1. The following are true with regard to this condition: 
 

a. this is an example of hamartoma 
b. astigmatism is a common cause of poor vision in this condition 
c. there may be problem with abduction 
d. deafness is a recognized association 
e. histology shows mainly adipose tissue only 

Answera.F     b.T     c.T     d.F     e.FDermoid lipoma is a choriostoma (tumourous malformationthat is composed of tissues not normally present at the involved site).Distortion of the cornea often causes some degrees ofastigmatism which can result in poor vision if severe.It is associated with Goldenharg's syndrome with auricularanomaly (but the hearing is normal),  Duane's syndrome anduveal melanoma.Histologically, it is composed of dense collagenous tissue in which pilosebaceous units, sweat glands, and fat can be identified.

2. True statements about the following corneal condition include: 
 

a. it occurs at the junction between the Descemet's membrane and the endothelium 
b. it has an autosomal dominant inheritance 
c. glaucoma occurs in 90% of cases 
d. it is a feature in Chandler's syndrome 
e. it occurs in Peter's anomaly 

Answera.F     b.T     c.F     d.F     e.TIt is the centrally displaced anterior border ring of Schwalbe (a circumferential collagenous band at the junction of Descemet's membrane and the trabecular meshwork).The condition has an autosomal dominant trait. On its own,this condition is not associated with glaucoma.It is associated with anterior segment dysgenesis(Axenfeld-Reiger's anomaly and Peter's anomaly) butnot the ICE syndrome.

3. This patient has this corneal conditions in both eyes. The following are true: 
 

a. the lesions first appears in the deep corneal stroma 
b. corneal graft is usually needed by the age of 30 
c. the chance of the offsprings with this condition is 50% 
d. enlarged corneal nerves are commonly seen 
e. the following cornea specimen is taken from a patient with similar condition 
 

Answera.F     b.F     c.T     d.F     e.FThe cornea shows a patient with granular dystrophy. It usually appears in superficial stroma and involves the posterior stroma as it  progresses.The condition is an autosomal dominant condition.Visual acuity is usually good and corneal graft is seldom needed.The cornea specimen is taken from a patient with lattice dystrophy which has  stained with Congo red.

4. Association with the following appearance include: 
 

a. past history of breast carcinoma 
b. high serum creatinine 
c. history of osteoarthritis 
d. history of schizophrenia 
e. history of coronary artery bypass 

Answera. F     b.T     c.T     d.T     e.TVortex keratopathy is associated with:breast carcinoma (long-term use of tamoxifen)Fabry's disease (in which renal failure can leadto high serum creatinine)osteoarthritis (use of brufan)schizophrenia (use of chlopromazine)heart diseases (use of amiodarone for ventriculararrhythmia)

5. True statements about this corneal specimen include: 
 

a. the specimen is stained with alcian blue 
b. the peripheral cornea is typically involved 
c. the condition is inherited in an autosomal dominant fashion 
d. recurrent erosion may be a presenting symptom 
e. it may be seen in the corneal button of this patient (picture below) who has 
    had a corneal graft

Answera.T     b.T     c.F     d.T     e.TThe specimen shows macular dystrophy which hasbeen stained with alcian blue. It is an autosomal recessive conditionRecurrent erosion is a common presenting featureThe cornea graft shows macular dystrophy in therecipient cornea as diffused cornea opacity.
 

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