Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
253 Cards in this Set
- Front
- Back
|
Elderly get (decr/incr) peri-orbital fat thus results in (exo/enophthalmos).
|
decr, enophthalmos
|
|
|
Elderly get (incr/decr) in horizontal palbebral aperture because lateral canthus goes (inward/outward)
|
decr, inward
|
|
|
Elderly get (incr/decr) vertical palpebral aperture due to ____ and ____.
|
decr, decr fxn of levator, flaccidity of eyelids/skin
|
|
|
T/F - Elderly get decr production of all components of tear film.
|
True - mucin, tear, and oil all decr production
|
|
|
Contraction of orbicularis oculi causes ___ of caniliculi which leads to...
|
shortening and compressing; leads to dilation of lacrimal sac thus suck in tears.
|
|
|
The orbicularis is attached to the ____ which is attached to the ____ which is attached to the ____.
|
medial palpebral ligament, lacrimal fascia, lacrimal sac
|
|
|
Elderly get (incr/decr) orbicularis force due to...
|
decr, due to anatomical changes (decr dist b/w pretarsal and preseptal areas of orbicularis)
|
|
|
T/F - Elderly have displaced lacrimal puncta which causes epiphora
|
True
|
|
|
T/F - Eyelashes get thicker in older people.
|
False - thinner
|
|
|
Orbit fat prolapse in elderly results in...
|
bulge at inner half of upper lid
|
|
|
T/F - Conj thickness is stable in elderly.
|
False - thinner
|
|
|
T/F - Elderly have higher tendency for subconj hemes.
|
True - capillaries more fragile
|
|
|
Elderly get (incr/decr) corneal sensitivity.
|
decr
|
|
|
Elderly get an increase in this kind of astigmatism.
|
ATR
|
|
|
What is the cause of the yellowish tinge of the sclera in the elderly?
|
Due to dehydration + lipid deposits.
|
|
|
What is the cause of the brownish tinge of the sclera in the elderly?
|
UV light, wind, dust exposure
|
|
|
What is the cause of the bluish tinge of the sclera in the elderly?
|
scleral thinning
|
|
|
What happens to the size of the ant chamber in elderly? Why?
|
more shallow b/c incr lens thickness
|
|
|
Describe the TM changes in the elderly.
|
hylanization and loss of endoth lining
|
|
|
What naturally happens to the iris in the elderly?
|
Iris atrophy - collagen fibers hyalinize which causes decr elasticity thus pupil more rigid
|
|
|
Pupil is (less/more) reactive to light in elderly. Why?
|
less; both sphincter and dilator muscles weaken, collagen fibers hyalinize which decr elasticity causing pupil become more rigid
|
|
|
What kind of Sx are assoc w/ the pupils of the elderly?
|
Complaints that objects are not as bright, bright light may be too bright, decr night vision
|
|
|
T/F - Elderly pupils results in bright light that may be too bright.
|
True
|
|
|
Which specific muscle of the ciliary muscle atrophies in the elderly?
|
circular muscle
|
|
|
IOP incr ___% in the elderly due to..
|
25%, due to incr aqueous production by CB, blockage of Schlemm's canal
|
|
|
T/F - Aqueous composition in ant chamber of elderly does not change.
|
True
|
|
|
Describe the lens changes in the elderly mentioned in the packet.
|
Sclerosis of lens substance, decr elasticity of capsule, incr lens weight
|
|
|
T/F - Lens weight remains stable despite being thicker in the elderly.
|
False - lens weight incr
|
|
|
Vitreous is __% water, __% solid.
|
99, 1
|
|
|
Vitreal solids are mainly composed of...
|
collagen filaments, hyaluronic acid molecules
|
|
|
In the elderly, what happens physiologically to the vitreous?
|
Syneresis: depolymerization of hyaluronic acid thus water molecules released; lacunae formation (pockets of liquified vitreous); collagen filaments come together to form fibrils thus further vitreal structure collapse.
|
|
|
How does a PVD occur according to the packet?
|
All lacunae come together, causes shrinkage and contraction of vitreous thus resulting PVD
|
|
|
T/F - Elderly lose the foveal reflex
|
True
|
|
|
T/F - Choroid thickness is stable in elderly.
|
False - decr
|
|
|
In elderly, choroid pigment (incr/decr), and RPE pigment (incr/decr).
|
decr, decr
(RPE hypopigmentation) |
|
|
Elderly have decr night vision due to...
|
poor pupil dilation, decr retinal illum, cataract, incr light scatter, uncorr myopia, decr dark adaptation (decr photoreceptor processing)
|
|
|
Phorias in the elderly shift to...
|
more exo (ciliary muscle atrophy)
|
|
|
T/F - Contrast sensitivity in elderly decr.
|
True
|
|
|
T/F - Elderly have decr sensitivity to blue colors only.
|
False - decr sensitivity to blue, green, red
|
|
|
Elderly tend to have a ___ colored lens so have trouble seeing ____ colored objects, i.e. ____ wavelengths.
|
yellow, blue, short
|
|
|
Normal VF in elderly decr ___ degrees per decade.
|
1-3
|
|
|
Elderly have a (incr/decr/stable) ability to attend to one object in presence of multiple objects.
|
decr
|
|
|
Elderly have (incr/decr/stable) hyperopia.
|
incr
|
|
|
What is a brow ptosis?
|
drooping of eyebrows due to aging + gravity + loss of elasticity
|
|
|
T/F - Brow ptosis is usually asymptomatic.
|
True - but if symptomatic, get brow ache, loss of superior field
|
|
|
What develops on the forehead due to brow ptosis?
|
Furrows b/c trying to lift up eyebrows
|
|
|
Tx brow ptosis?
|
Brow lift
|
|
|
If the measurement b/w the ___ to the ___ is less than ___mm, you have a brow ptosis.
|
inferior limbus of cornea, center of brow, 22 mm
|
|
|
T/F - Papillomas are non-viral benign epithelial lesions.
|
True
|
|
|
T/F - You see more papillomas with age.
|
True
|
|
|
T/F - Papillomas typically present with irritation.
|
False - asymptomatic
|
|
|
In your diabetic patient, you see a brown, soft, lobular lesion that is asymptomatic; you suspect...
|
Papilloma (commonly seen in diabetics)
|
|
|
Tx papilloma?
|
excision
|
|
|
Hyperkeratosis causes...
|
cutaneous horns
|
|
|
*What is an important observation that you must do with cutaneous horns???
|
May be a basal or squamous cell carcinoma at the BASE of the horn (20% of the time) - squamous cell is the most common type
|
|
|
You find a carcinoma at the base of a cutaneous horn - what kind of carcinoma is it, most likely?
|
most likely squamous cell; may be basal
|
|
|
Tx cutaneous horn?
|
excision w/ biopsy
|
|
|
Keratoacanthoma = benign or neoplastic?
|
benign
|
|
|
You see a dome-shaped lesion with a keratin-filled center on your patient. He said he noticed it about 3 weeks ago. You suspect...
|
Keratoacanthoma
|
|
|
You must DDx ____ vs Keratoacanthoma.
|
squamous cell carcinoma (does not develop as fast as Keratoacanthoma)
|
|
|
Tx keratoacanthoma?
|
Excision w/ biopsy
|
|
|
Keratoacanthomas grow (slow/fast) and typically resolve in ___ months.
|
fast (2-3 wks), 4-6 mos
|
|
|
What lid lesion is associated with smoking?
|
Keratoacanthoma
|
|
|
T/F - Lentigo maligna, despite its name, is not malignant.
|
False - it is premalignant, dev into lentigo maligna melanoma
|
|
|
Lentigo maligna is due to...
|
sun exposure
|
|
|
Describe what Lentigo maligna looks like
|
flat, dark "stain" (tan-brown with diff shadings)
|
|
|
T/F - Actinic keratosis is premalignant
|
True (squamous cell carcinoma)
|
|
|
What is the biggest risk factor for Actinic keratosis?
|
excessive sun exposure when young
|
|
|
Describe what Actinic keratosis looks like and its cause
|
dry, rough, scaly lesions eventually turns into a hard wart like surface; damage to keratinocytes (major component of epidermis), secondary to UV light
|
|
|
Tx Actinic keratosis?
|
sunscreen, biopsy, 5-fluorouracil cream (anti-metabolite), cryotherapy
|
|
|
Where do sebaceous adenocarcinomas come from?
|
sebaceous glands of lid (incl meibomian glands and glands of zeiss)
|
|
|
T/F - sebaceous adenocarcinomas are benign
|
False - maligant/fatal/very aggressive
|
|
|
T/F - sebaceous adenocarcinomas are more common in the upper lid
|
True
|
|
|
T/F - Sebaceous adenocarcinomas are flat, brown patches on the skin.
|
False - firm, slowly enlargening nodule (remember, sebaceous and mistaken for chalazion hence nodule)
|
|
|
Recurrent chalazion can be a possible sign of...
|
Sebaceous adenocarcinoma
|
|
|
T/F - Sebaceous adenocarcinomas are associated with hair loss or ulceration at the lid margin.
|
True
|
|
|
T/F - Sebaceous adenocarcinomas are often mistaken as recurrent chalazions or unilateral blepharitis
|
True
|
|
|
Tx Sebaceous adenocarcinoma?
|
excision w/ biopsy
|
|
|
What is xanthelasma?
|
Yellowish plaques that typically occur in medial upper lids
|
|
|
T/F - Xanthelasma does not cause ptosis.
|
False - can cause ptosis (think of mass bearing weight/gravity?)
|
|
|
Xanthelasma are composed of...
|
xanthoma cells (macrophages containing lipids)
|
|
|
T/F - Xanthelasma is usually assoc w/ high cholesterol
|
False - only assoc w/ high cholesterol 50% of time
|
|
|
T/F - Risk of high cholesterol increases if you see Xanthelasma in a younger pt
|
True
|
|
|
What are the causes of Xanthelasma?
|
high cholesterol (50%), DM, liver problems
|
|
|
T/F - Liver problems can cause Xanthelasma.
|
True
|
|
|
Tx Xanthelasma?
|
excision, trichloroacetic acid, laser, cryo
|
|
|
What is floppy eyelid syndrome?
|
Extreme eyelid laxity (decr in elastin and also may be due to chronic rubbing)
|
|
|
T/F - Floppy eyelid syndrome can be due to chronic eye rubbing.
|
True
|
|
|
T/F - Floppy eyelid syndrome is assoc w/ keratoconus
|
True
|
|
|
What conditions are assoc w/ Floppy eyelid syndrome?
|
obesity, sleep apnea, keratoconus
|
|
|
Tx Floppy eyelid syndrome?
|
water-based ung (lacrilube), tape lids, eye shield, surgery
|
|
|
T/F - Involutional/spastic entropion involves only vertical eyelid laxity.
|
False - both horz and vert
|
|
|
What causes Involutional/spastic entropion?
|
vert and horz eyelid laxity + orbicularis override (orbicularis overtakes action of lower eyelid retractors)
|
|
|
What is the "cycle" in Involutional/spastic entropion?
|
Eyelids are pushed in, leads to trichiasis, irritation, thus further inward turn of eyelids due to forced blinking/lid closure
|
|
|
What causes involutional ectropion?
|
Eyelid laxity both vert and horz WITHOUT orbicularis override (not strong enough to push lid inward) causes the ectropion
|
|
|
T/F - Involutional ectropion involves orbicularis override.
|
False - no orbicularis override in ECtropion, but present in ENtropion
|
|
|
What kind of lesion is a Sebeorrheic keratosis?
|
benign epithelial tumor (benign proliferation of keratinocytes and melanocytes)
|
|
|
T/F - Sebeorrheic keratosis is benign.
|
True
|
|
|
This lesion begins as light tan and flat, but then becomes more pigmented and elevated with a warty surface with age; looks like it's stuck on the skin.
|
Sebeorrheic keratosis
|
|
|
T/F - Sebeorrheic keratosis are mostly found on the upper lid.
|
False - lower lid
|
|
|
Tx Sebeorrheic keratosis?
|
electrocautery, cryo, excision
|
|
|
Most common type of benign tumor in elderly?
|
Sebeorrheic keratosis
|
|
|
Most common type of ptosis?
|
Aponeurotic ptosis
|
|
|
What is the etiology of Aponeurotic ptosis?
|
Disinsertion of levator aponeurosis (small tendon connecting levator to lid) due to aging, stretching
|
|
|
T/F - Aponeurotic ptosis involves abnormal levator fxn.
|
False - normal levator fxn
|
|
|
T/F - Aponeurotic ptosis involves a high upper eyelid crease.
|
True
|
|
|
When is a superior field 36 indicated?
|
To see if ptosis surgery is medically necessary; measure field with lids taped and untaped to see diff b/w the two. Use w/ Aponeurotic ptosis, dermatochalasis
|
|
|
Tx Aponeurotic ptosis?
|
surgery
|
|
|
Most common cause of pseudoptosis?
|
Dermatochalasis
|
|
|
What causes Dermatochalasis?
|
loss of elasticity from aging, uv light
|
|
|
T/F - Dermatochalasis can be caused by UV exposure
|
True
|
|
|
What is madarosis? What ocular dz is it assoc w/ as mentioned in the packet?
|
lose lashes; blepharitis/MGD
|
|
|
What is poliosis? What ocular dz is it assoc w/ as mentioned in the packet?
|
white lashes; blepharitis/MGD
|
|
|
What is tylosis? What ocular dz is it assoc w/ as mentioned in the packet?
|
thickened lashes; blepharitis/MGD
|
|
|
Where/what is a collarette found in blepharitis/MGD?
|
ringlike formation on BASE of lash due to staph
|
|
|
"Scurf" is associated with...
|
Seborrheic blepharitis - sticks to lash or can get sleeves along lashes
|
|
|
Seborrhea causes (incr/decr) oil production.
|
Decr - initially start with incr oil production, then formation of crusty debris around oil glands, thus blockage, thus causing decr oil production
|
|
|
How does damage to the cornea occur from blepharitis/MGD?
|
Bacterial exotoxins (lipases break down cholesterol into FFAs) damage the cornea
|
|
|
What ABs are indicated for blepharitis/MGD?
|
Doxy and tetra (decr lipase which decr FFAs - remember the reason for toxicity to cornea is FFAs)
|
|
|
What type of lesion is a squamous cell carcinoma?
|
malignant tumor of epithelial keratinocytes
|
|
|
Squamous cell carcinoma is the (#) most common eyelid skin cancer.
|
2nd
|
|
|
T/F - Males are at higher risk for Squamous cell carcinoma.
|
True
|
|
|
T/F - Exposure to UV light as a child puts you at higher risk for Squamous cell carcinoma.
|
True
|
|
|
T/F - Hx of immunosuppresion puts you at higher risk for Squamous cell carcinoma.
|
True
|
|
|
For Squamous cell carcinoma:
Differentiated = (firm/soft) Undifferentiated = (firm/soft) |
Differentiated = firm
Undifferentiated = soft |
|
|
Describe how a Squamous cell carcinoma looks like.
|
Ulcerated lesion with bleeding
|
|
|
T/F - Squamous cell carcinomas often metastasize.
|
False - but aggressive locally
|
|
|
Most common type of eyelid skin cancer?
|
Basal cell carcinoma
|
|
|
T/F - Basal cell carcinoma is benign.
|
False - malignant, but rarely metastasizes, unless along medial canthal area (can invade orbit)
|
|
|
Basal cell carcinomas arise from...
|
pluripotential cells of epidermis
|
|
|
T/F - Basal cell carcinomas typically metastasize.
|
False - rarely metastasizes, unless along medial canthal area (can invade orbit)
|
|
|
Basal cell carcinomas typically occur on (upper/lower) lid.
|
lower
|
|
|
T/F - You have a higher risk for Basal cell carcinomas if you had a lot of UV exposure as a child
|
True
|
|
|
What type of lesion does this describe?
Round lesion with depressed center, possibly ulcerated; teleangiectasia around lesion, pearly appearance, raised borders. |
Basal cell carcinoma
|
|
|
What is a Plasmacytoma?
|
Mass of plasma cells that occur in the bone and can spread into the soft tissue (can involve orbit, push globe out thus proptosis and ON compression)
|
|
|
When a Plasmacytoma becomes systemic, it is called...
|
multiple myeloma
|
|
|
Plasmacytoma = benign or malignant?
|
Either
|
|
|
Signs of Plasmacytoma?
|
Proptosis, displacement of globe, ON compression (remember, orbital tumor)
|
|
|
Tx Plasmacytoma?
|
Biopsy, systemic workup, radiation, chemo, CT scan
|
|
|
What is a damaged sinus ostium due to trauma or chronic sinus disease?
|
Mucocele (sinus ostium = connection of sinus to nasal cavity)
|
|
|
Mucocele leads to a _____ that can expand into the orbit.
|
mucous filled sinus
|
|
|
T/F - Mucoceles involve infection
|
True
|
|
|
Signs of Mucocele?
|
proptosis, displacement of globe, ON compression
|
|
|
A frontal mucocele has what ocular presentation?
|
push eye down
|
|
|
An ethmoid mucocele has what ocular presentation?
|
push eye out
|
|
|
A maxillary mucocele has what ocular presentation?
|
push eye up or in
|
|
|
A sphenoid mucocele has what ocular presentation?
|
compress nerve
|
|
|
Tx mucocele?
|
surgery
|
|
|
Lymphomas = benign or malignant?
|
malignant
|
|
|
What is lymphoid hyperplasia? Is it benign or malignant?
|
Benign precursor to lymphoma
|
|
|
Ocular signs of lymphoma?
|
proptosis, globe displacement
|
|
|
Majority of lymphomas are what type?
|
non-hodgkins lymphoma
|
|
|
This type of tumor is difficult to differentiate b/w malignant vs benign.
|
Lymphoma
|
|
|
Tx lymphoma?
|
biopsy, systemic work-up, chemo, radiation
|
|
|
What is Mucomycosis?
|
Fungal infection by inhalation of spores; life threatening
|
|
|
Mucomycosis has a tendency in what kinds of patients?
|
Very sick people, uncontrolled DM, dialysis pts
|
|
|
Why are dialysis pts susceptible to mucomycosis?
|
Pts receive iron overload during dialysis, which promotes fungal growth
|
|
|
Signs & Sx of mucomycosis (early and late)
|
Pain, fever, proptosis (looks similar to orbital cellulitis); visual loss due to thrombosis of retinal artery/fungal invasion
Late finding: black dead tissue in palate/nasal mucosa |
|
|
Prognosis of mucomycosis?
|
poor
|
|
|
Tx mucomycosis?
|
IV amphotericin B, debride necrotic tissue
|
|
|
#1 male metastatic cancer? Female?
|
male = lung
female = breast |
|
|
Sx of metastatic orbital tumor?
|
Ptosis, proptosis, decr ocular motility, decr VA
|
|
|
Tx metastatic orbital tumor?
|
biopsy, Tx primary malignancy, radiation and chemo for orbit
|
|
|
What autoimmune disease describes the unregulated secretion of T3 and T4 of the thyroid due to antibodies?
|
Grave's disease
|
|
|
What is the ocular pathophysiology of Grave's disease?
|
The same antibodies that attack the thyroid also attack the orbital fibroblasts of the EOMs and orbital fat; leads to production of hyaluronic acid thus incr water absorption, swelling. More swelling/fibrosis due to inflammation causing deposition of GAGS in soft tissue
|
|
|
Ocular Signs/Sx of Grave's?
|
Lid retraction (see sclera at top), proptosis, puffy lids, lagophthalmos, diplopia (inf rectus affected 1st), exposure keratitis, ON compression, true Von Graefe's sign
|
|
|
What EOM is affected first in Grave's?
|
inferior rectus
|
|
|
Tx Grave's?
|
ATs, lacrilube, systemic steroids, orbital decompression, stop smoking
|
|
|
T/F - You should tell your Grave's patients to stop smoking.
|
True
|
|
|
Acquired nasolacrimal duct obstruction is due to...
|
blockage secondary to aging changes in the lacrimal duct and sac
|
|
|
Acquired nasolacrimal duct obstruction leads to...
|
infections, epiphora
|
|
|
How can you test Acquired nasolacrimal duct obstruction?
|
disappearance dye test, dilation/irrigation, dacryocystography (x-ray)
|
|
|
Tx acquired nasolacrimal duct obstruction?
|
dacryocystorhinostomy - new tear channel created
|
|
|
Dacryocystitis is caused by...
|
nasolacrimal duct obstruction - fluid stays in lacrimal sac and leads to infection
|
|
|
T/F - Dacryocystitis expresses pus if you press on the sac.
|
True
|
|
|
T/F - To locate the blockage in Dacryocystitis, you can dilate and irrigate the puncta.
|
False - never dilate/probe/irrigate Dacryocystitis!
|
|
|
Tx Dacryocystitis?
|
Systemic antibiotics (Augmentin), dacryocystorhinostomy
|
|
|
What ocular disease involves an autoimmune process where the antibodies bind to the conj basement memb and cause inflammation, scarring?
|
Ocular pemphigoid
|
|
|
This autoimmune disease involves conj scarring, entropion, trichiasis, symblepharon, ankyloblepharon, and corneal damage (pannus, ulcers, dry eyes).
|
Ocular pemphigoid
|
|
|
T/F - Ocular pemphigoid can involve corneal ulcers.
|
True
|
|
|
What is symblepharon?
|
Bulbar and palpebral conj stick together
|
|
|
What is ankyloblepharon?
|
Upper and lower lid stick together
|
|
|
Tx Ocular pemphigoid?
|
Doxy (mild), immunosuppresants (severe); once inflammation reduced, need surgery; also need ATs
|
|
|
Conjunctival lymphoma = progressive or rapid onset?
|
progressive
|
|
|
Conjunctival lymphoma color?
|
salmon colored lesion
|
|
|
Conjunctival lymphoma location (be specific)?
|
bulbar or palpebral conj
|
|
|
Conjunctival lymphoma due to (Hodgkins/Non-Hodgkins) lymphoma?
|
Non-hodgkins
|
|
|
Tx Conjunctival lymphoma?
|
excision w/ biopsy, systemic work-up, CT to assess orbital involvement
|
|
|
Hyalinization of the sclera (thinned sclera) due to aging is called...
|
Senile scleral plaque
|
|
|
Senile scleral plaque lies...
|
along horz recti (combo of sun exposure + stress put on by horz recti)
|
|
|
Pingueculas are due to...
|
chronic wind exposure (dryness) and sun exposure
|
|
|
Pingueculas cause...
|
degenerative changes in the conj w/ incr fibrovascular tissue
|
|
|
Concretions are composed of...
|
mucin secretions and degen epith cells
|
|
|
Concretions may be secondary to...
|
dry eyes and allergies
|
|
|
You see a line leading a pterygium...what is this called?
|
Stocker's line
|
|
|
T/F - Warfarin can be the culprit of a subconj heme.
|
True
|
|
|
How long do subconj hemes usually last?
|
2 wks
|
|
|
T/F - Necrotizing scleritis is an autoimmune process.
|
True - inflammation of scleral tissue
|
|
|
What is the most severe form of scleritis?
|
Necrotizing scleritis
|
|
|
What signs/Sx present with Necrotizing scleritis?
|
avasc patch of tissue over scleral necrosis, more apparent uvea, painful, high chance of vision loss
|
|
|
Tx Necrotizing scleritis?
|
Oral NSAIDS for a week; if no improvement give systemic steroids; if no improvement again, IV steroid or immunosuppressive Tx
|
|
|
What Tx is contraindicated in Necrotizing scleritis?
|
No topical steroids (vascular system already compromised), no injection (thin sclera, can perf globe)
|
|
|
T/F - Scleromalacia perforans is an inflammatory scleritis.
|
False - no inflammation
|
|
|
T/F - Scleromalacia perforans does not involve scleral thinning
|
False - thinning occurs, revealing uvea
|
|
|
Tx Scleromalacia perforans?
|
Tx underlying cause (almost always RA), protective eyewear, ATs
|
|
|
What autoimmune disease is often associated w/ Scleromalacia perforans?
|
Rheumatoid arthritis
|
|
|
Which type of cataract involves vacuoles early on?
|
Cortical
|
|
|
T/F - Corneal arcus always involves high cholesterol.
|
False - in older caused by degeneration; if younger, then must be due to high cholest
|
|
|
Where does Corneal arcus typically start? Where next?
|
inferior, superior, rest
|
|
|
Corneal arcus can involve thinning cornea (with intact epith) at the area of clearing between the arcus and the limbus; what is this called and what is it assoc with?
|
Furrow degeneration, may be assoc w/ RA
|
|
|
This corneal disease is unilateral in the elderly, painful, inflammatory, and corneal tissue damage begins at periph cornea, progressing to the center; may lead to perf.
|
Mooren's ulcer
|
|
|
Mooren's ulcer has been associated with this disease.
|
Hep C
|
|
|
In Mooren's ulcer, corneal damage begins where?
|
Peripheral cornea (nasal or temporal)
|
|
|
Limbal girdle of Vogt = bilat or unilat?
|
bilat
|
|
|
Limbal girdle of Vogt is located...
|
nasal and temporal (perilimbal area)
|
|
|
Limbal girdle of Vogt is due to...
|
elastic degeneration
|
|
|
Crocodile shagreen = bilat or unilat?
|
bilat
|
|
|
Crocodile shagreen = dystrophy or degeneration?
|
degeneration
|
|
|
What corneal signs typically occur due to use of Amiodarone? What is this called?
|
Corneal verticillata (vortex keratopathy) - brown epithelial deposits in a swirl pattern; called Amiodarone keratopathy
|
|
|
T/F - Amiodarone keratopathy is permanent.
|
False - goes away when drug is stopped
|
|
|
Band keratopathy is due to (this deposit) and is usually located in which layers?
|
calcium deposits; in superepithelium, bowman's, ant stroma (anterior corneal layers)
|
|
|
T/F - Band keratopathy starts central then goes nasal/temporal.
|
False - vice versa
|
|
|
T/F - You can DDx Band keratopathy vs corneal arcus since there is no area of clearing separating it from the limbus.
|
False - there is an area of clearing
|
|
|
What does Band keratopathy look like?
|
Small holes/clefts (where nerves go thru Bowman's); looks like a band of swiss cheese looking spots going across the cornea
|
|
|
T/F - Band keratopathy can be caused by dry eyes.
|
True
|
|
|
T/F - Band keratopathy can be caused by acute ocular inflammation.
|
False - chronic (uveitis)
|
|
|
T/F - Band keratopathy can be caused by low systemic calcium.
|
False - hypercalcemia
|
|
|
T/F - Band keratopathy can be caused by kidney failure.
|
True
|
|
|
What corneal disease can be caused by gout?
|
Band keratopathy
|
|
|
T/F - Band keratopathy can be caused by ocular surgery.
|
True
|
|
|
T/F - Band keratopathy can be caused by chemical exposure.
|
True
|
|
|
Tx Band keratopathy?
|
ATs, EDTA (binds to calcium) w/ scraping, keratectomy
|
|
|
What corneal disease involves EDTA as the Tx?
|
band keratopathy (EDTA binds to calcium, then scrape)
|
|
|
What is Hutchinson's sign?
|
HZV vesicles on the nose; you have a 75% chance of getting ocular involvement
|
|
|
T/F - HZV involves persistent endothelial defects.
|
False - persistent epithelial defects
|
|
|
What is disciform keratitis?
|
inflammatory response to HZV; central stromal/epithelial edema, KPs, limbitis, uveitis, scarring
|
|
|
Tx disciform keratitis?
|
Topical steroids, viroptic
|
|
|
This corneal disease involves an epithelial defect that never heals with poor corneal sensitivity; it has multiple causes.
|
Neurotrophic keratopathy
|
|
|
Neurotrophic keratopathy causes?
|
HSV, HZV, topical NSAIDs, timolol, anesthetic, stroke, diabetes, ocular surgery
|
|
|
T/F - Neurotrophic keratopathy can be caused by topical NSAIDs.
|
True
|
|
|
T/F - Neurotrophic keratopathy can be caused by HSV but not HZV.
|
False - can be caused by either
|
|
|
Timolol can cause this corneal disease that involves poor corneal healing and decr corneal sensitivity
|
Neurotrophic keratopathy
|
|
|
What is guttata?
|
Depositied portion of descemet's resulting in endothelial dropout and endothelial cells trying to get bigger to cover up; results in pump dysfxn
|
|
|
Appearance of guttata?
|
beaten metal appearance
|
|
|
Bullous keratopathy is due to...
|
stromal edema in cornea, begins as sub-epithelial bullae
|
|
|
What is the main Sx of Bullous keratopathy?
|
Pain (due to bullae bursting) and dry eyes
|
|
|
Tx Bullous keratopathy?
|
Muro (wait until bullae heals), ABs, transplant
|
|
|
What is more common in the lid - squamous or basal cell carcinomas?
|
Basal cell carcinomas
|
|
|
T/F - Dermatochalasis can be caused by UV light exposure.
|
True
|
|
|
Trichloroacetic acid is used to Tx...
|
Xanthelasma
|
|
|
T/F - Metastatic orbital tumors can cause proptosis and not ptosis.
|
False - can cause either
|
|
|
How does the ON get involved in this hyperthyroid autoimmune disease?
|
(Grave's) - ON compression
|
|
|
Baggy eyelids can be an indication of what organ failures?
|
Kidney or heart failure
|
