What does the word vernal mean? A. summer B. spring Cc. new D. re-birth |1%Where is the thinning of the cornea in relation to the most elevated part of the cornea in keratoconus? A thi jing above the cone fk ing at the apecof the cone ewe C. thinning temporal to the cone |1% B. thi D. thinning inferior to the cone aeCe aed « mM PR nae ou etl) ACS eee uo Ophtho@uestions” a FOCUS YOUR KNOWLEDGE QUESTION 112 OF 113 (COMPLETED TEST) Where is the thinning of the cornea in relation to the most elevated part of the cornea in keratoconus? A. thinning above the cone B. thinning at the apex of the cone C. thinning temporal to the cone |1% D. thinning inferior to the cone 14% Category: Cornea Topic: Corneal Dystrophies and Degenerations High Yield: Yes Your Answer: B Correct Answer: B Explanation: Keratoconus, the most common of the corneal ectasias, is a degenerative disorder that results in thinning of the cornea at the apex of the cone. The apex of the coneis itself usually centered just below the visual axis of the cornea. These patients almost always demonstrate topographic abnormalities at a young age. It is thought to develop initially in puberty, It is commonly associated with painfulWhich of the following is a known association with contact lenses: ‘A. hard contact lens overwear can lead to 5% central epithelial edema B. micropannus with hard contact lenses D, modern contact lens cleaning solutions leading to superior limbic keratoconjuncti (SLK)Apatient presents with severe ocular pain and a linear epitheliopathy of the right eye. His past ocular history is only significant for contact lens wear. Gram stain and confocal microscopy show cysts within the corneal stroma. Which of the following would be the best choice for initial treatment? A. chlorhexidine 0.01% B. polyhexamethylene biguanide (PHMB) 0.02% C. propamidine isethionate 0.01% D. paromomycin 0.5% Category: Cornea Topic: Microbial and Parasitic Infections High Yield: Yes Your Answer: B Correct Answer: B Explanation: r me ) Acanthamoeba keratitis. bxApatient presents with a 2 month history of eye irritation. On exam there are thick pseudomembranes on both palpebral conjunctival surfaces with a woody appearance. What underlying biochemical defect is present? ‘A. deficiency in type 1 plasminogen TH B. deficiency in C1d39a erythrocyte transferin C. collagenase overexpression D, 6434 transferin overexpressionWhat is the name for the point located at the intersection of a person's line of fixation and the corneal surface? A. geographic center & ® crear me . cornea plana D. corneal apex (9%) =What is the approximate concentration of corneal endothelial cells that a human has at birth? A. 6,000 cells/mm? = B. 5,000cells/mm? (12% €. 4000s? ome D. 3,000 cells/mm? (16% |Which of the following steps should be done first in the repair of an open globe? A. repair of posterior scleral laceration (198 B. repair of anterior scleral laceration bs D. repairofanteriorcornea (12%You are told that the patient in the photo had a biopsy of the conjunctiva and there were autoantibodies to the basement membrane zone. What type of hypersensitivity reaction is seen in the condition in the photo (see image)? A. Typel \1% 2. Wel we C. Type (ae) = D. TypelV.CE eee Which of the following statements may be true regarding the corneal condition demonstrated in the slit-lamp photos above? A. itis caused by a defect in carbohydrate 12% sulfotransferase 7 (CHST7) B. there are GAG (glycosaminoglycans) 45% deposits that stain with colloidal iron and Alcian blue C. the corneal stroma between the lesions is 23% typically clear D. itnever involves Descemet’s membrane. 20% and/or the endothelium distrofia corneal macularWhat is the name of the condition that mimics Terrien marginal degeneration but is seen in children? A. Vosts limbal girdle B. Fuchs superficial marginal keratitis 4 C. peripheral ulcerative keratitis D. degeneration-of Helmholtz:Which of the following cells in the eye produce lactoferrin? A. corneal epithelial cells B. eyelid columnar cells C. lacrimal gland acinar cells D. conjunctival goblet cells nalWhich of the following is NOT associated with meibomian gland dysfunction (MGD)? A. rosacea [2x B. oral retinoid therapy 6 C. decreased tearbreakuptime &Which of the following clinical features of chlamydial conjunctivitis in neonates is TRUE compared ‘to chlamydial conjunctivitis seen in adults? A. Neonates willtypieally haveless (i mucopurulent discharge comparedtoadults boca thts seenpntesnaree ios developed B, Infection in neonates has a poor response & to topical medications C. Clinical examination of neonates is me unlikely to show a follicular response on the conjuneti D. Giemsa-stained specimens from the conjunctiva of neonates is unlikely to demonstrate intracytoplasmic inclusionsAdelle (plural is dellen) generally occurs centripetally to a raised conjunctiva area. What layers of the cornea are absent with a delle? A. epithelium only & B. epithelium-and-Bowmansiayer cod C. epithelium, Bowmans layer, and stroma (9%A 23-year-old woman presents with stromal keratitis, vertigo, and hearing loss. Which of the following laboratory values should you obtain? A. creatinine (i B. Blood Urea Nitrogen (BUN) to creatinine (i ratio C. Venereal Disease Research Laboratory me (VDRL) or Rapid plasma reagin (RPR) D. liver enzymes & sx coganWhat is the most common inheritance pattern of posterior polymorphous corneal dystrophy (PPCD or PPMD)? B. autosomal recessive 18% C. Minked-recessive [ex D. X-linked dominant |1%Aprostitute brings her 10-year-old son to be examined by you in the office. He has been experiencing difficulty seeing and eye irritation. On exam he has mulberry molars and a saddle nose. You examine his right eye first and notice interstitial keratitis and "salmon patch” vascularization. What is the chance that he will have involvement of the left eye as well? A. 25% & B. 40% C. 60% oo” om oom ome‘A46-year-old man presents to your clinic with complaints of redness and mucus discharge of both eyes for the past 1 months. On exam, you note a prominent follicular conjunctivitis that equally involves the superior and inferior palpebral conjunctiva. In addition, you see some mild macropannus of the perilimbal cornea. His history is significant for working at the local zoo. Which of the following would be the preferred treatment for this patient? A. topicaterythromycin = B. oral trimethoprim/sulfamethoxazole (ae double strength 800/160 mg, C. topical tobramycin D. oral doxycycline Category: Cornea Topic: Infectious Diseases of the External Eye High Yield: No Your Answer: A Correct Answer: D Explanation: This vignette is alluding to the chronic follicular conjunctivitis that can be caused by Chlamydia psittaci which is an organism that can be spread from birds and mammals to humans. "Psittacosis" is also known as "bird fanciers disease” since this organism is transmitted from either the aerosolized fecal matter of birds (e.g. parrots, cockatoos) or their respiratory secretions.A 40-year-old African American woman presents with acute, unilateral eye pain and photophobia. Slit-lamp exam of the involved eye is shown above. What type of inflammatory cells are associated with these specifically-shaped corneal endothelial lesions? A. antigen-presenting cells (APCs) Bx B. lymphocytes 11% C. macrophages 74% D. neutrophils 9%Assuming refractive stability and topography measurements are within normal limits, which of the following patients is an APPROPRIATE candidate for excimer laser refractive surgery? A. A32year-ld female taking oral i contraceptive pills, B. 27-year-old female patient undergoing & treatment for lupus C. A29-year-old female patient taking [2x isotretinoin for treatment of acne vulgaris, D. 28-year-old female patient taking (12% amiodarone for arrhythmiadistrofia granular Courtesy of Kamran Riaz, M.D. Which of the following is TRUE regarding the corneal condition demonstrated in the photo above? A. itis caused by a defect in locus 5q31 (gene 6% TGFBI) B. these deposits are made of hyaline material that stains bright red with Congo Red stain C. these opacities have a butterfly appearance without clear intervening spaces Bete ; mwWhat was the purpose of the topical antiviral in the stromal keratitis arm of Herpetic Eye Disease Study (HEDS)? A. it was used to prevent the formation of k Halstorn bodies itwas used to prevent an outbreak of pe epithelial keratitis, C. it was used to prevent the development of &: uveitis D. it was used to prevent the stromal viral (19% particle loadWhich of the following microorganisms is classically associated with an explosive endophthalmitis following penetrating trauma to the eye? A cc me B. Propionibacterium acnes k C. Staphylococcus aureus 5 D. Streptococcus pneumonia fk