Cornea/ED/Refractive 3

Which of the ff is associated w/ Mitomycin-C (MMC) use?

• High IOP after trabeculectomy

• Pterygium recurrence

• Haze after photorefractive keratectomy (PRK)

• Infectious sclerokeratitis

Answer explanation

Potential complications of MMC use:

-non-healing ulcers

-scleral melt/necrosis

-infectious sclerokeratitis (because eye is placed in a reduced immune level)

72/M comes in w/ bilateral arcus. You also note that the cornea is mildly thinned in the clear space between the arcus and limbus. VA is 20/20, no change in correction. No inflammation noted. What is the dx?

• Cornea farinata

• Polymorphic degeneration

• Senile furrow degeneration

• Terrien marginal degeneration

Answer explanation

Senile furrow degen - slight thinning of cornea in lucid area between limbus and start of arcus, tx rarely indicated

Terrien marginal degen - 5Ts

1. Thinning of Cornea

2. Top (starts superior)

3. Thirties

4. Transverse pannus

5. Transplant (tx)

Which of the ff is the most common indication for a PKP?

• Pseudophakic bullous keratopathy (PBK)

• Repeat PKP

• Keratoconus

• Fuch’s endothelial dystrophy

Answer explanation

Most common indication for PKP:

1. Keratoconus

2. Regraft

3. Other forms of corneal scarring (HSV scarring etc)

Which of the ff tests measures REFLEX tearing only?

• Basic secretion test

• Schirmer I

• Schirmer II

• Schirmer III

Answer explanation

BST - basic tear prodxn

Schirmer I - basic and reflex

Schirmer II - reflex only

Pls read on how these tests are performed

You are examining a post cataract sx px and note “2+ descemet folds”. What percentage does the corneal thickness have to increase before DM folds are seen on SLE?

• 5%

• 10%

• 30%

• 50%

Answer explanation

Descemet‘s folds occur when the overall corneal thickness increases by at least 10%

Corneal epithelial edema occurs when the overall corneal thickness increases to at least 700 microns