Ocular Disease & Pathology Flashcards

In a patient with type 2 diabetes, which finding in the posterior pole requires immediate referral for vitreoretinal evaluation?

Answer: Tractional retinal detachment threatening the macula

Tractional retinal detachment threatening or involving the macula requires urgent vitreoretinal surgical consultation.

Keratoconus most characteristically causes which type of astigmatism?

Answer: Irregular astigmatism

Keratoconus produces irregular corneal ectasia that cannot be corrected with spectacle lenses, requiring rigid contact lenses or surgery.

Which pattern of visual field loss is most consistent with a lesion at the optic chiasm?

Answer: Bitemporal hemianopia

Chiasmal compression (often by a pituitary adenoma) damages crossing nasal fibers, producing bitemporal hemianopia.

A 35-year-old Black American presents with bilateral hilar adenopathy, anterior uveitis with mutton-fat KP, and elevated serum ACE. The most likely diagnosis is:

Answer: Sarcoidosis

Sarcoidosis classically presents with bilateral hilar adenopathy, elevated ACE, and granulomatous anterior uveitis with mutton-fat KP.

Subretinal fluid that shifts with positioning and no retinal break characterizes which type of retinal detachment?

Answer: Exudative (serous)

Exudative retinal detachments have no break; subretinal fluid accumulates from underlying disease and gravitates with patient position.

Which of the following medications is most associated with corneal verticillata (vortex keratopathy)?

Answer: Amiodarone

Amiodarone deposits in the corneal epithelium in a whorl-like pattern (verticillata) in virtually all patients taking therapeutic doses.

Optic nerve drusen (disc drusen) can mimic papilledema but can be differentiated by:

Answer: Autofluorescence on fundus autofluorescence imaging

Disc drusen autofluoresce brightly on fundus autofluorescence (FAF) imaging, distinguishing them from true papilledema.