TO UNDIP

September 2022

1. For the last 10 days a patient has been in an ICU on mechanical ventilation. After a
febrile episode, blood cultures grew Candida. Why might an ophthalmologist be
consulted?
A. choroiditis or endophtnalmitis occurs in less than 1 % of in patients with
candidemia
B. More than 5 % of untreated candidemia patients develop ocular finding of infection
C. Intravitreal antifungal therapy are indicated in any patients with Candida sepsis
D. Intravitreal antifungal in combination with intravenous antifungal therapy are
indicated in any patients with Candida sepsis
E. There is no need to perform dilated ophthalmoscopy if the patients receiving
systemic antifungal therapy, so no consultation with ophthalmologist is indicated

2. A 40 years old woman came to the eye clinic with the chief complain of foreign
body sensation and whitening in her right eye. On ophthalmology examination
revealed RE VA Was 20 / 100, pericorneal injection, and peripheral corneal thinning
at 3-6 o'clock until limbus, lucid interval(-). There was no cell / flare in AC, the lens
and vitreous was clear, and the fundus within normal limits. The LE VA was 20 / 20,
and there was no obvious abnormality in left eye. The patient has a rheumatoid
arthritis and didn't control regularly to the rheumatologist. What is the most suitable
therapy for this patient?
a. Topical and oral corticosteroid
b. Topical non steroid antiinflammatory drug (NSAID) + oral corticosteroid
c. Topical lubricant + topical / oral collagenase inhibitor + immunosuppressive agent
d. Topical lubricants and topical autologus serum
e. Topical and oral antibiotic

3. A 39 ears old woman comes with blurred vision and photophobia in her both eyes
for 2 weeks. 1 weeks prior to the eye clinic, she had headache, fever, and tinnitus.
There are no history of eye trauma or intraocular surgery. Visual acuity is 20/200 in
both eyes. Significant finding on examination in both eyes are mild ciliary injection,
mutton fat KPs, mild anterior chamber cells and moderate vitreous cell. Funds
examination reveals sunset glow fundus in both eyes. There are no laboratory
evidence of systemic disease. The clinical presentation that could be found in this
patient:
a. Neuritis retrobulber
b. Neovascularization in the disc
C.Progressive outer retinal necrosis
d. Rhegmatogen retinal detachment
e. Dalen - Fuchs nodules

4. Which of the following is the most common corneal finding of Juvenile Idiopathic
Arthritis?
a. Thickening of Descemets membrane
b. Deep stromal neovascularization
c. Calcific band keratopathy
d. Nummular keratitis
e. Decompensated cornea

5. What test may suggest a specific surgical approach to persistent macular edema in
an eye With a long-standing (several years duration) intermediate uveitis that has no
active inflammation under treatment with immunosuppressive agents?
a. fluorescein angiography
b. MRI of the head and orbit
c. optical coherence tomography (OCT)
d. USG Bscan
e. indocyanine green

6. Bilateral CME in a patient with bilateral, chronio, granulomatous anterior uveitis

with 2+ cells in the anterior chamber, posterior synechiae, and 2+ vitreous cells, and
funduscopy Within normal limit is most effectively managed by which of the
following?
a. oral acetazolamide
b. topical ketorolac
c. systemic corticosteroids and systemic immunomodulatory therapy
d. pars plana vitrectomy
e. oral NSAID

7. A 78-year-old man presents for an eye examination. He reports no symptoms and

has a history of bilateral cataract extraction. On examination, there is low-grade cell
and flare in the anterior chamber of the right eye, an intraocular pressure of 6, and an
otherwise normal funds examination in that eye. Examination of the left eye is normal
and a review of systems is notable for a history of smoking, but is otherwise
unremarkable. The patient is not on any eye drops. What would be next step in
management of this patient's condition?
a. extensive uveitic workup, including assessing for sarcoidosis, syphilis, and
tuberculosis and starting the patient on topical corticosteroids
b. vitreous biopsy with flow cytometry to look for primary intraocular lymphoma
c. carotid Doppler ultrasonography to assess for significant stenosis of the right
carotid artery
d. reassurance and observation, as this is a common finding after intraocular surgery,
presumably due to breakdown of the blood-aqueous barrier

8. A 50-year-old woman presents with chronic scleritis, headaches, a history of

branch retinal artery occlusion, and tracheomalacia. What test may further assist in the
diagnosis and treatment?
a. quantitative and qualitative anti nuclear antibody testing
b. lumbar puncture and spinal fluid analysis
c. urinalysis
d. anti-cyclic citrullinated antibody test

9. What further testing may be required in a patient with non granulomatous anterior
uveitis with hypopyon and HLA-B27-positive ankylosing spondylitis?
a. urinalysis
b. pathergy test
c. aqueous tap for polymerase chain reaction testing
d. chest x-ray and cardiac echogram

10. A 23-year-old male medical student is very anxious about some test results and
seeks further information from an ophthalmologist. He reports that during a class
about human leukocyte antigen (HLA) haplotypes, his medical school performed
HLA screening on all of the students, and he learned that he is positive for HLA-B27.
He is now exceedingly worried about developing acute anterior uveitis (AAU). What
counseling should the ophthalmologist provide to this patient after a normal eye
examination?
a. Almost 10% of individuals who are HLA-B27 positive manifest AAU, but it
typically affects females, so he does not need to worry.
b. Approximately 8% of the population is positive for HLA-B27, while only 0.012%
of the population will develop AAU, so it is much more likely that he will never
manifest AAU.
C. Almost two-thirds of individuals who are HLA-B27 positive manifest AAU so
there is real risk of his developing the disease, and he should be monitored closely.
d. There is no need to worry, because HLA-B27 is not associated with AAU. It is
recommended that he see a rheumatologist, because HLA-B27 is associated with the
sero negative spondylo arthropathies.

11. Which of the following statements correctly describes the relationship between
intraocular lens (lOL) implant power, axial length, and corneal power?
a The loL power should be increased as the power of the cornea increases and the
axial length increases.
b. The lOL power should be increased as the power of the cornea decreases and the
axial length increases
C. The lOL power should be increased as the power of the cornea increases and the
axial length decreases.
d. The lOL power should be increased as the power of the cornea decreases and the
axial length decreases.

12. If a patient is found to have a best-corrected visual acuity of20/40 in each eye but
reports that vision is adequate for his needs, which factor would cause the
ophthalmologist to consider cataract surgery? (20)
a. The level of lens opacity equals the level of vision loss.
b. The patient has no medical problems that would contraindicate surgery.
c. The ophthalmologist is unable to see the patient's retina well enough to evaluate it.
d. The patient would be able to perform his activities of daily living more easily with
bettervision.

13. Which of the following is a source of potential complications during cataract

surgery in a uveitis patient?
a. shallow anterior chamber
b. zonular laxity
c. endogenous endophthalmitis
d. phacolytic glaucoma

14. All of the following may result in shallow or flat anterior chamber in the
postoperative period after cataract surgery, except
a. Wound leak
b. Pupillary block
c. Suprachoroidal effusion/ haemorrhage
d. Posterior infusion syndrome
e. Ciliary block with aqueous misdirection

15. You are a busy and experienced cataract surgeon. In the first week following an
uncomplicated phacoemulsification, you discover that your patient is left with a
spherical equivalent of +2.5 D. Your target refraction was plano. The patient's
preoperative axial length was 23.5mm on immersion axial biometry and the Ks were
44.0 D and 45.0 D, with normal corneal topography and a normal slit lamp exam.
What is the most likely explanation for this refractive surprise?
a. Inadvertent placement of the IOL in the sulcus instead of the capsular bag.
b. Use of the incorrect regression formula in the IOL power determination.
c. Placement of the wrong IOL due to confusion with another patient
d. Miscalculation of corneal power due to previous refractive surgery in the operated
eye.

16. If ciliary block glaucoma is suspected as causing a shallow anterior chamber after
cataract surgery, all of the following maneuvers may be useful, except:
a. Miotic drops such as pilocarpine to constrict the pupil, deepen the anterior chamber
and open up the trabecular meshwork
b. Aqueous suppressants such as beta blockers and carbonic anhydrase inhibitors to
lower the IOP
c. NdYag laser disruption of the anterior hyaloid face
d. Mechanical vitrectomy to decompress the vitreous and disrupt the anterior hyaloid
face

17. Evaluation of the cornea is important prior to cataract surgery. Which of the
following statements is true?
a. Corneal transplant surgery should be combined with cataract extraction when
guttata are present in order to speed visual rehabilitation
b. Specular microscopy is the best means of determining how well the cornea will fare
following cataract surgery
c. Normal corneal pachymetry measurements obtained in the early morning suggest
that the cornea will probably remain clear following cataract surgery
d. Corneal pachymetry should be performed late in the day, after the cornea has had
longer exposure to the environment
e. Other than determining lens implant power, keratometry does not have a role in the
preoperative evaluation for cataract surgery

18. A-76 year old man complains of difficulty driving because of reduced vision. His
best corrected visual acuity is 20/70 OD and 20/40 OS. Goldmann visual fields are
constricted, more in the OD than in the OS. A moderate nuclear cataract is present
OD, and a mild one is seen OS. His IOP is 23 mmHg OD and 18 mmHg OS. He uses
timolol ½ % bid OD and dorzolamide tid OD. His cup-disc ratio is 0,7 OD and 0,6
OS. The fundus is otherwise normal. Which of the following statements is true?
a. Cataract surgery should not be considered because of the risk of loss of fixation
postoperatively
b. cataract surgery combined with glaucoma filtering surgery is the only approach that
should be considered for this patient
c. Medical glaucoma treatment should be maximized before considering cataract
surgery
d. The visual field constriction in this case is probably caused by glaucoma
e. The use of latanoprost after cataract surgery may increase the risk of postoperative
CME
19. a 67 yo man presents with the diffuse corneal edema 1 day after
phacoemulsification and posterior chamber IOL implantation. The entire central and
peripheral cornea are equally affected. The cornea in the opposite eye was normal.
There is no pain and IOP 17 mmHg. what is most likely cause the edema?
a. anterior chamber collapse with IOL/endothelial touch
b. decompensated fuchs endothelial dystrophy
c. toxicity of intraocular solutions used during surgery
d. descemet’s membrane detachment

20. which pf the following statements is true about the management of cataract
associated with ocular trauma?
a. after blunt or penetrating trauma in children, fibrincan be deposited on the anterior
lens capsule that mimics the appearance of cataract.
b. cataract associated with large corneal lacerations should be removed through the
laceration to avoid making and additional corneoscleral wound.
c. if a cataract does not develop in the injured eye within 10 daysof the trauma, the
patient is unlikely to develop a cataract later.
d. phacoemulsification through a small limbal incision is the best approach to the
removal of any cataract associated with acut trauma.
e. the benefits of inserting an IOL at the time of surgery outweigh the risks when
removing a cataract during the repair of a paracentral corneal laceration.

21. wanita, 54 tahun datang ke poli mata dengan keluhan pandangan double. Riw.
Trauma disangkal. Pada pemeriksaan dijumpai VODS: 20/40 nc. Segmen anterior
tenang. Terdapat kekeruhan ringan di lensa. Hirschberg test kesan 0. Pasien diperiksa
Maddox Rod dan penlight dengan Maddox diletakkan pada mata kanan, didaptkan
hasilnya titik kuning berada diatas, garis merah berada di bawah. Apakah diagnosis
pasien dari hasil Maddox rod tersebut?
a. hipotrofi kanan
b. hipertrofi kiri
c. exotropia
d. esotropia
e. hipertrofi kanan
22. women, 23 yo come to hospital with chief complaint blurred vision in right eye
especially after exercise. Drop eyelid not found. Visual acuity RL: 20/80 nc.IOP 17
mmHg, pain RAPD (+) in right eye, funduscopy normal limit.what the mechanisms
underlie complaints of blurring especially after exercise?
a. ischemic
b. demyelinisasi
c. compression
d. degenerative

23. a 40 yo women came to the eyeclinic with complaint of constant double vision for
the last 4 months. Full eye examination showed proptosis and restrictive gaze palsies
on both eyes, higher grade on RE if move to lateral and superior. There were eyelids
retraction on both eyes. She revealed the history of palpitation and changes on her
menstrual cycle for the past months. In this patients, what muscle hypertrophy?
a. lateral and medial
b. lateral and superior
c. inferior and superior
d. inferior and medial

24. a woman 28 yo came with photophobia. On examinationthe visual acuity is 20/20

OU. There was no limitation on eye movement of both eyes. Anterior and posterior
segment are within normal limit except for the pupil anisocor. In bright light RE
2mm, and LE 3mm. in dim light RE 4mm, LE 6mm. after cocain pharmacological
testing, RLE 4mm. The most common diagnosis for the above patien is:
a. horner syndrome
b. third nerve palsy
c. pharmacologic pupil
d. physiological anisokor

25. Pasien wanita usia 45 tahun dengan keluhan nyeri kepala hebatdisertai pandangan
mata double. Dari pemeriksaan. Riwayat dahulu tidak jelas.Namun beberapa hari ini
pasien mengeluh sakit kepala habat disertai muntah. Pemeriksaan
opthalamologidijumpai adanya keterbatasan gerak bola mata, pemeriksaan MRI
terlampir. Berdasarkan gambaran MRI dibawah ini, manakah nervus kranialis
yangpaling sering terkena

a. III
b. IV
c. V
d. VI

26. A 50 years old man coma to eyeclints of episodic spasm of his eyelids slace 3
years ago. The complaints god worsened and progressive evertime that disrupted his
daily activities. From examination showed that there were contraction oculi of both
eyes during facial grimacing. The patient diagnosed with Meige syndrome. The most
probable diagnose of patient is
a. Hemianopia homonim
b. Facial myokimia
c. Myasthenia gravis
d. Essential blefarospasme

27. Obese woman 32 yo come to hospitas with blurred vision in right eye and
headache. VA RE 6/24 NC with IOP 15 mmHG. Funduscopy show papilledema.MRI
show empty sellar. What least likely condition correlate with her diagnosis :
a. Hemianopsia Homonim
b. Visual Obscuration
c. Enlargement blind spot
d. Incomitan esotropia

28. After a motor vehicle accident a 23 years -old maname to emergency departement
presents with unilateral marked proptosis, diplopia and prominent episkleral vessel.
He complains of a rushing sound in his head. Which of the following is most likely
possibillity :
a. Orbital floor fracture
b. Retroorbital haemorrhage
c. Carotid Cavernosus Fistula
d. Dissection of carotid artery
e. Posterior draining dural shunt

29. Man 60 yo with chief complain decreased vision in the left eye since the last 3
years. VOD 6/6 VOS 6/40 RAPD (+), VF examination shows inferior altitudinal
defect. Fundus examination revealed optic disc appear hyperemia . In fellow eye
show disc at risk. What is diagnosis?
a. Iskemik optic neuropathy
b. Optic disc drusen
c. Inflammatory optic neuropathy
d. Papilitis

30. A 15 year old female patient came with diplopia with past medical history DM (+)
, gaze palsy to the left in right eye ( limitation in adduksi ) and nystagmus at abduksi
left eye . What is the most likely the diagnosis on this patient?
a. One and half syndrom
b. INO
c. Eight and half syndrom
d. Bilateral Intranuclear Ophthalmoplegia

31. A 40 year old woman complains of headaches, eyepain, and blurry vision when
reading book. Gonioscopy shows a peripherally shallow chamber with a double iris
hump on indentation. What is the initial management of this patient?
a. Prostaglandin analog
b. Laser iridotomy
C. Clear lens extraction
D. Trabeculectomv
e. Laser iridoplasty
32. If we use a Goldman type, large diameter goniolens. What is the effect of applying
indentation?
a. This may indent the sclera and falsely narrow the angle
B. This may help differentiate between appositional and synechial angle closure
C. This may indent the cornea and falsely open the angle
D. This may help to break an attack of acute angle closure glaucoma

33. A day after cataract surgery on her left eye, a 55 year old woman with small eye
complained pain and blur. Visual acuity hand movement. There were flat bleb, flat
anterior chamber, anterior lens displacement and intraocular pressure 48 mmHg.
What is the díagnose of this patient:
a. Phacoanaphylactic glaucoma
B. Lens particle glaucoma
C. Phacomorphic glaucoma
d. Malignant glaucoma
E. Refracter glaucoma

34. Pada pasien glaukoma, setelah ditentukan berapa target TIO dan diberikan terapi,
saat dilakukan evaluasi TIO telah mencapai target namun terdapat progresifitas
glaukoma, apa
yang harus dilakukan?
A. Turunkan target TIO
B. Follow-up 6 bulan
C. Re-evaluasi setelah 6-12 bulan
d. Lanjutkan terapi evaluasi setelah 3 bulan
E. Ganti terapi dengan obat glaukoma lain

35. Seorang wanita 55 tahun datang dengan keluhan 2 hari yang lalu mata kana tiba-
tiba nveri, merah dan penglihatan kabur. Pada pemeriksaan didapatkan VOD 1/300,
kornea edema, CO kesan dangkal, pupil midilatasi, lensa keruh tak rata, lain-lain sulit
dinilai. Vos 6/15, segmen anterior tenang, lensa keruh tak rata, optic disc normal.
Pada pemeriksaan gonioskopi mata kiri tampak Schwalbeline d 4 kuadran.
Diagnosos apa yang paling mungkin:
a. Acute Primary Angle Closure
b. Primary Angle Closure Glaucoma
C. Phacomorphic glaucoma
d. Neovascular glaucoma
e. Phacoanaphylactic glaucoma

36. Characteristics of glaucama suspect :

a. suspicious optic nerve or nerve fiber layer appearance and a visual field defect
b. visual field defect suggestive of glaucoma and a corresponding glau-comatous optic
nerve abnormality
C. family history of glaucoma in a first-degree relative
d. elevated IP with evidence of optic nerve damage

37. Anti glaukoma di bawah ini kontraindikasi pada konsidi aquous misdirection
a. acetazolamide
b. latanoprost
c pilocarpin
d. timolol maleat

38. pasien 43 th datang dengan pandangan kabur dan mata tidak nyaman. Riw trauma
dijumpai. Pemeriksaan ophthalmologi dijumpai : VOD 6/48 NC, TIO 35 mmHg,
COA dalam. Funduscopy tidak ditemui adanya GON. Jika dilakukan pemeriksaan
gonioskopi maka gonioskopi apa yang ditemui pada pasien ini, kecuali
a. widening of the ciliary body band
b. absent or torn iris processes
c. white, glistening scleral spur
d. high PAS

39. pasien wanita 35 th datang dengan keluhan mata kanan buram, tanpa disertai rasa
nyeri ataupun mata merah. Pasien sedang hamil trimester 1. Pemeriksaa oftalmologi
didapatkan VOD 5/60,VOS 6/10, TIO OD 40 mmHg, TIO OS 20 mmHg. Segmen
anterior kedua mata normal, COA VH gr III, lensa jernih. Funduskopi OD papil N II
CDR vertikal 0.8, cupping glaucomatosa +. Funduscopy OS CDR vertikal 0.3.
Tatalaksana medikamentoosa yang diberikan pada pasien tersebut adalah
a. Golongan CAI
b. Golongan beta bloker
c. Golongan alfa agonis
d. golongan PGA

40. A 30 years old white male with myopia in the both eyes. The examination reveals
an IOP of 28 mmHg with anterior segment krukenberg spindle and mid peripheral iris
transillumination defect. Funduscopy is in normal limit, gonioscopy dense pigmented
trabecular meshwork. What is the recommended management for this patient
a. filtering surgery
b. peripheral laser iridotomy
c. timolol maleat eye drop
d. laser iridoplasty

41. laki-laki 32 th datang dengan keluhan pandangan mata kanan kabur, saat melihat
tulisan seperti bergelombang, sejak 1 minggu yang lalu. mata kiri tidak ada keluhan.
Visus OD 6/20 PH -, OS 6/6. Tidak ada riwayat sistemik maupun trauma. Pasien
seorang perokok, peminum kopi, pekerjaan teknisi computer. Dari pemeriksaan FFA
didapatkan gambaran smoke stack pattern. Tatalaksana yang tepat untuk kondisi
pasien saat ini adalah :
a. photo dynamic therapy
b. injeksi anti VEGF intravitreal
c. laser fotokoagulasi
d. observasi setiap bulan
e. injeksi triamcinolone acetonide subtenon

42. wanita 65 th mengeluh pandangan mata kiri Kabur mendadak sejak 1 bulan yang
lalu. Riwayat hipertensi dan DM terkontrol. Dari pemeriksaan oftalmologis
didapatkan visus OD 6/10, OS 1/300. Status oftalmologis mata kanan dalam batas
normal, mata kiri kornea jernih, COA dalam, pupil RAPD +, lensa keruh tak rata,
funduscopy didapatkan gambaran papil batas tidak tegas, flame shape hemorhage 4
kuadran, makula suram. Pemeriksaan penunjang sederhana yang dapat menjadi dasar
dilakukan inisiasi laser fotokoagulasi pada pasien tersebut adalah :
a. Gonioskopi
b. OCT
c. FFA
d. HFVA
e. Contast sensitivity test

43. Laki-laki 25 tahun dikonsulkan dengan keluhan mata kiri kabur. Visus 1/60
segmen anterior tenang, lensa jernih, CV cell grade 2. Funduscopy mata kiri
didapatkan opasifikasi sepanjang pembuluh darah besar disertai area perdarahan,
frosted branch angitis (+), periphlebitis (+). Saran pemeriksaan laboratorium yang
tepat adalah:
a. C- Reactive protein
b. CD4+ T cell count
c. Rhematoid Factor
d. Electrolyte sedimentation Rate
e. ANA test

44. wanita 30 th mengeluh mata kanan melihat bitnik hitam setelah bangun tidur sejak
2 minggu yll. Tidak didapatkan riwayat trauma, penyakit sistemik disangkal, pasien
tidak menggunakan kacamata. Visus mata kanan 6/10, mata kiri 6/7,5. Segmen
anterior kedua mata dalam batas normal. Pemeriksaan segmen posterior dan
funduscopy mata kanan didapatkan schaffer sign (-), operculated hole +
superotemporal, retinal detachment superotemporal perifer dengan subretinal fluid +
minimal. Tatalaksana terbaik untuk kondisi tersebut adalah:
a. Scleral Buckle
b. pneumatic retinopexy
c. laser demarkasi
d. vitrectomy pars plana
e. scleral buckle + vitrectomy pars plana

45. seorang pria 55 th dengan DM + sejak 15 tahun terakhir dengan control gula tidak
teratur dating dengan keluhan pandangan kedua mata kabur. Visus OD 4/60, OS 5/60
segmen anterior tenang dalam batas normal, lensa keruh tak rata, funduscopy
didapatkan: mata kanan neovascular vessel di papil N.II, traksi (+) tidak mengancam
fovea, hard eksudat (+) ekstra fovea. Mata kiri neovascular vessel di retina
superonasal, traksi (-), hard eksuddat (+) ekstra foveal. Tatalaksana yang tepat untuk
pasien tersebut:
a. OD observasi, OS laser fotokoagulasi
b. OD vitrectomy, OS laser fotokoagulasi
c. OD laser fotokoagulasi, OS laser fotokoagulasi
d. OD vitrektomi, OS vitrectomy
e. OD vitrektomi, OS Observasi

46. seorang laki-laki usia 14 th datang dengan keluhan mata kiri kabur, tidak disertai
mata merah sejak 6 bulan yll, visus mata kanan 6/6 dan dalam batas normal. Mata kiri
visus 2/60 lensa jernih, funduscopy didapatkan teleangiectasis retina, sea fan pattern
di retina perifer, serta eksudat di parafovea. Dari pemeriksaan FFA didapatkan
gambaran leakage. Gambaran yang paling mungkin pada pasien ini adalah:
a. Eales disease
b. Susac syndrome
c. Coats disease
d. von hippel-Lindau Disease
e. Idiopathic retinal vasculitis, aneurysma and neuroretinitis

47. bayi premature usia 32 minggu, BB 1460 gr dikonsulkan untuk screening ROP.
Dari funduscopy baik mata kanan dan kiri didapatkan ridge dengan fibrovascular
proliferation di zona anterior dari polus posterior sisi temporal. Kondisi tersebut
termasuk dalam tahapan:
a. Aggressive posterior ROP
b. Treshhold Disease
c. High Risk pretreshold ROP/Type 1 ROP
d. Lower risk pretreshold ROP/Type 2 ROP
e. plus disease

48. seorang mahasiswa 21 th datang ke poli mata dengan keluhan mata kiri kabur
mendadak setelah bermain basket 1 minggu yll. Riwayat trauma disangkal. Penyakit
sistemik disangkal, riwayat penggunaan kacamata ukuran -3.50 D kanan dan kiri.
Visus mata kanan 5/60 dengan koreksi 6/6, mata kiri 1/60.segmen anterior kedua mata
dalam batas normal, funduscopy mata kanan retina tigroid, lattice degeneration di
inferior, mata kiri retina detachment di inferior, macula off dengan apex disisi nasal,
break horseshoe di inferonasal anterior equator dengan indentasi, tamapak pigment
clamping. Hal ini sesuai dengan lokasi break pada:
a. lincoff rule 1
b. lincoff rule 2
c. lincoff rule 3
d. lincoff rule 4

49. Wanita usia 68 tahun, mengeluh pandangan mata kanan gelap mendadak 5jam
yang lalu, tidak nyeri, Visus mata kanan 1/300, segmen anterior tenang, lensa keruh
tak rata. Funduscopy didapatkan retinal whitening dan cherry red spot. Pemeriksaan
penunjang Yang perlu dilakukan pada pasien tersebut adalah
a. ESR dan CRP
b. VDRL dan TPHA
c. BGA dan Ferritin
d. Tekanan Darah dan Profil Lipid

50. Laki Taki 37 tahun datang dengan keluhan mata kiri kabur, visus mata kanan 6/15
mata kiri 6/60. Pemeriksaan oftalmologis segmen anterior kedua mata dalam batas
normal. Funduscopy kedua mata didapatkan gambaran material kekuningan dan bulat
seperti flekberbentuk pipih tersebar di area makula. Gambaran FFA didapatkan 'dark
choroid" Diagnosis yang tepat untuk pasien in adalah:
A. Best Vitelliform Dystrophy
b. Early Onset Drusen
C. Sorsby Macular Dystrophy
d. Stargard Disease
e. Pattern Dystrophy

51. A 24 vears old woman wants to wear a soft contact lens for her daily life activity.
Her last prescription for right eye : S -8.00 D, left eye : S-9.50 D. The contact lens
power will be
a. Right eye: S-8.00 D, left eye: S-9.50 D
b. Right eye: S-7.25 D, left eye: S-8.50 D
C. Right eye: S -6.00 D, left eye : S-6.50 D
d. Right eye: S -6.50 D, left eye: S-7.50 D

52. A -6.00 sphere S neutralizes at the retinoscopic reflex when the axis of the streak
at the 170 meridian. A -2.50 D sphere neutralizes at the retinoscopic reflex when the
axis of the streak at the 80 meridian. Assume that the working distance is 50 cm.
What is the appropriate refractive correction for the patient?
a. S-2.50 D C-6.00 D x 170
b. S -4.50 D C-6.00 D x 170
C. S -4.50 D C-3.00 D x 80
d. S-2.50 D C-6.00 D x 80

53. A patient diagnosed as Pigmentous Retinitis, the distance visual acuity is 20/200.
The predicted add will be:
a. S+4D
B. S+ 8 D
C. S + 10 D
d. S + 20 D

54. A 20 years old boy came to an eve clinic. He had used a soft contact lens for a
weeks. His chief complain is a red eye, a discomfort when using his contact lens.
Examination under slitlamp biomicroscope showed no movement during blinking
reflex, mild circumferential injection, corneal surface was quitè good. What is the
diagnosis of this condition?
a. Flat fitting
B. Steep fitting
C. Atipical alignment
D. Corneal infection

55. A patient comes to your clinic, she has a problem after using rigid gas permeable
(RGP) contact lens. Her chief complain were unstable visual acuity and the RGP lens
were easily move out. Contact lens fitting examination shows movement 4-6 mm.
Fluoerescein pattern were showed dark figure at the centre of RGP lens. What is the
possible problem that we are dealing with?
a. Deposit problem.
b. To loose syndrome.
c. Contact lens induce red eye.
d. Tight lens syndrome,
e. Hypoxia syndrome

56. A 20 years old female patient came to your clinic with a unilateral cataract at the
right eye. A cataract extraction were programmed next month. Ocular examination
were normal at the left eye. What is the best choice for her?
a. Doing the cataract extraction for her right eye and giving glasses prescritpion.
b. Doing the cataract extraction for her right eye and giving contact lens prescritpion.
c Doing the cataract extraction for right eye and doing clear lens extraction for her
LE.
d. Doing the cataract extraction for right eye and doing phakic IOL for her left eye

57. A fluorescein dye test of contact lens fitting procedure are listed below. What
parameter do you need to adjust?

a. Decrease the diameter.

b. Increase the base curve.
c. Increase the sagital depth.
d. Decrease the optical zone.
e. Decrease the periferal edge

58. A 50 years old female patient having a chief complain for her near work activity.
She has 4 Dioptre myop history for both eyes. She needs a glasses for reading a
newspaper and far activity. What kind of lens design would you give to your patient?
a. Trifocal design.
b. Bifocal round top design.
c. Bifocal flat top design.
d. Progressive addition lens design

59. Seorang pasien dengan dengan kelainan refraksi S -5.00 C -1.50 × 180° dilakukan
fitting lensa kontak lunak torik dengan axis 180. Pada pemeriksaan slit lamp
menunjukkan sentrasi lensa kontak cukup baik, namun posisi marker jam 6 lensa
kontak berada pada jam 4. Tuliskan resep lensa kontak torik yang seharusnya dipesan
untuk pasien tersebut
a. 5-5.00 C -1.50 x 30°
b. S -5.00 C -1.50 x 60°
c. S -5.00 C-1.50 x 120-
d. S -5.00 C -1.50 x 150°
e. S -5.00 C -1.50 x 180°

60. Pada kelainan refraksi S -5.00 D dengan hasil pemeriksaan Keratometri Flat K
7,80mm, akan menggunakan lensa kontak rigid gas permeable (RGP), Base curve
akhir yang dipilih berdasarkan fitting statis dan dinamis yaitu 7,85 mm. Berapakah
keukatan RGP yang diberikan?
a. S-4.00 D
b. S -4.25 D
c. S -4.50 D
d. S-4.75 D
e. S-5.00 D

61. You are asked to see a neonate to rule out ocular signs of intrauterine
infection. You note that the infant has microcephaly, jaundice and a history of
seizures. All of the following ocular findings would be suggestive of
congenital toxoplasmosis except:
a. Cataract
b. Retinochoroiditis
c. Vitreous cells
d. Optic nerve atrophy
62. The parents of a 5 month old boy bring him into you office concerned that he
does not to see anything. He was the product of a full term, uncomplicated
pregnancy and had neonatal problems. Developmental history reveals the he is
rolling over and starting to sit unsupported. On your examination, the child
does not fixate or follow but will blink at a bright light. Cyclopegic refraction
reveals +3.00 sphere OD and +3.00 sphere OS. Pupils are round, equal size
and briskly reactive to light, without a RAPD. He has full ductions and
versions an approximately 200 exotropia, but no nystagmus or wondering eye
movements. He also has clear media and a normal fundus. This child most
likely has
a. Leber’s congenital amaurosis
b. Refractive amblyopia
c. Delayed visual maturation
d. Foveal hypoplasia

63. The 5 month old child shown in the figure presents with a 5 to 6 week history
of progressive lid and orbital swelling. He has been otherwise healthy, eating
and gaining weight normally, without a history of fever. Appropriate treatment
of the patient, might consist of all of the following except:

a. Subcutaneous alpha interferon

b. Oral prednisone
c. Intralesional triamcinolone and betamethasone
d. Oral low dose methotrexate
 64. A 3 month old boy presents with a white pupil, which his parents first noticed
in photograph of the child. The patient’s fundus is shown in the figure:

This finding is commonly associated with all of the following except:

a. Microphthalmos
b. Retinal detachment
c. Foveal hypoplasia
d. Glaucoma

65. A 7 years old boy who sustained a fall 2 weeks ago developed swelling and 4
mm of proptosis of the left eye over the last 48 hours. He has not acted ill and
has been playing normally. His visual acuity is 20/25 OD and 20/40 OS. The
most likely cause on these finding is
a. Rhabdomyosarcoma
b. Orbital cellulitis
c. Optic nerve glioma
d. Lymphangioma

66. A 11 years old boy is diagnosed with well controlled, intermitten ecotropia.
Which one of the following is stereopsis testing is most likely to reveal?
a. Monofixation syndrome
b. Excellent stereopsis
c. No stereopsis because of temporal hemiretinal suppression
d. No stereopsis because of diplopia

67. Seorang anak usia 8 tahun dengan tajam penglihatan 6/6 pada kedua mata. Pada
pemeriksaan didapatkan 40 PD XT pada posisi primer, upgaze 60 PD XT dan
downgaze 20 PD XT, overaksi oblique inferior pada kedua mata, dengan kontrol fusi
buruk. Pembedahan yang dapat dipertimbangkan adalah
a. Recess R Lateral pada kedua mata
b. Recess R Lateral dengan infraplacement pada kedua mata
c. Recess R Lateral dengan inferior oblique anteriorization pada kedua mata
d. Recess R Lateral dengan inferior oblique anteriorization pada kedua mata dan
supraplacement pada kedua mata

68. A 6 year old patient with a history of strabismus surgery for congenital esotropia
presents with a history of a left that has begun to spontaneously drift upward several
times a day (figures)

What is the most likely diagnosis?

a. Dissociated vertical deviation
b. Superior oblique palsy
c. Consecutive hypertrophia
d. Orbital fat adherence syndrome

69. A patient with a near esodeviation greater than 10 PD more than the distance
deviation is considered to have which one of the following?
a. divergence insufficiency
b. High accommodative convergence to accommodation ratio (AC/A)
c. convergence insufficiency
d. high AC/A exotropia

70. A 45 years old man has a large esodeviation secondary to a complete unilateral
sixth cranial nerve palsy, which has shown no improvement after 1 year. Which one
of the following is the most appropriate treatment?
 a. Transposition of vertical recti
b. Large resection of the involved lateral recti muscle
c. Large resection of the involved lateral recti muscle with recession of the
ipsilateral medial rectus
d. Botulinum toxin injection to the ipsilateral medial rectus muscle

71. To investigate potential risk factor for cataract we collection group of samples,
one for cataract and the other for normal eyes afterwards we determined whether risk
factor were presents within both group, then compared the proportion of risk factor.
This research methodology is termed:
a. clinical trial
b. case report
c. cohort study
d. case control
e. cross sectional

72. There are 2 cataract surgeons in your working area with a total population of
1.000.000 people. Each surgeon has 2 surgery days/week and working for 50 weeks a
year. Reach a cataract surgical rate (CSR) of 1000 for every surgery days, each
surgeon has to operate as much as:
a. 10 patients/day
b. 20 patients/day
c. 30 patients/day
d. 40 patients/day
e. 5 patients/day
73. Your working area has a total population of 1.000.000. from extrapolation of the
population survery result, there are 10.000 people with blindness, 5000 of them
have cataract blindness. The prevalence of cataract blindness is :
a. 0,4%
b. 0,5%
c. 0,6%
d. 0,8%
e. 1.0%

74. A scening test using direct ophthalmology to look for diabetic retinopathy was
performed in 250 patient. The sensitivity was estimated to be 80%, if 100 patient
have the disease, how many patient will come out as false negative?
a. 20
b. 75
c. 170
d. 180
e. 200

75. Pada suatu penelitian yang meneliti pengaruh rokok dengan kejadian katarak di
salah satu kabupaten, mengambil sampel orang usia 30 tahun yang merokok dan
tidak merokok masing-masing sebanyak 2500 orang. Sampel diikuti selama 20
tahun untuk mendapatkan informasi kejadian katarak pada masing-masing
kelompok :
Pada pasien penelitian yang paling sesuai
a. Case control
b. Cohort
c. Cross sectional
d. Randomized control trial
e. Descriptive prospective

76. Penelitian factor resiko terus diikuti ke depan, perlu indictor?

a. Odd ratio
b. Prevalence ratio
c. Incidence ratio
 d. Prevalensi

77. Integrated people-centered eye care adalah, kecuali ?

a. Setiap pasien mendapatkan pelayanan Kesehatan mata seumur hidup
b. Setiap pasien mendapat promosi, prevensi, treatment, rehabilitasi
c. Kerjasama dengan lintas sector
d. Setiap pasien mendapatkan pelayanan Kesehatan mata selama menderita
sakit

78. Pemeriksaan GDS teratur pada pasien DM adalah pencegahan apa

a. Primer pada DM
b. Primer pada retinopati DM
c. Sekunder pada DM
d. Tersier pada retinopati DM

79. Devinisi prevalensi adalah :

a. Jumlah seluruh kasus penyakit pada periode waktu tertentu dibagi dengan
jumlah keselutuhan orang pada populasi selama periode waktu tersebut
b. Jumlah kasus baru pada periode tertentu, dibagi dengan jumlah orang yang
bebas penyakit pada awal periode
c. Jumlah kasus baru pada periode tertentu dibagi dengan jumlah orang yang
tidak mendapatkan penyakit pada periode tertentu
d. Jumlah kasus baru pada periode tertentu dibagi dengan person time at risk
selama periode tertentu

80. Penelitian melakukan penelitian di jawa barat untuk memeriksa apakah status
sosioekonomi dari rumah tangga berhubungan dengan cangkpan imunisasi pada
anak berusia 12-59 bulan. 4000 rumah tangga diseleksi secara acak dan diberikan
kuesioner kepada kepala rumah tangga untuk mengetahui stasus imunisasi anak
mereka. Seorang anak dikatakan telah diimunisasi bila mereka mereka menerima
sekurang-kurangnya satu dosis BCG, sekurang-kurangnya tiga dosis DPT, dan
sekurang-kurangnya satun dosis vaksin campak, baik yang catat melalui kart
vaksinasi atau yang dilaporkan oleh ibu atau pengasuhnya. Kuesioner juga
mencakup pernyataan mengenai status sosioekonomi.
 Apakah jenis rancangan penelitiann ini?
a. Cross sectional
b. Case control
c. Chort
d. Eksperimental

81. Seorang wanita, 78 tahun, datang dengan keluhan kedua mata seperti tertusuk –
tusuk kelopak mata dan bulu mata masuk ke dalam. Pemeriksaan didapatkan
distraction test 3 mm, snap back tes grade 1 ( 2-3 detik ) , cantal medial laxity
1mm, canthal lateral laxity 2 mm, Prosedur koreksi yang dilakukan pada pasien
tersebut adalah
a. Weiss procedure
b. Pentagonal incision + direct closure
c. Jones Procedure
d. Quicker Procedure

82. Patofisiologi terjadinya kondisi diatas adalalah

a. Diinsersi m. retractor palpebra
b. Horizontal laxity
c. Vertical instability
d. Overriding m orbicularis pre septal ke pre tarsal

83. Seorang wanita datang dengan mata berair sejak 3 bulan lalu. Riwayat 1 tahun lalu
terkena bell's palsy sudah dilakukan kelopak mata belum membaik. Diagnosis
pada pasien diatas
a. Ektropion sikatrikal
b. Ektropion paralitik
c. Ektropion involusional
d. Ektropion mekanikal

84. Tatalaksana ektropion pada kasus diatas adalah . . ..

a. Z plasty
b. Graft mucosa + cartilage
 c. Lateral Tarsal strip
d. Lamela anterior reposition

85. Pasien 68tahun datang dengankelopak mata turn.Pemeriksaan di dapatkan MRD 1

: 4 mm, MRD 2: 4 mm, fungsi levator 14 mm. Prosedur yang dipilih pada pasien
tersebut adalah.....
a. Fasanella servat
b. Aponeurosus surgery
c. Levator resection
d. Frontal sling

86. Kelaianan pada gambar dibawah in adalah….

a. Blepharophymosis syndrome
b. Telecanthus
c. Ptosis
d. Epicanthal fold
e. Cryptopthalmus

87. Tatalaksana pada kasus diatas adalah:

a. 1 steps /2 steps: koreksi ptosis + Y to V plasty
b. koreksi ptosis
c. Y to V plasty
d. Anterior lamellar reposition
88. Pasien dengan tumor 20 mm x 6 mm full thickness pada sentral margo palpebra
superior curiga ganas. Akan dilakukan eksisi dan rekonstruksi pasca eksisi luas.
Prosedur tindakan rekonstruksi yang akan dilakukan adalah ...
a. Mustade rotation flap
b. Cuttler beard Flap +graft cartilago
c. Hughes Flap + graft kulit
d. Glabellar flap

89. Pasien 55 tahun, datang dengan keluhan mata merah berulang, keluar kotoran,
Tatalaksana pasien tersebut adalah…

A. Spoeling dan probing

B. Pemberian antibiotik lokal, sistemik dan kuretase
C. Incise + drainage
D. Dacriosistorhinostomi

90. Seorang laki2 68 tahun datang dengan benjolan di kelopak mata. Diagnosis yang
paling memungkinkan dari kasus tsb adalah :
 A. Melanoma maligna
B. Ca basal
C. Ca squamosal
D. Sebaceous gland carcinoma

91. Pasien laki-laki 32 tahun, riwayat merokok datang dengan kedua mata menonjol.
Jantung berdebar, tremor dan berkeringat +. Pada pemeriksaan didapatkan mata
seperti melotot. Kelaianan tersebut dinamakan
a. Dalrymple's sign
b. Von Graefe's sign
c. Goldzeiher's sign
d. Cogan lid

92. Pasien laki-laki 32 tahun, riwayat merokok datang dengan kedua mata menonjol,
Jantung berdebar, tremor dan berkeringat +. Pada pemeriksaan didapatkan mata
seperti melotot. Pasien datang dengan mata merah, nyeri saat menggerakkan bola
mata, edema palpebra, chemosis. Tatalaksana pasien tersebut adalah
a. Lubricant, perubahan pola hidup, dan anti nyeri
b. Sistemik kortikosteroid dosis tinggi
c. Radiasi
D. Tarsoraphy

93. Predileksi umur pada rhabdomyosarcoma adalah

a. 1-3 tahun
b. 2-5 tahun
c. 5-7 tahun
d. 10-13 tahun

94. Pasien usia 68 tahun, datang dengan keluhan mata kanan merah sejak 1 tahun
terakhir.
 Diagnosis yang paling mungkin pada pasien tersebut adalah
a. Ocular surface squamous cell neoplasia
b. Limfoma
c. Adenitis
d. Pleomorphic adenoma

95. Tatalaksana yang tepat pada pasien diatas adalah

a. Wide excision dengan cryotherapy
b. Incisi + PA
c. Terapi antibiotik dan kortikosteroid sistemik
d. Eksisi in toto

96. Aa 4 year old child is referred for new onset of bilateral epiphora.
Examination show eyelashes on both lower eyelid rubbing against inferior
cornea. The parents states that an older sibling has similar symtomps, which
resolved without treatment. What is the most likely diagnosis ?
a. Entropion
b. Epiblepharon
c. Euryblepharon
d. Trichiasis
e. Ankyloblepharon

97. Tatalaksana kasus diatas adalah ?

a. Frontal sling
 b. Lateral tarsal strip
c. Tarsal fixation fracture
d. Blepharoplasty

98. Wanita muda memiliki massa di superotemporal. Dulu sudah dioperasi 2 kali,
sekarang nyeri. CT scan menunjukkan massa mendesak orbita dan ada titik
tulang / destruksi tulang. Diagnosis ?
a. ACC
b. Pleomorphic adenoma
c. Rhabdomyosarcoma
d. SCC

99. Lesi di konjungtiva mengarah ke kornea dengan feeder vessel dan leukoplakic.
Setelah dilakukan pemeriksaan PA, ditemukan adanya massa full thickness,
full thickness squamous cell metaplasia di epitel membran menginvasi ke
membran basalis dan stroma. Diagnosis ?
a. CIN
b. Squamous ca in situ
c. Invasive SCC
d. Squamous papilloma

100. Anak proptosis OS, visus 6/15. CT scan menunjukkan fusiform optic
nerve enlargement. Hasil PA menunjukkan hair-like juvenile pilocitoma
dengan astrositoma dan rossental fiber serta arachnoid hyperplasia. RAPD (+)
disertai optic disc swelling. Diagnosis ?
a. Glioma
b. Schwannoma
c. ON sheath meningioma
d. AVM