1. Sara A Mahony, MD, PharmD Assistant Professor Department of Ophthalmology & Visual Sciences

7.  Traumatic  Shield ulcer (VKC)  Herpetic ulcer  Neurotrophic Keratopathy

8. Pseudophakic Bullous Keratopathy Fuch’s Corneal Dystrophy Endothelial Failure from uveitis Hydrops Angle Closure

9. Degenerations

16. Visual acuity  with and without pinhole  Quantification – 20/30+ 2, 20/40 -2, CF at how many feet? HM with or without direction at how many feet. Always pinhole even if patient is CF.  History of trauma – dropped intraocular lens, dehiscence of natural lens with high plus prescription (pinhole will clue you) Workup  Autorefract, Topography, Refraction  Pachymetry – corneal edema, fuchs, pseudophakic or aphakic bullous keratopathy  Large K ulcer – be prepared for md to request b scan to rule out endophthalmitis  if patient is dry, place artificial tears during topography, refraction, and autorefraction, ask patient to blink blink blink  Slit lamp photo (when requested)

17.  Red or painful and watery eye or blurry vision with acute presentation  ?HSV ?HZV  Chemical burns, thermal injuries  History of HSV or HZV or brain tumor or facial trauma (?trigeminal nerve involvment – schwannoma, acoustic neuroma, memingioma, aneurysms, radiation therapy to route of CN5))  History of neurotrophic keratopathy in chart, multiple sclerosis  Zebras: Congenital -Ridley-Day syndrome, anhidrotic ectodermal dysplasia, Moebius syndrome, Goldenhar syndrome, and congenital corneal anaesthesia  Medications causing K anesthesia: timolol, betaxolol, trifluridine, s Sulfacetamide, diclofenac, antipsychotics, antihistamines  Always check for apd as cn5 anesthesia + apd may suggest intraconal nerve injury ? Tumor  Cornea ulcers, Epithelial Defects

18.  As previously mentioned with regards to proparacaine use  Post op day 1 DSAEK, no pressure should be placed on globe, do not touch the eye or eyelid, only visual acuity check (not an issue with PKP)

19.  Corneal edema  Goldmann is not as accurate as tonopen  Corneal hysteresis altered, distorted meyers  Tonopen contacts one spot  Underestimate iop  Corneal calcification (band keratopathy)  Falsely elevated iop  In general goldmann is more accurate than tonopen, except in above case

20.  Swab and cultures brought to room prior to physician arrival. Technician available to assist with eyelid holding, labeling, and transport of samples

21.  Rooms stocked with fluoroscein and rose bengal strips for vital staining  Rooms stocked with jewelers, bandage contact lens, punctal plugs, 30 gauge needle  Appropriate Culture media