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65 Cards in this Set

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congenital malformation, may be isolated or as part of systemic pattern, may have a hereditary pattern. is this a Dysgenesis, dystrophy, or degeneration?
dysgenisis
generally a hereditary pattern, generally bilateral, tends to predispose the central cornea, may become more pronounce with age but age is not the primary cause, each exhibits a distictive pattern based on corneal layer involved and appearance with biomicroscopy scope.is this a Dysgenesis, dystrophy, or degeneration?
dystrophy, bilateral, bereditary, and central cornea are the give aways
no developmental or gereditary pattern, unilateral or bilateral, may be a manifestation of age, usually starts in peripheral cornea, but may ultimately involve the central cornea, inflammoatory process may be involved early i the process, systemic disease may be associated with the degeneration. is this a Dysgenesis, dystrophy, or degeneration?
degeneration. uni or bi, no pattern, and starts peripheral are the give away's.
what race is arcus most common in
African Americans
is arcus unilateral or bilateral?
bilateral
what is characterized by a 1-2 mm white band in the mid periphery of the cornea? (the white is cholesterol)
Arcus (senilis)
what layer of the cornea is arcus found in?
Bowmans
DDX of arcus
hyperlipidemia/high cholesterol
not an unusual facror if over 40 or 50
if under 40 consider CV disease and risk factors.
what is the treatment plan for arcus?
refer for medical exam if it has been more than 2 years and re-evaluate again in a year.
what corneal degeneration is bilateral, consists of a narrow band of white crystalline like opacity in nasal and temporal limbus area and stays there.
Limbal Girdle of Vogt
what is the difference b/t type I and type II limbal girdle of vogt?
type I - is associated with early band keratopathy. you can see a clear zone b/t the limbus and the opacity line.
type II- no clear zone.
what is the treatment for limbal girdle of vogt?
nothing for type II for type I you treat the band keratopathy.
what is the cause of limbal girdle of vogt? on a cellular level
degeneration of collagen fibers, not vascularized.
is limbal girdle of vogt unilateral or bi?
bi
is limbal girdle of vogt unilateral or bi?
bi
age range for limbal girdle of vogt?
older 45+, old women need girdles
what is seen as an area of corneal thinning secondary to corneal drying from an adjacent area of tissue elevation, appear as focal thinning with overlying pool of flourescein.
dellen
what is the treatment for dellen?
lubrication and therapeutic scl
hassall henle bodies is a thickening of what corneal layer
descemets
what should Hassall Henle bodies be ddx from
Fuchs central
small round thickenings of descemets membrane with overlying endothelial displacement in peripheral cornea = peripheral corneal guttata. describes what?
hassall henle bodies.
what do you need to DDX nalssall henle bodies from?
Fuchs which is central
what is described as bilateral inferior (possibly peripheral) corneal thinning with bulging of the cornea above the thinning to give ATR astigmatism?
pellucid marginal degeneration
how would you treat pellucid marginal degeneration?
with a gas perm cl, or possibly keratoplasty.
what is a slowly progressive peripheral thinning of the cornea with pannus that starts superiorly and spreads circumferentially?
terriens marginal degeneration.
what is seen as bilateral thinning in or adjacent to arcus?
marginal furrow degeneration
what systemic diseases is marginal furrow degeneration associated with?
ring ulcer seen with acure rheumatoid arthritis, systemic lupus erythematous,leukemia, polyarteritis nodosa, tuberculosis.
what is the treatment for marginal furrow degeneration?
treat the underlying systemic cause
describe Moorens ulcer in older pts and younger pts
older patients - unilateral, and usually responds to tx
younger patients - bilateral 25% and is difficult to manage.
what is bilateral and appears as small gray polygonal patches of various sizes at the level of descemets membrane
posterior crocodile shagreen
objectively you see a fleshy mass that creates a nodular surface that is salmon pink to yellow in color with possibly some vascularization. what is it describe where it is and why.
Amyloid degeneration, this is degenerations in the area of bowmans and the epi and is secondary to long standing disease like trachoma, glaucoma, uveitis, bullous keratopathy.
a patient has a history of getting a foreign body in the eye and now has a white ring what is it called?
coats white ring.
what type of deposits are seen with band keratopathy? And where are they located?
calcium deposits located in the interpalpebral fissure
what layer are the deposits located in, in band keratopathy?
bowmans or anterior stroma, It may cause RCE
what may be secondary to ocular inflammation or systemic diseases such as chronic anterior uveitis, prolonged glaucoma, phthisis bulbi, hypercalcemia conditions: sarcoid, vit D toxicity, hyper parathyroid, metastatic carcinoma of the bones.
band keratopathy
what would you do to treat band keratopathy?
refer if systemic,
for ocular you could use lubricating drops, chelating agents (EDTA), or you could scrap off.
what has multiple bluish white nodules usually at the mid periphery that look like many fingers coming in from the periphery of the cornea?
salzmann's Nodular Degeneratoin.
what has keratinization of the epithelium from atrophy of conjunctival goblet cells, corneal edema and neo. usually due to vit. A deficiency and looks like yeast under the conj?
xerophthalmia
What is generally from Vit. A deficiency and consists of acute corneal tissue liquefaction?
Keratomalacia.
what is in a verticle spindle shape, brown in color on the posterior cornea, usually on the inferior 1/3 to 1/2?
kruckenbergs spindle
what does kruckenbergs spindle suggest has happened before?
old uveitis, or pigment dispersion.
what kind of precautionary tests should be done if you see a Kruckenbergs spindle?
you should perform a transillumination on the iris to look for loss of pigment and also test for glaucoma.
wht looks like greyish or golden epithelial deposits that appear in a swirl pattern from a point below the pupil and occurs in pts with Fabry dz or that are taking drugs such as amiodarone, hydroxychloroquine, indomethacin, or tamoxifen.
vortex keratopathy.
what is in the shape of a triangle or diamond on the endo of the cornea at the 6 o'clock position and is a pathognomonic for old uveitis
Arlt's Triangle
what consists of a brownish pixle looking haze on the cornea that can be edematous and is pathognomonic for EBMD and RCE
Brawny cornea
what is a ferric ring around a surgical filtration bleb that is orangish-brown in color called?
Ferry ring
what is the ferric ring around a keratoconic cone called? think of a fly fisherman casting around a street cone.
fleishers ring
what can you do to see the ferric ring at the base of a keratoconic cornea?
use a cobalt blue filter.
brown horizontal line in the inferior cornea related to pigmentary glaucoma
Goars line
reddish brown in color inside of the inracorneal or posterior corneal surface blood stain what is it called
hemosiderosis
orangish brown in color deposition in the areas of the upper and lower lid junction. this is a frequent site of RCE.
Hudson Stahli line. the key is that is can be on the superior and inferior where as goars line is only in the inferior.
what is related to wilsons dz and shows as copper deposit in the posterior cornea? looks like arcus but is orangeish
kaiser fleischer ring. wilsons dz is lever cirrhosis.
what is it called when there are pigmented spokes radiating out into the cornea from the limbus usually at 4 and 8 oclock and usually in darker eyes.
deratomelanocytosis.
what is similar to pannus other than its color. this is more orange and is in the mid stroma
salmon patch
pigment granules at schwalbes line is called what?
sampaolesi's line.
orangish brown line at the leading edge of a pterygium.
stockers line.
what is the ICE stand for in ICE syndrome?
iridocorneal endothelial syndrome
is the ice syndrome usually unilateral or bilateral?
typically unilateral
The ice syndrome consists of three overlapping disorders what are they?what is the link b/t them all?
chandler syndrome, cogan reese syndrome, progressive iris atrophy.
they all have abnormal corneal endothelium
what is abnormal about the endothelium in ICE syndrome?
the endo can migrate into the angle and cause an angle closure.
what are some of the objective signs that you will see with the ICE syndrome?
corectopia (malposition of the pupil)
pseudopolycoria (multiple pupils) in a previously normal pupil.
iris atrophy
corneal endothelial abnormalities (edema or fuch's)
ICE syndrome is associated with chandler, cogan reese syndrome, and progressive iris atrophy. which one consists of severe corneal changes, corneal edema, and the iris is normal or has mild atrophy?
chandler syndrome
ICE syndrome is associated with chandler, cogan reese syndrome, and progressive iris atrophy. which one consists of diffuse nevi (iris nodules), iris surface is matted looking, and 50% of the iris is atrophied (is that a word?)
cogan reese syndrome.
ICE syndrome is associated with chandler, cogan reese syndrome, and progressive iris atrophy. which one consists of severe iris changes, iris stromal atrophy, iris hole formation, pupil displacement towards area of synechiae
progressive iris atrophy
with all three ICE disorders what needs to be watched closely other than the endothelium?
pressures with progressive iris atrophy having the highest prevelance.