631 -11 Lens Abnormalities Mid Term 2

Front 1

% of water that makes up the lens

Back 1

65% water, 35% protein and trace minerals

Front 2

glucose metabolism in the lens is mainly aerobic or anaerobic?

Back 2

anaerobic

Front 3

the Y sutures surround what nucleus?

Back 3

the fetal

Front 4

name the nuclei in the lens from outer to inner

Back 4

adult, infantile and fetal

Front 5

why is an adult lens brighter

Back 5

b/c of light scatter

Front 6

the lens epithelium is only present on the anterior or posterior of the lens

Back 6

anterior

Front 7

what is the diameter of the lens, at birth, age 2, adult W x D

Back 7

at birth - 7mm
age 2 - 9mm
adult - 9.6mm diameter and 4.2mm width.

Front 8

congenital/ developmental lens anomalies include what

Back 8

aphakia, lens shape abnormalities, congenital/developmental cataract, and downs syndrome

Front 9

what are the two types of congenital aphakia

Back 9

primary where there was no induction of the lens
secondary aphakia where the lens was expelled or reabsorbed in utero

Front 10

secondary congenital aphakia is associated with what genetic problems

Back 10

wallenbergs syndrome, trisomy 18, rubella, peters anomaly.

Front 11

objective findings of a pt with congenital aphakia

Back 11

microphthalmos, lack of fully formed anterior segment, flat corneas and a small palpebral fissure.

Front 12

is putting a lens in a pt that has congenital aphakia a good idea?

Back 12

no b/c they do not have a capsule so you would have to put it in the anterior which is dangerous

Front 13

microphakia could be caused by anything that causes early arrestment of the development of the eye such as

Back 13

smoking and drinking

Front 14

what type of problems are associated with microaphakia

Back 14

severely reduced VA's, blindness, nystagmus

Front 15

microphakia is?

Back 15

a smaller than normal diameter lens

Front 16

microspherophakia is

Back 16

abnormally small crystalline lens

Front 17

microspherophakia could be from

Back 17

familial microspherophakia (isolated to the eye)
weill marchesani syndrome CT disorder, short, brachydactyly, stiff
marfans syndrom
hyperlysinemia

Front 18

microspherophakia pts are usually myopic or hyperopic

Back 18

severely myopic due to rounder lens

Front 19

lens colobomas are generally in what direction

Back 19

inferior- nasal.

Front 20

what is posterior lenticonus

Back 20

curcumscribed round or oval bulge at the posterior axial zone of the lens that increases in size with age

Front 21

what is the difference in etiology in a person that has posterior lenticonus in one eye versus two

Back 21

unilateral: sporatic genetic pattern
Bilateral: familial genetic pattern.

Front 22

which part of the lens may become opaque in a person that has posterior lenticonus

Back 22

the cortex

Front 23

anterior lenticonus is associated with what synderome

Back 23

Alports syndrome

Front 24

what is Alports syndrome

Back 24

a basement membrane disorder, with progressive hereditary nephritis, sensorineuronal deafness, cataracts, retinal flecks, and corneal posterior polymorphous dystrophy

Front 25

when a lens is completely dislocated from pupillary space it is known as

Back 25

luxated

Front 26

when a lens is partially dislocated from pupillary space either to the left, right, high or low it is known as

Back 26

sub luxated

Front 27

Ectopia lentis refers to what

Back 27

a lens being either subluxated or luxated

Front 28

what are some ways that an ectopia lentis could be acquired

Back 28

trauma, very large eye, anterior uveal tumors, congenital syphilis, hypermature cataract.... or it could be hereditary

Front 29

what are some ways that ectopia lentis is present due to hereditary problems

Back 29

marfans syndrome
weill marchiesani syndrome
homocystinuria
hyperlysinemia
stickler's syndrom
ehlers danlos syndrome
familial ectopia
aniridia
sulphite oxidase deficiency

Front 30

what syndrome is is described as a multi organ connective tissue disorder that is autosomal dominant, causes long legs, and possibly aortic aneurism.

Back 30

marfan syndrome

Front 31

what is the triad of marfan syndrom

Back 31

cardiac anomalies - aortic aneurism
skeletal anomalies - high arched pallet, long limbs/fingers
muscular underdevelopment - hernias

Front 32

what syndrome is associated with a bilateral subluxed lens upward, that may be microspherophakic

Back 32

marfan syndrome

Front 33

other than lens abnormalities what other ocular affects are seen with marfan syndrome

Back 33

angle anomaly (thick tm), RD, hypoplasia of dilator pupillae muscle, flat corneas, axial myopia.

Front 34

what syndrome is an autosomal dominant CT dissorder that causes short stubby fingers and mental handicap

Back 34

weill marchesani syndrome

Front 35

this pt has microspherophakia, a lens dislocated downward that happened around age 20 and there is an angle anomaly secondary to mesodermal dysgeneses.

Back 35

weill marchiesani syndrome

Front 36

what appears like marfans syndrome but instead of having arachnodactyly they have osteoporosis with froctures and frequent mental handicap, platelet stickiness, fine light hair, and rosy cheeks

Back 36

homocystinuria

Front 37

is the lens subluxated down or up with homocystinuria? can they still accommodate

Back 37

down and they cannot accommodate

Front 38

if a person is lysine dehydrogenase deficient at birth what is it called

Back 38

hyperlysinemia

Front 39

what ocular problems are associated with hyperlysinemia

Back 39

microspherophakia

Front 40

a person has a wedge shaped cataract and retinal degeneration and tears what syndrome do they most likely have

Back 40

sticklers syndrome

Front 41

what is the name of the syndrome that is a collagen disorder that causes hyperelastic skin/joints, aneurysms, and hernias. in the eye you may see angioid streaks, keratoconus, blue sclera and a subluxed lens

Back 41

ehlers-danlos syndrome

Front 42

what are angiod streaks. what syndrome are they associated with

Back 42

breaks in bruchs membrane that cause leakage. associated with ehlers danlos syndrome

Front 43

aniridia has a high association with what general eye problem

Back 43

glaucoma

Front 44

deficiency of what can cause, hereditary ectopic lens, progressive muscular rigidity and death b/f age five.

Back 44

sulphite oxidase deficiency

Front 45

what problem is thought to be secondary to abnormal basement membrane produced by aging epi cells

Back 45

pseudoexfoliation

Front 46

if a person has glaucoma and pseudoexfoliation what is known as

Back 46

pseudoexfoliative glaucoma

Front 47

what is the most common presenting sign on a person with pseudoexfoliation

Back 47

secretion of grey white fibrillogranular material off of the lens epi. see this by dilating.

Front 48

pseudoexfoliation is unilateral or bilateral?

Back 48

often unilateral but could be asymetric bilateral

Front 49

what causes the excretions to come off of the lens in pseudoexfoliation

Back 49

the iris rubbing on the lens

Front 50

other than the lens where else could pseudoexfoliation occur?

Back 50

iris, ciliary body, zonules

Front 51

what symptoms are present with pseudoexfoliation

Back 51

none

Front 52

pseudoexfoliation is most common is what ancestory of people

Back 52

northern europeans

Front 53

what drug should you use if pseudoexfoliation glaucoma is present

Back 53

a beta blocker to stop the production of aqueous

Front 54

are pts with pseudoexfoliation a good candidate for cataract surgery

Back 54

nope their zonules are weak

Front 55

glaukomflecken is due to what? what occurs?

Back 55

glaukomflecken is secondary to acute congestive angle closure glaucoma. epithelial tissue on the lens is necrotic.

Front 56

what kind of VA changes come with glaukomflecken

Back 56

none

Front 57

is glaukomflecken reversible?

Back 57

yes if the IOP is treated properly

Front 58

what are the three types or locations for glaukomflecken

Back 58

anterior, subcapsular or capsular

Front 59

what type of cataract may have an associated persistent pupillary membrane

Back 59

anterior polar

Front 60

where does a lamellar cataract occur

Back 60

b/t two zones usually surrounding the fetal or nuclear zones

Front 61

what two cataracts could both be at the nuclear cortical junction?

Back 61

lamellar and coronary. coronary is a type of lamellar

Front 62

a cataract with granular flecks could be in what layer(s)

Back 62

either nuclear or cortical

Front 63

sub capsular cataracts are generally what shape

Back 63

round and distinct

Front 64

do cataracts progress faster in diabetics or nondiabetics

Back 64

diabetics

Front 65

describe a true diabetic related cataract

Back 65

bilateral white punctate or snowflake that could be on the anterior or posterior and may appear in a few days

Front 66

central "oil droplet" cataract is associated with what metabolic problem

Back 66

galactosemia

Front 67

are cataracts (oil droplet) due to glactosemia reversible or not

Back 67

yes is all milk products are removed from diet

Front 68

what is autosomal recessive and causes a lamellar cataract in early infancy

Back 68

galactokinase deficiency

Front 69

in galactokinase deficiency what does galactose get reduced into

Back 69

they are unable to metabolize galactose so it is reduced to dulcitol - increasing the osmotic pressure

Front 70

what condition is worse galactosemia or galactokinase deficiency

Back 70

galactosemia

Front 71

mannosidosis is an accumulation of oligosaccharides. what type of cataract is formed in alpha mannosidase deficiency?

Back 71

corticle posterior subcapsular. this is what differentiates it from Hurlers disease

Front 72

is lowes syndrome recessive or dominant

Back 72

X linked recessive

Front 73

what type of ocular signs come with Lowes syndrome

Back 73

microphakia (small disc like lens) and lens opacities in the capsule, nuclear, or total

Front 74

what will be seen in hypocalcimia in the lens

Back 74

multicolored crystals/ discrete white flecks in the lens that seldomly progress to maturity

Front 75

blue dot cataract is seen in what dystophy

Back 75

myotonic dystrophy. blue dot can turn in to psc and this can turn to a total cataract

Front 76

what signs other than cataract will you see with myotonic dystrophy

Back 76

frontal balding, temporal muscle wasting, and ptosis

Front 77

what is the most common cause of a congenital cataract

Back 77

rubella

Front 78

why is rubella less common now

Back 78

immunizations

Front 79

what are the classic rubella signs

Back 79

deafness, cataracts, heart defects, microcephaly, severe mental retardation

Front 80

cerebral calcification is associated with what

Back 80

congenital toxoplasmosis

Front 81

a person may get a cataract from aids associated with congenital cytomegalovirus. what causes the cataract

Back 81

the drug cocktail

Front 82

anterior, posterior or total cataract could be seen with uveitis. what is it from

Back 82

either long standing anterior or posterior uveitis or from the steroids in treatment

Front 83

why would a person with aniridia get cataracts

Back 83

increased uv exposure

Front 84

true or false high myopes have an increased risk for cataracts

Back 84

true, posterior lens opacities, earlier nuclear cataract development....?

Front 85

glassblowers get exfoliation or pseudoexfoliation

Back 85

true exfoliation they get splitting and peeling of the capsule

Front 86

welders flash burn is called what

Back 86

actinic keratopathy/solar keratopathy

Front 87

what type of deposits occur in a traumatic cataract

Back 87

crystallin deposits

Front 88

what % of reduction of cataracts is seen in people that take a multi vitamin for more that 10 years

Back 88

60%

Front 89

what reduces the risk of cortical cataracts in women

Back 89

vit. C

Front 90

what reduces the risk of posterior cataracts in women that have never smoked

Back 90

carotinoids

Front 91

lutein and zeaxanthin are what

Back 91

carotinoids that reduce the risk of cataracts

Front 92

true or false a cataract can form before birth if the mother is taking steroids

Back 92

true

Front 93

chlorpromazine is a drug that is taken for schizophrenia. what are the 5 stages for cataract formation in these pts

Back 93

fine dots anterior
opaque dot like in early stellate pattern
anterior stellate patter - yellowish
3-9 point star seen w/naked eye
central pearl like mass w/clumps

Front 94

how often should you see a person that is on the drug chlorpromazine for schizophrenia

Back 94

annually

Front 95

what anti arrhythmic drug is notorious for corneal whorl keratopathy

Back 95

amiodarone

Front 96

what type of cataract is seen with amiodarone

Back 96

fine anterior subcapsular

Front 97

what compounds used for tanning skin call for extra precautions when in use and in uv light

Back 97

psoralen - wear sunglasses up to 24 hrs a day if high risk

Front 98

your pt has gold deposits in their lens and corneal stroma. From taking gold supplements for arthritis. how do you manage this

Back 98

you dont it is usually not a problem

Front 99

long acting cholinesterase inhibitors (miotics) cause what in the lens

Back 99

anterior subcapsular vacuoles that eventually coalesce and become more advanced opacities

Front 100

mercury causes what color of deposits on the cornea

Back 100

grey