A Quiz About Cornea For All Opticians
The cornea is the transparent part of the eye that covers the front portion of the eye. It covers the pupil (the opening at the center of the eye), iris (the colored part of the eye), and anterior chamber (the fluid-filled inside of the eye). The cornea's main function is to refract, or bend, light.
This is a quiz about Cornea for all Opticians.
- 1.
Your patient is a 25yoM who is also a wielder. He comes in for his yearly exam, although he has no complaints, you notice a small corneal opacity which indicates the presence of a previous foreign body. The deposit contains iron or possibly calcium. At this time you decide this particular finding does not require treatment or management. What is this corneal degeneration called?
- A.
Descemet's striae
- B.
Corneal farinata
- C.
Hassal-Henle bodies (Descemet's warts)
- D.
Coat White ring
Correct Answer
D. Coat White ringExplanation
Option 1, 2 and 3 are all corneal involutional degenerations (age related)Rate this question:
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- 2.
Select the false statement
- A.
The deeper that a cut or injury goes into the epithelium, the longer it takes to heal.
- B.
Map dot fingerprint dystrophy or anterior basement membrane dystrophy that we will talk about that has weakened epithelium. Its about this type of condition that the epithelium does adhere very well and it sloughs off and leads to corneal erosion.
- C.
The stroma is the pump that keeps the cornea clear, the less stroma you have the less ability you have to control hydration
- D.
If you traumatize bowman’s, that’s when you develop scarring.Cells cannot regenerate so damage causes scarring
- E.
Bowman’s membrane, it is a tough piece of tissue, very difficult to perforate
Correct Answer
C. The stroma is the pump that keeps the cornea clear, the less stroma you have the less ability you have to control hydrationExplanation
Option 3 - refers to endotheliumRate this question:
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- 3.
Select the following conditions that do not require treatment according to Dr. N.
- A.
Limbal Girdle of Vogt
- B.
Calcific Band Keratopathy
- C.
Hudson-Stahli line
- D.
Terrien's marginal degeneration (gutter degeneration)
Correct Answer(s)
A. Limbal Girdle of Vogt
C. Hudson-Stahli lineExplanation
Calcific Band Keratopathy - pg. 5
Terrien's marginal degeneration (gutter degeneration) - pg 4Rate this question:
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- 4.
What does the acronym CAP stand for? Select all 3 answers that apply
- A.
Antibiotic
- B.
Anesthetize
- C.
Cycloplegic
- D.
Conjunctival flap resection
- E.
Pulse - steroid pulse
- F.
Pressure patching
Correct Answer(s)
A. Antibiotic
C. Cycloplegic
F. Pressure patchingExplanation
pg. 5Rate this question:
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- 5.
Your patient is a 30yoF. Before the exam you notice that in your patient's file it states that the patient had a slowly progressive ulcer that has been present since the patient was 16. The ulcer is bilateral. The patient is diligent about coming to her yearly appointments because her condition can become difficult to manage. The patient reports that her eye can become red and painful. The ulcer is beginning to extend into the central cornea from the periphery. What condition does this patient have?
- A.
Salzmann's nodular degeneration
- B.
Recurrent erosion
- C.
Mooren's degeneration
- D.
Meesman's epithelial
Correct Answer
C. Mooren's degenerationExplanation
pg. 6Rate this question:
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- 6.
Your patient is a 30yoF. Before the exam you notice that in your patient's file it states that the patient had a slowly progressive ulcer that has been present since the patient was 16. The ulcer is bilateral. The patient is diligent about coming to her yearly appointments because her condition can become difficult to manage. The patient reports that her eye can become red and painful. The ulcer is beginning to extend into the central cornea from the periphery. What are the treatment options for this patient?
- A.
Observation
- B.
Keratoplasty
- C.
Conjunctival resection
- D.
No treatment is necessary in this condition
Correct Answer(s)
A. Observation
B. Keratoplasty
C. Conjunctival resectionExplanation
The patient's history of a slowly progressive ulcer that has been present since the age of 16, along with the fact that the ulcer is bilateral and can become red and painful, suggests a chronic condition that requires management. The fact that the ulcer is beginning to extend into the central cornea indicates a worsening of the condition. Therefore, treatment options such as observation, keratoplasty (corneal transplant), and conjunctival resection (removal of the affected conjunctival tissue) may be considered to manage the patient's condition.Rate this question:
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- 7.
A dystophy is a primary corneal disease not associated with previous inflammatory, infectious or systemic disease. They are typically inherited as an autosomal dominant (AD) trait.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
pg. 6Rate this question:
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- 8.
Corneal farinata
- A.
Had a couple of types, the anterior and posterior type. The anterior type is where you have the central corneal shows these polygonal pattern of grayish white opacities separated by bowman’s and the epithelium. The posterior type looks like it’s in the deep stroma and descemets region. Really its not causing any functional problem. The treatment and management is none.
- B.
Is a yellowish/white cholesterol rings in the peripheral cornea, lipids at the termination of Bowman’s. You’re going to be noticing this sort of whitish rings, some of them are very subtle and some of them very dense going around the cornea
- C.
Leads to a differential diagnoses of corneal guttata. When you have corneal guttata, it affects the endothelium,. So now when you have farinata, you have these grayish white flecks in the deep corneal stroma.
- D.
Could be from mechanical injury like forceps injury at birth, or could it be from increased IOP called congential glaucoma If the pressure is so high its pushing on the endothelium, so it’s going to cause problems to the endothelium and descemet’s
Correct Answer
C. Leads to a differential diagnoses of corneal guttata. When you have corneal guttata, it affects the endothelium,. So now when you have farinata, you have these grayish white flecks in the deep corneal stroma.Explanation
So a way to help you determine if you’re dealing with guttata, which is a precursor to fuch’s endothelial dystrophy, a way to tell is to do specular reflection, and you notice that the endothelial surface quality is normal. But you see these opacities close to the endothelium. You do optic section one more time and you increase the magnification and you notice these opacities are at the layer of the posterior stroma. You may be dealing with farinata.
Option 1 - Mosaic shagreen or crocodile shagreen
Option 2 - Corneal arcus
Option 4 - Descemet's striaeRate this question:
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- 9.
Why are dellen's problematic?
- A.
It increases the likelihood of a pterygium or a pinguecula forming in that area
- B.
The cornea starts to shrink in that region, the tissue doesn’t have its normal integrity like it used to. Then, over time what happens is that area becomes depressed and the tear film collects and a lot of stagnant tear film and a lot of bacteria may start to harbor in that area. So you run a higher chance of infection to occur because you don’t have good flushing of tears in that area.
- C.
That area will become non-responsive to attempts to hydrate it
- D.
It is a progressive non-inflammatory thinning of the cornea.
Correct Answer
B. The cornea starts to shrink in that region, the tissue doesn’t have its normal integrity like it used to. Then, over time what happens is that area becomes depressed and the tear film collects and a lot of stagnant tear film and a lot of bacteria may start to harbor in that area. So you run a higher chance of infection to occur because you don’t have good flushing of tears in that area.Explanation
Option 4 - Terrien's Marginal degenerationRate this question:
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- 10.
You have a 20yoF. Her chief complaint is blurred vision. You don’t see a lot of redness or injection. You’ve done your case history, VA, cover test, EOM’s and pupils, all these findings are normal. You do your ret and you’re getting distortion. You do both sides and you’re getting that scissor reflex. Next you do your refraction and you’re not getting really solid endpoint like you typically would on a patient 20-30 years of age. Her responses are confusing you. You do keratometry and that’s also distorted as well. Then you take a look at the cornea on slit lamp and start noticing some thinning of the cornea. So perilimbal thinning of the cornea that begins superiorly and spreads laterally. you decide to do staining and the fluorescein pools it doesn’t stain. What condition do you think your patient most likely has?
- A.
Calcific Band Keratopathy
- B.
Reis Buckler
- C.
Terrien’s Marginal Degeneration
- D.
Anterior keratoconus
Correct Answer
C. Terrien’s Marginal DegenerationExplanation
So usually it begins superior and spreads across laterally. It doesn’t go so much central. Starts at the top and works its way around. The epithelium usually stays intact.
The fluorescein pools because it’s depressed in that area and it doesn’t stain. You’re getting thinning in the area in general overall area of the cornea.
o What’s the management for these patients? A lot of times what they have to do bc it’s thinning of the peripheral cornea they’ll take a piece of the bulbar conj the adjacent bulbar conj, and flap it over that thin piece. That is typical for terrien’s marginal degeneration. They haven’t pinpointed the systemic disease it’s associated with. The management is usually a resection.Rate this question:
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- 11.
You are scribing for a 4th year. They tell you to look in the slit lamp to see a cool finding on the cornea of a 23yoM. The 4th year says that the endothelium shows a beaten metal appearance. This is due to the abnormal production of Descemet's collagen by endothelial cells causing areas of thickening in the central corneas. They explain to you that no treatment is necessary at this time but the patient should continue to be monitored. What condition are they describing?
- A.
Corneal guttata
- B.
Stromal dystrophy
- C.
Reiger's anomaly
- D.
Fleischer's ring
Correct Answer
A. Corneal guttataExplanation
pg. 10Rate this question:
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- 12.
Select the false statement regarding Fuch's endothelial dystrophy.
- A.
Symptoms include decreased vision due to edema, usually worse in the morning, decreased VA may also be due to scarring.
- B.
It is an apical thinning of the cornea typically inferior and nasal to the visual axis which is bilateral, it results from the fragmentation of Bowman's membrane.
- C.
The pain may experience pain associated with ruptured bullae and epithelial loss.
- D.
Treatments include 5% NaCl 4-6 times per day and ointment at night, banadge contact lens as well as use od a hair dryer at arm's lengthe 5-10 minutes upon awakening.
Correct Answer
B. It is an apical thinning of the cornea typically inferior and nasal to the visual axis which is bilateral, it results from the fragmentation of Bowman's membrane.Explanation
Other Tx includes Descemet's stripping endothelial keratoplasty ( more modern) older Tx penetrating keratoplasty.
Option 2 - describes Anterior keratoconusRate this question:
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- 13.
Which of the following is a false statement regarding Anterior keratoconus?
- A.
Late signs include Fleischer's ring, the deposition of iron in basal epithelium around the base of the cone.
- B.
Acute hydrops can occur which is the ruptured Descemet's membrane leading to corneal edema usually resolving in 8-10 weeks.
- C.
Thinning of corneal stroma will be visible via biomicroscopy
- D.
Corneal topography will show areas of flattening, however there will be no distortions of the retinoscope reflex
- E.
Munsons sign manifests
Correct Answer
D. Corneal topography will show areas of flattening, however there will be no distortions of the retinoscope reflexExplanation
The statement that corneal topography will show areas of flattening, however, there will be no distortions of the retinoscope reflex is false. In anterior keratoconus, corneal topography will show areas of steepening and distortion, not flattening. Additionally, the retinoscope reflex will be irregular and distorted due to the abnormal shape of the cornea.Rate this question:
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- 14.
In Axenfeld's anomaly the iris strands extend across AC angle to insert onto prominent Schwalbe's ring. 50% of people with this anomaly can develop glaucoma aka Axenfeld's syndrome.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
In Axenfeld's anomaly, the iris strands extend across the angle of the anterior chamber to attach to the prominent Schwalbe's ring. This abnormality can lead to the development of glaucoma, which is known as Axenfeld's syndrome. Therefore, the statement "True" is correct as it accurately reflects the association between Axenfeld's anomaly and the potential development of glaucoma.Rate this question:
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- 15.
The difference between mooren’s and terriens – some people get them mixed up, is the inflammatory sign. The inflammatory sign shows up in mooren’s and with terriens you don’t have that inflammatory indication.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The explanation for the correct answer, which is True, is that the main difference between Mooren's and Terriens is the presence of the inflammatory sign. Mooren's disease is characterized by the presence of an inflammatory sign, while Terriens does not exhibit this indication. Therefore, it is true that the inflammatory sign is a distinguishing factor between the two conditions.Rate this question:
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- 16.
Select the false statement regarding Salzmann’s nodular degeneration
- A.
Phlyctenulosis is an immune response from Staph exotoxins
- B.
Often Salzmann’s nodular degeneration comes from phlyctenulosis
- C.
It is the most common type of epithelial dystrophy
- D.
In Salzmann’s nodular degeneration, if the patient does have symptomology becaue it’s interfering with vision that’s when you think about removing them. You use the excimer laser to ablate it. if it’s way off to the side close to the limbus then you’re just going to leave it and watch those conditions.
- E.
Ask the patient if they had some type of red eye or eye infection in the past to help you with your current diagnosis. They say a couple years ago I had an eye infection and they gave me some antibiotics, or eye medication to help get rid of the problem. That helps you with your diagnosis because now you’re thinking maybe the patient had phlyctenulosis in the past and what we’re seeing is salzmann’s nodular degeneration.
Correct Answer
C. It is the most common type of epithelial dystrophyExplanation
Option 3 - map -dot fingerprint most common.Rate this question:
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Current Version
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Mar 21, 2023Quiz Edited by
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Apr 24, 2012Quiz Created by
Mchllmijares
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