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67 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Which is the best descriptor for PUNCTATE EPITHELIAL KERATITIS?
a) small epithelial erosions with uptake on staining b) small epithelial erosions without uptake on staining c) hallmark of viral disease d) inflammatory subepithelial fibrovascular growths |
c
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hallmark of viral disease – granular, opalescent swollen epithelial cells that are visible without staining
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Which is the best descriptor for PUNCTATE EPITHELIAL EROSIONS?
a) opalescent swollen epithelial cells with uptake on staining b) small comma shaped mucous strands lined with corneal epithelium c) indicative of acute rise in IOP d) small nonspecific epithelial defects that take up fluorescein |
d
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small epithelial defects that take up fluorescein on K staining. Non-specific (numerous etiologies); superior, interpalpebral or inferior
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Which is the best descriptor for PANNUS?
a) inflammatory or degenerative growth that stains only with rose bengal b) subepithelial ingrowth of fibrovasculat tissue from limbus c) focal areas of stromal inflammation d) equivalent to band keratopathy |
b
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inflammatory or degenerative sub epithelial ingrowth of fibrovascular tissue from the limbus
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Which is the best descriptor for CORNEAL INFILTRATES?
a) accumulation of leukocytes at the epithelium b) focal areas of stromal inflammation c) small epithelial defects with uptake on staining d) present in posterior stroma and associated with Fuch's dystrophy |
b
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focal areas of active stromal inflammation – composition: accumulated leukocytes and cellular debris. Focal, grey-white opacities in anterior stroma; associated with limbal or conjunctival hyperemia. Caused by non-infectious antigen sensitivity (CLs, keratitis) or infectious keratitis.
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Which is true?
a) epithelial edema is a hallmark sign of viral disease b) stromal edema may cause visible filaments at the corneal surface c) corneal enlargement causes breaks in Descemet membrane d) endothelial dysfunction can cause epithelial edema and acute increase in IOP |
d
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3. Epithelial Edema – sign of endothelial decompensation, acute elevation in IOP, loss of K lustre, may be vesicles and bullae.
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Which is false?
a) Antimicrobials are contraindicated in the treatment of Herpes Simplex associated epithelial disease b) Topical antimicrobials are indicated in the the treatment of some types of atopic conjunctivitis c) systemic immunosuppressive agents may be used in patients with severe ulceration of the cornea d) promotion of re-epithelialization may be done with the surgical closure of the eyelid |
a
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Steroids are contraindicated, not antimicrobials
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Microbial keratitis is frequently preceded by
a) corneal abraison b) corneal ulcer c) hypoxia d) all of the above e) none of the above |
d
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usually preceded by hypoxia OR epithelial compensation
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Which of the following would you suspect in a contact lens wearer with conjunctivitis and corneal findings?
a) staphylococcus aureus b) streptococcus pneumoniae c) pseudomonas aeruginosa d) haemophilus influenzae |
c
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pseudomonas bacterial keratitis frequently causes infection in contact lens wearers
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Which corneal dystrophy are these symptoms indicative of? gradual increase in guttata, stromal edema, formation of bullae, gradual stromal opacification
a) Fuch's Corneal Dystrophy b) Posterior Polymorphous Dystrophy c) Macular Dystrophy d) Lattice Dystrophy |
a
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3rd most common dystrophy - onset in old age and begins with increase in guttata.. etc
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Deposition of Calcium salts in the anterior part of Bowman's membrane is denoted as?
a) Pannus b) Salzman Nodular Degeneration c) Band Keratopathy d) Theil-Behnke Dystrophy |
c
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Deposition of Ca salts in anterior Bowman membrane. Causes: chronic uveitis, chronic keratitis, age related, metabolic, hereditary. Tx: chelation
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Patient presents with an acute, follicular conjunctivitis with serous discharge that has resolved on it's own after a few weeks. Most likely diagnosis was?
a) Bacterial Keratoconjunctivitis b) Allergic Conjunctivitis c) Acanthamoeba Keratitis d) Viral Conjunctivitis |
d
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Likely adenoviral keratoconjunctivitis/ keratitis/ conjunctivitis..
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Adenovirus is known to cause
a) Epidemic Keratoconjunctivitis b) Acanthamoeba Keratitis c) Pharyngoconjunctival Fever d) Atopic Keratoconjunctivitis e) (a) and (c) f) none of the above |
e
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Which of the following best describes a follicle?
a) small raised bump, red centrally, present on palpebral conjunctiva b) small raised lesion encircled by blood vessel c) hallmark sign of Giant Papillary Conjunctivitis d) Have a cobblestone appearance on the bulbar conjunctiva |
b
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Foci of hyperplastic lymphoid tissue; usually multiple discrete elevated lesions appearing like grains of rice encircled by small BV – suggests VIRAL or CHLAMYDIAL infx
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Which is false?
a) Pseudomembranes are usually found in severe adenoviral infections of the eye b) True membranes are usually found in streptococcal infections of the eye c) Limbal injection is usually a sign of an external eye condition d) bacterial conjunctivitis is more common in children than in adults |
c
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Limbal injection usually a sign of intraocular problem; injection proximal to the fornices a sign of external
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Which is a predisposing factor to bacterial keratitis?
a) contact lens wearer b) pre-existing corneal disease c) poor ocular hygeine d) all of the above |
d
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The following would be appropriate treatment for a patient with bacterial keratitis and borderline risk for VA loss.
a) stop CL wear and give lubricants b) stop CL wear and give steroid ointment at night to help with inflammation c) stop CL wear, give fortified antibiotics, intensive fluoroquinolone therapy initially giving one drop every 5 minutes d) stop CL wear, give fluoroquinolone every hour |
d
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The following findings would likely be noted in a patient with bacterial keratitis and HIGH risk for VA loss:
a) small, non-staining peripheral infiltrates b) central corneal ulcer and positive anterior chamber reaction c) medium sized peripheral infiltrates and moderate discharge d) minimal anterior chamber reaction |
b
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The following would be most likely to infect the eye after trauma with organic material:
a) pseudomonas b) aspergillus c) herpes zoster d) staphylococcus |
b
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usually fungal
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On slit lamp examination of a patient who happens to be a farmer with a painful, red eye, you note scattered dendritic like anterior stromal infiltrates and radial perineuritis (?). What is the likely diagnosis?
a) fungal keratitis b) allergic conjunctivitis c) foreign body associated conjunctivitis d) acanthamoeba keratitis |
d
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Which is false?
a) Herpes Simplex Virus-1 remains dormant in the Spinal Ganglion b) Herpes Zoster Virus is retained in dorsal root ganglia and is reactivated at a later stage c) Herpes Simplex Virus-2 can be transmitted to the eye via the birth canal d) HIV+ patients are at higher risk for reactivation of Herpes Zoster related infections |
a
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HSV-1 in trigeminal ganglion
HSV-2 in spinal ganglion |
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Th following would be appropriate therapy in a patient with an acute HSV eye infection affecting the corneal epithelium:
a) debridement of infected epithelium, viroptic drops, cycloplegic, oral antivirals, antibiotic to skin lesions b) viroptic drops, oral antivirals, topical steroid c) artificial tears, antibiotic drops, antibiotic to skin lesions d) debridement of infected epithelial area, cycloplegic, topical steroid |
a
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recall - no topical steroids in HSV affecting epithelium
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Dellen may be caused by
a) large pingueculum b) Herbert pits c) blepharitis d) viral conjunctivitis |
a
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pingueculum can affect blinking - area just proximal to the pingueculum on the cornea is therefore not hydrated properly, creating a pit of thinning.
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marginal keratitis is associated with
a) staph exotoxins on lower lid margin b) chronic blepharitis c) corneal exposure d) a and b |
d
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Phlytenulosis is best described by which of the following statements
a) pingueculitis b) inclusion cyst in a child c) delayed hypersensitivity to staph d) usually presents in adults |
c
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on slit lamp examination of a patient with rheumatoid arthritic disease, you note whorl-like epithelial deposition and grey-brown opacification of the epithelium inferiorly. Likely ocular diagnosis is:
a) Thyroid Eye Disease b) Vortex Keratopathy c) Exposure Keratopathy d) Atopic Conjunctivitis |
b
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Vortex keratopathy is drug induced from antimalarials like chloroquine used to treat rheumatic disease
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A Kayser-Fleischer ring is seen in which disease?
a) Keratoconus b) Wilson Disease c) Crocodile Shagreen d) Arcus Senilis |
b
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Copper deposition
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congenital unilateral corneal diameter of 8mm and shallow anterior chamber:
a) megalocornea b) cornea plana c) microcornea d) vogt limbal girdle |
c
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Unilateral, nonprogressive increased curvature of the posterior cornea:
a) keratoconus b) Fuch's dystrophy c) Epithelial Basement Membrane Dystrophy d) Posterior Keratoconus |
d
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Which of the following is most associated with a ring of lipid deposition in the stroma?
a) young age b) cornea guttata c) peripheral edges are sharp, central rim is diffuse e) copper deposition |
c
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Arcus Senilis
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Bilateral crescent shaped lines at nasal and temporal limbus are:
a) vogt limbal girdle b) limbal crescent c) pterygium d) cornea farinata |
a
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Th following would be appropriate therapy in a patient with an acute HSV eye infection affecting the corneal epithelium:
a) debridement of infected epithelium, viroptic drops, cycloplegic, oral antivirals, antibiotic to skin lesions b) viroptic drops, oral antivirals, topical steroid c) artificial tears, antibiotic drops, antibiotic to skin lesions d) debridement of infected epithelial area, cycloplegic, topical steroid |
a
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recall - no topical steroids in HSV affecting epithelium
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Dellen may be caused by
a) large pingueculum b) Herbert pits c) blepharitis d) viral conjunctivitis |
a
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pingueculum can affect blinking - area just proximal to the pingueculum on the cornea is therefore not hydrated properly, creating a pit of thinning.
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marginal keratitis is associated with
a) staph exotoxins on lower lid margin b) chronic blepharitis c) corneal exposure d) a and b |
d
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Phlytenulosis is best described by which of the following statements
a) pingueculitis b) inclusion cyst in a child c) delayed hypersensitivity to staph d) usually presents in adults |
c
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on slit lamp examination of a patient with rheumatoid arthritic disease, you note whorl-like epithelial deposition and grey-brown opacification of the epithelium inferiorly. Likely ocular diagnosis is:
a) Thyroid Eye Disease b) Vortex Keratopathy c) Exposure Keratopathy d) Atopic Conjunctivitis |
b
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Vortex keratopathy is drug induced from antimalarials like chloroquine used to treat rheumatic disease
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A Kayser-Fleischer ring is seen in which disease?
a) Keratoconus b) Wilson Disease c) Crocodile Shagreen d) Arcus Senilis |
b
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Copper deposition
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congenital unilateral corneal diameter of 8mm and shallow anterior chamber:
a) megalocornea b) cornea plana c) microcornea d) vogt limbal girdle |
c
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Unilateral, nonprogressive increased curvature of the posterior cornea:
a) keratoconus b) Fuch's dystrophy c) Epithelial Basement Membrane Dystrophy d) Posterior Keratoconus |
d
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Which of the following is most associated with a ring of lipid deposition in the stroma?
a) young age b) cornea guttata c) peripheral edges are sharp, central rim is diffuse e) copper deposition |
c
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Arcus Senilis
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Bilateral crescent shaped lines at nasal and temporal limbus are:
a) vogt limbal girdle b) limbal crescent c) pterygium d) cornea farinata |
a
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Th following would be appropriate therapy in a patient with an acute HSV eye infection affecting the corneal epithelium:
a) debridement of infected epithelium, viroptic drops, cycloplegic, oral antivirals, antibiotic to skin lesions b) viroptic drops, oral antivirals, topical steroid c) artificial tears, antibiotic drops, antibiotic to skin lesions d) debridement of infected epithelial area, cycloplegic, topical steroid |
a
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recall - no topical steroids in HSV affecting epithelium
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Dellen may be caused by
a) large pingueculum b) Herbert pits c) blepharitis d) viral conjunctivitis |
a
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pingueculum can affect blinking - area just proximal to the pingueculum on the cornea is therefore not hydrated properly, creating a pit of thinning.
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marginal keratitis is associated with
a) staph exotoxins on lower lid margin b) chronic blepharitis c) corneal exposure d) a and b |
d
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Phlytenulosis is best described by which of the following statements
a) pingueculitis b) inclusion cyst in a child c) delayed hypersensitivity to staph d) usually presents in adults |
c
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on slit lamp examination of a patient with rheumatoid arthritic disease, you note whorl-like epithelial deposition and grey-brown opacification of the epithelium inferiorly. Likely ocular diagnosis is:
a) Thyroid Eye Disease b) Vortex Keratopathy c) Exposure Keratopathy d) Atopic Conjunctivitis |
b
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Vortex keratopathy is drug induced from antimalarials like chloroquine used to treat rheumatic disease
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A Kayser-Fleischer ring is seen in which disease?
a) Keratoconus b) Wilson Disease c) Crocodile Shagreen d) Arcus Senilis |
b
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Copper deposition
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congenital unilateral corneal diameter of 8mm and shallow anterior chamber:
a) megalocornea b) cornea plana c) microcornea d) vogt limbal girdle |
c
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Unilateral, nonprogressive increased curvature of the posterior cornea:
a) keratoconus b) Fuch's dystrophy c) Epithelial Basement Membrane Dystrophy d) Posterior Keratoconus |
d
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Which of the following is most associated with a ring of lipid deposition in the stroma?
a) young age b) cornea guttata c) peripheral edges are sharp, central rim is diffuse e) copper deposition |
c
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Arcus Senilis
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Bilateral crescent shaped lines at nasal and temporal limbus are:
a) vogt limbal girdle b) limbal crescent c) pterygium d) cornea farinata |
a
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Corneal Guttata are present in
a) Descemet membrane b) Corneal Endothelium c) Posterior Stroma d) Bowman's Membrane |
a
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Band keratopathy is treated by which of the following:
a) lubricants b) chelation c) topical steroids d) topical antibiotic drops |
b
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This corneal epithelial dystrophy is often misdiagnosed because of its variety of appearances; characterized by bilateral recurrent corneal erosions and nonprogressive nature.
a) Fuch's Dystrophy b) Meesman Dystrophy c) Epithelial Basement Membrane Dystrophy d) Reis-Bückler Dystrophy |
c
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Your patient presented to you today with acute unilateral ocular pain on awakening this morning. Slit lamp exam reveals a moderate epithelial defect and loose epithelium at the edges. What is the likely diagnosis?
a) Allergic Conjunctivitis b) Corneal Abraison c) Floppy Eyelid Syndrome d) Recurrent Corneal Erosion |
d
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Epithelial Basement Membrane dystrophy is commonly seen (onset) within
a) 5th to 6th decade of life b) congenital c) 2nd decade of life d) 4th decade of life |
c
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On slit lamp examination, you note mild ocular irritation and numerous, very small intraepithelial cysts. This is likely
a) Reis-Bückler Dystrophy b) Meesman Dystrophy c) Recurrent Corneal Erosion d) Epithelial Basement Membrance Dystrophy |
b
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Fine, translucent criss-cross lines in anterior stroma:
a) granular stromal dystrophy b) lattice stromal dystrophy c) macular dystrophy d) Fuch's dystrophy |
b
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Choose the answer that is FALSE. Both Reis-Bückler Dystrophy and Theil-Behnke Dystrophy:
a) present in late childhood b) show recurrent corneal erosion c) are Bowman's membrane dystrophies d) Affect visual acuity markedly |
d
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Theil Behnke has Appearance similar to Reis-Bückler but less effect on VA.....
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Which is true about Fuch's corneal dystrophy?
a) Affects men more than women b) is not painful c) treated with Muro-128, Bandage contact lens and penetrating keratoplasty d) is a degenerative condition of central cornea |
c
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Which is true regarding Keratoconus?
a) Corneal apex in keratoconus is displaced inferotemporally b) Posterior keratoconus shows positive Munson sign at Intermediate stage c) Kayser-Fleisher ring in Bowman's membrane is present at the base of the cone d) Keratoconic patients may have polyopia and excellent pinhole acuity |
d
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On slit lam examination you notice folds in Descemet membrane that disappear with digital pressure. These are ___________ which are associated with ____________.
a) Vogt Limbal Girdle; Recurrent Corneal Erosion b) Bullae; Posterior Keratoconus c) Striae; Posterior Keratoconus d) Vogt Striae; Keratoconus |
d
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Your patient has keratoconus. Her recent keratometry readings are K1 = 54.75 D and K2 = 56.37 D. Which keratoconic stage is your patient currently in? Do you expect a positive or negative Munson sign?
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Advanced
Positive |
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First line of treatment in keratoconus is:
a) spectacles b) INTACS c) riboflavin/UV exposure therapy d) Corneal transplant surgery |
a
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Your patient returns to your clinic after corneal transplant surgery for keratoconus. He is happy with the surgical result but is still complaining of some astigmatic distortion. When should you attempt to correct this with a new Rx?
a) immediately since the patient is symptomatic b) not until 6 months after the transplant surgery c) 6 months after suture removal and stable K readings d) immediately with rigid contact lenses |
c
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Which type of corneal ectasia can be induced with the wear of rigid gas permeable lenses?
a) keratoglobus b) posterior keratoconus c) pellucid marginal degeneration d) corneal warpage syndrome |
d
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T or F: Corneal Warpage Syndrome is reversible.
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T
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Inferior corneal bulging and "butterfly" shape on corneal topography is usually indicative of:
a) keratoconus b) pellucid marginal dystrophy c) corneal warpage syndrome d) megalocornea |
b
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