A. Wavefront provides less low level aberrations thus allowing the patient to achieve 20/20 without spectacle correction

C. Corneal stroma thinning is affected in both Keratoconus and PMN. Note on the topography the red indicated corneal steeping and blue is corneal flattening.

B,E,G. Ferry’s line is corneal epithelial iron deposits, Stocker’s line is caused by pterygium, Kayser- fleischer ring is caused by wilson’s disease

C. Megalocornea is determined by corneal diameter of greater than 10mm, abnormal axial length, and can lead to congenital glaucoma.

D. 67 degree mirror. The more angled the mirror the more anterior the structure you will see. Trapezoid or 73 degree mirror is used to see the equator of the eye.

D. Near visual acuity. Standard of care for glaucoma testing is goldmann tonometry for IOP, Humphrey visual field for any nerve damage analysis, Pachymetry in order to accurately adjust the IOP readings, Gonioscopy for determining if its closed angle or open angle glaucoma.

C. High IOP and thicker cornea. A thicker cornea will cause a falsely low IOP reading. A thinner cornea will cause a falsely high IOP. The higher the IOP is past 21mmHg the higher the likelihood the patient will have glaucoma.

A. Horner’s syndrome. Patients pupils will have anisocoria with the ptotic eye having the smaller pupil. The anisocoria is more prominent in the dark, indicating pathology of the pupillary dilator. The smaller pupil takes a longer time to dilate when a bright source of light is moved away from the eye. This phenomenon is called dilation lag

C. III. Grade 1: Mild, generalized constriction of retinal arterioles. Grade 2: Definite focal narrowing of retinal arterioles + AV nicking. Grade 3: Grade 2 + flame-shaped hemorrhages + cotton-wool spots + hard exudates. Grade 4: Severe Grade 3 retinopathy + papilledema or retinal edema.

B. Glutamate cytotoxicity. Glaucoma is a disease of pressure irregulation leading to retinal necrosis. Glutamate is the eye’s excitatory neurotransmitter. As pressure on these nerves increases it will tend to over compensate for the lack of the signal transduction that occurs. Thus excess release of glutamate is a secondary issue that can cause damage to the nerves causing a glaucoma like damage.

A. Trachoma is a disease of the eye caused by infection with the bacterium Chlamydia trachomatis.

D. Autosomal dominant skin condition. Corneal verticillata can be caused by chloroquine, hydroxychloroquine, amiodarone ( RA drug), Indomethacin, Tamoxifen, Rho kinase inhibitors, and fabry’s disease.

D. Anterior capsular stars have no association with krukenberg spindles. Lens cataracts can push on the iris and can be a secondary cause of krukenberg spindles. The most common cause is lens zonules rubbing against the back of the iris releasing pigment causing those spindles to form.

C. length of vitreous. Megalocornea is a rare developmental defect characterized by nonprogressive, usually symmetric, bilateral enlargement of the diameter of the cornea ≥13 mm. Buphthalmos is used to describe the visible enlargement of the eyeball detected at birth or soon after, due to any uncontrolled glaucoma in early childhood.

C. Nebular corneal opacity is a faint opacity which results due to superficial scars involving Bowman’s layer and superficial stroma.

A. Dry eye disease is directly linked to the lack of aqueous produced by the tear glands.

A. Acids = Coagulation/denaturation/precipitation of proteins. Alkali = Saponification of fatty acids within cell membranes

A,B. nanophthalmos is caused by fetal alcohol syndrome, mucopolysaccharidosis, myotonic dystrophy, achondroplasia

A. Pupillary capture. YAG capsulotomy is the procedure of removing the capsular bag that is posterior to the IOL. Pupillary capture is an unusual complication of posterior chamber intraocular lens implantation and may occur in the early or late postoperative period

A. Type 1. Human scleral tissue contains approximately 50% collagen by weight, consisting predominantly of type I collagen. There is little or no evidence for the presence of substantial quantities of type II, type III or other collagen types.

D. The question is asking what is an infectious cause of episcleritis. Anything granulomatosis automatically means infectious with the exception of sarcoidosis.

C. Scleromalacia perforans is a rare, severe eye disorder developing an autoimmune damage of episcleral and scleral performing vessels.

D. Rapid neovascularization is present. Staphyloma of sclera present with no neovascularization. The sclera is avascular.

A. Hyaline degeneration occurs when smooth muscle is replaced by fibrous connective tissue and is the most common form of degeneration in leiomyomas. Patients do not present with uveitis, glaucoma, and keratitis when hyaline degeneration occurs.

B. Ciliary muscle when stimulated will pull on the scleral spur thus opening the Uveal scleral outflow pathway

D. Scleral injury cause a decrease in IOP not an increase in IOP

E. Aniridia is a loss or lack of iris. Synechia will only present when an iris is present.

D. 40. The eye total has 60 Diopters of power. Cornea contributes 40D, and the lens contributes 20D.

C. Excimer laser is used to reshape the cornea thus resulting in correction of refractive error. Femtosecond laser is used to create the flap in LASIK

B. Purkinje image 1 is a direct result of reflection from the anterior corneal surface. When we do keratometry we are measuring the shape of the anterior cornea to see how to fit a RGP properly on that surface.

B. Ovaries are where female gametes are stored (eggs).

A. ONL. The photoreceptor receives its signal from the RPE so the OS portion of the photoreceptor is like a dendrite and collects the photon. Interpretation occurs where a nucleus is present. ONL is the first layer of nuclear location in the retina.

A. Redness of the conjunctiva is the most commonly reported side effect of netarsudil AKA Rhopressa. This is due to the fact that there are rho kinase receptors found on blood vessels. Rhopressa is an inhibitor of rho kinase which causes vasodilation of the blood vessels.

A. Topical ocular hypotensive medications such as latanoprost was affected in delay or prevent POAG individual with elevated IOP by 30% once IOP pressure was between 24 and 32 mm Hg

B. Zyrtec is a second generation antihistamine that has an off label treatment for eyelid myokymia. However there is no understanding to why this works.

B. K is actively outside on the tear film and moves into the stroma to the aqueous humor. As this happens Na passively enters epithelial cells from the tear film

A. Toxoplasmosis is more commonly found systematically than sarcoidosis. All options do cause posterior uveitis. Syphilis rarely causes posterior uveitis.

E. Together, the zygomatic bone makes up the lateral wall of the orbit with the greater wing of the sphenoid bone. Remember SMEL my medial wall → sphenoid, maxillary, ethmoid, lacrimal.

A. The cotton swab test is used to evaluate corneal sensitivity, specifically cranial nerve V1, the nasociliary branch off of the ophthalmic nerve.

B. Blinking occurs from lateral to medial canthus and helps to move tears towards the puncta. The puncta under open conditions collect the tears through capillary attraction method

D. The glands of wolfring are located in the tarsal conjunctiva and are assistant lacrimal glands along with the glands of Kruse that provide aqueous layer to the tear film.

B. parasympathetic nerve endings surround goblet cells and cause increase in mucous secretions

A. Stargardt’s disease is directly caused by a mutation in the ABCA4 membrane protein and is responsible for moving all trans retinal from the photoreceptor to the cytoplasm

B. Pressure inside is set to a infinite thin and covered by thin membrane is equal to the force necessary to flatten the sphere of the corneal shape

C. 15.5 mm Hg is the average IOP found in non glaucoma patients under the age of 50.

C. Posner Schlossman Syndrome, also known as glaucomatocyclitis crisis, presents as an acute unilateral nongranulomatous anterior uveitis due to inflammation in the trabecular meshwork. These episodes are recurring and self-limiting each time and with the slit lamp biomicroscope, the practitioner will be able to see fine keratic precipitates. In addition herpes and Fuch’s Heterochromic Iridocyclitis result in a unilateral chronic non-granulomatous anterior uveitis.

Any type of systemic condition would result in a bilateral uveitis. Keep in mind the ones to cause a chronic granulomatous anterior uveitis include sarcoidosis, tuberculosis, syphilis, lyme disease and herpes amongst others. All five of these conditions may also result in a panuveitis and/or posterior uveitis.