The patient depicted in the photograph below would be best treated with:

Tuesday, September 22, 2009

Acetylcysteine 10% drops
Prednisolone drops
Sodium cromolyn drops
Olopatadine drops

Correct Answer: Acetylcysteine 10% drops

The patient in the photograph has filamentary keratitis. Along with elimination of the underlying condition and removing the filaments with jeweler’s forceps, acetylcysteine 10% drops are beneficial and act as a mucolytic agent to alleviate symptoms.

The photograph below depicts:
1. A punctum occluded by an intracanalicular collagen plug
2. A punctum occluded by a silicone punctal plug
3. A punctum occluded by punctal cautery
4. A punctum occluded by an extruding Jones tube
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A 40 y.o. female pictured below comes to the office with swelling of both upper lids, mild shortness of breath and symptoms of dry eyes. One would expect to see as part of her work up:
1. A monocytic B cell infiltrate of her lacrimal glands
2. Pain on palpation of her lacrimal glands.
3. An elevated ACE.
4. A history of breast cancer.
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The following is true of the photograph below:
1. This particular stain stains only devitalized and dead cells and mucus.
2. This eye has been stained with 2% rose Bengal.
3. This stain pools in epithelial erosions and stains exposed basement membrane.
4. This stain may be a more sensitive indicator of early or mild cases of keratoconjuncitivitis sicca.
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After permanent punctal occlusion with cautery:
1. 5-10% rate of recanalization is expected.
2. 10-20% rate of recanalization is expected.
3. 20-30% rate of recanalization is expected.
4. 30-40% rate of recanalization is expected.
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The most common cause of mucin deficiency is:
1. Vitamin D deficiency
2. Vitamin C deficiency
3. Vitamin K deficiency
4. Vitamin A deficiency
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