Flashcards in QUESTIONS Deck (136):
How do you treat post op pupillary block
How do you treat post op ciliary block?
cycloplegia, LPI (to r/o pupillary block), aqueous suppression
patients with elevated IOP from ICE syndrome...what is best therapy?
tube shunt vs trabeculectomy. laser angle surgery doesn't work due to angle abnl
What serologic markers are most associated with uveitis in JIA patients?
postive ANA with negative RF
First line treatment for fungal keratitis?
natamycin--only available topical anti fungal in US
When should you consider giving steroids in EKC?
SEIs or pseudomembranes
prostaglandin ocular side effects?
macular edema, uveitis
topical carbonic anhydrase ocular side effects?
laser trabeculoplasty is good for patients for what kind of angle structure?
open angles such as in pseudo exfoliation syndrome
what is Kasabach Merritt syndrome?
infantile hemangioma on organs leading to thrombocytopenia due to sequestration
anterioposterior width of lens at birth and in adult?
3.5 mm and 5 mm in adults
what's the width of a phase tip?
what optic disc features are seen in NTG?
larger CDR, sloping, PPA, disc hemorrhage
what is scleromalacia perforans?
necrotizing scleritis WITHOUT inflammation. Associated with RA and is painless. High mortality--manage with a rheumatologist
redundant periumbilical fold is associated with what condition?
interrupted PKP sutures are best for what kind of patients?
inflamed K, children, thin cornea, and vascularized corneas.
allows sutures to be removed individually if needed
rubella infection of second trimester is associated with what?
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
myasthenia gravis is also associated with what comorbid condition?
Graves and thymoma
Get TSH and CT chest/neck
salt pepper fundus
congenital rubella mostly associated with second trimester infection
describe Lisch Epithelial Corneal Dystrophy?
X link dominant condition with micro cysts in epithelium forming whirl like pattern. Similar to Meesman's
definition and width of perifovea
1.5 mm, area of the very peripheral macula
width of parafovea
0.5mm, area surrounding fovea. It is where ganglion cells are the thickest
foveola definition. width of foveola?
area where there's only cones.
where is foveola in relations to optic nerve?
0.4mm temporal, and 0.8mm inferiorly
What is the width of fovea?
1.5mm--aka 1 disc diameter
thickness of K epithelium?
thickness of Bowman's layer?
Thickness of decedent's membrane?
3 microns at birth ---increases to 10 microns in adulthood
nevus of Ota is associated with what condition?
glaucoma in 10% pts
Feldenstrucktur muscle is at what NMJs for what movements
at En grappe NMJs for smooth pursuits
Fibrillenstruktur muscle is at what NMJs for what movements
en plaque NMJs for saccades
Cidofovir ocular side effect?
what conditions are associated with enlarged K nerves/
MeN2 large k nerves
how many % of melanomas come from PAM (with atypic)? de novo? nvus?
70% from PAM. de novo 20% rest from nevus
dieffenbachia plant exposure causes what?
corneal calcium oxalate crystals called raphides
treatment for toxo?
oral: pyrimethamine, sulfadiazine, folic acid...(triple therapy)... then later on prednisone
or IV of clindamycin and dexamethasone
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
Lens capsule is thickest where?
posterior pre equatorial 23 microns
anterior lens capsule thickness?
direct eye lid closure is used for what size of eye lid defects?
how do you close lid defect 33-50%?
lateral canthotomy then rotate flap (Tenzel flap)
what is Cutler-Beard procedure?
for UPPER lid defects of >50% by using lower lid as flap
What is the modified Hughes procedure?
to fix lower lid defects >50% with upper eyelid flap to construct posterior lamella
what is echothiophate?
indirect Miotics. Do NOT give succinylcholine with it as it may prolong paralysis
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)
what are the two flattest quadrants of the cornea?
superior and nasal
1.5mm same as ON
microscopic breaks in bowman's layer is associated with early stages of what condition?
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.
what is astigmatism keratotomy?
parallel corneal incisions about 1mm from apex in order to flatten steep meridian and steepen the flat meridian (coupling)
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
Cidofovir is used for CMV retinitis. what are its side effects?
what is the only medicine proven to reduce rebleed s/p traumatic hyphema?
christmas tree cataract are associate with what two conditions?
what kind of collagen is associated with decemet's membrane
corneal power total? anterior? posterior?
total is 43. anterior is 48, posterior is -6
sudden vision loss with disc edema/peripapillary telangiectasia. waht condition? pattern of inheritance?
Leber hereditary optic neuropathy. mitochondrial
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
ONTT. how many % of patients with optic neuritis had pain with EOM?
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.
How many posterior short ciliary arteries enter the globe around the optic nerve? how many posterior short ciliary nerves?
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?
whats the difference between prolapsed orbital fat and lipodermoid
lipodermoid is choristoma present at birth vs prolapse happen with age
rate of aqueous production
what substances are at increased concentration in Aqueous than blood
vit C, hydrogen, chloride
type 2 parafoveal telangiectasia is associated with what lab test finding?
impaired glucose tolerance
Duane type 1. preferred surgical procedure?
medial rectus recession
Duane type 2. preferred surgical procedure?
lateral rectus resection
the orbits are separated by how many mm?
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
volume of vitreous cavity
volume of AC
which immunemodulator is associated with drug induced lupus?
vitrectomy induces what kind of cataract?
silicon oil induces what kind of cataract
average power of the lens is how many diopters?
ectopia lentis et pupilae. mode of inheritance
what is the most common cause of congenital unilateral cataract?
persisting fetal vasculature (PFV)
how often is Rb bilateral
1/3 of the time
beer belly cornea, crab claw on keratometry. Dx?
pellucid marginal degeneration
what is snowflake degeneration?
degenerative changes to PMMA IOLs.
IOL calcifications happen with what kind of IOL material?
glistening occur with what kind of IOL material
encephaloceles are associated with what two optic nerve abnormalities?
morning glory nerve
optic nerve hypoplasia
what is Heerford syndrome?
It's uveitis, parotidis, and fever (uveoparotid fever)
can be a presentation of sarcoid
What is Lofgren's syndrome?
erythema nodosum, hilarious LAD, and arthritis
what are the signs of intraoperative suprachoroidal hemorrhage?
tense eye, shallowing AC, loss of red reflex.
What do you do in the case of intraoperative suprachoroidal hemorrhage.
close wound with suture
the two oblique muscles are at how many degrees from visual axis?
the superior and inferior rectus muscles are at how many degrees from visual axis?
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
What is coma?
coma and trefoil are 3rd order aberrations.
Coma is due to eccentric light focusing causing light to look like a comet
what are second order aberrations?
myopia (positive defocus) and hyperopia (negative defocus)
What are first order aberrations?
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
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
CN with the longest intracranial course?
which sub nuclei of CN III are fused (and thus supplies both eyes)?
which EO muscle receives innervation from both ipsilateral and contralateral nerve fibers?
Superior rectus... from both CNIII fibers
Saltzmann's nodules are in what layer of the K?
Middle age women--trachoma/interstitial keratitis/phlyctenules
most common hormone deficiency in de Morsier syndrome?
what is a contraindication to azathioprine?
hx of treatment with alkylating drug or hx of allergy
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
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.
What settings of PRP increase chance of choroidal neovascular membrane?
higher power, longer duration, and SMALLER spot size (breaks through Bruch's membrane)
what's the magnification of a simple magnifier equation?
Msimple magnifier=D x distance
what is oscillopsia?
subjective sensation that environment is moving in patients with nystagmus or nystamtoid eye disorders
what are some drugs that causes uveitis?
rifabutin, bisphosphonates, sulfonamides, OCPs
What meds are associated with uveitis
proliferative sickle cell retinopathy should be treated how?
low intensity PRP to ischemic regions
benefits of YAG contact lens?
stabilizes eye, reduces depth of field, and magnifies image.
Bacterias that can penetrate intact K epitheliuM?
No Hard or Soft Contact Lenses
Neisseria (both), Haemophilis aegyptus, Shigella, Corynebacterium, Listeria
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
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
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
how many degrees do you treat when doing CPC?
270 --so that 90 degrees are spared--decreases anterior segment necrosis risk.
Plateau iris is diagnosed s/p doing LPI and pressure is still elevated. What should you do to treat plateau iris?
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
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
Neuroblastoma associations in children?
Forster Fuch's spots. what are they. what condition do you seen them in?
RPE changes/hyperpig spots. In high myopia
Dalen Fuch's spots. What conditions do you see them in?
neuroretinitis with macular star and papilledema. What's the organism that causes this?
magnification of image with a lens is calculated how?
Mag=power of eye/power of lens
Bird shot chorioretinitis is characterized by what HLA marker
best tested with ERG and VF
Young child who has bilateral ptosis and cannot look up.
congenital fibrosis extra ocular muscle syndrome 1. autosomal dominant hesitance of muscle fibrosis.
iris atrophy, k edema
energy pathway of the lens? (glucose)
what is pseudoxanthalasma elasticuma?
xanthalasmas on skin
Fundus has angio streaks and peau d'orange appearance. These eyes are prone to CNVM, choroidal hemorrhage.
how do retinoblastoma escape the eye and disseminate?
via optic nerve
what is bilateral diffuse uveal melanocytes proliferation (BDUMP)
leopard spots withOUT leakage on FA. associated with lung cancer.
uveal effusion syndrome
leopard spots WITH. leakage on FA
not associated with lung cancer
uncontrolled IIH with progressive vision loss--tx? uncontrolled HA--tx?
optic nerve fenestration for vision loss.
lumboperitoneal shunt for headache
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