Ophthalmology MCQs questions and answer

Which of the following is true regarding Mittendorf dot?
A. Glial tissue projecting from optic disc
B. Obliterated vessel running forward into the vitreous
C. Associated with posterior polar cataract
D. Commonest congenital anomaly of hyaloid system

human eyeAnatomy of the eye – Hyaloid canal is visible

Correct answer : C. Associated with posterior polar cataract

Mittendorf dot is a remnant of the anterior end of hyaloid artery.
It is attached to the posterior lens capsule.
It is associated with posterior polar cataract.

Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p253.
Image credits: File:Schematic diagram of the human eye en.svg - Wikipedia

All of the following are seen in Favre-Goldmann syndrome except?
A. Ectopia lentis
B. Retinoschisis
C. Nyctalopia
D. Pigmentary changes similar to retinitis pigmentosa

Correct answer : A. Ectopia lentis

Favre-Goldmann syndrome is an autosomal recessive condition.
It usually presents in childhood with nyctalopia.
Central and peripheral retinoschisis is present.
There is marked pigmentary changes similar to retinitis pigmentosa.

Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p271.

Axenfeld anomaly is seen in glaucoma associated with?
A. Aniridia
B. Phakomatosis
C. Ectopia lentis
D. Iridocorneal dysgenesis

Correct answer : D. Iridocorneal dysgenesis

Axenfeld syndromeFeatures of Axenfeld syndrome – a.Microdontia and hypodontia; b.Slit pupil and iris atrophy; c.Corectopia with iris atrophy; d,e.Posterior embryotoxon; f.Broad peripheral anterior synechiae.

Axenfeld anomaly is seen in glaucoma associated with iridocorneal dysgenesis.
It is a posterior embryotoxon characterised by prominent Schwalbe’s ring.

Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p214.
Image credits: L Dhir, K Frimpong-Ansah, Nabil E Habib: Missed case of Axenfeld-Rieger syndrome: a case report. Cases Journal 2008, 1:299. Licensed under the Creative Commons Attribution 2.0 license. Missed case of Axenfeld-Rieger syndrome: a case report | Cases Journal | Full Text

Stocker’s line is seen in?
A. Pinguecula
B. Trachoma
C. Pterygium
D. Concretions

Correct answer : C. Pterygium

PterygiumPterygium extending into pupillary area

Pterygium is usually seen in elderly males and it presents as a triangular fold of conjunctiva which encroaches the cornea.
It is usually seen on the nasal side.
Stocker’s line is a deposition of iron seen in corneal epithelium anterior to advancing head of pterygium.

Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p80.
Image credits: José Miguel Varas, MD. Licensed under the Creative Commons Attribution 3.0 Unported license. File:Pterygium Slitlamp.jpg - Wikimedia Commons

Cogan’s syndrome is associated with?
A. Keratitis
B. Conjunctivitis
C. Iritis
D. Myopia

Correct answer : A. Keratitis

Cogan’s syndrome is seen in middle aged adults.
The features include interstitial keratitis, acute tinnitus, vertigo and deafness.
Treatment is by usage of topical and systemic corticosteroids.
Early treatment is necessary to prevent permanent deafness and blindness.

Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p114.

All of the following are anterior dystrophies except?
A. Reis-Buckler’s dystrophy
B. Meesmann’s dystrophy
C. Schnyder’s dystrophy
D. Stocker-Holt’s dystrophy

Correct answer : C. Schnyder’s dystrophy

Reis Bucklers corneal dystrophyReis-Buckler’s dystrophy – reticular opacity of the cornea

Anterior (superficial) corneal dystrophy affects epithelium and Bowman’s layer.
Examples include Reis-Buckler’s dystrophy, Meesmann’s dystrophy and Stocker-Holt’s dystrophy.
Schnyder’s dystrophy is a crystalline stromal dystrophy.

Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p117.
Image credits: Klintworth. Orphanet Journal of Rare Diseases 2009 4:7 Licensed under the Creative Commons Attribution 2.0 Generic license. Corneal dystrophies | Orphanet Journal of Rare Diseases | Full Text

Which of the following is seen in Lowe’s syndrome?
A. Glaucoma
B. Choroiditis
C. Secondary cataract
D. Myopia

Correct answer : A. Glaucoma

X-linked recessiveLowe’s syndrome has X-linked recessive inheritance.

Lowe’s syndrome is oculo-cerebro-renal syndrome.
It is an inborn error of amino acid metabolism.
Congenital cataract and glaucoma are the ocular features.
Mental retardation, dwarfism, osteomalacia and muscular hypotonia are the other features seen in this syndrome.

Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p181.
Image credits: National Institutes of Health. File:X-linked recessive.svg - Wikipedia

Which of the following is seen in Lowe’s syndrome?
A. Glaucoma
B. Choroiditis
C. Secondary cataract
D. Myopia

Correct answer : A. Glaucoma

Gunn sign is?
A. Silver wiring of arterioles
B. Deflection of veins at arteriovenous crossing
C. Copper wiring of arterioles
D. Tapering of veins on the either side of the crossings

Correct answer : D. Tapering of veins on the either side of the crossings

Hypertensive retinopathyFundus picture in hypertensive retinopathy

Gunn sign is seen in grade III hypertensive retinopathy.
The other findings in grade III hypertensive retinopathy include
    copper wiring of arterioles
    banking of veins distal to arteriovenous crossings
    right-angle deflection of veins
    flame shaped haemorrhages
    cotton wool spots
    hard exudates.

Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p258.
Image credits: Frank Wood. Licensed under the Creative Commons Attribution 3.0 Unported license. File:Hypertensiveretinopathy.jpg - Wikipedia

Weiss operation is done for?
A. Cicatricial entropion
B. Senile entropion
C. Senile ectropion
D. Cicatricial ectropion

Correct answer : B. Senile entropion

Weiss operation is done for senile entropion.
An incision is placed 3mm below the lid margin extending along the whole length of the eyelid.
It involved the skin, orbicularis and the tarsal plate.
Mattress sutures are used for correcting the entropion by transpositioning the tarsus.

Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p350-353.

Bilateral granulomatous panuveitis is seen in?
A. Heerfordt’s syndrome
B. Reiter’s syndrome
C. Behcet’s disease
D. Toxoplasmosis

Correct answer : A. Heerfordt’s syndrome

Anterior uveitisAnterior uveitis

Bilateral granulomatous panuveitis is seen in Heerfordt’s syndrome (Uveoparotid fever).
It is also associated with painful enlargement of parotid glands.
Cranial nerve palsy, fever, malaise and skin rashes are also seen.

Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p156, 157.
Image credits: Jonathan Trobe, M.D. Licensed under the Creative Commons Attribution 3.0 Unported license. http://www.kellogg.umich.edu/theeyeshaveit/red-eye/anterior-uveitis.html

X-linked recessiveLowe’s syndrome has X-linked recessive inheritance.

Lowe’s syndrome is oculo-cerebro-renal syndrome.
It is an inborn error of amino acid metabolism.
Congenital cataract and glaucoma are the ocular features.

Appendages of the eyes include all except?
A. Lacrimal gland
B. Eyelids
C. Eyebrows
D. Extraocular muscles

Correct answer : D. Extraocular muscles

Anatomy of the eye

Appendages of the eyes (adnexa of the eye / accessory visual structures) are:

Eyelids
Eyebrows
Conjunctiva
Lacrimal apparatus

Ref: Khurana 4th, p5

Image credits: Author: BruceBlaus. Licensed under the Creative Commons Attribution 3.0 Unported license. Source: File:Blausen 0388 EyeAnatomy 01.png - Wikipedia
Mental retardation, dwarfism, osteomalacia and muscular hypotonia are the other features seen in this syndrome.

Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p181.
Image credits: National Institutes of Health. File:X-linked recessive.svg - Wikipedia

Ophthalmoplegic migraine is best characterised as?
A. Recurrent headache with transient palsy of ophthalmic nerve
B. Headache associated with irreversible palsy of 3rd nerve
C. Recurrent headache with transient palsy of 3, 4 and / or 6th cranial nerves
D. Headache with optic neuritis

Correct answer : C. Recurrent headache with transient palsy of 3, 4 and / or 6th cranial nerves
Ophthalmoplegic migraine

It is  a rare condition which was previously considered as a type of migraine.
Recent studies suggest that is it likely to be an inflammatory cranial neuropathy.
The International Headache Classification has reclassified ophthalmoplegic migraine as a type of neuralgia from its earlier classification as a type of migraine.
It is characterised by transient migraine like headache associated with paresis of oculomotor, trochlear and/or abducens nerves.
To arrive at a diagnosis of ophthalmoplegic migraine, other causes should be ruled out by appropriate investigations (like digital subtraction angiography / magnetic resonance angiography of the brain).

References:

Levin M1, Ward TN. Ophthalmoplegic migraine. Curr Pain Headache Rep. 2004 Aug;8(4):306-9.

False about Argyll Robertson Pupil is?
A. Accommodation reflex normal
B. Direct pupillary reflex absent
C. Indirect pupillary reflex normal
D. Visual acuity normal

Correct answer : C. Indirect pupillary reflex normal
Argyll Robertson Pupil (ARP)

It is characterised by bilateral constricted pupils.
Accommodation reflex (near reflex) is normal.
Pupillary reflex (light reflex) – both direct and indirect – are absent.
This feature is known as light – near dissociation.
ARP was first described in neurosyphilis by Douglas Moray Cooper Lamb Argyll Robertson, a Scottish Ophthalmologist.
It is also seen in other conditions like encephalitis, diabetic neuropathy, multiple sclerosis, stroke etc.

Site of lesion:

It occurs due to damage to fibers which travel from the pretectal part of midbrain to the Edinger Westphal nucleus.
The rostral fibers which are responsible for the light reflex are affected.
But the caudal fibers which facilitate the accommodation reflex are not affected.
Hence the light reflex is absent and accommodation reflex is present.

Which of the following is false regarding intraocular retinoblastoma?

A. 94% cases are sporadic
B. Individuals with sporadic retinoblastoma do not pass their genes to their children
C. Reese Ellsworth classification is used for predicting visual prognosis following radiotherapy
D. Tumour calcification can be detected by an ultrasound scan

Correct answer : B. Individuals with sporadic retinoblastoma do not pass their genes to their children

One third of sporadic cases of retinoblastoma are heritable. The remaining sporadic cases do not pass their genes to their children.

Bitemporal hemianopia is a characteristic feature of?

a) Glaucoma
b) Optic neuritis
c) Pituitary tumour
d) Retinitis pigmentosa

Correct answer : c) Pituitary tumour

Pituitary tumours compress the optic chiasma and cause bitemporal hemianopia.

Diplopia in superior oblique palsy is?

A. Vertical diplopia on downward gaze
B. Vertical diplopia on upward gaze
C. Horizontal diplopia on inward gaze
D. Horizontal diplopia on outward gaze

Correct answer : A. Vertical diplopia on downward gaze
Diplopia in superior oblique palsy

In paralysis of the superior oblique muscle (trochlear nerve palsy), maximum diplopia is experienced when the patient looks down.
This is especially important when the patient tries to climb downstairs and when trying to read a book.
The patient tries to compensate by tucking the chin towards the chest.

Which of the following is a topical NSAID for ophthalmic use?

A. Ibuprofen
B. Diflunisal
C. Nepafenac
D. Oxaprozin

Correct answer : C. Nepafenac

Nepafenac is a topically administered NSAID sold as 0.1% eye drops. It is used for the treatment of pain and inflammation in patients undergoing cataract surgery. Nepafenac is a prodrug of amfenac which has COX-1 and COX-2 inhibitor activity. Treatment is started 1 day prior to cataract surgery and is continued 2 weeks postoperatively. Side effects include foreign body sensation and decreased visual acuity.

Arden index is used for interpretation of?

A. Visual evoked response

B. Electrooculogram

C. Electroretinogram

D. Visual field charting

Correct answer : B. Electrooculogram

Arden index is used for interpretation of an electrooculogram.

All of the following are involved in endophthalmitis except?

A. Retina

B. Vitreous

C. Sclera

D. Uvea

Correct answer : C. Sclera

Endophthalmitis does not involve the scleral coat of the eye. Sclera in involved only in panophthalmitis.

Organism most commonly implicated in Late onset endophthalmitis after cataract surgery is?

A. Pseudomonas aeruginosa

B. Staphylococcus epidermidis

C. Candida albicans

D. Propionibacterium acnes

Correct answer : D. Propionibacterium acnes

Propionibacterium acnes is a gram positive, non spore forming bacillus which is most commonly implicated in Late onset endophthalmitis after cataract surgery.

An 18 year old boy comes to the eye casuality with history of injury with a tennis ball. On examination there is no perforation but there is hyphaema. The most likely source of the blood is
A. Iris vessels
B. Circulus iridis major
C. Circulus iridis minor
D. Short posterior ciliary vessels

Correct answer : B. Circulus iridis major

In Von Hippel Lindau Syndrome, the retinal vascular tumours are often associated with intracranial hemangioblastoma. Which one of the following regions is associated with such vascular abnormalities in this syndrome?
A. Optic radiation
B. Optic tract
C. Cerebellum
D. Pulvinar

Correct answer : C. Cerebellum

The mother of a one and a half year old child gives history of a white reflex from one eye for the past 1 month. On computed tomography scan of the orbit there is calcification seen within the globe. The most likely diagnosis is:
A. Congenital cataract
B. Retinoblastoma
C. Endophtalmitis
D. Coats disease

Correct answer : B. Retinoblastoma

1 1/2 year old child with white reflex and calcification in the eye is diagnostic of retinoblastoma.

Enlarged corneal nerves may be seen in all of the following except:
A. Keratoconus
B. Herpes simplex keratitis
C. Leprosy
D. Neurofibromatosis

Correct answer : B. Herpes simplex keratitis

Contact lens wear is proven to have deleterious effects on the comeal physiology. Which of the following statements is incorrect in connection with contact lens wear?
A. The level of glucose availability in the corneal epithelium is reduced
B. There is a reduction in hemidesmosome density
C. There is increased production of CO2 in the epithelium
D. There is a reduction in glucose utilization by corneal epithelium

Correct answer : A. The level of glucose availability in the corneal epithelium is reduced

Contact lens wear decreases gas exchange across the anterior surface of cornea resulting in hypoxia and hypercapnia. In the hypoxic state there is decrease in glucose utilisation. But there is no decrease in glucose availability as it occurs through the aqueous humour on the posterior surface of cornea. Also, there is decreased epithelial cell adhesion due to decrease in hemidesmosome density.

Which of the following statement is true regarding Acanthamoeba keratitis?
A. For the isolation of the causative agent, corneal scraping should be cultured on a nutrient agar plate
B. The causative agent, Acanthamoeba is a helminth whose normal habitat is soil
C. Keratitis due to Acanthamoeba is not seen in the immunocompromised host
D. Acanthamoeba does not depend upon a human host for the completion of its life-cycle

Correct answer : D. Acanthamoeba does not depend upon a human host for the completion of its life-cycle

A 25 year old male gives history of sudden painless loss of vision in one eye for the past 2 weeks. There is no history of trauma. On examination the anterior segment is normal but there is no fundal glow. Which one of the following is the most likely cause?
A. Vitreous haemorrhage
B. Optic atrophy
C. Developmental cataract
D. Acute attack of angle closure glaucoma

Correct answer : A. Vitreous haemorrhage

Among the options given, only vitreous haemorrhage causes sudden painless loss of vision.

A 30 year old man has 6/5 vision each eye, unaided. His cycloplegic retinoscopy is +1.0 D sph. at 1 metre distance. His complaints are blurring of newsprint at 30 cm, that clears up in about two minutes. The most probable diagnosis is:
A. Hypermetropia
B. Presbyopia
C. Accommodative inertia
D. Cycloplegia

Correct answer : C. Accommodative inertia

His distant vision is normal. He has blurring of newsprint at 30cm distance for 2 minutes. This is due to accommodative inertia. His accommodation system takes some time to focus on near objects. (Normally it should take only 1 second).

Horner’s syndrome is characterized by all of the following except:
A. Miosis
B. Enopthalmos
C. Ptosis
D. Cycloplegia

Correct answer : D. Cycloplegia

Components of horner’s syndrome –

Ptosis
Miosis
Anhidrosis
Enophthalmos
Loss of ciliospinal reflex

The most common second malignancy in survivors of retinoblastoma is:
A. Thyroid cancer
B. Nasopharyngeal carcinoma
C. Optic glioma
D. Osteosarcoma

Correct answer : D. Osteosarcoma

Osteosarcoma and retinoblastoma both can arise in those with RB gene mutation.

Which one of the following statements is incorrect about Optic glioma?
A. Has a peak incidence in first decade
B. Arises from oligodendrocytes
C. Causes meningeal hyperplasia
D. Is associated with type I neurofibromatosis

Correct answer : C. Causes meningeal hyperplasia

Features of optic glioma:

Cells of origin – astrocytes, oligodendrocytes of optic nerve
Peak incidence – 2 to 5 years
Optic glioma is not known to cause meningeal hyperplasia.

Which of the following statements is incorrect about phthisis bulbi?
A. The intraocular pressure is increased
B. Calcification of the lens is common
C. Sclera is thickened
D. Size of the globe is reduced

Correct answer : A. The intraocular pressure is increased

Intraocular pressure is decreased in phthisis bulbi.

Which one of the following stromal dystrophy is a recessive condition?
A. Lattice dystrophy
B, Granular dystrophy
C. Macular dystrophy
D. Fleck dystrophy

Correct answer : C. Macular dystrophy

It is autosomal recessive

The most common retrobulbar orbital mass in adults is:
A. Neurofibroma
B. Meningioma
C. Cavernous hemangioma
D. Schwannoma

Correct answer : C. Cavernous hemangioma

In which of the following uveitic conditions is it contraindicated to put in an intraocular lens after cataract surgery?
A. Fuch’s heterochromic cyclitis
B. Juvenile rheumatoid arthritis
C. Psoriatic arthritis
D. Reiter’s syndrome

Correct answer : B. Juvenile rheumatoid arthritis (JRA)

There is a high incidence of cataract in those with JRA. But implantation of intraocular lens following cataract surgery is associated with high risk for development of fibrosis, secondary retrolental membranes and lens capture.

Typically bilateral inferior subluxation of lens is seen in:
A. Marfan’s syndrome
B. Homocystinuria
C. Hyperinsulinemia
D. Ocular trauma

Correct answer : B. Homocystinuria

Bilateral subluxation of lens:

Marfan’s syndrome – upwards and outwards
Homocystinuria – downwards and inwards

The most common cause of vitreous hemorrhage in adults is:
A. Retinal hole
B. Trauma
C. Hypertension
D. Diabetes

Correct answer : D. Diabetes

Proliferative diabetic retinopathy is the most common cause of spontaneous vitreous haemorrhage in adults.

When should a case of Non-Insulin dependent diabetes mellitus (NIDDM) with a history of diabetes for one year have an ophthalmic examination?
A. As early as feasible
B. After 5 years
C. After 10 years
D. Only after visual symptoms develop

Correct answer : A. As early as feasible

The person may have been diabetic for some time before the diagnosis of NIDDM. Retinopathy may have already occured. Hence, ophthalmological testing should be done as early as possible after diagnosis of NIDDM. If there are no pathologic changes, he should come for review every 6 months / 1 year.

But in case of IDDM (Insulin dependant diabetes mellitus), the patients are diagnosed early in life. There is much less chance of any ophthalmologic disease at the time of diagnosis. Hence ophthalmologic examination is recommended 5 years after the diagnosis of IDDM.

When should a case of Non-Insulin dependent diabetes mellitus (NIDDM) with a history of diabetes for one year have an ophthalmic examination?
A. As early as feasible
B. After 5 years
C. After 10 years
D. Only after visual symptoms develop

Correct answer : A. As early as feasible

The person may have been diabetic for some time before the diagnosis of NIDDM. Retinopathy may have already occured. Hence, ophthalmological testing should be done as early as possible after diagnosis of NIDDM. If there are no pathologic changes, he should come for review every 6 months / 1 year.

But in case of IDDM (Insulin dependant diabetes mellitus), the patients are diagnosed early in life. There is much less chance of any ophthalmologic disease at the time of diagnosis. Hence ophthalmologic examination is recommended 5 years after the diagnosis of IDDM.

Which drug can cause macular toxicity when given intravitreally?
A. Gentamicin
B. Vancomycin
C. Dexamethasone
D. Ceftazidime

Correct answer : A. Gentamicin

Vancomycin and Ceftazidime can cause macular toxicity when given in high doses. But macular toxicity has been reported with even low dose of gentamycin.

Which of the following drugs is not used topically for treatment of open angle glaucoma:
A. Latanoprost
B. Brimonidine
C. Acetazolamide
D. Dorzolamide

Correct answer : C. Acetazolamide

Acetazolamide is a carbonic anhydrase inhibitor. It is given orally and parenterally. It is not used topically. Dorzolamide is a topically active carbonic anhydrase inhibitor.

Which of the following antiglaucoma medications can cause drowsiness?
A. Latanoprost
B. Timolol
C. Brimonidine
D. Dorzolamide

Correct answer : C. Brimonidine

Drowsiness, BP changes and Fatigue are the known side effects of Brimonidine.

Neural crest derivitive is
A. Corneal stroma
B. Corneal epithelium
C. Iris stroma
D. Corneal endothelium
E. Trabecular meshwork

Please contribute to the discussion by posting the answer with references and pointing out any errors in the question!

Lamina cribrosa is absent in
A. Iris coloboma
B. Retinal coloboma
C. Morning glory sign
D. ??
E. ??

Please contribute to the discussion by posting the answer with references and pointing out any errors in the question!

True regarding blow out fracture of orbit:
A. Medial wall
B. Floor
C. Restriction of eye movement
D. Lateral wall
E. ??

Please contribute to the discussion by posting the answer with references and pointing out any errors in the question!

Which of the following is the drug of choice for treatment of corneal ulcers caused by filamentous fungi?
A. ltraconazole
B. Natamycin
C. Nystatin
D. Fluconazole

Correct answer : C. Nystatin

SAFE strategy is recommended for the control of :
A. Trachoma
B. Glaucoma
C. Diabetic retinopathy
D. Cataract

Correct answer : A. Trachoma

The magnification obtained with a direct ophthalmoscope is:
A. 5 times
B. 10 times
C. 15 times
D. 20 times

Correct answer : C. 15 times

Band shaped keratopathy is caused by:
a) Amyloid
b) Calcium
c) Monopolysaccharide
d) Lipid

Correct answer : b) Calcium

Band shaped keratopathy occurs due to the accumulation of calcium salts in a band pattern in the anterior corneal layers.

A recurrent chalazion should be subjected to histopathologic evaluation to exclude the possibility of:
a) Squamous cell carcinoma
b) Sebaceous cell carcinoma
c) Malignant melanoma
d) Basal cell carcinoma

Correct answer : b) Sebaceous cell carcinoma

Sebaceous cell carcinoma is a neoplasm of the eyelid with high malignant potential. It arises from Sebaceous glands of caruncle, meibominan glands and the glands of Zeis.

The crystalline lens derives its nourishment from:
a) Blood vessels
b) Connective tissue
c) Aqueous and vitreous
d) Zonules

Correct answer : c) Aqueous and vitreous

Lens is an avascular structure. Nutrition and oxygen for the lens is derived from the aqueous humor (major part) and vitreous humor.

Which of the following is the most important factor in the prevention of the endophthalmitis in cataract surgery?
a) Preoperative prepartion with povidone iodine
b) One week antibiotic therapy prior to sugery
c) Trimming of eyelashes
d) Use of intravitreal antibiotics

Correct answer : a) Preoperative prepartion with povidone iodine

Most important source of infection is the patient’s own lid and conjunctival flora. Topical povidone iodine helps prevent this.

The laser procedure, most often used for treating iris neovascularization, is:
a) Goniophotocoagulation
b) Laser trabeculoplasty
c) Panretinal photocoagulation (PRP)
d) Laser iridoplasty

Correct answer : c) Panretinal photocoagulation (PRP)

Panretinal photocoagulation is the treatment of choice for neovascularization of iris. It stops the angiogenic stimulus from the retina which is responsible for neovascularization.

Mucin layer tear film deficiency occurs in:
a) Keratoconjunctivitis sicca
b) Lacrimal gland removal
c) Canalicular block
d) Herpetic keratitis

Correct answer : a) Keratoconjunctivitis sicca

Mucin synthesising goblet cells are destroyed in Keratoconjunctivitis sicca caused by trachoma and ocular pemphigoid

Which one of the following statements, concerning persistent hyperplastic primary vitreous (PHPV) is true?
a) It is generally unilateral
b) Visual prognosis is usually good
c) It may calcify
d) It is most easily differentiated from retinoblastoma by the presence of exophthalmos or cataract.

Correct answer : a) It is generally unilateral

True stereopsis is perceived due to the following:
a) Overlay of contours
b) Motion parallax
c) Bi-nasal disparity
d) Linear perspective

Correct answer : c) Bi-nasal disparity

The following ocular structure is not derived from surface ectoderm:
a) Crystalline lens
b) Sclera
c) Corneal epithelium
d) Epithelium of lacrimal glands

Correct answer : b) Sclera

A patient presented with unilateral proptosis which was compressible and increases on bending forward. No thrill or bruit was present. MRI shows a retroorbital mass with enhancement. The likely diagnosis is –
a) AV malformations
b) Orbital encephalocoele
c) Orbital varix
d) Neurofibromatosis

Correct answer : c) Orbital varix

Proptosis that increases with Valsalva manouvre or bending forwards is probably due to vascular lesions such as orbital varix.

Occulomotor nerve palsy causes all except :
a) Miosis
b) Ptosis
c) Outward eye deviation
d) Diplopia

Correct answer : a) Miosis

Occulomotor nerve supplies:

Superior rectus
Inferior rectus
Medial rectus
Inferior oblique
Levator palpebrae superioris
Parasympathetic supply from ciliary ganglion to sphincter pupillae and ciliary body

Hyaluronic acid is present in
a) Vitreous humour
b) Cartilage
c) Cornea
d) Aqueous humour

Correct answer : a) Vitreous humour

All are common causes of childhood blindness except
a) Malnutrition
b) Glaucoma
c) Ophthalmia neonatorum
d) Congenital dacryocystitis

Correct answer : d) Congenital dacryocystitis

Which does not handle free radicals inside lens
a) Vitamin A
b) Vitamin C
c) Vitamin E
d) Catalase

Correct answer : a) Vitamin A

Disease with autosomal dominant inheritance is
a) Best’s disease
b)Bassen Kornzweig disease
c) Gyrate atrophy
d) Laurence Moon Biedl syndrome

Correct answer : a) Best’s disease

Which of the following does not handle the oxidative damage in the lens?
A. Vitamin C
B. Vitamin A
C. Glutathione
D. Catalase

Correct answer : Vitamin A

Hyaluronic acid is present in?
A. Aqueous humor
B. Vitreous humor
C. Lens
D. Cornea

Correct answer : Vitreous humor, Hyaluronic acid is also present in cartilage, synovial fluid and loose connective tissue.