Cataract Quiz: Symptoms and Epidemiology
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Questions and Answers

Epidemiologically, cataracts are:

  • More prevalent in men than women
  • The most common cause of reversible blindness (correct)
  • Not a congenital condition
  • Entirely an age-related process

    • Cataracts are associated with the following systemic diseases:

  • Tuberous sclerosis
  • Osler-Weber-Rendu syndrome
  • Marfan syndrome (correct)
  • Multiple sclerosis

    • Which of the following is NOT a symptom arising from the formation of cataracts?

  • Reduced contrast sensitivity
  • Blurred vision for both near and distance
  • Photophobia (correct)
  • Poor night vision

    • Which one of the following types of cataracts is NOT age-related?

    <p>Posterior polar</p> Signup and view all the answers

    Which of the following is TRUE - with age, the lens:

    <p>Becomes increasingly curved and has increasing refractive power</p> Signup and view all the answers

    Which of the following is FALSE regarding the anatomy of lens?

    <p>The lens is biconcave</p> Signup and view all the answers

    The contraction of the ciliary muscle ring is related to the shape of the lens via the following mechanism:

    <p>Ciliary muscle ring contracts, the ring diameter is reduced and the zonular fibres relax, resulting in the lens becoming rounder</p> Signup and view all the answers

    Which of the following is FALSE regarding the "pump-leak theory"?

    <p>All ion movement into the lens is mediated by active transport</p> Signup and view all the answers

    Which of the following is NOT a feature of terminal differentiation?

    <p>The cells become less dependent on glycolysis for energy</p> Signup and view all the answers

    Which of the following refers to a Morgagnian cataract?

    <p>There is cortical liquefaction resulting in the nucleus sinking inferiorly</p> Signup and view all the answers

    Which one of the following systemic diseases results in the formation of fine, needle-like opacities that resemble a Christmas tree cataract?

    <p>Myotonic dystrophy</p> Signup and view all the answers

    Which one of the following is associated with the formation of snowflake cataracts?

    <p>Diabetes mellitus</p> Signup and view all the answers

    Which of the following is FALSE?

    <p>Chronic anterior uveitis is not associated with cataract formation</p> Signup and view all the answers

    Which of the following drugs is associated with intraoperative floppy iris syndrome?

    <p>Tamsulosin</p> Signup and view all the answers

    Which of the following regarding a preoperative ophthalmic assessment is FALSE?

    <p>Nuclear cataracts tend to require lower ultrasonic energy during phacoemulsification</p> Signup and view all the answers

    Which of the following is NOT an intraocular lens (IOL) power calculation formula?

    <p>Javal-Schiotz</p> Signup and view all the answers

    Which one of the following surgical steps refers to the separation of the lens nucleus and cortex from the capsule?

    <p>Hydrodissection</p> Signup and view all the answers

    Which of the following is NOT a sign of posterior lens capsule rupture?

    <p>The vitreous gel can be visualised</p> Signup and view all the answers

    Which of the following perioperative measure is established as the most effective preventative measure for endophthalmitis prophylaxis?

    <p>Topical administration of 5% povidone-iodine a few minutes prior to surgery</p> Signup and view all the answers

    Which of the following is NOT a risk factor for cystoid macular oedema?

    <p>Topical NSAIDs</p> Signup and view all the answers

    Which one of the following statements regarding posterior capsular opacification (PCO) is FALSE?

    <p>PCO is the most common early complication of cataract surgery</p> Signup and view all the answers

    Which of the following morphologies is NOT seen in congenital cataract?

    <p>Snowflake opacities</p> Signup and view all the answers

    A 45-year-old lady presents with a history of increasing difficulty in reading books and newspapers, especially under bright lights. You are told her sole ocular pathology is cataracts. Which one of the following cataract is she MOST likely to have?

    <p>Nuclear sclerotic</p> Signup and view all the answers

    Which of the following is NOT a type of congenital cataract?

    <p>Cortical</p> Signup and view all the answers

    Which of the following is the MOST common lens protein?

    <p>Beta crystallin</p> Signup and view all the answers

    What is the most common cause of reversible blindness worldwide?

    <p>Cataracts</p> Signup and view all the answers

    What is the name of the genetic disorder that weakens connective tissue and can lead to cataracts?

    <p>Marfan syndrome</p> Signup and view all the answers

    What is the name of the theory that describes the mechanism by which ions and other molecules are transported into and out of the lens?

    <p>Pump-leak theory</p> Signup and view all the answers

    What is the name of the process by which lens epithelial cells elongate into lens fibers?

    <p>Terminal differentiation</p> Signup and view all the answers

    What is the name of the type of hypermature cataract that is characterized by liquefaction of the cortex and the nucleus sinking inferiorly?

    <p>Morgagnian cataract</p> Signup and view all the answers

    What is the name of the genetic disorder that often causes the formation of cataracts that resemble a Christmas tree?

    <p>Myotonic dystrophy</p> Signup and view all the answers

    What is the name of the type of cataract that is often associated with diabetes mellitus?

    <p>Snowflake cataracts</p> Signup and view all the answers

    What is the name of the common complication of cataract surgery that is caused by inflammation of the macula?

    <p>Cystoid macular oedema (CMO)</p> Signup and view all the answers

    What is the most common early complication of cataract surgery?

    <p>Posterior capsular opacification (PCO)</p> Signup and view all the answers

    What is the name of the type of cataract that is often seen in a younger demographic and is characterized by its rapid progression?

    <p>Posterior subscapular cataract</p> Signup and view all the answers

    What is the most common type of congenital cataract?

    <p>Punctate cataracts</p> Signup and view all the answers

    What is the most common type of crystallin in the lens?

    <p>Beta crystallin</p> Signup and view all the answers

    What is the name of the surgical procedure that involves injecting a fluid into the space between the lens nucleus and the surrounding capsule?

    <p>Hydrodissection</p> Signup and view all the answers

    What is the name of the syndrome that causes the iris to become floppy during cataract surgery?

    <p>Intraoperative floppy iris syndrome (IFIS)</p> Signup and view all the answers

    What is the name of the medication that is known to increase the risk of intraoperative floppy iris syndrome?

    <p>Tamsulosin</p> Signup and view all the answers

    What is the name of the rare but serious complication of cataract surgery that can occur when the posterior lens capsule ruptures?

    <p>Endophthalmitis</p> Signup and view all the answers

    What is the term used to describe the clouding of the posterior capsule of the lens that is a common complication of cataract surgery?

    <p>Posterior capsular opacification (PCO)</p> Signup and view all the answers

    Study Notes

    Cataract Questions - Summary

    • Epidemiology: Cataracts are more common in women than men, are not entirely age-related, and are not a congenital condition. They are the most prevalent cause of reversible blindness.

    • Systemic Diseases: Cataracts are linked to Marfan syndrome, Osler-Weber-Rendu syndrome, tuberous sclerosis, and multiple sclerosis.

    • Cataract Symptoms: Poor night vision, reduced contrast sensitivity, and blurred vision (both near and far) are symptoms. Photophobia is not a symptom.

    • Age-Related Cataract Types: Nuclear sclerotic, cortical, and posterior subcapsular cataracts are age-related, unlike posterior polar cataracts.

    • Lens Changes with Age: The lens becomes less curved with age, leading to decreased refractive power.

    • Anatomy of the Lens: The lens is biconcave, avascular, and held in place by zonular fibres. It lacks neural innervation.

    • Ciliary Muscle Contraction: Ciliary muscle contraction reduces the ring diameter and relaxes zonular fibers, resulting in the lens becoming rounder.

    • Pump-Leak Theory: Potassium and amino acids are actively pumped into the anterior lens, while sodium is concentrated in the posterior lens with the movement of ions being regulated by active transport. Intercellular gap junctions also facilitate passive diffusion.

    • Terminal Differentiation: Lens differentiation involves cell elongation into lens fibers, loss of cell organelles, increased cellular protein mass, and decreased reliance on glycolysis.

    • Morgagnian Cataract: Complete lens opacity, with some transparent proteins. Nucleus sinking inferiorly from cortical liquefaction.

    • Christmas Tree Cataract: Fine, needle-like opacities resembling Christmas trees associated with myotonic dystrophy, a muscle disorder.

    • Snowflake Cataract: Associated with conditions like tuberous sclerosis.

    • Nuclear Sclerotic Cataract: Not associated with myopia.

    • Acute Close-Angle Glaucoma: Can cause subcapsular or capsular opacities.

    • Chronic Anterior Uveitis: Can lead to cataract formation.

    • Intraoperative Floppy Iris Syndrome (IFIS): Associated with tamsulosin.

    • Preoperative Assessment: Important to evaluate for shallow anterior chamber, ectropion, and endophthalmitis risk, and a poor red reflex.

    • Intraocular Lens Power Calculation: Several formulas, such as SRK-T, Hoffer Q, Javal-Schiotz, and Holladay 1, are used for these calculations.

    • Surgical Step: Separation of the lens nucleus and cortex from the capsule is referred to as "Phaco-chop" or "Divide and conquer".

    • Posterior Lens Capsule Rupture: Signs of rupture include pupillary dilation and shallowing of the anterior chamber; and the phaco probe tip unable to approach the nucleus as it moves posteriorly.

    • Perioperative Measures for Endophthalmitis Prevention: Topical administration of 5% povidone-iodine before surgery is recommended to prevent infection.

    • Diabetes-related Cataracts: Poorly controlled diabetes results in hyperglycemic aqueous humor, leading to sorbitol accumulation in the lens and increased osmotic pressure. This causes lens swelling.

    • Risk Factors for Cystoid Macular Edema: Poorly controlled diabetes mellitus, topical NSAIDs, posterior capsule rupture, and vitreous loss.

    • Posterior Capsular Opacification (PCO): Is a common late complication of cataract surgery, characterized by lens epithelial cell proliferation.

    • Congenital Cataract: Blue dot opacities, central opacities, and lamellar opacities seen. Snowflake opacities may occur in young diabetic patients, but may self resolve.

    • Age-related Cataract Types: Nuclear sclerotic, cortical, posterior subscapular. Posterior polar is congenital.

    • Lens Protein Composition: Beta crystallin is the most common lens protein.

    • Cataract Classification: Categorized as immature, mature, hypermature, and Morgagnian.

    Cataract Origin and Associated Conditions

    • Etiology: May be age-related, congenital, or traumatic, or can result from certain systemic conditions such as diabetes.

    • Systemic Disease Association: Several systemic diseases have been linked to cataract formation, such as metabolic disorders (diabetes), renal diseases, dermatologic conditions, connective tissue disorders, and central nervous system conditions.

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    Duke Elder Ophthalmology Exam PDF - Cataract Questions

    Description

    Test your knowledge on cataracts with this quiz covering their epidemiology, systemic diseases associated with them, and their various symptoms. Explore the anatomy of the lens and understand the types of age-related cataracts as well. Perfect for anyone studying ophthalmology or healthcare.

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