REVISION

MCQs
MCQs
Professor
Osama Shalaby
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INSTRUCTIONS

2
Pay attention to the head
Single answer pattern
Single answer pattern

3
 blindness worldwide;

• Senile cataract
• Age related macular degeneration
• Glaucoma
• Diabetic retinopathy
• Trachoma
 blindness in Egypt:

• Senile cataract
• Age related macular degeneration
• Glaucoma
• Diabetic retinopathy
• Trachoma
All of the following types of
entropion are known except

• Spastic entropion
• Senile entropion
• Paralytic entropion
• Cicatricial entropion
All of the following are causes
of lagophthalmos except

• Facial nerve palsy

• Proptosis
• Cicatricial ectropion
• Third nerve paralysis
Corneal ulcers can occur with
the following CN disorders

• VII CN palsy
• III CN affections
• VI CN paralysis
• IV CN paralysis
Ectropion of the upper lid most
commonly:

• Spastic ectropion
• Senile ectropion
• Paralytic ectropion
• Cicatricial ectropion
 Ectropion of the upper eyelid
may be:

• Senile
• Paralytic
• Congenital
• Non of the above
A patient suffered from acute
onset of facial palsy, the first
line of treatment is:
• Frequent ocular lubrication.
• Lateral tarsorrhaphy
• Topical corticosteroids.
• Levator muscle resection.
The levator palpebrae superioris is
inserted into the following
structures except:
• Skin of upper eye lid

• Upper border of tarsus

• Bulbar conjunctiva

• Medial orbital margin & medial palpebral ligament

Rolling in of the lid margin can
be due to:

• Thermal injury of lid skin

• Facial palsy
• Trachoma
• Ophthalmoplegia
The most important examination
in case of congenital ptosis is:

• The state of extraocular muscles

• Fundus examination
• Amount of levator function
• Pupillary light reflex
 Stye is an acute suppurative
inflammation of:

• Meibomian glands
• Accessory lacrimal glands
• Zeiss glands of the lash follicles
• Lid margin
 A female patient C / O diffuse
hyperemic lid margin with multiple
grayish yellow crustations covering
the lashes. The best treatment is:

• Epilation of affected lashes

• Electrolysis
• Hot fomentations and local antibiotics
• Systemic corticosteroids
In recurrent squamous blepharitis
you should:

• Give long acting corticosteroids

• Give long acting antibiotics
• Correct any refractive errors
• Give maintenance dose of vitamins.
 Chalazion is defined as:
• Acute suppurative inflammation of
meibomian glands
• Chronic suppurative inflammation of
meibomian glands
• Chronic inflammatory lipogranuloma of
meibomian glands.
• Chronic non granulomatous inflammation
of meibomian glands
 Tarrsorraphy is essential in:

• Bacterial corneal ulcer

• Viral corneal ulcer
• Exposure keratopathy
• Traumatic corneal ulcer
Chalazion can cause the following
complications except:

• Irrigular astigmatism
• Mechanical ptosis
• Anterior uveitis
• Internal hordeolum
A male patient is C / O chronic eye lid redness
and frequent loss of lashes.
The most propable diagnosis is
The most propable diagnosis is

• Cicatricial entropion
• Squamous blepharitis
• Ulcerative blepharitis
• Active trachoma
A case presented with hypermic lid margin,
matting of eye lashes, yellow crustations.
The treatment include all the following
except:

• Local lid hygeine

• Rubbing the lid margin by antibiotic
ointment
• Elctrolysis
• Systemic antibiotic
Epilation of maldirected lashes
is indicated in:

• When the number is less than four

• When the lashes are close together
• In presence of acute corneal ulcer
• In cases of high refractive error.
 Congenital ptosis may be
associated with the following
congenital anomalies except:

• Blepharophimosis
• Telecanthus
• Epicanthus
• Naso lacrimal duct obstruction.
Complications of congenital causes
include the following except:

• Ocular torticollis.
• Amblyopia.
• Complicated cataract.
• Anbormal head posture.
 Lagophthalmos can be caused
by the following except:

• Hyperthyroidism.
• Facial palsy.
• Severe entropion
• Lid coloboma.
 The commonest cause of
bilateral ptosis is:

• Horner syndrome.
• Third nerve palsy.
• Congenital
• Mechanical.
Lid splitting and everting sutures is an
operation used for the correction of:

• Pure trichiasis of the upper eye lid.

• Trichiasis and entropion of the upper
eye lid.
• Ectropion of the lower eye lid.
• Paralytic entropion of the lower eye
lid.
 All these are true about
ulcerative blepharitis except:

• Can cause madarosis.

• Can be complicated by ulcerative
keratitis.
• Can be caused by Morax Axenfeld
bacillus.
• Can be treated by antibiotics.
A 65 ys old patient had recurrence
of chalazion after removal from the
same site two times. The best
management is:

• Systemic antibiotic and steroids.

• Excision and histopathological evaluation.
• Excision and curette evacuation.
• Excision and cautery of the edges.
 A patient has about 10
maldirected localized lashes of the
upper eye lid. The treatment of
choice is:

• Snellen’s operation.
• Lid splitting and cryo application.
• Epilation
• Weiss procedure.
 Fasaenella operation for ptosis is
carried out in cases with:

• Severe ptosis. Levator action less than 5

mm.
• Moderate ptosis. Levator action 5-8 mm.
• Mild ptosis. Levator action more than 8 mm.
• None of above.
Incision and curette of chalazion
should be.

• Vertical.
• Horizontal.
• Any shape.
• circular.
Grey line indicates a tissue plane
between:

• Skin muscle layer & tarsus conjunctival

layer.
• Tarsus & canjunctiva.
• Skin & meibomian glands.
• Palpebral conjunctiva & meibomian gland
orifices.
 Ankyloblepharon is :

• The adhesion of the lids.

• The adhesion between palpebral and bulbar
canjunctiva.
• The adhesion of the margins of the two lids.
• All of the above.
 Glands of Zeis are:

• Modified sweat glands.

• Modified sebaceous glands.
• Modified meibomian glands.
• None of above.
Levator palpebrae is inserted into:

• Upper border of the tarsus.

• Skin of upper lid.
• Upper fornix.
• All of above.
Hordeolum externum is an acute
suppurative inflammation of:

• Gland of Zeis.
• Gland of Moll.
• Gland of Wolfring.
• Gland of Krause.
 All of the following types of
entropion are known except:

• Spastic entropian.
• Senile entropion.
• Paralytic entropion.
• Cicatricial entropion.
The amount of normal levator
function is :

• 5 mm.
• 8 mm.
• 25 mm.
• 13 mm .
In brow suspension operation of
ptosis, the best suspension
material is :

• Fascia lata.
• Supramid.
• Prolene.
• Silicone.
All of the following are the causes
of lagophthalmus except:

• Facial nerve palsy.

• Proptosis.
• Lid fibrosis.
• Third nerve paralysis.
43
Conjunctival injection is characterized
by the following except:

• Bright red colour.

• Movable.
• Not affected by vasoconstrictors.
• Individual vessels are easily distinguished.
One of these is not manifested
by ciliary injection:

• Corneal ulcer
• Episcleritis
• Acute congestive glaucoma.
• Acute iridocyclitis.
 Persistent unilateral
conjunctivitis is usually due to:

• Purulent conjunctivitis.
• Chronic dacryocystitis.
• Mucopurulent conjunctivitis.
• Foreign body.
In ophthalmia neonatorum, all
are true except:

• Caused by birth trauma.

• Frequently caused by gonococcal infection.
• Maternal infection plays a role.
• Silver nitrate drops were used as a prophylaxis.
All the following can be caused
by chlamydial infection except:

• Ophthalmia neonatorum
• Trachoma.
• Inclusion Conjunctivitis.
• Central corneal ulcer.
These organisms can be seen
normally in the conjunctiva:

• Koch- Weeks bacillus.

• Pneumococci.
• Corynobacterium xerosis.
• Corynobacterium diphtheria.
 Most common organism in
purulent conjunctivitis is:

• Pneumococci.
• Streptococci.
• Gonococci.
• Herpes simplex virus.
Subconjunctival hemorrhage is
not caused by:

• Trauma.
• Mucopurulent conjunctivitis.
• Adenoviral infection.
• Acute hemorrhagic conjunctivitis.
 conjunctivitis:

• Vernal keratoconjunctivitis
• Phlyctenular keratoconjunctivitis
• Viral conjunctivitis
• Angular conjunctivitis
 Which is true about vernal
conjunctivitis :

• Always unilateral.
• Usually occurs in young boys.
• Antibiotic drops are the main therapy.
• Main symptom is foreign body
sensation.
All of the following are non-
specific signs in conjunctivitis
except

• Subconjunctival hemorrhage
• Papillae
• Follicles
• pseudomembranes
 Patient presented with itching,
lacrimation, excoriation and macerated
outer canthus, the claimed organism is:

• Morax Axenfeld diplobacillus.

• Haemophylus influenza.
• Pnumococci..
• Koch- Weeks diplobacillus.
 presented with severe red eye after acute
attack of cough, most propably may be due
to:

• Corneal abrasion.
• Acute conjunctivitis.
• Spontaneous subconjunctival hemorrhage.
• Acute iritis.
 All are sure signs of trachoma except:

• Arlt’s line.
• Papillae of upper tarsal conjunctiva.
• Herbert’s Pits.
• Expressible follicles.
 Itching is common with:

• Spring catarrh.
• Trachoma.
• Mucopurulrnt conjunctivitis.
• Corneal ulcer.
 The secretions of spring catarrh are
rich in:

• Eosinophils.
• Neutrophils.
• Basophils.
• Lymphocytes.
 Pinguecula is:

• Fatty degeneration.
• Hyaline degeneration.
• Elastoid hyaline degeneration.
• Elastoid degeneration.
 Giant papillary conjunctivitis can be
caused by the following except:

• Artificial prosthesis.
• Spring catarrh.
• Contact lens wear.
• Acute conjunctivitis.
Topical treatment used for phlyctenular
conjunctivitis is:

• Antibiotic drops.
• Vasoconstrictor drops.
• Corticosteroid drops.
• Antiviral drops.
 These may cause pterygium,
except:

• Exposure to ultra violet rays.

• Viral infection.
• Pinguecula.
• Living in tropical area.
 Etiology of ptrygium is:

• Neoplastic
• Infection
• Inflammation
• Degenerative
 Pneumococci can cause:

• Acute dacryocystitis
• Chronic dacryocystitis
• Atypical hypopyon ulcer
• Ulcerative blepharitis
 Staphyloococci can cause:

• Acute dacryocystitis
• Stye
• Atypical hypopyon ulcer
• Ulcerative blepharitis
• All of the above
Episcleritis is similar to phlycten
clinically but differs in being:

• Tender
• Flat
• Pigmented
• Multiple
Patient had a pterygium, excised since
one month, and starts to see double
vision, this may be due to:

• Medial rectus weakness.

• Lateral rectus paralysis.
• Symblepharon formation.
• Recurrence.
 These treatments are useful in
preventing the recurrence after
pterygium excision except:

• Topical antibiotics.
• Topical corticosteroids.
• Beta irradiation.
• 5 FU eye drops.
 Which of the following is specific for
the diagnosis of allergic conjunctivitis?

• Eye redness
• Itching
• Foreign body sensation
• Excessive lacrimation
71
The corneal touch reflex involves
the following cranial nerves:

• II and III
• II and IV
• V and III
• V and VI
• V and VII
The corneal light reflex depends on
the following, except:

• Healthy tear film.

• The convex mirror property of the cornea.
• Corneal nerve fibers are demyelinated.
• Intact corneal epithelium.
• The corneal epithelium is non-keratinized.
 The direct and immediate
consequence of corneal endothelial
injury is:

• Corneal vascularization.
• Corneal edema.
• Corneal hyposthesia.
• Corneal scarring.
• Corneal ulcer.
 Munson’ sign is seen in:

• Corneal fistula
• Corneal dystrophy
• Keratoconus
• Corneal facet
In corneal edema; all are true
except:

• There is increase in corneal diameter

• There is increase in corneal thickness
• Cloudy cornea
• Epithelial bullae
Corneal damage with trachoma
is due to:

• Trichiasis
• Dryness
• Lagophthalmos and exposure
• All of the above
Double staining pattern of the
cornea is characteristic for:

• Fungal corneal ulcer

• Herpetic corneal ulcer
• Exposure keratopathy
• Acanthaembic corneal ulcer
 Corticosteroids are given in:

• Bacterial corneal ulcer

• Herpetic corneal ulcer
• Fasicular ulcer
• Stromal fungal keratitis
Corticosteroids are the main
line in the treatment of:

• Bacterial corneal ulcer

• Herpetic corneal ulcer
• Interstitial desciform keratitis
• Stromal fungal keratitis
 Blood staining of the cornea is
due to:

• Hyphema
• Hyphema with rise of IOP
• Corneal edema
• Corneal FB
 Infective corneal ulcers include
all except:

• Bacterial corneal ulcer

• Fungal corneal ulcer
• Mooren’s ulcer
• Viral corneal ulcer
 In treating bacterial corneal
ulcer all are true except:

• Antibiotics drops
• Vitamin A,C
• Mydriatics and cycloplegics drops
• Corticosteroids drops
 In treating bacterial corneal
ulcer all are true except:

• Antibiotics drops
• Vitamin A,C
• Mydriatics and cycloplegics drops
• Corticosteroids drops
• Gonococci
• Pneumococci
• Staphylococci
• Pseudomonas
 corneal ulcers:

• Gonococci
• Pneumococci
• Staphylococci
• Pseudomonas
• Gonococci
• Pneumococci
• Staphylococci
• Pseudomonas
• Typical hypopyon corneal ulcers.
• Herpetic corneal ulcers.
• Acanthameba corneal ulcers.
• Neuroparalytic corneal ulcers.
• Typical hypopyon corneal ulcers.
• Herpetic corneal ulcers.
• Acanthameba corneal ulcers.
• Neuroparalytic corneal ulcers.
• Fascicular ulcer.
• Typical trachomatous ulcer.
• Typical hypopyon ulcer.
• Mooren’s ulcer.
 include:

• Keratectasia.
• Keratoconus.
• All of the above.
• Non of the above
keratoconus progression except:

• Frequent change of glasses.

• Progressive irregular astigmatism.
• Progressive hypermetropia.
• Appearance of Fleisher ring.
 except:

• Rigid gas permeable contact lenses

• Laser in situ keratomileusis (LASIK)
• Intracorneal ring segment implantation
• Penetrating or lamellar keratoplasty
94
• A nuclear cataract present more than 10 years
• A posterior subcapsular cataract that reduces
visual acuity to 6/60 or worse
• A cortical cataract that involves the entire
cortex
• An anterior subcapsular cataract that causes
capsular wrinkling.
• Visual acuity HM
• Absent RR
• Absent iris shadow
• All of the above
• Its shadow lies on the macula
• Close to the nodal point
• It matures early
• It blocks the pupillary area
• Myopia
• Hypermetropia
• Astigmatism
• No change in refraction
• Myopia
• Hypermetropia
• Astigmatism
• No change in refraction
 is:

• Cystoid macular edema

• Posterior capsule opacification
• Corneal decompansation
• Retinal detachment
• Surgical excision
• Laser opening
• Surgical polishing
• Leave alone
• Yag laser
• Argon laser
• Diode laser
• Excimer laser
• Decreased aqueous production
• Increased aqueous drainage
• Lower episcleral venous peressure
• All of the above
104
• Exophthalmos
• Lid retraction
• Diplopia
• Conjunctival chemosis
• Trauma
• Orbital cellulitis
• Rhabdomyosarcoma
• All of the above
• Trauma
• Cachexia
• Post radiotherapy
• Secondaries of breast scirrhus carcinoma
• All of the above
• Congenital
• Vitamine A defficiency
• Nuclear cataract
• Retinitis pigmentosa
• Partial anterior staphyloma
• Ciliary staphyloma
• Intercalary staphyloma
• Equatorial staphyloma
• Posterior staphyloma
• Phlycten
• Hypopyon ulcer
• Iridocyclitis
• Metastatic endophthalmitis
• Large deep cup
• Interrupted retinal vessels
• Waxy yellow colour
• Overhanging margins
• Papillitis
• Papilloedema
• Retrobulbar neuritis
• All of the above
• Prednisolone
• Observation
• Antibiotics
• Atropine
• Rapid deterioration of vision
• Amaurosis Fugax
• Pain on eye movements
• Early loss of color vision
• Nasal step
• Arcuate scotoma
• Cocentric contraction of peripheral field
• Enlarged blind spot
 pathologies except:

• Degenerative myopia
• Chorioretinitis
• CRAO
• CRV thrombosis
• Papillitis
• Hysteria
• Optic atrophy
• Retrobulbar neuritis
118
• Phaco morphic glaucoma
• Phacoanaphylactic glaucoma
• Phacolytic glaucoma
• Neovascular glaucoma
• Hypermetropic eye
• Myopic eye
• Astigmatic eye
• Aphakic eye
 after:

• Gonioscopic examination
• Fundus examination
• Tonometry
• Visual field examination
 except:

• Large deep cup

• Overhanging margins
• Retinal vessels appear broken at the margin
• Lamina cribrosa is not visible
• Decreased aqueous production
• Increased aqueous drainage
• Lower episcleral venous peressure
• All of the above
• Retinoblastoma
• Megalocornea
• Congenital High myopia
• Babies of diabetic mothers
• Lacrimation and sneezing
• Optic cupping
• Enlarged hazy cornea
• Flattened sublaxated lens
• Projection of light
• Cofrontation test
• Automated perimetry
• Bjerrum screen
• Projection of light
• Cofrontation test
• Automated perimetry
• Bjerrum screen
• Perception of light
• Post sublaxated lens
• Post dislocated lens
• Intumescent cataract
• Anterior dislocated lens
• Pilocarpine + anti-inflammatories
• Pilocarpine + beta blockers
• Atropine
• Cyclocryotherapy
 Phakomorphic Glaucoma is:

• Induced by intumescent cataract

• Induces pupillary block
• A closed angle secondary glaucoma
• Urgent cataract extraction is indicated
• All of the above are correct
 Amaurotic cat’s eye reflex,
In all except:

• Retinoblastoma
• Coat’s disease
• Toxocariasis
• Malignant melanoma of the choroid
 Third cranial nerve innervates all
the following except:

• Superior oblique muscle

• Levator palpebre muscle
• Inferior oblique muscle
• Medial rectus muscle
 Horner’s syndrome

• Ptosis + myosis + enophthalmos + anhydrosis

• Ptosis + mydriasis + enophthalmos +
anhydrosis
• Lagophthalmos + myosis + enophthalmos +
anhydrosis
• Diplopia + myosis + enophthalmos +
anhydrosis
Diplopia due to right 6 CN palsy
increases while looking:

• To the right
• To the left
• Up
• Down
Diplopia due to right 4 CN palsy
disappears on covering:

• Right eye
• Left eye
• Either one
• Neither one
The commonest cause of crossed
eyes in the first year of life:

• Infantile esotropia
• Accomodative esotropia
• Six CN palsy
• Duane’s syndrome
Convergent squint may be due to:

• Accommodative esotropia
• 6 nerve palsy
th

• Graves’ disease
• All of the above
139
• Aphakia
• Sublaxation of the lens
• Hypermature cataract
• Posterior dislocation of the lens
• All of above
 A 30 ys old patient was subjected to face
burn with strong acid, two months later he
presented with watering and inability to close
his left eye. The explanation of this may be:

• Mechanical ectropion.

• Cicatricial ectropion.

• Paralytic ectropion.

• Corneal ulcer.
 A patient subjected to vertical lid
wound, he is unable to to close his eye
properly. This condition can lead to:

• Corneal scarring

• Exposure keratopathy.

• Vascularized corneal scar.

• Corneal pannus.
The first line of treatment in acid burn
of the eye is:

• Eye patching.

• Immediate wash with plain water.

• Instilling local antibiotic drops.

• Neutralization of the acid with alkali.

A 10 ys old boy, received blunt ocular
trauma by tennis ball to his right eye,
you will expect to have:

• Hypopion ulcer.

• Blood staining of the cornea.

• Hyphema.

• Tractional retinal detachment.

A patient had penetrating eye injury in
the right eye, the first aid management
is:

• Washing with plain water.

• Sterile eye bandage.

• Application of antibiotic ointment.

• Instilling atropine eye drops.

 A patient is C / O monocular diplopia
after blunt ocular trauma, the following
could cause this except:

• Sublaxated lens.

• Iridodialysis.

• Traumatic hyphema.

• Incipient immature cataract.

A patient had blunt ocular trauma, now
he is C / O severe visual defect, the
cause of this may be due to:

• Anteflexion of the pupil.

• Berlin’s edema.

• Conjunctival chemosis.

• Angle recession.
A patient with a history of blunt trauma to the left
eye C / O double vision that disappears on
covering the left eye & persists on covering the
right eye. Examination of this patient would reveal:

• Miotic pupil.

• Ectropion uveae.

• Pupil showing lens equator.

• Dilated pupil.
 Trauma to the eye cannot cause:

• Vitreous hemorrhage.

• Macular edema.

• Central retinal vein occlusion.

• Retinal breaks.
A patient had blunt ocular trauma & C /
O double vision that disappears on
covering either eye. The cause might be:

• Orbital hematoma.

• Corneal edema.

• Orbital blow out fracture.

• Iridodialysis.
A aptient had history of blunt ocular trauma
3 months ago, now is C / O severe headache
due to increased intraocular pressure.the
most important diagnistic tool is:

• Automated field of vision .

• Manual field of vision.

• Gonioscopic examination.

• Fundus examination.
 A patient with recent history of ocular
trauma & C/ O blurry vision.ocular
motility was normal, the most needed
investigation is:

• Ocular ultrasound.

• Fluorescein angiography.

• Field of vision.

• Performing CT brain.
Sympathetic ophthalmia is rarely seen in:

• Corneo scleral wounds

• PECCE.

• Acute suppuration

• Iris encarceration.
 Metallic IOFB can be localized by the
following methods except

• Limbal ring & X ray

• CT scan

• US

• MRI
 Pathognomonic sign of IOFB

• Corneal wound

• Root in the iris

• Traumatic cataract

• hyphema
The weakest part of the eye affected by
blunt trauma is:

• Canal of Schlemm

• Muscle insertion

• Equator

• Lens zonules
 Worker with arc light is exposed to:

• UVR corneal burn.

• Infra red heat burn.

• Gamma radiation.

• X ray radiation.
Which of the following conditions does
NOT require emergency
ophthalmological management?

• Anterior uveitis

• Acute angle-closure glaucoma

• Orbital floor fracture

• Orbital cellulitis
 Patient had right maxillary tumours treated
successfully with multiple doses of radiotherapy,
after that he noted dramatic decrease of visual acuity
of the right eye, the explanation of this may be due
to:

• Complicated cataract.

• Anterior uveitis.

• Central retinal vein thrombosis.

• Acute congestive glaucoma.

Which of the following is not advised in
the early management of a patient with
hyphema?

• Admission to hospital.

• Cycloplegics.

• IOP lowering agents.

• None of the above.

 GOOD
LUCK FOR
ALL