39 Questions
What is the main reason for the development of microcysts in contact lens wearers?
Epithelial edema due to oxygen compromise
How does epithelial surface staining usually present in individuals with microcysts due to prolonged contact lens wear?
Punctate staining as cysts surface
What is the recommended treatment approach for resolving microcysts in contact lens wearers?
Frequent lubrication with preservative-free artificial tears
Why does delayed development and resolution of microcysts occur in contact lens wearers?
Long-term oxygen compromise leading to cyst formation
What role does prophylactic topical antibiotic ointment play in managing microcysts in contact lens users?
Preventing bacterial infections but not affecting cysts
What is the recommended length of time for resolving microcystic edema after discontinuing lens wear?
10-12 weeks
What can lead to an increase in the number of cysts during the first 3-4 weeks of resolving microcystic edema?
Oxygen deprivation
What is an essential consideration when refitting lenses after resolving microcystic edema for proper lens movement?
Higher DK material
During the recovery period from microcystic edema, what can be used for epithelial surface healing and protection?
Topical steroid eye drops
Why should patients be educated about the potential need for gas-permeable (GP) lenses during microcystic edema recovery?
To improve oxygen supply to the cornea
What is a long-term effect of epithelial edema?
Persistant Microcysts
Why is the smaller diameter of a gp lens beneficial for the cornea?
It exposes more surface area to oxygen for corneal health
What is a common symptom experienced by the patient in Case 2?
Constant Blood Shot Eyes
How does oxygen permeability differ in Cooper Vision 55 lenses?
They are 55% hydrogel lenses
Which is a potential risk associated with not using prophylactic topical steroid antibiotic?
Hypersensitivity reactions
What is the risk associated with deep stromal corneal neovascularization?
Vessels growing 2-3mm into the stroma due to oxygen deprivation
What is the significance of chronic stromal edema folds?
Prominent appearance due to thickened lamellar layers doubling up and folding
What is the effect of microcysts on the cornea?
Increased risk of epithelial edema
How does the prophylactic use of a topical steroid antibiotic help in treating stromal tissue folds?
By decreasing edema in the stroma
What role does lubrication play in preventing blood staining in the cornea?
It helps prevent blood staining near the apex of the cornea
What is the main reason vision cannot reach 20/20 in cases of stromal edema?
Presence of lamellar layers of collagen holding fluids
Why does the orientation of lamellar lines change when pressure is applied to the globe in cases of stromal edema?
The swollen stroma allows for movement of lamellar tissue layers
Why is it recommended to prescribe a topical steroid in cases of stromal edema?
To dampen the inflammatory response and decrease neo-vessel growth
How does Muro 128 aid in treating stromal edema?
By drawing fluid out of the cornea to reduce swelling
Why is it important to monitor lens wear carefully during treatment for stromal edema?
To track any changes in post-lens tear film exchange
What is the most likely diagnosis based on the presented symptoms of central corneal haze, engorged limbal vessels, constant tearing, and irritated feeling in the eye?
Epithelial edema
Which condition is characterized by individual lamellar cells of stroma swelling, appearing thicker than adjacent cells?
Stromal edema
What is the main precursor of deep stromal neo-vessels according to the text?
Compact nature of stroma
Which action would most likely worsen the condition of chronic stromal edema and striae?
Prophylactic topical steroid antibiotic use
What change in orientation is observed in the lines when pressing on the inferior bulbar conjunctiva?
They change their orientation
What is the typical corneal thickness mentioned in the text?
550 microns
Which condition results in dropout of endothelial function in older patients?
Polymorphism & Guttata
What is the main cause of epithelial edema progression to stromal edema?
Fluid retention
What is the purpose of using bandage lenses in the treatment of edematous cornea with chronic epithelial breakdown?
To decrease swelling of the stroma
What type of cells are seen in abusive contact lens wear that results in compromised pumping action?
Amorphous endothelial cells
What is the sign of significant compromise to metabolism in stromal edema?
>6% swelling of stroma
How can topicals be used to address corneal swelling according to the text?
To reduce swelling
What is observed when there is loss of endothelial cells due to age or contact lens wear?
>6% anterior stromal swelling
'Amorphous endothelial cells' are a characteristic feature of which condition mentioned in the text?
'Abnormal Endothelium' with polymorphism & Guttata
Explore the impact of gas-permeable (GP) lenses on corneal health over time, including reduced mitotic rate, compromised junctional integrity, persistant epithelial fragility, hypoesthesia, persistant microcysts, and risk of microbial keratitis.
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