OPHTHALMOLOGY Multiple Choice Questions and Answers:-

1. All of the following can be seen with ocular adenoviral infection except:
A. Preauricular lymphadenopathy
B. large central geographic corneal erosions
C. Multifocal subepithelial infiltrates
D. Enlarged corneal nerves
Ans: D
2. Tucking the superior oblique tendon?
A. is appropriate to correct superior oblique muscle palsy
B. can result in Brown syndrome
C. is the procedure of choice when the symptoms and measurements indicate principally a torsional
misalignment
D. a and b
E. b and c
Ans: D
3. The ability of a light wave from a laser to form interference fringes with another wave from the
same beam, separated in time, is a measure of its?
A. temporal coherence
B. spatial coherence
C. polarization
D. directionality
Ans: A
4. Which of the following is not a point of firm attachment between the sclera and uvea?
A. Ora serrata
B. Scleral spur
C. internal ostia of vortex veins
D. peripapillary tissue
Ans: A
5. a 1 year old child presents with monocular vertical nystagmus. What is the best course of action?
A. Follow the case to see whether head nodding develops
B. Follow the case to see whether abnormal head position develops
C. Undertake drug toxicology screening
D. Undertake neuroimaging (perferably MRI)
Ans: D
6. a 9 year old boy with a history of atopy presents with a seasonally recurrent bilateral conjunctivitis
and complains of blurred vision for 1 week. giant papillae are seen upon lid eversion. All of the
following could also be seen on the slit-lamp except:
A. vascular pannus and pnctate epithelial erosions involving the superior cornea
B. An oval epithelial ulceration with underlying stromal opacification in the central cornea
C. Limbal follicles
D. Conjunctical symblephara
Ans: D
7. All of the following organisms can invade an intact corneal epithelium except:
A. Neisseria meningitidis
B. Corynebacterium diphtheriae
C. Shigella
D. Pseudomonas aeruginosa
Ans: D
8. All of these diagnostic tests are useful in evaluating a patient with a retained magnetic intraocular
foreign body except:
A. indirect ophthalmoscopy
B. computed tomography
C. electrophysiology
D. magnetic resonance imaging (MRI)
E. echography
Ans: D
9. Optic disc drusen typically demonstrate all of the following features except
A. arcuate visual field defects
B. high reflective signal on b-scan ultrasonography
C. visual acuity loss
D. optic disc elevation and blurred margins
Ans: C
10. The power of an intraocular lens should be increased
A. as the power of the cornea increases and the axial length increases
B. as the power of the cornea decreases and the axial length increases
C. as the power of the cornea increases ans the axial length decreases
D. as the power of the cornea decreases and the axial length decreases
Ans: D
11. The five major branches of the facial nerve include the temporal, buccal, marginal mandibular,
cervical and
A. Temporal parietal
B. Zygomatic
C. Infraorbital
D. Zygomaticofacial
Ans: B
12. A lens coloboma?
A. is usually associated with previous lens trauma
B. is typically located superiorly
C. is typically associated with normal zonular attachments
D. is often associated with cortical lens opacification
Ans: D
13. The near point of the fully accomated hyperopic eye?
A. is beyond infinity, optically speaking
B. is between infinity and the cornea
C. is behind the eye
D. is beyond minus infinity, optically speaking
E. cannot be determined without additional information
Ans: E
14. Which of the following statements is false?
A. Epiblepharon is well-tolerated and only occaionally requires surgical correction
B. telecanthus indicates increased separation between the bony orbits
C. Amblyopia resulting from ptosis is usually a result of induced astigmatism rather than occlusion
D. The blepharophimosis syndrome is often inherited in an autosomal dominant fashion
Ans: B
15. Risk factor(s) for nuclear o pacification identified by epidemiological studies include?
A. current smoking
B. white race
C. lower education
D. all of the above
Ans: D
16. The following statement about diffuse unilateral subacute neuroretinitis (dusn) is correct:
A. The disease never occurs bilaterally
B. DUSN is a common casue of incorrectly diagnosed “unilateral retinitis pigmentosa”
C. Eradication of the subretinal nematode often results in an intense inflammatory reaction
D. Visual loss typically continues after successful eardication of the subretinal nematode
E. The condition is seen only in individuals with a history of travel to endemic areas
Ans: B
17. Patients with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) may have all
of the following clinical features except:
A. unilateral or asymmetric fundus involvement
B. recurrent or relentless progression of fundus lesions leading to permanent loss of central vision
C. associated cerebral vasculitis
D. prompt response to oral steroids
Ans: D
18. In the CNTG, Collaborative Normal-Tension glaucoma treatment study, progression was
reduced by nearly threefold by a reduction in IOP of?
A. 20%
B. 30%
C. 40%
D. 50%
Ans: B
19. Which of the following signs is most likely to be prsent in a patient with Graves ophthalmopathy?
A. Exophthalmos
B. Exernal ophthalmoplegia
C. Eyelid Retraction
D. Optic neuropathy
Ans: C
20. Topical anesthesia can include?
A. IV sedation
B. intracameral lidocaine
C. lidocaine jelly
D. tetracain drops
E. all of the above
Ans: E
21. A family history of retinoblastoma is present in what percent of newly diagnosed retinoblastoma
patients?
A. 1%
B. 6%
C. 18%
D. 40%
Ans: B
22. Which of the following infectious agents can be linked to interstital keratitis?
A. Herpes simplex virus
B. Herpes zoster virus
C. Chlamydia trachomatis
D. All of the Above
Ans: D
23. During phacoemulsification, when the srgeon notes a tear in the posterior capsule, the first
priority is?
A. finish phacoemulsification on the nucleus
B. convert to extracapsular extraction
C. freeze the action and assess
D. perform a vitrectomy
Ans: C
24. Which of the following is most likely to prompt additional evaluation in a patient with facial palsy?
A. simultaneous bilateral facial palsy
B. recovery of facial nerve function that occurs 3 weeks after the facial palsy
C. facial palsy occuring in a patient older than 50 years of age
D. upper and lower facial musculature equally affected
Ans: A
25. Sturge-Weber Syndrome?
A. is usually bilateral
B. is always inherited in an autosomal dominant pattern
C. is more common in males
D. is rarely associated with glaucoma
E. may be associated with glaucoma in infants
Ans: E
26. All of the following are common causes of transient visual loss except?
A. nonarteretic ischemic optic neuropathy
B. migraine
C. giant cell arteritis
D. pseudotumor cerebri
Ans: A
27. The far point of the nonaccommodated myopic eye?
A. and the fovea are corresponding points
B. is posterior to the eye, optically speaking
C. is nearer to the eye than the point of focus of the fully accommodated eye
D. cannot be moved by placing a lens in front of the eye
Ans: A
28. In normals, the average normal corneal thickness is?
A. 520 um
B. 540 um
C. 560 um
D. 580 um
E. 600 um
Ans: B
29. Congenital anterior chamber anomalies include all of the follow except:
A. posterior embryotoxon
B. Peters anomaly
C. Axenfeld-Rieger syndrome
D. posterior keratoconus
E. iris colomboas
Ans: E
30. Which of the following is most likely to be positive in an American patient with acute non-
granulomatous uveitis?
A. HLA-B27
B. HLA-B51
C. HLA-B5
D. HLA-B54
Ans: A
31. Which of the following statements about pleomorphic adenoma of the lacrimal gland is false?
A. It can recur in a diffuse manner
B. it can transform to a malignant tumor if present long enough.
C. recurrences can transform to malignancy
D. it can resolve spontaneously
Ans: D
32. In the US all of the following conditions could cause xerophthalmia except:
A. Chronic alcoholism
B. Cystic Fibrosis
C. Bowel resection
D. Glomerulonephritis
Ans: D
33. Two tumors commonly associated with so-called masquerade syndrome are?
A. conjunctival lymphoma, choroidal melanoma
B. conjunctival lymphoma, intraocular lymphoma
C. eyelid sebaceous carcinoma, intraocular lymphoma
D. basal cell carcinoma, retinoblastoma
Ans: C
34. Proper distance visual acuity testing for a low vision patient includes all except:
A. a testing chart with symbols arranged in rows of decreasing size that are equally legible
B. nonstandardized room illuminations
C. a snellen visual acuity chart
D. a +1.00 D lens placed over the patient’s distance refraction
Ans: C
35. Compared to CT scanning, MRI scanning provides better?
A. View of bone and calcium
B. View of the orbital apex and orbitocranial junction
C. Elimination of motion artificat
D. Comfort for claustrophobic patients
E. Safety to patients with prosthetic implants
Ans: B
36. Current smokers should avoid which one of the following?
A. beta carotene
B. cupric oxide
C. zinc oxide
D. vitamin e
Ans: A
37. What is the retinal magnification of an eye with a refractive error of +5D when viewed with a
direct opthalmoscope?
A. 13.75x
B. 15.00x
C. 10.75x
D. 5.00x
Ans: A
38. Which of the rectus muscles inserts the closes to the limbus?
A. lateral rectus
B. medial rectus
C. superior rectus
D. inferior rectus
Ans: B
39. Clear corneal incisions are associated with all of the following characteristics except:
A. more susceptible to wound burn
B. more difficult to construct
C. less likely to be watertight
D. less incidence of endophthalmitis
Ans: D
40. Which of the following is not considered to be an illusion?
A. Pulfrich phenomenon
B. metamorphopsia
C. micropsia
D. palinopsia
Ans: D
41. Which of the following is commonly associated with host defenses against parasitic infections?
A. neutrophils
B. basophils
C. eosinophils
D. macrophages
Ans: C
42. All of the following are risk factors for cystoid macular edema after cataract surgery except:
A. diabetes mellitus
B. flexible open-loop anterior chamber IOL implantation
C. ruptured posterior capsule
D. marked postoperative inflammation
E. vitreous loss
Ans: B
43. Which of the following viruses is transmissible even after medical instrumentation is cleaned with
alcohol?
A. Herpes simplex virus
B. Adenovirus
C. Human immunodeficiency virus
D. Epstein-Barr Virus
Ans: B
44. Which of the following statements about cataract surgery in patients with diabetes is correct?
A. Patients with diabetes enrolled in the ETDRS who underwent cataract surgery did not show an
immediate imporvement in visual acuity.
B. Patiens with diabetes with CSME should have cataract surgery performed prior to focal laser
C. Patients with diabetes and high risk proliferative changes visible through their cataract should
ideally have scatter laser immediately before cataract extraction
D. Patients with diabetes and high risk proliferative changes visible through their cataract should
have scatter laser 1 to 2 months prior to cataract extraction
E. Preoperative phenylephrine drops for dilation are contraindicated in patients with diabetes
undergoing cataract surgery
Ans: D
45. Which of the follow is most useful in distinguishing the cause of anisocoria that is greater in dark
than in light?
A. cocaine 10 %
B. pilocarpine 0.1%
C. pilocarpine 1%
D. pilocarpine 2.5%
Ans: A
46. A single intraoperative application of mitomycin C has been associated with an increase risk of?
A. hypotony
B. bleb hyperemia
C. bleb leaks and infections
D. all of the above
E. a and c only
Ans: E
47. The risk of cataract development may be decreased by foods rich in?
A. vitamin a
B. vitamin c
C. beta carotene
D. leutin
Ans: D
48. The parents of a 7 month old child complain of intermittent tearing OD only, beginning 3 months
ago. Their pediatrician prescribed lacrimal sac massage but noticed a decreased red reflex OD on a
follow-up visit. The most likely diagnosis is?
A. congenital glaucoma
B. infantile cataract
C. chlamydial conjunctivitis with corneal scarring
D. rentinoblastoma
Ans: A
49. Which of the following statements regarding Herpetic Eye Disease Study (HEDS. is false?
A. It demonstrated that topical corticosteroids given together with a prophylactic antiviral reduce
persistence or progression of stromal inflammation and shorten the duration of herpes simplex
stromal keratitis
B. It showed that long term suppressive oral acyclovir theraphy reduces the rate of recurrent HSV
keratitis and helps to preserve vision
C. It showed some additional benefit of oral acyclovir in treating active HSV stromal keratitis in those
patients also receiving concomitant topical cortiscosteroids and trifluridine
D. It deomstrated that oral acyclovir did not appear to prevent subsequent HSV stromal keratitis or
iritis when it was given briefly along with trifluridine during an episode of epithelial keratitis
Ans: C
50. The goal of anterior vitrectomy is?
A. removal of vitreous from the wound
B. removal of vitreous so that a posterior chamber lens can be placed
C. prevention of CME
D. removal of vitreous anterior to the posterior lens capsule
Ans: D
OPHTHALMOLOGY Objective type Questions and Answers ::
51. The percentage of primary congenital glaucoma that is now known to have a definite genetic
component is
A. 1%
B. 10%
C. 25%
D. 50%
E. 75%
Ans: E
52. A healthy 60 year old man presents with a 2 day history of a painful rash on the right side of his
forehead extending down to the eyelids. A vesicular skin lesion is also seen near the tip of his nose.
Which of the following therapies would be most appropriate?
A. Topical trifluridine 1% drops 8 times per day for 14 days
B. Oral famciclovir 500 mg two times per day for 10 days
C. Oral valacyclovir 1000mg three times per day for 10 days
D. Oral acyclovir 800mg three times per day for 10 days
Ans: C
53. Parasympathetic fibers destined for the pupil reside in the?
A. medulla
B. medial portion of CN III
C. posterior communicating artery
D. pons
Ans: B
54. In patients with a facial nerve paralysis, all of the following characteristics may be present
except:
A. Eyebrow ptosis
B. Blepharoptosis
C. Lower eyelid ectropion
D. Epiphora
E. Ocular exposure symptoms
Unanswered
55. Which of the following is a true basement membrane?
A. Bowman’s layer
B. zonules of Zinn
C. Descemet’s membrane
D. anterior border layer of iris
Ans: C
56. Which of the following nerves does not enter the orbit through the superior orbital fissure?
A. CN II
B. CN III
C. CN IV
D. CN VI
Ans: A
57. Which of the following extraocular muscles inserts farthest from the limbus?
A. Superior rectus
B. inferior rectus
C. inferior oblique
D. superior oblique
Ans: C
58. All of the following conditions have a characteristic anterior-segment finding except:
A. sickle cell disease
B. marfan syndrome
C. galactosemia
D. wilson disease
Ans: A
59. The superior transverse ligament is also referred to as?
A. Lockwood’s ligament
B. Sommerring’s ligament
C. The ROOF
D. Whitnall’s ligament
Ans: D
60. Which of the following statements regarding graft-versus-host disease (GVHD) is false?
A. It is a relatively common complication of allogeneic bone marrow transplantation in which the
grafted cells can attack the patient’s tissues.
B. Conjunctival inflammation and severe sicca are the main features
C. Cicatrical lagophthalmos can occur
D. Aggressive lubrication is adequate even in severe cases of GVHD
Ans: D
61. Multiple evanescent white dot syndrome (MEWDS) is characterized by each of the following
clinical features except:
A. enlargement of the physiologic blind spot on visual field testing
B. individual hyperfluorescent spots on fluorescein angiogrpahy arranged in a wreathlike patter
around the fovea
C. typically presents with unilateral photopsias and loss of vision in young females with myopia
D. absence of cell in the anterior chamber
E. granular appearance of the fovea
Ans: B
62. The epidemiology of cataracts suggests that?
A. they are more prevalent in those under 65 years of age
B. they are more prevalent in women
C. they occur only as a consequence of age
D. they rarely lead to blindness
Ans: B
63. Which of the following uveitic syndromes is least likely to require topical corticosteroid
management?
A. sarcoidosis
B. juvenile rheumatoid arthritis
C. Fuchs heterochromic iridocyclitis
D. Reiter syndrome
Ans: C
64. Which of the following statements about stabismus secondary to thyroid ophthalmopathy is
false?
A. It can be restrictive
B. it can be caused by extraocular muscle weakness
C. it usually is surgically corrected early after onset
D. it is unrelated to the degree of thyroid function
E. both b and c are correct
Ans: C
65. Which eye movement disorder is most commonly seen in patients with paraneoplastic
syndromes?
A. downbeat nystagmus
B. upbeat nystagmus
C. superior oblique myokymia
D. opsoclonus
Ans: D
66. Goldmann tonometry?
A. is not affected by alteration in scleral rigidity
B. is unaffected by laser in situ keratomileusis (LASIK)
C. may give an artificially high IOP measurement with increased central corneal thickness
D. may give pressure measurements taken over a corneal scar that are falsely low
Ans: C
67. Which of the following ocular histologic changes is not considered to be associated with
diabetes? mellitus?
A. Lacy vacuoliztiaon of the iris
B. retinal hemorrhages
C. iris hemorrhages
D. thickened basement membranes
Ans: C
68. An underlying condition is most likely to be determined in a patient with isolated eye pain and?
A. pain for greater than 2 years
B. ipsilateral facial numbness
C. normal neuroimaging of the brain and orbits
D. poor reponse to tricyclic antidepressants
Ans: B
69. You are about to write the postoperative spectacle prescription for a cataract surgery patient with
macular degeneration. The best choice for a reading add for the patient with 20/70 best-corrected
vision is?
A. +3.00 D
B. +3.50 D
C. +7.00 D
D. a 3.5x magnifer
Ans: B
70. Reiter syndrome is associated with all except which of the following?
A. nonspecific urethritis
B. poly arthritis
C. conjunctivitis
D. ankylosing spondylitis
Ans: D
71. The preferred therapy for infantile glaucoma is?
A. topical beta blockers
B. topical bromonidine
C. trabeculotomy or goniotomy
D. oral acetazolamide
Ans: C
72. Congenital dacryocele?
A. presents with a mass above the medical canthal ligament
B. usually responds to systemic antibiotics alone
C. can be associated with an intranasal mucocele
D. is best treated with incision and drainage through the skin
E. usually indicates stenoisis of the bony nasolacrimal canal
Ans: C
73. Vision loss in Riley-Day syndrome is most often due to?
A. cataracts
B. optic nerve hypoplasia
C. amblyopia
D. corneal scarring
Ans: D
74. a 65 year old woman presents with a progressively enlarging mass in the right inferior orbit.
distraction of the lower eyelid reveals a “salmon patch” appearance to the fornix. The most likely
diagnosis is?
A. Reactive lymphoid hyperplasia
B. Lymphoma
C. sebaceous carcinoma
D. melanoma
E. Apocrine hidrocystoma
Ans: B
75. HLA-B27-associated acute anterior uveitis is associated with all except which of the following
systemic disorders?
A. Behcet syndrome
B. Reiter syndrome
C. psoriatic arthritis
D. ankylosing spondylitis
Ans: A
76. Which is true regarding orbital anatomy?
A. The lacrimal gland fossa is located within the lateral orbital wall.
B. The optic canal is located within the greater wing of the sphenoid bone
C. The medial wall of the optic canal is formed by the lateral wall of the spenoid sinus.
D. The nerve to the inferior rectus muscle travels anteriorly along the medial aspect of the muscle
and innervates the muscle on its posterior surface
Correct
Ans: C
77. The Joint Statement of the American Academy of Pediatrics, Section on Ophthalmology; the
American Association for Pediatric Ophthalmology and Strabismus; and the American Academy of
Ophthalmology recommends at l east 2 dilated funduscopic examinations using binocular indirect
ophthalmoscopy for all infants with:
A. a birth weight less than 1500 grams
B. a gestational age of 28 weeks or less
C. a birth weight between 1500 and 2000 grams and an unstable clinical course
D. all of the above (Your Answer.
Ans: D
78. The most common secondary tumors in retinoblastoma patients within and outside of the field of
ocular radiation re?
A. within, fibrosarcoma; outside, osteosarcoma
B. within, osteosarcoma; outside, melanoma
C. within, osteosarcoma; outside, pinealoblastoma
D. within, osteosarcoma; outside, osteosarcoma
Ans: D
79. Behcet syndrome is associated with all except which of the following?
A. aphthous stomatitis
B. arthritis
C. gential ulceration
D. retinal vasculitis
Ans: B
80. The gene known to be associated with aniridia is?
A. CYP1B1
B. P1TX2
C. FKHL7
D. PAX6
E. LMX1B
Ans: D
81. Optic disc edema may precede vision loss in AION?
A. True
B. False
Ans: A
82. Incorrect statement regarding contact lense wear?
A. There is a reduction in hemidesmosome density
B. Level of glucose availability in the corneal epithelium is reduced
C. There is increased production of CO2 in the epithelium
D. There is a reduction in glucose utilization by corneal epithelium
Ans: B
83. Which is NOT a feature of Horner’s syndrome?
A. Enophthalmos
B. Miosis
C. Ptosis
D. Anhydrosis
E. Loss of ciliospinal reflex
F. Exophthalmos
Ans: F
84. “morning glory” sign is seen in MRI of patients with?
A. Retinoblastoma
B. Progressive Supranuclear palsy
C. Multiple scelerosis
D. Retinal coloboma
Ans: B
85. Source of bleeing in a case of hyphaema due to blunt injury eye is?
A. Circulus iridis major
B. Circulus iridis minor
C. Short posterior ciliary vessels
D. Iris vessels
Ans:A
86. In which of the following conditions bilateral inferior subluxation of lense is seen ?
A. Ocular trauma
B. Marfan’s syndrome
C. Homocystinuria
D. Hyperlysinemia
Ans:C
87. Most common cause of vitreous hemorrhage in adults is?
A. Trauma
B. Hypertension
C. Diabetes
D. Pathological myopia
Ans:C
88. FALSE regarding phthisis bulbi is?
A. Calcification of the lens
B. Thickened sclera
C. Size of the globe is reduced
D. I.O.P is increased
Ans:D
89. A physician diagnosed a new case of Type 2 DM. What is the correct time to refer the patient for
ophthalmologic examination ?
A. As early as possible
B. After 5 years
C. After 10 years
D. symptomatic
Ans:A
90. Retinoscopy is?
A. visualization of retina alone
B. visualization of retina and all other posterior segment contents
C. objective measurement of the refractive error of patient
D. subjective measurement of the refractive error of patient
Ans:C
91. Most common 2nd malignacy in survivors of retinoblastoma is?
A. Optic glioma
B. Thyroid cancer
C. Pap CA thyroid
D. Osteosarcoma
Ans:D
92. Substance deposited in Band Shaped Keratopathy is?
A. calcium phosphate
B. magnesium phosphate
C. magnesium sulphate
D. Iron
Ans:A
93. Corneal nerves are NOT enlarged in
A. Keratoconus
B. Leprosy
C. Herpes simplex keratitis
D. Neurofibromatosis
Ans:C
94. False about Bitot spots is?
A. accumulation of keratinized epithelial debris
B. appear on the conjunctiva
C. appear on the cornea
D. develop into xerophthalmia if not treated
Ans:C
95. Which anti-glaucoma drug can not be used topically ?
A. Latanoprost
B. Brimonidine
C. Acetazolamide
D. Dorzolamide
Ans:C
96. NOT a component of SAFE strategy ?
A. Surgery
B. Antifungals
C. Facial cleanliness
D. Environmental mprovement
Ans:B
97. Image produced by Indirect ophthalmoscopy is?
A. Virtual, erect
B. Virtual, inverted
C. Real, erect
D. Real, inverted
Ans:D
98. Contraindication for enucleation is?
A. painful, blind eye
B. endophthalmitis
C. Congenital cystic eye
D. retinoblastoma
Ans:B
99. Which is NOT a feature of 3rd Nerve palsy ?
A. Ptosis
B. Diplopia
C. Miosis
D. Outwards Deviation of eye
Ans:C
100. All of the following can be seen with ocular adenoviral infection except:
A. Preauricular lymphadenopathy
B. large central geographic corneal erosions
C. Multifocal subepithelial infiltrates
D. Enlarged corneal nerves
Ans:D