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Questions and Answers
What is the primary etiology of corneal neovascularization?
Which type of corneal opacity completely obscures the view of the iris and pupil?
What is the most common symptom or complaint associated with superficial corneal neovascularization?
Which management option is least effective for addressing corneal neovascularization?
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Which of the following conditions is most commonly linked to the development of deep corneal neovascularization (pannus)?
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What type of corneal opacity can be described as 'like a fog' and allows visibility of posterior structures?
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Which procedure may be used for managing cases of chemical injuries leading to corneal neovascularization?
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What typically characterizes the condition known as adherent leucoma?
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What is the defining characteristic of central corneal leucoma?
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Which treatment is appropriate for large central opacity in the cornea?
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Filamentary keratitis is commonly associated with which underlying condition?
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What symptom is NOT typically associated with filamentary keratitis?
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Which of the following is NOT a typical treatment for filamentary keratitis?
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What best describes Thygeson's keratitis?
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What is a likely outcome of peripheral leucoma?
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What is the main clinical sign of filamentary keratitis?
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What is the typical duration of active disease in neurotrophic keratopathy before entering remission?
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Which of the following symptoms is most strongly associated with exposure keratopathy?
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In neurotrophic keratopathy, which stage is characterized by stromal lysis and potential perforation?
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What is the appropriate management for a large ulcer in the second stage of neurotrophic keratopathy?
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Which of the following is NOT a characteristic of corneal lesions in active disease?
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What primary treatment is recommended for mild cases of corneal disease?
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Which factor is least likely to contribute to exposure keratopathy?
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What is the hallmark symptom of neurotrophic keratopathy?
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What is an underlying condition that necessitates a tarsorrhaphy as a treatment for exposure keratopathy?
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What type of corneal disease is characterized by a cycle of active disease and remission typically lasting 6 months to 4 years?
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Study Notes
Corneal Conditions Overview
- Corneal anterior staphyloma occurs when the iris is trapped in corneal tissue, forming an ectatic scar.
- Peripheral leucoma does not obstruct the visual axis but may lead to astigmatism.
- Central leucoma interferes with the visual axis.
- Small central macular opacity is classified as a leucoma.
Treatment Options
- Small Central Opacity: Tattooing is a cosmetic option if it doesn't distort light refraction; otherwise, management may involve observation.
- Large Central Opacity: Managed with anterior/deep anterior lamellar keratoplasty or penetrating keratoplasty.
Non-Infectious Keratitis/Keratopathy
- Filamentary Keratitis: Caused by disrupted epithelial integrity, resulting in threads formed from dead cells and mucin, often due to conditions like keratoconjunctivitis sicca (KCS) and superior limbic keratoconjunctivitis (SLK).
- Common symptoms include foreign body sensation, burning, tearing, and photophobia.
Signs and Symptoms
- Free-floating filaments observed on the corneal epithelium.
- Filaments stain with rose bengal or NAFL.
- Treatment involves addressing underlying conditions, debridement, and lubricants.
Thygeson’s Keratitis
- A bilateral, chronic, central epithelial keratitis without associated conjunctival or stromal inflammation.
- More common in individuals aged 20-30; treatment includes stromal puncture with Nd:YAG laser or excimer laser phototherapy keratectomy.
Corneal Neovascularization
- The cornea is avascular; however, neo-vessel growth from the limbal vascular plexus can occur due to hypoxia, contact lens wear, or chronic inflammation.
- Symptoms: May be asymptomatic or lead to vision loss and photophobia.
Corneal Opacities
- Resulting from corneal scarring where lamellae become fibrous scar tissue.
- Types include nebula (mild opacity), macula (denser opacity), and leucoma (completely opaque).
Leucomas
- Adherent leucoma occurs when the iris adheres to the leucomatous opacity after a corneal ulcer perforation.
- Corneoiridic scar is flat if the iris is trapped due to corneal ulcer healing.
- Duration of symptoms can range from 6 months to 4 years, often involving active disease followed by periods of remission.
Symptoms and Signs of Leucomas
- Symptoms: Photophobia, foreign body sensation, tearing, and mild vision decrease.
- Active lesions appear as coarse, ovaloid, slightly raised white or gray dots that stain with NAFL.
Exposure Keratopathy
- Primary causes include Bell’s Palsy, incomplete eyelid closure (lagophthalmos), proptosis, ectropion, and floppy eyelid syndrome.
- Symptoms include foreign body sensation and dryness, particularly noticeable in the morning.
- Treatment focuses on addressing underlying causes, using lubricants, and potentially tarsorrhaphy for severe cases.
Neurotrophic Keratopathy
- A degenerative disease characterized by impaired healing and reduced corneal sensitivity.
- Common causes include herpes simplex, herpes zoster, and fifth nerve palsy.
- Stages classify severity: Stage I involves superficial punctate keratitis, Stage II shows localized epithelial loss, and Stage III may lead to stromal lysis and perforation.
Management of Neurotrophic Keratopathy
- Stage I management focuses on discontinuing certain topical drugs and emphasizing lubricants.
- Stage II may require antibiotic ointments and bandage contact lenses.
- Stage III treatment includes cyanoacrylate glue with bandage lenses or amniotic membrane; larger defects may necessitate penetrating keratoplasty.
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Description
Explore the various corneal conditions and their treatment options in this quiz. From understanding staphyloma and leucomas to managing keratitis and keratopathy, test your knowledge on these critical ocular issues. Suitable for students of ophthalmology and related fields.
