Study sets, textbooks, questions
Upgrade to remove ads
High Yield OKAPs
Terms in this set (271)
Optociliary shunt vessels
My God, Penises Can Grow!
Bacteria that can penetrate an intact epithelium
N & N Can Lyse Hole Skin
Causes of CME
Nicotinic acid maculopathy
DDx of CME without fluorescein staining
Nicotinic acid maculopathy
DDx of blood in ever retinal layer
Sickle cell retinopathy
Vein occlusion (rare)
Type 1 vs 2 vs 3 sex predilection and laterality?
Type 1: male > female (10:1), uni
Type 2: male = female, bilateral
Type 3: male = female, bilateral
Type 1 vs 2 age of onset?
Type 1: middle age
Type 2: 5th-6th decade
Juxtafoveal telangiectasia Type 1a vs 1b age of onset?
Type 1a: congenital
Type 1b: idiopathic
Juxtafoveal telangiectasia Type 1 is thought to be a variant of _______ disease
Singerman's spots are seen in what disease?
Type 2 Juxtafoveal telangiectasia - superficial glistening white dots in temporal macula
Pseudovitelliform macular degeneration can be seen in what disease?
Type 2 juxtafoveal telangiectasia
Elschnig's spots are seen in _________ retinopathy
Hypertensive retinopathy - they are pale white or red patches of RPE in zones of nonperfused choriocapillaris
What is the leading cause of new blindness in working aged adults?
Define severe NPDR
4 quadrants of hemorrhage/MA
2 quadrants of venous beading
1 quadrant of IRMA
Define very severe NPDR
2 or more findings from "4-2-1" RULE
Define high risk PDR
Any of the following:
1. NVD ≥ 1/4 to 1/3 disc area
2. Any NVD + vit heme
3. NVE ≥ 1/2 disc area + vit heme
What type of diabetic is more likely to have background diabetic retinopathy at time of diagnosis?
IDDM2 > NIDDM2 > DM1
What type of diabetic is more likely to have PDR at 20 years?
DM 1 > IDDM2 > NIDDM2
1. Thickening within 500µm of FAZ
2. Exudate within 500µm of FAZ with associated thickening
3. 1DA of thickening within 1DD of foveal center
DDx for appearance of asymmetric diabetic retinopathy?
Ocular ischemic syndrome
Classic histopathology findings of iris in diabetic?
lacy vacuolization of iris pigment epithelium in 40% and PAS+ glycogen filled cyst
Classic histopathology findings of vasculature in diabetic?
loss of pericytes and endothelial cells, thickened capillary basement membrane, breakdown of blood-retinal barrier
Name the 2 blood-retinal barriers
1. Inner: Retinal vascular endothelial tight junctions
2. Outer: RPE tight junctions
Main conclusion of ETDRS regarding focal laser?
Focal laser decreases vision loss from CSME by 50%; treat all CSME regardless of presenting visual acuity.
Main conclusion of ETDRS regarding aspirin?
Main conclusion of DRS regarding PRP?
PRP reduces severe vision loss in high risk PDR by 60%; treat all high risk PDR regardless of presenting visual acuity.
What is the DRVS? What was the main conclusion?
Diabetic Retinopathy Vitrectomy Study: early vitrectomy for vit heme in DM1 only; can defer in DM2
What is the DCCT? What type of diabetic does it apply to?
Diabetic Control and Complications Trial - tight control in Type 1 DM slows progression of retinopathy, macular edema, and vision loss.
What is the UKPDS? What type of diabetic does it apply to?
United Kingdom Prospective Diabetes Study - tight control in Type 2 DM slows progression of retinopathy, macular edema, and vision loss.
Sickle cell retinopathy is most severe in what genotype?
Hb SC > S Thal > SS > SA
DDx of angioid streaks?
Pagets disease of the bone
Sickle cell retinopathy
What are the 5 stages of sickle cell retinopathy?
1 - peripheral arterial occlusions
2 - Peripheral anastamoses
3 - NV (seafan)
4 - vitreous hemorrhage
5 - traction RD
What is Eales disease?
Idiopathic retinal perivasculitis and peripheral nonperfusion with NV
What is the typical demographic and laterality of Eales disease?
young healthy men
Middle eastern or Indian
Eales disease has increased risk of what type of vascular occlusion?
What are the 4 stages of Eales disease?
1 - sheathing of retinal venues, edema, hemorrhage
2 - + vitreous haze
3 - peripheral NV
4 - NV with VH, TRD
DDx of peripheral NV?
Indication for focal grid laser for BRVO according to BVOS?
macular edema with vision < 20/40 for > 3 months if no macular ischemia is present on FA
Indication for sector PRP for BRVO according to BVOS?
≥5DD nonperfusion with NEOVASCULARIZATION
Is NVI in ischemic BRVO common or rare?
Indication for focal grid laser for CRVO according to CVOS?
There is none; there is no benefit from focal laser for macular edema.
Indication for PRP for ischemic CRVO according to CVOS?
PRP if 2 clock hours of NVI or any NVA develops; no benefit from early PRP prior to NV.
CVOS recommendations for follow up interval for CRVO?
Gonioscopy q1mo for first 6 months.
DDx of CRAO?
Ophthalmic artery occlusion
Gentamycin toxicity (intravitreal)
DDx of cherry red spot?
Macular hole with surrounding RD
Subacute sclerosing panencephalitis
DDx of negative ERG?
(depressed b wave due to inner retina layer damage)?
Juvenile X-linked retinoschisis
Duchenne's muscular dystrophy
Ceroid lipofuscinosis (Batten's disease)
Noninfectious unilateral neuroretinitis with good prognosis?
Leber's idiopathic stellate neuroretinitis
What is DUSN? What is the causative organism?
Diffuse Unilateral Subacute Neuroretinitis.
Ancylostoma caninum (dog hookworm) or Baylisascaris procyonis (raccoon worm)
What is the cumulative toxic dose of Plaquenil (hydroxychloroquine)?
6.5mg/kg/day or 700g total
What is the cumulative toxic dose of Aralen (chloroquine)?
3.5mg/kg/day or 300g total
DDx of bulls eye maculopathy?
Fenestrated sheen mac dystr
Central areolar choroidl dyst
Benign concentric annular mac dystr
Trifuloperazine HCl (Stelazine)
What changes in the retina are seen with phenothiazine toxicity?
Early - pigment stippling
Late - RPE atrophy in posterior pole and midperipheral retina (can appear similar to gyrate atrophy)
What is the toxic dose of Mellaril?
What is the toxic dose of Thorazine?
1200-2400 mg/day for at least 12 months; rare with doses < 800mg/day
What retinal changes are seen with chloramphenicol toxicity?
atrophy of maculopapillary bundle
DDx of crystalline retinopathy?
Salmon patch lesions of the retina are seen in what disease? What do they represent?
Sickle cell retinopathy - intraretinal hemorrhage
Black sunburst lesions of the retina are seen in what disease? What do they represent?
Sickle cell retinopathy - prior subretinal hemorrhage with RPE hyperplasia
Seafan lesions of the reina are seen in what disease? What do they represent?
Sickle cell retinopathy - NV
What is a tritan color defect? What disease types may mimic this defect?
Blue-yellow color defect, can be seen in macular diseases.
What is Kollner's rule?
Errors made by persons with optic nerve disease resemble protans and deutans, while errors made by persons with retinal disease resemble those made by tritans.
What is the inheritance pattern of pattern macular dystrophies? Age of presentation?
Risk factors for developing PVR?
Large/multiple retinal break
Is PVR more likely to develop after scleral buckling versus vitrectomy?
Indications for ROP screening?
Gestational age < 30 wk
Birth weight < 1300g
Tenuous hospital course
Required supplemental O2
When should the first ROP screening take place?
Prior to hospital discharge, or 4-6 weeks of age
T/F, Extension of malignant melanoma through Bruch's membrane is a poor prognostic sign
False; it has no predictive value.
ARN causes an occlusive arteriolar or venous vasculopathy?
In juvenile retinoschisis, are female carriers readily identified clinically?
In juvenile retinoschisis, are outer or inner retinal breaks more common?
In juvenile retinoschisis, what percentage develop RD?
In juvenile retinoschisis, if foveal radiating retinal folds are seen, what percentage will have peripheral retinoschisis?
What is the most common cause of spontaneous vitreous hemorrhage in adults?
What are the key structures pre- and post-septal?
Palpebral lobe of lacrimal gland
Lateral canthal tendon
Trochlea of SO muscle
A septated branching hyphae.
A NONseptated branching hyphae.
In medial canthal tendon avulsion, where do the anterior and posterior limbs attach? Which is more important in reconstructing the natural appearance of the medial canthus?
Anterior - attaches to anterior lacrimal fossa. Posterior - attaches to posterior lacrimal fossa and is more important in reconstruction.
Where is the most common location of blowout fracture?
Posteromedial orbital floor, medial to the infraorbital nerve.
What is the treatment for lentigo maligna?
Complete excision with delayed reconstruction after pathology confirmation of clear margins.
What eyelid malignancy spreads along nerves?
Squamous cell carcinoma
What is the treatment for rhabdomyosarcoma?
Chemo + radiation
What is the treatment for lymphoma confined to the orbit?
Radiation only (2000-3000 cGy)
What syndrome is characterized by multiple capillary hemangiomas of the skin and viscera, as well as thrombocytopenia?
How does retinoblastoma spread?
Via optic nerve
Treatment for docetaxel-induced canalicular stenosis?
Early silicone intubation of the NLD.
Most common orbital malignancy of childhood?
For suspected adenoid cystic carcinoma, what is the correct diagnosis technique? Once confirmed, what is the treatment?
Diagnose by incisional biopsy. Treat by exenteration if bone involved.
Most common benign orbital tumor in adults?
Innervation of the inferior tarsal muscle?
Sympathetic nervous system
Middle lamellar deficiency is characterized by traumatic shortening of the ________ and can cause ________.
orbital septum, tethering of the lid to the orbital rim
Indications for external DCR?
1. Common canalicular obstruction
2. Acquired nasolacrimal duct obstruction
For suspected orbital lymphoma, what is the correct diagnosis technique? Once confirmed, what is the treatment?
Incisional biopsy. Treat by radiation is isolated to orbit without systemic involvement.
The optic canal is completely contained within which bone?
Lesser wing of the sphenoid
What is the treatment for hemangiopericytoma?
Complete surgical excision
What is the most common metastatic tumor in childhood?
Chloroma can be an initial presenting sign of what disease?
Chloroma = granulocytic sarcoma, can be due to myelogenous leukemia
T/F - orbital metastasis is a poor prognostic factor for neuroblastoma
Classic radiographic sign of the orbit with CC fistula?
dilated superior ophthalmic VEIN
What percentage of lacrimal sac tumors are malignant?
What is the treatment for orbital fibrous histiocytoma?
Complete surgical excision with free margins
What is the most common orbital tumor in adults of mesenchymal origin?
What orbital lesion contains phleboliths?
What triad is commonly seen in blepharophimosis syndrome?
What is the inheritance pattern of blepharophimosis?
T/F - blepharophimosis is associated with infertility
T/F - lead exposure is a risk factor for squamous cell carcinoma of the eyelid
Branches of the facial nerve?
"To Zanzibar By Motor Car"
What is the inheritance pattern of fibrous dysplasia?
McCune-Albright syndrome is characterized by:
What is the preferred initial imaging modality for suspected McCune-Albright syndrome?
CT - examine for fibrous dysplasia
In a patient with downbeat nystagmus, where is the lesion likely to localize to?
In a patient with seesaw nystagmus, where is the lesion likely to localize to?
parasellar or 3rd ventricle
What are characteristics of septo-optic dysplasia (Demorsier's syndrome)?
optic nerve hypoplasia
absent septum pellucidum
Rebound nystagmus is associated with a lesion of what brain structure?
What retinal lesion is associated with Von Hippel-Lindau?
capillary hemangioma of the retina
What retinal lesion is associated with Sturge- Weber?
capillary hemangioma of the choroid
What retinal lesion is associated with Wyburn Mason?
racemose hemangioma of the retina
What is cogan syndrome?
Interstitial keratitis + hearing loss or vertigo
All mucopolysaccharidoses are what inheritance pattern except for _______?
All are autosomal recessive except Hunter's, which is x-linked.
All sphingolipidoses are what inheritance pattern except for _______?
All are autosomal recessive except Fabry's, which is x-linked.
What disorder is a Fleischer ring/line seen in?
keratoconus (iron line)
What disorder is a Stocker's line seen in?
pterygium (iron line)
What disorder is a Ferry's line seen in?
filtering bleb (iron line)
What is a Hudson Stahle line?
iron line of inferior 1/3 cornea in normals (from tear stasis and nocturnal exposure)
Mooren's ulcer is Type ___ hypersensitivity reaction.
What is a Wessely's ring? What type of hypersensitivity reaction is it?
ring of HSV antigen precipitates and neutrophils (type III hypersensitivity)
All corneal dystrophies are what inheritance pattern? Excpt for ____, ____, ____, and ____.
Autosomal dominant, except macular, type 3 lattice, gelatinous, and type 3 CHED which are autosomal recessive.
What is the DDx for prominent corneal nerves?
"Look At My Really Fat Nerves"
"C F I Kare"
MEN 2a or 2b
Familial dysautonomia, failed graft
Fuch's endothelial dystrophy
What microbes penetrate intact epithelium?
What medications cause corneal epithelial deposits (verticillata)?
What medications cause corneal stromal deposits?
What is the mechanism of adhesion by Pseudomonas to the cornea?
binds receptors on injured epithelial cells
What type of corneal dystrophy is most likely to recur in a graft after transplantation?
Granular/Reis Bucklers > Lattice > Macular
Classically, it has been thought that lattice dystrophy had the highest recurrence rate after corneal grafting, but recent data from one study suggests that granular dystrophy may have a higher rate. Avellino dystrophy is a combination of lattice and granular dystrophy. Macular dystrophy has the lowest rate of recurrence after keratoplasty.
What gene is associated with pigmentary glaucoma?
What gene is associated with pseudoexfoliation glaucoma?
What is the inheritance pattern of Marfan's disease?
What direction of lens subluxation occurs in Marfans?
What is the inheritance pattern of Weill-Marchesani syndrome?
What direction of lens subluxation occurs in Weill-Marchesani?
inferior or anterior
What is the inheritance pattern on Ehlers-Danlos syndrome?
AD, AR, or X-linked
What is the protein defect in Ehlers-Danlos?
Collagen type III
What is the inheritance pattern of homocystinuria?
What is the enzyme deficiency in homocystinuria?
cystathionine beta-synthase, converts homocysteine to cystathionine
What accumulates in the serum in homocystinuria?
homocysteine and methionine
Serum levels of _____ are found in homocystinuria.
What should be restricted from the diet in patients with homocystinuria?
Patients with homocystinuria should have what 2 substances supplemented to the diet?
folate (vit B6) and cysteine
What is the inheritance pattern of hyperlysinemia?
What 2 syndromes are associated with aniridia?
WAGR and Gillespie
What are the features of WAGR?
What are the features of Gillespie syndrome?
What type of cataract is seen in patients with atopic dermatitis?
anterior or posterior subcapsular cataract, usually centrally located and bilateral
What type of cataract is seen in Alport syndrome?
bilateral anterior lenticonus
What contact lens materials have higher Dk value?
Silicon acrylate and fluoropolymer (RGPs, Dk 100-300)
Hydroxyethylmethacrylate (HEMA, SCLs, Dk 8-30)
PMMA (Dk 0, not oxygen permeable)
What chromosome is involved in VHL?
What chromosome is involved in tuberous sclerosis?
9 and 16
What chromosome is involved in NF1?
What chromosome is involved in NF2?
What is the inheritance pattern of Bests' disease?
What chromosome is involved in Bests disease?
What is the DDx for hearing loss and pigmentary dystrophy?
Dysplasia spondyloepiphysaria congenita
What is the inheritance pattern of Bardet-Biedel syndrome?
autosomal recessive, polygenic mutations required
What are the physical features of Bardet-Biedel syndrome?
poly/syn/brachydactyly, central obesity, short stature, MR
What are the retinal findings and ERG of a patient with rubella retinopathy?
salt and pepper fundus
DDx of unilateral RP (i.e. ERG of 1 eye is normal for 5 years)?
What gene is abnormal in Stargardts disease?
What chromosome is affected in Stargardts disease?
ERG finding in Stargardts?
Normal ERG with macular dysfunction
What is the inheritance pattern of choroideremia?
What gene is affected in choroideremia?
What is the inheritance pattern of gyrate atrophy?
What chromosome is involved in gyrate atrophy?
What enzyme is dysfunctional in gyrate atrophy?
OAT (ornithine aminotransferase)
What is the most common mesenchymal tumor of the orbit in adults?
What is the most common mesenchymal tumor of the orbit in children?
In a child presenting with opsoclonus, what must be ruled out?
Neuroblastoma, which can cause a paraneoplastic syndrome
What is the inheritance pattern of galactosemia?
What is the enzyme defect in galactosemia?
galactose-1P-uridyl transferase (most common), glactokinase, or UDP galactose-4-epimerase
What substance should be eliminated from diet in a patient with galactosemia?
What is the enzyme deficiency in mannosidosis?
What is the enzyme deficiency in Fabry's disease?
What is the inheritance pattern of Lowe's syndrome?
What percentage of Lowe's syndrome patients have congenital cataract?
What is the enzyme deficiency in Lowe's syndrome?
PIP 2,5 - phosphatase
What is the gene identified in Lowe's syndrome?
What is another name for Lowe's syndrome?
What is the inheritance pattern of Alport's syndrome?
What type of cataract is characteristic of Alport's syndrome?
What is the gene identified in Alport's syndrome?
How is a diagnosis of Alport's syndrome made?
Renal or skin biopsy shows lack of type IV collagen (alpha5)
How is a diagnosis of Lowe's syndrome made?
urinalysis showing elevated amino acids
What is the basic workup for bilateral congenital cataracts?
If AD, no work up needed.
If not AD:
Urinalysis (AA, reducing substance)
Karyotype (trisomy 13, 18, 21)
DDx of congenital cataracts and glaucoma?
What gene is associated with juvenile glaucoma?
What are the screening criteria for ROP?
Gestational age < 30 wks
Birth weight < 1500g
What are the indications for ROP laser/cryo according to ET-ROP study?
Zone 1, any stage with plus
Zone 1, stage 3
Zone 2, stage 2 or 3 with plus
At what age does the nasal retina become fully vascularized?
At what age does the temporal retina become fully vascularized?
What are the stages of ROP?
1. Demarcation line
2. Elevated ridge
3. Ridge + NV
4. RD (a=fovea on, b = off)
5. Total RD
What is the inheritance pattern of FEVR?
Autosomal dominant or
What is the inheritance pattern of PHPV?
What is the inheritance pattern of Coats' disease?
What is another name for VHL?
What is the inheritance pattern of Norrie's disease?
What is the inheritance pattern of fundus flavimaculatus?
What is the inheritance pattern of Stargardt's disease?
Autosomal recessive, rarely dominant
Buzzwords associated with Stargardt's?
bulls eye maculopathy
pisciform flecks of RPE
salt and pepper pigment changes
What is the inheritance pattern of Best's Disease?
What is the gene involved in Best's Disease?
What chromosome is Bestrophine gene on?
What is the typical testing profile seen with Best's disease?
Normal ERG, Abnormal EOG with arden ration < 1.6
What is another name for complete rod monochromatism?
What is the inheritance pattern for congenital achromatopsia?
What is the inheritance pattern of blue cone monochromatism?
The most severe form of RP is inherited in what pattern?
What type of collagen is Bowman's membrane made of?
What type of collagen is Descemet's membrane made of?
What cell layer produces aqueous?
nonpigmented ciliary epithelium
Lens zonules insert into the ________.
Nucleated lens fibers are located at the ________ of the lens.
The macula (compared to peripheral retina) has multiple layers of ________ cells.
What are the PAS positive membranes of the eye?
Internal limiting membrane
GMA is used to stain ________.
Aiell Nielsen stain is used to detect ________.
Calcoflour white is used to detect _______.
Von Kossa/Alizarin Red stains ______.
Verhoeff von Giesen stains _____.
Prussian blue stains ______.
Masson Trichrome stains ______.
Alcian blue stains ______.
Mucicarmine stains _____.
mucin (mucoepidermoid CA)
Crystal violet stains _____.
Thioflavin T stains _____.
Oil red O stains _____.
lipid (need frozen tissue)
Fontana stains _____.
What two organisms are associated with giant cells on pathology?
fungus and mycobacteria
Touton giant cells are associated with ________.
What is a Russell body?
Intracytoplasmic vesicle of Ig in plasma cell
What is a Deutcher body?
Intranuclear vesicle of Ig in plasma cell
Langhans giant cells
Touton giant cells have a halo of ______.
What organism is associated with granulomatous inflammation of Descemet's membrane?
What are Dalen Fuch's nodules? What 3 diseases can they be found in?
Giant cells under the RPE. VKH, Sympathetic ophthalmia, sarcoid.
What is the inheritance pattern of posterior polymorphous membrane dystrophy?
Autosomal Dominant, sometimes AR
In what conditions would you see intraocular cartilage?
teratoid meduloepithelioma and trisomy 13
What is the tarsus made of?
Collagen (NOT cartilage!)
What is a zimmerman's tumor?
Phacomatous choriostoma, usually infranasal lid in children
What is the difference between epithelial inclusion cyst vs. dermoid cyst?
Dermoid cyst has pilosebacious units
What types of squamous cell carcinoma have the worst prognosis?
spindle cell and mucoepidermoid variants
What type of basal cell carcinoma has the worst prognosis?
Where does an oncocytoma occur?
With sebaceous adenoma, what syndrome do you have to worry about?
Muir-Torre: need to worry about colon carcinoma
What are 4 causes of posterior leukoma?
What substance appears as an acellular PAS positive substance?
What is the inheritance pattern of Meesman's dystrophy?
What is the inheritance pattern of Reis Buckler's corneal dystrophy?
Reis Buckler's is a more anterior form of ______ dystrophy.
What is the inheritance pattern of Lattice Corneal Dystrophy?
What is the inheritance pattern of Macular Corneal Dystrophy?
All mucopolysaccharidoses have ______ inheritance except for ______.
Hunter's -- X-linked
What is the inheritance pattern of Avellino Corneal Dystrophy?
Which mucopolysaccharidoses have corneal vs. retinal involvement?
"Sam the Sly Hunter can see".
"Type I, II, III have retinopathy".
Cytoid bodies are seen in what retinal pathology?
microinfarcts to the RNFL
Splendore Heppley phenomenon is associated with what organism?
Toxocara canis -- eosinophilic infiltrates in retina
What is the inheritance pattern of Stickler's Syndrome?
What gene and chromosome is involved in Stickler's syndrome?
COL 11A1, 11A2, 2A1 on Chromosome 1
What gene product is dysfunctional in Stickler's syndrome?
Collagen Type 2 and 11
What is the most common inheritance pattern of Albinism?
What subtype of albinism is associated with absent pigmentation?
What fixative is used for biopsy samples requiring immunofluorescence staining?
Sets found in the same folder
5.4 Corneal Dystrophies
Drug list (pt. 2)
Other sets by this creator
Intraocular Inflammation and Uveitis (BC…
B2.2-2.4: Prismatic effect, effective po…