QUESTIONS Flashcards
1
Q
How do you treat post op pupillary block
A
cycloplegia, LPI
2
Q
How do you treat post op ciliary block?
A
cycloplegia, LPI (to r/o pupillary block), aqueous suppression
3
Q
patients with elevated IOP from ICE syndrome…what is best therapy?
A
tube shunt vs trabeculectomy. laser angle surgery doesn’t work due to angle abnl
4
Q
What serologic markers are most associated with uveitis in JIA patients?
A
postive ANA with negative RF
5
Q
First line treatment for fungal keratitis?
A
natamycin–only available topical anti fungal in US
6
Q
When should you consider giving steroids in EKC?
A
SEIs or pseudomembranes
7
Q
prostaglandin ocular side effects?
A
macular edema, uveitis
8
Q
topical carbonic anhydrase ocular side effects?
A
K edema
9
Q
laser trabeculoplasty is good for patients for what kind of angle structure?
A
open angles such as in pseudo exfoliation syndrome
10
Q
what is Kasabach Merritt syndrome?
A
infantile hemangioma on organs leading to thrombocytopenia due to sequestration
11
Q
anterioposterior width of lens at birth and in adult?
A
3.5 mm and 5 mm in adults
12
Q
what’s the width of a phase tip?
A
1.6mm
13
Q
what optic disc features are seen in NTG?
A
larger CDR, sloping, PPA, disc hemorrhage
14
Q
what is scleromalacia perforans?
A
necrotizing scleritis WITHOUT inflammation. Associated with RA and is painless. High mortality–manage with a rheumatologist
15
Q
redundant periumbilical fold is associated with what condition?
A
axenfeld rieger
16
Q
interrupted PKP sutures are best for what kind of patients?
A
inflamed K, children, thin cornea, and vascularized corneas.
allows sutures to be removed individually if needed
17
Q
rubella infection of second trimester is associated with what?
A
retinopathy
18
Q
rubella of first trimester is associated with sequestration of virus in lens leading to cataracts… what other association is almost never seen at the same time with cataracts in these patients
A
congenital glaucoma
19
Q
myasthenia gravis is also associated with what comorbid condition?
A
Graves and thymoma
Get TSH and CT chest/neck
20
Q
salt pepper fundus
A
congenital rubella mostly associated with second trimester infection
21
Q
describe Lisch Epithelial Corneal Dystrophy?
A
X link dominant condition with micro cysts in epithelium forming whirl like pattern. Similar to Meesman’s
22
Q
definition and width of perifovea
A
1.5 mm, area of the very peripheral macula
23
Q
width of parafovea
A
0.5mm, area surrounding fovea. It is where ganglion cells are the thickest
24
Q
foveola definition. width of foveola?
A
area where there’s only cones.
250 microns
25
where is foveola in relations to optic nerve?
0.4mm temporal, and 0.8mm inferiorly
26
What is the width of fovea?
1.5mm--aka 1 disc diameter
27
thickness of K epithelium?
50 microns
28
thickness of Bowman's layer?
8-14 microns
29
Thickness of decedent's membrane?
3 microns at birth ---increases to 10 microns in adulthood
30
nevus of Ota is associated with what condition?
glaucoma in 10% pts
31
Feldenstrucktur muscle is at what NMJs for what movements
at En grappe NMJs for smooth pursuits
32
Fibrillenstruktur muscle is at what NMJs for what movements
en plaque NMJs for saccades
33
Cidofovir ocular side effect?
uveitis, hypotony
34
what conditions are associated with enlarged K nerves/
neurofibromatosis 2
MENIIB
leprosy
MeN2 large k nerves
35
how many % of melanomas come from PAM (with atypic)? de novo? nvus?
70% from PAM. de novo 20% rest from nevus
36
dieffenbachia plant exposure causes what?
corneal calcium oxalate crystals called raphides
37
treatment for toxo?
oral: pyrimethamine, sulfadiazine, folic acid...(triple therapy)... then later on prednisone
or IV of clindamycin and dexamethasone
38
LASIK. what organisms are common infections in <10 days post op? what about >10 days post op?
Gram + <10 days
| Fungal or atypical mycobacteria >10 days
39
Lens capsule is thickest where?
posterior pre equatorial 23 microns
40
anterior lens capsule thickness?
14microns
41
direct eye lid closure is used for what size of eye lid defects?
<33%
42
how do you close lid defect 33-50%?
lateral canthotomy then rotate flap (Tenzel flap)
43
what is Cutler-Beard procedure?
for UPPER lid defects of >50% by using lower lid as flap
44
What is the modified Hughes procedure?
to fix lower lid defects >50% with upper eyelid flap to construct posterior lamella
45
what is echothiophate?
indirect Miotics. Do NOT give succinylcholine with it as it may prolong paralysis
46
What is central cloudy dystrophy of Francois?
exactly the same appearance as crocodile shagreen. Except for crocodile shagreen develops over time and central cloudy dystrophy of Francois is from birth (it's a dystrophy)
47
what are the two flattest quadrants of the cornea?
superior and nasal
48
fovea size
1.5mm same as ON
49
microscopic breaks in bowman's layer is associated with early stages of what condition?
Keratoconus
50
What is the difference between CHED and CHSD?
CHSD is extremely rare --there is no corneal edema, but there's thickening with flaky stromal lesions.
51
what is astigmatism keratotomy?
parallel corneal incisions about 1mm from apex in order to flatten steep meridian and steepen the flat meridian (coupling)
52
what effect do radial incisions on the cornea have on the curvature?
radial incisions flatten both the meridian at hand as well as 90 degrees from it
53
Cidofovir is used for CMV retinitis. what are its side effects?
anterior uveitis.
hypotony
renal toxicity
54
what is the only medicine proven to reduce rebleed s/p traumatic hyphema?
aminocaproic acid
55
christmas tree cataract are associate with what two conditions?
myotonic dystrophy
| hypoparathyroidism
56
what kind of collagen is associated with decemet's membrane
type IV
57
corneal power total? anterior? posterior?
total is 43. anterior is 48, posterior is -6
58
sudden vision loss with disc edema/peripapillary telangiectasia. waht condition? pattern of inheritance?
Leber hereditary optic neuropathy. mitochondrial
59
symptomatic patients and what % of carotid occlusive disease should get CEA? what's the periop risk of stroke in CEA? how does stenting compare?
70-99%. Periop risk of stroke for CEA is 6%. vs higher with stenting
60
ONTT. how many % of patients with optic neuritis had pain with EOM?
92%
61
square wave jerks. associated with what condition? it's nystamoid movement but not nystagmus because?
parkinson's and cerebellar/pontine disease.
It is saccdic intrusion and does not have fast/slow phase.
62
How many posterior short ciliary arteries enter the globe around the optic nerve? how many posterior short ciliary nerves?
20 arteries
| 10 nerves
63
what's the length of intraorbital portion of optic nerve?
what's the length of intrascleral portion of optic nerve?
what's the length of intra canal portion of optic nerve?
24mm
1mm
10mm
64
whats the difference between prolapsed orbital fat and lipodermoid
lipodermoid is choristoma present at birth vs prolapse happen with age
65
rate of aqueous production
2 microliters/min
66
what substances are at increased concentration in Aqueous than blood
vit C, hydrogen, chloride
67
type 2 parafoveal telangiectasia is associated with what lab test finding?
impaired glucose tolerance
68
Duane type 1. preferred surgical procedure?
medial rectus recession
69
Duane type 2. preferred surgical procedure?
lateral rectus resection
70
the orbits are separated by how many mm?
25
71
light induced scotoma that improves with laying down. dx? diagnostic studies?
ocular ischemic syndrome. also could present as hypotony and mid-peripheral DBH
can do FA, CTA, MRA, carotid doppler--carotid endarterectomy
72
volume of vitreous cavity
5ml
73
volume of AC
200 microliters
74
which immunemodulator is associated with drug induced lupus?
infliximab
75
vitrectomy induces what kind of cataract?
nuclear
76
silicon oil induces what kind of cataract
PSC
77
average power of the lens is how many diopters?
20
78
ectopia lentis et pupilae. mode of inheritance
autosomal recessive
79
what is the most common cause of congenital unilateral cataract?
persisting fetal vasculature (PFV)
80
how often is Rb bilateral
1/3 of the time
81
beer belly cornea, crab claw on keratometry. Dx?
pellucid marginal degeneration
82
what is snowflake degeneration?
degenerative changes to PMMA IOLs.
83
IOL calcifications happen with what kind of IOL material?
hydrogel
84
glistening occur with what kind of IOL material
hydrophobic
85
encephaloceles are associated with what two optic nerve abnormalities?
morning glory nerve
| optic nerve hypoplasia
86
what is Heerford syndrome?
It's uveitis, parotidis, and fever (uveoparotid fever)
| can be a presentation of sarcoid
87
What is Lofgren's syndrome?
erythema nodosum, hilarious LAD, and arthritis
88
what are the signs of intraoperative suprachoroidal hemorrhage?
tense eye, shallowing AC, loss of red reflex.
89
What do you do in the case of intraoperative suprachoroidal hemorrhage.
close wound with suture
90
the two oblique muscles are at how many degrees from visual axis?
51 degrees
91
the superior and inferior rectus muscles are at how many degrees from visual axis?
23 degrees
92
What is spherical aberration?
4th order aberration. Due to stronger focusing at peripheral corneal vs central. Risk factors: young, large pupil, myopic corneal ablation
night myopia is a side effect
93
What is coma?
coma and trefoil are 3rd order aberrations.
| Coma is due to eccentric light focusing causing light to look like a comet
94
what are second order aberrations?
myopia (positive defocus) and hyperopia (negative defocus)
95
What are first order aberrations?
prisms.
96
What are ophthalmoplegic migraines?
intermittent 3rd nerve palsy. Almost always in Peds.
| Always a diagnosis of exclusion (lymphomas, sarcoid..etc). enhancement on MRI is seen
97
what are the three FA patterns seen with central serous chorioretinopathy--- in order of most common to least common?
expansile dot pattern, smoke stack (10%), diffuse
98
CN with the longest intracranial course?
CN 4
99
which sub nuclei of CN III are fused (and thus supplies both eyes)?
levator palpebrae
100
which EO muscle receives innervation from both ipsilateral and contralateral nerve fibers?
Superior rectus... from both CNIII fibers
101
Saltzmann's nodules are in what layer of the K?
Bowman's.
| Middle age women--trachoma/interstitial keratitis/phlyctenules
102
most common hormone deficiency in de Morsier syndrome?
growth hormone
103
what is a contraindication to azathioprine?
hx of treatment with alkylating drug or hx of allergy
104
What is Foster-Kennedy Syndrome vs Pseudo Foster-Kennedy Syndrome? How do you distinguish?
Foster Kennedy syndrome: mass compression induced optic neuropathy/atrophy. Then compression of CSF flow results in unilateral papilledema in other eye.
PSeudo Foster Kennedy syndrome: sequential NAION at least 6 weeks apart. One nerve is atrophic already and one is swollen.
Both have one atrophic and one swollen nerve
distinguished by VF defect of the swollen side--> pseudo Foster Kennedy will have altitudinal or arcuate defect like NAION. Pseudo FK will have only enlarged blind spot
105
latent nystagmus is associated with what kind of deviation? when does it occur?
congenital estropia with fast beats AWAY from viewing eye.
| Occurs when binocularity is disrupted.
106
What settings of PRP increase chance of choroidal neovascular membrane?
higher power, longer duration, and SMALLER spot size (breaks through Bruch's membrane)
107
what's the magnification of a simple magnifier equation?
Msimple magnifier=D x distance
108
what is oscillopsia?
subjective sensation that environment is moving in patients with nystagmus or nystamtoid eye disorders
109
what are some drugs that causes uveitis?
rifabutin, bisphosphonates, sulfonamides, OCPs
110
What meds are associated with uveitis
metoprolol, travaprost.
111
proliferative sickle cell retinopathy should be treated how?
low intensity PRP to ischemic regions
112
benefits of YAG contact lens?
stabilizes eye, reduces depth of field, and magnifies image.
113
Bacterias that can penetrate intact K epitheliuM?
No Hard or Soft Contact Lenses
| Neisseria (both), Haemophilis aegyptus, Shigella, Corynebacterium, Listeria
114
What is Sherrington's law? what condition violates Sherrington's law?
When one rectus muscle contracts the opposite muscle relaxes. Duane's violates Sherrington's thus the globe retracts
115
What is Herring's law?what condition violates this?
The two eyes are yolked together. so refixation of a hyperopic eye should result in corresponding downward movement of the other eye. Dissociative vertical deviation (DVD) violates this
116
What is the lens maker's equation?
Power (D)= (n'-n)/r
n'=index of refraction of lens. n=index of refraction of air. R is focal length
117
how many degrees do you treat when doing CPC?
270 --so that 90 degrees are spared--decreases anterior segment necrosis risk.
118
Plateau iris is diagnosed s/p doing LPI and pressure is still elevated. What should you do to treat plateau iris?
ALT
119
Touton giant cells are associated with what condition?
Erdheim-Chester (two tons of chest nuts)
Associated with early cardiac disease
Skin findings of Juvenile Xanthogranuloma (little red bumps)
yellow iris lesions
120
Unilateral ischemic eye disease with mid periphery retinal hemorrhage seen on exam. What condition is this? what's the work up?
Ocular ischemic syndrome.
| You need to do carotid US
121
Neuroblastoma associations in children?
periorbital ecchymosis
| Horner's syndrome
122
Forster Fuch's spots. what are they. what condition do you seen them in?
RPE changes/hyperpig spots. In high myopia
123
Dalen Fuch's spots. What conditions do you see them in?
Sympathetic ophthamia
| VKH
124
neuroretinitis with macular star and papilledema. What's the organism that causes this?
Bartonella
125
magnification of image with a lens is calculated how?
Mag=power of eye/power of lens
126
Bird shot chorioretinitis is characterized by what HLA marker
HLA A29
| best tested with ERG and VF
127
Young child who has bilateral ptosis and cannot look up.
congenital fibrosis extra ocular muscle syndrome 1. autosomal dominant hesitance of muscle fibrosis.
128
chandler's
iris atrophy, k edema
129
energy pathway of the lens? (glucose)
anerobic glycolysis
130
what is pseudoxanthalasma elasticuma?
xanthalasmas on skin
| Fundus has angio streaks and peau d'orange appearance. These eyes are prone to CNVM, choroidal hemorrhage.
131
how do retinoblastoma escape the eye and disseminate?
via optic nerve
132
what is bilateral diffuse uveal melanocytes proliferation (BDUMP)
leopard spots withOUT leakage on FA. associated with lung cancer.
133
uveal effusion syndrome
leopard spots WITH. leakage on FA
| not associated with lung cancer
134
uncontrolled IIH with progressive vision loss--tx? uncontrolled HA--tx?
optic nerve fenestration for vision loss.
| lumboperitoneal shunt for headache
135
When you do surgery on the inferior rectus the lower eye lid tend to go in the direction where you move it. Recession --> lower lid retraction, Resection -->lower lid elevation
---
136
dieffenbachia house plants can cause what complication?
corneal crystals. painful
