Opthalmology

1. A 22-year-old female presents with an eight weeks history of headaches, which have
deteriorated over the last week. She is aware of a frontal headache, which is constant in
nature and unrelieved by paracetamol. These headaches have tended to be present when
she wakes in the morning and lately have been present all day. Over the last six months
she also explains that she has gained more than 7 kg in weight.

On examination, she is rather tearful, has a BMI of 32 kg/m2 but has no nuchal rigidity
and neurological examination is normal except for bilateral optic disc swelling on fundal
examination. Her blood pressure is noted to be 122/88 mmHg and her temperature is
37oC.

Which of the following is the single best investigation for this patient?

(Please select 1 option)

Lumbar puncture
MRI brain Correct
CT brain
EEG
Fluorescin angiogram

The history suggests BIH. However, brain imaging is needed to exclude a space
occupying lesion, hydrocephalus and cerebral venous thrombosis. MRI brain is better
than CT brain to look for cerebral venous thrombosis where a ‘pyramidal’ defect in
venous flow is noted.

2. The patient, whose fundus is shown, is likely to demonstrate which of the following
physical signs?

click and drag to move the ophthalmoscope

(Please select 1 option)

absent red reflex
 nystagmus Correct
ptosis
rubeosis iridis
xanthelasma

This is an albino fundus - there is no retinal pigmentation and all the blood vessels can be
clearly seen. Nystagmus and photophobia are common findings in albinos.

3. These are ophthalmoscopic appearances of a 62-year-old male who has recently been
diagnosed with diabetes mellitus. He has been referred by his optician after noting the
visual acuity in his left eye is 6/36 and 6/12 in his right. There is no correction with pin
hole. What is the likely cause of his fundal appearance?

(Please select 1 option)

Glaucoma Correct
Hypertensive retinopathy
Macular degeneration
Proliferative diabetic retinopathy
Retinitis pigmentosa

This patient has optic atrophy as revealed by a particularly pale disc. Causes include
Glaucoma, external compression of the optic nerves eg pituitary tumour and Multiple
sclerosis.

4. This 74-year-old man presents with poor vision.

click and drag to move the ophthalmoscope

What is the diagnosis?

(Please select 1 option)

 diabetic retinopathy
glaucoma
hypertensive retinopathy
macular degeneration Correct
pan-retinal photocoagulation

The fundus shows small pale dots over the macular area typical of Drusen. This is
macular degneration and one of the commonest causes of blindness.

5. With what diseases is this appearance associated?

(Please select 3 options)
Acromegaly Correct
Poorly controlled diabetes mellitus
Pseudoxanthoma elasticum Correct
Chronic lymphocytic leukaemia
Hypertriglyceridaemia
Paget's disease of bone Correct
Acquired Immune Deficiency Syndrome
Retinitis pigmentosa
Cytomegalovirus infection
 Closed angle glaucoma

The slide shows angioid streaks, caused by breaks in Bruch's membrane. Angioid streaks
may be associated with pseudoxanthoma elasticum, Ehlers-Danlos syndrome, sickle cell
disease, Acromegaly (and other pituitary disorders), and Paget's disease.

6. These are the ophthalmoscopic appearances of a 74-year-old female who presents with
a long history of deterioration in her vision. Her vision is 6/36 in both eyes and
uncorrected with a pinhole.

What is the most likely diagnosis?

(Please select 1 option)

Glaucoma Correct
Macular degeneration
Optic atrophy
Papilloedema
Retinitis pigmentosa

This fundus shows cupping of the optic disc which is typical of glaucoma. Almost
invariably there is an increase in pressure which is sufficient to cause damage to the optic
nerve head and causes changes in the visual field. The mean value for intraocular
pressure is 15-16 mm Hg with a standard deviation of +/- 2.5. The upper limit of normal
is considered to be 21 mm Hg.

7. A 35 year-old woman with sickle cell disease was admitted to hospital with abdominal
pain. This appearance was noted on fundoscopy.
What is the diagnosis?

(Please select 1 option)

Branch retinal artery occlusion
Angioid streaks Correct
Papilloedema
Central retinal vein occlusion
Lipaemia reinalis

The slide shows angioid streaks, caused by breaks in Bruch's membrane.

8. This 42-year-old lady has a history of repeated bone fractures.

What is the diagnosis?

(Please select 1 option)

Familial hypercholesterolaemia
Gaucher disease Correct
Sarcoidosis
Phenylketonuria
Wilson's disease

The slide shows yellow papules (pingeculae) in the cornea; these are characteristic of
Gaucher disease. Gaucher disease is inherited as an autosomal recessive disease. Disease
is caused by a deficiency of the enzyme glucocerbrosidase, essentail for the metabolism
of glycolipids. There are three types of Gaucher disease:

1. Type 1 (chronic non-neuropathic; adult Gaucher disease)

2. Type 2 (acute neuropathic; infentile Gaucher disease)
3. Type 3 (subacute neuropathic; juvenile Gaucher disease)

Patients with all types of disease have hepatosplenomegaly and large glucocerebroside-
rich cells (Gaucher cells) infiltrating the bone marrow. Type 2 (infentile Gaucher disease)
carries the worst prognosis, with children seldom surviving beyond 2 years. Type 1
disease is the commonest, usually presenting in childhood with hepatosplenomegaly, but
not uncommonly in middle- or old-age. Bone marrow replacement and hypersplenism
result in anaemia and thrombocytopoenia. Pathological bone fractures and avascular
necrosis of the femoral heads are not uncommon. Bony disease may be confined to the
distal ends of the femurs, with formation of characteristic 'Erlenmeyer flask' shaped cysts.
The skin may show a grey-brown discolouration, especially around the forehead, hands
and pre-tibial regions. Characteristic yellow or yellow-brown papules (pingeculae)
develop at the sclerocorneal junctions.
9. A 76-year-old male presents with visual loss. Examination reveals a blood pressure of
168/102 mmHg and fundoscopy shows an embolus to right superior temporal branch of
the retinal artery. Carotid dopplers are arranged and these show normal left sided
carotids, but 90% Right External Carotid Artery stenosis with approximately 50% Right
Internal Carotid Artery stenosis. What would be the most appropriate treatment?

(Please select 1 option)

Aspirin Correct
Dipyridamole
Right External Carotid Artery endarterectomy
Right Internal Carotid Artery endarterectomy
Warfarin

Endarterectomy is only beneficial if internal carotid artery stenosis is greater than 70%. If
less than that aspirin and control of vascular risk factors is the treatment of choice. In this
case hypertensive control is advised.

10. A 24-year-old female presents with an eight weeks history of headaches, which have
deteriorated over the last week. She is aware of a frontal headache, which is constant in
nature and unrelieved by paracetamol. These headaches have tended to be present when
she wakes in the morning and lately have been present all day. Over the last six months
she also explains that she has gained more than 7 kg in weight.

On examination, she is rather tearful, has a BMI of 32 kg/m2 but has no nuchal rigidity
and neurological examination is normal except for bilateral optic disc swelling on fundal
examination. Her blood pressure is noted to be 122/88 mmHg and her temperature is
37oC. An MRI scan of her brain is normal and LP reveals an opening pressure of 30 cm
H2O but normal CSF analysis.

What treatment would you offer this patient if her vision were threatened?

(Please select 1 option)

IV dexamethasone
Acetazolamide
Lumbo-peritoneal shunt Correct
 IV mannitol
Furosemide

Visual loss is the single threatening complication of BIH. Urgent LP shunt is the
treatment of choice Optic nerve fenestration is an alternative. There are no comparative
studies between the two interventions.

11. A 64-year-old lady presented to the Accident and Emergency Unit with orbital pain
and swelling (shown below). She had been under review in the endocrinology clinic and
had been started on some new treatment four weeks previously.

Thyroid function four weeks ago showed:

T4 99 µg/dL (5-12)
TSH <0.04 mU/L (0.4-6.0)

Thyroid function in A&E shows:

T4 2 µg/dL (5-12)
TSH 28 mU/L (0.4-6.0)
What treatment has she received?

(Please select 1 option)

Carbimazole
Prednisolone
Propranolol
Propylthiouracil
Radioiodine Correct

The slide shows malignant exophthalmos: malignant refers to the rapidity of onset and
threat to eyesight rather than association with malignancy. Radioiodine therapy can
worsen thyroid-associated ophthalmopathy patients with thyroid eye disease are generally
treated with steroids for 1-2 weeks prior to starting radioiodine therapy. Treatment for
malignant exophthalmos is rapid administration of steroids. Where sight is threatened,
orbital decompression may be necessary.
12. A 35 year-old man with HIV disease presents with sudden loss of vision in his right
eye. He is not curently taking antiretroviral therapy. A recent CD4 count was measured at
20 cells/mm3.

What is the most appropriate therapy to initiate?

(Please select 1 option)

High-dose intravenous aciclovir
Intravenous ganciclovir Correct
Zidovudine + lamivudine + nevirapine
Sulfadiazine + pyrimethamine
Amphotericin B + flucytosine

The slide shows the typical 'cottage cheese and tomato ketchup' or 'pizza' appearance of
CMV retinitis in a patient with HIV disease. Intravenous ganciclovir is currently the
treatment of choice. Available forms of ganciclovir include intravenous and oral
preparations as well as an ocular implant. The principal disadvantages of the latter two
are: the poor bioavailability of the oral preparation; the implant is effective at clearing
ocular disease, but CMV is disseminated at this stage of AIDS and the implant does not
address systemic infection. Pyrimethamine + sulfadiazine are used to treat toxoplams
retinitis; zidovudine + lamivudine + nelfinavir constitutes highly active antiretrovral
('combination') therapy (HAART) for HIV disease. Initiation of HAART has been shown
to worsen active CMV eye disease and should be witheld until CMV is in remission.

13. A 62-year-old woman presented acutely to Casualty Department with sudden visual
loss of the right eye. She had been reading at the time and suddenly noticed that she could
not see the print. She denied any headache preceding the symptoms and had not noticed
any weakness in her arms or legs. She had a past medical history of hypertension and
took regular atenolol. She was a smoker of 20 cigarettes per day and did not drink any
alcohol.

On examination she was anxious and distressed. Her blood pressure was 145/85 mmHg,
pulse was 89/min and irregular and temperature was 36.7oC. On auscultation of the heart
there was a mitral regurgitation murmur. On examination of the eyes the pupils were
equal and reactive to light and ocular movements were full. Visual field analysis revealed
a defect in the right inferior nasal field. The rest of the cranial nerves appeared normal
and no abnormalities could be found in the peripheral nervous system. She had bilateral
non-tender pulsatile temporal arteries.

Investigations revealed:

Haemoglobin 12.3 g/dl (13.0 – 18.0 g/dL)

White cell count 7.8 x 109/L (4 – 11 x 109/L)
Platelets 345 x 109/L (150 – 400 x 109/L)
ESR (Westergren) 30 mm/1st hour (0 – 30 mm/1st hour)
Serum sodium 134 mmol/L (137 – 144 mmol/L)
Serum potassium 4.6 mmol/L (3.5 – 4.9 mmol/L)
Serum urea 6.7 mmol/L (2.5 – 7.5 mmol/L)
Serum creatinine 120 umol/L ( 60 – 110 umol/L)
Serum C-reactive protein 9 IU/L (<5 IU/L)
Serum cholesterol 8.6 mmol/L (< 5.2 mmol/L)

The electrocardiogram showed atrial fibrillation with a ventricular rate of 88 beats per
minute.

The appearance of the retina on fundoscopy is shown below:

What is the most likely diagnosis in this patient?

(Please select 1 option)

Cholesterol embolus of the retinal artery Correct
Factitious disorder
Infective endocarditis
Parietal lobe infarct
Temporal arteritis

This patient presents with a monocular visual disturbance. This places the lesion from the
retina to the optic tract. She has a very specific visual disturbance affecting the inferior
nasal portion of the right visual field. Fundoscopy shows an embolus to the right superior
temporal branch of the retinal artery, which would explain the clinical findings. Temporal
arteritis presents with a history of a curtain descending over the eye and, given a normal
ESR and non-tender arteries, this diagnosis is unlikely. Infective endocarditis is unlikely
given normal inflammatory markers and haematology.

14. A 60-year-old man was seen in Casualty Department having developed transient
painless loss of vision in the right eye lasting several minutes. The loss of vision had been
sudden in onset and appeared to descend affecting the entire field of vision. He had no
associated symptoms of headache or any weakness of the face or limbs. He had had an
episode 2 months ago of left facial weakness, which had lasted approximately 20
minutes. He had a history of migraines and had also recently attended his GP with
worsening dyspnoea and occasional palpitations. He took Pizotifen and Imigran as
required. He was a non smoker and did not drink any alcohol.

On examination there were some purpuric skin lesions over the arms and his face
appeared flushed. His blood pressure was 138/76 mmHg, pulse was 88 beats per minute
and irregular and temperature was 36.7oC. Auscultation of the heart revealed a mid-
diastolic murmur heard at the left sternal edge and there were bilateral basal crackles
heard in the chest. There were no carotid bruits. Fundoscopy did not reveal any
abnormalities, pupils were intact and peripheral nervous system examination did not
reveal any abnormalities.

Investigations revealed:

Haemoglobin 13.4 g/dL (13.0-18.0 g/dL)

White cell count 8.0 x109/L (4-11 x109/L)
Platelets 285 x109/L (150-400 x109/L)
ESR (Westergren) 5 mm/1st hour (0-15 mm/1st hour)
Serum sodium 136 mmol/L (137-144 mmol/L)
Serum potassium 3.8 mmol/L (3.5-4.9 mmol/L)
Serum urea 4.5 mmol/L (2.5-7.5 mmol/L)
Serum creatinine 88 µmol/L (60-110)
Serum C-reactive protein 4 U/L (<5 U/L)
Fasting plasma glucose 5.7 mmol/L (3-6 mmol/L)
Serum cholesterol 4.7 mmol/L (< 5.2 mmol/L)

A lumbar puncture was performed and yielded the following data:

Opening pressure 14 cmH2O (6-18 cm H2O)

CSF protein 0.35 g/L (0.15-0.45 g/L)
CSF white cell count 4 cells per mL (<5 per mL)
CSF red cell count 1 cell per mL (<5 per mL)

What is the most likely diagnosis?

(Please select 1 option)

Cardiac embolus Correct

Carotid artery embolus
Cerebral vasculitis
Complex migraine
Temporal arteritis

The patient is describing amaurosis fugax, which is unilateral transient loss of vision that
develops over seconds, remains for maximal for up to 5 minutes and resolves over 10 -
20 minutes. The only feature that differentiates the middle cerebral artery syndrome from
the carotid artery syndrome is amaurosis fugax. The most likely cause in this patient is a
cardiac embolus secondary to mitral stenosis as evidenced by malar flush, purpuric
embolic skin lesions, signs of left heart failure and a mid-diastolic murmur.

Emboli secondary to atheroma is less likely, given the lack of additional risk factors.
There are no features in the history suggestive of temporal arteritis and there was no
history of headache at the onset of symptoms. Cerebral vasculitis can present with a
myriad of symptoms, but is unlikely given the normal inflammatory markers and normal
cerebro-spinal fluid analysis.

15.
What is the diagnosis?

(Please select 1 option)

Anterior uveitis
Dislocation of the lens
Hyphaema Correct
Hypopyon
Malignant melanoma of the iris

The slide shows hyphaema, blood in the anterior chamber. Usually caused by trauma –
often small objects (champagne corks, squash balls) hitting the eye. Aspiration may be
required to prevent loss of vision.

16.
What is the most likely visual field defect?

(Please select 1 option)

Arcuate
Central Correct
Concentric
Lower quadrantic
Temporal

The slide shows the typical appearance of toxocara retinitis with a lesion at the macula. In
retinitis due to Toxocara canis, there is usually only a single, well demarcated lesion.

17. A 44-year-old woman complains of gradual loss of night vision. She has had
increasing difficulty driving in the dark and recently stumbled on steps when leaving a
restaurant. Clinical examination revealed loss of peripheral visual fields. Her fundoscopy
is shown below. What is the diagnosis?

click and drag to move the ophthalmoscope

(Please select 1 option)

Angioid streaks
Branch retinal vein occlusion
Central retinal artery occlusion
Panretinal photocoagulation scarring
Retinitis pigmentosa Correct

Loss of night vision and peripheral vision are classic features of Retinitis Pigmentosa.
The fundi shows the characteristic 'bone spicule' areas of pigmentation in the periphery of
the retina.

18. A 29-year-old man presents with a 6 months history of nasal congestion. He was seen
by an ENT consultant who diagnosed sinusitis. He presents now with a two day history of
right periorbital swelling and diplopia.
Examination reveals him to be unwell, with no neck stiffness or photophobia and his
temperature is 37.4°C. He has marked drooping of the right eyelid with the right eye
congested and deviated right with an enlarged right pupil. Left eye appears normal.
Fundoscopy is normal. There is also loss of sensation of the right forehead.

What is the likely diagnosis?

(Please select 1 option)

Cavernous sinus thrombosis Correct

Epidural abscess
Meningitis
Pituitary adenoma
Tolosa Hunt syndrome

The history is typical for cavernous sinus thrombosis possibly secondary to sinusitis. This
is a life threatening condition. Urgent CT brain and antibiotics are needed.

19. A 35 year-old man with HIV disease presents with sudden loss of vision in his right
eye. He is not curently taking antiretroviral therapy. A recent CD4 count was measured at
20 cells/mm3.

What is the most likely causative agent?

(Please select 1 option)

Cytomegalovirus Correct
Toxocara canis
Toxoplasma gondii
Cryptococcus neoformans
Human immundeficiency virus

The slide shows the typical 'cottage cheese and tomato ketchup' or 'pizza' appearance of
CMV retinitis in a patient with HIV disease.

20. A 23-year-old obese woman presented to Casualty Department with a 4 day history of
progressively worsening generalised headache associated with a buzzing in her ears. In
the last few days she had noticed some blurring of her vision and reduction in her visual
field. She had started to feel nauseated particularly early in the morning and on the
morning of admission had vomited several times. She had a history of severe acne which
was treated with long-term oral doxycycline and smoked 35 cigarettes a day.

On examination she was orientated with a Glasgow coma scale of 15/15. Visual acuity
was recorded as 6/18 in both eyes. There was reduction in temporal visual fields
bilaterally and enlargement of the blind spot bilaterally. The rest of the neurological
examination was entirely normal.

The fundoscopic appearance is shown below:

An MRI scan of the brain was normal.

A lumbar puncture was performed and yielded the following data:

Opening pressure 33 cm H2O (6 – 18 cm H2O)

CSF protein 0.42 g/L (0.15 – 0.45 g/L)
CSF white cell count 2 cells per mL (<5 per mL)
CSF red cell count 2 cells per mL (<5 per mL)
CSF oligoclonal bands Negative

Given the above clinical account, what is the likely cause for this patient’s visual
disturbance?

(Please select 1 option)

Benign intracranial hypertension Correct

Central retinal vein occlusion
Optic nerve meningioma
Optic papillitis
Pseudopapilloedema

The slide shows papilloedema. Management of optic disc oedema begins with a correct
diagnosis. Most importantly, it is crucial to distinguish between papilloedema and the
many other forms of optic disc oedema, including 'masqueraders' such as buried optic
disc drusen. Consider the acuity, visual fields, ophthalmoscopy findings and especially
the laterality of presentation carefully in the initial work-up."

21. A 24-year-old woman presents with an eight weeks history of headaches, which has
deteriorated markedly over the last two days and has resulted in her admission. These
headaches are distressing her have been problematical in the morning but she has found
some relief from paracetamol. However, the headache has deteriorated quite markedly
over the last two days being constant and intolerable. The only other information is that
she has gained 6 kg in weight the last 6 months.

On examination she is noted to be obese with a BMI of 32 kg/m2 and a blood pressure of
122/76 mmHg. Fundoscopy reveals bilateral swelling of both optic discs with loss of
venous pulsation but otherwise neurological examination is normal. Investigations reveal
normal MRI appearances of the brain and a lumbar puncture reveals an opening pressure
of 30 cm H2O but CSF analysis is normal.

What is the most likely diagnosis?

(Please select 1 option)

Benign Intracranial Hypertension Correct

Subarachnoid Hemorrhage
Migraine
Tension type headache
Multiple sclerosis

This is a typical history of BIH. An obese female patient with headaches and
papilloedema, normal Brain imaging, CSF analysis and high pressure. The other possible
differential diagnosis would be cerebral/sagittal vein thrombosis but one might expect to
pick up evidence for this on the MRI.

1. Most widely used mydratic in clinics is

Phenylephrine

Atropine

Scopolamine

Homatropine

Cyclopentolate

2. Intraocular pressure in acute congestive glaucoma

10-21 mm hg

22-24 mm hg

30-35 mm hg
90-100 mm hg

3. Best investigation for foreign body localization is

B scan

A scan

MRI

CT scan

X ray

4. Condition that develops in eyelid of a diabetic patient is

Stye

Chalazion

Basal cell carcinoma

Ptosis

Sq cell carcinoma

5. Regarding basal cell carcinoma of eyelid

Grows slowly but is painful in nature

Infiltrative in nature

Is related to diabetes mellitus

Is radiosensitive

Is related to high rate of recurrence after excision

6. Most common cause of cataract is

Smoking
Heredity

Systemic disease such as diabetes

Ageing

Toxins

7. Most common cause of failure of surgical repair for tractional retnal

detachment is

Neovascular formation

Proliferative viteroretinopathy

Infection after surgery

Hemorrhage

Retinal breaks

8. Clinical assessment of cataract progression is done through

Snellen visual acuity test

Direct ophthalmoscope

Indirect ophthalmoscope

Retinoscope

Premetry

9. Which of the following is not the differential diagnosis of congenital

glaucoma

Megalocornea

Corneal clouding

Traumatic rupture of descements layer

Mucopolyscaccridoses

Calcification of lens

10. Snowflake or punctuate dot cataract is seen in

Trauma

Ocular contusion

After cataract surgery

Diabetes

Hyperthyroid

11. At the time of birth the eye of neonate is

Hyperopic

Astigmatic

Myopic

Presbyopic

12. Tonometer used when corneal surface is irregular is

Schiotiz tonometer

Goldman tonometer

Parkins tonometer

Pneumatic tonometer

Tono pin

13. A perimetry is used to measure

Central and peripheral fields

Visual acuity

ssIntra ocular pressure

Central field only

Peripheral field only

14. Characteristic findings on fundoscope of a myopic eye is

Tractional detachment

Hemorrhagic spots

Lacqer cracks

Neovascularisation

All of the above

15. Soft lenses are made up of material named

PMMA

HEMA

Silicone

Cellulose acetate

Perspex

16. Kayser flescher ring is present in

Pigment dispersion syndrome

Traumatic hyphema

Hepatolenticular degeneration

Haematochromatosis
None of the above

17. In marfan syndrome there is usual manifestation of

Krukenberg spindles

Hyphema

Ptosis

Ectopic lens

Cataract

18. Common treatment for posterior uveitis is

Antibiotics

Sympatamatic

Steroids

NSAIDS

Both a and c

19. Most important infection in HIV is

CMV retinitis

Toxoplasmosis

Tuberculous uveitis

Sarcoidosis of eye

Styphlococcus infection of lid and cornea

20. Photophobia is minimal in

Styphlococcus keratitis
Adenovirus keratitis

Herpetic keratitis

Varicella zoster keratitis

Exposure keratitis

21. Rarest canalicular anomalies of lacrimal system is

Imperforate puncta

Accessory puncta

Canalicular fistula

Agenesis of canalicular system

All are common

22. Most common cause of blindness in developing countries is

Trachoma

Onchocerciasis

Xeropthalmia’

Leprosy

Cataract

23. WHO safe strategy is given for

Herpes infection

Trachoma = = =

Onchocerciasis

Adenovirus infections
24. Most common cause of cronic dacrocystitis

Haemophilus infection

Staph aurus infection

Candida infection

Nasolacrimal duct obstruction

Nasolacrimal duct stenosis

25. Keratomalacia is due to deficiency of

it A

vit b

vit c

vit d

vit e

26. Most common cause of visual impairment in old age is

Glaucoma

Cataract

Macular degeneration

Retina; detachment

Systemic disease

27. Drug that causes retinopathy due to long term usage is

Chlorthiazide

Chloroquinine

Vigabatrin
Corticosteroids

Phenothiazine

28. Hypopyon is seen in

Bacterial infection

Viral infection

fungal infection

all of these

both a and c

29. Indication for cataract surgery

Uveitis

Glaucoma

Loss of vision

Retinal disease

Both b and c

30. Most of the refraction occurs at the site of

Ant surface of cornea

Post surface of cornea

Lens

Aqueous humor

Vitrous

31. Glands present at the anterior margin of eyelid are

Zeis glands

Moll glands

Meibomian glands

All of these

Both a and b

32. Proliferative diabetic retinopathy is best treated by

Pan retinal photocoagulation

Pneumatic retinopexy

Scleral buckling

Par plana vitrectomy

Gas tamponade

33. Success rate of scelral buckling in retina detachment is

50%

60-65%

70-75%

80-90%

90-94%

34. Vitreous is composed mostly of

Collagen fiber matrix

Hyauronic acid

Water
All three are in equal proportion

35. Surgical treatment for myopia with minimal complications

Clear lens extraction

Lasik

Contact lenses or spectacles

Lasek

Prk

36. Treatment for after cataract surgery consequences is

Extra capsular extraction

Co2 laser surgery

Yaq laser

Argon laser

Phecoemulsification

37. Pigmented retinal scar or macular hole is seen in

Central serous chorioretinopathy

Commotion retinae

Myopic eye

Macular edema

Angiod streaks

38. Most common age related corneal degeneration is

Arcus senilis

keratoconus
band keratopathy

Salzmann s nodular degeneration

Droplet keratopathy

39. Large ant chamber is seen in condition

Myopia

Glaucoma

Hyperopia

Astigmatism

Presbyopia

40. Refractive index of cornea is

1.3

1.5

1.8

41. Immediate treatment of acute angle closure glaucoma is

Acetazolamide

apraclonidine

pilocarpine

epinephrine

mannitol

42. Rubeosis iridis is seen in

Central retinal vein occlusion

Central retinal artery occlusion

Hypertension

Hyperthyroidism

Glaucoma

43. Best examination for lens is with

Slit lamp only

Slit lamp and dilated pupil

Direct ophthalmoscope

Indirect ophthalmoscope

Fundoscope

44. Most common acquired cause of cataract in young patients

Smoking

Connective tissue disorder

Trauma

Infection

Malignancy of any part of eye

45. Visual acquity of 1/60 implies that a person is

Low vision

Myopic

Hyperopic

Presbyopic

Legally blind
46. Most common type of myopia is

Axial

curvature

refractive

simple

all of these are equally frequent

47. Symptoms with which a person present with spring catarrha are

Severe itching ropy discharge

exudation

tearing

prearicular adenopathy

hyperemia and itching

48. Aqueous humor is

Proteineous material in ant chamber

Watery material in ant chamber

Watery material in post chamber

Connective tissue material in ant chamber

49. Prulent conjunctivitis is caused by

Gram positive cocci

Gram negative cocci

Gram positive bacilli

Gram negative bacilli

Acid fast bacteria

50. Profuse tearing occur in

Viral conjunctivitis

Bacterial = = =

Chlamydial = = =

Allergic = = =

All of these
51. Sore throat and fever are occasionally associated with

Viral conjunctivitis

Bacterial = = =

Chlamydial = = =

Allergic = = =

Both a and b

52. Infection associated with soft contact lens using

Herpes

Staphylococcus

Acanthomameba

Fungal infection

Adenovirus

53. Characteristic finding associated with pharangioconjuctival fever is

Non tender lymph nodes

Tender lymph nodes

Raspberry tongue
tonsilitis

prulent conjunctivitis

54. Herberts pits are found in

Trachoma

Ectropion

Fungal keratitis

Herpetic keratitis

None of these

55. Sceleral buckling is done in

Proliferative diabetic retinopathy

Retina detachment

Retinal edema

Retinal hemorrhage

Angiod streaks

56. Regarding keratoconus

Degenerative unilateral common disease

Associated with turner syndrome

Corneal clouding and pointing of cornea are symptoms

Vogts lines are found in basements membrane

Is one of the coomon indications for corneal transplant

57. Regarding Salzmann s nodular degeneration

Degeneration of superficial layer occurs

Deep layer degeneration occurs

Rigid lenses have no effective role

Symptoms include itching

Fleischer s rings are visible in cornea

58. Earliest finding in diabetic retinopathy is

Micro aneurysm

Macro aneurysm

Both of above

None of above

59. Glaucoma causes

Central 30 degree field loss

Central 60 degree field loss

Peripheral 30 degree field loss

Peripheral 60 degree field loss

60. Tractional retinal detachemnet occur in

Diabetes

Hypertension

Carotid artery stenosis

Polycythemia

arteritis

61. Major complication of trachoma that can cause blinding is

Corneal scaring and entropion

Follicles formation

Papillary hypertrophy

Corneal scaring and ectropion

62. Ideal site for intacapasular lens transplant is

Posterior chamber

Anterior chamber

Vitreous

Aqueous humor

Both a and d are favourable

63. Most common cause of optic atrophy in young patients is

Multiple sclerosis

Tobacco and alcohol amblyopia

Drug induced optic atrophy

trauma

increased intracranial pressure

64. Most common cause of proptosis in children is

Dermoid

Sinus muccele

Meningocele

Orbital cellulitis

Retinoblastoma
65. Most common epithelial tumor of lacrimal gland is

Sq cell carcinoma

Pleomorphic adenoma

Adenoid cystic tumor

Mixed tumor

Adenosarcoma

66. The lesions to optic chiasma are most due to

Bony erosion

Pituitary gland tumors

Craniophrangioma

Hemangioma of cavernous sinus

All causes are frequent

67. Which of the following is not associated with amaurosis fuqax (transient
retinal ischemia)

Retinal emboli

Arterial disease

Haematologic disease

Mechanical disease

Hyperthyroidism

68. Probable diagnosis of painless visual loss within period of seconds is due
to

Trauma

Retinal detachement

Macular edema
Commotio retinae

Cebtrak retinal artery occlusion

69. Reduced visual acuity in the absence of detectable anatomic defect in the
eye or visual pathway is

Ametropia

Amblyopia

Xerosis

Scotoma

Presbyopia

70. Which condition is not associated glaucoma

Rubeosis iridis

Uveal tract melanoma

Chandler s syndrome

Uveitis

Corneal degenerative diseases

71. Cause of glaucoma in pleateau iris is due to

Depth of ant chamber is very shallow

Ant position of ciliary process

Occlusion of mesh formation

Aniridia

Lens dislocation

72. Glaucoma is more common in

Myopic persons

Astigmatic persons
Hyperopic persons

Corneal degeneration

Both a and b

73. Keratic precipitates if found are usually located in

Calots triangle

Arlt s triangle

Heislebach triangle

Mayo triangle

74. Keratorefractive surgery implies

Changing curvature of ant eye surface

Surgery to treat myopia

Surgery to treat hyperopia

Surgery to treat glaucoma

75. Retinoblastoma is associated in some cases with

Osteoid osteoma

Osteoma

Osteosarcoma

Fibrosarcoma

Liposarcoma