Ohp II Mt 2 Cataracts

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About This Quiz

This OHP II MT 2 Cataracts quiz assesses knowledge on various types of senile cataracts, their appearances, associated symptoms, and related conditions. It's designed for medical students preparing for exams, enhancing understanding of ophthalmological conditions affecting vision.

Ohp II Mt 2 Cataracts - Quiz

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  • 2. 

    What aspect of the cataract surgery is particularly important for a pt with COPD & Parkinson's?

    • Wide dilation

    • Antibiotics

    • Anesthesia

    • Steroids

    Correct Answer
    A. Anesthesia
    Explanation
    Since COPD pts have increased chances of coughing, its important to make sure they are under the proper anesthesia to reduce this potential. Parkinson's pts have increased change of shaking.

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  • 3. 

    For sutural (stellate) cataracts, anterior sutures are inverted 'Y'-shaped and posterior sutures are 'Y'-shaped

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Anterior: Y
    Posterior: inverted Y

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  • 4. 

    The anterior lens spike is slighly shorter than the posterior lens spike

    • True

    • False

    Correct Answer
    A. False
    Explanation
    anterior lens spike > posterior lens spike

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  • 5. 

    Oral glaucoma meds are used pre-sx to help control IOP.  It is best to switch the patient from using prostaglandins, however, in order to reduce the aggravation of inflammation.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The statement is true. Oral glaucoma medications are indeed used before surgery to help control intraocular pressure (IOP). However, it is recommended to switch the patient from using prostaglandins because they can aggravate inflammation.

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  • 6. 

    Peribulbar block is riskier than than retrobulbar block

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Peribulbar is less risky than retrobulbar
    Retrobular is the most dangerous...you inject the needle as in peribulbar, but then you tilt upward to go into the muscle cone...this is risky bc you might hit the optic nerve

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  • 7. 

    Which of anethestic uses paracentsis (micro-holes in cornea and Xylocaine injected into AC)?

    • Peribulbar

    • Retrobulbar

    • Intracameral

    • Local

    Correct Answer
    A. Intracameral
    Explanation
    Intracameral has less potential side effects

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  • 8. 

    The most common type of senile cataract is _______.

    Correct Answer
    Nuclear Sclerosis
    NSC
    Explanation
    The LEAST common is PSC

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  • 9. 

    Damage by speculum or complication of retrobulbar anesthesia can cause what post-op lid complication?

    Correct Answer
    ptosis
    Explanation
    Damage by speculum or complication of retrobulbar anesthesia can cause ptosis, which is a post-operative lid complication. Ptosis refers to the drooping of the upper eyelid, which can occur due to various reasons, including trauma or nerve damage during surgery. In this case, the speculum or retrobulbar anesthesia might have caused damage to the muscles or nerves responsible for lifting the eyelid, resulting in ptosis.

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  • 10. 

    What is the most common cause of Total Congenital cataract?

    • Rubella

    • Mumps

    • Hepatitis

    • Toxoplasmosis

    Correct Answer
    A. Rubella
    Explanation
    All of the above are causes, but RUBELLA is most common cause
    Rubella is assoc with ear/heart defects + salt/pepper fundus

    Mneumonic: "Salt&Pepa were such (ru)bellas, they went through my ear straight to my heart"

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  • 11. 

    Wilson's Disease involves copper accumulation from poor metabolism and is associated with a Keiser-Fleisher Ring

    • True

    • False

    Correct Answer
    A. True
    Explanation
    --> Sunflower cataract

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  • 12. 

    A phacomorphic lens can cause narrow angle glaucoma because with age the lens grows and can close off the angle.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    As a person ages, the lens in their eye can grow and become thicker, potentially causing a condition known as phacomorphic lens. This condition can lead to narrow angle glaucoma, where the angle between the iris and the cornea becomes blocked or closed off. This blockage can increase the pressure inside the eye, leading to symptoms such as eye pain, blurred vision, and even vision loss if left untreated. Therefore, the statement "A phacomorphic lens can cause narrow angle glaucoma because with age the lens grows and can close off the angle" is true.

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  • 13. 

    Cataract surgery can proceed even if there is an active uveitis as long as necessary precaustions (antibiotics etc) are administered.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The surgery itself will cause inflammation and therefore a uveitis must be treated 3-6 mo prior to sx

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  • 14. 

    Cataract sx can result in _____% loss of endothelial cells.

    • 15%

    • 25%

    • 40%

    • 60%

    Correct Answer
    A. 60%
    Explanation
    Cataract surgery can result in a significant loss of endothelial cells, specifically 60% of them. The endothelial cells are responsible for maintaining the clarity of the cornea by regulating the fluid balance. During cataract surgery, the natural lens of the eye is removed and replaced with an artificial lens. This surgical procedure can cause damage to the endothelial cells, leading to their loss. It is important to consider this potential loss when assessing the risks and benefits of cataract surgery.

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  • 15. 

    AC-IOL and iris-fixed IOL are associated with what type of cat sx?

    • ICCE

    • ECCE

    • Femto Lasers

    • Couching

    Correct Answer
    A. ICCE
    Explanation
    ICCE: increased risk of inflammation & complications (CME, RD)
    - iris-fixed IOL will produce square-shaped pupil

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  • 16. 

    At what point post-cataract sx can you perform a refraction on a patient and give SRx?

    • 1 week

    • 3-5 weeks

    • 3 month

    • This person will never need SRx bc they have new IOL

    Correct Answer
    A. 3-5 weeks
    Explanation
    The correct answer is 3-5 weeks. After cataract surgery, it is important to wait for the eye to heal and stabilize before performing a refraction and prescribing a new spectacle prescription (SRx). This typically takes around 3-5 weeks for the patient's vision to stabilize and for any residual refractive error to become apparent. Waiting until this point ensures that the refraction is accurate and that the patient's vision is optimized with the new intraocular lens (IOL).

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  • 17. 

    If a patient is on Warfarin, what test must be taken before cataract sx?

    Correct Answer
    INR
    Explanation
    INR will tell us how much blood clots and how thin blood is
    Normal INR = 2-4
    If blood too thin --> inc'd risk of bleeding out/orbital hemorrhage

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  • 18. 

    A 'rosette (star of david) or vossius ring is associted with which type of cataract?

    • NSC

    • Cortical

    • Traumatic

    • Morganian

    Correct Answer
    A. Traumatic
    Explanation
    Vossius Ring: pigment ring on anterior capsule from iris

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  • 19. 

    Absence of scleral spikes during A Scan indicates that the probe is oriented toward the ONH

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The absence of scleral spikes during A Scan indicates that the probe is oriented toward the optic nerve head (ONH). This is because scleral spikes are reflections from the sclera, which is the white outer layer of the eye. When the probe is properly oriented towards the ONH, the scleral spikes are not visible because the sound waves are directed towards the optic nerve head instead of reflecting off the sclera. Therefore, the statement is true.

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  • 20. 

    RAM is the most commonly used potential acuity meter in the ECC.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    97% accurate

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  • 21. 

    How would you interpret the results of a glare test if the VA improves?

    • No significant glare problem

    • Glare is a problem

    • Pinhole effect

    • Results cannot be determined

    Correct Answer
    A. Pinhole effect
    Explanation
    VA same = no significant glare problem
    VA reduced = glare is a problem
    VA improves = pinhole effect --> recheck Rx

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  • 22. 

    Glare testing is typically done with the patient dilated.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Glare testing is typically done with the patient undilated, not dilated. Dilating the eyes can affect the accuracy of the test results, as it changes the size of the pupil and can alter the perception of glare. Therefore, it is important for the patient to be undilated during glare testing to obtain accurate and reliable results.

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  • 23. 

    Galactosemia causes what type of secondary cataract?

    • Polychromatic

    • Diabetic

    • Anterior Subcapsular

    • Oil Droplet

    Correct Answer
    A. Oil Droplet
    Explanation
    Galactosemia: no galactose metabolizing enzymes --> galactose b/u to toxic levels and damages tissue --> inc'd intracellular osmotic pressure + fluid influx --> oil-droplet apperance from zonular/nuclear opacity

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  • 24. 

    Posterior subcapsular is rarely visually devastating.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Posterior & Anterior Subcapsular cataracts are commonly associated with being VISUALLY DEVASTATING.

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  • 25. 

    A 'milky NSC' apperance is associated with what type of secondary cataract?

    • Sunflower

    • Diabetic

    • Posterior Subcapsular

    • Hypermature

    Correct Answer
    A. Diabetic
    Explanation
    Diabetic cataracts = osmotic cataract --> cause LARGE MYOPIC SHIFT

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  • 26. 

    If you see nuclear contents that have sunken inferiorly, what type of cataract would you consider?

    • Diabetic

    • Hypermature

    • Morganian

    • Total Congenital

    Correct Answer
    A. Morganian
    Explanation
    Nuclear contents can break through capsule in Morganian cataract.

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  • 27. 

    Which of the following endothelial cell counts should you NOT recommend for cataract sx?

    • < 800 cells/mm2

    • < 1200 cells/mm2

    • < 1500 cells/mm2

    Correct Answer
    A. < 800 cells/mm2
    Explanation
    < 800 = poor candidate
    1200-1400 = OK candiate (minimally acceptable range for sx)

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  • 28. 

    Interferometry has a more optimistitic prediction than PAM

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Interferometry: UNDERPREDICTS VA w/ dense cataracts & OVERPREDICTS VA w/ macular issues

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  • 29. 

    At what point post-cataract sx can you stop antibitoics and start to taper steroids?

    • 1 day

    • 1 week

    • 3-5 weeks

    • 6 months

    Correct Answer
    A. 1 week
    Explanation
    Begin tapering steroids 1 week post-op ONLY if no inflammation/cells remain

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  • 30. 

    Down's Syndrome and Myotonic Dystrophy are associated with what type of congenital cataract?

    • Lamellar

    • Sutural

    • Coronary

    • Blue Dot

    Correct Answer
    A. Coronary
    Explanation
    Coronary: radial, club-shaped opacities in cortex (similar to cortical cataracts)

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  • 31. 

    What is the VA limit for Medicare to cover cataract extraction?

    • 20/30

    • 20/40

    • 20/50

    • 20/60

    Correct Answer
    A. 20/50
    Explanation
    Or significant impairment with glare...most other insurance policies will cover once 20/40

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  • 32. 

    Topical NSAIDs are used pre-sx to maintain mydriasis and prevent post-op CME.  Choose the appropriate regimen.

    • 1 gtt Acular q 30min, 2 hr before surgery

    • 2 gtt Acular q 1 hr, 3 hr before surgery

    • 1 gtt Acular q 30 min, 2 days before surgery

    • 2 gtt Acular q 2 hr, 1 day before surgery

    Correct Answer
    A. 1 gtt Acular q 30min, 2 hr before surgery
    Explanation
    Topical NSAIDs are used pre-sx (pre-surgery) to maintain mydriasis (dilation of the pupil) and prevent post-op (post-operative) CME (cystoid macular edema). The appropriate regimen is to administer 1 drop of Acular every 30 minutes, starting 2 hours before surgery. This ensures that the medication is present in the eye at the time of surgery to maintain mydriasis and minimize the risk of post-operative complications.

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  • 33. 

    Sutural cataracts can occur in both the anterior and posterior of the lens.  Anterior is more common.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Sutural cataracts can occur in both the anterior and posterior of the lens, but anterior cataracts are more common. This means that while cataracts can form in both parts of the lens, they are more likely to occur in the anterior portion.

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  • 34. 

    Infantile (congenital) catracts typically do NOT affect vision.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Infantile (congenital) cataracts typically do not affect vision because they are present from birth and the brain adapts to the cloudy lens, allowing the child to develop normal vision. In some cases, if the cataracts are severe or left untreated, they can cause visual impairment. However, in general, infantile cataracts do not have a significant impact on vision.

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  • 35. 

    Which of the following is the most common type of congenital cataract?

    • Fetal Nuclear

    • Lamellar

    • Blue Dot

    • Coronary

    Correct Answer
    A. Lamellar
    Explanation
    Lamellar has a SAND DOLLAR apperance (ring of opacity around nucleus)

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  • 36. 

    Fetal Nuclear Cataracts are limited to what area of the nucleus?

    • Embryonic nucleus

    • Fetal nucleus

    • Adult nucleus

    Correct Answer
    A. Embryonic nucleus
    Explanation
    Fetal Nuclear Cataracts are limited to the embryonic nucleus. This means that the cataracts only affect the nucleus of the lens during the fetal stage of development. It suggests that the condition does not extend to the adult nucleus, which is the central part of the lens in the eye that develops after birth. The answer implies that the occurrence of cataracts is specific to a particular stage of fetal development and does not persist into adulthood.

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  • 37. 

    A Mature cataract is one where there is liquefaction of lens contents and wrinkling of capsule; a Hypermature cataract is complete opacification of lens capsule, cortex and nucleus

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Mature: complete opacification of lens capsule, cortex and nucleus
    Hypermature: liquefaction of lens contents and wrinkling of capsule

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  • 38. 

    When performing the Maddox Rod test, if the patient cannot see the line then that indicates poor macular function

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Visible whole line = good macular fxn
    Broken/wavy line = leakage/hole in macula
    No visible line = need more testing (not a good indicator of poor macular fxn'ing)

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  • 39. 

    Coronary and Blue Dot cataracts occur in the lens nucleus.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Both of these occurs in the CORTEX

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  • 40. 

    Which phacoemulsification procedure is causes less damage to the endothelium?

    • Grooving

    • Phaco-Chop

    Correct Answer
    A. Phaco-Chop
    Explanation
    Grooving: groves weaken lens --> lens slowly breaks apart
    Phaco-Chop: chopper breaks lens apart with force --> less time = less heat/energy = less stress on zonules = less risk of damage to endothelium (requires more skill however)

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  • 41. 

    Glassblower's cataract is also known as a pseudo-exfoliation cataract

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Glassblower's: TRUE exfoliation cataract (capsule splits/chips off and flakes stick to lens)
    Glaucoma: psuedo-exfoliation cataract

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  • 42. 

    The most common anesthsia for sx used is topical.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Most common = LOCAL
    However, topical is recently popular bc it reduces risk of complications, however pain control is not as good.

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  • 43. 

    Retinal spike sloping during A Scan will result in what? Choose all that apply.

    • Falsely long axial length

    • Falsely short axial length

    • Weaker IOL

    • Stronger IOL

    • - SRx needed

    • + SRx needed

    Correct Answer(s)
    A. Falsely long axial length
    A. Weaker IOL
    A. + SRx needed
    Explanation
    Retinal spike sloping: falsely long axial length = weaker IOL = hyperopia = + SRx needed
    AC depth inconsistency = corneal compression: falsely short axial length = stronger IOL = myopia = -Srx needed

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  • 44. 

    The endpoint or Interferometry is when the pt can only read 1 out of 4 presentations.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    endpoint = 2/4 presentations

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  • 45. 

    In which cat sx are you concerned with the capsule rupturing during sx?

    • ICCE

    • Femto Lasers

    • Couching

    • ECCE

    Correct Answer
    A. ECCE
    Explanation
    ECCE: posterior capsule left in place so you are concerned that it may rupture
    ECCE uses a PC-IOL, but if the capsule ruptures, forced to use AC-IOL

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  • 46. 

    Indicate some early post-op signs that would be indicative of endophthalmitis.

    • Ecchymosis

    • Lid edema

    • Chemosis

    • Diplopia

    Correct Answer(s)
    A. Lid edema
    A. Chemosis
    Explanation
    The early post-op signs of lid edema and chemosis are indicative of endophthalmitis. Lid edema refers to swelling of the eyelids, which can occur as a result of inflammation or infection in the eye. Chemosis, on the other hand, refers to swelling of the conjunctiva, the clear membrane that covers the white part of the eye. These signs suggest an inflammatory response in the eye, which can be a sign of endophthalmitis, an infection that can occur after eye surgery.

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  • 47. 

    Indicate the potential causes of Polychromatic (christmas tree) cataracts.

    • Thermal radiation

    • Wilson's Disease

    • Myotonic dystrophy

    • Trauma

    • Cholesterol issues

    Correct Answer(s)
    A. Myotonic dystrophy
    A. Cholesterol issues
    Explanation
    thermal radiation: Glassblower's
    Wilson's disease: Sunflower

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  • 48. 

    A diabetic lens is easier to 'break up' during cataract surgery because the swelling and de-swelling that has occured has already damaged the lens in most cases.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Diabetic lens is MORE DIFFICULT to break up

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  • 49. 

    Which anesthesia has the best pain control?

    • Local

    • Peribulbar

    • Retrobulbar

    • Intracameral

    • More than one of the above

    Correct Answer
    A. More than one of the above
    Explanation
    Pain Control:
    retrobulbar = peribulbar > local > topical

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  • Mar 20, 2023
    Quiz Edited by
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  • May 03, 2012
    Quiz Created by
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