thee lens

Question 1

what is cataract ?

Answer 1

clearing of the normally clear lens

Question 2

what is the cause of blurry vision in cataract ?

Answer 2

cloudiness of the lens doesn’t allow for the focusing of light on the retina - leading to blurry vision

Question 2

what are the different types of cataract ?

Answer 2

congenital
acquired
secondary
traumatic

Question 3

what are the causes of acquired cataract ?

Answer 3

either due to aging
or due to systemic or local causes

Question 4

what are the different types of cataract maturity ?

Answer 4

immature - partially opaque
mature - totally opaque
hyper mature -shrunken and wrinkled anterior capsule due to leakage of water out of the lens

Question 5

what are the types of age related cataract ?

Answer 5

subcapsular cataract
nuclear cataract
cortical cataract

Question 6

what is the pathology in sub capsular cataract ?

Answer 6

lies directly underneath the capsule whether anterior or posterior
due to fibrous metaplasia of the lens epithelium
posterior sub capsular has a profound effect on vision

Question 7

what is the pathology in nuclear cataract ?

Answer 7

nuclear sclerotic cataract is considered an exaggerated aging process
deposition of urochrome pigments giving it a yellow hue

Question 8

what is the second sight of age phenomenon ?

Answer 8

nuclear cataract is associated with myopia due to the increased refractive index of the nucleus resulting in some elderly patients being able to read again without spectacles

Question 9

what is the pathology associated with cortical cataract ?

Answer 9

opacities start as clefts between fibres of the lens then opacification occurs due to cortical hyddration

Question 10

what is the typical image of opacities in cortical cataract ?

Answer 10

typical wedge shaped
or
radial spoke like opacities

Question 11

what cause of congenital cataract is associated with cortical cataract ?

Answer 11

Lowe’s syndrome

Question 12

what cause of congenital cataract is associated with radial spoke like arrangements of opacities in the posterior lens cortex ?

Answer 12

mannosidosis

Question 13

what are the systemic diseases associated with cataract ?

Answer 13

Diabetes
Myotonic dystrophy: Beckers and Duchenne
Neurofibromatosisi type 2
Atopic dermatitis

Question 14

what is the pathology in cataract associated with diabetes ?

Answer 14

glucose is metabolized into sorbitol
sorbitol accumulates inside the lens
becomes osmotic due to over hydration

Question 15

fluctuations in sight in diabetes ?

Answer 15

hyperglycaemia - inc RI - myopia
hypoglycaemia - dec RI - hypermetropia

Question 16

what does classical diabetic cataract look like ?

Answer 16

snowflake cortical appearance
but rare

Question 17

what type of cataract forms in myotonic dystrophies
?

Answer 17

wedge shaped cortical opacities with a star configuration

Question 18

what type of cataract is associated with atopic dermatitis ?

Answer 18

cataracts are Shield-like dense anterior subcapsular plaque that wrinkles the anterior capsule

Question 19

what is the type of cataract associated with neurofibromatosis type 2 ?

Answer 19

posterior subcapsular
capsular
cortical
or mixed

Question 20

what are the local diseases of the eye associated with cataract ?

Answer 20

chronic anterior uveitis
acute congestive glaucoma
high myopia
hereditary fundus dystrophy
or secondary to mediications

Question 21

what is the most common cause of secondary cataract ?

Answer 21

chronic anterior uveitis
related to duration and intensity of inflammation

Question 22

what does the cataract look like associated with acute congestive glaucoma ?

Answer 22

anterior grey white capsular opacities in the pupillary area
glaukomflecken

Question 23

what is thee association between high myopia andd cataract ?

Answer 23

associated with posterior subcapsular lens opacitty
and early onset nuclear sclerosis

Question 24

what are the hereditary fundus dystrophies ?

Answer 24

retinitis pigmentosa leber congenital amaurosis Stickler syndrome

Question 25

what is the type of cataract associated with steroids whether topical or systemic ?

Answer 25

posterior sub capsular

Question 26

what is the most common cause of unilateral cataract in young individuals ?

Answer 26

traumatic cataract

Question 27

what other ocular injuries are associated with traumatic cataract ?

Answer 27

iridiodialysis seperation of the iris from its insertion on the ciliary body

Question 28

what are the symptoms of cataract ?

Answer 28

blurry vision - cloudy photophobia glare - halos around light especially at night changes of glasses prescription ( including sudden near sightedness ) need for brighter light to read difficulty seeing at night

Question 29

what are the indications of surgery in age related cataract ?

Answer 29

visual improvement - most important indication cataract affecting health of the eye

Question 30

what is the concept in cataract surgery ?

Answer 30

removal of the clouded lens insertion of thee IOL

Question 31

what is the difference between ICCE and ECCE surgery ?

Answer 31

ICCE - removal of thee whole lens including the capsule ECCE - lens is reemoved capsule is left for thee IOL

Question 32

when is ECC indicated ?

Answer 32

in patients with very hard cataract

Question 33

what is phaeoemulsification ?

Answer 33

emulsification of the contents of the lens using ultrasonic vibrations aspirating the emulsified cataract new IOL implants conventional surgery nowadays

Question 34

what are the ophthalmic pre operative assessments ?

Answer 34

visual acuity cover test - to seen if there is any amblyopia pupillary reflex - as cataract doesn't cause RAPD Cornea examination Anterior chamber depth lens Fundus exam current refractive status informed consent biometry

Question 35

what are thee operative complications associated with cataract surgery ?

Answer 35

post op endophthalmitis rupture of the posterior capsule of the lens loss of some lens fragments in the vitreous dislocation of the IOL suprachoroidal hge

Question 36

what is ectopia lentis ?

Answer 36

displacement of the lens from its place

Question 37

what are the types of ectopia lentis ?

Answer 37

hereditary acquired

Question 38

what are the 2 possible presentations of ectopic lentis ?

Answer 38

luxated - making the eye essentially aphakic subluxated - partial displacement

Question 39

what is the clinical presentation of the early stages of subluxation ?

Answer 39

phacodenesis - vibration of the lens with eye movement

Question 40

what are the acquired causes of ectopia lentis ?

Answer 40

Hypermature cataract Inflammatory - chronic uveitis Trauma Large eye - bupthalmous , high myopia A - anterior uveal tumors

Question 41

what are the hereditary causes of ectopica lentis ?

Answer 41

with no systemic association : ectopia lentis et pupillae familial ectopic lentis with systemic associations : Marfans syndrome homocystinurea Weill-Marchesani Syndrome

Question 42

what is thee mode of inheritance of ectopica lentis et pupillae familial ectopica lentis

Answer 42

ectopica lentis et pupilla : AR familial ectopica lentis : AD

Question 43

what is the presentation of ectopica lentis et pupillae ?

Answer 43

congenital bilateral affection where thee pupil and the lens are displaced in the opposite direction asymmetric and eccentric oval pupils dilate poorly

Question 44

what is the presentation of familial ectopica lentis ?

Answer 44

symmetrical supertemporal dislocation of thee lens

Question 45

what are the features of marfan's syndrome ?

Answer 45

superotemporal subluxatiioin high-arched plate long fingers andd toes

Question 46

what are the ocular features associated with marfan's syndrome ?

Answer 46

superotemporal lens dislocation glaucoma retinal detachement strabismus

Question 47

what are the systemic features of weill-marchesani syndrome ?

Answer 47

short fingers short stature learning difficulties

Question 48

what are the ocular manifestations of weill-marchesani syndrome ?

Answer 48

ectopica lentis subluxation is in the inferior direction microspherophakia

Question 49

what is a common ocular compliicattion associated with weill-marchhesani synddrome ?

Answer 49

acute angle closure glaucoma

Question 50

what are the systemic features of homocystinuria ?

Answer 50

coarse blonde hair blue irises malar flush

Question 51

what are the ocular manifestations associated with homocystinuria ?

Answer 51

zonules are lax so lack of accomodation ectopia lentis is infero nasal

Question 52

what is the treatment for homocystinuria ?

Answer 52

oral pyridoxine folic acid vitamin b12