MBARARA UNIVERSITY OF SCIENCE & TECHNOLOGY

FACULTY OF MEDICINE

Department of Ophthalmology

MB ChB IV Ophthalmology Progressive Test, 26 Feb 2018, 13:00 -14:00

Venue: Mbarara University & Referral Eye Centre, Seminar Room

Instructions:

1. Answer all the questions on the question paper.

2. Remember to write your name and registration number on top of each sheet that you use.

Questions:
1. Name each of the following instruments/articles and state what it is used for. (10 marks)

A Operating microscope, used in eye surgery

B Posterior chamber intraocular lens, used to correct aphakia during cataract

surgery

C IIndite Indirect ophthalmoscope for fundus examination

D Goldmann applanation tonometer for measuring IOP

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E Snellen E chart for checking distance VA for illiterate adults and children

F Chalazion clamp for chalazion I&C

G Eyelid speculum for keeping eye open during surgery

H Simcoe irrigation-aspiration cannula for removing lens cortex during cataract

surgery

I Trial frame for refraction

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J Pinhole, used to check if a patient is likely to have a refractive error.

2. For each of the conditions illustrated below, Name the condition/abnormality, state at least one method of
treatment. (10 marks)

A : Right ptosis, could be congenital, Ptosis surgery: frontalis suspension

B Eyelid retraction in Thyroid eye disease (thyrotoxicosis)

C : Mature cataract, age, diabetes mellitus, trauma, uveitis

D : Pterygium, Excision

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E Dendritic ulcer, acyclovir

3. Match the following procedures/drugs used in the treatment of cataract glaucoma with the
statements that follow: (10 marks)

i. Acetazolamide
ii. Mannitol
iii. Peripheral iridectomy
iv. Trabeculectomy
a) Acute angle closure glaucoma iii
b) Chronic open angle glaucoma iv
c) Rapid reduction of intraocular pressure ii
d) Renal stones i

4. Regarding the Retina: (10 marks)

a) Between which layers does fluid accumulate in retinal detachment? Retinal pigment epithelium and
neuroretina (or photoreceptor layer)
b) Name the cells useful in vision in dim light - Rods
c) Name the Outermost layer -Retinal pigment epithelium
d) Name the part for most acute vision -Fovea
e) What are the cells whose axons make up the optic nerve? Ganglion cells

5. Briefly describe (in one or two sentences) each of the following conditions/signs: (10 marks)

a) Hyphaema - blood in the anterior chamber

b) Hypopyon -Pus in the anterior chamber
c) Keratic precipitates -Deposits of inflammatory cells on the endothelium in uveitis
d) Papilloedema Optic nerve head swelling due to raised intracranial pressure
e) Rubeosis iridis- Blood vessels on the iris surface, usually due to retinal hypoxia following DR or
central retinal vein occlusion

6. Briefly describe each of the following eyelid conditions and name one procedure or treatment
method in its management: (10 marks)

a) Blepharitis - Inflammation of the eye lid margin

b) Chalazion Chronic inflammation of meibomian gland, painless swelling, treated by I & C
c) Entropion inturning of eyelid, treated by lid rotation, lateral tarsal strip

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 d) External hordeolum - Acute inflammation of eye lash follicle glands, treated by I&D, horizontal
skin incision
e) Ptosis Drooping of upper eyelid, treated by ptosis surgery such as frontalis/brow suspension

7. The following are visual acuity of 4 patients: (10 marks)

i) VARE=1/60, VALE=NPL

ii) VARE=2/60, VALE=5/60

iii) VA RE=6/24, VALE=6/60

iv) VARE=6/18, VALE=6/6

a) Which of the above patients is categorized as having normal vision according to WHO? iv

b) Which of the above patients is categorized as having mild visual impairment according to WHO?
iii

c) Which of the above patients is categorized as unilaterally blind according to WHO? ii

d) Which of the above patients is categorized as having severe visual impairment according to
WHO? ii,

e) Which of the above patients is bilaterally blind? i

8. Regarding the iris/pupil: (10 marks)

a) Which muscle causes pupil constriction? Pupillary sphincter

b) Which muscle causes pupil dilatation? Dilator muscle
c) What nerve palsy causes ptosis and a fixed dilated pupil? III palsy
d) What condition causes ptosis and a constricted pupil? Horner’s syndrome
e) Name one drug that can be used to constrict the pupil? Pilocarpine

9. Regarding accommodation and refractive errors: (10 marks)

a) Draw a diagram to illustrate myopia

b) Draw a diagram to illustrate hypermetropia
c) Draw a diagram to illustrate astigmatism
d) Mention two ways of correcting astigmatism Spectacles, contact lens, refractive surgery
e) Mention two ways of correcting aphakia IOL, contact lens, spectacles

10. Regarding red eyes: (10 marks)

a) Which condition is characterized by purulent discharge? Bacterial conjunctivitis

b) Which condition is characterized by itching? Allergic conjunctivitis

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c) Which condition is characterized by a shallow anterior chamber and dilated oval pupil? Acute
angle closure glaucoma
d) Which condition is characterized by a dendritic corneal staining pattern? Herpes simplex keratitis
e) In which of the above conditions (in a) to d)) is Acyclovir indicated? Herpes simplex keratitis