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841 Cards in this Set
- Front
- Back
Horner-Trantas dot |
grey, jelly-like limbal conj nodule filled iwth eosinophils and epithelioid cells seen in vernal keratoconjunctivitis |
|
time of onset after birth for chemical conjunctivitis |
24 hours |
|
time of onset after birth for gonococcal conjunctivitisi
|
within first 3-4 days |
|
time of onset after birth for chlamidial conjunctivitis |
7 days (earlier if prolonged rupture of membranes) |
|
time of onset after birth for HSV conjunctivitis
|
2 weeks |
|
MALE pneumonic for A and V pattern strabismus
|
Medial to Apex, Lateral to Empty space (i.e. medial recti displaced down and laterals up in V pattern strabismus, medials displaced up and laterals down in A pattern strabismus). |
|
typical iris coloboma
|
located in inferonasal quadrant and may involve ciliary body, choroid, retina and/or optic nerve. caused by failure of the embryonic fissure to to close in fifth week of gestation |
|
atypical iris coloboma |
areas other than the inferonasal quadrant and not usually associated with more posterior uveal colobomas. probably result from fibrovascular remnants of the anterior hyaloid system and pupillary membrane |
|
which extraocular muscle is typically involved in high myopes who have symptomatic strabismus
|
lateral rectus; high myopia can result in stretching and slippage of the lateral rectus, resulting in esotropia |
|
What are the contents of the superior orbital fissure? |
Superior to the annulus of Zinn (stupid mnemonic: LFTS) |
|
What passes through the annulus of Zinn
|
superior division of CN III |
|
what are the contents of the inferior orbital fissure?
|
infraorbital branch of CN V2 |
|
dorsal midbrain syndrome synonyms
|
prectal syndrome |
|
clinical features of dorsal midbrain syndrome
|
convergence retraction nystagmus |
|
common etiologies of dorsal midbrain syndrome
|
pineal tumors |
|
diagnostic criteria for NF1
|
(2 or more of the following) |
|
what are the waves of neural crest migration to form the AC
|
First wave: corneal endothelium |
|
what are the layers of the retina?
|
internal limiting membrane |
|
what are the components of the layers of the retina?
|
internal limiting membrane = footplates of Muller cells |
|
what is the watershed layer of the retina
|
inner nuclear layer and out is supplied by choriocapilaris; inner plexiform layer and inward is supplied by central retinal artery |
|
what are the diagnostic criteria for NF2
|
Bilateral acoustic neuromas |
|
What are the types of Duane's Syndrome?
|
All forms have anomalous co-contraction of the medial and lateral rectus muscles producing retraction of the globe in actual or attempted adduction. |
|
What are Brushfield spots?
|
hypopigmented spots on the iris associated with down's syndrome. |
|
order the cylcoplegics/mydriatics from shortest acting to longest
|
phenylephrine: 3-5 hours |
|
what is brown syndrome?
|
Deficient elevation in adduction that improves in abduction (but often not completely). |
|
Anton Syndrome
|
denial of blindness |
|
Riddoch phenomenon
|
patients perceive moving targets but not static ones. |
|
Balint Syndrome
|
Rare phenomenon resulting from bilateral occipotopiarietal lesions: |
|
Lateral Medullary (aka Wallenberg) syndrome
|
Damage to lateral region of brainstem |
|
Gradenigo syndrome
|
chronic inflammation of the petrous bone causing an ipsilateral abducens palsy and facial pain, especially in children who have experienced recurrent infections of the middle ear |
|
dorello canal
|
opening in the cavernous sinus below the petroclinoid ligament where the sixth enters. Site of injury due to shearing or elevated ICP.
|
|
Heimann-Beilschowsky phenomenon
|
monocular nystagmus in an eye with longstanding poor vision |
|
Alexander's law
|
nystagmus is more pronounced when gaze is directed toward the side of the fast-beating component. |
|
Melkersson-Rosenthal syndrome
|
recurrent unilateral or bilateral facial paralysis accompanied by chronic facial swelling (usually bilateral even when facial paralysis is unilateral) and lingua plicata (furrowing of the tongue). |
|
Kearns-Sayre syndrome
|
inherited mitochondrial myopathy |
|
Louis-Bar syndrome
|
ataxia-telangectasia
|
|
Terson syndrome
|
combination of vitrous and subarachnoid hemorrhage
|
|
Heidenhain variant of CJD
|
patients present primarily with isolated visual symptoms |
|
Interstitial nucleus of Cajal
|
inhibitory burst neurons for vertical saccades |
|
nucleus raphe interpositus
|
omnipause cells |
|
omnipause cells
|
cells of the nucleus raphe interpositus that normallyh inhibit bursts from the paramedian pontine reticular formation. Saccades are thought to be initiated by supranuclear inhibition of the omnipause cells, which allows burst cell impulses to activate the horizontal and vertical gaze centers. |
|
rostral interstitial nucleus of the medial longitudinal fasciculus
|
excitatory burst neurons that generate vertical and torsional saccades
|
|
region of the rostral interstitial nucleus of the medial longitudinal fasciculus and the interstitial nucleus of cajal |
inhibitory burst neurons for vertical and torsional saccades
|
|
posterior commisure
|
projecting axons from the interstitial nucleus of cajal (INC) to the contralateral CNs II, IV, VI and the contralateral INC |
|
dorsolateral pontine nuclei
|
neurons for smooth pursuit |
|
pontine paramedian reticular formation
|
excitatory burst neurons that generate horizontal saccades |
|
medullary reticular formation
|
inhibitory burst cells for horizontal gaze
|
|
y-group cells
|
cells that project ot CNs II and IV for vertical smooth pursuit and vertical vestibular eye movements |
|
nephrogenic fivbrosing dermopathy
|
potential complication of gadolinium administration in a patient with renal disease
|
|
statokinetic dissociation
|
aka Riddoch phenomenon |
|
visual allesthesia
|
patents see their environment rotated flipped or inverted |
|
dissociated nystagmus
|
difference in the amplitude of nystagmus between the two eyes |
|
Progressive Supranuclear Palsy
|
supranuclear gaze palsy that initially affects down gaze |
|
Budge-Waller nucleus
|
where the first order symapthetic neurons of the orbital pathways synapse with the second order neurons in the cervical spinal cord (at C8-T12) |
|
Idiopathic Stabbing Headache
|
aka “ice pick headache” and “Jabs and jolts syndrome” |
|
Still disease
|
systemic onset JIA usually seen in children under 5. Characterized by fever, rash, lymphadenopathy and hepatosplenomegaly. Joint invovlement may be minimal or absent, initially.
20% of all JIA cases few than 6% have uveititis |
|
pauciarticular vs. polyarticular
|
paucyarticular <= 4 joints
polyarticular > 4 joints |
|
Löfgren syndrome
|
acute sarcoidosis consisting of erythema nodosum, febrile arthropathy, bilateral hilar adenopathy and acute iritis. It is highly responsive to systemic corticosteroids and has a good long-term prognosis.
|
|
what is the inheritence pattern for axenfeld reiger
|
autosomal dominant
|
|
what are the mutations cause axenfeld reiger?
|
PITX2 and FOXC1
|
|
Heerfort syndrome
|
aka uveoparotid fever: a form of acute sarcoidosis associated with uveitis, parotitis, fever and facial nerve palsy
|
|
What do the divisions of the oculomotor nerve innervate?
|
|
|
when does retinal vascularization complete?
|
nasal quadrants at 36 weeks
temporal quadrants at 40 weeks |
|
what is the treatment for homocysteinuria?
|
oral pyridoxine, folic acid and vitamin B12
|
|
when should visually significant congenital cataracts be fixed?
|
unilateral: before 6 weeks
bilateral: before 10 weeks |
|
what are the yoke muscle pairs
|
|
|
What is PHACE(S) syndrome?
|
PHACE(S) actually stands for: |
|
spiral of tilaux
|
medial rectus inserts 5.5 mm from the limbus
inferior rectus inserts 6.5 mm from the limbus lateral rectus inserts 6.9 mm from the limbus superior recuts inserts 7.7 mm from the limbus |
|
what kind of hypersensitivity in becets disease?
|
initially the lesions resemble delayed-type hypersensitivity. later lesions resemble immune complex type reactions
|
|
what type of hypersensitivity is steven's johnson
|
type III |
|
what is the definition of threshold disease in ROP
|
(>= 5 contiguous clock hours of stage 3 ROP OR >= 8 cumulative clock hours of stage 3 ROP) in zone 1 or 2 in the presence of plus disease
|
|
what is plus disease in ROP |
vascular dilitation and tortuosity in the pole (indicative of active progression) |
|
what is the average volume of the vitreous cavity
|
5-6 mL |
|
what is the average volume of the vitreous
|
4 mL
|
|
what is the average volume of the AC
|
200 mL
|
|
what is the basic secretion test?
|
steps |
|
what is the Schirmer 1 test?
|
steps
1. blotting of residual film from the inferior fornix 2. application of standard filter paper strip 3. wait 5 minutes interpretation of results less 5.5mm is abnormal |
|
what is the average volume of the posterior chamber |
60 microliters
|
|
what mutation causes granular corneal dystrophy
|
TGFB1 (locus 5q31)
|
|
what material is deposited in granular corneal dystrophy
|
hyaline
|
|
what stain for granular corneal dystrophy
|
Masson's trichrome
|
|
what mutation causes reis-buckler's corneal dystrophy?
|
TGFB1
|
|
what mutation causes lattice dystrophy type one
|
TGFB1
|
|
what mutation causes Avellino corneal dystrophy |
TGFB1
|
|
what kind of immune hypesensitivity reaction is OCP |
type II cytotoxic
|
|
how many ganglion cell axons make up the optic nerve?
|
1-1.2 million
|
|
what HLA associated with chronic arthritis in lyme disease?
|
HLA-DR4, -DR2 (in north america)
|
|
what HLA associated with poorer response to antibiotics in lyme disease?
|
HLA-DR4.
|
|
what corneal dystrophy is this?
|
Reis-Bucklers or Theil-Beneke (only possible to differentiate on electron microscopy).
|
|
What layer is ****** up in Reis-Bucklers corneal dystrophy
|
bowmans
|
|
What layer is ****** up in Theil-Beneke corneal dystrophy
|
bowmans
|
|
how are Reis-Buckler and Theil Beneke differentiated?
|
EM; Theil-Beneke has curly fibers.
|
|
what protein is ****** up in Reis-Buckler and Theil-Beneke?
|
keratoepithelin
|
|
what are the corneal dystrophies associated with defects in TGFB1? |
Ries-Buckler
Theil-Beneke lattice granular |
|
what is the rate of aqueos production?
|
2-3 microliters per minute.
|
|
what is Chediak-Higashi syndrome
|
oculocutaneous albinism associated with extreme susceptibility to infection.
|
|
what is Hermansky-Pudlak syndrome?
|
features
oculocutaneous albinism platelet deficit easy bruising bleeding diathesis lysosomal storage dysfunction pulmonary fibrosis colitis more common in Puerto Ricans |
|
what does the right 3rd nerve nucleus innervate?
|
RIO, RIR, RMR, LSR (only the fibers to the LSR decussate).
|
|
what does the right 4th nerve nucleus innervate?
|
the LSO (because the fibers decussate before exiting the brainstem).
|
|
what is the classic manifestation of a lesion of the third nerve nucleus
|
Ipsilateral third nerve palsy and contralateral palsy of the superior rectus and levator palpebrae.
|
|
what glaucoma drop has the highest incidence of blepharitis/dermatitis
|
apraclonidine
|
|
what glaucoma drops are safe in pregnanacy?
|
all drops are pregnancy class C (bad in animals, no studies in humans) except brimonidine and dipivefrin which are class B (animal studies ok, no studies in humans). |
|
what glaucoma drops should not be given to breast feeding mothers
|
brimonidine and timolol |
|
which steroids produce less of a rise in IOP
|
loteprednol
fluoromethalone rimexolone |
|
what glaucoma drops should be avoided in people with herpetic keratitis
|
prostaglandin analogs (risk of reactivation)
|
|
when do the lacrimal glands start working?
|
6 weeks after birth
|
|
what percentage of infants have obstruction at the valve of Hasner at birth/
|
50%
|
|
what is the Jones I test?
|
Aka primary dye test
1. put fluorescein into fornices 2. put cotton tipped applicator in the region of the ostium of the NLD at 2 and 5 minutes occasionally yields false positives, so not uniformly performed. |
|
what is the Jones II test?
|
Used to determine level of obstruction
Steps 1. If Jones I was performed, the residual fluorescein is flushed from the fornix 2. Lacrimal drainage system irrigation is performed with clear saline 3. fluid is retrieved from the nose * Not routinely done because it is a pain in the ass |
|
what is the immune response to parasitic infections? |
Th2-mediated response leading to local eosinophilia.
|
|
what is the most common infectious cause of neuroretinitis?
|
b. henselae
|
|
what imaging modality is best for the orbital apex?
|
MRI (CT sucks)
|
|
what is echothiophate?
|
aka phopholine iodide. indirect-acting muscarinic agonist that works by inactivating acetylcholineesterase.
Used in accomodative esotropia to directly stimulate the ciliary body, reducing the central demand for accomodation and thereby reducing excessive convergence of the eye No longer available for glaucoma therapy |
|
what medication should not be used with echothiophate? |
succinylcholine (will lead to prolonged paralysis) |
|
what is the main side effect of echothiophate?
|
formation of iris cysts
|
|
how can the formation of iris cysts by echothiophate be prevented?
|
co-administration of phenylephrine
|
|
what is Alagille syndrome?
|
Jaundice, Cardiac defects, posterior embryotoxon, broadened forehead, pointed chin, butterfly hemivertebrae, mild developmental delay.
|
|
what is the inheritance of Alagille syndrome
|
autosomal dominant (mutation of JAG1 gene, chromosome 20p12)
|
|
what 3 GAGs are found in the corneal stroma?
|
keretan sulfate
dermatan sulfate chondroitin sulfate |
|
what mutation has been linked to juvenile-onset open-angle glaucoma?
|
TIGR (renamed myocillin MYOC)
|
|
what mutation has been linked to normal tension glaucoma?
|
OPTN (optineurin)
|
|
what mutations have been linked to axenfeld-reiger syndrome?
|
PITX2 and FOXC1
|
|
what are the bones of the orbital roof?
|
frontal and lesser wing of the sphenoid
|
|
what are the bones of the medial wall of the orbit
|
lesser wing of sphenoid, maxillary, ethmoid, lacrimal (SMEL)
|
|
what are the bones of the floor of the orbit
|
maxillary, palatine, zygomatic
|
|
what are the bones of the lateral wall of the orbit?
|
greater wing of sphenoid and zygomatic
|
|
what is the inheritance pattern of lattice corneal dystrophy
|
autosomal dominant
|
|
what site of perioocular origin has the highest risk for subsequent sytemic non-hodgkins lympohoma?
|
eyelid
|
|
what are the two most common causes of vision loss in congenital rubella syndrome?
|
cataract and micoophthalmos
|
|
what is the chance of a child of a person with hereditary retinoblastoma getting retinoblastoma?
|
0.5 chance of inheriting gene x 0.9 penetrance = 0.45
|
|
what is a fleischer ring?
|
ring of iron deposited at base of keratoconus cone
|
|
what is Rizzuti sign?
|
conical reflection is seen on nasal cornea when light is shone from the temporal side.
|
|
what are vogt lines |
parallel, usually vertical, lines in deep stroma of some keratoconus patients
|
|
what corneal diameter defines microcornea? |
9mm in infants, 10 mm at age 2 |
|
what is the normal corneal diameter in childreN?
|
9.5-10.5mm in newborns
10.0-11.5 in 1 year olds |
|
what mutations cause congenital glaucoma?
|
CYP1B1
GLC3A GLC3B GLC3C |
|
what mutation causes pseudoexfoliation glaucoma?
|
LOXL1
|
|
what factors increase the risk for PBK?
|
endothelial counts < 1000
corneal thickness greater than 650 microns |
|
what is the normal endothelial cell count?
|
1500-3500
|
|
What is De Morsier syndrome
|
septo-optic dysplasia
|
|
how long can dropped nuclear remnants be left in the eye before vitrectomy before increasing the risk of CME
|
3 weeks.
|
|
how long after injury to retinal ganglion cells or their axons does it take for optic nerve atrophy to appear? |
4-6 weeks
|
|
what is the minimum AC depth required for implantation of an intraocular contact lens (ICL)?
|
3mm |
|
what is the angle alpha?
|
the angle between the visual and optical axis. positive when the object is on the nasal side of the optical axis. |
|
what are axenfeld loops
|
ciliary nerves in the sclera near the limbus |
|
angiod streaks associations
|
P seudoxanthoma elasticum
E hlers dahnlos P aget's disease S ickle cell I diopathic |
|
does UVA or UVB penetrate deeper and **** up the lens?
|
UVA
|
|
which type of aniridia is associated with Wilm's tumor, familial or sporatic?
|
sporatic; however, due to reports of Wilm's tumor in familial cases, screening is advocated
|
|
what mutation causes aniridia?
|
PAX6
|
|
why is sporatic aniridia associated with wilm's tumor?
|
the responsible gene, PAX6, is adjacent ot the gene for wilms tumor (WT1). IN cases of of aniridia with wilms tumor, both genes are deleted. |
|
what diseases cause true conjuntival membranes?
|
bacterial conjunctivitis, chemical burns, ligneous conjunctivitis
|
|
what diseases cause conjunctival pseudomembranes?
|
OCP, stephen's johnson, EKC, superior limbic keratitis
|
|
what are membranous cataracts?
|
lens proteins are resorbed and the anterior and posterior capsules fuse
|
|
what diseases are associated with membranous cataracts?
|
lowe syndrome, hallerman streif syndrome, microphthalmos and congenital rubella syndrome |
|
which uveitis causes in increase in IOP?
|
herpetic. most other uveitisis causes a decrease in IOP due to decreased production of acqueous by the ciliary body
|
|
what kind of cataract is caused by galactosemia?
|
oil droplet
|
|
what type of cataract is cause by myotonic dystrophy
|
christmass tree-appearing crystaline cataracts, posterior subcapsular cataracts that will lead to complete opacification
|
|
what causes snowflake cataracts
|
diabetes
|
|
what things cause ectopia lentis?
|
Marfan syndrome |
|
what are the criteria for mild, moderate and severe non-proliferative diabetic retinopathy (NPDR)
|
Nonproliferative diabetic retinopathy
Mild: Indicated by the presence of at least 1 microaneurysm Moderate: Includes the presence of hemorrhages, microaneurysms, and hard exudates Severe (4-2-1): Characterized by one of the followign: 1) hemorrhages and microaneurysms in 4 quadrants, with venous beading in at least 2 quadrants and intraretinal microvascular abnormalities in at least 1 quadrant |
|
how long does the retisert (fluocinolone acetide) implant last?
|
median of 30 months
|
|
what is the incidence of side effects with the retisert (fluocinolone acetide implant)
|
virtually all phakic patients develop a cataract
30% require glaucoma filtering surgery after 2 years of implantation |
|
what blood disorder increaes the risk of leukemia when taking chloambucil?
|
polycythemia vera
|
|
what cnacer is increased with cyclophosphamide? |
33 fold increase risk of bladder cancer
|
|
what ar ethe AAOs preferred practice guidelines for treating retinal breaks with laser demarkation
|
acute symptomatic horschoe tears: treat promptly |
|
what is a paradoxical pupillary reaction?
|
constriction in dark. Most significant in children with poor vision. Highly suggestive of optic nerve or retinal pathology
|
|
what is the differential diagnosis for paradoxical pupillary reaction?
|
congenital stationary night blindness
congenital achromatopsia Best disease dominant optic atrophy optic nerve hypoplasia Leber congenital amaurosis Albinism retinitis pigmentosa |
|
what causes sunflower cataracts?
|
copper foreign bodies (chalcosis)
wilson's disease |
|
what is the differential for corneal verticillata?
|
amiodarone (most common)
chloroquine hydroxychloroquine chlorpromazine subconj gentamycin ibuprofen indomethacin naproxen tamoxifen Fabry disease |
|
what is the WAGR complex?
|
Wilm's tumer, Aniridia, Genitourinary abnormalities and Retardation; caused by PAX6 mutation.
|
|
what can be caused by PAX6 mutations?
|
aniridia, peter's anomaly, axenfeld anomaly, posteriro embyrotoxon, congenital cataracts, WAGR complex
|
|
what type of cataract is caused by topical or systemic steroids?
|
posterior subcapsular
|
|
what mutation causes Fabry disease?
|
alpha galactosidase A
|
|
what metabolic product accumulates in Fabry disease?
|
ceramide trihexoside
|
|
what is the maximum luminance that the humphrey VF can project?
|
10K apostlibs
|
|
what is the maximum luminance that the goldman VF can project?
|
1K apostlibs
|
|
what is Raymond syndrome?
|
6th nerve palsy with contralateral hemiparasis due to a lesion in the mid pons affecting the 6th nerve fasciculus and the corticospinal tract
|
|
what is weber syndrome? |
3rd nerve palsy and contralateral hemiparesis caused by a midbrain lesion
|
|
what is Benedikt syndrome?
|
ipsilateral 3rd nerve palsy and contralateral rubral tremor (slow frequency termor with activity and at rest) due to midbrain lesion affecting the 3rd nerve fascicle and red nucleus
|
|
what is claude syndrome?
|
ispilateral 3rd nerve palsy and contralateral ataxia due to damage to the dorsal midbrain affecting the superior cerebellar peduncel and the 3rd nerve fasciculus
|
|
what mutation has been associated with weil marchesani syndrome?
|
adams10
|
|
what are the eponyms of the iris nodules seen in sarcoidosis?
|
Berlin - iris angle
Busacca - iris stroma Koeppe - pupillary margin start at the angle and proceed to pupil margin in alphabetical order |
|
how is meesman corneal dystrophy inherited?
|
autosomal dominant
|
|
what is meesman corneal dystrophy
|
multiple small epithelial vesicles or microcysts
causes slight irritation and slighty decreases in visual acuity sometimes painful recurrent erosions can occur |
|
what gene is responsible for meesman corneal dystrophy?
|
mutations in keratin K3 and K12
|
|
what are the layers of the TM from inner to outer
|
1. uveal
2. corneoscleral 3. juxtacannalicular |
|
what layer of the TM is responsible for the majority of aqueous resistance?
|
juxtacannalicular
|
|
what does the superior division of CN III innervate?
|
superior rectus and levator
|
|
what does the inferior division of CN III innervate?
|
medial, lateral and inferior rectus and inferior oblique
|
|
what is the average thickness of the corneal epithelium?
|
50 microns
|
|
what is the inheritance pattern of ectopia lentis e pupillae?
|
autosomal recessive
|
|
what is Heimann-Beilchowsky phenomon
|
Monocular nystagmus in an eye with longstanding poor vision. It may become manifest in adulthood and may not remit even if the visual problem is corrected.
|
|
what type of leukemia is most likely to metastasize to the orbit
|
ALL
|
|
what is the most common orbital lymphoma?
|
non-hodgkin's b-cell lymphoma, usually presenting as part of primary CNS lymphoma
|
|
which beta blocker glaucoma drop is beta-1 selective?
|
betaxolol
|
|
which beta blocker drop has intrinsic sympathomimetic activity and reduces cardiac and pulmonary symptoms
|
carteolol
|
|
what is the proper treatement for eye clap in a newborn
|
systemic ceftriaxone; eye clap can rapidly cause ulceration and perforation, so systemic treatment is necessary
|
|
why do you do a dilated peripheral fundus exam on patients with pigmentary glaucoma?
|
typically occurs in high myopes so they are at increased risk of retinal breaks
|
|
below what pupil diameter can you get global depression defects on HVF?
|
2.5
|
|
what was the most common organism isolated from culture in the EVS?
|
staph epi. (coag neg, catalase pos)
|
|
at what CD4 count do HIV patients typically become symptomatic?
|
< 200
|
|
what is the inheritance pattern of LIsch corneal dystrophY?
|
x-linked dominant
|
|
what percentage of patient's with ankylosing spondylitis are HLA-B27 positive?
|
90%
|
|
what is the inheritance pattern of Theil-Beneke corneal dystrophy?
|
autosomal dominant
|
|
what is the diameter of the foveal avascular zone/
|
250-600 microns
|
|
What are the only proven treatments for sjs
|
Iv steroids and amniotic membranes
|
|
What is cogan's lid teitch
|
Sign seen in myasthenia gravies where eyelids overshoot when looking up after prolonged down gaze.
|
|
What is the volume of the orbit?
|
30 mL
|
|
how do quinolones and fluoroquinolones work?
|
inhibit DNA gyrase and topoisomerase II and thus inhibit bacterial replication
|
|
how do tetracyclines work? |
inhibit 30s ribosomal subunit
|
|
how do polymixins work?
|
disrupt the structure of a bacterial cell wall by interacting with its phospholipids; selectively toxic to gram negative bacteria due their specificity for a lipopolysaccharide in their outer membranes
|
|
what is Usher syndrome?
|
RP + congenital sensorineural hearing loss
|
|
what is the inheritance pattern of Usher syndrome
|
autosomal recessive
|
|
what corneal diameter is suggestive of congenital glaucoma?
|
>12mm
|
|
what is the treatment for HZO?
|
acyclovir 800mg 5x/day for 7-10 days |
|
what gene causes autosomal dominant optic atrophy (kjer syndrome)
|
OPA1 |
|
where are the most common sites of globe rupture after blunt eye trauma?
|
under insertions of rectus muscles and at the limbus
|
|
what breakdown pathway is responsible for diabetic cataracts?
|
sorbitol
it is usually minimally activated in the lens, but in hyperglycemic states becomes more activated. sorbitol becomes trapped in the lens and creates an osmotic gradient that causes lens swelling |
|
what is marcus-gun jaw winking?
|
2 forms
abberrent co-innervation of the external-pterygoid and levator leads to eyelid elevation with: movement of mandible to opposite side jaw thrust opening mouth aberrent co-innervation of the internal-pterygoid and levator leads to eyelid elevation with teeth are clenched uncommonly, in some patients ptosis may worsen with movement of the jaw |
|
what is the inheritance of Hermansky-Pudlak syndorme?
|
autosomal recessive
|
|
what is the inheritance of Chediak-Higashi?
|
autosomal recessive
|
|
which fungi have septate hyphae?
|
fusariam, aspergillus, curvularia
|
|
which fungi have non-septate hyphae?
|
mucor, absidia, rhizopus
|
|
why is pilocarpine 4% (but not 1%) contraindicated during acute angle closure glaucoma?
|
shifts the lens-iris diaphragm forward. pilocarpine 1% is used to bring the pupil down to do a laser PI.
|
|
what is Henle's layer?
|
outer plexiform layer in the macula
|
|
what layer do exudates deposit in in macular star formation?
|
outer plexiform layer
|
|
what are pseudodendrites?
|
not completely devoid of epithelium with distinct margins like real dendrites in herpes are
|
|
what causes pseudodendrites?
|
tyrosinemia
|
|
what is the most common endocrinopathy in septo-optic dysplasia?
|
GH deficiency
|
|
what are the criteria for clinically significant diabetic macular edema?
|
Criteria (based only on slit lamp exam) are one of the following:
1. retinal edema within 500 micrometers of the center of the macula 2. hard exudates within 500 micrometers of the center of the macula, if associated with adjacent thickening 3. a zone of thickening larger than 1 disc area if located within 1 disc diameter of the macula |
|
what is the treatment for clinically significant diabetic macular edema?
|
focal laser photocoagulation
|
|
in what direction is the lens dislocated in ectopia lentis e pupillae
|
opposite the direction of the pupil
|
|
what percentage of hyperthyroid patients will develop eye disease?
|
30%
|
|
what percentage of thyroid eye patients will become hyperthyroid at some point?
|
90%
|
|
where is the marginal artery located?
|
3mm superior to the superior eyelid margin
|
|
where is the peripheral arterial arcade located?
|
just superior to the tarsus between muller's muscle and the levator
|
|
what is the primary collage of the sclera?
|
type I
|
|
what chromosome is the Rb gene on
|
13
|
|
what chromosome is responsible for NF1 |
17
|
|
what chromosome is responsible for NF2 |
22
|
|
what genes are responsible for tuberous sclerosis?
|
TSC1 on chromosome 9
TSC2 on chromosome 16 |
|
what is the weakest part of the maxilla?
|
posteromedial part
|
|
what organism is most commonly involved in pre-septal cellulitis after trauma?
|
staph aureus
|
|
what collagen is associated with stromal wound healing?
|
type III
|
|
is ICE syndrome typically unilateral or bilateral?
|
unilateral
|
|
is axenfeld rieger usually unilateral or bilateral?
|
bilateral
|
|
is peters anomaly usually unilateral or bilateral? |
bilateral
|
|
what is the treatment for congenital dacryocystocoele?
|
gentle massage plus topical antibiotics for 1-2 weeks, followed by lacrimal duct probing if failure to resolve
|
|
what imaging modality is best for the orbital apex?
|
MRI
|
|
what is Melkersson-Rosenthal syndrome?
|
recurrent unilateral or bilateral facial paralysis accompanied by chornic facial swelling and lingua plicata (furrowing of the tongue)
|
|
what cytokines do Th1 helper cells produce?
|
IL-2, INF-γ, TNF-β, IL-12
|
|
what cytokines do Th2 helper cells produce? |
IL-4, IL-5 and IL-10
|
|
what is the length of the lacrimal cannaliculi?
|
2mm vertical + 8-10mm horizontal
|
|
what is the length of the lacrimal sac?
|
12-15mm
|
|
what is the length of the nasolacrimal duct?
|
12-18mm
|
|
what direction does the pupil usually decenter when constricted?
|
superonasally
|
|
what antibiotics can be used for b. cereus endophthalmitis?
|
vancomycin or clindamycin
|
|
what medicine is given to prevent heart block when performing the tensilon test for myasthenia gravis?
|
atropine
|
|
what is the diameter of the optic nerve head?
|
1.5mm
|
|
what is the diameter of the intraorbital optic nerve?
|
3mm
|
|
what myelinates the optic nerve?
|
oligodendrocytes
|
|
does POHS have vitritis?
|
never
|
|
does MFC have vitritis?
|
yes
|
|
what is the least common presenting symptom of orbital rhabdomyosarcoma?
|
pain (10%)
|
|
what is the most common presenting symptom of orbital rhabdomyosarcoma?
|
proptosis (80-100%) followed by globe displacement (80%)
|
|
what glaucoma drops should not be used with an open posterior capsule?
|
non-selective alpha agonists such as epinephrine and dipivefrin because they can cause or exacerbate CME
|
|
what glaucoma drops can exacerbate CME
|
dipivefrin
epinephrine prostaglandin analogs |
|
what types of collagen are in the corneal stroma/
|
I, III, V, VI
|
|
what is Löfgren syndrome?
|
acute sarcoidosis with
erythema nodosum febrile arthropathy bilateral hilar adenopathy acute iritis |
|
what is Heerfordt syndrome?
|
acute sarcoidosis with
uveitis parotitis fever facial nerve palsy |
|
where does the sphenoid sinus drain?
|
sphenoethmoidal recess (which is above the superior turbinate)
|
|
what drains into the medial meatus?
|
frontal sinus
anterior and medial ethmoidal sinuses maxillary sinus |
|
what drains into the inferior meatus |
NLD
|
|
what drains into the superior meatus?
|
posterior ethmoidal sinus
|
|
what are the earliest signs of malignant hyperthermia? |
elevation of end-tidal CO2
tachycardia |
|
where are the limbal palisades of vogt located?
|
1-2mm posterior to the limbus where the conj and tenons fuse
|
|
how long does it take for the corneal endothelium to completely regenerate?
|
7 days
|
|
what is the hallmark of limbal stem cell deficiency?
|
presence of goblet cells on impression cytology, using PAS or alcian blue stain
|
|
how can you diagnose limbal stem cell deficiency
|
A. impression cytology (preferred):
1. presence of goblet cells (hallmark) 2. presense of conj epithelial cells (also a sign) B. excisional biopsy |
|
what does the ventral ophthalmic artery become (embryology)?
|
the nasal long posterior artery
|
|
what does the dorsal ophthalmic artery become (embryology)
|
the ophthalmic artery
|
|
what medication frequently used in HIV and CMV retinitis causes a secondary anterior uveititis?
|
cidofovir
|
|
what antivirals cause bone marrow suppression?
|
gancyclovir
zidovudine (AZT) |
|
what is the most common location for limbal dermoids?
|
inferotemporal
|
|
what is the treatment for blebitis
|
blebitis has no hypopyon or vitritis and can be treated with topic antibiotics
|
|
what is the treatment for bleb-related endophthalmitis?
|
controversial, but typically vitrectomy
|
|
what are the most common cancers associated with BDUMP
|
ovarian, urterine and lung
|
|
what immunomodulator can worsen MS?
|
infliximab
|
|
what immunomodulatory drug is the best monotherapy for behcets disease?
|
chlorambucil
|
|
what are the settings for ALT?
|
50 micron spot
0.1 s duration 300-1000mW of power |
|
what are the settings for SLT?
|
400 micron spot
3 nanosecond duration 0.5-1.2 mJ of power |
|
what is the most common type of functional pituitary adenoma? |
prolactinoma
|
|
is PFV usually unilateral or bilateral
|
90% unilateral
|
|
what are the risk factors for suprachoroidal hemorrhage?
|
advanced age
myopia atherosclerotic cardiovascular disease aphakia glaucoma HTN tachycardia |
|
what is the best screening test for sarcoidosis?
|
CXR
|
|
what is the morphology of bartonella henselae?
|
gram negative rod
|
|
what is the primary limiting side effect of zidovudine (AZT)
|
bone marrow suppression
|
|
what is the Somogyi phenomenon?
|
institution of medications in diabetics causes hypoglycemia which subsequently leads to a rebound hyperglycemia
|
|
what is the dawn phenomenon?
|
the occurrence of morning hyperglycemia not associated with hypoglycemia at night. It is thought to be due to a growth hormone surge.
|
|
what are optocilliary shunt vessels?
|
Optociliary shunt vessels (aka retinochoroidal collaterals) are a dilation of the naturally-occurring veins that drain from the peripapillary retinal circulation into the choroidal circulation. Similar to hemorrhoids or esophageal varices, optociliary shunt vessels evolve in response to chronically-poor drainage of the central retinal vein. The differential for optociliary shunt vessels is an important one and includes: optic nerve sheath meningiomas, low-grade optic nerve gliomas, chronic papilledema, chronic glaucoma, and old central retinal vein occlusions.
|
|
which rectus muscle has only one anterior cilliary artery?
|
lateral rectus. all the others have two.
|
|
Diffraction limits the visual acuity in a person's eye when the pupil size is below what threshold diameter?
|
2.5mm
|
|
what does the orbital part of the orbicularis do?
|
forced (voluntary) eyelid closure
|
|
what does the palpebral (pre-septal, pre-tarsal) part of the orbicularis do?
|
involuntary blinking
|
|
what is the followup period after initiating full-time patching for amblyopia?
|
one week per year of age
|
|
how do radial incisions affect the topography of the cornea?
|
flatten in the meridian of the incision and 90 degrees away
|
|
how do arcuate incisions affect the topography of the cornea |
flatten in the meridian of the incision and steepen in the meridian 90 degrees away
|
|
what gene causes congenital hereditary stromal dystrophy
|
decorin gene, chromosome 12
|
|
what gene causes macular stromal dystrophy?
|
carbohydrate sulfotransferase 6 (CHST6)
|
|
what gene causes gelatinous drop-like corneal dystrophy?
|
tumor-associated calcium signal transducer 2 (TACSTD2)
|
|
what are the largest crystalins in the lens?
|
alpha
|
|
what is the background luminance of the goldmann and humphry VF machines?
|
31.5 apostlibs
|
|
how long should a uveitic eye be quiet before elective (e.g. cataract) surgery
|
3m
|
|
what part of the lacrimal gland should be biopsied
|
orbital. the ductules pass through the palpebral part, so it should not be biopsied
|
|
what medications cause delayed corneal stromal healing?
|
acutane and amiodarone
|
|
what medications cause delayed corneal epithelial healing?
|
antihistamines, sumatriptan, HRT
|
|
what are the major side effects of cyclosporine?
|
HTN and kidney damage
|
|
what is the difference between wavefront-optimized and wavefront-guided laser ablation
|
optimized means more peripheral spots to attempt to minimize higher order aberations
guided means a wavefront-sensing aberrometer is used to quantify higher-order preop abberations and fix them |
|
what layers of the lateral geniculate nucleas receive fibers from the ipsilateral eye?
|
prime numbers: 2,3,5
|
|
what layers of the latearl geniculate nucleas receive fibers from the contralateral eye?
|
1,4,6 (non-primes)
|
|
what VF defect is produced by a lesion of the optic nerve where it meets the chiasm?
|
junctional scotoma: central scotoma of ipsilateral eye and temporal hemianopia of the contralateral eye
|
|
what is the pupillary light reflex pathway?
|
The signal travels with the optic nerve, decussates in the chiasm, travels with the optic tracts, then splits from the optic tracts to reach the pretectal nuclei at the level of the superior colliculus.
Efferent fibers decussate and go to the Edinger-Westphal nuclei (note that there are TWO decussations before reaching the Edinger-Westphal nuclei). Pre-ganglionic parasympathetic fibers leave the Edinger-Westphal nuclei, traveling with CN III, and then the inferior division of CN III in the orbit. These fibers synapse with the ciliary ganglion. The ciliary ganglion gives off the post-ganglionic short posterior ciliary nerves which innervate the iris sphincter and ciliary muscle. |
|
Ps mneumonic for MEN syndromes
|
MEN I (3 Ps) - Pituitary, Parathyroid, Pancreas
MEN IIa (1M,2Ps) - Medullary Thyroid Ca, Pheochromocytoma, Parathyroid MEN IIb (2Ms,1P) - Medullary Thyroid Ca, Marfanoid habitus/mucosal neuroma, Pheochromocytoma |
|
what is alagille syndrome?
|
intrahepatic cholestasis (causing jaundice), posterior embryotoxon and/or Axenfeld anomaly, pigmentary retinopathy, congenital heart disease, flattened facies, and other bony abnormalities.
|
|
what is the reconstructive ladder for lower eyelid defects?
|
|
|
what is the treatment for insecticide?
|
pralidoxime and/or atropine
|
|
what is the most common cause of bacterial keratitis in contact-lens wearers?
|
pseudomonas
|
|
what is the capsulopalpebral fascia?
|
the equivalent of the levator aponeurosis in the lower eyelid. The capsulopalpebral fascia originates from the muscle fibers of the inferior rectus. It extends forward, wraps around the inferior oblique, and then inserts into the inferior tarsal border.
|
|
what glaucomas does laser trabeculoplasty suck for?
|
low tension glaucoma
uveitic glaucoma angle recession glaucoma ICE syndrome neovascular glaucoma glaucomas associated with elevated episcleral venous pressure (e.g. sturge weber, CC fistula) |
|
what is Pulfrich phenomenon ?
|
he illusion that an object moving perpendicular to a person's line of sight is actually moving toward them or away from them. Theoretically, it could be seen in any disease affecting the conduction of visual information in one optic nerve more than the other. It is usually described in patients who have partially recovered following a bout of optic neuritis.
|
|
at what endothelial cell count threshold will corneal edema typically occur (without any additional insult)
|
500 cells/mm2
|
|
what is Mikulicz syndrome
|
lacrimal gland enlargment, salivary gland enlargement, and keratoconjunctivitis sicca
|
|
Which molecule is found in aqueous humor at concentrations 10-50 times higher than in plasma? |
ascorbic acid (vitamin c)
|
|
A pupil-involving third nerve palsy is assumed to caused by an aneurysm until proven otherwise by neuro-imaging. Where is the most common location of the causative aneurysm?
|
at the junction of the posterior communicating artery and the internal carotid artery
|
|
what is the inheritance pattern of macular dystrphy
|
autosomal recessive
|
|
What is the 5-year risk of contralateral involvement in patients with acute monocular non-arteritic anterior ischemic optic neuropathy?
|
12-19%
|
|
in what quadrant does a BRVO usually occur in?
|
superotemporal
|
|
what are the steps of astigmatic dial refraction?
|
First, fog the patient to about 20/60 by adding plus sphere.
Second, ask the patient which line of the astigmatic dial appears darkest and sharpest. Third, add minus cylinder perpendicular to the axis or plus cylinder parallel to this axis until all of the lines are equally sharp. Fourth, reduce the sphere using the Snellen acuity chart until vision is clearest. If you are using a plus cylinder phoropter, for every 0.50 diopter of cylinder that you add, you must also subtract 0.25 diopters of sphere. |
|
what is the definition of ocular hypertelorism?
|
increase in both the medial and lateral intercanthal distances (distance between the two eyes)
|
|
what is the definition of orbital hypertelorism?
|
increased distance between the medial orbital walls
|
|
what is telecanthus?
|
increased distance between the medial canthi
|
|
what type of ganglion cells does frequency doubling technology typically stimulate?
|
M cells
|
|
what type of ganglion cell does short wave automated perimetry preferentially stimulate?
|
koniocellular
|
|
what is Raymond syndrome?
|
a 6th nerve palsy with a contralateral hemiparesis due to a lesion in the mid pons affecting the 6th nerve fasciculus along with the corticospinal tract.
|
|
what is Claude syndrome?
|
Claude syndrome is caused by damage to the dorsal midbrain affecting the superior cerebellar peduncle and 3rd nerve fasiculus typically resulting in ipsilateral 3rd nerve palsy and contralateral ataxia.
|
|
what is Millard-Gubler syndrome?
|
a lesion in the ventral pons that disrupts: 1) the 6th nerve fasciculus resulting in an ipsilateral abduction deficit; 2) the corticospinal tract before decussation in the medulla causing contralateral spastic hemiplegia; and 3) the 7th nerve fasciculus resulting in an ipsilateral facial weakness.
|
|
what infectious agents are associated with Bell's palsy? |
varicella zoster virus, Mycoplasma pneumonia1, and Borrelia burgdorferi (Lyme disease).
|
|
how do you obtain a better 3D view through a small pupil with the indirect?
|
In situations where the patient's pupil is small, light rays from the observer's pupils can be brought closer together by either retracting the mirror closer to the observer's forehead or by increasing the interpupillary distance of the indirect. This allows light rays from each observer's pupils to strike closer to the tip of the mirror and be closer together as they enter the patient's pupil.
|
|
what are Cowdry type 1 bodies?
|
inclusion bodies seen in HSV and VZV
|
|
what are Halberstaedter-Prowazek Bodies?
|
inclusion bodies seen in trachoma
|
|
what is the refractive power of the anterior corneal surface?
|
+48D
|
|
what are the main nutritional sources of the cornea?
|
(1) glucose from the underlying aqueous humor; and (2) oxygen diffusing through the tear film. The peripheral cornea does receive some oxygen from the limbal circulation.
|
|
how many degrees apart are the testing points in the 24-2 and 30-2 HVF?
|
6
|
|
What is the normal adult number of axons in the optic nerve?
|
1.1M
The largest number of axons achieved in the optic nerve is 3.7 million at 16 wks. These nerves are pruned to 1.1 million by the 33 week and stay at that number. |
|
What are dellen?
|
saucerlike areas of corneal depression adjacent to raised areas of conjunctiva. There is thinning of the epithelium and stroma secondary to drying due to a poor blink.
|
|
where does the levator aponeurosis attach?
|
lower 1/2 of the anterior part of the tarsal plate
|
|
what is the optimal Q value
|
-0.5
|
|
what is the Q value of the average human cornea?
|
-0.26
|
|
what does Q mean?
|
asphericity of the cornea. Q<0 = prolate, Q>0 = oblate
|
|
what are the surgical margins for CIN?
|
3-4 mm margins and cryotherapy to the bordering conjunctiva.
|
|
what are the medical treatments for CIN?
|
topical interferon-a2b, mitomycin-C, and 5-fluorouracil eyedrops.
|
|
what percentage of optic neuritis patients have pain?
|
92%
|
|
what is the treatment for gyrate atrophy?
|
arginine restriction and vitamin B6 supplementation
|
|
what is the treatment for homocystineuria?
|
methoinine restriction, high cysteine, vitamin B6 supplementation
|
|
What is the blood supply to the intracanalicular portion of the optic nerve?
|
ophthalmic artery
|
|
what is aicardi syndrome?
|
x-linked dominant
widespread round or oval depigmented chorioretinal lacunae infantile spasms agenesis of the corpus callosum typically lethal in males colobomas and microphthalmos may also occur |
|
where is the foveola in relation to the optic nerve?
|
4.0 mm temporal and 0.8 mm inferior to the optic nerve
|
|
what is the diameter of the foveola?
|
350 microns
|
|
what is the diameter of the fovea?
|
1.5mm
|
|
what is the treatment for ciliary block glaucoma (aka aqueous misdirection)
|
Medical treatment is successful 50% of the time and involves intense mydriasis and cycloplegia (phenylephrine 10% and atropine), aqueous suppressants, and oftentimes hyperosmotics.
If these treatments fail, disruption of the anterior hyaloid face with YAG laser or pars plana vitrectomy is needed. |
|
what is Loewenstein-Jensen medium for?
|
Mycobacteria and Nocardia
|
|
what is chocolate agar for?
|
Haemophilus species and Neisseria gonorrhoeae.
|
|
what is Sabouraud's medium for?
|
fungi.
|
|
what is Middlebrook agar for?
|
non-tuberculous mycobacteria
|
|
what is congenital stromal corneal dystrophy (CSCD)?
|
a very rare disorder that presents at birth. It features bilateral opacification of the central stroma (at all levels) with whitish flakes. The peripheral cornea is clear. The central opacities result in moderate-to-severe visual loss. This condition is typically non-progressive or very slowly progressive.
|
|
what mutation causes congenital stromal corneal dystrophy?
|
decorin gene located on chromosome 12
|
|
what is the inheritance pattern of congenital stromal corneal dystrophy?
|
autosomal dominant
|
|
what is Raymond syndrome?
|
6th nerve palsy with a contralateral hemiparesis due to a lesion in the mid-pons affecting the 6th nerve fasciculus along with the corticospinal tract.
|
|
what is weber syndrome?
|
a midbrain lesion causing a fascicular 3rd nerve palsy and a contralateral hemiparesis.
|
|
what is Benedikt syndrome?
|
a lesion of the midbrain affecting the 3rd nerve fascicle and the red nucleus which causes an ipsilateral 3rd nerve palsy and a contralateral "rubral" tremor (a slow tremor present with activity and rest).
|
|
what is Epicanthus palpebralis
|
a medial eyelid skin fold that is equally prominent in the upper and lower eyelid
|
|
what is Epicanthus tarsalis
|
medial eyelid skin fold that is more prominent in the upper eyelid.
|
|
what is Epicanthus inversus
|
a medial eyelid skin fold that is more prominent in the lower eyelid
|
|
what is Epicanthus supraciliaris
|
a medial eyelid skin fold that is more prominent from the eyebrow to the lacrimal sac.
|
|
what is thioglycolate broth for?
|
anaerobic bacteria
|
|
what is Thayer-Martin agar for?
|
Neisseria
|
|
how do you culture acanthamoeba?
|
nonnutrient agar with E. coli overlay.
|
|
what swabs are used for viral cultures |
dacron |
|
how do you minimize image jump and image displacement from bifocals? |
Image jump can be minimized with flat-top segments since the optical center of the bifocal segment is closer to the optical center of the distance lens. Image jump can be eliminated with executive-type bifocal segments where the optical center is located at the top of the bifocal segment.
A separate concept is image displacement which is the prismatic effect induced by the combination of the bifocal type and the power of the distance lens prescription in the reading position. For plus-power lenses, image displacement is minimized with round-top bifocal segments. For minus-power lenses, image displacement is minimized with flat-top bifocal segments. Typically, image displacement is more bothersome than image jump. |
|
what are the standard laser settings for PRP |
1200 or more 500 micron burns, separated by one-half to one burn width apart, at 0.1 sec duration
|
|
what is the average length of the orbital part of the optic nerve?
|
25-30mm
|
|
what is the size of the goldmann applanator tip?
|
3.06mm
|
|
what are Cerulean ("blue-dot") cataracts?
|
bilateral, small, bluish-white opacities in the peripheral cortex. They are typically asymptomatic and can be associated with Down's syndrome, but can also be found in normal individuals during puberty. |
|
what mitochondrial mutation is the most common cause of Leber's hereditary optic neuropathy?
|
11778
|
|
what axis to tight sutures steepen the cornea in?
|
same axis as the suture |
|
what is the basic secretion test?
|
steps
1. instillation of topical anesthetic 2. blotting of residual film from the inferior fornix 3. application of standard filter paper strip 4. wait 5 minutes interpretation of results less 3mm is abnormal 3-10mm is equivocal |
|
what is the schirmer 1 test?
|
NO anesthetic
wait 5 minutes interpretation of results less than 5.5mm of wetting after 5 minutes is abnormal |
|
what is the most common side effect of methotrexate? |
GI upset
|
|
what are the common side effects of cylcosporine?
|
renal toxicity
gingival hyperplasia GI upset |
|
what type of glands are meibomian glands
|
sebaceous
|
|
what type of secretion to meibomian glands use?
|
holocrine
|
|
what type of secretion do the lacrimal glands use? |
exocrine
|
|
what type of secretion do the glands of Krauss use?
|
exocrine
|
|
what type of secretion do the glands of Moll use?
|
apocrine
|
|
what retinal antigen has been identified in cancer associated retinopathy?
|
recoverin |
|
what gene increases the risk of pseudoexfoliation?
|
lysil oxidase like protein 1 (LOXL1)
|
|
what are the largest crystallins?
|
alpha
|
|
what are the most predominant crystallins?
|
beta
|
|
what are the smallest crystallins?
|
gamma
|
|
what is the wavelength of the excimer laser?
|
193nm (ultraviolet)
|
|
what antibiotics are used for chlamydia?
|
azithromycin 1 gram (single dose), doxycycline 100 mg bid for 7 days, and erythromycin 500 mg qid for 7 days.
|
|
at what age will infants get sensory nystagmus if bilateral cataracts are not removed?
|
3m
|
|
what is the average dioptric power of the lens
|
15-20
|
|
what clinical feature differentiates an orbital apex process from a cavernous sinus one?
|
involvement of the optic nerve indicates a process in the orbital apex.
|
|
where should a soft contact lens touch the cornea?
|
The 3 point touch is ideal for soft contact lens fitting. It should lightly touch the corneal apex and should lightly touch at the limbus on both sides.
|
|
how many short posterior ciliary arteries and nerves enter the globe around to optic nerve?
|
20 arteries, 10 nerves
|
|
what is the most sensitive test for lupus?
|
ANA
|
|
what are the most specific tests for lupus?
|
anti-dsDNA, anti-Smith
|
|
what is the SUN grading scheme for anterior uveitis?
|
|
|
what is paradoxical inversion of the OKN response?
|
slow phase moves in the direction opposite of the rotating drum, dampening of the nystagmus with rotation of the drum opposite the direction of the fast jerk
this is opposite the normal response where rotating a drum in the opposite direction of the nystagmus worsens it reversal of the OKN response only happens in congenital nystagmus |
|
what are the three main causes of involutional ectropion
|
horizontal eyelid laxity
eyelid rectractor disinsertion over-riding orbicularis |
|
what do mutations in ABCA4 cause?
|
stargardts
|
|
what passes through the cavernous sinus?
|
cranial nerves 3, 4, V1, V2, 6, internal carotid artery and the third order sympathetic neurons
|
|
what isolated CN palsy is most likely with cavernous sinus pathology?
|
When only one nerve is affected, the abducens is the most commonly affected because it passes relatively unprotected through the heart of the cavernous sinus while the other nerves are protected within the tough dural wall of the cavernous sinus
|
|
what glands produce mainly reflex tears?
|
lacrimal
|
|
how does one make a definitive diagnosis of plateau iris syndrome?
|
one must document a lack of change in the angle configuration after LPI.
|
|
what is the most common type of rhabdomyosarcoma?
|
embryonal
|
|
what kind of cataract is most commonly caused by vitrectomy
|
nuclear, unless silicone oil is placed. then it is PSC.
|
|
what type of cataract commonly forms in RP patients |
posterior subcapsular
|
|
where is the thinnest part of the sclera?
|
just posterior to the extraocular muscle insertions
|
|
what can happen to the eyelid after inferior rectus surgery?
|
There are extensive fascial connections between the inferior rectus muscle and the lower eyelid. Inferior rectus recession can cause lower eyelid retraction and thus widening of the palpebral fissure. The opposite can occur with inferior rectus resection (i.e. lower eyelid elevation).
|
|
what exits through the foramen rotundum?
|
V2
|
|
what passes through the foramen spinosum
|
middle meningeal artery
|
|
what passes through the foramen ovale
|
V3
|
|
what passes through the foramen lacerum?
|
the internal carotid artery, the artery of pterygoid canal, the nerve of pterygoid canal and some venous drainage
|
|
what does middlebrook agar grow?
|
non-tuberculous mycobacteria
|
|
when is the peak onset of CME after cataract surgery
|
6-10 weeks
|
|
what is the strongest modifiable risk factor for the development of cataracts?
|
smoking
|
|
what ligament changes the angle of the levator aponeurosis? |
whitnall's ligament
|
|
what is CD45 a marker for? |
lymphocytes
|
|
what is lockwoods ligament?
|
the fusion of the sheath of the inferior rectus muscle, the inferior tarsal muscle, and the check ligaments of the medial and lateral rectus muscles. It provides support for the globe and the anterioinferior orbit.
|
|
what is the inheritance of Lisch epithelial dystrophy?
|
x-linked dominant
|
|
what is the difference between lisch and meesman corneal dystrophies?
|
Lisch and Meesmann both have intraepithelial microcysts.
The difference between these two dystrophies is that Meesmann has diffuse, evenly- spaced cysts while Lisch has broad, band-shaped, feathery lesions in whorled patterns that are more densely crowded together. |
|
what is the optic strut?
|
the piece of bone that separates the optic canal from the superior orbital fissure
|
|
how much does yag capsulotomy increase the risk of retinal detachment?
|
4x
|
|
what is the thickness of the sclera just posterior to the rectus muscle insertions?
|
0.3mm
|
|
what is posterior amorphous corneal dystrophy
|
Posterior amorphous corneal dystrophy patients tend to have flat and thin corneas which lead to hyperopia. There is no increase in glaucoma rates. It is inherited autosomal dominantly. It presents in the first decade of life as a sheet-like opacity in the posterior cornea. These patients tend to have only minimal loss in vision and therefore corneal transplant is rarely indicated.
|
|
what is the inheritance of posterior amorphous corneal dystrophy? |
autosomal dominant
|
|
what stains can be used for iron
|
Prussian blue or Perls test
|
|
what type of cataract is caused by hyperparathyroidism?
|
christmas tree
|
|
what is ankyloblepharon?
|
partial failure of the eyelids to complete developmental separation with residual strands of tissue connecting the eyelid
|
|
what is epiblepharon?
|
Epiblepharon is when pretarsal skin and orbicularis override the eyelid margin. |
|
what is euryblepharon?
|
lengthening of the horizontal palpebral fissure and generally involves the lower lateral eyelid. It is also associated with shortening of the vertical palpebral fissure and with blepharophimosis syndrome
|
|
what is epicanthus
|
a prominent fold of eyelid skin perpendicular to and overlying the medial canthal tendon.
|
|
what is the treatment for toxoplasmosis?
|
classic regimen: pyrimethamine, sufadiazine, prednisone, plus folinic acid (because sulfonamides and pyrimethamine inhibit folic acid metabolism)
some add clindamycin to this regimen |
|
what is dissociated nystagmus?
|
is a nystagmus where the amplitude of the wave form differs in each eye
|
|
what is disconjugate nystagmus?
|
(also known as disjunctive nystagmus) occurs when the direction of nystagmus differs between two eyes
|
|
what is the staging for DLK?
|
1. peripheral faint WBCs, granular appearance
2. central scattered WBCs, granular appearance 3. central dense WBCs in visual axis 4. permanent scarring or melting |
|
what is the treatment for DLK>
|
stages 1-2: topical steroids
stages 3-4: lift flap, irrigate -> topical steroids; some surgeons use topical and oral steroids instead of lifting flap |
|
what risk factors increase the risk of corneal edema after phaco?
|
CCT > 650
endothelial cell count less than 1000 cells/mm2 |
|
where is the thinnest part of the cornea?
|
1.5 mm temporal to the geographic center.
|
|
when should coumadin be stopped prior to cataract surgery?
|
3-5 days
|
|
summarize the COMS trial?
|
The COMS large choroidal melanoma trial evaluated approximately 1000 patients with tumors >16 mm in basal diameter and/or >10mm in apical height and compared enucleation alone versus external beam radiotherapy followed by enucleation. The trial concluded that adjunctive radiotherapy did not impact overall survival, thus establishing that primary enucleation alone is sufficient to manage large melanomas. |
|
what is the size of the different goldman stimuli?
|
The smallest target size is 0 which equals 1/16 mm2. Every successive Roman numeral has an area 4 times the previous such that target size I = 1/4 mm2, II = 1 mm2, III = 4 mm2, IV = 16 mm2, and V = 64 mm2. |
|
what is the order of colors in the visible spectrum?
|
ROYGBIV (low energy to high energy)
|
|
what is the earliest sign of anterior segment ischemia?
|
cell and flare
|
|
What condition should you think of in a child presenting with proptosis, an ecchymotic eyelid, and a Horner's?
|
neuroblastoma (rhabomyosarcoma would be without the horners)
|
|
what suture should be used for scleral fixed IOL?
|
9-0 prolene |
|
how much does IOP normally vary over the coures of a day? |
2 to 6 mmHg over the course of a day. A sign of glaucoma is if the IOP fluctuates by more than 10 mmHg over 24 hours.
|
|
what is the distribution of IOP in normal individuals?
|
non-Gaussian distribution that is skewed toward higher pressures.
|
|
what happens to IOP in pregnancy?
|
decreases
|
|
how much prism do you add for high reading adds?
|
High adds decrease the working distance. Decreasing the working distance requires increased convergence demands. To help with this, base in prism is prescribed. The general rule is to prescribe 2 diopters more of prism than add for each eye so a +10 add will need an additional 12 diopters of base in prism per eye or 24 diopters total.
|
|
when does endophthalmitis occur after cataract surgery (board answer)?
|
3-10 days after cataract surgery, with a median of 6 days (from EVS)
|
|
what is the optimal pinhole size?
|
1.2mm
|
|
What is the most common ocular manifestation of fetal alcohol syndrome? |
optic nerve hypoplasia
|
|
What percentage of "microvascular" or "vasculopathic" 3rd nerve palsies demonstrate some degree of pupil involvement?
|
~20%
|
|
what is a hruby lens?
|
The Hruby lens is a high-powered planoconcave lens (-55 D) that is typically attached to the slit-lamp for convenience. Unlike most other slit-lamp biomicroscopy lenses, it gives a direct (non-inverted) image.
The disadvantage of this lens is that the field of view is very restricted (~5-8 degrees or about one disc diameter). |
|
what is the 4:2:1 rule?
|
defines severe NPDR as any 1 of the following:
diffuse intraretinal hemorrhages and microaneurisms in 4 quadrants venous beading in 2 quadrants intraretinal microvascular abnormalities (IRMAs) in 1 quadrant very severe NPDR is any two of the above severe NPDR: 15% progression to high-risk PDR within 1 year very severe NPDR: 45% progression to high-risk PDR within 1 year any patient with sever NPDR or worse should be considered for early treatment with PRP |
|
what is the difference between senile marginal degerenation and terrien marginal degerenation?
|
Senile furrow degeneration involves slight thinning of the cornea in the lucid area between the limbus and the start of arcus. It can induce astigmatism but treatment of the condition is rarely indicated.
Terrien Marginal Degeneration is generally unilateral or asymmetrically bilateral. The cornea starts to thin superiorly and the thinning spreads circumferentially. The epithelium remains intact and a fine pannus traverses the area of corneal thinning. At the end of the pannus is a line of lipid deposition. Perforation of the thinned cornea is rare. Crescent shaped lamellar transplantation can be used if perforation does occur. It generally starts in the 2nd or 3rd decade of life. |
|
in what percentage of people do the cannaliculi combine to form a common cannaliculus?
|
90%
|
|
what are the relative contraindications for ICG
|
prior severe allergic reaction to iodide or shellfish
liver disease metformin |
|
what are the diagnostic criteria for AIDS>
|
The diagnosis of AIDS is defined by one or more of the following:
CD4 count less than 200 cells/µl CD4 percentage of total lymphocytes <14% presence of an "AIDS-defining" illness (e.g. Kaposi sarcoma or Pneumocystis carinii pneumonia). |
|
What are the two most common causes for internuclear ophthalmoplegia (INO)?
|
The most common causes of INO in older adults is stroke. The most common cause of INO in teens and young adults is demyelination.
|
|
what is the blood supply of the optic nerve?
|
The blood supply to the nerve fiber layer portion of the optic nerve is by the central retinal artery. |
|
what are the four types of hyperopia?
|
(1) Absolute hyperopia. Minimum (non-cycloplegic) plus correction required for clear vision at distance. |
|
what is the blood supply of the optic nerve?
|
The blood supply to the nerve fiber layer portion of the optic nerve is by the central retinal artery. |
|
What etiology is most common for congenital blepharoptosis?
|
myogenic
|
|
what stain for sebaceous cell carcinoma?
|
oil red O
|
|
what stains for glycosaminoglycans
|
Alcian blue
colloidal iron (glycosaminoglycans are in macular dystrophy) |
|
what is lens partical glaucoma?
|
Lens particle glaucoma generally occurs when portions of the lens (mainly cortex) remain unnoticed after cataract surgery. These pieces then make their way to the anterior chamber and directly clog the trabecular meshwork.
|
|
what is Phacoanaphylactic uveitis (also known as phacoantigenic uveitis)
|
hen the capsular bag is violated which leads to inflammation.
|
|
What produces the oil portion of the tear film?
|
meibomian glands
|
|
what produces the aqueous component of tears
|
accessory glands of Krause and Wolfring
|
|
where are the glands of wolfring found?
|
non-marginal tarsal borders
|
|
where are the glands of krauss found?
|
fornices
|
|
what do goblet cells produce?
|
mucin
|
|
what things can be difficult to distinguish from corneal dermoids?
|
corneal keloids
|
|
what is saltzman nodular degeneration
|
Salzmann nodular degeneration is secondary to hyaline material deposited in Bowman's layer. It is generally thought to be due to chronic irritation of the cornea. It is rarely secondary to contact lens use.
|
|
Approximately how many corneal endothelial cells do you have at birth? |
4,000 cells/mm2 |
|
how many corneal endothelial cells do young adults have?
|
3000 cells/mm2
|
|
how many corneal endothelial cells do 60 year olds have?
|
2,500 cells/mm2
|
|
what is the rate of endothelial cell loss?
|
You have approximately 4,000 cells/mm2 at birth. "Young adults" have about 3000 cells/mm2. It decreases approximately linearly till the age of 60 when you have about 2,500 cells/mm2. At that point, humans lose cells at a slower rate than when young. Thus, a 70- and 80-year-old would have more endothelial cells than you would think.
|
|
how do you confirm the diagnosis of HIV
|
ELISA must yield positive results *twice* and be confirmed with a Western Blot or immunofluorescence assay.
|
|
what medications increase uveoscleral outflow of aqueous?
|
atropine
epinephrine dipivefrin prostaglandin analogs |
|
how does dorzolamide work?
|
CAI that reduces aqueous production
|
|
how does timolol work?
|
aqueous suppressant
|
|
what does pilocarpine do for glaucoma? |
increases trab outflow but *decreases* uveoscleral outflow
|
|
What is the most common orbital metastasis in men
|
Lung
|
|
what LHON mutation has the highest rate of spontaneous visual recovery?
|
14484
|
|
what is the ratio of females to males with graves
|
10:1
|
|
what's different about the iris vessels in Fuch's heterochromic iridocyclitis?
|
not associated with a fibrous membrane and do not typically lead to PAS
|
|
what IOL formula is better for long eyes
|
SRK/T
|
|
what does herpetic uveitis do to IOP vs uveitis from other ****?
|
herpetic increases, whereas others tend to decrease IOP
|
|
what SSRI is particularly associated with angle closure?
|
paxil (paroxetine) (all SSRIS are to some degree assocaited with angle closure due to their anticholinergic effect; paxil is the most).
|
|
what is tolosa hunt?
|
Tolosa-Hunt syndrome is idiopathic sterile inflammation of the cavernous sinus marked by severe ipsilateral periorbital pain along with deficits of any or all of the nerves passing through the affected cavernous sinus (CN 3,4,V1,V2,6 and the sympathetics). It is a diagnosis of exclusion after infectious causes of inflammation, lymphoma, and carcinoma have been excluded. Many patients who were previously given the diagnosis of Tolosa-Hunt are later found to have malignancies leading some experts to regard Tolosa-Hunt as a "waste basket" term used for other undiagnosed pathology.
|
|
what is the treatment for corneal microsporidia? |
topical fumagillin
|
|
what dose of pilocarpine do you use to diagnose a tonic pupil?
|
Tonic pupils demonstrate denervation hypersensitivity by constricting with dilute pilocarpine 0.125%
|
|
what strength of pilocarpine do you use to diagnose a pharmacologically dilated pupil? |
A normal pupil and pupil involving 3rd nerve palsy will both constrict to full strength pilocarpine 1% while a pharmacologically dilated pupil will not.
|
|
what happens to RK incisions when they swell?
|
flattening.
|
|
Why do nanophthalmic eyes tend to have complications during cataract surgery?
|
Nanophthalmos describes an abnormally small eye that has normal internal organization. This condition contrasts microphthalmos which is a small, disorganized eye.
Patients with nanophthalmos have high hyperopia (e.g. +8.00 D), a short axial length (e.g. 19 mm), crowded anterior segments, and thick/rigid sclera. These properties lead to constriction of blood flow through scleral vessels and predispose the eye to choroidal detachments and hemorrhages. For glaucoma surgery, many surgeons will create prophylactic draining sclerotomies to minimize choroidal effusion formation. |
|
what is a choreostoma?
|
normal tissue in an abnormal location.
|
|
what is a hamartoma?
|
abnormal proliferation of tissue in its normal location.
|
|
what is a teratoma?
|
a tumor derived from all 3 germ layers
|
|
where does muller's muscle attach?
|
superior border of the tarsal plate
|
|
which has more frequent and more severe corneal erosions: Reis-Buckler or Theil-Beneke?
|
Reis-Buckler
|
|
what chromosome in Avelino corneal dystrophy?
|
5q
|
|
Which subnuclei within the CN III nucleus is the only subnuclei that is fused and therefore supplies axons to muscles in both eyes?
|
levator subnucleii
|
|
which CNIII fibers serve the contralateral muscle?
|
superior rectus
|
|
what cranial nerve has the longest intracranial course
|
IV
|
|
what shape cornea is at risk for free cap in LASIK
|
flat
|
|
what shape cornea is at risk for buttonhole flap in LASIK
|
steep cornea
|
|
what is the inheritance of posterior polymorphous dystrophy?
|
autosomal dominant usually, but rarely autosomal recessive
|
|
what happens to lenses when you tilt them?
|
If the lens is positive, plus cyl will be added with the same axis as the tilt. If the lens is negative, minus power will be added with the same axis as the tilt.
Positive lenses will add sphere power and negative lenses will add negative sphere power. |
|
what are the risk factors for the different types of vein occlusion>?
|
|
|
how much excursion does the levator provide?
|
12-15mm
|
|
what is the most common cause of PUK
|
RA
|
|
how do you differentiate PUK from Moorens?
|
PUK involves both the cornea and the sclera whereas Mooren's ulcer only involves cornea.
|
|
what type of secretion are meibomian glands?
|
holocrine
|
|
what type of secretion are goblet cells
|
holocrine
|
|
what type of secretion are glands of Zeiss?
|
holocrine
|
|
what type of secretin are the glands of wolfring?
|
exocrine
|
|
what type of secretion are that glands kraus?
|
exocrine
|
|
what type of secretion is the lacrimal gland?
|
exocrine
|
|
what is the FA pattern for a retinal cavernous hemangioma?
|
slow filling of the lesion with pooling of the dye in the upper part of the vascular space
|
|
what are cowdry bodies?
|
eosinophilic nuclear inclusions composed of nucleic acid and protein seen in cells infected with herpes simplex virus, varicella-zoster virus, and cytomegalovirus.
|
|
what are the most to least frequent sites for periocular BCCs?
|
inferior lid
medial canthus superior lid lateral canthus (same as order of rectus muscle involvement in thyroid eye disease) |
|
what percentage of people have physiologic anisocoria?
|
50%
|
|
what difference in pupil sizes makes physiologic anisocoria less likely?
|
physiologic anisocoria is almost always less than 1 mm
|
|
how do you differentiate foster-kennedy from pseudo-foster-kennedy?
|
FK will show only an enlarged blind spot and PFK will show a visual field defect consistent with NAION (for testing purposes you will likely be shown an altitudinal defect).
|
|
how long do migranous aureas typically last?
|
10-60 min
|
|
According to the Early Manifest Glaucoma Trial (EMGT), each 1-mmHg decrease in intraocular pressure was associated with WHAT PERCENTAGE reduction in progression of glaucoma?
|
10%
|
|
what is this blue crap in the optic nerve of a glaucoma patient?
|
cavernous atrophy of Schnabel; the substance is vitreous
|
|
what type of collagen primarily makes up the corneal stroma?
|
type 1
|
|
what spatula is money for corneal bacterial cultures?
|
platinum Kimura spatula (because it heats and cools rapidly), metal blade, calcium alginate, or Dacron swab
|
|
what is the lifetime odds of developing a uveal melanoma from a blue nevus?
|
1:400
|
|
what percentage of glucose metabolism goes through the HMP pathway in the corneal epithelium and endothelium?
|
35-65%
|
|
what is the average refractive state of a newborn?
|
3D of hyperopia
|
|
what is the average refractive state of a 1 year old?
|
1D hyperopia
|
|
What is the most common cell of origin for optic nerve gliomas?
|
pilocytic astrocyte
|
|
what is the treatment for optic nerve gliomas? |
these tumors are usually slow-growing and compatible with long-term survival, so these tumors are typically observed unless progressive visual loss or growth more posteriorly into the CNS occurs. Treatment of gliomas itself can result in vision loss in the affected eye.
|
|
how can FA be used to distinguish between AION and NAION?
|
non-arteritic ischemic optic neuropathy likely stems from diminished perfusion to the optic nerve head, but artertic anterior ischemic optic neuropathy is due to a vasculitis of posterior ciliary arteries supplying the optic nerve head and the adjacent choroid. Therefore, cases of arteritic ischemic optic neuropathy often demonstrate patchy choroidal perfusion on fluorescein angiography.
|
|
graves occurs in what percentage of patient with thyroid eye disease?
|
90%
|
|
what percentage of hyperthyroid patients will get thyroid eye disease?
|
30%
|
|
what bugs are associated with reactive arthritis?
|
Chlamydia trachomatis, salmonella, shigella, yersinia and Campylobacter
|
|
what shape of corneal infiltrates are characterstic of zoster>
|
nummular
|
|
What is the average length from the posterior globe to the optic foramen in an adult?
|
18mm
|
|
where is the lesion in one and a half sydnrome?
|
pontine region which contains the medial longitudinal fasciculus (MLF) and paramedian pontine reticular formation (and CN VI nucleus).
|
|
what is Raymond-Cestan syndrome?
|
damage to MLF and corticospinal tracts; leads to INO + contralateral hemiparesis
|
|
what is 8 and a half syndrome?
|
one-and-a-half syndrome + ipsilateral facial palsy (i.e. 1.5 + 7)
|
|
what is the drainage pathway of the aqueous from the eye to the cavernous sinus?
|
Aqueous humor leaves the eye by passing through the trabecular meshwork and then into Schlemm's canal. From there, aqueous flows into collector channels then to deep and midscleral venous plexuses and then into the episcleral venous plexus.
The blood then drains into the anterior ciliary veins --> superior ophthalmic veins --> cavernous sinus. |
|
what is the thickness of the anterior and psoterior lens capsules?
|
anterior 14 microns
posterior 4 microns |
|
why should trifluridine (viroptic) be stopped after 14 days
|
toxic to epithelium and can result in neurotrophic ulcers
|
|
what glands are f'd in chalazia> |
meibomian glands or zeis |
|
What are the two most common ocular findings seen in Lowe syndrome? |
congenital cataracts and glaucoma
|
|
what is the inheritance of lisch epithelial corneal dystrophy?
|
x-linked dominant
|
|
what is the inheritance of gelatinous droplike dystrophy?
|
autosomal recessive
|
|
what mutations cause gelatinous drop-like corneal dystrophy>
|
tumor-associated calcium signal transducer 2
|
|
what is the age of onset of gelatinous drop-like corneal dystrophy?
|
teens to twenties
|
|
what is the recurrence rate for gelatinous drop-like corneal dystrophy after PK?
|
virtually 100%
|
|
what do the numerator and denominator mean in snellen notation?
|
Snellen optotypes are designed so that the letter as a whole subtends an angle of 5 minutes of arc at the distance denoted by the denominator. Thus a "20/20" optotype, viewed at 20 feet, would subtend 5 minutes of arc on the observer's retina.
|
|
what is a Ferry's line?
|
iron line at leading edge of a filtering blead
|
|
what is a stocker line?
|
iron line at leading edge of a pterygium
|
|
what is a hudson stahl line?
|
iron line at upper border of normal tear layer
|
|
What is the location of venous drainage from post tarsal eyelid tissues?
|
the orbital veins, deeper branches of the anterior facial vein, and pterygoid plexus.
|
|
what is the venous drainage of the medial pretarsal tissues of the eyelid?
|
angular vein
|
|
what is the venous drainage of the lateral pretarstal tissues of the eyelid?
|
superficial temporal vein
|
|
what is the F:M ratio of thyroid eye disease
|
6:1
|
|
what is the difference between nanophthalmos and microphthalmos
|
nanophthalmos is a small eye with Normal structures, micorphthalmos is a small Messed up eye.
|
|
what is the index of refraction of the cornea?
|
1.376
|
|
what is the index of refraction of the aqueus
|
1.336
|
|
what is the index of refraction of crown glass?
|
1.523
|
|
what is the index of refraction of silicone?
|
1.438
|
|
what is the index of refraction of acrylic?
|
1.46
|
|
what is Meretoja syndrome?
|
Meretoja syndrome is also known as familial amyloid polyneuropathy, type IV or lattice corneal dystrophy, gelsolin type. As the latter name implies, it is caused by mutations in the gelsolin gene and is inherited in an autosomal dominant fashion.
Clinical findings in Meretoja syndrome include: (1) lattice corneal dystrophy; (2) masked facies; (3) lagophthalmos; (4) cranial and peripheral nerve palsies; and (5) loose skin. In contrast to other forms of lattice corneal dystrophy, the lattice lines in Meretoja syndrome are fewer in number and involve less of the central cornea. |
|
what is the most common medication to cause corneal vorticillatat?
|
amiodarone
|
|
what is the minimum refractive change allowed to be a candidate for lasik?
|
0.5D over one year
|
|
What are the most common tumors of the lacrimal sac?
|
squamous cell papillomas and carcinomas
|
|
tetracyclines are contraindicated in children less than what age?
|
10
|
|
what bugs cause reactive arthritis?
|
gram-negative bacterial dysentery (most frequently associated with Salmonella, Shigella, and Yersinia) or Chlamydia trachomatis.
|
|
where does sebaceous cell carcinoma most often present
|
upper eyelid?
|
|
what is the normal vertical fusional amplitude?
|
2PD
|
|
what are the dimensions of the nasolacrimal drainage system?
|
|
|
what is the treatment for gonococcal conjunctivitis?
|
one time dose of 1 gram of intramuscular (IM) ceftriaxone. In penicillin-allergic patients, a one time dose of IM spectinomycin or 5-7 days of oral fluoroquinolones can be used.
patients with gonococcal conjunctivitis also be treated for Chlamydia. The best treatment options for Chlamydia are doxycycline or azithromycin. |
|
how do you adjust for toric contacts that have twisted?
|
A general rule of thumb is that if the mark has shifted to the Left then you add the corresponding amount of cylinder axis. And if the mark has shifted to the Right then you subtract the corresponding amount of cylinder axis. This can be remembered with the mnemonic LARS. One clock hour is about 30 degrees.
|
|
what is fleck corneal dystrophy?
|
Fleck dystrophy is characterized by dandruff-like deposits throughout the stroma
|
|
what is the inheritance of fleck corneal dystrophy?
|
autosomal dominant
|
|
what is the inheritance of CHED1?
|
autosomal dominant
|
|
when do clinical signs appear in in CHED1
|
age 1 or 2
|
|
which CHED develops nystagmus?
|
CHED2
|
|
which CHED is progressive and which is stationary?
|
CHED1= progressive
CHED2 = stationary |
|
what is the inheritance of CHED2
|
autosomal recessive
|
|
what is the upper limit for ESR?
|
males: [age] / 2
females: [age + 10] / 2 |
|
what are the average adult corneal diameters?
|
12Hx11V
|
|
What is the most common quadrant for scleral rupture in an open globe caused by blunt trauma?
|
superonasal
|
|
what is the prismatic effect of slab-off? |
base-up prism over the reading area of bifocals.
|
|
What is the inheritance pattern of blepharophimosis syndrome?
|
autosomal dominant
|
|
What type of hypersensitivity reaction is seen with scleritis?
|
type III (immune complex)
|
|
Where is the germinative zone of the lens epithelium?
|
anterior to the equator;
Epithelial cells in the germinative zone (anterior to the equator) divide and then migrate to the equator. At the equator the epithelial cells attain a very long ribbon-like shape called lens fibers. |
|
what gene is fked in congenital stromal corneal dystrophy>
|
decorin (DCN)
|
|
what are teh types of hypersensitivity reactions?
|
Type I immune reactions are anaphylactic or atopic reactions. In these reactions, preformed IgE antibodies bound on mast cell receptors react with the antigen causing degranulation of the mast cell with histamine release. An example of a Type I reaction is allergic conjunctivitis.
Type II immune reactions are cytotoxic. This reaction is where antibodies bind to foreign antigen and activate the complement pathway. An example of a type II reaction is ocular cicatricial pemphigoid. Type III immune reactions are also known as "immune-complex reactions." These reactions result from immune complex deposition in tissues which activate the complement and other effector systems. Examples of Type III reactions are Stevens-Johnson syndrome and scleritis. Type IV immune reactions are delayed hypersensitivity reactions. These involve recruitment of pre-sensitized immune cells. An example of a type IV reaction is allergic contact dermatitis. |
|
what genen is f'ked in macular corneal dystrophy?
|
carbohydrate sulfotransferase 6 (CHST6).
|
|
what gene is fu'ked in gelatinous drop-like dystrophy?
|
tumor-associated calcium signal transducer 2 (TACSTD2)
|
|
do long or short wavelengths slow more in media?
|
short
|
|
what enzyme is f'ked in LHON?
|
NADH dehydrogenase
|
|
What is the most common benign orbital tumor in adults?
|
Cavernous hemangiomas
|
|
What percentage of carbonic anhydrase enzyme in the eye has to be inhibited before a significant lowering of intraocular pressure (IOP) occurs?
|
99%
|
|
what are the main ocular effects of direct-acting muscarinic agonists?
|
miosis, accommodation, and contraction of the longtudinal muscle of the ciliary body leading increased aqueous outflow
|
|
After how many days does rebleeding generally occur after a traumatic hyphema?
|
2-7 days
|
|
what is meige's syndrome?
|
blepharospasm with facial dystonia
|
|
how do you calcluate the power of a piggyback IOL for residual errors?
|
for myopic errors the power is the same as the error
for hyperopic errors the power is 1.5 times the error |
|
where is the thinning in keratoconus?
|
apex
|
|
where is the thinning in pellucid?
|
inferior to apex
|
|
where is the thinning in keratoglobus?
|
periphery
|
|
what type of anesthesia has the highest risk of globe penetration?
|
retrobulbar
|
|
what should you do in the event of posterior capsular rupture?
|
stop phaco , continue irrigation, insert dispersive viscoelastic, then remove phaco tip
|
|
what are the risk factors for expulsive choroidal hemorrhage?
|
hypertension
tachycardia obesity high myopia anticoagulation advanced age glaucoma chronic ocular inflammation |
|
what is the inheritance of von hippel lindau |
autosomal dominant
|
|
what is the inheritance of stargaardt diseaes
|
autosomal recessive
|
|
what is the most common cause of bacterial endophthalmitis in the united states?
|
cataract surgery
|
|
what is the power of the anterior corneal surface?
|
48D
|
|
what HLA is most associated with VKH
|
DR4
|
|
what is the medial treatment of aqueous misdiretion?
|
intensive aqueous suppressants (e.g. beta-blockers, alpha agonists) along with cycloplegics (e.g. atropine) and possibly hyperosmotics (e.g. mannitol). Miotics, like pilocarpine, should never be used in this situation since it can make this situation worse.
|
|
What type of cataract develops most frequently in patients with atopic dermatitis?
|
shield-like anterior subcapsular cataracts
|
|
what is the only oral agent useful for CMV infections?
|
valgancyclovir
|
|
what uveititis treatment is contraindicated in multiple sclerosis?
|
TNF-alpha inhibitors (eg.g infliximab, etanercept) |
|
what is the prefered treatment for fusarium keratitits?
|
natamycin
|
|
what is the preferred treatment for candida keratitis?
|
amphotericin
|
|
what is the preferred treatment for aspergillus keratitis? |
amphotericin
|
|
what percentage of patients with the fluocinolone intravitreal implant will need glaucoma therapy?
|
60%
|
|
what percentage of patients with the fluocinolone intravitreal implant will need glaucoma surgery?
|
30%
|
|
what is the maximum dose of plaquenil?
|
6.5mg/kg/day
|
|
what people are at highest risk of angle closure?
|
hyperopes
women asians and Inuits |
|
what is the inheritance of posterior polymorphous corneal dystrophy?
|
autosomal dominant
|
|
WHY IS brimonidine contraindicnated in infants?
|
central nervous depression and apnea
|
|
what is the inheritance of oculopharyngeal muscular dystrophy
|
autosomal dominant or autosomal recessive
|
|
what location of periocular lymphoma is least likely to be associated with systemic lymphooma?
|
conj |
|
what is the inheritance of ectopia lentis e pupillae?
|
autosomal recessive
|
|
why don't you resect the lateral rectus in duane's
|
worsneing of co-contraction
|
|
what is the clinical triad of primary congenital glaucoma?
|
epiphora, photophobia and blepharospasm
|
|
what kind of cataracts do you get in Lowe syndrome?
|
disciform
|
|
which laser refracgive procedure is prone to haze? |
PRK
|
|
what is mitomycin C used for in refractive surgery
|
to prevent haze in PRK
|
|
what is the dimer in the excimer laser?
|
argon-fluoride
|
|
What is the 5-year risk of contralateral involvement in patients with acute monocular non-arteritic anterior ischemic optic neuropathy?
|
12-19%
|
|
what do sutures do to the cornea?
|
flatten over hte suture, steepen central to it.
|
|
what systemic disease is associated with superior limbic keratitis
|
thyroid disease |
|
what is the anatomy of the medial canthal tendon?
|
An upper and a lower limb fuse. Then the tendon splits into an anterior and posterior limb. The anterior and posterior limb go around the lacrimal sac. The anterior limb inserts on the anterior lacrimal crest. The posterior limb inserts on the posterior lacrimal crest.
|
|
what is the smallest size corneal perf that can be treated with glue?
|
<3mm
|
|
what chlamydia serotypes cause trachoma?
|
A-C
|
|
what chlamydia serotypes cuase neonatal inclusion conjunctivitis? |
D-K
|
|
what chlamydia serotypes case lymphogranuloma venerium?
|
L1-L3
|
|
What is the most common cause of chronic angular blepharitis?
|
Moraxella lacunata
|
|
what is cogan's syndrome?
|
Cogan syndrome is an autoimmune disorder that produces stromal keratitis, vertigo, and hearing loss. The etiology of the syndrome is unknown, but it shares features with polyarteritis nodosa. The earliest corneal findings include bilateral, faint, white, subepithelial infiltrates in the peripheral cornea. Later, multifocal nodular infiltrates may develop in the posterior cornea. |
|
What is the suppression dose of acyclovir that was used to prevent recurrence of herpes simplex epithelial keratitis in the HEDS (Herpetic Eye Disease Study) study?
|
acyclovir 400 mg PO BID
|
|
what is WAGR syndrome
|
syndrome is an autosomal dominant condition seen in 13% of aniridia patients that includes Wilms tumor, aniridia, genitourinary abnormalities, and mental retardation.
|
|
what is Gillespie syndrome?
|
an autosomal recessive form of aniridia that is associated with cerebellar ataxia and mental retardation occurring in 2% of patients with aniridia.
|
|
where do conjunctival melanomas metastesize to?
|
lymph nodes
|
|
what is kestenbaum's rule?
|
the reading add in a low vision pt should be the inverse of the BCVA (i.e. 20/40 = 4/2 = +2)
|
|
what are the risk factors for suprachoroidal hemorrhage?
|
The classic risk factors predisposing to a suprachoroidal hemorrhage include: |
|
What is the stimulus used in short-wavelength automated perimetry (SWAP)?
|
size V blue
|
|
does terrien's marginal degeneration have loss of epitheliyum
|
no
|
|
does PUK have loss of epithelium
|
yes
|
|
does mooren's ulcer have loss fo epithelium?
|
yes
|
|
what are the feilds of action of the extraocular muscles?
|
A muscle’s "field of action" is the position of gaze in which the muscle is the primary mover of the eye (e.g. cardinal directions of gaze). |
|
Which of the following general anesthetic agents can lower the intraocular pressure in a child?
|
halothane
|
|
what is vossius ring?
|
truama causes iris to smash against the lense and leave pigment deposit
|
|
retinal dialysis is most likely in what quardrants?
|
inferotemporal or superonasal |
|
what path medium should be used for electron microscopy?
|
glutaraldehyde |
|
what path medium shoudl be used for cytologic preparations?
|
ethyl alcohol
|
|
what path medium should be used for immunofluorescence sutdies
|
Michel medium
|
|
what is bouin fixative for?
|
small biopsies |
|
waht is B5 (fixative) jused for?
|
lymphoprolipherative tissue
|
|
what is Zenker acetic fixative used for?
|
muscle differentiation
|
|
what stains cavernous optic atrophy?
|
alcian blue
|
|
what does colloidal iron staing?
|
acid mucopolysaccharide (blue)
|
|
what does Ziehl-Neelsen stain |
Acid-fast organisms (red)
|
|
what does Perls prussian blue stain?
|
iron (blue)
|
|
what does thioflavin T (ThT) stain?
|
amyloid (fluorescent yellow)
|
|
what does verhoeff-van geison (elastic stain( stain?
|
ealstif fibers (black)(
|
|
how many days prior to cataract surgery should coumadin be stopped
|
3-5 dasy, but no everybody stops that sh!t. (no conclusive evidence to support_
|
|
how many days prior to cataract surgery shoudl aspirin be stopped |
10, but not everybodystops that sh!t (no conclusive evidence to support)
|
|
how many days prior to cataract surgery should plavix be stopped
|
10, but not everybodystops that sh!t (no conclusive evidence to support)
|
|
how many days prior to cataract surgery should vit E be stopped
|
10, but not everybodystops that sh!t (no conclusive evidence to support) |
|
what peripheral retinal lesions predispose to breaks?
|
cycstic retinal tufts |
|
what is the inheritance of gelatinous drop-ike corneal dystrophy
|
autosomal recessive
|
|
what drugs are associated with decreasesd corneal stromal healing |
isotretinoin
amiodarone |
|
what drugs are assocaited with delayed corneal epithelial healing?
|
antihistamines |
|
what is the inheritance of schnyder corneal dystrophy?
|
autosomal dominanat
|
|
what gene is fu[ked in schnyder corneal dystrophy?
|
UBIAD1
|
|
what sh!t is deposited in schnyder corneal dystrophy?
|
cholesterol and phospholipids
|
|
what stain for schnyder corneal dystrophy?
|
oil red O
|
|
when are fu[kers with schnyder corneal dystrophy usually diagnosed?
|
2nd to 3rd decade of life
|
|
what systemic workup do fu[kers with schnyder corneal dystrophy need?
|
cholesterol levels checked |
|
What are other names for map-dot fingerprint dystrophy?
|
cogan microcystic dystrophy |
|
What is this? |
macular dystrophy |
|
what is this? |
granular corneal dystrophy
|
|
what are the side effects of cidofivir? |
nephrotoxicity anterior uveitis - do not need to stop cidofovir if uveitis responds to medications |
|
Which class of glaucoma medication is contraindicated in patients taking tricyclic anti-depressants? |
alpha-2 agonists are relatively contraindicated |
|
what type of hypersensitivity reaction is seen with scleritis? |
type III (immune complex) |
|
what are the antidotes for parathion poisoning? |
pralidoxime atropine |
|
what are the clinical features of galactosemia? |
hepatomegaly liver failure food intolerance hypoglycemia hypotonia sepsis bilateral "oil drop" cataracts caused by the accumulation of galactitol |
|
what is the diet for abetalipoproteinemia? |
Treatment is with large doses of vitamin supplements (A, D, E, K). To avoid intestinal symptoms, substitution of medium-chain triglycerides for long-chain triglycerides may be employed. |
|
what is the dietary restriction in Refsum disease |
phytanic acid |
|
what is the treatment for non-tuberculous micobacterial keratitis? |
fortified amikacin (the classic treatment) + clarithromycin (topical +/- oral) + a 4th-generation fluoroquinolone. |
|
wAht is the mean age of diagnosis of Rb in pts with known family history? |
4 months |
|
what is the mean age of diagnosis of Rb in pts with unilateral disease |
24 months |
|
what is the mean age of diagnosis of Rb in pts with bilateral disease |
14 months |
|
hwo do the different nystagmus pattersn localize? |
* Downbeat -- cervicomedullary junction (e.g. Chiari type 1 malformation), cerebellar flocculus |
|
what is tuberous sclerosis? |
Tuberous sclerosis complex (TSC) is a multisystem disorder characterised byhamartomatous growths that can occur in almost organ. The ophthalmic manifestations of this autosomal dominant disorder are seen in 50-80% of cases and can can be divided into retinal and non-retinal. Retinal findings: * Astrocytic hamartomas. |
|
what are the side-effects of cidofovir? |
renal toxicity anterior uveitis - responds to steroids; do not need to stop cidofovir hypotony in 50% of treateted patients |
|
what is slab-off and reverse slab off? |
Slab-off is also known as bicentric grinding. It involves grinding the more minus or least plus lens and creates a base up prism effect over the reading area of the lens. Reverse slab-off involves adding base down prism to the more plus lens. Because of the manufacturing methods of glasses, the reverse slab-off method is most commonly used (compared to slab-off). |
|
what is the refractive power of the posterior corneal surface? |
-5.8D |
|
what is the refractive power of the anterior corneal surface? |
48D |
|
what is the refractive power of the cornea? |
43D |
|
what drugs cause retinal toxicity |
|
|
what causes christmass tree cataracts? |
myotonic dystrophy hypoparathyroidism |
|
what is the 5 years risk of sequential NAION in the contralateral eye in a patient with unilateral NAION? |
15% |
|
what is the 10 year risk for MS in a patient with optic neuritis and no demyelinating lesions on MRI |
22%
|
|
what is the 10 year risk for MS in a patient with optic neuritis and 1 or more demyelinating lesions on MRI |
56% |
|
what is the 10 year risk of MS in a patient with optic neuritis, not taking into account MRI findings? |
38% |
|
what is the triad of congenital toxoplasmosis |
retinochoroiditis, hydrocephalus and intracranial calcification |
|
what medications cause delayed corneal stromal healing? |
accutane, amiodarone |
|
what medications are associated with delayed corneal epithelial healing |
antihistamines, sumatriptan, HRT |
|
How long after injury to the retinal ganglion cells or their axons does it take for optic nerve atrophy to appear? |
4-6 weeks |
|
how do you differentiate Brown's syndrome from inferior oblique palsy? |
|
|
what corneal dystrophy presents earliest? |
macular, then lattice, then granula |
|
what is the 10/20/40/60 rule? |
10 year risk of MS after optic neuritis 20% if no MRI findings 40% if unknown MRI 60% if 1 or more white matter lesions on MRI |
|
what cranial nerve has the longest intracrnail course |
trochlear (IV) |
|
what cranial nerve crosses before it exits the brainstem |
trochlear (IV) |
|
what sh!t is associated with morning glory disc anomoly? |
(1) Similar to optic nerve head pits, serous retinal detachments frequently occur in eyes with MGD. |
|
what are the measurements of the muscular and tendinous portions of the extraocular muscles? |
The active muscular portions of the medial rectus, superior rectus, lateral rectus, inferior rectus, and levator are 40 mm. The superior oblique has an active muscular portion of 32 mm. The inferior oblique has an active muscular portion of 37 mm. The muscles with the longest tendons are the superior oblique and levator with 26 mm and 14-20 mm, respectively. This makes the superior oblique the longest overall muscle and the levator the second longest. Because of its small tendon length (1 mm) the smallest overall muscle is the inferior oblique. |
|
What are the systemic manifestations fo axenfeld reiger syndrome? |
jacked up teeth (microdontia, hypodontia, anodontia) maxillary hypoplasia redundant periumbilical skin hypospadius autosomal dominant (pitx2, foxc1) |
|
what are the side-effecgts of infliximab? |
* Drug-induced lupus syndrome. The risk of this adverse reaction can be lessened by co-administration of low-dose methotrexate.
* Reactivation of latent tuberculosis (TB) infection. In addition, these cases of infliximab-associated TB reactivation have a higher risk of beingdisseminated at presentation. Thus, a positive PPD or Quantiferon test is considered a contraindication to infliximab (or other TNF-alpha inhibitor) treatment. * Demyelinating disease. The causal link between TNF-alpha inhibitors and demyelinating disease has not been proven definitely. However, temporal relationships between use of TNF-alpha inhibitors and demyelinating disease have been observed.1 * Heart failure. * Malignancy |
|
what infections are associated with mooren's ulcers |
helmiths, hepatitics c |
|
what is the average anterior chamber depth? |
3 mm |
|
prolate? |
steeper centrally than peripherally |
|
what causes PSC |
aging steroids inflammation radiation alcoholism ischemia myotonic dystrophy (after xmass tree) silicone oil NF2 DM smoking |
|
what are Halberstaedter-Prowazek Bodies? |
inclusion bodies seen in trackhoma |
|
what are Cowdry type I bodies (Lipschutz Inclusions)? |
inclusion bodies seen in HSV VZV |
|
what is the major toxicity of gancyclovir |
bone marrow suppression |
|
what type of immune reaction is scleritis? |
type III (immune complex) |
|
what is the risk of melanoma from nevus of ota? |
1/400 |
|
what is the risk of glaucoma from nevus of ota? |
10% |
|
WHatis the difference bretween asian and cuacasian eyelids? |
In Caucasians, the septum fuses with the levator above the tarsal plate (2-5 mm above). In Asians, the septum fuses with the levator between the superior border of the tarsal plate and the eyelid margin. This allows fat to occupy a lower position than in Caucasians and gives the eyelid a softer and more full appearance in addition to a lower eyelid crease. |
|
how long do people need to stay out of contacts before lasik? |
soft spheric: 3d - 2w soft toric: 2w rigid: 2-3w + 1m for every decade of wear |
|
what are the 4 Ps of hermansky-pudlak syndrome? |
Platelet disorder, Pulmonary Fibrosis, Puerto Ricans, and Pigment-less (albino) |
|
what is the size of the foveal avascular zone? |
250-600 microns |
|
who should get AREDs |
Extensive intermediate (64-124 μm) drusen ≥1 large druse non-central geographic atrophy advanced AMD in 1 eye |
|
angioid streaks associations? |
p seudoxanthoma elasticum e hlerhs dahnlos p agets disease s ickle cell i idiopathic + beta thalassemia |
|
what is the order of age of presentation of granula, macular and lattice dystrophy? |
'Might Like to Grow' before getting a corneal stromal dystrophy (macular, lattice, granular |
|
order granula, macular reis bucklers, adn macular dystrophy in order of frequency of recurrence after transplant? |
Rude Little Green Men keep coming back (Reis-Bucklers > Lattice > Granular > Macular |
|
order granulat, lattice and macular dystrophies in order of prevalence |
douchebags Get a Little More corneal dystrophies (Granular > Lattice > Macular; |
|
fdmneumonic for holes that transmit branches of CN V |
Standing Room Only" V1:Superior orbital fissure; V2: foramen Rotundum; V3: foramen Ovale. |
|
waht is the cutoff for elevated ESR? |
[age] / 2 (males) or [age + 10] / 2 (females). |
|
what is the classic triad for congenital glaucoma? |
photophobia, tearing (i.e. epiphora), and blepharospasm in bright lights |
|
what are the criteria for AC washout in hyphema? |
IOP > 60 for 2 days IOP > 35 for 7 days IOP > 25 for 1 day + sickle cell Corneal blood staining |
|
what does teh pretarsal part of the orbi ularis do? |
involuntary blinking |
|
what does the orbital part of the orbiculars do? |
voluntary blinking |
|
what are the thicknesses of the anterior nad posterior lens caplsues? |
The thickness of the anterior capsule is often-quoted to be approximately 14 microns while the thickness of the posterior capsule is often-quoted to be approximately 4 microns. Of course, there is some variability in these measurements as reflected by various texts. |
|
wehn shoudl the first screening for ROP be? |
4-6 weeks of post-natal age or 31st-33rd week fo postconeptual/postmenstrual age (whichever is later) |
|
what is sthe formula for piggyback lenses? |
myopia: 1 * refractive error hyperopia: 1.5 * refractive error |
|
what Sh!it causes blue sclera? |
Three syndromes that manifest blue sclera include Osteogenesis imperfecta type I, Ehlers-Danlos type VI, and brittle cornea syndrome. Brittle cornea syndrome may be the same as Ehlers-Danlos type VI except for normal lysyl hydroxylase enzyme levels. |
|
how does cellcept (mycophenolate mofetil) work? |
inhibits production of guanosine ( a purine) in B and T cells |
|
how does azothioprine work? |
inhibits purine synthesis |
|
how does chlorambucil work? |
DNA alkylating agent |
|
how does cyclophosphamide work? |
DNA alkylating agent |
|
how does cyclosporine work? |
inhibtis IL2 synthesis by T cells |
|
how does tacrolimus work? |
inhibtis IL2 synthesis by T cells |
|
how does rituxan work/ |
monoclonal antibody that binds CD20 and depletes B-cells |
|
what is the most common malignancy associated with CAR? |
small cell lung cancer |
|
what is the typical age of presentation for terrien marginal degeneration? |
thirties |
|
what is the gender predilection of terrien marginal degeneration? |
3:1 males:females |
|
what is a paradoxical pupillary reaction? |
pupils constrict to dark |
|
what aare the differences between acid and base injuries to the ocular surface? |
Actually, acidic chemicals denature and precipitate proteins in the tissues they contact. These precipitated proteins then serve as a type of barrier to further damage by the acidic chemical. In addition, ocular tissues have a higher buffering capacity for acidic compounds. In contrast, alkali chemicals cause saponification of fatty acids in cell membranes (e.g. corneal epithelium) which leads to cellular disruption. After the corneal epithelium is destroyed, the alkali chemical can easily penetrate and destroy the collagen fibrils and proteoglycans in the corneal stroma. In addition, very strong alkali chemicals can eat through the cornea and enter the anterior chamber with disastrous results, including a high incidence of severe glaucoma. |
|
How do you reduce anisometropia caused by glasses? |
This can be accomplished by reducing the front surface power(decreasing magnification), reducing vertex distance (the distance from the glasses to the eyeball), and decreasing the central thickness of the glasses. Putting the patient in contact lenses will further reduce the effects of the anisometropia as can intraocular implants. |
|
what is the most common sing in thyroid associated orbitopathy? |
upper eyelid retraction |
|
what is von graeffe's sign? |
lid lag: lids slow to come down when patient looks down. along with upper lid retraction, most common sign in thyroid eye disease |
|
what histopathologic features of choroidal melanoma increase the risk of metastasis? |
high mitotic index, high cell proliferation indices, complex microvascular patterns, tumor infiltrating lymphocytes, the presence of trisomy 8, the presence of monosomy 3, and a predominance of epthelioid cells. |
|
what is morning glory disc anomaly associated with? |
serous retinal detachments frequently occur in eyes with MGD. |
|
how do you size ACIOLs? |
horiuzontal white-to-white + 1 mm |
|
how much does 1mm of corneal light reflex deviation measure in degrees and prism diopters |
7° = 15∆ |
|
what direction is the line made by a maddox rod? |
steep axis of the cylinders |
|
what factors increase the risk of RD in lattice? |
(a) high myopia; (b) history of RD in the other eye; (c) presence of flap tears within the lattice; and (d) aphakia |
|
what is the most common location for BRVO? |
superotemporal quadrant |
|
chronic exposure to what sh!t causes optic neuropathy |
hambutol, ethanol, chloramphenicol, hydroxyquinolones, penicillamine, cisplatin, and vincristine |
|
ingestion of what sh!t causes acute vision loss and disc edema |
Methanol and ethylene glycol |
|
what are the side effects of topical carbonic anhydrase inhibitors? |
Ocular irritation is more common with dorzolamide (brand name: Trusopt) due to its greater acidity while blurring of vision is more common withbrinzolamide (brand name: Azopt). Both topical CAIs may negatively affect the corneal endothelium resulting in worsening corneal edema in those with already-compromised endothelial function (e.g. Fuchs dystrophy patients). |
|
what is the definition of microcornea? |
Microcornea is a condition characterized by a clear cornea of normal thickness, but whose horizontal diameter is than 9 mm at birth or less than 10 mm at one year of age. |
|
what are the side effects of topical carbonic anhydrase inhibitors? |
Ocular irritation is more common with dorzolamide (brand name: Trusopt) due to its greater acidity while blurring of vision is more common withbrinzolamide (brand name: Azopt). Both topical CAIs may negatively affect the corneal endothelium resulting in worsening corneal edema in those with already-compromised endothelial function (e.g. Fuchs dystrophy patients). |
|
what percentage of people with severe NPDR will progress to high-risk PDR in one year? |
15% |
|
what percentage of people with very severe NPDR will progress to high-risk PDR in one year |
45% |
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how do you measure high AC/A ratio? |
There are two main methods of calcuating the AC:A ratio: (1) the heterophoria method; and (2) the gradient method. The heterophoria method involves moving the fixation target. The heterophoria is measured while fixating at 0.33 m and also at 6 m and is calculated via this formula:AC/A = PD (in cm) + (Δn - Δd) / Dwhere, PD is the interpupillary distance in centimetersΔn is the near deviation in prism diopters Δd is the distance deviation in distance diopters D is the amount of accommodation needed for the near target (in diopters) (typically, this value is "3" diopters since the near deviation is measured at 0.33 m)The AC:A ratio can also be measured using the gradient method. In turn, there are two variations of the gradient method. One way consists of stimulating accommodation:Measure the heterophoria with the target distance fixed at 6 m.Re-measure the induced phoria after putting a -1.00 D sphere in front of both eyes.The difference between these 2 measurements is the AC/A ratio.The second variation of the gradient method consists of relaxing accommodation:With a target distance of 0.33 m, measure the phoria before and after putting up +3.00 spheres in front of both eyes.The difference in phoria measurements divided by 3 is the AC/A ratio.The normal AC/A ratio is approximately 3:1 to 5:1. |
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what are the functions of the non-pigmented epithelium of the cilliary body? |
1. The lens zonules originate from the basal laminae of the NPECB. 2. Aqueous humor is secreted by the NPECB. 3. The intercellular tight junctions (i.e. zonulae occludens) between the apices of the cells of the NPECB form the major element of the blood-aqueous barrier. |
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what is the reconstructive ladder for upper eyelid defects? |
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what kind of cataracts happen after vitrectomy? |
The most common cataract that is induced by pars plana vitrectomy in phakic patients is a nuclear cataract. The most common cataract that is induced ifsilicone oil is instilled in the eye is a posterior subcapsular cataract.According to the BCSC, >90% of eyes in patients over age 50 will develop a visually-significant nuclear cataract within 2 years of vitrectomy. |
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what kind of cataracts happen after vitrectomy? |
The most common cataract that is induced by pars plana vitrectomy in phakic patients is a nuclear cataract. The most common cataract that is induced ifsilicone oil is instilled in the eye is a posterior subcapsular cataract.According to the BCSC, >90% of eyes in patients over age 50 will develop a visually-significant nuclear cataract within 2 years of vitrectomy. |
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what do beta blockers do to cholesterol? |
decrease HDL and increase LDL; no evidence that this increases risk of cardiovascular events |
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what is the characteristic FA finding of PIC? |
early hyperfluorescense with late staining of the lesions |
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what is the characteristic FA finding of birdshot? |
quenching: idiopathic rapid clearing of fluorescein |
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what are the EOG and ERG findings in best disease? |
abnormal EOG and normal ERG |
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what is the most common sign of thyroid orbitopathy? |
eyelid retraction |
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what is the most common sign of thyroid orbitopathy? |
eyelid retraction |
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what is the most common sign of thyroid orbitopathy? |
eyelid retraction |
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what is the most common sign of thyroid orbitopathy? |
eyelid retraction |
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what is the most common sign of thyroid orbitopathy? |
eyelid retraction |
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what is the most common sign of thyroid orbitopathy? |
eyelid retraction |
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what is the characteristic congenital nystagmus waveform? |
exponential increase in slow wave |
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what is the a-scan pattern of choroidal melanoma? |
low internal reflectivity |
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what are the lab findings in Miller-Fischer syndrome? |
Antibodies against GQ1b gangliosides are found in up to 90% of MFS patients depending on the study and geographic location of the sample population. Other classic laboratory findings of MFS (and GBS in general) are an elevated CSF protein with a normal or relatively low CSF white blood cell count (i.e. "albuminocytologic dissociation") and evidence of conduction block on nerve conduction studies. |
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which white dot syndromes have CNV? |
MCP: 20% -> leading cause of blindness Birdshot: rare Serpiginous: rarely at the margin of atrophy PIC: 30% in areas of scarring |
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which white dot syndromes have CNV? |
MCP: 20% -> leading cause of blindness Birdshot: rare Serpiginous: rarely at the margin of atrophy PIC: 30% in areas of scarring |
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which white dot syndromes have CNV? |
MCP: 20% -> leading cause of blindness Birdshot: rare Serpiginous: rarely at the margin of atrophy PIC: 30% in areas of scarring |
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which white dot syndromes have CNV? |
MCP: 20% -> leading cause of blindness Birdshot: rare Serpiginous: rarely at the margin of atrophy PIC: 30% in areas of scarring |
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which white dot syndromes have CNV? |
MCP: 20% -> leading cause of blindness Birdshot: rare Serpiginous: rarely at the margin of atrophy PIC: 30% in areas of scarring |
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what is the FA pattern for cavernous hemangioma |
fills slowly with pooling in the upper part of the lesion |
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what is the FA pattern for the choroidal hemangioma? |
large choroidal vessels seen the the arterial phase and late staining of the lesion |
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what is the FA pattern for capillary hemangioma? |
rapid arteriovenous phase with massive leakage into the tumor |
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is axenfeld reiger usually bilateral or unilateral |
bilateral |
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is ICE usually unilateral or bilateral |
unilateral |
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what medications can cause IIH |
vitamin A and derivitives tetracyclines cyclosporine oral contraceptives prednisone (use of and sudden withdrawal) synthetic growth hormone |
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what type of glaucoma does LTP suck for? |
uveitic, angle recession, ICE, NVG, congential, those associated with increased episcleral venous pressure (e.g. sturge weber, CCF) |