Crystalline Lens Disorders

Front 1

types of age related cataracts

Back 1

nuclear
cortical
(morgagnian)
subcapsular

Front 2

at what age do age related cats first appear?

Back 2

30-40

Front 3

age related cats occur in ___% of people over 70

Back 3

90%

Front 4

what test should be done on pts over 50 with suspected cats?

Back 4

BAT

Front 5

medicare standards for cat removal

Back 5

VA <20/70 BAT

Front 6

t/f nuclear, cortical, subcap are usually found in coexistance

Back 6

true

Front 7

subdivisions of nuclear cat

Back 7

early or advanced
brunescent, milky, or nigra

Front 8

subdivisions of cortical cat

Back 8

early or incipient
immature or intumescent
mature
hypermature

Front 9

subdivisions of subcap cat

Back 9

early
moderate
advanced

Front 10

t/f it is normal for the lens to harden and pigment with age

Back 10

true

Front 11

pigmenting with age is called

Back 11

nuclear sclerosis

Front 12

t/f nuclear sclerosis interferes with VA

Back 12

false - only in advanced stage, which is then considered nuclear cat

Front 13

describe the color progression of a nuclear cataract

Back 13

from orange to dark brown (brunescent)

Front 14

nuclear cat involves fetal nuc - does fetal nuc appear darker or lighter than adult nucleus?

Back 14

darker

Front 15

what type of cat can result in lenticular myopia (second sight)?

Back 15

nuclear cat

Front 16

the most common type of age related opacity

Back 16

cortical cat

Front 17

cortical cat can be in what two shapes?

Back 17

cuneiform (wedge) or coronary (spoking)

Front 18

early stage cortical cat appearances..

Back 18

water clefts (ant cortex)
lamellar separation (ant cortex)
cuneiform opacity
clear vacuoles
senile punctate opacities

Front 19

how would you 'look' at the clear vacuoles found in corical cat?

Back 19

w/ retroillum

Front 20

the most characteristic sign of cortical cat

Back 20

cuneiform opacity

Front 21

most common location of the water clefts assoc with cortical cat

Back 21

anterior cortex

Front 22

what type of cat is formed from a large number of senile punctate opacities?

Back 22

snowflake cat (type of cortical cat)

Front 23

appearance of a hypermature cortical cat

Back 23

shrunken, dry, yellow
capsular folding
appears as a bag of milk

Front 24

morgagnian cat is a type of what kind of cat?

Back 24

cortical cat

Front 25

appearance of morgagnian cat

Back 25

brown nucleus sunk to bottom of capsular bag due to excess liquification

Front 26

christmas tree cat is a type of what kind of cat?

Back 26

cortical

Front 27

christmas tree cat is assoc with what non-ocular condition?

Back 27

Myotonic Dystrophy

Front 28

appearance of christmas tree cat

Back 28

cholesterol crystals scattered throughout cortex

Front 29

under what conditions is good VA still obtained in a morgagnian cat?

Back 29

if nucleus sinks below optic axis

Front 30

subcap cat is aka

Back 30

cupuliform cat

Front 31

cupuliform cat is aka

Back 31

subcap cat

Front 32

what type of cat affects vision the most?

Back 32

subcap

Front 33

does subcap cat usually appear earlier or later than nuclear or cortical?

Back 33

earler

Front 34

t/f anterior subcap is more common than posterior subcap

Back 34

false

Front 35

PSC is almost always found along with a nuclear cat....
under what conditions would we find a PSC alone?

Back 35

middle aged pts on long term NSAID use

Front 36

symptoms of PSC

Back 36

glare when driving
trouble seeing in bright sun
reading difficulties

Front 37

types of metabolic cats

Back 37

galactosemic
diabetic

Front 38

galactosemic cat is due to...

Back 38

inborn error, infant unable to metabolize galactose to glycogen (no galactose-1-phosphate uridyl transferase)

Front 39

what happens if a galactosemic cat goes untreated?

Back 39

death

Front 40

When is a galactosemic cat first evident

Back 40

at birth

Front 41

describe progression of galactosemic cat

Back 41

starts in equatorial cortex and spreads anteriorly till entire lens is opacified

Front 42

two types of cataractous lens changes due to diabetes:

Back 42

1. Early senile lens changes
2. true diabetic cataract

Front 43

early senile changes - what are they and what are they caused from?

Back 43

same changes as seen with age-related type cats, but tend to progress more rapidly; cause diabetic cataract due to diabetes

Front 44

in what type of pts is a true diabetic cat usually found?

Back 44

diabetic children with severe diabetes

Front 45

is diabetic cat usually bilateral or unilateral?

Back 45

bilateral

Front 46

t/f snowflake cortical opacities can be assoc with diabetes mellitus

Back 46

true

Front 47

types of "miscellaneous" cats

Back 47

radiation cat
traumatic cat
complicated cat

Front 48

what type of radiation causes radiation cat?

Back 48

microwave
IR
visible
UV
ionizing

Front 49

most common types of radiation cats

Back 49

exfoliative cat
ionizing radiation cat

Front 50

t/f radiation cats are common

Back 50

false

Front 51

what type of pts get exfoliation cats?

Back 51

those exposed to severe heat; glass blowers & furnace operators

Front 52

which is more common - exfoliation or psuedoexfol?

Back 52

pseudoexfoliation

Front 53

is there a lens opacity found in exfoliation of the lens? what about pseudoexfoliation?

Back 53

exfoliation - yes, starts in posterior subcap region
pseudo - no opacity

Front 54

in what type of pts would you find pseudoexfoliation?

Back 54

no definitive predilection

Front 55

the flakes found in exfoliation are due to...

Back 55

splitting of the anterior lens capsule

Front 56

the flakes found in pseudoexfoliation are due to...

Back 56

the iris rubbing away the deposited material on the anterior lens capsule

Front 57

how does trauma create a cat?

Back 57

consuccsion of the iris to lens with sudden force leads to a semipermeable capsule, which leads to opacification

Front 58

vossius ring

Back 58

a circular pigment deposition on capsule surrounding pupil due to trauma (found in a traumatic cat)

Front 59

capsular tear causes diffuse changes in the lens leading to a quick development of what kind of cat?

Back 59

traumatic

Front 60

subcapsular changes found in a traumatic cataract...

Back 60

rosette shaped opacity
sunflower cat(Cu deposits)
siderosis oculi (rust FBs)
punctate opacities
film-like opacities

Front 61

what type of cat appears to be assoc with uveitis, retinal det, and tumors?

Back 61

complicated cat

Front 62

describe the progression of a complicated cat..

Back 62

start at posterior pole and progress in the form of a rosette cat

Front 63

congenital cat are present at what age?

Back 63

birth to 3 mos

Front 64

are congenital cats usually unilateral or bilateral?

Back 64

either

Front 65

t/f congenital cats aren't usually assoc with ocular or systemic defects

Back 65

false; they're frequently assoc with ocular and systemics

Front 66

ocular defects that cause congenital cats...

Back 66

PHPV
aniridia (no iris)
colobomas
microphthalmos

Front 67

systemic defects that cause congenital cats...

Back 67

ectodermal dysplasia
Werner's
congen Ichthyosis
Dwarfism
LMB syndrome
Sjogrens
RA
Down's

Front 68

Types of developmental cats...

Back 68

anterior axial embryonal cat
suture cat
cerulean cat
coronary cat
polar cat
zonular cat
central pulverulent cat
rubella cat

Front 69

by what age does anterior axial embryonal cat form?

Back 69

6 mos

Front 70

anterior axial embryonal cat affects ____% of children

Back 70

30%

Front 71

describe appearance of anterior axial embyronal cat

Back 71

small crystalline opacities at anterior Y suture

Front 72

is anterior axial embryonal cat unilateral or bilateral?

Back 72

bilateral

Front 73

t/f anterior axial embryonal cats cause no vision symptoms

Back 73

true

Front 74

by what age does suture cat form?

Back 74

6 mos

Front 75

describe appearance of suture cat

Back 75

small crystalline opacities at posterior Y suture; gray or greenish-white lines

Front 76

is suture cat unilateral or bilateral?

Back 76

bilateral

Front 77

does suture cat usually cause a lot of vision probs?

Back 77

no

Front 78

what is the diff btw an anterior axial embryonal cat and a suture cat?

Back 78

ant axial embryonal - anterior Y suture
suture cat - posterior Y

Front 79

cerulean cat is aka

Back 79

blue-dot cat

Front 80

blue dot cat is aka

Back 80

cerulean cat

Front 81

cerulean cat are seen in ____% of infants

Back 81

25%

Front 82

t/f cerulean cats are common

Back 82

true (25% infants)

Front 83

describe appearance of cerulean cat

Back 83

tiny white dots scattered thru entire lens

Front 84

where is a coronary cataract found?

Back 84

outer layers of adult nuc and inner layers of cortex - found in peripheral lens

Front 85

describe appearance of coronary cat

Back 85

corona (spokes) all around peripheral lens

Front 86

is a polar cat found on the capsule or the cortex?

Back 86

can be both

Front 87

what is a polar cat called if its found at both the ant and posterior poles?

Back 87

bipolar cat

Front 88

if a polar cat is peaked forward into the ant chamber, its called...

Back 88

pyramidal cat

Front 89

which parts of the lens are unaffected by an anterior polar cat?

Back 89

embryonic and fetal nucleus

Front 90

is anterior polar cat usually bilateral or unilateral?

Back 90

bilateral, symmetric

Front 91

t/f VAs are usually affected by an anterior polar cat

Back 91

false

Front 92

what other ocular condition is an anterior polar cat usually assoc with?

Back 92

anterior lenticonus

Front 93

what causes a posterior polar cat?

Back 93

hereditary dominant trait

Front 94

abnormal persistence of hyaloid artery remnants are assoc with what type of cat?

Back 94

posterior polar cat (will see mittendorfs dot)

Front 95

describe appearance of the opacity found in a posterior polar cat

Back 95

concave and fastened to back of lens

Front 96

two types of posterior polar cat

Back 96

prenatal form and postnatal form

Front 97

what is the diff btw the prenatal and postnatal forms of posterior polar cats?

Back 97

pre-clear at birth, remains clear for life
post - clear at birth, opacifies later

Front 98

what type of posterior polar cat is most common - pre or postnatal?

Back 98

prenatal

Front 99

what type of opacity is formed in a postnatal (progressing) posterior polar cat?

Back 99

radiating cuneiform and never affecting the nucleus

Front 100

zonular cat is aka

Back 100

lamellar cat

Front 101

lamellar cat is aka

Back 101

zonular cat

Front 102

most common type of developmental cat

Back 102

zonular cat

Front 103

t/f zonular cat affects females more than males

Back 103

false

Front 104

is zonular (lamellar) cat usually bilateral or unilateral? symmetric or asymmetric?

Back 104

bilateral, symmetric

Front 105

two types of zonular cats

Back 105

prenatal
postnatal

Front 106

what is prenatal zonular cat caused from?

Back 106

genetic

Front 107

what is postnatal zonular cat caused from

Back 107

inherent, genetic

Front 108

size of of a prenatal zonular cat

Back 108

<5.75mm

Front 109

size of a postnatal zonular cat

Back 109

>5.75mm

Front 110

what type of cat is often assoc with ca metabolism and vitamin D disorders?

Back 110

zonular cat

Front 111

which parts of the lens are unaffected in a zonular cat?

Back 111

embryonic nucleus & cortex

Front 112

riders can be found in what type of cat?

Back 112

zonular

Front 113

v-shaped opacities that extend out into cortex are called

Back 113

riders

Front 114

central pulverulent cat is aka

Back 114

diffuse nuclear cat of Vogt

Front 115

diffuse nuclear cat of vogt is aka

Back 115

central pulverulent cat

Front 116

at what age does a central pulverulent cat form?

Back 116

3 mo fetus

Front 117

is a central pulverulent cat unilateral or bilateral

Back 117

bilateral

Front 118

describe appearance of a central pulverulent cat

Back 118

distinct white dots in center of lens

Front 119

t/f a central pulverulent cat is nonprogressive

Back 119

true

Front 120

does a central pulverulent cat cause a decrease in VA?

Back 120

no

Front 121

what is the cause of rubella cat

Back 121

maternal infection in first trimester of rubella virus

Front 122

is a rubella cat obvious at birth?

Back 122

yes - as a partial or total opacity

Front 123

rubella syndrome consists of:

Back 123

mental retard
heart probs
deaf
glaucoma
microphthalmos
miotic pupil
salt and pepper retina

Front 124

local deformations in the contour of the anterior and posterior lens surfaces are called

Back 124

lenticonus/lentiglobus

Front 125

which is more common - anterior or posterior lenticonus/globus

Back 125

posterior

Front 126

is anterior lenticonus bilateral or unilateral

Back 126

bilateral

Front 127

describe the appearance of posterior lenticonus/globus in retroillum

Back 127

oil drop

Front 128

is posterior lenticonus bilateral or unilateral?

Back 128

unilateral

Front 129

microphakia

Back 129

small lens

Front 130

small lens

Back 130

microphakia

Front 131

is microphakia unilateral or bilateral

Back 131

bilateral

Front 132

t/f microphakia is fairly common

Back 132

false - its rare

Front 133

what is the name of the condition of a small spherical lens?

Back 133

microspherophakia

Front 134

a frequent complication of microphakia

Back 134

inverse angle closure glaucoma

Front 135

in what syndrome is microphakia commonly found?

Back 135

Weill-Marchesani syndrome

Front 136

most common position of a lenticular coloboma

Back 136

inferior nasal

Front 137

is lenticular coloboma acquired or congenital?

Back 137

congenital

Front 138

t/f lenticular coloboma is common

Back 138

true

Front 139

t/f the lens in the case of lenticular coloboma is usually non-cataractous

Back 139

false

Front 140

ciliary zonules missing in area of deformation in a lenticular coloboma and lead to an increase in what type of RE?

Back 140

astigmatism

Front 141

subluxation due to defective zonules is called

Back 141

ectopia lentis

Front 142

this type of lens anomaly is characterized by high internal astigmatism

Back 142

ectopia lentis

Front 143

ectopia lentis is due to:

Back 143

hereditary
traumatic
spontaneous

Front 144

most common cause of ectopia lentis (displaced lens)

Back 144

Marfan's Syndrome

Front 145

where is the lens typically displaced to in the case of ectopia lentis due to Marfan's syndrome?

Back 145

superior temporal (due to postition of baby in utero)

Front 146

___% of lens displacements (ectopia lentis) is due to trauma

Back 146

50%

Front 147

diameter of lens at birth =
at 15yo =

Back 147

6.5mm, 9.0mm

Front 148

is the anterior capsule thicker or thinner than the posterior capsule?

Back 148

5x's thicker

Front 149

ant capsule is produced by what kind of cells?

Back 149

epi (polygonal cuboidal)

Front 150

posterior capsule is produced by ...

Back 150

elongating fiber cells

Front 151

bulk of the lens material is..

Back 151

cortex fibers

Front 152

lens fibers consist of 2 major types of cells:

Back 152

crystallin (90%)
cytoskeletal (10%)

Front 153

cortex appears what color? why?

Back 153

blue b/c scatters short wavelengths most - yellow with age

Front 154

what part of the lens thickens with age

Back 154

cortex

Front 155

t/f embryonic fiber cells form sutures

Back 155

false

Front 156

what is the name of the bright bands which separate the layers of the lens

Back 156

zones of discontinuitys

Front 157

location and type of cataracts can be found using what feature of the lens?

Back 157

bright zones (discontinuity)

Front 158

innermost area of lens is called ____ and is formed by ____ fibers

Back 158

embryonic nucleus
primary lens fibers

Front 159

describe appearance of the embryonic nucleus

Back 159

dark and coffee bean shaped

Front 160

does the embryonic nucleus have sutures?

Back 160

no

Front 161

secondary lens fibers form what part of the lens?

Back 161

fetal nucleus

Front 162

what part of the lens is prominent in children and becomes harder to see with age?

Back 162

fetal nucleus

Front 163

t/f fetal nucleus contains sutures

Back 163

true

Front 164

approx 25% of normal eyes show small white dots in the region of the anterior Y suture found in what part of the lens? - what is the name of these dots?

Back 164

fetal nucleus; anterior axial embryonal cataract of vogt

Front 165

senile nuclear relief is what is found where?

Back 165

irregular depression and knobs in the adult nucleus

Front 166

how can you differentiate btw early cat formation and senile nuclear relief of the adult nucleus?

Back 166

no opacification seen in retroillum in senile nuclear relief

Front 167

material types of iols

Back 167

pmma
silicone

Front 168

where do the haptics of ac-iols fit?

Back 168

angle

Front 169

where do the haptics of iris-supported iols fit?

Back 169

behind or either side of iris

Front 170

where do the haptics of pc-iols fit

Back 170

ciliary sulcus or capsular bag

Front 171

three types of cat surgery

Back 171

intracap cat extracttion-ICCE
extracap cat extraction - ECCE
phacoemulsification

Front 172

what is removed in intracap cat extraction?

Back 172

nucleus cortex and capsule all at once

Front 173

what type of iol must be used in a pt who has intracap cat extraction?

Back 173

ac-iol b/c no capsule left to hold lens in place

Front 174

what is removed in extracap cat extraction (ECCE)

Back 174

nucleus and cortex - all at once (capsule stays in)

Front 175

describe phacoemulsification

Back 175

nucleus and cortex broken up by ultrasound and gently vaccumed out

Front 176

UGH (uveitis, glaucoma, hyphema) syndrome is specific to what type of IOLs? (caused by what type of iol?

Back 176

ac-iol

Front 177

what other surgical procedure must be performed when using iris-supported iols and why?

Back 177

iridectomy - to provide aqueous outflow

Front 178

sunset/sunrise syndrome is a problem caused by pc-iols placed where?

Back 178

ciliary sulcus