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

Question 1

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?

Accepted Answer

Polyhexamethylene biguanide (PHMB) with propamidine

Answer

Topical fluoroquinolone monotherapy

Answer

Oral acyclovir

Answer

Topical natamycin alone

Question 2

Which layer of the cornea is most affected in Fuchs endothelial corneal dystrophy?

Accepted Answer

Descemet membrane and endothelium

Answer

Bowman layer

Answer

Epithelial basement membrane

Answer

Stroma

Question 3

A patient with recurrent corneal erosion syndrome has failed conservative management with lubricants and bandage contact lenses. What is the next appropriate intervention?

Accepted Answer

Anterior stromal micropuncture or epithelial debridement with diamond burr polishing

Answer

Penetrating keratoplasty

Answer

Amniotic membrane transplantation

Answer

Topical cyclosporine alone

Question 4

What is the hallmark finding on slit-lamp examination in lattice corneal dystrophy type I?

Accepted Answer

Refractile branching lines in the anterior stroma

Answer

Central geographic iron deposits

Answer

Dense white granular deposits in Bowman layer

Answer

Diffuse posterior stromal haze

Question 5

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?

Accepted Answer

Fusarium or Aspergillus species

Answer

Staphylococcus aureus

Answer

Pseudomonas aeruginosa

Answer

Herpes simplex virus

Question 6

Which surgical procedure selectively replaces the posterior corneal layers while preserving the patient's anterior stroma?

Accepted Answer

Descemet membrane endothelial keratoplasty (DMEK)

Answer

Penetrating keratoplasty (PKP)

Answer

Deep anterior lamellar keratoplasty (DALK)

Answer

Phototherapeutic keratectomy (PTK)

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?

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?