1. The tissue below is taken from a patient who had had a corneal graft. The following are 
    true about this condition:
 

a. the tissue has been stained with PAS
b. the picture above shows multiple abnormal endothelial cells
c. the patient is more likely to be a female than male
d. vision is typically worse towards the end of the day
e. the condition is painless

Answer
a.T    b.F   c.T    d.F    e.F
The tissue is taken from a patient with Fuch's endothelial dystrophy.
The picture shows thickened Descemet's membrane and guttata.
Although the condition has a autosomal dominant tendency, it is commoner in females than males.
Vision is typically worse in the morning.
Pain is common when the condition progresses due to the formation of bullae which burst.

2. True statements about ferritin lines include:
 

 
a. ferritin line around keratoconus (A) is called the Fleischer's ring
b. ferritin line at the edge of a trabeculectomy bleb (B) is called the Stocker's line
c. ferritin line seen in the elderly cornea (C) is called the Henle's line
d. ferritin line at the edge of pterygium (D) is called the Ferry's line
e. ferritin lines result from iron deposition from the tear

Answer
a.T    b.F     c.F   d.F    e.T
B is Ferry's line.
C is Hudson-Stahli line
D is Stocker's line

3. True statements about this corneal condition include:
 

Slit-lamp appearance

Histology

a. it is an autosomal dominant condition
b. the corneal appearance usually appears in the third decade of  life
c. ferritin lines are commonly seen on the epithelium
d. the corneal abnormality involves the Bowman's membrane
e. irregular astigmatism is a common cause of poor vision

Answer
a.T    b.F    c.T    d.T    e.T
The condition is Reis-Buckler's dystrophy.
The epithelium is irregular with opacities in the Bowman's membrane.
There are fragmentations of the collagen fibrils in the Bowman's membrane with secondary epithelium changes.
The corneal appearance usually appears in the first or second decade of  life.
Recurrent corneal erosion is common.
The irregular epithelium causes formation of ferritin lines and is a common cause of poor vision due to irregular epithelium.

4. Anterior segment signs associated with the appearance of these hands include:
 

a. b. c.

d. e.

Answer
a.T    b.T    c.T    d.F    e.F
The hands shows synovial swellings of the metacarpodigital and proximal digital joints typical of rheumatoid arthritis.
Rheumatoid arthritis is associated with peripheral melt (a), episcleritis (b) and filamentary keratitis (c) due to dry eyes.
Iritis (d) is not a feature. (e) is Munson's sign in a patient with conical cornea and corneal opacity (seen in keratoconus).

5. This is the corneal appearance of a patient with poor vision. The eye is white.
 

a. the patient is more likely to be a male than female
b. the poor vision is due to corneal astigmatism
c. lipid deposit in the cornea is a common feature 
d. fluorescence staining shows epithelial defect in the periphery
e. descemetocele does not develop

Answer
a.T   b.T   c.T   d.F   e.F
Terrien's marginal degeneration is commoner in male than female.
The condition causes against the rule astigmatism because it usually begins superiorly.
Lipid deposit is common seen.
Despite the thinning the epithelium remains intact and does not stain with fluorescence.
In advanced cases, descemetocele and perforation can occur though rare.