common nerve palsy?
FRONTAL nerve 3rd nerve nd 7th nerve
27
Lesion @ nose tip is accompanied by corneal involvement in HZO by which rule?
Hutchinson’s rule
28
Signs of HZO
1. Pseudo dendritic ulcer 2. Nummular keratitis- coin shaped subepith lesions 3. Mucosal plaque keratitis 4. Sclerokeratitis(least common) 5. 3 rd nerve palsy 6. Episcleritis
29
Treatment of HZO
Acyclovir 800mg 5/day for 10days
30
What is arcus senilis? Space btw limbus nd AS? Cause of arcus juvenilis?
Paralimbal Lipid deposition @ stroma in old age(physiological) Lucid interval of VOGT Hyperlipidemia
31
What is band shaped keratopathy?
It is calcific deposition in the interpalpebral zone@ bowman membrane. Chronic Iridocyclitis in adults nd STILLs disease in children 1. Chelation with EDTA 2. PTK with excimer laser
32
What is HUTCHINSONs TRIAD?
``` Interstitial keratitis + Hutchinson’s teeth + Vestibular deafness ```
33
Etiology nd clinical features of Syphilitic interstitial keratitis?
*90% cong cases=B/L involv 3 stages 1.Initial progressive=edema nd symptoms....diffuse corneal haze=Ground glass app 2. Florid stage=deep vascularisation-SALMON PATCH app 3. Stage of regression= leaves opacities nd vessels
34
Hallmark of keratoconus
``` Central/paracentral stromal thinning + Inferior Apical protrusion of Anterior cornea + Irregular astigmatism ``` ***B/L,progressive,non inflam
35
Signs of keratoconus
1.Window reflex distorted 2.Placido disc - irregularity of circles 3.Slit lamp - Fleischer ring @ base VOGTs striae(tears of Desc memb) 4.Retinoscopy - Scissoring or Yawning reflex 5.DDO - Oil droplet reflex 6.Munson’s sign
36
What is Munson’s sign? What is Rizzuti’s sign?
Bulging of Lower eyelid on down gaze Light on temporal side prod ARROWHEAD pattern on nasal limbus
37
Investigation nd app seen for keratoconus
Corneal topography Symmetric BOWTIE app
38
Management of keratoconus
1. Glasses - cylinders 2. Contact lens - RGP 3. Keratoplasty if apical scarring +nt 4. ICRS-Intracorneal ring segments(PMMA)=intrastromally in mid peripheral stroma 5. C3R-Corneal Collagen Cross linking with Riboflavin
39
Complication of keratoconus
ACUTE HYDROPS
40
Corneal opacity causes
STUMPED
41
Cornea verticellata
Whorl like opacity d/t long term treatment with 1. Amiodarone 2. Chloroquine 3. Phenothiazines 4. Indonethacin Or in Fabry disease
42
Superficial corneal vascularisation is seen in?
1. Superficial corneal ulcers 2. Contact lens users 3. Trachoma 4. phlyctenular keratoconjunctivitis 5. Rosacea keratitis
43
Deep corneal vascularisation is seen in?
1. Deep corneal ulcer 2. Chemical burns 3. Corneal graft rejection 4. Interstitial keratitis 5. Disciform keratitis

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