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88 Cards in this Set
- Front
- Back
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Type I
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anaphylactic/immediate hypersensitivity
hay fever, vernal, atopic, GPC |
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Type II
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cytotoxic hypersensitivity
OCP, Mooren's ulcer |
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Type III
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immune complex deposition
Stevens-Johnson, marginal infiltrates, disciform keratitis, subepithelial infiltrates, Wessley ring, scleritis, retinal vasculitis |
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Type IV
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cell-mediated, delayed hypersensitivity
phlyctenule, graft reaction, contact dermatitis, interstitial keratitis, granulomatous disaease (TB, syphilis, leprosy) |
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Type V
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stsimulating antibody
Graves' disease, myastenia gravis |
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iron lines
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stocker = pterygium
Ferry = filter bleb Fleischer = KC Hudson-Staehli = normal aging, nocturnal exposure |
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Bowman vs Descemet's
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- Bowman: not a true basement membrane, 10 micron, type 1 collagen, does not regenerate
- Descemet's: 3 - 12 micron, PAS positive basement membrane, type 4 collagen, regenerates if endothelium intact |
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MMPs
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only MMP2 found in healthy cornea, all other only after injury
MMP1: collagenase-1, breaks down 1, 2 and 3 MMP2: gelatinase A: only found in healthy cornea, 4, 5 and 7, gelatin, fibronectin MMP3: stromalysin: proteogycans and fibronectins MMP9: 4, 5 and 7, gelatins, fibronectin MMP1, 2, 3 made by stroma, 9 by epithelium MMP2 |
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cornea innervation
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CNV1, 70 to 80 branches of long posterior ciliary nerves
loose myelin sheath 1-2 mm before limbus |
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corneal staining
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fluorescein: epithelial defects
Rose bengal: tissue deficient of albumin and mucin including devitalized cells Lissamine green: devitalized cells, CIN, more comfortable than Rose bengal |
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EKC
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epidemic keratoconjuunctivitis, AV 8 and 19
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PCF
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pharyngoconjunctival fever: AV 3 and 7
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recurrence of malignant melanoma
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usually amelanotic
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bleach
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sodium hypochloride, ph11
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interstitial keratitis
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lymphgranouloma venerum (chlamydiae)
protozoae: leshmaniasis, african sleeping sickness (TAenia cruzi), malaria, onchocerciasis, cysticercosis (Taenia solium) |
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filametnary keratitis
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also: prolonged patching
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Crocodiles shagreen
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cracked ice appearance
anterior at Bowman's level posterior at Descemet's |
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inheritance of mucopolysaccharidoses
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AR, except Fabry's (XR)
most retina (except Fabry's) |
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inheritance of sphingolipidoses
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AR, except Fabry's (XR)
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Mooren's ulcer
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painful
nasally or temporally, then 360 type 2 hypersensitivity reaction hep C, Crohn's |
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crystalline keratopathy
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strep viridans, candida
topical steroids in graft |
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HSV epithelial keratitis
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terminal bulbs (accumlation of vesicular cells)
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immune ring
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Wessley's ring
type 3 hypersensitivity reaction HSV antigen precipitates and neutrophilas around area of stromal edema |
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HSV stromal keratitis
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topical steroids reduce risk of persistent or progression by 68%
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HZO
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blunt ends, no terminal bulbs, no ulceration, minimal staining
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acanthamoeba meds
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antibacterial: neomycin
antifungal: miconazole antiparasitic: polyhexamethylene biguanide (PHMB, Baquacil) |
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keratoconus
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also associated with CHED and PPMD
breaks in Bowmans membrane |
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BIGH-3
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TGF-beta inducible gene H3 = keratoepithelin
affect central cornea not BIGH3: Meesmann's, macular, fleck, CHED, CHSD, all of which extent to limbus |
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Reiss-Buckler's
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AD, BIGH3, common recurrence in PKP
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mnemonic corneal dystrophies
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macular, mucopolysaccharide, Alcian blue
Granular, Hyaline, Masson's trichrome lattice, amyloid, congo red |
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macular
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limbus to limbus
keratan sulfate AR |
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lattice
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more likely recurrence in PK than macular or granular but less than Reis-Bucklers
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necrotizing scleritis
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14% associated with life-threatening autoimmune disease (5-year mortality 25%)
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blue sclera
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Ehler-Danlos, Hurlers, Turners, Marfans?, osteogenesis imperfecta, scleromalacia perforans, congenital staphyloma
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excimer laser ablation depth
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193 nm
Munnerlyn equation: depth = (refractive error/3)xOZ^2 |
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DLK
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diffuse lamellar keratitis
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VLDLR and RPR
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detect antilipoidal antibodies produced by the host during treponemal infection
RA, lupus erth have similar anitbodies |
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agar to identify mycobacteria
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Loewenstein-Jensen
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agar to identify fungi
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Sabouraud's agar
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calcofluor white
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binds to cell wall of fungi and acanthamoeba
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agar to grow Moraxella
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blood agar in 5-10% CO2
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Haemophilus agar
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chocolate agar (requires hemin and nicotinamide adenine dinucleotide (NAD))
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filamentous fungi antifungal (fusarium)
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natamycin
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HSV keratitis
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- trifuridine (viroptic) 9/day
- vidarabine 3% oint 5/day - acyclovir oint 5x/day - famiciclovir 500 mg 2x/day - valacyclovir 500 to 1000 mg 2x/day |
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megalocornea
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x-linked, >13 mm
Down, Marfan's, Alport's, craniosynostosis, facial hemiatrophy |
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posterior embyrotoxon
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autosomal dominant
anteriorly displaced Schwalbe's line |
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Axenfeld's anomaly
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autosomal dominant
posterior embryotoxon and prominent iris processes attaching to Schwalbe's line |
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Axenfeld syndrome
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autosomal dominant
Axenfeld anomaly - glaucoma, skeletal abnormalities, hypertelorism, hypoplastic shoulder |
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Rieger's anomaly
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autosomal dominant
Axenfelds anomaly and anterior iris stromal hypoplasia, glaucoma 60% |
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Riegers syndrome
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autosomal dominant
Rieger's anomaly + maxillary hypoplasia, microdontia, bony malformations |
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Peter's anomaly
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sporadic
absence of posterior corneal tissue and leukoma can have iris adhesions to leukoma can have lens-corneal adhesions |
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blue sclera
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Hurler's (mucopolysaccharidosis type 1
Turner's osteogenesis imperfecta |
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conjunctival cicatrization
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atopic keratoconjunctivitis
Steven's Johnson ocular cicatricial pemphigoid |
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sclerocornea
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90% OU
50% sporadic, 50% dominant or recessive |
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ICE
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iridocorneal endothelial syndrome
Chandler's syndrome (corneal edema) Cogan-Reese syndrome (iris nevus) essential iris atrophy |
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choristoma
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normal tissue in abnormal location
versus hamartomas with abnormal growth of tissue in normal location |
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enlarged corneal nerves
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MEN IIb
Refsum disease congenital glaucoma ichtyosis |
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CHED
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congenital hereditary endothelial dystrophy
rare, bilateral corneal clauding due to endothelial and Descemet's defect AR: more common, at birth, nystagmus, no pain, no progression AD: 2nd year of life, pain, photophobia, no nystagmus, progressive |
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CHSD
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AD rare, nonprogressive, diffuse, feathery opacification of superficial cornea
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corneal erosions in granular dystrophy
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uncommon; very common in lattice dystrophy
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Meesmann dystrophy
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peculiar substance subepi but not BIGH3
AD |
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tx of staphylococcal marginal infiltrate
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steroids
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invade intact cornea
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HIB, Neisseria spp, Croynebacterium, Listeria
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sectoral iris atrophy
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only HZV, not HSV
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ulcerated epithelial lesion: HZV vs HSV
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only HSV
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central crystalline Schnyders
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AD, minute yellow white crystals beneath Bowman's in central doughnut-like pattern
cholesterol |
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intracytoplasmatic inculsions
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chlamydia
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rose bengal and HSV/HZV
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HSV devitalized, stains well bordering dendritic lesions
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acanthamoeba keratitis
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simple mechanical debridement may be curative when confined to the epithelium
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CL ulcer
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pseudomonas
no gram negative coverage with cefazolin |
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ocular cicatricial pemphigoid
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dapsone, systemic steroids,
caused by timolol, antivirals, mitotics, epinephrine |
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filamentous keratitis
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not caused by floppy iris
patching, dry eyes, superior limbal keratoconjunctivitis |
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superficial phototherapeutic keratectomy
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Reis-Bucklers, granular dystrophy, EBMD
not: Fleck dystrophy |
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chemical burn and PF
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only for 7 days not to potentiated collagenases
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scleritis and Behcet
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no association
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most frequent indication of PK in children
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Peters anomaly
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endothelial graft rejection percentage
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25%
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maximal arcuate incision length
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90 degree
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anterior polar cataract
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90% idiopathic remnants of the hyaloid system
association with anterior lenticonus and Alport's syndrome (deafness, glomerulonephritis) |
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amiodarone cataract
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stellate anterior axial pigment deposition (same as phenothiazine)
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risk of RD in Marfan
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very high
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homocystinuria
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associated with ectopia lentis along with PHPV
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Wedl cells, hydropic swelling, morgagnian gobules
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- Wedl (or bladder) cells = posterior migration of lens epithelial cells, which swell along th eposterior capsule
- cortical cataracts = hydropic swelling - eosinophilic, globular material between lens fibers |
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homocystinuria and vitamins
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elevated serum homcystine and methionine
AR, vit b6 seizures, osteoporosis, mental retardation lens dislocation bilateral, symmetric, inferonasal |
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hyperlysinemia
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ectopia lentis
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microspherophakia
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Alport syndrome
congenital rubella Weill-Marchesani |
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sutured PCIOL
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sulcus is 0.83 mm posterior to limbus
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"vitamin" for Leber's hereditary optic neuropathy
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coenzyme Q
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