Ohp II Mt 2 Cataracts
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Questions and Answers
- 1.
The most common type of senile cataract is _______.
Explanation
The LEAST common is PSCRate this question:
- 2.
Infantile (congenital) catracts typically do NOT affect vision.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
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.Rate this question:
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- 3.
Indicate which conditions can result due to anterior/posterior polar cataracts.
- A.
Uveitis
- B.
Myopic shift
- C.
Increased glare issues
- D.
Capsular rupture
- E.
Hyperopic shift
Correct Answer(s)
A. Uveitis
D. Capsular ruptureExplanation
Anterior/Posterior Polar cataracts are a type of congenital cataract.
These present as a dot on the anterior or posterior capsule and can be confused with PSC.
The lens capsules are weaker in these pts and can cause capsular rupture + uveitis.
Can also occur due to TRAUMARate this question:
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- 4.
Zonular cataracts present as a region/zone of the lens that is opaque and is usually unilateral.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Zonular cataracts are usually BILATERALRate this question:
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- 5.
Which of the following is the most common type of congenital cataract?
- A.
Fetal Nuclear
- B.
Lamellar
- C.
Blue Dot
- D.
Coronary
Correct Answer
B. LamellarExplanation
Lamellar has a SAND DOLLAR apperance (ring of opacity around nucleus)Rate this question:
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- 6.
Fetal Nuclear Cataracts are limited to what area of the nucleus?
- A.
Embryonic nucleus
- B.
Fetal nucleus
- C.
Adult nucleus
Correct Answer
A. Embryonic nucleusExplanation
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.Rate this question:
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- 7.
Sutural cataracts can occur in both the anterior and posterior of the lens. Anterior is more common.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
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.Rate this question:
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- 8.
For sutural (stellate) cataracts, anterior sutures are inverted 'Y'-shaped and posterior sutures are 'Y'-shaped
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Anterior: Y
Posterior: inverted YRate this question:
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- 9.
Coronary and Blue Dot cataracts occur in the lens nucleus.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Both of these occurs in the CORTEXRate this question:
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- 10.
Down's Syndrome and Myotonic Dystrophy are associated with what type of congenital cataract?
- A.
Lamellar
- B.
Sutural
- C.
Coronary
- D.
Blue Dot
Correct Answer
C. CoronaryExplanation
Coronary: radial, club-shaped opacities in cortex (similar to cortical cataracts)Rate this question:
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- 11.
What is the most common cause of Total Congenital cataract?
- A.
Rubella
- B.
Mumps
- C.
Hepatitis
- D.
Toxoplasmosis
Correct Answer
A. RubellaExplanation
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"Rate this question:
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- 12.
Galactosemia causes what type of secondary cataract?
- A.
Polychromatic
- B.
Diabetic
- C.
Anterior Subcapsular
- D.
Oil Droplet
Correct Answer
D. Oil DropletExplanation
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 opacityRate this question:
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- 13.
Indicate which type(s) of cataracts can cause a myopic shift.
- A.
Oil Droplet
- B.
Cortical
- C.
Diabetic
- D.
Traumatic
- E.
Morganian
- F.
NSC
Correct Answer(s)
A. Oil Droplet
C. Diabetic
F. NSCExplanation
Cortical: hyperopic shiftRate this question:
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- 14.
Indicate the potential causes of Polychromatic (christmas tree) cataracts.
- A.
Thermal radiation
- B.
Wilson's Disease
- C.
Myotonic dystrophy
- D.
Trauma
- E.
Cholesterol issues
Correct Answer(s)
C. Myotonic dystrophy
E. Cholesterol issuesExplanation
thermal radiation: Glassblower's
Wilson's disease: SunflowerRate this question:
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- 15.
A 'milky NSC' apperance is associated with what type of secondary cataract?
- A.
Sunflower
- B.
Diabetic
- C.
Posterior Subcapsular
- D.
Hypermature
Correct Answer
B. DiabeticExplanation
Diabetic cataracts = osmotic cataract --> cause LARGE MYOPIC SHIFTRate this question:
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- 16.
Glassblower's cataract is also known as a pseudo-exfoliation cataract
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Glassblower's: TRUE exfoliation cataract (capsule splits/chips off and flakes stick to lens)
Glaucoma: psuedo-exfoliation cataractRate this question:
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- 17.
Wilson's Disease involves copper accumulation from poor metabolism and is associated with a Keiser-Fleisher Ring
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
--> Sunflower cataractRate this question:
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- 18.
Drugs such as phenothiazines and miotics can cause what type of secondary cataract?
- A.
Polychromatic
- B.
Hypermature
- C.
Anterior Subcapsular
- D.
Mature
Correct Answer
C. Anterior SubcapsularExplanation
Other causes of anterior subcapsular cataract: chronic iritis, traumaRate this question:
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- 19.
Posterior subcapsular is rarely visually devastating.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Posterior & Anterior Subcapsular cataracts are commonly associated with being VISUALLY DEVASTATING.Rate this question:
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- 20.
A 'rosette (star of david) or vossius ring is associted with which type of cataract?
- A.
NSC
- B.
Cortical
- C.
Traumatic
- D.
Morganian
Correct Answer
C. TraumaticExplanation
Vossius Ring: pigment ring on anterior capsule from irisRate this question:
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- 21.
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
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Mature: complete opacification of lens capsule, cortex and nucleus
Hypermature: liquefaction of lens contents and wrinkling of capsuleRate this question:
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- 22.
If you see nuclear contents that have sunken inferiorly, what type of cataract would you consider?
- A.
Diabetic
- B.
Hypermature
- C.
Morganian
- D.
Total Congenital
Correct Answer
C. MorganianExplanation
Nuclear contents can break through capsule in Morganian cataract.Rate this question:
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- 23.
What is the VA limit for Medicare to cover cataract extraction?
- A.
20/30
- B.
20/40
- C.
20/50
- D.
20/60
Correct Answer
C. 20/50Explanation
Or significant impairment with glare...most other insurance policies will cover once 20/40Rate this question:
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- 24.
Phacolytic glaucoma and lens particle glaucoma are very similar in that they both involve lens proteins that go into the AC and clog the TM. Describe the 2 main differences between these two.
- 25.
Inflammation due to lens proteins can clog up the TM and is associated with what tyepe of lens-associated glaucoma condtiion?
- A.
Lens particle
- B.
Closed angle (phacomorphic)
- C.
Phacoanaphylaxis
Correct Answer
C. PhacoanaphylaxisExplanation
Inflammation due to lens proteins can lead to the blockage of the trabecular meshwork (TM), which is responsible for draining the fluid from the eye. This blockage can result in increased intraocular pressure, leading to a type of lens-associated glaucoma called phacoanaphylaxis.Rate this question:
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- 26.
A phacomorphic lens can cause narrow angle glaucoma because with age the lens grows and can close off the angle.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
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.Rate this question:
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- 27.
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.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Diabetic lens is MORE DIFFICULT to break upRate this question:
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- 28.
Cataract surgery can proceed even if there is an active uveitis as long as necessary precaustions (antibiotics etc) are administered.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
The surgery itself will cause inflammation and therefore a uveitis must be treated 3-6 mo prior to sxRate this question:
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- 29.
What aspect of the cataract surgery is particularly important for a pt with COPD & Parkinson's?
- A.
Wide dilation
- B.
Antibiotics
- C.
Anesthesia
- D.
Steroids
Correct Answer
C. AnesthesiaExplanation
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.Rate this question:
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- 30.
If a patient is on Warfarin, what test must be taken before cataract sx?
Correct Answer
INRExplanation
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 hemorrhageRate this question:
- 31.
When would a B-Scan be important for pre-cataract sx testing?
- 32.
When performing the Maddox Rod test, if the patient cannot see the line then that indicates poor macular function
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
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)Rate this question:
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- 33.
Absence of scleral spikes during A Scan indicates that the probe is oriented toward the ONH
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
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.Rate this question:
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- 34.
The anterior lens spike is slighly shorter than the posterior lens spike
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
anterior lens spike > posterior lens spikeRate this question:
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- 35.
Retinal spike sloping during A Scan will result in what? Choose all that apply.
- A.
Falsely long axial length
- B.
Falsely short axial length
- C.
Weaker IOL
- D.
Stronger IOL
- E.
- SRx needed
- F.
+ SRx needed
Correct Answer(s)
A. Falsely long axial length
C. Weaker IOL
F. + SRx neededExplanation
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 neededRate this question:
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- 36.
The average AC depth is 3.24 mm. 0.1 mm error in measurement is equal to what dioptric error?
Correct Answer(s)
0.25 DExplanation
1 mm error = 0.25 DRate this question:
- 37.
Indicate when an A Scan should be retaken.
- A.
Axial length less than 22 mm
- B.
Axial length greater than 23 mm
- C.
Axial length greater than 25 mm
- D.
Axial length difference of 0.4mm
Correct Answer(s)
A. Axial length less than 22 mm
C. Axial length greater than 25 mm
D. Axial length difference of 0.4mmExplanation
Retake: < 22 mm, >25 mm, difference btw eyes > 0.3 mm, pt uncooperativeRate this question:
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- 38.
Cataract sx can result in _____% loss of endothelial cells.
- A.
15%
- B.
25%
- C.
40%
- D.
60%
Correct Answer
D. 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.Rate this question:
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- 39.
Which of the following endothelial cell counts should you NOT recommend for cataract sx?
- A.
< 800 cells/mm2
- B.
< 1200 cells/mm2
- C.
< 1500 cells/mm2
Correct Answer
A. < 800 cells/mm2Explanation
< 800 = poor candidate
1200-1400 = OK candiate (minimally acceptable range for sx)Rate this question:
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- 40.
RAM is the most commonly used potential acuity meter in the ECC.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
97% accurateRate this question:
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- 41.
The endpoint or Interferometry is when the pt can only read 1 out of 4 presentations.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
endpoint = 2/4 presentationsRate this question:
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- 42.
Interferometry has a more optimistitic prediction than PAM
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Interferometry: UNDERPREDICTS VA w/ dense cataracts & OVERPREDICTS VA w/ macular issuesRate this question:
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- 43.
Indicate all of testing set-ups for interferometry.
- A.
Undilated
- B.
Moderate room illumination
- C.
8 deg field
- D.
Moderate setting
- E.
Dim room illumination
- F.
Dilated
- G.
18 deg field
- H.
High setting
- I.
Start at 20/60
- J.
Start at 20/80
- K.
Start with worse eye
Correct Answer(s)
B. Moderate room illumination
C. 8 deg field
F. Dilated
H. High setting
J. Start at 20/80Explanation
start with better eyeRate this question:
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- 44.
How would you interpret the results of a glare test if the VA improves?
- A.
No significant glare problem
- B.
Glare is a problem
- C.
Pinhole effect
- D.
Results cannot be determined
Correct Answer
C. Pinhole effectExplanation
VA same = no significant glare problem
VA reduced = glare is a problem
VA improves = pinhole effect --> recheck RxRate this question:
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- 45.
Glare testing is typically done with the patient dilated.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
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.Rate this question:
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- 46.
Topical NSAIDs are used pre-sx to maintain mydriasis and prevent post-op CME. Choose the appropriate regimen.
- A.
1 gtt Acular q 30min, 2 hr before surgery
- B.
2 gtt Acular q 1 hr, 3 hr before surgery
- C.
1 gtt Acular q 30 min, 2 days before surgery
- D.
2 gtt Acular q 2 hr, 1 day before surgery
Correct Answer
A. 1 gtt Acular q 30min, 2 hr before surgeryExplanation
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.Rate this question:
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- 47.
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.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
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.Rate this question:
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- 48.
Which anesthesia has the best pain control?
- A.
Local
- B.
Peribulbar
- C.
Retrobulbar
- D.
Intracameral
- E.
More than one of the above
Correct Answer
E. More than one of the aboveExplanation
Pain Control:
retrobulbar = peribulbar > local > topicalRate this question:
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- 49.
Peribulbar block is riskier than than retrobulbar block
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
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 nerveRate this question:
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- 50.
The most common anesthsia for sx used is topical.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Most common = LOCAL
However, topical is recently popular bc it reduces risk of complications, however pain control is not as good.Rate this question:
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Current Version
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Mar 20, 2023Quiz Edited by
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May 03, 2012Quiz Created by
Tseemore
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