AIPG DNB HOT MCQs Ophthalmology

Q-1. Herbert’s pits are seen in
a) Trachoma
b) Acute end-ophthalmitis
c) Thyroid ophthalmopathy
d) Iridocyclitis

Answer: Trachoma
Corneal signs of Trachoma:
Superficial keratitis
Herbert follicles
Corneal ulcer
Herbert pits
Corneal opacity

Q-2. Most common muscle involved in Grave’s ophthalmopathy is
a) Medial rectus
b) Lateral rectus
c) Inferior rectus
d) Superior rectus

Answer: Inferior rectus
Ocular motility defects in Grave’s ophthalmopathy:
Convergence weakness- Mobius’s sign
The most common ocular motility defect is uni-lateral elevator palsy caused by an involvement of the inferior rectus muscle followed by failure of abduction due to involvement of medial rectus muscle.
Exophthalmos is a common and classical sign of disease.

Q-3. Haab’s striae is seen in
a) Trachoma
b) Congenital glaucoma
c) Scleritis
d) Cataract

Answer: Congenital glaucoma
Haab’s striae are horizontal breaks in the Descemet’s membrane associated with congenital glaucoma.
This occurs because Descemet’s membrane is less elastic than the corneal stroma.

Q-4. Muddy appearance of iris is seen in
a) Glaucoma
b) Iridocyclitis
c) Iris cyst
d) Persistent papillary membrane

Answer: Iridocyclitis
Anterior uveitis or Iridocyclitis:
Iris usually becomes muddy in color during active phase and may show hyper-pigmented and de-pigmented areas in healed stage.
Iris nodules: Koeppe’s nodules and Busacca’s nodules
Irregular pupil shape or festooned pupil

Q-5. Normal flora of the eye constitutes
a) E. coli
b) B. proteus
c) C. gonococci
d) Diphtheroids

Answer: Diphtheroids
Normal ocular flora remains:
The most commonly reported bacteria include coagulase-negative Staphylococcus (CNS), Staphylococcus aureus, Streptococcus spp., Corynebacterium spp., and Proprioni-bacterium acnes.
Corynebacterium diphtheriae and the non-diphtherial corynebacteria collectively referred to as diphtheroids.
Commonly-isolated pathogenic organisms include gram negative rods such as Pseudomonas aeruginosa, Haemophilus influenzae and fungal species.

Q-6. Transparency of cornea is mainly due to which layer
a) Endothelium
b) Descemet’s membrane
c) Bowman’s membrane
d) None

Answer: Endothelium
The human cornea is comprised mainly of the stroma, which lies between Bowman’s layer anteriorly and Descemet’s membrane posteriorly.
The corneal epithelium forms the most superficial layer of the cornea while the endothelium lies deepest and is in contact with the aqueous humor of the anterior chamber.
The epithelium and endothelium play important roles in maintaining corneal transparency by serving as a mechanical barrier to fluid diffusion and by creating a gradient that allows osmotic transport of water out of the stroma.

Q-7. Vossius ring is seen in
a) Epi-scleritis
c) Blunt trauma
d) Penetrating trauma

Answer: Blunt trauma
Vossius ring is a circular ring of brown pigment seen on the anterior capsule.
It occurs due to striking of the contracted pupillary margin against the crystalline lens.
It is smaller than the size of pupil.

Q-8. True about blow out fracture of the orbit is
a) Involve root of orbit
b) Downward gaze difficult
c) Enophthalmos
d) Downward gaze difficult and Enophthalmos
Answer: d
Blow out fractures of the orbit mainly involve orbital floor and medial wall.
Clinical features:
Peri-orbital edema and blood extra-vasation
Emphysema of eye lids
Paraesthesia and anesthesia
Ipsilateral epistaxis
Enophthalmos and mechanical ptosis
Severe ocular damage rarely

Q-9. Most common complication of corneal transplant is
a) Lenti-conus
b) Melting of cornea
c) Neo-vascularization
d) Post transplant astigmatism

Answer: Post transplant astigmatism
Complications of keratoplasty or corneal grafting or corneal transplant:
Early complications:
Flat anterior chamber
Iris prolapse
Secondary glaucoma
Epithelial defect
Primary graft failure
Late complications:
Recurrence of disease

Q-10. Most common ocular feature in rheumatoid arthritis is
a) Uveitis
b) Ectopic lentis
c) Kerato-conjunctivitis
d) Epi-scleritis

Answer: Kerato-conjunctivitis
Ocular manifestations involved with RA are Kerato-conjunctivitis sicca, episcleritis, scleritis, Keratitis, cranial nerve palsies, geniculo-cortical blindness and retinal vasculitus.
Kerato-conjunctivitis sicca (KCS) is the most common ocular manifestation of RA; it occurs in 15-25% of patients.

Q-11. Snow banking is seen in
a) Anterior uveitis
b) Posterior uveitis
c) Intermediate uveitis
d) None

Answer: Intermediate uveitis
Fundus findings in intermediate uveitis (Pars planitis):
Whitish exudates present near the ora serrata in the inferior quadrants.
The typical exudates are referred as snow ball opacities.
These may coalesce to form a grey white plaque called snow banking.

Q-12. Argyll Robertson pupil are seen in all except
a) Chronic alcoholism
b) Encephalitis
c) Hypertension
d) Diabetes mellitus

Answer: Hypertension
The Argyll Robertson pupil has been defined as a pupil that is small and constricts poorly to direct light but briskly when a target within reading distance is viewed (“light-near dissociation”). It is caused by a lesion in the region of Tectum.
Brain injury
Thiamine (Vitamin B1) deficiency
Parinaud syndrome
Tabes dorsalis
A pseudo-Argyll Robertson pupil is a neurological sign indicating a normal near reflex but the absence of a light reflex (light-near dissociation), a lack of miosis, and pupil irregularity.
It has been reported in patients with diabetes mellitus, multiple sclerosis, Wernicke’s encephalopathy, sarcoidosis, tumors, and hemorrhage.

Q-13. Bitots spots are seen in
a) Bulbar conjunctiva
b) Palpabral conjunctiva
c) Cornea
d) Eye lid

Answer: Bulbar conjunctiva
Bitot’s spot is extension of xerotic process.
Bitots spot is raised, silvery white, foamy, triangular patch of keratinized epithelium, situated on the bulbar conjunctiva in the inner palpabral area.
It is usually bilateral and temporal and less frequently nasal.