Board Certified Ophthalmologist Board Certified Ophthalmologist Cornea and External Disease Questions and Answers 2

Question 1

A patient presents with a unilateral, chronic, red eye with a strawberry-like papillary reaction on the upper tarsal conjunctiva. What is the most likely diagnosis?

Accepted Answer

Giant papillary conjunctivitis

Answer

Giant papillary conjunctivitis is characterized by large cobblestone-like papillae on the upper tarsal conjunctiva, commonly associated with contact lens wear or ocular prostheses.

Question 2

Which layer of the cornea is most responsible for maintaining corneal transparency through its deturgescence function?

Accepted Answer

Endothelium

Answer

The corneal endothelium maintains stromal deturgescence through active Na+/K+-ATPase pump function, which is critical for corneal transparency.

Question 3

A 65-year-old patient develops a peripheral corneal ulcer with an overlying epithelial defect adjacent to an area of limbal injection. Workup reveals elevated ESR and positive c-ANCA. What is the most likely systemic association?

Accepted Answer

Granulomatosis with polyangiitis

Answer

Peripheral ulcerative keratitis with positive c-ANCA is most strongly associated with granulomatosis with polyangiitis (formerly Wegener's granulomatosis).

Question 4

What is the most common causative organism of crystalline keratopathy?

Accepted Answer

Streptococcus viridans

Answer

Streptococcus viridans is the most common organism causing infectious crystalline keratopathy, typically occurring in immunosuppressed corneas such as post-graft patients on chronic steroids.

Question 5

During pterygium surgery, which antimetabolite is most commonly used as an adjunct to reduce recurrence?

Accepted Answer

Mitomycin C

Answer

Mitomycin C is the most widely used adjunctive antimetabolite in pterygium surgery, applied intraoperatively to inhibit fibroblast proliferation and reduce recurrence.

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Board Certified Ophthalmologist Board Certified Ophthalmologist Cornea and External Disease Questions and Answers 2