FREE Board Certified Ophthalmologist Cornea and External Disease Questions and Answers Flashcards
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Read the first 6 FREE Board Certified Ophthalmologist Cornea and External Disease Questions and Answers flashcards as text
A 45-year-old contact lens wearer presents with a ring-shaped corneal infiltrate and severe pain. Culture reveals Acanthamoeba. What is the most appropriate initial treatment?
Answer: Polyhexamethylene biguanide (PHMB) with propamidine
Acanthamoeba keratitis is treated with dual therapy using a biguanide (PHMB or chlorhexidine) combined with a diamidine (propamidine) to target both trophozoites and cysts.
Which layer of the cornea is most affected in Fuchs endothelial corneal dystrophy?
Answer: Descemet membrane and endothelium
Fuchs dystrophy is characterized by progressive loss of endothelial cells and thickening of Descemet membrane with guttae formation.
A patient with recurrent corneal erosion syndrome has failed conservative management with lubricants and bandage contact lenses. What is the next appropriate intervention?
Answer: Anterior stromal micropuncture or epithelial debridement with diamond burr polishing
Anterior stromal micropuncture or diamond burr polishing promotes stronger epithelial adhesion by disrupting the abnormal basement membrane.
What is the hallmark finding on slit-lamp examination in lattice corneal dystrophy type I?
Answer: Refractile branching lines in the anterior stroma
Lattice dystrophy type I (TGFBI mutation) is characterized by refractile branching amyloid deposits in the anterior and mid-stroma.
A 60-year-old presents with a chronic, non-healing corneal ulcer with a gray-white feathery border and satellite lesions. What is the most likely causative organism?
Answer: Fusarium or Aspergillus species
Feathery borders with satellite lesions are classic features of fungal keratitis, most commonly caused by filamentous fungi such as Fusarium or Aspergillus.
Which surgical procedure selectively replaces the posterior corneal layers while preserving the patient's anterior stroma?
Answer: Descemet membrane endothelial keratoplasty (DMEK)
DMEK transplants only the donor Descemet membrane and endothelium, providing faster visual recovery and lower rejection rates than full-thickness grafts.