Random refractive, glauc, lens march 8

kuleya's version from 2016-03-09 06:16


Question Answer
what should you do about pleomorphic adnomaresect, no biopsy, don’t leave pseudocapsule
which glaucoma shunt is valve?ahmed
which side of hypertropia is MLF lesion in skew deviation caused by it?ipsilateral (typically contralateral for skew)
Culter beard used for what?50% defect upper lid greater than
medial spindle used for what?medial ectropion that looping thingy
PAX6 mutation causes what?aniridia, axenfeld, posterior embryotoxon, peters anomaly, congenital cataract
pilocarpine stimulates accommodation and miosis!cool
digoxin stimulates what syndrome?chromatopsia – yellowish green hue everywhere gets better with drug cessation
sildenafil causes what? in eyes?blue chromatopsia and ?NAION
kestenbaums rule fo low vision near correction is what?inverse snellen is near add (20/40 → 40/20 → +2.00)
stromal rings are placed for who?low myope keratoconus patients..flatten the cornea
tears start getting formed 3-6 weeks from birthOk!
vertical fusional amplitudes are typically what?< 2 pd, convergence 14 pd, divergence 6
making a CL fit tighter you increase the diameter or decrease the ____...base curve… the numbers are 8.5 BC/14 D/+10.00 correction
keratometry measures what?reflecting power to calculate shit. n = 1.335 on the device and posterior curvature contributes ~-5 D
WAGR complex gene? acronym stands for?PAX6 – Wilms tumor, Aniridia, GU abnormalities, and Retardation
2/3 of aniridia is inhiriated autosomal ___?dominant. 1/3 sporadic
fuchs heterochromic iridocyclitis has post op hyphema why?long fragile vessels cross the angle and insert high into the angle.. Amsler Sign
laterality of FHIC?unilateral
KP diffusely that is stellate, unilateral heterocrhia, DX?fuchs
No PS or PAS on fuchscool
high incidence of what kind of cataract in fuchs?PSC
how do you usually control FHIC glaucoma? surgical
how do you treat uveitic FHIC?you DON’T!... take out cataract and tx glaucoma
defect in marfan is in what protein?fibrillin… weak zonules
dietary restrictions in homocysteinuria?low methionine and high cysteine… high pyridoxine or B6
thromboembolic events under general anesthesia disease?homocysteinuria… they are tal with mental retardation
formation of bubbles to cause lens breakdown called what?cavitation
what is a dispersive viscoelastic agent? effect on iop? benefits?viscoat…less iop spike if retained in eye, coats corneal endothelium better
healon is what kind of agent?cohesive
benefit of cohesive agent?clump, easily removed, HIGH IOP
how does aging lens cause worsening vision?lens protein aggregation, crosslinking… more water soluble
which part of lens can be left in eye?cortex gets resorbed… may get inflammation
nuclear fragments need to be removed when before causing CME? 3 weeks
PSC associated with RP and ___?chronic uvieits, steroid, radiation exposure, NF2
sunflower cataracts by what?copper
galactosemia causes what kind of cataracts?oil droplet
myotonic dystrophy cataract?Christmas tree
transverse incisions cause what kind of shift in refractive state?hyperopic, coupling ratio > 1
difference between astigmatic keratotomy and LRI?AK done closer to apex → stronger. …both maintain same spherical equivalent…. coupling ratio 1
sequelae of epithelial down growth postop?PAS, secondary glaucoma, epithelial cells clogging trabecular meshwork.. need glaucoma valve
anaerobic metabolism in lensyay
phaco power is whatpercentage of length the phaco tip moves relative to maximal possible length
phaco load is what?amount of surface area of nuclear material in contact with tip
post-lasik patients needing cataract surgery need what method to ascertain the correct lens?contact lens… equation! --IOL power = CL base curve + CL power + CL over refraction - (manifest refraction)
LASIK patients tend to get what kind of post-cataract surprise?hyperopic
reasons post-refractive surgery calc errors happen (3)?1. radius error - lasik flattens central cornea more than keratometry realizes…2. index of refraction error - difference between anterior and posterior cornea is assumed in calculating assumed index of refraction 1 D for ever 7D myopic ablation3. Formula error - corneal power is used to predict effective lens position, which is thusly estimated to be farther from retina than reality by Holladay, Hoffer, and SRK… use ELP that is not derived from Ks like Haigis
when is Threshold DLK in post-lasik? (sands of sahara)grade 3 – clumped central WBCs, beginning of scarring, need to lift flap and clean out interface on top the the steroids you are already using..grade 4 is stromal melt.. (grade 1 is peripheral granular cells no central involvement)
late infection in lasik is by what?mycobacteria and fungus…> 10 days
Risk factors for epithelial abrasions in LASIK flap creation?suction during microkeratome, old age, topical anesthetic > 5 minutes preoperatively, microkeratome after femtosecond flap made
do what procedure in EBMD for refractive surgery?PRK
Late post lasik haze and decreased vision suspect what?pressure induced stromal keratitis from steroid use, decrease drops
limbal based trabs have conj incision where? is it easier? is it less prone to leak? is it diffuse or focally elevated?fornix conj incision, harder due to view, less prone to leak, focally elevated
fornix based trabs have conj incision where? is it easier? is it prone to leak? is it diffuse or focally elevated?conj incision at limbus, easier due to exposure, more prone to leak, diffuse low elevation
aniridia carries risk of what kind of glaucoma?angle closure
iridoschisis is associated with what?chronic angle closure glaucoma
selective beta-blockers for glaucoma are?betaxolol and carteolol (this one actually has intrinsic sympathomimetic activity)
common systemic side effects of brimonidine?dry mouth and lethargy
bad taste is caused by what glaucoma med?dorzolamide
ocular signs of aniridia.iris stump, nystagmus, foveal hypoplasia, chronic angle closure
2 micro liters per minute is normal rate of aqueous production.ok!
microspherophakia is what? what med can be given to help glaucoma in it?small displaced anteriorly globular lens causing pupillary block glaucoma…atropine can dilate pupil and flatten the lens to pull it back posteriorly in the bag…avoid pilo
goal % iop decrease for normal tension glaucoma patients?30
methazolamide metabolized by liverOKOKOKOK. use for kidney patients
risk factors for suprachoroidal hemorrhage?advanced age, myopia, arteriosclerotic CVD, aphaki, glaucoma, HTN, tachycardia…warfarin, prior vitrectomy, sever hypotony…SHEAR FRAGILE VESSELS
last areas to go from glaucoma?central island and inferotemporal field
most systemically active topical glaucoma class?beta blocker
Juveniles like the Tigger and Winnie the poo)Juvenile glaucoma, TIGR/MYOC gene (trab meshwork glucocorticoid response gene)
normal tension glaucoma gene/product?OPTN optineurin
congenital glaucoma gene?CYP1B1
axenfeld rieger genes?PITX3 and FOXC1