Cataracts and Intraocular Lenses Quiz
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Questions and Answers

Which type of cataract is characterized by an autosomal dominant inheritance pattern and is not always congenital in origin?

  • Lamellar cataract (correct)
  • Mittendorf's dot
  • Cerulean cataract
  • Persistent pupillary membrane

    • What structure is a remnant of the hyaloid system, previously attached to the lens?

  • Persistent pupillary membrane
  • Cerulean cataract
  • Mittendorf's dot (correct)
  • Lamellar cataract

    • Which of the following is NOT a type of cataract discussed in the text?

  • Blue dot cataract
  • Persistent pupillary membrane
  • Nuclear cataract (correct)
  • Zonular cataract

    • Which type of cataract is considered a common and rarely vision-affecting congenital cataract?

    <p>Cerulean cataract (A)</p> Signup and view all the answers

    What is the most common type of intraocular lens implant used to replace the crystalline lens in cataract surgery?

    <p>Posterior chamber lens implants (A)</p> Signup and view all the answers

    What is the name for web-like projections attached to the iris surface that sometimes persist as remnants of the pupillary membrane?

    <p>Persistent pupillary membrane strands (A)</p> Signup and view all the answers

    What is the primary reason for the preference of posterior chamber lens implants over other types in cataract surgery?

    <p>They are located in the same location as the original lens, resulting in a more natural post-surgery vision. (D)</p> Signup and view all the answers

    What is the term for the transitory network of blood vessels anterior to the lens that forms during the third month of development?

    <p>Pupillary membrane (A)</p> Signup and view all the answers

    In which quadrant of the lens periphery do cortical cataracts most commonly occur in their early stages?

    <p>Inferior-nasal (B)</p> Signup and view all the answers

    Which of the following ocular conditions is MOST associated with the formation of glaukomflecken?

    <p>Acute angle closure (D)</p> Signup and view all the answers

    Which of the following changes DOES NOT occur during accommodation?

    <p>The depth of the anterior chamber increases (A)</p> Signup and view all the answers

    What type of cataract is MOST commonly associated with atopic dermatitis?

    <p>Shield-like anterior subcapsular plaques (D)</p> Signup and view all the answers

    Which of the following is the LEAST common cause of congenital cataracts?

    <p>Birth trauma (C)</p> Signup and view all the answers

    Which of the following systemic diseases is NOT associated with a specific type of cataract?

    <p>Atopic dermatitis (A)</p> Signup and view all the answers

    What type of astigmatism does the progression of cataracts induce?

    <p>Against-the-rule astigmatism (D)</p> Signup and view all the answers

    Which Purkinje image is inverted?

    <p>Fourth Purkinje image (C)</p> Signup and view all the answers

    Which of the following is the MOST likely ocular consequence of long-term treatment with corticosteroids in a patient with chronic anterior uveitis?

    <p>Posterior subcapsular cataracts (B)</p> Signup and view all the answers

    Which of the following is NOT a hereditary fundus dystrophy associated with posterior subcapsular cataracts?

    <p>Oguchi disease (D)</p> Signup and view all the answers

    Which of the four Purkinje images is the largest?

    <p>Third Purkinje image (C)</p> Signup and view all the answers

    Which of the following is the LEAST likely cause of a secondary cataract?

    <p>Acute angle closure (A)</p> Signup and view all the answers

    Which of the following changes DOES NOT contribute to fluctuating vision in a patient with poorly controlled diabetes mellitus?

    <p>Changes in corneal curvature (B)</p> Signup and view all the answers

    Which of the following statements about congenital cataracts is TRUE?

    <p>They can lead to amblyopia if left untreated (C)</p> Signup and view all the answers

    What type of cataract is MOST commonly associated with Wilson's disease?

    <p>Green &quot;sunflower&quot; cataracts (B)</p> Signup and view all the answers

    Which of the following is NOT a common etiology of a congenital cataract?

    <p>Age-related changes (A)</p> Signup and view all the answers

    What is the primary mechanism by which elevated glucose levels contribute to changes in the crystalline lens in diabetic patients?

    <p>Increased osmotic pressure within the lens due to glucose accumulation (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the accommodative changes that occur when focusing on a near object?

    <p>The ciliary muscle contracts, decreasing tension on the zonules, causing the lens to become more spherical. (C)</p> Signup and view all the answers

    Which type of cataract is characterized by a granular, plaque-like appearance on retroillumination and is often associated with long-term corticosteroid use?

    <p>Posterior subcapsular cataract (A)</p> Signup and view all the answers

    A patient with diabetes mellitus complains of fluctuating vision, particularly when reading or in bright light. What is the MOST likely underlying cause of this symptom?

    <p>Changes in the crystalline lens due to fluctuating glucose levels (B)</p> Signup and view all the answers

    What is the metabolic pathway responsible for the accumulation of sorbitol in the lens of diabetic patients?

    <p>Aldose reductase pathway (A)</p> Signup and view all the answers

    Which type of cataract is characterized by a yellowing or browning discoloration of the lens nucleus?

    <p>Nuclear sclerotic cataract (C)</p> Signup and view all the answers

    A patient presents with a cataract that appears as wedge-shaped or radial spoke-like opacities on slit-lamp examination. What is the MOST likely diagnosis?

    <p>Cortical cataract (D)</p> Signup and view all the answers

    What is the primary function of the zonules of Zinn?

    <p>To attach the lens to the ciliary body (C)</p> Signup and view all the answers

    Which of the following factors can contribute to the development of posterior subcapsular cataracts?

    <p>All of the above (D)</p> Signup and view all the answers

    A patient with a mature cataract will typically experience:

    <p>A gradual decrease in vision (A)</p> Signup and view all the answers

    What is the difference between nuclear sclerosis and brunescence?

    <p>Nuclear sclerosis refers to hardening of the lens, while brunescence refers to yellowing or browning of the lens. (C)</p> Signup and view all the answers

    What is the MOST likely reason why a patient with a posterior subcapsular cataract may experience decreased vision particularly during reading or in bright light?

    <p>The cataract scatters more light in these conditions. (C)</p> Signup and view all the answers

    What is the mechanism by which the crystalline lens changes shape during accommodation?

    <p>Contraction of the ciliary muscle, which decreases the tension on the zonules of Zinn. (D)</p> Signup and view all the answers

    Why might a doctor defer prescribing glasses for a diabetic patient with fluctuating vision?

    <p>The patient's vision may improve with better glucose control. (D)</p> Signup and view all the answers

    What is the primary difference between a cortical cataract and a nuclear sclerotic cataract?

    <p>Cortical cataracts involve the lens periphery, while nuclear sclerotic cataracts affect the lens nucleus. (A)</p> Signup and view all the answers

    Which type of cataract is MOST likely to cause glare and difficulty seeing in bright light?

    <p>Cortical cataract (C)</p> Signup and view all the answers

    Which of the following conditions is NOT associated with an increased risk of posterior capsular rupture during cataract surgery?

    <p>Primary open angle glaucoma (B)</p> Signup and view all the answers

    In patients with homocystinuria, what is the typical direction of crystalline lens subluxation?

    <p>Downward and inward (D)</p> Signup and view all the answers

    Which of the following anatomical changes is believed to occur with the development of presbyopia?

    <p>Crystalline lens axial thickness increases (C)</p> Signup and view all the answers

    Which of the following corneal conditions is most likely to be associated with impaired wound healing?

    <p>Ligneous conjunctivitis (A)</p> Signup and view all the answers

    A patient presents with recurrent corneal erosions and wishes to undergo refractive surgery. What procedure is considered the most appropriate option in this case?

    <p>Photorefractive keratectomy (PRK) (A)</p> Signup and view all the answers

    What is the anatomical space referred to as Berger's space?

    <p>The space between the posterior face of the lens and the anterior face of the vitreous (B)</p> Signup and view all the answers

    A patient presents with blurred vision and glare at night following cataract surgery. Slit-lamp examination reveals fibrosis on the posterior surface of their intraocular lens implant. What is the most likely diagnosis?

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

    Which corneal dystrophy is characterized by amyloid deposition and can present with both thick and thin lines as well as dots?

    <p>Lattice dystrophy (A)</p> Signup and view all the answers

    Which of the following retinal layers is NOT pushed aside at the foveola?

    <p>The retinal pigment epithelium (C)</p> Signup and view all the answers

    Which of the following conditions involves inflammation solely in the corneal stroma, without involvement of the epithelium or endothelium?

    <p>Interstitial keratitis (B)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of a mature cataract?

    <p>Best visualized with retroillumination (D)</p> Signup and view all the answers

    Which of the following corneal dystrophies is characterized by the deposition of glycosaminoglycans in the stroma?

    <p>Macular dystrophy (B)</p> Signup and view all the answers

    What is the most likely reason for inserting a capsular tension ring during cataract surgery in a patient with pseudoexfoliation syndrome?

    <p>To stabilize the posterior capsule and prevent IOL dislocation (C)</p> Signup and view all the answers

    A patient presents with corneal thinning and enlargement of opacities that extend from the central cornea to the limbus, affecting all layers. Which corneal dystrophy is most likely the cause?

    <p>Macular dystrophy (D)</p> Signup and view all the answers

    Which of the following surgical procedures involves replacing the full thickness of the cornea with donor tissue?

    <p>Penetrating keratoplasty (B)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of Elschnig pearls?

    <p>Usually present in the natural crystalline lens (B)</p> Signup and view all the answers

    What is the most common late complication of uncomplicated cataract surgery?

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

    Which of the following procedures is NOT recommended for patients with recurrent corneal erosions who wish to undergo refractive surgery?

    <p>LASIK (A), Femtosecond flap creation (C), Microkeratome flap creation (D)</p> Signup and view all the answers

    Which of the following is NOT a common manifestation of homocystinuria?

    <p>Macular degeneration (B)</p> Signup and view all the answers

    Which of the following corneal conditions is characterized by deposits of eosinophilic hyaline in the anterior stroma?

    <p>Granular dystrophy (C)</p> Signup and view all the answers

    Which of the following is a common ocular complication associated with systemic lupus erythematosus?

    <p>Uveitis (E)</p> Signup and view all the answers

    What is the name of the corneal surgical procedure that involves transplanting a partial thickness of the corneal epithelium and stroma, leaving the deeper layers intact?

    <p>Lamellar keratoplasty (A)</p> Signup and view all the answers

    What is the primary justification for early cataract surgery in patients with pseudoexfoliation syndrome?

    <p>To minimize complications associated with dense cataracts (D)</p> Signup and view all the answers

    In which corneal dystrophy is a clear limbal zone usually preserved in the early stages?

    <p>Granular dystrophy (A)</p> Signup and view all the answers

    What is the rationale for placing an IOL in the sulcus or suturing it in some cases of cataract surgery in patients with pseudoexfoliation syndrome?

    <p>To prevent IOL dislocation due to weakened zonules (A)</p> Signup and view all the answers

    Which of the following is a TRUE statement regarding the preferred surgical intervention in patients with macular dystrophy?

    <p>Corneal transplant is the preferred surgical intervention. (B)</p> Signup and view all the answers

    Which of the following is NOT a typical complaint associated with posterior capsular opacification?

    <p>Blurred vision at near only (A)</p> Signup and view all the answers

    Which form of keratitis is primarily associated with syphilis?

    <p>Interstitial keratitis (C)</p> Signup and view all the answers

    Which of the following statements is NOT true of anterior capsular contraction?

    <p>It is typically treated with posterior capsular opacification surgery (D)</p> Signup and view all the answers

    Which of the following procedures removes almost all opaque corneal tissue, leaving only Descemet's membrane intact?

    <p>Deep anterior lamellar keratoplasty (C)</p> Signup and view all the answers

    Which of the following conditions involves inflammation of the corneal epithelium and stroma, but not the endothelium?

    <p>Neurotrophic keratitis (B)</p> Signup and view all the answers

    Which of the following is a rare form of chronic conjunctivitis characterized by the presence of pseudomembranes on the palpebral conjunctiva?

    <p>Ligneous conjunctivitis (A)</p> Signup and view all the answers

    Which of the following retinal structures is the most central (smallest diameter)?

    <p>Foveola (A)</p> Signup and view all the answers

    What is the principle behind the measurement of retinal nerve fiber layer (RNFL) thickness by scanning laser polarimetry?

    <p>The RNFL exhibits birefringence due to its unique structure. (C)</p> Signup and view all the answers

    Which of the following vascular beds has the lowest flow rate and the highest resistance?

    <p>Retinal vessels (D)</p> Signup and view all the answers

    What percentage of patients presenting with a stage 1 macular hole typically resolve spontaneously without treatment?

    <p>50% (A)</p> Signup and view all the answers

    Which of the following phenomena contribute to the dark appearance of the fovea in fluorescein angiography images? (Select 3)

    <p>An increased density of xanthophyll in the foveal region (A), The absence of retinal blood vessels in the center of the fovea (B), The retinal pigment epithelial cells in the foveal region are larger and contain more melanin (E)</p> Signup and view all the answers

    Which of the following conditions are associated with an increased likelihood of developing a posterior vitreous detachment? (Select 3)

    <p>High myopia (C), Intraocular surgery (D), Diabetes (F)</p> Signup and view all the answers

    What is the approximate diameter of the fovea centralis?

    <p>1.5 mm (C)</p> Signup and view all the answers

    Which of the following retinal structures directly surrounds the fovea?

    <p>Parafoveal area (A)</p> Signup and view all the answers

    What is the approximate diameter of the perifoveal area?

    <p>4 mm (D)</p> Signup and view all the answers

    What is the primary function of birefringent materials in scanning laser polarimetry?

    <p>To split the light into two different components that travel at different velocities. (B)</p> Signup and view all the answers

    What anterior segment structure contributes to birefringence, and how does it affect scanning laser polarimetry?

    <p>The cornea refracts light differently based on direction, requiring compensation for accurate RNFL measurements. (B)</p> Signup and view all the answers

    Which of the following statements about the characteristics of stage 1 macular holes is TRUE?

    <p>Patients are typically symptomatic with both eyes open. (B)</p> Signup and view all the answers

    What is the primary reason for observing a dark appearance in the foveal region during fluorescein angiography?

    <p>The fovea is devoid of retinal blood vessels. (E)</p> Signup and view all the answers

    What role does xanthophyll play in the dark appearance of the fovea in fluorescein angiography?

    <p>Xanthophyll blocks background choroidal fluorescence, contributing to the dark appearance. (A)</p> Signup and view all the answers

    What is the primary factor that influences the rate of vitreous aging and the likelihood of developing a posterior vitreous detachment?

    <p>Age (B)</p> Signup and view all the answers

    Which of the following statements regarding the retinal pigment epithelium (RPE) in the fovea is TRUE?

    <p>Foveal RPE cells are larger and contain more melanin than RPE cells in other areas. (D)</p> Signup and view all the answers

    What is the primary function of the retinal pigment epithelium (RPE) in the eye?

    <p>To regenerate rhodopsin in photoreceptors (A)</p> Signup and view all the answers

    Which bacterium is most commonly associated with acute bacterial conjunctivitis in children?

    <p>Moraxella catarrhalis (B)</p> Signup and view all the answers

    What type of hypersensitivity reaction is responsible for allergic conjunctivitis?

    <p>Type I Hypersensitivity (C)</p> Signup and view all the answers

    Which condition is characterized by the presence of Neisseria gonorrhoeae?

    <p>Hyperacute conjunctivitis (A)</p> Signup and view all the answers

    In the context of keratometry, what does an elliptical reflection with a vertical long axis indicate?

    <p>Against-the-rule astigmatism (D)</p> Signup and view all the answers

    What is the most prominent bacterium causing chronic conjunctivitis?

    <p>Chlamydia trachomatis (B)</p> Signup and view all the answers

    Why do gram-positive bacteria appear purple when stained with crystal violet?

    <p>They have thicker peptidoglycan layers in their cell walls. (A)</p> Signup and view all the answers

    Which of the following is a characteristic of Type II hypersensitivity reactions?

    <p>Antibody-dependent cytotoxicity (B)</p> Signup and view all the answers

    What is the expected keratometry reading for a patient with against-the-rule astigmatism?

    <p>48.62 @045 / 40.00 @135 (C)</p> Signup and view all the answers

    What is the most common cause of rhegmatogenous retinal detachments?

    <p>Vitreoretinal adhesion during PVD (D)</p> Signup and view all the answers

    Which type of retinal detachment occurs due to tractional forces?

    <p>Tractional retinal detachment (C)</p> Signup and view all the answers

    Which structure is NOT associated with cone photoreceptors?

    <p>Free-floating discs in the outer segment (A)</p> Signup and view all the answers

    What age group and gender is most commonly associated with Central Serous Retinopathy?

    <p>Males; ages 30-50 (C)</p> Signup and view all the answers

    Which vitamin, if taken in excess, may interfere with Vitamin A uptake?

    <p>Vitamin E (B)</p> Signup and view all the answers

    During the Watzke-Allen test, what observation indicates a potential macular hole?

    <p>Beam appears thinned and broken vertically (B)</p> Signup and view all the answers

    What is the most common systemic disease associated with angioid streaks?

    <p>Pseudoxanthoma elasticum (B)</p> Signup and view all the answers

    What type of retinal detachment is primarily caused by choroidal or retinal disease?

    <p>Exudative retinal detachment (B)</p> Signup and view all the answers

    Which characteristic is associated with combined tractional/rhegmatogenous retinal detachments?

    <p>Always associated with retinal breaks (D)</p> Signup and view all the answers

    In the context of macular holes, what does a 'pedicle' refer to?

    <p>The terminal of cone photoreceptors (B)</p> Signup and view all the answers

    What typically happens in most cases of Central Serous Retinopathy?

    <p>They resolve without intervention within 6 months (B)</p> Signup and view all the answers

    What determines the condition of vitreous traction in a tractional retinal detachment?

    <p>Presence of lattice retinal degeneration (C)</p> Signup and view all the answers

    Which feature can be noted during a fluorescein angiography in CSR?

    <p>Hyperfluorescence likened to a smoke-stack (B)</p> Signup and view all the answers

    What is the primary systemic disease associated with angioid streaks in patients?

    <p>Pseudoxanthoma elasticum (B)</p> Signup and view all the answers

    Which ocular complication is most commonly developed by patients with Pseudoxanthoma elasticum?

    <p>Angioid streaks (B)</p> Signup and view all the answers

    Which systemic condition is frequently associated with lens subluxation and blue sclera?

    <p>Ehlers-Danlos syndrome (D)</p> Signup and view all the answers

    What is the most typical eye examination test recommended for patients taking tamoxifen?

    <p>Macular optical coherence tomography (OCT) (C)</p> Signup and view all the answers

    In retinitis pigmentosa, which optic nerve change is most commonly observed?

    <p>Waxy optic disc pallor (C)</p> Signup and view all the answers

    What is the common complication of a posterior vitreous detachment?

    <p>The perception of a floater (B)</p> Signup and view all the answers

    Which of the following characteristics are the MOST common risk factors for the development of a retinal detachment?

    <p>Aphakia (A), Diabetes (B), Myopia (D)</p> Signup and view all the answers

    What is identified as the most common cause of irreversible vision loss in individuals over 50 years of age?

    <p>Age-related macular degeneration (A)</p> Signup and view all the answers

    Angioid streaks may occur in patients with which of the following conditions?

    <p>All of the above (D)</p> Signup and view all the answers

    How many photons need to be detected by a rod photoreceptor to initiate a stimulus?

    <p>1 photon (D)</p> Signup and view all the answers

    Which of the following is NOT a characteristic sign in patients with Pseudoxanthoma elasticum?

    <p>Fractures (D)</p> Signup and view all the answers

    What condition is characterized by accelerated atherosclerosis according to the disorders listed?

    <p>Pseudoxanthoma elasticum (A)</p> Signup and view all the answers

    What is the term for the region that represents the posterior termination of Cloquet's canal?

    <p>Area of Martegiani (A)</p> Signup and view all the answers

    Which differentiates between a papillary and follicular reaction in conjunctivitis?

    <p>Size and morphology of lesions (C)</p> Signup and view all the answers

    Which of the following is NOT an indication of wet age-related macular degeneration (ARMD)?

    <p>Drusenoid pigment epithelial detachment (B)</p> Signup and view all the answers

    What type of cells contribute to the formation of the internal limiting membrane of the retina?

    <p>Muller cells (A)</p> Signup and view all the answers

    What increase can be observed in serum tests for patients with Paget's disease?

    <p>Increased serum alkaline phosphatase (B)</p> Signup and view all the answers

    Which retinal structure has the strongest attachment site for the posterior cortical vitreous?

    <p>Vitreous base (D)</p> Signup and view all the answers

    What is a feature of Ehlers-Danlos syndrome related to skin?

    <p>Very loose skin folds (B)</p> Signup and view all the answers

    What is the location of the peak density of rod photoreceptors in relation to the fovea?

    <p>4.5 mm from the foveal pit (A)</p> Signup and view all the answers

    Which ocular condition has the highest risk in patients taking tamoxifen?

    <p>Full-thickness macular holes (A)</p> Signup and view all the answers

    Which molecule acts as a second messenger in the retina and is crucial in the phototransduction cascade?

    <p>cGMP (D)</p> Signup and view all the answers

    Where do flame hemorrhages typically occur in the retina?

    <p>Nerve fiber layer (B)</p> Signup and view all the answers

    Which of the following types of retinal cells does NOT undergo a graded potential?

    <p>Ganglion cells (D)</p> Signup and view all the answers

    What percentage of patients with myopia greater than 8 diopters is at increased risk for retinal detachment?

    <p>40-55% (C)</p> Signup and view all the answers

    What percentage of patients with Paget's disease may exhibit angioid streaks?

    <p>2-10% (C)</p> Signup and view all the answers

    What condition is presumed to lead to a higher incidence of retinal detachments in aphakic patients?

    <p>Posterior vitreous detachments (A)</p> Signup and view all the answers

    Which condition is categorized as a 'white dot syndrome'?

    <p>Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) (B), Birdshot retinochoroidopathy (D)</p> Signup and view all the answers

    Among these lifestyle choices, which is the least likely to contribute to macular degeneration risk?

    <p>Excessive alcohol consumption (B)</p> Signup and view all the answers

    What percentage of individuals over age 75 experience some degree of central vision loss due to age-related macular degeneration?

    <p>30% (B)</p> Signup and view all the answers

    Which of the following ocular manifestations is commonly associated with malignant hypertension?

    <p>Cotton wool spots (C)</p> Signup and view all the answers

    Which factor significantly increases the risk of retinal detachment due to the possibility of retinal tears?

    <p>Ocular trauma (D)</p> Signup and view all the answers

    What defines the peak region of rod photoreceptors in relation to the fovea's photoreceptor distribution?

    <p>No rod photoreceptors within the fovea (D)</p> Signup and view all the answers

    What aspect of retinal cells allows for graded potentials without generating action potentials?

    <p>Changes in membrane potential (C)</p> Signup and view all the answers

    Which is a key distinguishing feature of polypoidal choroidal vasculopathy?

    <p>Dilated choroidal vessels with terminal aneurysms (C)</p> Signup and view all the answers

    In the context of glaucoma, what is the typical structural change observed?

    <p>Optic nerve head cupping (C)</p> Signup and view all the answers

    Which layer of the retina is specifically affected by flame hemorrhages?

    <p>Nerve fiber layer (D)</p> Signup and view all the answers

    What is the most common cause of rhegmatogenous retinal detachment in adults?

    <p>Retinal tears (B)</p> Signup and view all the answers

    Which factor significantly increases the risk for age-related macular degeneration?

    <p>Positive family history (A)</p> Signup and view all the answers

    Which retinal structure has the weakest attachment site for the posterior vitreous?

    <p>Peripheral retinal blood vessels (B)</p> Signup and view all the answers

    In patients with malignant hypertension, which ocular symptom is often observed?

    <p>Papilledema (A)</p> Signup and view all the answers

    What physiological change in retinal cells allows for a range of signal amplitudes?

    <p>Graded changes in membrane potential (C)</p> Signup and view all the answers

    What is the potential serious complication of untreated conjunctivitis caused by gonorrhoeae?

    <p>Central corneal perforation (D)</p> Signup and view all the answers

    Which organism is the predominant cause of bacterial conjunctivitis in adults living in warmer climates?

    <p>Haemophilus influenza (B)</p> Signup and view all the answers

    Arlt's lines and Herbert's pits are associated with which ocular condition?

    <p>Trachoma (C)</p> Signup and view all the answers

    Acute conjunctivitis is typically characterized by what type of discharge?

    <p>Mucopurulent (B)</p> Signup and view all the answers

    Which treatment is generally recommended for recurrent corneal erosion?

    <p>Topical antibiotics and a bandage contact lens (B)</p> Signup and view all the answers

    What is the most common isolate causing acute conjunctivitis in adults under normal circumstances?

    <p>Staphylococcus aureus (A)</p> Signup and view all the answers

    What are Tranta's dots and in which condition are they typically observed?

    <p>Calcified eosinophils in VKC (B)</p> Signup and view all the answers

    Which condition is associated with the rule of 8s regarding serotype and presentation timing?

    <p>Epidemic keratoconjunctivitis (EKC) (D)</p> Signup and view all the answers

    Which treatment modality is contentious for use in patients with Epidemic keratoconjunctivitis?

    <p>Topical corticosteroids (B)</p> Signup and view all the answers

    Which ocular condition typically shows symptoms first occurring before the age of 14 and may last several years?

    <p>Vernal limbic keratoconjunctivitis (VKC) (A)</p> Signup and view all the answers

    Which of the following can cause severe corneal scarring and potentially lead to blindness if untreated?

    <p>Trachoma (C)</p> Signup and view all the answers

    What is the recommended treatment for acute trachoma?

    <p>Oral doxycycline and topical tetracycline (A)</p> Signup and view all the answers

    In terms of demographic preference, for whom is the incidence of VKC more prevalent?

    <p>Males before age 14 (C)</p> Signup and view all the answers

    Endophthalmitis is a possible complication of which untreated ocular condition?

    <p>Gonococcal conjunctivitis (A)</p> Signup and view all the answers

    What is the condition called when there is a decrease in corneal sensitivity?

    <p>Hypoesthesia (B)</p> Signup and view all the answers

    Which refractive surgery procedure completely removes the corneal epithelium before ablation?

    <p>Photorefractive keratectomy (PRK) (C)</p> Signup and view all the answers

    Which layer of the cornea is most susceptible to thinning in patients with keratoconus?

    <p>Stroma (B)</p> Signup and view all the answers

    During hypoxic conditions, which layer of the cornea is the first to become edematous?

    <p>Epithelium (B)</p> Signup and view all the answers

    The most common complication associated with a LASIK enhancement is which of the following?

    <p>Epithelial ingrowth (D)</p> Signup and view all the answers

    Patients with vernal keratoconjunctivitis are more susceptible to which corneal disease?

    <p>Keratoconus (C)</p> Signup and view all the answers

    What condition is characterized by excessive levels of carbon dioxide in the blood?

    <p>Hypercapnia (D)</p> Signup and view all the answers

    In which refractive surgery technique is a flap of corneal tissue created?

    <p>Laser-assisted in-situ keratomileusis (LASIK) (D)</p> Signup and view all the answers

    What type of changes are typically observed in the cornea of a patient with keratoconus?

    <p>Presence of Vogt's striae (B)</p> Signup and view all the answers

    What is the rate of nerve regeneration after corneal surgical injury?

    <p>1 mm per month (C)</p> Signup and view all the answers

    Which condition leads to the cornea becoming cloudy and losing transparency?

    <p>Hypoxia (A)</p> Signup and view all the answers

    Which part of the cornea is most affected by acute corneal hydrops?

    <p>Descemet's membrane (C)</p> Signup and view all the answers

    Which type of keratoplasty uses laser burns to induce stromal shrinkage?

    <p>Conductive keratoplasty (CK) (A)</p> Signup and view all the answers

    What is a common treatment needed if significant epithelial ingrowth occurs after LASIK?

    <p>Flap lifting and cell removal (A)</p> Signup and view all the answers

    In patients with vernal keratoconjunctivitis, which phenomenon is heightened due to their condition?

    <p>Corneal neovascularization (C)</p> Signup and view all the answers

    Which statement accurately describes Vogt's striae in keratoconus?

    <p>They typically disappear when external pressure is applied to the globe. (A), They often originate in Bowman's membrane and extend to Descemet's membrane. (D)</p> Signup and view all the answers

    What is the correct method to measure keratometry values when a patient's curvature is extremely flat?

    <p>Add a +1.00 lens; and subtract 6D from the drum reading. (B)</p> Signup and view all the answers

    Which statement about pellucid marginal degeneration (PMD) is FALSE?

    <p>Irregular astigmatism is uncommon in patients with PMD. (B), The area of corneal protrusion is inferior to corneal thinning. (D)</p> Signup and view all the answers

    Which condition does NOT typically warrant the use of a bandage contact lens?

    <p>Limbal girdle of Vogt (C)</p> Signup and view all the answers

    Which type of conjunctival response is most associated with viral infections?

    <p>Conjunctival follicles (A)</p> Signup and view all the answers

    What best describes hypoesthesia in the context of corneal sensitivity?

    <p>Decreased sensitivity to noxious stimuli. (B)</p> Signup and view all the answers

    What is a significant characteristic of conjunctival follicles?

    <p>Size of 0.5 to 2.0 mm (D)</p> Signup and view all the answers

    Which surgical option is most appropriate for a patient with a refractive error of -16.00 D?

    <p>Implantable collamer lens (ICL) (B)</p> Signup and view all the answers

    Which of the following trial lenses is typically preferred for measuring steep keratometry readings?

    <p>+1.25 trial lens adding 9D to the drum reading. (A), +2.25 trial lens adding 16D to the drum reading. (D)</p> Signup and view all the answers

    What complication is a risk with implantable collamer lens surgery?

    <p>Endothelial cell loss (A)</p> Signup and view all the answers

    In PMD, what characteristic is NOT typically seen in topography?

    <p>Uniform central corneal thickness. (A)</p> Signup and view all the answers

    What is a common clinical feature of gonococcal keratoconjunctivitis?

    <p>Pseudomembrane formation (C)</p> Signup and view all the answers

    Which option correctly identifies the location of Vogt's striae?

    <p>Deep stroma and Descemet's membrane. (A)</p> Signup and view all the answers

    What adjustment should be made when utilizing a -1.00 lens in keratometry?

    <p>Subtract 6D from the drum reading. (B)</p> Signup and view all the answers

    What type of reaction can conjunctival papillae indicate?

    <p>Allergic conjunctivitis (D)</p> Signup and view all the answers

    What type of astigmatism is predominantly associated with PMD?

    <p>Against-the-rule astigmatism. (A)</p> Signup and view all the answers

    What characteristic distinguishes eyelid tenderness in gonococcal infections?

    <p>Severe discomfort (A)</p> Signup and view all the answers

    Which of the following symptoms would NOT be expected in acute hydrops associated with PMD?

    <p>Immediate visual improvement. (D)</p> Signup and view all the answers

    Which statement about Neisseria gonorrhoeae is FALSE?

    <p>It leads to significant corneal scarring (B)</p> Signup and view all the answers

    What is a common size for micropapillae?

    <p>Less than 0.5 mm (D)</p> Signup and view all the answers

    Which procedure should be performed to assess corneal sensation after LASIK?

    <p>Hypoesthesia assessment. (A)</p> Signup and view all the answers

    What is a common characteristic of keratoconus regarding corneal structure?

    <p>Protrusion and thinning of the central cornea. (B)</p> Signup and view all the answers

    Which type of surgery alters corneal curvature without excising the natural lens?

    <p>Implantable collamer lens (ICL) (D)</p> Signup and view all the answers

    Which of the following procedures is NOT ideal for patients with high myopia?

    <p>Conductive keratoplasty (CK) (C)</p> Signup and view all the answers

    Which condition allows for Vogt's striae to be observed aside from keratoconus?

    <p>Pellucid marginal degeneration. (A)</p> Signup and view all the answers

    What is the primary difference between conjunctival papillae and follicles?

    <p>Papillae have vascular cores, follicles do not (C)</p> Signup and view all the answers

    Which characteristic is typical for both viral and chlamydial conjunctivitis?

    <p>Presence of conjunctival follicles (C)</p> Signup and view all the answers

    In which condition is lymphadenopathy usually prominent?

    <p>Gonococcal keratoconjunctivitis (C)</p> Signup and view all the answers

    Which of the following conditions can result in hyperfluorescence during fluorescein angiography due to pooling of fluorescein secondary to breakdown of the outer blood-retinal barrier?

    <p>Central serous retinopathy (D)</p> Signup and view all the answers

    In a patient with a history of chloroquine use for rheumatoid arthritis, what is the significance of an Arden ratio below 1.80 during an electrooculogram?

    <p>It suggests a possible early sign of chloroquine retinopathy. (B)</p> Signup and view all the answers

    What is the estimated percentage of patients with a macular hole in one eye who develop a macular hole in the fellow eye?

    <p>10-20% (B)</p> Signup and view all the answers

    What term BEST describes the diagnosis of a right eye with vitreomacular traction observed on OCT, in a patient with a macular hole in the left eye?

    <p>Stage O macular hole (B)</p> Signup and view all the answers

    In addition to its use in acute angle closure, oral acetazolamide can also be utilized in patients with which of the following ocular conditions?

    <p>Macular edema (A)</p> Signup and view all the answers

    Which of the following is the standard treatment protocol for central serous retinopathy?

    <p>Monitor monthly for resolution (C)</p> Signup and view all the answers

    Hypofluorescent regions on fluorescein angiography can be caused by which of the following?

    <p>Increased density of the retinal pigment epithelium (C)</p> Signup and view all the answers

    What is the Arden ratio calculated from?

    <p>Light peak value divided by dark trough value (B)</p> Signup and view all the answers

    Which of the following is NOT a common finding in a patient with a central serous retinopathy?

    <p>Myopic shift (A)</p> Signup and view all the answers

    Which of the following conditions is characterized by an absence or atrophy of the RPE?

    <p>Transmission defect (D)</p> Signup and view all the answers

    What is the most common age group affected by macular hole?

    <p>60-70 years (D)</p> Signup and view all the answers

    Which of the following conditions can lead to increased density of the RPE, potentially resulting in hypofluorescence during fluorescein angiography?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the primary mechanism by which oral acetazolamide reduces intraocular pressure?

    <p>Decreases aqueous humor production (D)</p> Signup and view all the answers

    Which of the following is NOT a potential cause of hyperfluorescence during fluorescein angiography?

    <p>Increased density of the RPE (D)</p> Signup and view all the answers

    Which of the following is a common characteristic of a patient with a macular hole?

    <p>Higher prevalence in individuals with myopia (B)</p> Signup and view all the answers

    Which of the following statements accurately describes the characteristics of an iris-fixed intraocular lens implant?

    <p>Pupil dilation after surgery is contraindicated due to the risk of lens dislocation. (C)</p> Signup and view all the answers

    What is the primary reason why dilation is contraindicated in patients with iris-fixed intraocular lenses?

    <p>Dilation can lead to lens implant dislocation. (C)</p> Signup and view all the answers

    A patient presents with a completely opaque lens and a shrunken, wrinkled anterior capsule. What type of cataract is MOST likely present?

    <p>Hypermature cataract (C)</p> Signup and view all the answers

    Which two measurements are MOST crucial for determining the intraocular lens power needed for cataract surgery?

    <p>Axial length and keratometry (D)</p> Signup and view all the answers

    What mechanism does the crystalline lens employ to minimize spherical aberrations?

    <p>A lower index of refraction at the edge compared to the center. (C)</p> Signup and view all the answers

    In which order do the structures of the crystalline lens develop embryologically?

    <p>Lens plate (placode), lens vesicle, lens pit, lens capsule, embryonic lens nucleus (D)</p> Signup and view all the answers

    Which of the following features is NOT typically associated with a hypermature cataract?

    <p>A yellow or brown discoloration of the lens (B)</p> Signup and view all the answers

    What is the primary reason for the shrunken and wrinkled anterior capsule in a hypermature cataract?

    <p>Leakage of water out of the lens. (B)</p> Signup and view all the answers

    What specifically causes the nuclear sinking observed in a Morgagnian cataract?

    <p>The weight of the liquefied lens nucleus. (B)</p> Signup and view all the answers

    Which of the following is NOT a typical measurement made in calculating intraocular lens power?

    <p>Refractive error (C)</p> Signup and view all the answers

    Which of the following statements accurately reflects the relationship between spherical aberrations and the crystalline lens?

    <p>The crystalline lens's gradient index of refraction helps offset spherical aberrations. (C)</p> Signup and view all the answers

    Why is the lens capsule important in the development and function of the crystalline lens?

    <p>It provides structural support for the lens fibers. (C)</p> Signup and view all the answers

    What is the primary function of the lens epithelium in the crystalline lens?

    <p>Production of new lens fibers. (C)</p> Signup and view all the answers

    Age-related cortical cataracts are MOST commonly initially found in which quadrant of the crystalline lens?

    <p>Temporal (C)</p> Signup and view all the answers

    A patient presents with a significant cataract affecting the central portion of the lens, causing significant visual blurring, especially in bright light. What type of cataract is MOST likely present?

    <p>Nuclear cataract (D)</p> Signup and view all the answers

    What is the main difference between a mature and a hypermature cataract?

    <p>A mature cataract has a shrunken and wrinkled anterior capsule, while a hypermature cataract has a normal capsule. (A)</p> Signup and view all the answers

    Which of the following statements accurately describes the location of the ora serrata?

    <p>The ora serrata is located at the junction of the peripheral retina and the pars plana of the ciliary body. (C)</p> Signup and view all the answers

    What is the primary function of the dentate processes?

    <p>To facilitate the attachment of the retina to the pars plana. (A)</p> Signup and view all the answers

    Which of the following features is NOT characteristic of oral bays?

    <p>They are located at the junction of the pars plana and the retinal pigment epithelium. (D)</p> Signup and view all the answers

    What is the name of the layer in the macula that corresponds to the outer plexiform layer in the rest of the retina?

    <p>Henle's fiber layer (C)</p> Signup and view all the answers

    Which of the following electroretinograms (ERGs) is specifically designed for the evaluation of ganglion cells in the central retina?

    <p>Pattern electroretinogram (pERG) (B)</p> Signup and view all the answers

    Which electrodiagnostic test is primarily used to assess the function of the retinal pigment epithelium (RPE)?

    <p>Electro-oculogram (EOG) (D)</p> Signup and view all the answers

    Which colored filter enhances visualization of the retinal nerve fiber layer during fundus examination?

    <p>Green (D)</p> Signup and view all the answers

    Which of the following retinal findings is NOT considered a characteristic of severe non-proliferative diabetic retinopathy (NPDR)?

    <p>At least 2 quadrants containing cotton wool spots (A)</p> Signup and view all the answers

    Which of these layers of the retina is NOT pushed aside at the foveola?

    <p>Outer plexiform layer (C)</p> Signup and view all the answers

    What is the primary function of the internal limiting membrane?

    <p>To provide a barrier between the vitreous humor and the retina. (B)</p> Signup and view all the answers

    Which layer of the retina is comprised of the axons of cone photoreceptors in the macula?

    <p>Outer plexiform layer (C)</p> Signup and view all the answers

    Which of the following statements concerning the fovea is TRUE?

    <p>The fovea is the region of highest visual acuity in the retina and contains only cone photoreceptors. (A)</p> Signup and view all the answers

    What is the primary difference between the fovea and the foveola?

    <p>The fovea has a more complex structure than the foveola. (C)</p> Signup and view all the answers

    What is the most common function of the retinal pigment epithelium (RPE)?

    <p>To absorb light that is not capture by photoreceptors. (B)</p> Signup and view all the answers

    Which type of retinal microvascular abnormality is most often associated with severe non-proliferative diabetic retinopathy?

    <p>Intraretinal microvascular abnormalities (IRMAs) (A)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of the ora serrata?

    <p>It is the junction between the retina and the choroid. (C)</p> Signup and view all the answers

    Study Notes

    Common Congenital Cataracts

    • Cerulean cataract (blue dot cataract): A common congenital cataract, appearing as blue dots of varying shapes and sizes dispersed throughout the crystalline lens. It rarely affects vision.

    Intraocular Lens Implants

    • Posterior chamber intraocular lens implant (PCIOL): The most common type of intraocular lens implant used in cataract surgery. It's placed in front of the posterior capsule, ideally intact, to provide natural vision and lower complications compared to other options.
    • Morgagnian cataract: A hypermature cataract with significant liquefaction, causing the lens nucleus to sink inferiorly.
    • Hypermature cataract: A fully opaque cataract with significant wrinkling and shrinking of the anterior capsule.

    Intraocular Lens Implant Calculations

    • Keratometry: Measures corneal curvature.
    • Axial length: The anteroposterior dimension of the eye.

    Spherical Aberrations in the Crystalline Lens

    • Index of refraction variation: The crystalline lens's index of refraction is lower at the edge than the center, offsetting spherical aberration.

    Crystalline Lens Embryological Development

    • Lens plate → lens pit → lens vesicle → embryonic lens nucleus → lens capsule
    • Inferior-nasal quadrant: The most common initial location of age-related cortical cataracts.

    Purkinje Images

    • Fourth Purkinje image: Inverted.

    Secondary Cataract Etiology

    • Chronic anterior uveitis: The most common cause of secondary cataract formation, due to long-standing intraocular inflammation and potential corticosteroid use.

    Accommodation

    • Ciliary muscle contraction: Decreases tension on zonules, allowing lens to become more spherical and increase dioptric power.

    Christmas Tree Cataracts

    • Myotonic dystrophy: Associated with this type of granular crystalline lens opacity.

    Congenital Cataract Etiology

    • Genetic mutation: The most common cause of congenital cataracts.

    Cataract-Induced Astigmatism

    • Against-the-rule astigmatism: A refractive shift towards this type of astigmatism occurs during cataract progression, due to lens steepening in the horizontal meridian.

    Diabetic Ocular Changes

    • Crystalline lens refractive index changes: Fluctuations in blood glucose levels cause changes in the lens's refractive index.

    Posterior Subcapsular Cataracts

    • Granular appearance on retroillumination due to the migration of epithelial cells causing a posterior cell cluster..

    Nuclear Sclerotic Cataracts

    • Brunescence: A yellowing or browning of the crystalline lens nucleus.

    Photoreceptor Density in Retina

    • Foveola → Fovea → Parafoveal area → Perifoveal area: The correct order of retinal structures from most central to most peripheral.
    • Rod photoreceptor peak density: Approximately 4.5 mm from the foveal pit.

    Retinal Structures and Function

    • Photoreceptor cells, bipolar cells, and horizontal cells use graded potentials for signaling, while amacrine and ganglion cells use action potentials.

    Posterior Vitreous Detachment

    • High myopia, diabetes, and previous ocular surgery are risk factors for posterior vitreous detachment.
    • The most common cause of irreversible vision loss in the US for those over 50.

    Retinal Structures and Function

    • Photoreceptor cells and other retinal cells utilize graded potentials for signaling.
    • Melanin-containing RPE cells contribute to the dark appearance of the fovea during fluorescein angiography.
    • Rod photoreceptors are most dense approximately 4.5mm from the foveal pit.

    Vitreous Structures and Function

    • Area of Martegiani, also known as Erggelet's space: The funnel-shaped region anterior to the optic disc, representing the posterior termination of Cloquet's canal.

    Retinal Detachment

    • Myopia, aphakia, and ocular trauma represent the most common risk factors involved.

    Electrodiagnostic Tests for Retina

    • Different electrodiagnostic tests target varying retinal cell types (e.g., mfERG for ganglion cells).

    Ocular Examination Using Filters

    • Green (red-free) filters: Enhance visualization of the retinal nerve fiber layer.

    Diabetic Retinopathy

    • Cotton wool spots are characteristic of diabetic retinopathy but not part of the severity classification of non-proliferative diabetic retinopathy.

    Fluorescein Angiography

    • Pigment epithelial detachment is a condition that shows up in hyperfluorescence during fluorescein angiography

    Retinal Disease and Electrooculogram

    • Arden ratio (light peak / dark trough): A measure of RPE function during an electrooculogram (EOG).

    Macular Hole Etiology

    • 10-20% incidence of developing macular holes in fellow eye

    Acute Angle Closure and Macular Edema

    • Acetazolamide treatment for macular edema.

    Central Serous Retinopathy

    • Monthly monitoring is the standard treatment protocol.

    Retinal Structures and Function

    • Order of retinal structures from central to peripheral: foveola→ fovea → perifoveal area → parafoveal area.
    • Foveola is the core of the central retina where cone density is the greatest, followed by fovea, paravovea and perifoveal area .

    Retinal Vascularity

    • Choroidal vessels have lower resistance and higher flow rates (greater blood flow) compared to retinal vessels.

    Retinal Conditions and Laser Technologies

    • Scanning laser polarimetry measures retinal nerve fiber layer thickness based on its birefringence properties.

    Retinoscopy in Cataract Patients

    • Posterior subcapsular cataracts are best viewed with an obliquely oriented parallel-piped light beam rather than retroillumination.

    Ocular Conditions and Systemic Diseases

    • Pseudoxanthoma elasticum (PXE) is commonly associated with angioid streaks, in which connective tissues containing elastin are significantly affected.

    Refractive Surgery and Tamoxifen Use

    • Tamoxifen use may cause macular changes seen with SD-OCT evaluations.

    Retinitis Pigmentosa

    • Optic disc pallor is a common associated finding.

    Posterior Vitreous Detachment Complication

    • Perception of a floater is a common but typically non-serious complication.

    Conjunctivitis in Adults

    • Haemophilus influenzae is the most common cause of bacterial conjunctivitis in adults in warmer climates.

    Corneal Conditions and Abnormalities

    • Interstitial keratitis: Inflammation solely in the corneal stroma.
    • Ligneous conjunctivitis: Associated with a deficiency of plasminogen.
    • Pellucid marginal degeneration (PMD): Characterized by a narrow band of inferior corneal thinning.
    • Vogt's Striae: Fine, vertical lines in the corneal stroma, commonly found in keratoconus.

    Recurrent Corneal Erosions and Refractive Surgery

    • Phototherapeutic keratectomy (PTK) can be an appropriate surgical treatment in recurrent corneal erosion cases and patients who wish to undergo refractive surgery.

    Corneal Dystrophies

    • Lattice dystrophy: Amyloid deposition.
    • Granular, macular, and fleck dystrophies have different deposition types and clinical features impacting vision .

    Corneal Surgical Procedures

    • Lamellar keratoplasty: Partial thickness cornea transplant .

    Keratometry and LASIK Enhancements

    • Adjustments to keratometry readings may be needed if the corneal curvature is outside the normal range following LASIK enhancement (due to flatter or steeper curvature).

    Ocular Conditions and Risk Factors

    • Vernal keratoconjunctivitis: Linked to keratoconus through the pathway of atopic disease risk.

    Bacterial Conjunctivitis in Children

    • Haemophilus influenzae is the most common cause of bacterial conjunctivitis in children.

    Hypersensitivity Reactions

    • Allergic conjunctivitis: A type I hypersensitivity reaction.

    Corneal Conditions and Examination

    • Against-the-rule astigmatism and steepness in a horizontal meridian.

    Corneal Hypoesthesia

    • Decrease in corneal sensitivity to noxious stimuli

    Corneal Layers and Procedures

    • Stroma is the most susceptible layer to thinning in keratoconus
    • Epithelium is the first to swell in hypoxic conditions.

    LASIK Enhancement Complications

    • Diffuse lamellar keratitis and epithelial ingrowth represent the most common complications

    Ocular Conditions and Systemic Diseases

    • Specific conditions like Pseudoxanthoma elasticum (PXE) are associated with certain ocular findings like angioid streaks.

    Ocular Conditions and Risk Factors

    • Conditions like myopia, aphakia, previous ocular surgery, and ocular trauma are higher risk factors for retinal detachments in adults , due to risk of retinal tears or dialysis that may develop .

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    Test your knowledge on cataracts, their types, and the associated intraocular lens implants used in cataract surgery. This quiz covers various aspects, including genetic patterns of cataracts, remnants of the hyaloid system, and surgical preferences. Challenge yourself to see how much you know about this important topic in ophthalmology.

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