Eye Mcqs Chapter Wise

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A Short Book Of
MULTIPLE CHOICE QUESTIONS
(MCQs)
Ophthalmology
For Undergraduate MBBS Students
By
Dr.Col (R) Iftikhar Ahmed

MBBS, MCPS, FCPS, FICS (Ophth)
Professor Of Ophthalmology
Rahbar Medical & Dental College, Lahore

Email: driftikhar759@gmail.com
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Dedication
Dedicated to my mother as a token of appreciation for her
incessant prayers. To my senior & junior collegues for their
valuable guidance. To my wife and all the children for their
relentless encouragement and support they provided me
throughout this project. And lastly, to my students for their
unwavering respect and admiration that has always been a
source of motivation and impetus to outdo myself.
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Index
Chapter No. Topic Page No.
1 The eyelids 4
2 Nasolacrimal system 13
3 The conjunctiva 21
4 The cornea 30
5 The sclela 42
6 The uveal tract 46
7 The Lens 56
8 The Glaucoma 65
9 The Retina 78
10 The optic nerve 93
11 Abnormalities of pupil & optic pathways 102
12 The Orbit 106
13 The Ocular injuries 112
14 The ocular motility & strabismus 117
15 The light & refractive errors 126
Chapter-1
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The Eyelids
Q.1 The eyelids develop from:

a. Endoderm
b. Neuroectoderm
c. Optic vesicle
d. Surface ectoderm
e. Surface mesoderm
Q.2 The eyelids remain united with each other until:

a. 5th month of intrauterine life
b. 6th month of intrauterine life
c. 7th month of intrauterine life
d. 8th month of intrauterine life
e. 9th month of intrauterine life
Q.3 The glands associated with eye lash follicles include:

a. Glands of Manz
b. Glands of Zeis & Moll
c. Glands of wolfring
d. Sebacious glands
e. Tarsal glands
Q.4 Meibomian glands are:

a. Ordinary sebaceous glands
b. Mucous secreting glands
c. Modified sebaceous glands
d. More numerous in the lower eyelid than the upper
e. Not associated with tear film stability
Q.5 The lymphatics of eyelid drain in to:

a. Cervical lymph nodes
b. Preauricular lymph nodes
c. Preauricular & sub mandibular lymph nodes
d. Submandibular lymph nodes
e. Submaxillary lymph nodes
Q.6 Levator palpebrae superioris ( LPS) muscle is supplied by:

a. CN 11
b. Lower division of 3rd CN
c. Upper division of 3rd CN
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d. CN IV
e. CN VII
Q.7 Chalazion is a painless nodular swelling of eyelid. It is:

a. An acute staphylococcal infection of a meibomian gland.
b. A chronic lipo-granulomatous inflammation of a meibomian gland.
c. A chronic inflammation of glands of zeis.
d. Acute staphylococcus infection of a lash follicle
e. Treated by excision.
Q.8 A young patient presents with history of a painless nodular swelling equal to the size of a pea on
lower eyelid of recent onset. He is most likely having:
a. Basal cell CA
b. Chalazion
c. Cyst of Moll
d. Molluscum contagiosum
e. Squamous cell CA
Q.9 In a young man having chalazion right upper eyelid for the last several months is best treated by:
a. Excision
b. Hot fomentations
c. Injection of steroids in the lesion
d. Incision & Curettage
e. Use of topical & systemic antibiotics
Q.10 Hordeolum internum is the acute suppurative infection of :

a. Glands of Zeis
b. Glands of moll
c. Lash follicles
d. Meibomian glands
e. Sebacious glands
Q.11 Hordeolum internum is the acute suppurative infection of meibomian glands and is best treated by:
a. Excision
b. Hot fomentations
c. Injection of steroids in the lesion
d. Incision & Curettage
e. Use of topical & systemic antibiotics & hot fomentations
Q.12 A young man complains of painfull nodular swelling on left upper eyelid, watering and foreign body
sensation for the last 3 days.The most likely diagnosis is:
a. Basal cell carcinoma
b. Chalazion
c. Hordeolum externum
d. Hordeolum internum
e. Posterior blephritis
Q.13 Hordeolum externum is a localised tender swelling at the lid margin and is due to:
a. Acute suppurative infection of the lash follicles and its associated glands
b. Acute suppurative infection of the sebaceous glands of the eyelids
c. Acute infection of the meibomian glands
d. Chronic infection of the eye lid structures
e. Granulomatous inflammation of the eye lid structures
Q.14 A young lady presents with painful swelling of the eyelid margin and abscess formation at the base of
an eyelash for the past 3 days. The diagnosis is:
a. Anterior blephritis
b. Chalazion
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c. Hordeolum externum
d. Hordeolum internum
e. Infected sebaceous cyst
Q.15 Trichiasis is inward misdirection of the lashes and is best treated by:
a. Cryotherapy
b. Contact lenses
c. Catholysis
d. Epiliation
e. Lubricant eye drops
Q.16 An individual presents with H/O foreign body sensation, watering and photophobia in the right eye .
O/E a few eyelashes in the lower lid are misdirected inward. The diagnosis is:
a. Anterior blephritis
b. Districhiasis
c. Entropion
d. Trichiasis
e. Pseudotrichiasis
Q.17 The most important complication of trichiasis is:

a. Anterior uveitis
b. Chronic conjunctivitis
c. Corneal ulceration and opacification
d. Entropion
d. Symblephron formation
Q.18 In districhiasis:
a. Entropion is always present
b. The eye lashes are white in colour.
c. There is an extra row of eye lashes.
d. The eye lashes are absent.
e. Treatment is by epiliation.
Q. 19 An individual presenting with H/O foreign body sensations, watering and photophobia is diagnosed to
be having pseudotrichiasis. It is a condition in which the:
a. Additional row of eyelashes is directed backwad
b. Eyelashes are misdirected inward
c. Eyelashes are directed backward secondary to entropion
d. Eyelashes are absent
e. Eyelashes are turned white
Q.20 A semilunar fold of skin situated above and sometimes covering the medial canthus is called:
a. Dermochalasis
b. Epicanthus
c. Epicanthus inversus
d. Epiblephron
e. Telecanthus
Q.21 Lagophthalmos is the condition in which there is:

a. Adhesion of eyelid to the eye ball
b. Adhesion of the eyelid margins
c. Drooping of the upper eyelid
d. Incomplete closure of the palpebral fissure
e. Forward protrusion of eye ball
Q.22 Symblephron is the condition in which there is formation of:
a. Adhesions between the upper and lower eyelid margins
b. Adhesions between the palpebral and bulbar conjunctiva
c. Adhesions between cornea and eyelid
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d. A fold of skin in the medial canthus

e. Scars in the conjunctiva
Q.23 Ankyloblephron is the condition in which;

a. Both eyelids are adhered
b. Bulbar and palpebral conjunctiva adhered
c. Eyelids are absent
d. Eyelid adhered with cornea
e. Palpebral fissure is small
Q.24 In seborrhoeic blephritis there is :

a. Chronic bacterial inflammation of lash follicles
b. Dysfunction of meibomian glands
c. Dysfunction of glands of zeis
d. Dysfunction of glands of moll
e. Dysfunction of sebaceous glands of the eyelids
Q.25 Posterior blephritis is due to:

a. Acute infection of meibomian glands
b. Allergic reaction to secretions of meibomian glands
c. Chronic infection of lash follicles
d. Disorder of glands of zeis & moll
e. Meibomian gland dysfunction
Q.26 A 35 years old male complains of burning sensations, frothy secretion on lid margins and recurrent
hordeolum internum for the last several months.What is the probable diagnosis?
a. Anterior staphylococcal blepharitis
b. Chronic blepharoconjunctivitis
c. Posterior blepharitis
d . Mixed blepharitis
e.Seborrhoeic blepharitis
Q.27 Ectropion is the condition in which the :

a. Eyeball is turned outward
c. Eyelid margin rolls inward
d. Eyelid margin turns outward
e. The lids are inflammed and swollen
Q.28 Entropion is the condition in which the:

a. Eyeball is turned outward
c. Eyelid margin rolls inward
d. Eyelid margin turns outward
e. The lids are inflammed and swollen
Q.29 The commonest type of entropion in older age group is:

a. Cicatricial entropion
b. Congenital entropion
c. Involutional entropion
d. Mechanical
e. Spastic entropion
Q.30 A young man sustained chemical burn over his face and eyelids. After healing he is likely to develop:
a. Cicatricial ectropion
b. Cicatricial ectropion
c. Paralytic ectropion
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d. Ptosis
e. Spastic entropion
Q.31 Paralytic ectropion is caused by :

a. Aging changes in elderly
b. Fourth nerve palsy
c. Fifth nerve palsy
d. Seventh nerve palsy
e. Third nerve palsy
Q.32 Epiblephron is a rare congenital condition in which the:

a. Entire lower eyelid is turned inward
b. Medial part of the lower eyelid is turned inward
c. Palpebral fissure is small
d. Upper eyelid is turned inward
e. Upper eyelid is turned outward
Q.33 The Wies operation is done to treat:

a. Districhiasis
b. Ptosis
c. Senile entropion
d. Spastic entropion
e. Senile ectropion
Q.34 Mild medial ectropion is corrected surgically by:

a. Bick’s procedure
b. Fox procedure
c. Medial conjunctivoplasty
d. Transverse lid everting sutures
e. Wies operation
Q.35 Modified Kuhnt szymanoski operation was done to treat an old patient complaining of redness and
watering in his one eye.The most likely diagnosis is:
a. Entropion lower eyelid
b. Involutional Ectropion lower eyelid
c. Pseudotrichiasis
d. Symblephron
e. Trichiasis
Q.36 Cicatricial ectropion due to extensive scarring of the lower eyelid in a young individual is treated
by:
a. Fox procedure
b. Full or partial thickness skin grafting
c. Tarsorrhaphy
d. V-Y operation
e. Z- Plasty
Q.37 An old individual having entropion due to essential blepharospasm is best treated by:
a. Bick’s procedure
b. Botulinum toxin (Botox) injections in to the orbicularis oculi muscle
c. Fox procedure
d. Transverse lid everting sutures
e. Wies operation
Q.38 An impression of drooping of upper eyelid due to lack of support in unilateral enophthalmos is called:
a. Acquired ptosis
b. Aponeurotic ptosis
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c. Myogenic ptosis
d. Pseudoptosis
e. Phthisis bulbi
Q.39 The commonest variety of ptosis is:

a. Aponeurotic ptosis
b. Congenital myogenic ptosis
c. Mechanical ptosis
d. Myogenic acquired ptosis
e. Neurogenic ptosis
Q.40 The action of LPS in a normal individual as determined by Upper Lid Excursion test is:
a. 4 mm
b. 8 mm
c. 10 mm
d. 12 mm
e. 15 mm or >
Q.41 LPS action on Upper Lid Excursion (ULE) test in a 3 years old child having myogenic ptosis is 6 mm.
So, the action of LPS in this case is graded as:
a. Fair
b. Good
c. Normal
d. Poor
e. Very poor
Q.42 The amount of ptosis as measured by MRD (Margin Reflex Distance) test in an old man having
involutional ptosis is 3mm. So, the degree of ptosis in this patient is:
a. Mild
b. Moderate
c. Negligible
c. Severe
d. Very severe
Q.43 The most common cause of congenital myogenic ptosis is:

a. Defective development of LPS muscle
b. Defective action of mullers muscle
c. Muscle trauma at the time of birth
d. Mysthenia gravis
e. Paralysis of LPS
Q.44 The other extraocular muscle associated with the defective development of LPS causing ptosis is:
a. Inferior rectus
b. Lateral rectus
c. Medial rectus
d. Superior rectus
e. Superior oblique
Q.45 A child of 4 years has 2 mm of ptosis with good LPS action, is planned for ptosis surgery. Which one
of the followings will be the most appropriate procedure?
a. Aponeurosis strengthening operation
b. Fasanella- Servat operation
c. Fascia lata sling procedure
d. LPS resection
e. Wies procedure
Q.46 Severe ptosis with poor LPS action is best treated by :

a. Aponeurotic strengthening operation
b. Fascia lata sling operation
c. LPS resection
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d. Modified wheelers operation

e. Sling procedure
Q.47 The ptosis surgery is done to correct drooping of eyelids but it is contraindicated in:
a. Absent Bell’s phenomenon
b. Before 5 years of age
c. Macus Gunn Jaw Winking Phenomenon
d. Mild ptosis
e. Severe ptosis
Q.48 A small child having unilateral severe ptosis covering the pupillary area, if not treated early is likely
to develop:
a. Amblyopia
b. Blindness
c. Cataract
d. Myopia
e. Optic atrophy
Q.49 Pinkish raised lesion on the upper eyelid which blanches with pressure and increases on crying in a 6
month old infant is most likely to be:
a. Capillary haemangioma
b. Keratocanthoma
c. Kaposi’s sarcoma
d. Port wine stain
e. Xanthelasma
Q.50 Xanthelasmas are bilateral raised yellowish plaque like lesions due to deposition of lipids in dermal
histocytes and occur more commonly in the skin of:
a. Lower eyelid near medial canthus
b. Upper eyelid near medial canthus
c. Upper & lower eyelids near medial canthus
d. Upper eyelid in the centre
e. Upper & lower eyelids near outer canthus
Q.51 A 28 years old lady presents with H/O itching and apainless swelling on her upper eyelid for the last
two months. O/E the swelling is pale, waxy, umblicated nodule with follicular reaction in the inferior
fornix.The most likely diagnosis is:
a. Basal cell CA
b. Chalazion
c. Molluscum contagiosum
d. Squamous papilloma
e. Verruca vulgaris
Q.52 Basal cell CA is the most common malignant tumour of the eyelid. It most frequently arises from:
a. The upper eyelid
b. The lower eyelid
c. Lateral canthus
d. Medial canthus
e. Medial canthus & lower eyelid
Q.53 Basal cell CA of the eye lid is:

a. A fast growing malignant tumour
b. Characterised by early metastasis in the regional lymph nodes
c. More common in females
d. The most malignant tumour of eyelid
e. The most common malignant tumour of eyelids
Q.54 A 70 years old male presented with a nonhealing ulcer on lower eyelid with well defined , indurated
rolled edges and fine telangiectatic blood vessels on its surface. The most likely diagnosis is:
a. Basal cell CA
b. Kaposi sarcoma
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c. Merkel cell CA
d. Malignant melanoma
e. Squamous cell CA
Q.55 The best way to get rid of basal cell carcinoma is:
a. Cryotherapy
b. Chemotherapy
c. Radiation therapy
d. Systemic steroids
e. Surgery with 4 mm normal margin excision using frozen section
Q.56 Squamous cell CA is the most malignant tumour of eyelid and accounts for:
a. 5% of all malignant tumours of the lid
b. 10% of all malignant tumors of lid
c. 20% of all malignant tumours of the lid
d. 50% of all malignant tumours of the lid
e. 90% of all malignant tumours of lid
Q. 57 The treatment of a large lesion of squamous cell carcinoma ( > 1/2of the lid) in an old patient is:
a. Cryotherapy
b. Exenteration
c. Radiation therapy
d. Surgical excision
e. Surgical excision and reconstruction by raising a flap
Q.58 A patient presenting with H/O a painless nodular swelling on the upper eyelid. The swelling is firm in
consistency and has recurred twice after chalazion surgery. What is the probable diagnosis?
a. Basal cell carcinoma
b. Malignant melanoma
c. Recurrent chalazion
d. Squamous cell carcinoma
e. Sebaceous gland carcinoma
Q.59 The lesion in spreading meibomian gland carcinoma simulates:

a. Anterior blepharitis
b. Blepharoconjunctivitis
c. Basal cell carcinoma
d. Chronic blephritis
e. Squamous cell carcinoma
KEY
Q.1 d Q.9 d Q.17 c Q.25 e Q.33 c Q.41 a Q.49 a Q.57 e
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Q.2 b Q.10 d Q.18 c Q.26 c Q.34 c Q.42 b Q.50 b Q.58 e
Q.3 b Q.11 e Q.19 c Q.27 d Q.35 a Q.43 a Q.51 c Q.59 d
Q.4 c Q.12 d Q.20 b Q.28 c Q.36 b Q.44 d Q.52 e
Q.5 c Q.13 a Q.21 d Q.29 c Q.37 b Q.45 b Q.53 e
Q.6 c Q.14 c Q.22 b Q.30 a Q.38 d Q.46 e Q.54 e
Q.7 b Q.15 c Q.23 a Q.31 d Q.39 b Q.47 a Q.55 e
Q.8 b Q.16 d Q.24 c Q.32 b Q.40 e Q.48 a Q.56 a
Chapter- 2
The nasolacrimal system & Dry eyes

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Q.1 The lacrimal fossa is formed by:

a. Frontal & lacrimal bone
b. Frontal process of maxilla & ethmoid bone
c. Frontal process of maxilla & lacrimal bone
d. Lacrimal & palatine bone
e. Lacrimal & ethmoid bone
Q.2 The new born attains normal adult values of tear secretion at :
a. Birth
b. 2 weeks of life
c. 3-4 weeks of life
d. 6 weeks of life
e. 8 weeks of life
Q.3 The canalization of naso-lacrimal duct is not complete at the time of birth. It completes:
a. Before birth
b. 1 week after birth
c. 03 weeks after birth
d. 01month after birth
e. 02 months after birth
Q.4 The nasolacrimal duct extends from the lacrimal sac to the inferior meatus. It is approximately:
a. 5 mm long
b. 10 mm long
c. 15-18 mm long
d. 20 mm long
e. 25 mm or more
Q.5 Nasolacrimal duct opens in the nose in :
a. Inferior meatus
b. Middle meatus
c. Maxillary sinus
d. Nasopharynx
e. Superior meatus
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Q.6 Basal rate of tear production under standard conditions of humidity & temperature is:
a. 2.2 ul/mint
b. 3 ul/mint
c. 4 ul/mint
d. 5 ul/mint
e. 10 ul/mint
Q.7 Maximum drainage capacity of nasolacrimal system in a normal individual is:

a. 20 ul/mint
b. 30 ul/mint
c. 40 ul/mint
d. 50 ul/mint
e. 100 ul/mint
Q.8 The orbital part of main lacrimal gland opens in the superior fornix by lacrimal ducts which are:
a. 5-6 in number
b. 10-12 in number
c. 10-20 in number
d. 20-25 in number
e. 25-30 in number
Q.9 The lacrimal sac lies in the lacrimal fossa and when fully distended it is about:
a. 5 mm long and 5 mm wide
b. 10 mm long and 5 mm wide
c. 15 mm long and 5 mm wide
d. 20 mm long and 10 mm wide
e. 25 mm long and 15 mm wide
Q.10 Nasolacrimal duct opens in to the:

a. Inferior meatus
b. Maxillary sinus
c. Middle meatus
d. Nasopharynx
e. Superior meatus
Q.11 The narrowest part of the nasolacrimal duct is:

a. Distal end of the duct
b. Junction of upper with middle part
c. Junction of middle with lower part of the duct
d. Middle part of the duct
e. Upper end of the duct
Q.12 The bulk of tears is secreted by:

a. Crypts of Henle
b. Glands of Wolfering
c. Glands of Krauz
d. Glands of Manz
e. The main lacrimal gland
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Q.13 The secretomotor fibers to the main lacrimal gland reach via lacrimal nerve from:
a. Ciliary ganglion
b. Otic ganglion
c. Pterygopalatine ganglion
d. Submandibular ganglion
e. Trigeminal ganglion
Q.14 The function of precorneal tear film is to keep the corneal surface wet, smooth and transparent. It
consists of:
a. 1 layers
b. 2 layers
c. 3 layers
d. 4 layers
e. 5 layer
Q15 The corneal tear film keeps the cornea wet for comfort and normal functioning. Its deepest layer is
secreted by:
a. Glands of Menz & Goblet cells
b. Glands of Wolfering
c. Mainl lacrimal gland
d. Main & accessory lacrimal glands
e. Meibomian glands
Q.16 The basal lacrimal secretion is secreted by:

a. Accessory lacrimal glands
b. Crypts of Henle
c. Goblet cells
d. Glands of Menz
e. The main lacrimal gland
Q.17 The most abundant immunoglobulin (Ig) present in the tears is:
a. Ig A
b. Ig D
c. Ig E
d. Ig G
e. Ig M
Q.18 In Conjunctival xerosis due to Vit. A deficiency (xerophthalmia) there is:

a. Associated chronic anterior blephritis
b. Deficiency of aquous layer in tear film
c. Deficiency of lipid layer in tear film
d. Deficiency of mucin layer in tear film
e. Infection with corynebacterium xerosis
Q.19 Schirmer test-1 is supposed to be positive if the wetting of the strip is:
a. Less than 6 mm
b. 10 mm
c. 15 mm
d. 20 mm
e. 25 mm
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Q.20 Schirmer test-1 was positive in a patient presenting with history of burning, grittiness and diminished
vision. What is the possible diagnosis?
a. Anterior uveitis
b. Corneal ulcer
c. Posterior blephritis
d. Keratoconjunctivitis sicca
e. S-J Syndrome
Q.21 Standard Schirmer test is performed for:

a. 1 minute
b. 2 minutes
c. 3 minutes
d. 5 minutes
e. 10 minutes
Q.22 Schirmer test-2 is performed to measure the reflex tear secretion. Normally the amount of wetting at
the end of 2 minutes is:
a. < 15 mm
b. 20 mm
c. 25 mm
d. 30 mm
e. 35 mm
Q.23 Secondary Jones dye test- was done in a patient complaining of epiphora. What is the interpretation if
the dye recovers from the nose after irrigation of the nasolacrimal passage?
a. Complete nasolacrimal duct obstruction
b. Canalicular obstruction
c. Lacrimal pump failure
d. Partial obstruction of the lacrimal passage
e. Punctal stenosis
Q.24 Tear film breakup time (BUT) is a simple test which assesses the stability of tear fim. The value is
considered abnormal when it is:
a. 25 sec or more
b. 20 sec
c. 15 sec
d. 10 sec
e. <10 sec
Q.25 Keratoconjunctivitis sicca (KCS) due to fibrosis of lacrimal gland tissue is the main manifestation of :
a. Ankylosing spondylitis
b. Sjogren’s syndrome
c. Psoriatic arthritis
d. Reiter’s syndrome
e. Vitamin A deficiency
Q.26 1% rose Bengal dye used in KCS will stain :

a. Devitalised conjunctival & corneal epithelium
b. Conjunctival epithelial defects
c. Corneal epithelial defects
d. Normal conjunctival epithelium
e. Normal corneal epithelium
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Q.27 Epiphora is watering of eyes due to obstruction in the drainage passage and a common symptom in :
a. Acute conjunctivitis
c. Chronic dacryocystitis
d. Corneal foreign body
e. Corneal ulceration
Q.28 A patient of 45 years age presented with Bell’s palsy and epiphora.The epiphora in this case is due to:
a. Canalicular obstruction
b. Entropion
c. Exposure keratitis
d. Lacrimal pump failure
e. Partial obstruction in lacrimal passage
Q. 29 The site of obstruction in congenital nasolacrimal duct block is at :

a. Centre of nasolacrimal duct
b. Lacrimal sac- duct junction
c. Lower part of nasolacrimal duct
d. Upper part of nasolacrimal duct
e. Valve of Hasner
Q.30 A one month old infant born with bluish cystic swelling below medial canthus is brought with H/O
watering in one eye. The probable diagnosis is:
b. Dacryocystitis
c. Dacryocystocele
d. Meningoencephalocele
e. Orbital dermoid
Q.31 A child of about 6 months is presented with H/O watering and sticky discharge in left eye soon after
birth. On examination the regurgitation test is positive. What is the diagnosis?
a. Common canaliculus block
b. Congenital glaucoma
c. Chronic conjunctivitis
d. Congenital nasolacrimal duct block
e. Punctal atresia
Q.32 In congenital nasolacrimal duct obstruction (CNLDO), usually spontaneous recovery takes place till
the age of 1 year in about:
a. 75% cases
b. 80 %
c. 90 % cases
d. 95 % cases
e. 100% cases
Q.33 In congenital nasolacrimal duct block, the initial treatment of choice is:
a. Assurance
b. Dacryocystorhinostomy
c. Local massage and assurance
d. Probing and syringing
e. Punctum dilatation
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Q.34 In congenital nasolacrimal duct obstruction, probing and syringing is usually done at the age of:
a. 3 months
b. 6 months
c. 9 months
d. 12 months
e. 18 months
Q.35 Congenital NLD block at the age of 1 year is best treated by:
a. Antibiotic drops
b. Dacryocystectomy
c. Dacryocystorhinostomy
d. Local massage
e. Probing and syringing
Q.36 If not treated , the most serious complication of congenital NLD obstruction is:
b. Chronic dacryocystitis
c. Lacrimal abscess and fistula formation
d. Mucocoele formation
e. Preseptal cellulitis
Q.37 In congenital NLD block , when symptoms persist despite two or three attempts of probing, it becomes
mandatory to perform DCR. The appropriate age of operation is :
a. 3 years
b. 5 years
c. 7 years
d. 10 years
e. 18 years
Q.38 Common site of blockage in common NLD block in older patients due to involutional stenosis is at
the level of:
a. Lacrimal sac
b. Sac -NLD junction
c. Middle part of NLD
d. Lower part of NLD
e. Lower end of the duct
Q.39 The commonest cause of dacryoadenitis is:

a. Dacryocystitis
b. Influenza
c. Mumps
d. Typhoid fever
e. Pneumonia
Q.40 A 15 years old girl developed pain in upper and outer portion of the orbit and upper eyelid swelling
with S- shaped deformity after an attack of mumps. What is the most likely diagnosis?
a. Acute dacryoadenitis
b .Chronic dacryoadenitis
c. Inflammatory orbital disease (IOD)
d. Orbital dermoid
e. Orbital cellulitis
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Q.41 Dry eyes in Sjogren’s syndrome are usually associated with:

a. Ankylosing spondylosis
b. Dermatomyositis
c. Osteoarthrosis
d. Rheumatoid arthritis
e. Systemic lupus arythematosis
Q.42 A young lady complains of severe pain and swelling in lacrimal area, fever and watering in her right
eye for the last 3 days. O/E there is marked swelling & redness in the sac area, regurgitation test not
possible due to local tenderness and submandibular lymph nodes are palpable. The probable diagnosis
is:
a. Acute dacryoadenitis
b. Acute dacryocystitis
c. Chronic dacryocystitis
d. Lacrimal sac tumour
Q.43 The lacrimal sac swelling in nasolacrimal duct obstruction presents:

a. Above the medial palpebral ligament
b. Below the medial palpebral ligament
c. In the medial canthus
d. In the superomedial angle of the orbit
e. On lateral side of the nose
Q.44 A 60 years old lady presents with history of persistent watering in her one eye and a painless swelling
in lacrimal sac area since one year.There is no local tenderness but mucoid material regurgitates on
pressure over sac. What is the diagnosis:
a. Acute dacryocystitis
b. Chronic dacryocystitis
c. Chronic canaliculitis
c. Lacrimal abscess
e. Orbital dermoid
Q.45 A middle age woman having constant epiphora is diagnosed to be suffering from chronic
dacryocystitis. In your opinion what is the best surgical procdure to treat her:
a. Dacryocystorhinostomy (DCR)
b. Dacryocystectomy
c. Local massage
d. Probing and syringing
e. Topical and systemic antibiotics
Q.46 A patient having obstruction at the level of common canaliculus is best treated by:
a. Canaliculo- dacryocystorhinostomy (CDCR)
b. Dacryocystectomy
c. Dacryocystorhinostomy (DCR)
d. Local massage
e. Probing and sac syringing
20
Q.47 In dacryocystorhinostomy (DCR), the communication of the lacrimal sac is estabolished with:
a. Conjunctival sac
b. Inferior meatus of the nose
c. Middle meatus of the nose
d. Nasopharynx
e. Superior meatus of the nose
Q.48 Endolaser DCR is done through nasal approach without incision to the skin. When compared with
the traditional external DCR:
a. Its equipment is very costly
b. It is easier to perform
c. It can be performed without general anaesthesia
d. Long term results are good
e. Operation time is long.
Key
Q.1 c Q.9 c Q.17 a Q.25 b Q.33 c Q.41 d
Q.2 c Q.10 a Q.18 d Q.26 a Q.34 d Q.42 a
Q.3 c Q.11 e Q.19 a Q.27 c Q.35 e Q.43 b
Q.4 c Q.12 e Q.20 d Q.28 d Q.36 c Q.44 b
Q.5 a Q.13 c Q.21 d Q.29 c Q.37 b Q.45 a
Q.6 a Q.14 c Q.22 a Q.30 c Q.38 b Q.46 a
Q.7 d Q.15 e Q.23 d Q.31 d Q.39 c Q.47 d
Q.8 b Q.16 a Q.24 e Q.32 d Q.40 a Q.48 a
Chapter-3
The Conjunctiva
21
Q.1 The conjunctiva is a thin translucent membrane covering the eyeball and under surface of eyelids. Its
part firmly adherent to the underlying tissue is called:
a. Bulbar conjunctiva
b. Forniceal conjunctiva
c. Marginal conjunctiva
d. Orbital conjunctiva
e. Palpebral conjunctiva
Q.2 The lymph drainage of conjunctiva is in the :

a. Cervical lymph nodes
b. Preauricular lymph nodes
c. Submandibular lymph nodes
d. Submaxillary
e. Preauricular & submandibular lymph nodes
Q.3 In conjunctiva, the glands of wolfring are situated:

a. Along upper border of upper and lower border of inferior tarsal plate
b. In superior fornix
c. In inferior fornix
d. In bulbar conjunctiva
e. In perilimbal area
Q. 4 The glands of Krause are present in the conjunctival lamina propria of:
b. Inferior fornix
c. Superior fornix
d. Superior & inferior fornices
e. Upper tarsal conjunctiva
Q.5 The glands of Wolfring and Krause secrete:

a. Antibodies
b. Lysozymes
c. Mucin
d .Tears
e. Sebaceous secretion
Q.6 The goblet cells, glands of Manz & Crypts of Henle secrete:
a. Antibodies
b. Enzymes
c. Mucin
d.Tears
e. Sebaceous secretion
22
Q.7 The microorganism normally present in conjunctival sac is

a. Corynebacterium xerosis
b. Escherichia coli
c. Pseudomonas aureginosa
d. Pneumococci
e. Streptococci
Q.8 In conjunctivitis, Giemsa staining is used to identify:

a. The causative organism
b. The type of inflammatory cells
c. The viral inclusion bodies
d. The conjunctival ulceration
e. The presence of mucous in the discharge
Q.9 In conjunctivitis, Gram staining is used to identify:

a. The type of causative organisms
b. The type of inflammatory cells
c. The viral inclusion bodies
d. The presence of mucous in the discharge
e. The conjunctival ulceration
Q.10 Cnjunctival chemosis is the ballooning of the bulbar conjunctiva away from the sclera as a result of
transudation of fibrin and protein rich fluid through the walls of the damaged blood vessels and is
seen in its most severe form in :
a. Acute allergic or urticarial conjunctivitis
b. Gonococcal conjunctivitis
c. Trachoma
d. Thyroid ophthalmopathy
e. Vernal keratoconjunctivitis
Q.11 The conjunctival follicles are multiple, round, slightly elevated lesions which are:
a. Aggregations of lymphocytes with a germinal centre and surrounded by a tiny blood vessel in the
adenoid layer.
b. Aggregations of acute inflammatory cells in fibrous layer
c. Collection of macrophages in the subconjunctival tissue
d. More than 5 mm in size
e. Usually most prominent in the superior fornix
Q. 12 Conjunctival inflammation in a newborn can not produce follicular reaction due to the absence of
adenoid layer which develops:
a. 1-2 weeks postnatally
b. 2-3 weeks postnatally
c. 4-6 weeks
d. 2-3 months postnatally
e. 3-4 months postnatally
Q.13 Conjunctival papillae are:

a. Most frequently seen on the bulbar conjunctiva
b. Collection of inflammatory cells between fixed septa on tarsal conjunctiva
c. Frequently seen in KCS
d. Rectangular in shape
e. Vascular structures that have been invaded by inflammatory cells
Q.14 Giant papillae which are more than 3 mm in size, are formed when connective tissue seta in between
the papilla are ruptured and are most commonly seen in:
a. Acute allergic conjunctivitis
b. Adult inclusion conjunctivitis
c. Advance vernal keratoconjunctivitis
d. Chronic conjunctivitis
e. The upper & lower fornices
23
Q.15 Trachoma is a contigious disease and spreads by:

a. Autoinoculation from genital secretions
b. Contaminated fingers & flies
c. Drinking infected water
d. Droplet infection
e. Eating infected foods
Q.16 The Halber staedter- Prrowazek (HP) inclusion bodies are seen in conjunctival epithelial cell in:
a. Allergic conjunctivitis
b. Adenoviral keratoconjunctivitis
c. Gonococcal conjunctivitis
d. Trachoma
e. vernal keratoconjunctivitis
Q.17 The Halber staedter-Prowazek (HP) inclusion bodies in trachoma are:

a. Extracellular
b. Intranuclear
c. Stained basophilic on Gram staining
d. Stained eosinophilic on Gram staining
e. Stained basophilic on Giemsa staining
Q.18 Trachoma is caused by which serotypes of Chlamydia trachomatis?

a. A
b. A, B
c. A, B, Ba
d. A, B, C,
e. A, B, Ba, C
Q.19 A middle aged patient presentes with irritation and burning sensation in both the eyes. On slitlamp
examination the most conspicuous finding is the presence of Herbert’s pits at limbus. What is the
most appropriate diagnosis?
a. Adenoviral conjunctivitis
c. Acute bacterial conjunctivitis
d. Trachoma
e. Vernal conjunctivitis
Q.20 Pannus formation is seen in the:

a. Incipient stage of trachoma
b. Stage 2a trachoma
c. Stage 2b trachoma
d. Stage 3 trachoma
e. Stage 4 trachoma
Q.21 Adult inclusion conjunctivitis & chlamydial neonatal conjunctivitis are caused by which serotypes of
chlamydial trachomatis?
a. A -- C
b. A--D
c. C – F
d. D – K
e. D – L
Q.22 Topical antibiotic of choice in the treatment of chlamydial conjunctivitis is:
a. Ampicillin
b. Azithromycin
c. Chloamphenicol
d. Cephalosporins
e. Tetracycline
Q.23 Arlt’s line, a linear line of scarring on upper tarsal conjunctiva 2mm from the upper
24
eyelid margin is commonly seen in

a. 3rd stage of trachoma
b. Adenoviral keratoconjunctivitis
c. Haemorrhagic conjunctivitis
d. Inclusion conjunctivitis
e. Phlyctenular conjunctivitis
Q.24 Ophthalmia neonatorum is the conjunctival inflammation and is the most common infection of
neonates. It occurs during:
a. First 2 weeks of life
b. First 3 weeks
c. First 1 month of life
d. 2nd month of life
e. 3rd month of life
Q.25 A 3- days old baby brought to the hospital, was diagnosed to be suffering from ophthalmia
neonatorum. The most common causative organism in this case will be:
a. Candida albicans
b. Chlamydia tachomatis
c. Chemical conjunctivitis
d. Herpes simplex virus
e. N. Gonorrhoea
Q.26 A young boy having H/O itching, photophobia, excessive lacrimation and thick mucoid discharge
since the age of 5- years. The upper tarsal conjunctiva shows diffuse papillary reaction.The most
probable diagnosis is:
a. Bacterial conjunctivitis
b. Epidemic keratoconjunctivitis
c. Keratoconjunctivitis sicca
d. Vernal conjunctivitis
e. Xerophthalmia
Q.27 A 3 days old newborn is brought with diffuse lid swelling, intense conjunctival congestion and
purulent discharge. He is most likely having:
a. Chemical conjunctivitis
b. Chlamydial conjunctivitis
d. Herpes simplex virus- 2 conjunctivitis
e. Spring catarrah
Q.28 Ophthalmia neonatorum due to chlamydial infection is usually presented :

a. 2 days after the delivery
b. 2-4 days after the delivery
c. 4-5 days after the delivery
d. 1 -2 week after the delivery
e. 1-3 weeks after the delivery
Q.29 A patient complaining of redness, grittiness and watery discharge in both the eyes of recent onset is
most likely suffering from?
a. Acute bacterial conjunctivitis
b. Atopic keratoconjunctivitis
c. Trachoma
d. Viral conjunctivitis
25
Q.30 A young patient presents with itching,burning, foreign body sensation and mucopurulent
discharge.The most probable diagnosis is?
a. Adenoviral keratoconjunctivitis
b. Chlamydial infections
d. Keratoconjunctvitis sicca
e. Epidemic keratoconjunctivitis
Q.31 Presence of follicles in the upper tarsal conjunctiva is an important clinical finding in:
a. Bacterial conjunctivitis
b. Trachoma
c. Toxic conjunctivitis
d. Vernal conjunctivitis
e. Viral conjunctivitis
Q.32 Hypertrophied papillae mapped out in to polygonal raised areas in the upper tarsal conjunctiva giving
it a cobblestone appearance is seen in:
a. Acute bacterial conjunctivitis
b. Pharyngo-conjunctival feaver
c. Phlyctenular conjunctivitis
d. Spring catarrh
e. Trachoma
Q.33 A young boy having H/O itching, watering and thick mucoid discharge. The upper tarsal conjunctiva
shows diffuse papillary hypertrophy. The most probable diagnosis is?
a. Adenoviral conjunctivitis
b. Bacterial conjunctivitis
c. Epidemic keratoconjunctivitis
Q.34 Mucoid nodules and Tranta’s spots at limbus are the characteristic features of :
a. Adult inclusion conjunctivitis
b. Gonococcal conjunctivitis
c. Phlyctenular conjunctivitis
d. Trachoma
Q.35 Secretions in spring catarrh contain:

a. Basophils
b. Eosinophils
c. Monocytes
d. Macrophages
e. Neutrophils
Q.36 In Vernal keratoconjunctivitis, a macroerosion covered with mucoid plaque material is called:
a. Corneal ulcer
b. Corneal phlycten
c. Fascicular ulcer
d. Interstitial keratitis
e. Shield ulcer
Q.37 Vernal keratoconjunctivitis is :
a. A Type – 1 hypersensitivity reaction to external allergens
b. A Type-1 and type- iv hypersensitivity reaction to exogenous allergens
c. A hypersensitivity reaction to staph. Exotoxins
d. An auto immune reaction
e. More common in females
Q.38 The mainstay of treatment in Vernal keratoconjunctivitis is the use of:

26
a. Atropine eye drops

b. Antibiotics
c. Antihistamines
d. Anti inflammatory agents
e. Topical corticosteroids
Q.39 Phlyctenular Conjunctivitis is due to:

a. A Type – 1V delayed hypersensitivity reaction to staph.or other bacterial antigens
b. A Type-1 hypersensitivity reaction to to exogenous allergens
c. A hypersensitivity reaction to staph. Exotoxins
d. An autoimmune reaction
e. Meningococcal infection
Q.40 Phlyctens are most commonly seen in the:

a. Bulbar conjunctiva at or near limbus
b. Conjunctival fornices
c. Fornices
d. Lid margins
e. Upper tarsal conjunctiva
Q.41 Topical treatment of phlyctenular conjunctivitis is by:

a. Antibiotic drops
b. Antihistamine drops
c. Antiviral drosp
d. Mast cell stabilizers
e. Steroid drops
Q.42 Acute haemorrhagic conjunctivitis is usually caused by?

a. Adenoviral infection
b. Chlamydial infection
c. Enterovirus 70
d. Herpers simplex virus
e. Pneumococcal infection
Q.43 Epidemic keratoconjunctivitis (EKC) is an adenoviral infection in all age groups and not associated
with systemic symptoms. It is caused by adenoviral serotypes :
a. 3and 7
b. 3 and 9
c. 5 and 18
d. 8 and 19
e. 9 and 22
Q.44 Pharyngoconjunctival fever (PCF) usually affects children, is associated with systemic symptoms and
caused by adenoviral serotypes:
a. 3and 7
b. 3 and 9
c. 5 and 18
d. 8 and 19
e. 9 and 22
Q.45 Pannus is lymphoid infiltration and vascularisation in the upper cornea.The blood vessels lie :
a. In the epithelium
b. Between epithelium and bowman’s membrane
c. Between bowman’s membrane and stroma
d. Betweem stroma and descemet’s membrane
e. In the corneal stroma
Q.46 Pterygium is a triangular, fleshy fibrovascular growth usually on medial limbus and is the result of:
27
a. Chronic conjunctivitis
b. Conjunctival xerosis
c. Conjunctival epithelial hyperplasia
d. Degenerative changes in the conjunctiva
e. Malignant changes in the conjunctiva
Q.47 Pinguecula is a yellowish white raised lesion on bulbar conjunctiva near the medial limbus and is the
result of:
a. Collagen fiber elastotic degeneration
c. Conjunctival epithelial hyperplasia
d. Malignant changes in conjunctiva
e. Vit. D deficiency
Q.48 Bitot’s spots are greyish white glistening , foam like triangular patches on the nasal and temporal
bulbar conjunctiva. They are an important finding in :
a. Vit. A deficiency
b. Vit.B deficiency
c. Vit. C deficiency
d. Vit. D deficiency
e. Vit. E deficiency
Q.49 Spontaneous subconjunctival haemorrhage in a young adult is treated by:

a. Antibiotic eye drops
b. Cold compresses
c. Lubricant eye drops
d. Nonsteroidal anti inflammatory drops
e. Steroid eye drops
Q.50 True membranous conjunctivitis is a rare acute inflammation of the conjunctiva and :
a. Is caused by corynebacterium diphtheria
b. Membrane is loosely attached with the epithelium
c. Membrane does not reform if removed
d. Not associated with preauricular lymphadenopathy
e. Treated by systemic steroids
Q.51 Pseudomembranous conjunctivitis is caused by adenoviral, vernal and gonococcal infections. The
membrane :
a. Consists of coagulated fibrinous exudates on the surface of inflamed epithelium
b. Can not be peeled off easily
c. Causes bleeding on peeling from conjunctival surface
d. Reforms if removed
e. Usually forms on bulbar conjunctiva
Q.52 Conjunctival cysts present as translucent fluid filled cavities on the bulbar conjunctiva and are due to:
a. Blockage of ducts of accessory lacrimal glands
b. Chronic conjunctival allergy
c. Dilatation of lymph spaces
d. Implantation of epithelial cells
e. Retension of secretions in the meibomian glands
Q.53 A dermoid cyst is smooth , solid, round congenital growth at limbus and is mass of:
a. Collagen fibers
b. Collagen fibers and fat
c. Dermoid tissue with fat
d. Epidermoid epithelium with pilosebacious structures
e. Hyperplastic conjunctival epithelium
Q.54 Squamous cell CA presents as a slightly raised fleshy mass with tufted vessels usually at:
28
b. Cruncle
c. Limbus
d. Outer canthus
e. Palpebral conjunctiva
Q.55 A young teacher complaining of bilateral lid swelling, redness, a feeling of grittiness, watery
discharge and preauricular lymphadenopathy of recent onset. He is most likely suffering from?
a. Atopic keratoconjunctivitis
c. Bacterial conjunctivitis
d. Epidemic Keratoconjunctivitis
e.Vernal Keratoconjunctivitis
Q.56 The management of Epidemic keratoconjunctivitis consists of:

b. Corticosteroid eye drops
c. Cold compresses, antibiotic and lubricant eye drops
d. Non steroidal anti inflammatory eye drops
e. Simple assurance
Q.57 A young swimmer presents with history of redness, irritation and mucopurulent discharge in his both
eyes. The most probable diagnosis is:
a. Adult inclusion conjunctivitis
b. Epidemic keratoconjunctivitis
d. Keratoconjunctvitis sicca
e. Trachoma
Q.58 What is the most common ocular complication of Rheumatoid arthritis ?

a. Anterior uveitis
b. Cataract
c. Episcleritis
e. Scleritis
Key
Q.1 e Q.9 a Q.17 e Q.25 e Q.33 e Q.41 e Q.49 c Q.57 a
Q.2 e Q.10 a Q.18 e Q.26 d Q.34 e Q.42 c Q.50 a Q.58 d

29
Q.3 a Q.11 a Q.19 d Q.27 c Q.35 b Q.43 a Q.51 a
Q.4 d Q.12 d Q.20 c Q.28 d Q.36 e Q.44 d Q.52 c
Q.5 d Q.13 e Q.21 d Q.29 d Q.37 b Q .45 b Q.53 d
Q.6 c Q.14 c Q.22 e Q.30 b Q.38 e Q.46 d Q.54 c
Q.7 a Q.15 b Q.23 a Q.31 b Q.39 a Q.47 a Q.55 d
Q.8 b Q.16 d Q.24 c Q.32 d Q.40 a Q.48 a Q.56 c
Chapter-4
The cornea
30
Q.1 The corneal epithelium develops from:

a. Endoderm
b. Mesoderm
c. Neuroectoderm
d. Partly from surface ectoderm and partly from endoderm
e. Surface ectoderm
Q.2 The corneal stroma, dsescemet’s membrane and endothelium develop from:
a. Endoderm
b. Mesodem and endoderm
c. Mesoderm
d. Neuroectoderm
e. Surface ectoderm
Q.3 Cornea is the main refracting surface of the eye and constitutes anterior 1/6th of the eyeball. It is:
a. Thickest in the centre
b. Thinnest in the centre
c. Thinnest in the periphery
d. The toughest part of the eyeball
e. Uniform in thickness
Q.4 The thickest layer of cornea is:

a. Bowman’s layer
b. Corneal epithelium
c. Descemet’s membrane
d. Endothelium
e. Lamina propria
Q.5 The corneal epithelium consist of:

a. A single layer of polyhedral cells
b. 2- 3 layers of cells
c. 2-5 layers of cells
d. 5-6 layers of cells
e. 6-8 layers of cells
Q.6 The cornea is kept in dehydrated state by :
a. Intraocular pressure
b. Intact corneal epithelium
c. Na, K ATPase pump
d. Na Bicarbonate pump
e. Passive diffusion
31
Q.7 The vital role in maintaining detergence of the cornea is played by:
a. Bowman’s membrane.
c. Corneal endothelium
d. Descemet’s membrane
e. Lamina propria
Q.8 The cornea is supplied by:

a. Frontal nerve
b. Lacrimal nerve
c. Nasociliary nerve
d. Oculomotor nerve
e. Trochlear nerve
Q.9 The corneal endothelium is a single layer of flattened hexagonal cells.The cell count:
a. Decreases with advancing age
b. Increases with advancing age
c. Is measured by pachymetry
d. Plays little role in keeping the cornea transparent
e. Remains constant throughout life
Q.10 The Specular Microscopy is done to:

a. Assess the angle of anterior chamber
b. Count and study the endothelial cell morphology
c. Examine corneal epithelial cell defect
d. Measure corneal thickness before refractive surgery
e. See anterior chamber cells in uveitis
Q.11 The endothelial decompensation occurs when:

a. 10%
b. 20% cells are damaged
c. 30% cells are damged
d. 50% cells are damaged
e. >75% cells are damaged
Q.12 The cornea acts as a major refractve medium. Its average refractive power is:
a. 25 diopters
b. 35 diopters
c. 42 diopters
d. 48 diopres
e. 58 diopters
Q.13 The cornea obtains its nutrition from :

a. Aqueous humour
b. Atmospheric air & Aqueous humour
c. Perilimbal capillaries
d. Tears
e. Vitreous humour
32
Q.14 Fleischer’s ring is deposition of iron in corneal epithelium in:

a. Intraocular iron foreign bodies
b. Keratconus
c. Old age
d. Pterygium
e. Wilson’s disease
Q.15 Kayser-Fleischer ring is due to deposition of copper in peripheral descemet’s membrane in:
a. Corneal dystrophies
b. Keratoconus
c. Pinguecula
d. Pterygium
e. Wilson’s disease
Q.16 Stocker’s line is the iron pigment deposition in corneal epithelium in:
a. Band keratopathy
b. Chronic uveitis
b. Chronic simple glaucoma
d. Progressive pterygium
e. Stationary pterygium along the edge
Q.17 Hudson-stahli line is the iron pigment deposition in corneal epithelium and is located:
a. At the junction of lower and upper 2/3 of the cornea
b. At the junction of upper and lower half
c. Along the edge in stationary pterygium
d. In the periphery along limbus
e. In the central cornea
Q.18 A corneal epithelial defect is best stained with:

a. Alcian blue
b. Fluorescein sodium
c. Methylene blue
d. Rose Bengal
e. Tryptan blue
Q.19 The devitalised epithelial cells of the conjunctiva and cornea are best stained with:
a. Alcian blue
c. Giemsa staining
d. Methylene blue
e. Rose Bengal
Q.20 The earliest symptom in a corneal ulcer is :

a. Decrease in visual acuity
b. Excessive lacrimation
c. Lid swelling
d. Pain
e. Photophobia
33
Q.21 Pain in corneal ulcer is relieved by using:

b. Cycloplegic eye drops
c. Non steroidal anti inflammatory eye drops
d. Steroid eye drops
e. Topical anaesthetic drops
Q.22 Haloes around lights are seen due to :

a. Corneal opacity in the central cornea
b. Diffraction of light as a result of epithelial odema
c. Mature cataract
d. Presence of flare in the AC
e. Refractive errors
Q.23 Herpes Simplex Keratitis (HSK) is caused by ?

a. Adenovirus
b. HSV-1
c. HSV-2
d. Measles virus
e. Varicella- Zoster virus
Q.24 After primary infection, the H.Simplex virus-1 travels along the axons of sensory nerves to ?
a. Cervical ganglions
b. Ciliary ganglion
c. Dorsal root ganglion
d. Otic ganglion
e. Trigeminal ganglion
Q.25 A young patient presents with H/O pain, photophobia and excessive lacrimation. On examination, the
corneal ulcer has a typical dendritic pattern of staining with fluorescein. In your opinion this type of
ulcer is caused by which micro-organism ?
a. Aspergillus
b. Candida albicans
c. Herpes simplex virus-1
d. Herpes simplex virus -2
e. Varicella- zoster virus
Q.26 In disciform keratitis due to Herpes simplex-1, there is:

a. Epithelial and stromal odema
b. Epithelial and stromal odema with endothelialitis
c. Loss of bowman’s membrane
d. Normal endothelial layer
e. Stromal odema & thickening
Q.27 In interstitial keratitis there is:

a. Corneal odema due to endothelial decompensation
b. Inflammation of corneal stroma without involvement of epithelium or endothelium
c. Inflammation of corneal stroma and epithelial odema
d. Inflammation of corneal stroma and endothelium
34
e. Involvement of peripheral cornea
Q.28 Treatment of disciform keratitis due to HS-1 virus is by:

b. Antiviral ointment
c. Antiviral ointment & weak steroid drops
d. Lubricant eye drops
Q.29 Herpes simplex keratitis in children is usually associatd with;

a. Cervical lymphadenopathy
b. Follicular conjunctivitis
c. Fever and rhinitis
d. Haemorrhagic conjunctivitis
e. Mucopurulent conjunctivitis
Q.30 The specific drug treatment of HSK is with:

a. Antibiotc drops
b. 3% Acyclovir eye ointment 5 imes a day
c. 5% Acyclovir ointment 3 times a day
d. 1% cyclopentolate eye drops
e. Corticosteroid eye drops
Q.31 Oral anti-viral drug treatment is given in:

a. Dendritic keratitis
b. Disciform keratitis
c. Herpes zoster ophthalmicus
d. Interstitial keratitis
e. Stromal necrotic keratitis
Q.32 Corneal sensitivity was decreased in a patient having HSK in the past . This is due to involvement of
which nerve fibers?
a. Facial nerve
b. Oculomotor nerve
c. Ophthalmic branch of trigeminal nerve through long ciliary nerves
d. Trochlear nerve
e. Trigeminal nerve - maxillary branch
Q.33 Herpes zoster ophthalmicus is caused by:

a. Adenovirus
b. Herpes simplex virus -1
c. Herpes simplex virus-2
d. Measles virus
e. Varicella- Zoster virus
Q.34 The most agonising symptom in Herpes zoster ophthalmicus is :

a. Deterioation of vision in early phase of the disease
b. Excessive lacrimation
c. Fever
d. Severe pain along the distribution of 1st div. of trigeminal nerve
e. Skin vesicles
35
Q.35 The earliest corneal lesion in HZO is:

a. Disciform keratitis
b. Filamentary keratitis
c. Nummular keratitis
d. Punctate epithelial keratitis
e. Sromal necrosis
Q.36 An important predisposing factor in the development of bacterial corneal ulceration is:
a. Infection by pseudomonas aregenosa
b. Iridocyclitis
c. Old age
d. Presence of a surface ocular disease
e. Working in the fields
Q.37 The pathogens reputed to be able to cause corneal infection in the presence of intact epithelium
include:
a. Acanthamoeba
b. Aspergillus & fusarium
c. N. Gonorrhoea, meningitides & .Corynebact. Diphtheria
d. Staphylococcus aureus
e. Pseudomonas
Q.38 The most common organism responsible for hypopyon corneal ulcer is:
a. Candida albicans
b. E. coli
c. Pneumococcus
d. Pseudomonas
e. Staphylococcus aureus
Q.39 If not treated early, the most serious complication of bacterial keratitis is:
a. Corneal perforation
b. Cataract formation
c. Decrease in visual acuity
d. Formation of corneal opacity
e. Rise in IOP
Q.40 The most prominent feature of regressive stage of a corneal ulcer is:
a. Appearance of hypopyon in the anterior chamber
b. Formation of grey zone in the surrounding area due to infiltration of leucocytes
c. Presence of slough in the floor of ulcer
d. Vessels start growing in towards ulcer site
e. Wall of ulcer becomes odematous
Q.41 In bacterial corneal ulceration, the impending perforation is more efficiently dealt by:
a. Bandage contact lens
b. Conjunctival flap
c. Cycloplegic eye drops
d. Effective controle of infection
e. Tarsorrhaphy
36
Q.42 Steroid eye drops are indicated in:

a. Bacterial keratitis
c. Dendritic keratitis
d. Mycotic keratitis
e. Traumatic corneal abrasions
Q.43 The use of corticosteroid eye drops is contraindicated in:

a. Acute anterior uveitis
c. Interstitial keratitis
d. Scleritis
e. Viral keratitis
Q.44 In suspected Fungal Keratitis, the scraped corneal material is inoculated for growth on:
a. Chocolate agar
b. MacConkey agar
c. Nutrient agar
d. Sabouraud’s agar
e. Thyoglycate broth
Q45 Fungal keratitis caused by Filamentous organisms is:

a. Associated with dense suppuration similar to bacterial infection
b. Characterised by raised whitish lesions with indistinct margins, feathery projections and intact
epithelium.
c. More common in old age, diabetics and immunocompromised individuals
d. Not associated with hypopyon formation
e. Treated by aminoglycoside eye drops
Q.46 Fungal keratitis caused by Yeast organisms is:

a. b. Characterised by raised whitish lesions with indistinct margins, feathery projections and intact
epithelium
b. Characterised by dense suppuration similar to bacterial keratitis
c. Most prevalent in agricultural areas
d. Treated by intravitreal injections of Amphoteracin-B
e. Typically proceeded by ocular trauma involving vegetable matter
Q.47 In the treatment of Fungal Keratitis, the drug of choice is:

a. Aminoglycosides ( systemic & topical)
b. 0.1 % Broline eye drops
c. 0.5% Moxifloxacin eye drops
d. 5% Natamycin eye drops
e. 1% Steroid eye drops
Q.48 Acanthamoeba keratitis is an uncommon:
a. Bacterial infection of the cornea
b. Chlamydial infection of cornea
c. Fungal infection of the cornea
d. Protozoal infection of the cornea
e. Viral infection of the cornea
37
Q.49 Acanthamoeba Keratitis is a blinding condition. It is:

a. Associated with severe iridocyclitis
b. Characterised by severe pain and photophobia which is out of proportion to clinical findings
c. Treated by antifungal drops
d. Treated by broad spectrum antibiotic eye drops
e. Very common in our country
Q.50 Phlyctenular keratitisis is due to

a. Adenoviral infection
b. A Type-1 hypersensitivity reaction to exogenous allergens
c. A Type-iv delayed hypersensitivity reaction to bacterial antigens
d. An autoimmune reaction
e. Staphylococcal exotoxins
Q.51 Marginal keratitis (Catarrhal Ulcer) is due to:

a. An auto immune disorder
b. Delayed hypersensitivity reaction to bacterial antigens .
c. Hypersensitivity reaction to staph. exotoxins
d. Type-1 hypersensitivity reaction
e. Hypersensitivity reaction to viral antigen.
Q.52 A 65 years old individual presents with lagophthalmos due to facial palsy. He is likely to develop:
a. Band keratopathy
b. Exposure keratitis
c. Lipid keratopathy
d. Neurotrophic keratopathy
e. Pterygium
Q.53 Filamentary keratitis is a superficial keratitis associated with the formation of corneal filaments and its
one of the commonest causes is:
a. Acute congestive glaucoma
c. Interstitial keratitis
Q.54 The best treatment of exposure keratitis is:

b. Artificial tears eye drops
c. Soft bandage contact lens
d. Temporary or permanent tarsorrhaphy
e. Use of eye pads
Q.55 Neuroparalytic keratitis is due to the paralysis of which cranial nerve :

a. 2nd cranial nerve
b. 3rd cranial nerve
c. 4th cranial nerve
d. 4th cranial nerve
e. 5th cranial nerve
38
Q.56 Neurotrophic keratopathy is due to:

a. Absent blink reflex
b. Corneal anaesthesia caused by paralysis of ophthalmic branch of trigeminal nerve
c. Decreased lacrimal secretions
d. Lagophthalmos
e. Vitamin A deficiency
Q.57 Mooren’s ulcer is a peripheral painful condition. It is:

a. A common peripheral ulcerative keratitis
b. An autoimmune disease causing ischaemic necrosis due to vasculitis of limbal vessels
c. Commonly associated with hypopyon formation and perforation
d. Due to degenerative changes in an old leucoma
e. Treated by systemic tetracycline
Q.58 A 75- years old lady admitted in hospital for some geriatric problem developed pain, redness and
photophobia in her left eye. On examination, it was noted that the visual acuityis decreased and the
lower eyelid turned in towards the globe. What is the most likely cause of these symptoms?
b. Acute iridocyclitis
c. Acute congestive glaucoma
d. Corneal ulceration
e. Conjunctival ulceration
Q.59 Corneal dystrophies differ from degenerations as:

a. Pain is the prominent feature
b. They are associated with systemic diseases
c. They are bilateral and genetically determined
d. They start in the periphery and are accompanied by vascularization
e. They manifest after the age of 50 years
Q.60 Corneal degenerations are:

a. Bilateral and genetically determined
b. Not associated with systemic or eye diseases
c. Slowly progressive without vascularization
d. The result of action of environmental factors on biological processes and the genetics does not play
any role
e. Mnifested earlier than dystrophies
Q.61 Arcus senilis is a degenerative condition of cornea and due to deposition of:
a. Calcium in the peripheral corneal stroma
b. Lipids in the peripheral corneal stroma in old age
c. Amyloid material in descemet’s membrane
d. Hyaline material in corneal epithelium
e. Iron pigment in lamina propria
Q.62 Arcus Juvenilis is deposition of lipids in the corneal stroma. It is:

a. A peripheral corneal dystrophy
b. Associated with dysproteinemia
c. Clinically evident before the age of 40 years
d. Genetically determined
e. More common in old age
39
Q.63 Band shaped keratopathy is a common corneal degenerative disorder, characterised by:
a. Corneal vascularization in the periphery
b. Deposition of lipids in the corneal stroma
c. Deposition of calcium salt in superficial corneal layers
d. Defective synthesis of mucopolysaccharides in the stroma
e. Nodular opacities in the cornea
Q.64 Band shaped keratopathy is seen in :

a. Lower part of the cornea
b. Nasal half of the cornea
c. Middle part of cornea
d. Temporal half of the cornea
e. Upper half of the cornea
Q.65 Keratoconus is a non- inflammatory ectatic corneal condition, usually manifests at puberty and in
70% of cases it is associated with:
a. Congenital cataract
b. Ectopia lentis
c. Hypermetropic astigmatism
d. Recurrent erosion syndrome
Q.66 In Munson’s sign there is indentatation of the lower eyelid in down gaze and is a diagnostic clinical
sign in:
a. Anterior staphyloma
b. Exophthalmos
c. Fuch’s endothelial dystrophy
d. Keratoconus
e. Keratoglobus
Q.67 In keratoconus:
a. Apex of the cone is situated in the centre of the cornea
b. Apex of the cone is situated just below the centre of cornea
c. Keyser- Fleischer ring is present in the peripheral cornea
d. Vogot’s lines are horizontal parallel lines at the level of descemets membrane
e. Vision deteriorates due to regular astigmatism
Q.68 In an established case of keratoconus, the best treatment is:

a. Corneal refractive surgery
b. Hard contact lenses
c. Prescription of suitable glasses
d. Soft contact lenses
e. Penetrating keratoplasty
Q.69 The most serious complication of Fuch’s Endothelial Dystrophy is :

a. Anterior uveitis
b. Corneal endothelial decompensation
c. Cataract formation
d. Open angle glaucoma
e. Punctate epithelial keratitis
40
Q.70 In Fuch’s endothelial dystrophy, the corneal epithelial odema appears when:
a. IOP rises > 30 mm of Hg
b. Thickness of corneal stroma increases by 10%
c. Thickness of corneal stroma increase by 20%
d. Thickness of corneal stroma increases by 30%
e. Thickness of corneal stroma increase by 40%
Q71 A nebular corneal opacity results when a scar involves:

a. Bowman’s membrane
b. Bowman’s membrane and superficial stroma
c. Bowman’s membrane and 50% of the stroma
d. Bowman’s membrane and full thickness of the stroma
e. Full thickness of stroma
Q.72 A macular corneal opacty is the result of involvemet of:

a. Bowman’s membrane
b. Bowman’s membrane and superficial stroma
c. Bowman’s membrane and 50% of the stroma
d. Bowman’s membrane and full thickness of stroma
e. Full thickness of the stroma
Q.73 An adherent leucoma is a leucomatous opacity in which the:

a. Cornea is in contact with the lens
b. Corneal opacity is associated with PAS
c. Iris tissue lines the opacity
d. Iris tissue is incarcerated in the layers of cornea
e. Opaque cornea bulges forward
Q.74 Restoration of corneal transparency in leucomatous corneal opacities is best done by:
a. Full thickness keratoplasty
b. Raising conjunctival flap
c. Use of topical lubricant drops
d. Use of immunosuppressive agents
e. Using contact lenses
Q.75 Keratoplasty is the operation in which abnormal host tissue is replaced by healthy donor tissue. The
absolute contraindication for donors is:
a. Associated adnexal disorders
b. Controlled open angle glaucoma
c. Diabetes mellitus
d. Very young patients
e. HIV- positive donors
Q.76 Early graft failure is characterised by irreversible cloudiness of donor cornea on the very first post
operative day and one of the common cause is:
a. Allograft reaction
b. Endothelial dysfunction due to defective donor endothelium or poor surgical technique
c. Ocular surface disease
d. Post operative rise in IOP
e. Very old patients
41
Q.77 Full thickness keratoplasty was done in a 35 years old man. The graft remained clear initially but after
about 6 months, it showed signs of rejection. What is the cause of this Late Corneal Graft Failure?
a. Allograft reaction
b. Defective donor endothelium
c. Infective keratitis
d. Pre- existing Intraocular disease
e. Post operative anterior uveitis
Q.78 A patient suffering from keratoconjunctivitis sicca (KCS), presents with multiple filamentary keratitis
lesions. The treatment of this condition is?
a. Lubricant drops
b. Mechanical removal of the filaments, patch the eye and use lubricant drops
c. Tarsorrhsphy
d. Use of antibiotic drops
e. Use of steroid drops
Key
Q.1 e Q.13 b Q.25 c Q.37 c Q.49 b Q.61 b Q.73 d
Q.2 c Q.14 b Q.26 b Q.38 c Q.50 c Q.62 c Q.74 a
Q.3 b Q.15 e Q.27 b Q.39 a Q.51 c Q.63 c Q.75 e
Q.4 e Q.16 e Q.28 c Q.40 b Q.52 b Q.64 c Q.76 b
Q.5 d Q.17 a Q.29 b Q.41 b Q.53 d Q.65 e Q.77 a
Q.6 c Q.18 b Q.30 b Q.42 b Q.54 d Q.66 d Q.78 b
Q.7 c Q.19 e Q.31 c Q.43 e Q.55 e Q.67 b
Q.8 c Q.20 e Q.32 c Q.44 d Q.56 b Q.68 e
Q.9 a Q.21 b Q.33 e Q.45 b Q.57 b Q.69 b
Q.10 b Q.22 b Q.34 d Q.46 b Q.58 d Q.70 d
Q.11 e Q.23 b Q.35 d Q.47 d Q.59 c Q.71 b
Q.12 c Q.24 e Q.36 d Q.48 d Q.60 d Q.72 c
Chapter-5
The Sclera
42
Q.1 Sclera is a dense, fibrous, collagenous structure and comprises the:

a. Posterior 1/3 of the eyeball
b. Posterior 2/3 of the eyeball
c. Posterior 3/4 of the eyeball
d. Posterior 4/6 of the eyeball
e. Posterior 5/6 of the eyeball
Q.2 Sclera is composed of bundles of collagen fibers. It is white and opaque due to:
a. Irregular arrangement of fibrous bundles
b. Due to the presence of mylinated nerve fibers
c. Presence of elastic fibers among the collagen fibrous bundles
d. Regular arrangement of fibrous bundles
e. Relative avascularity
Q.3 Sclera is a tough, white fibrous layer. Its thickness is :

a. 0.5 mm
b. 1 mm
c. 1.5 mm
d. 2 mm
e. 2.50 mm
Q.4 Lamina fusca is:

a. Composed of elastic fibers
b. The inner most part of sclera
c. The outer most part of the sclera
d. The intermediate part of sclera
e. The outer most layer of choroid
Q.5 The vortex veins exit through 4 scleral apertures located at:
a. Equator of the eyeball
b. 2 mm behind the limbus
c. 2 mm in front of the equator
d. 4 mm behind the equator
e. Limbus
Q.6 The thinnest part of sclera is at :

a. Equator
b. Limbus
43
c. 2 mm behind the limbus

d. Posterior pole
e. Places where extraocular muscles are attached
Q.7 The potential space between lamina fusca and suprachoroidal lamina is called:
a. Sub choroidal space
b. Sub conjunctival space
c. Supra choroidal space
d. Sub retinal space
e. sub tenon space
Q.8 Episclera is a vascularised connective tissue layer. It :

a. Is supplied by superficial conjunctival vessels
b. Lies between conjunctiva & tenon’s capsule
c. Lies between tenon’s capsule & sclera
d. Lies between conjunctiva and sclera
e. Merges with conjunctiva anteriorly
Q.9 Episcleritis is a benign , non infectious, recurrent, self limiting disorder. It :

a. Is less common than scleritis.
b. Is rarely associated with Rheumatoid arthritis
c. Is associated with serious complications
d. May progress to true scleritis
e. Occurs in old individuals
Q.10 The circumscribed nodule of episcleritis is due to the infiltration of the episcleral tissue by:
a. Eosinophils
b. Lymphocytes, plasma cells and monocytes
c. Monocytes
d. Macrophages
e. Neutrophils
Q.11 Scleritis is a potentially blinding condition, it is:

a. Much less common than episcleritis
b. More common in young adults
c. More common in men than women
d. Not associates with a systemic disease
e. Usually associated with conjunctival foreign body or granuloma
Q.12 The commonest cause of scleritis is:

a. Allergic reactions
b. Anterior uveitis
c. Bacterial infections
d. Connective tissue disorders
e. Idiopathic
Q.13 On examination, in Episcleritis maximum congestion is in the:

a. Circumcorneal region
b. Conjunctival vessels
c. Deep vascular plexus
d. Posterior conjunctival vessels
e. Superficial episcleral vessels
Q.14 On examination of a case of scleritis, maximum congestion is in the:

a. Conjunctival vessels
44
b. Circumcorneal region
c. Deep vascular plexus
d. Posterior conjunctival vessels
e. Superficial episcleral vessels
Q.15 In Nodular Episcleritis, the nodule is:

a. A raised circumscribed lesion in the interpalpebral region 2-3 mm from the limbus
b. Associated with scleritis
c. Fixed to the underlying tissues
d. Tender to touch
e. Pinkish in colour
Q.16 In Nodular Scleritis, the nodule is:

a. Less circumscribed and fixed to the underlying tissues
b. Mobile over the deeper tissues
c. Non tender to touch
d. Purplish in coloure
e. Situated at limbus
Q.17 Instillation of 2.5% phenyl epinephrine drops in a case of episcleritis:

a. Blanches deep vascular plexus
b. Blanches superficial episcleral vessels completely
c. Blanches superficial episcleral vessels partially
d. Blanches conjunctival and to a certain extent the superficial episcleral vessels
e. Has no effect on conjunctival vessels
Q.18 The most common complication of scleritis is:

a. Angle closure glaucoma
b. Ciliary staphyloma due to sclera thinning
c. cataract formation
d. Retinal detachment
e. Uveitis
Q.19 Scleritis is associated with connective tissue disorders in:

a. 25% of cases
b. 30% of cases
c. 40% of cases
d. 50% of cases
e. 75% of cases
Q.20 In scleritis associated with collagen disorders the involvement of cornea is in the form of:
a. Disciform keratitis
b. Diffuse stromal thickening
c. Punctate epithelial keratitis
d. Punctate epithelial erosions
e. Peripheral stromal keratitis
Q.21 The episclerits usually resolves spontaneously in 1-2 weeks but if discomfort is more it is treated by:
a. 1% Atropine eye drops
b. Cyclosporin eye drops
c. Non steroidal anti inflammatory drops
d. Topical antibiotic eye drops
e. Topical steroid drops
Q.22 Anterior necrotizing scleritis also known as Scleromalacia perforans is:

a. Associated with uveal effusion syndrome and retinal & choroidal detachment
45
b. More common in old males

c. Optic disc and macular odema is common
d. Typically in females with long standing rheumatoid arthritis
e. Very painful condition
Q.23 The first line systemic treatment of anterior necrotizing and posterior scleritis is by:
a. Cytotoxic drugs
b. Immunosuppressive agents
c. Non steroidal anti inflammatory drugs
d. Steroids in large doses initially and tappered off gradually
e. Topical and systemic antibiotics
Key
Q.1 e Q.6 e Q.11 a Q.16 a Q.21 c
Q.2 a Q.7 c Q.12 d Q.17 d Q.22 d
Q.3 b Q.8 c Q.13 e Q.18 b Q.23 d
Q.4 b Q.9 b Q.14 c Q.19 e
Q.5 d Q.10 b Q.15 a Q.20 e
Chapter-6
The uveal tract
46
Q.1 The iris is a circular diaphragm with central aperture. It is thinnest:

a. At its attachment to the ciliary body
b. At collerrette
c. At the places where where endothelium is missing
d. In the middle
e. In its pupillary part
Q.2 The sphincter and dilator pupillae originate from:

a. Endoderm
b. Mesoderm
c. Neuro- ectoderm
d. Partly from ectoderm and partly from endoderm
e. Surface ectoderm
Q.3 The short posterior ciliary arteries are about:

a. 10 in number
b. 15 in number
c. 20 in number
d. 25 in number
e. 30 in number
Q.4 Long posterior ciliary arteries are:

a. 2 in number
b. 3 in number
c. 4 in number
d. 5 in number
e. 10 in number
Q.5 Circulus iridis arteriosus major is situated in the:

a. Anterior part of ciliary body at the base of the iris
d. Centre of the iris
c. Choroid
d. Ora serrate
e. Pars plan
Q. 6 Choriocapillaris is the:
a. Inner most vascular layer of the choroid
b. Inner most layer of the choroid
c. Middle vascular layer of the choroid
d. Outer most vascular layer of the choroid
e. Vascular layer of the iris
47
Q.7 Pars plana is the posterior 2/3 of ciliary body:

a. It is about 6 mm from the limbus
b. Gives attachment to ciliary zonules
c. Measures about 2 mm in length
d. Posterior segment of eye is approached from here
e. Secretes aqueous humor
Q.8 When the colour of one iris is different from the other, the condition is called:
a. Albinism
b. Hetrochromia iridium
c. Hetrochromia iridis
d. Hetrochromic iridocyclitis
d. Iris atrophy
Q.9 Typical coloboma of the iris is situated:

a. Inferiorly
b. Inferonasally
c. Inferotemporally
d. Supronasally
e. Suprotemporally
Q.10 In order to label uveitis “chronic”, it must be present for a duration more than:
a. 2 weeks
b. 4 weeks
c. 6 weeks
d. 8 weeks
e. 10 weeks
Q.11 In circumcorneal congestion, the vessels are the branches of:

a. Anterior ciliary arteries
b. lacrimal arteries
c. Marginal arteries
d. Posterior conjunctival arteries
e. Short posterior ciliary arteries
Q.12 A 25 years old man comes to eye OPD with pain and redness in right eye. On examination there is
circumcorneal congestion. Inflammation of which of the following structures leads to this type of
congestion:
a. Conjunctiva
b. Choroid
c. Cornea & Iris
d. Eyelids
e. Sclera
Q.13 Photophobia is a prominent feature in corneal and uveal tract diseases and it is:
a. A fear of bright light
b. An abnormally increased sensitivity to ambient light
c. Decreased vision in bright light
d. Excess awareness of light
e. Due to an increased sensitivity of retinal photoreceptors to light
Q.14 Which one is the most common cause of anterior uveitis ?

48
a. Idiopathic
b. Juvenile chronic arthritis
c. Sarcoidosis
d. Toxoplasmosis
e. Tuberculosis
Q.15 Which one is the commonest type of uveitis?

a. Anterior uveitis
b. Choroiditis
c. Cyclitis
d. Intermediate uveitis
e. Panuveitis
Q.16 Earliest sign of anterior uveitis is :
a. Aqueous flare
b. Circumcorneal congestion
c. Hypopyon
d. Keratitic precipitates
e. Posterior synechiae
Q.17 Granulomatous uveitis is characterized by:

a. Acute onset and short course
b. Diffuse infiltration of tissues by lymphocytes and polymorphs
c. Localised infiltaration of tissues by macrophages and epitheloid cells
d. Marked flare with numerous cells
e. Small and greesy KPs
Q.18 In Non-granulomatous inflammation of the uveal tract, the uveits is:

a. Chronic with remissions and exacerbations
b. Characterised by diffuse infiltration of tissues by lymphocytes and polymorphs
c. Characterised by Koeppe and Busacca nodules
d. Mild with few small KPs
e. Slow and insidious in onset
Q.19 The presence of aqueous flare in the anterior chamber is:

a. A clinical sign of active anterior uveitis
b. Always associated with cells in anterior chamber
c. An indication for treatment with steroids
d. Due to leakage of proteins through damaged blood vessels
e. Necessarily a sign of posterior segment inflammation
Q.20 In acute anterior uveitis, the pupil is:

a. Dilated and fixed
b. Constricted and sluggishly reacting
c. Fixed and non reacting
d. Jet black in colour
e. Normally reacting
Q.21 A patient presented with marked decrease in vision in one eye. On torch examination, there was ciliary
congestion and small constricted and poorly reacting pupil.What is the probable diagnosis?
a. Anterior uveitis
b. Acute congestive glaucoma
c. Acute Conjunctivitis
d. Chronic simple glaucoma
e. Episcleritis
49
Q.22 Typical sign of posterior uveitis is:

a. Aqueous flare
b. Anterior synechiae
c. Floaters in the field of vision
d. Occlusive papillae
e. Presence of KPs in AC
Q.23 The KPs are inflammatory cells adhered on :

a. Anterior lens surface
d. Posterior lens sutface
e. iris
Q.24 The small KPs are:

a. Characteristic of acute anterior uveitis
b. Darker in color
c. Formed by the adhesion of lymphocytes on the endothelial surface of cornea
d. Most commonly distributed all over the endothelial surface of cornea
e. Visible without microscope
Q.25 Mutton fat KPs are:

a. Aggregation of mononuclear macrophages and epitheloid cells
b. Clusters of acute inflammatory cells
c. Composed of aggregation of mononuclear macrophages
d. Smaller in size
e. Usually seen in non-granulomatous inflammations
Q.26 The old KPs need to be differentiated from the fresh . They are:
a. Creaneated & pigmented
b. Larger in size
c. More numerous
d. Round & white
e. Scatered all over the endothelial surface
Q.27 Black spots floating in front of eyes is a symptom of :

a. Choroiditis
b. Cataract
c. Endophthalmitis
d. Iridocyclitis
e. Panophthalmitis
Q.28 Koeppe and Busacca nodules are the characteristic of :

a. Exudative uveitis
b. Endophthalmitis
c. Granulomatous uveitis
d. Non granulomatous uveitis
e. Posterior uveitis
Q.29 Koeppe nodules are:

50
a. Formed by aggregation of neutrophils and lymphocytes

b. Located on the surface of the iris away from the pupil
c. Less common than Busacca nodules
d. Present in non- granulomatous uveitis
e. Situated at the papillary border
Q.30 Busacca nodules are present on the surface of the iris and are:
a. Aggregation of acute inflammatory cells
b. An important clinical sign of granulomatous uveitis
c. Located at pupillary margin
d. Smaller in size and more numerouse
d. Visible on naked eye examination
Q.31 Pars Planits is the inflammation of :

a. Ciliary body and choroid
b. Iris and ciliarybody
c. Pars plana & pars plicata
d. Pars plicata and the anteriort part of retina
e. Posterior 2/3 of ciliary body (Pars plana) and the anterior part of retina & choroid
Q.32 Vitritis is a clinical sign of:

a. Anterior segment inflammatory disease
b. Optic nerve disease
c. Posterior segment inflammatory disease
e. Vitreous disease
Q.33 The vitreous activity in posterior segment inflammation is best examined with the help of :
a. Direct ophthalmoscope
b. Distant direct ophthalmoscopy
c. Indirect ophthalmoscope
d. Streak retinoscope
e. Slitlamp bio microscope
Q.34 All patients of JCA which develop anterior uveitis are:

a. Associated with severe symptoms at their onset
b. Above the age of 16 years
c. Mostly negative for ANA
d Seropositive for RA factor
e. Seronegative for RA factor
Q.35 A young man of 35 years presents with H/O chronic backache and recent visual deterioration in his
one eye. O/E the eye revealed a VA of 6/18 and signs of acute anterior uveitis, What is the most likely
diagnosis?
c. Psoriatic arthritis
c. Reiter’s syndrome
d. Rheumatoid arthritis
51
Q.36 A 40 years old man notices diminished vision and difference in iris colour between the two eyes. O/E
the VA is 6/60, low grade uveitis, hetrochromia and cataract changes. What is the diagnosis?
b. Behcet’s disease
c. Chronic uveitis
d. Fuchs uveitis syndrome
e. Pars planitis
Q.37 The most common complication of chronic anterior uveitis is:

a. Corneal opacification
b. Cystoid macular odema
c. Phthisis bulbi
e. Secondary glaucoma
Q.38 A young man presents with H/O diminished vision and floaters in the field of vision. After
examination he was diagnosed as a case of pars planitis. What can be the most probable cause of
diminished vision in this case?
a. Anterior chamber reaction
b. Cystoid macular odema
c. Papillitis
d. Snow banking
e. Vitritis
Q.39 The late rise in IOP in a case of anterior uveitis due to Herpes zoster ophthalmicus is due to:
a. Increased production of aqueous humour
b. Occlusion of canal of schlemm
c. Presence of exudates & cells in the anterior chamber angle & trabecular meshwork
d. Rise in episcleral venous pressure
e. Trabeculitis
Q.40 When there is inflammation of the whole uveal tract, the condition is called?
a. Choroiditis
b. Endophthalmitis
c. Iridocyclitis
d . Panuveitis
e.Panophthalmitis
Q.41 The term endophthalmitis means inflammation of :

a. All the coats of eyeball
b. Choroid
c. Internal structures of the eye
d. Iris & ciliary body
e. Retina & choroid
Q.42 The earliest sign in postoperative endophthalmitis is :
a. Circumcorneal congestion
b. Hypopyon
c. Loss of red reflex / Yellow fundus reflex
d. Presence of cells in A.C
e. Keratitic precipitates
Q.43 Complete loss of vision is seen at its onset in :

a. Cavernous sinus thrombosis
52
b. Choroiditis
c. Endophthalmitis
d. Pars planitis
e. Panophthalmitis
Q.44 Most common parasitic cause of uveitis is :

a. Amoeba
b. Echinococcus granulosus
c. Oncosercosis
d. Toxoplasma
e. Toxocara
Q.45 A 30 years old patient is diagnosed to be having Pars Planitis. The criteria for the use of posterior
subtenon steroid injections is:
a. Poor response to topical steroids
b. Poor compliance of the patient
c. Recurrent disease
d. Severity of vitritis
e. VA less than 6/9 due to CMO
Q.46 A 3 years old boy with right chronic anterior uveitis has posterior subcapsular lens opacity with
polychromatic lusture in the same eye. What is this opacity called?
a. Secondary cataract
b. Complicated cataract
c. Congenital cataract
d. Cortical cataract
e. Nuclear cataract
Q.47 A 10 year old boy with pain in multiple joints is having bilateral anterior uveitis with complicated
cataract. What is the most probable cause of this uveitis?
b. Juvenile idiopathic iridocyclitis
c. Juvenile idiopathic arthritis (JCA)
d. Reiter’s arthritis
e. Sarcoidosis
Q.48 An 8 years old girl presents with complaints of diminished vision and white patch on the cornea in
her one eye. No H/O pain, redness or joint pain. O/E there are signs of low grade uveitis, band
keratopathy and cataract changes . What is the likely diagnosis?
c. Juvenile idiopathic iridocyclitis
d. Reiter’s syndrome
e. Psoriatic arthritis
Q.49 In Reiter’s syndrome :

a. Conjunctivitis is associated with uveitis
b. Conjunctivitis is associated with urethritis
c. Keratitis is associated with urethritis & uveitis
d. Urethritis , arthritis and conjunctivitis are present with or without uveitis
e. Uveitis is granulomatous in characteristics
Q.50 Acute recurrent bilateral non granulomatous uveitis associated with painful mouth ulcers and hypopyon
is a common feature in:
a. Behcet’s disease
b. Chronic uveitis
53
c. Intermediate uveitis
d. Sarcoidosis
e. Syphilis
Q.51 The lightening of the colour of iris, iris atrophy, presence of Kps, and association of cataract in a young
individual are the features of:
a. Behcet’s disease
b. Chronic uveitis
c. Idiopathic juvenile arthritis
d. Fuch’s uveitis syndrome
e. Sarcoidosis
Q.52 Sarcoidosis is a multisystemic granulomatous disorder of unknown etiology. The diagnosis is

established by:
a. Abnormally low levels of immunoglobulins
b. Hypocalcaemia
c. Low levels of angiotensin converting enzyme (ACE)
d. Positive Montoux test
e. Wide spread non caseating granulomas and a positive Kveim-Slitzbach skin test
Q.53 Sympathetic uveitis a bilateral granulomatous panuveitis which occurs in the healthy eye after:
a. Contusion injury -in the other eye
b. Concussion injury in the other eye
c. Penetrating injury with uveal tissue prolapse- in the other eye
d. Severe bacterial infection in the other eye
e. Viral infection in the other eye
Q.54 To prevent the development of sympathetic uveitis, enucleation of the exciting eye is recommended
within:
a. 2 weeks of the injury
b. 3 weeks
c. 4 weeks
d. 6 weeks
e. 8 weeks
Q.55 The glaucomatocyclitic crisis is characterized by:

a. Absence of signs of uveitis
b. Narrow angle of anterior chamber
c. Recurrent attacks of rise in IOP and mild anterior uveitis
d. Shallow AC
e. Vitritis
Q.56 Postoperative choroidal detachment is a rare complication which develops due to:
a. Explosive vitreous haemorrhage
b. Severe acute iridocyclitis
c. Sudden lowering of IOP and exudation of fluid in outer part of choroid
d. Sudden rise in IOP in ACG
e. Vitreous loss during surgery
Q.57 A patient operated for cataract developed choroidal detachment on 1st post operative day. The
treatment is:
a. Antibiotic drops
b. Acetazolamide drops
c. Cycloplegic drops
d. Self limiting, no treatment is required
e. Steroid drops
Q.58 A 25 years old lady presents with history of pain and redness in her left eye. On examination, there is
ciliary congestion, cells (++) and moderate flare in the anterior chamber. What is the first line
treatmentt?
54
a. Antibiotic drops
b. Oral steroids
c. Steroid eye drops
d. Oral antibiotics
e. Non steroidal anti inflammatory drops
Q.59 The steroids are the mainstay in the treatment of uveitis. The most notorious complication of using
topical prednisolone eye drops is development of:
a. Cataract
b. Herpes simplex keratitis
c. Mydriasis
d. Open angle glaucoma
e. Ptosis
Q.60 In anterior uveitis, the inflammatory reaction is controlled by :

a. Acetazolamide drops
b. Antibiotic eye drops
c. Cycloplegic eye drops
d. Coticosteroid eye drops
e. Non-steroidal anti-inflammatory eye drops
Q.61 What is the main advantage of using cycloplegic eye drops in the treatment of anterior uveitis?
a. Relieve ciliary spasm and pain
b. Decrease inflammation
c. Decrease intraocular pressure
d. Helps in healing
e . Improve vision
Q62 The advantage of periocular injections of steroids over topical administration is that :
a. It prevents the formation of synechiae
b. Lipid soluble drugs can penetrate easily through the sclera
c. No steroid complications
d. Spread of inflammation posterior to the lens is prevented
e. Water soluble drugs can penetrate easily through the sclera
Q63 Which of the following steroids given by posterior sub-tenon route has a duration of action upto 4-6
weeks?
a. Betamethsone
b. Dexamethasone
c. Fluoromethalone
d. Prednisolone
e. Triamcilone
Q.64 Long term systemic steroid therapy in resistant cases of uveitis may cause:
a. Behavioural changes
b. Bronchial asthma
c. Cushingoid face
d. Necrosis head of femur
e. Peptic ulceration
Q.65 What is the indication of using immunosupprersive agents in the treatment of uveitis?
a. Bilateral anterior uveitis
b. Bilateral posterior uveitis
c. Failure to respond to steroids & cytotoxic drug therapy
55
d. Long standing diabetes mellitus

e. Renal failure
Q.66 The treatment of a large intraocular malignant melanoma of uveal tract is :

a. Chemotherapy
c. Enucleation
c. Evisceration
d. Exentration
e. Radiotherapy
Key
Q.1 a Q.11 a Q.21 a Q.31 e Q.41 c Q.51 d Q.61 a
Q.2 c Q.12 c Q.22 c Q.32 c Q.42 c Q.52 e Q.62 e
Q.3 c Q.13 b Q.23 c Q.33 c Q.43 e Q.53 e Q.63 e
Q.4 a Q.14 a Q.24 c Q.34 e Q.44 d Q.54 a Q.64 c
Q.5 a Q.15 a Q.25 a Q.35 a Q.45 e Q.55 c Q.65 c
Q.6 a Q.16 b Q.26 a Q.36 d Q.46 b Q.56 c Q.66 c
Q.7 d Q.17 c Q.27 a Q.37 b Q.47 c Q.57 d
Q.8 c Q.18 b Q.28 c Q.38 b Q.48 c Q.58 c
Q.9 b Q.19 d Q.29 e Q.39 e Q.49 d Q.59 d
Q.10 c Q.20 b Q.30 b Q.40 d Q.50 a Q.60 d
Chapter-7
The Lens
56
Q.1 The crystalline lens develops from:

a. Endoderm
b. Neuro-ectoderm
c. Mesoderm
d. Partly from surface ectoderm and partly from mesoderm
e. Surface ectoderm
Q.2 The lens epithelium lines:

a. Inner aspect of anterior lens capsule
b. Inner aspect of posterior lens capsule
c. Inner aspects of both anterior and posterior lens capsules
d. Outer aspect of anterior lens capsule
e. Outer aspect of posterior lens capsule
Q.3 Bilateral or unilateral displacement (Subluxation) of lens in Marfan’s Syndrome frequently occurs:
a. Downward
b. Down and outward
c. Inward
d. Up and outward
e. Up and inward
Q.4 The lens derives its nutrition from:

a. Atmospheric air
b. Aqueous humour
c. Ciliary zonules
d. Perilimbal capillaries
e. Vitreous humour
Q.5 The metabolic activity of the crystalline lens is largely confined to the:
a. Lens capsule
b. Lens nucleus
c. Lens cortex
d. Subcapsular epithelium and cortex
e. Suspensory ligaments
Q.6 Lactic acid is found in considerable quantity in the aqueous humour in:
a. Aphakia
b. Anterior uveitis
c. Normal phakic eye
d. Pseudophakia
e. Vitreous haemorrhage
57
Q.7 The radius of curvature of anterior surface of human lens is approximately:

a. 6 mm
b. 8 mm
c. 9 mm
d. 10 mm
e. 12 mm
Q.8 The radius of curvature of posterior surface of the lens is approximately 6 mm. So,
a. Anterior and posterior surfaces are equally convex.
b. It is less convex than the anterior surface
c. It is more convex than the anterior surface
d. Its radius of curvature is more than anterior surface
e. Its refractive power is less than the anterior surface
Q.9 The dioptric power of human lens is:

a. 16 Diopters
b. 18 Diopters
c. 20 Diopters
d. 22 Diopters
e. 24 Diopters
Q.10 The lens lies between the iris and the vitreous and suspended by the suspensory ligaments which are
attached to it at the:
a. Anterior surface of the lens
b. Anterior and posterior surfaces of the lens
c. Equator of the lens
d. Posterior surface of the lens
e. Posterior pole of the lens
Q.11 The lens is responsible for:

a. 30 % of the refracting power of the eye
b. 35% of the refracting power of the eye
c. 40 % of the refracting power of the eye
d. 45 % of the refracting power of the eye
e. 50 % of the refracting power of the eye
Q.12 The accommodative power of the human lens varies with age. It is maximum:
a. At birth
b. At adolescence
c. In childhood
d. In adults
e. In old age
Q.13 During accommodation, the AP diameter of the lens increases. In this phenomenon:
a. Anterior surface of the lens bulges forward more than posterior
b. Both anterior and posterior surfaces protrude equally
c. Posterior surface of the lens protrudes more
d. The overall diameter of the eyeball is increased
e. The depth of anterior chamber decreases
58
Q.14 The lens capsule is a thin, transparent membranous structure secreted by the anterior cuboidal cells. Its:
a. Anterior capsule is the thinnest in its central part
b. Anterior capsule is thicker than the posterior capsule
c. Anterior & posterior capsules are equal in thickness
d. Posterior capsule is the thickest at posterior pole
e. Posterior capsule is the thinnest at posterior pole
Q.15 The commonest cause of cataract in this subcontinent is:

a. Diabetes mellitus
b. Hypoparathyroidism
c. Malnutrition
d. Old age
e. Trauma
Q.16 Heriditary cause accounts for a significant number of congenital cataracts; It is usually:
a. Autosomal recessive
b. Autosomal dominant
c. X- linked recessive
d. X- linked dominant
Q.17 The commonest type of congenital cataract is:

a. Blue –dot cataract
b. Coronary cataract
c. Lamellar cataract
d. Nuclear cataract
e. Oil droplet cataract
Q.18 The most common cause of congenital cataract is:

a. Chromosomal abnormalities
b. Maternal malnutrition
c. Maternal drug ingestion
d. Metabolic disorders
e. TORCH infection
Q.19 An infant is born with congenital cataract. Which one of the following maternal infections is the most
common cause of this cataract?
a. Herpes simplex
b. Herpes zoster
c. Rubella
d. Syphilis
e. Toxoplasmosis
Q.20 The earliest pathological change in the lens in the development of cortical senile cataract is:
a. Appearace of cortical opacities in the periphery
b Diffuse corticak opacification
c. Formation of posterior subcapsular opacities
d. Lamellar separation
59
e. Nuclear sclerosis
Q.21 Black discolouration of cataract in nuclear sclerosis is due to:

a. Deposition of pigment derived from aquous humor
b. Depositin of pigment derived from vitreous
c. Melanin pigment derived from amino acids in the lens
d. Pigment derived from uveal tract
e. Pigment derived from blood
Q.22 Posterior subcapsular cataract is typical of:

a. Anterior uveitis
b. Angle closure glaucoma
c. Diabetese mellitus
d. Panuveitis
Q.23 Rossette shaped cataract is a feature of:

a. Complicated cataract
b. Diabetic cataract
c. Retained intraocular F.B
d. Senile cataract
e. Traumatic cataract
Q.24 Most common type of cataract in adults is :

a. Anterior subcapsular cataract
b. Cortical cataract
c. Morgagnian cataract
d. Nuclear cataract
e. Posterior subcapsular cataract
Q.25 The cortical changes in senile cataract are usually associated with:
a. Axial myopia
b. Deep anterior chamber
c. Hypermetropia
d. Irregular astigmatism
e. Lenticular myopia
Q.26 Myopic change in refractive state of the eye in nuclear sclerosis is due to:
a. Anterior displacement of the lens-iris diaphragm
b. Decrease in the refractive index of the lens
c. Decrease in curvature of the lens
d. Increase in the refractive index of the eye
e. Increase in the curvature of the lens
Q.27 A 60 years old patient had been using + 2.0 D glasses for near only . Now he has come to eye OPD
with the complaint of diminished far vision while he is comfortable for near vision without glasses.
After examination he is found to have cataract. Which type of cataract he is likely to have?
a. Cortical cataract
b. Intumescent cataract
c. Nuclear sclerosis
d. Posterior subcapsular cataract
e. Sunflower cataract
60
Q.28 A 40 years old male having pain in multiple joints and taking oral steroids presented with H/O gradual
blurring of vision in his both eyes. He is diagnosed to be having cataract bilaterally.What type of
cataract he is likely to have?
a. Anterior subcapsular cataract
b. Anterior capsular cataract
c. Nuclear sclerosis
d. Oil droplet cataract
e. Posterior subcapsular cataract
Q.29 A 35 years old patient with chronic anterior uveitis developed complicated cataract.The lenticular
opacity in this type of cataract is:
a. Anterior subcapsular
b. Cuniform
c. Lamellar
d. Nuclear
e. Posterior sub-capsular
Q.30 A patient having cataract in one eye develops severe pain. O/E there is circumcorneal congestion,
corneal odema, shallow anterior chamber and raised IOP.What is the type of cataract ?
a. Hypermature cataract
b. Incipient cataract
c. Intumescent cataract
d. Mature cataract
e. Nuclear cataract
Q.31 A 60 years old female has senile cataract. Which of the following tests will help to assess the macular
status?
a. Distant visual acuity test
b. Ophthalmoscopy
c. Pin hole test
d. Two point discrimination test
e. Visual field test
Q.32 What is the most popular type of anaesthesia given in cataract surgery now a days?
a. General anaesthesia
b. Periocular infiltration
c. Retrobulbar anaesthesia
d. Subtenon anaesthesia
e. Topical anaesthesia
Q.33 The most common complication of retrobulbar anaesthesia is;

a. Damage to an extraocular muscle
b. Damage to optic nerve
c. Perforation of the globe
d. Retro-bulbar haemorrhage
e. Vasovagal shock
Q.34 Which dye is used to stain anterior capsule for capsulorhexis?

61
a. Alcian blue
c. Methyline blue
d. Rose Bengal
e. Trypan blue
Q.35 Calculation of power of IOL before cataract surgery is called:

a. Biometry
b. Keratometry
c. Pachymetry
d. Specular microscopy
e. Tonometry
Q.36 Hard IOLs are made of :

a. Hydrophilic acrylate
b. Hydrophobic acrylate
c. HEMA
d. PMMA
e. Silicon
Q.37 The most common Foldable IOLs in use now a days are made of:
a. Acrylate
b. Collamer
c. HEMA
c. PMMA
d. Silicon
Q.38 A 3 years old baby is brought with H/O leukocoria. There was no deviation of the eyes or nystagmus.
After examination, the diagnosis of congenital cataract is made and surgery advised. The best
procedure in this case will be:
a. Conventional ECCE
b. I/ Aspiration, anterior vitrectomy & PC IOL implantation
c. Intracapsular cataract extraction
d. Lensectomy
e. Pacoemulsificaon
Q.39 In a patient with coexistent cataract and diabetic odema, which of the following is a preferable
treatment?
a. Inj. of intavitreal triamcilone acetonamide followed by surgery
b. Inj. of triamcilone acetonamide 4 weeks after surgery
c. Intravitreal inj. AVEGF followed by cataract surgery
d. Laser photocoagulation before the surgery
e. Surgery followed by intravitreal steroid injection
Q.40 A 65 years old patient presents with H/O gradual deterioration of vision in one eye. After examination
and relevant investigations, he is planned for cataract surgery. In your opinion which of the following
procedures is the best to rehabilitate his vision?
a. Intracapsular cataract extraction with prescription of glasses
b. Extracapsular cataract extraction with prescription of glasses
c. Extracapsular extraction with posterior chamber IOL implantation
d. Phacoemulsification with posterior chamber IOL implantation
62
e. Pars plana lensectomy
Q.41 Phacoemulsification is the standard procedure for cataract surgery. Its most serious intraoperative
complication is:
a. Corneal endothelial damage
b. Iris prolapse
c. Posterior capsular tear & nuclear drop
d. Pupillary constriction
e. Sub – conjunctival haemorrhage
Q.42 Phaco-emulsification is relatively cotraindicated when there is:

a. Subluxated lens
b. Imature catataract
c. Mature cataract
d. Hypermature cataract
e. Posterior polar cataract
Q.43 Clear lens extraction is indicated in:

a. Astigmatism
b. High myopia
c. Hypermetropia
d. Keratoconnus
e. Presbyopia
Q.44 In an aphakic eye, the image magnification is:

a. 5%
b. 10 %
c. 15 %
d. 20 %
e. 30 %
Q.35 After removal of lens the eye becomes:

a. Astigmatic
b. Emetropic
c. Highly hypermetropic
d. Highly myopic
e. Presbyopic
Q.46 After phacoemulsification, the standard power of posterior chamber intraocular lens implanted in an
emetropic eye is:
a. 10 diopters
b. 15 diopters
c. 20 diopters
d. 25 bdioptetrs
e. 30 diopters
Q.47 The earliest post operative complication of cataract surgery is:

63
a. Cystoid macular odema

b. Expulsive intraocular haemorrhage
c. Retinal detachment
d. Striate keratopathy (Corneal Odema)
e. Wound leak
Q.48 The commonest late post operative complication after an uneventful congenital cataract surgery is:
b. Late endophthalmitis
c. Posterior capsular opacification
Q.49 An old patient with low endothelial cell count on specular microscopy is planned for cataract surgery.
He is likely to develop which of the following post operative complications?
a. Hyphaema
b. Post operative rise in IOP
cs. Posterior capsular opacification
d. Striate keratopathy
e. Shallow anterior chamber
Q.50 Postoperative wound leak can be identified by:

a. Alcian blue dye
b. Fluorescein dye
c. Methyline blue dye
d. Rose Bengal dye
e. Tryptan blue
Q.51 In posterior capsular opacification, laser capsulotomy is done by:

a. Argon laser
b. Diode laser
c. Eximer laser
d. Femtosecond laser
e. Yag laser
Q.52 Post operative endophthalmitis is a rare but very dreadful complication after cataract surgery. It can be
best prevented by using:
a. Povidine- Iodine solution in conjunctival sac preoperatively
b. Preoperative systemic broad spectrum antibiotics
c. Postoperative systemic antibiotics
d. Topical steroid drops pre opertively
e. Topical antibiotic drops pre operatively
Q.53 A patient operated for cataract develops Post operative bacterial endophthlmitis. If the VA in this eye
is 6/60, the treatment of choice will be;
a. Intrvitreal antibiotics
b. Subconjunctival antibiotic injections
c. Systemic antibiotics
d. Systemic steroids and topical antibiotic drops
e. Topical, subconjunctival & intravitreal antibiotic injections
64
Q.54 A patient operated for cataract develops Post operative bacterial endophthlmitis. If the VA in this eye
is just perception of light (PL+), treatment of choice in this case will be:
a. Intrarvitreal antibiotics
b. Pars plana vitrectomy, topical, subconjunctival & intravitreal antibiotic injections
c. Systemic antibiotics and steroids
d. Topical drops and subconjunctival antibiotic injections
e. Topical, subconjunctival & intravitreal antibiotic injections
Q.55 A patient presents with late endophthalmitis after cataract surgery. This is most commonly caused by:
a. Propionibacterium acnes
b. Pseudomonas aurogenosa
c. Staphylococcus aureus
d. Staphylococcus epidermidis
e. Streptococcus pneumonia
Key
Q.1 e Q.9 b Q.17 a Q.25 c Q.33 c Q.41 c Q.49 d
Q.2 a Q.10 c Q.18 e Q.26 d Q.34 e Q.42 a Q.50 b
Q.3 d Q.11 a Q.19 c Q.27 c Q.35 a Q.43 b Q.51 e
Q.4 b Q.12 a Q.20 d Q.28 e Q.36 d Q.44 e Q.52 a
Q.5 d Q.13 a Q.21 c Q.29 e Q.37 a Q.45 c Q.53 e
Q.6 c Q.14 e Q.22 a Q.30 c Q.38 b Q.46 c Q.54 b
Q.7 d Q.15 d Q.23 e Q.31 d Q.39 c Q.47 d Q.55 d
Q.8 c Q.16 b Q.24 b Q.32 e Q.40 d Q.48 c
Chapter-8
The Glaucoma
65
Q.1 Which of the following muscles is attached to the scleral spur ?

a. circular muscles
b. Constrictor pupillae
c. Dilator pupillae
d. Longitudinal muscle
e. Radial ciliaryl muscles
Q.2 The ciliary processes are finger like projections which are attached to:
a. Iris root
b. Ora serrata
c. Pars plana
d. Pars plicata
e. Scleral spur
Q.3 Aqueous humor production is the function of ciliary processes by :

a. Active metabolic process of secretion
b. Active secretion, ultrafiltration and Passive diffusion
c. Passive diffusion
d. Ultrafiltration
e. Ultrafiltration & diffusion
Q.4 The actively secreted aqueous humour is rich in which of the following compounds more than the
blood plasma?
a. Ascorbic acid
b. Bicarbonates
c. Chlorides
d. Sodium
e. Potassium
Q.5 Increase in osmotic pressure of the blood will cause:

a. Fall in IOP
b. First fall and then rise in IOP
c. First rise and hen fall in IOP
d. Rise in IOP
e. No effect on IOP
66
Q.6 Plasmoid aqueous humour is formed in the anterior uveitis due to:
a. Break down of blood retinal barrier
b. Break down of blood aqueous barrier
c. Break down of blood brain barrier
d. Increased osmotic pressure
e.Increased systemic blood pressure
Q.7 The angle of anterior chamber is examined by:

a. Applanation tonometer
b. Direct ophthalmoscopy
c. Indirect slitlamp biomicroscopy
d. Three mirror goniolens
e. Tonography
Q.8 The Schwalbe’s line represents the termination of corneal:

a. Bowman’s membranel
b. Descemet’s membrane
c. Epithelium
d. Endothelium
e. Stroma
Q.9 The normal width ( degrees) of anterior chamber angle is:

a. 10-15 degrees
b. 15-25 degrees
c. 25-30 degrees
d. 35-45 degrees
e. 45-55 degrees
Q.10 The normal depth of anterior chamber in the centre is:

a. 1.5 mm
b. 2.5 mm
c. 3.5 mm
d. 4 mm
e. 4.5 mm
Q.11 The rate of aqueous humour secretion is:

a. 0.1 microlitres per minute
b. 0.2 microlitres per minute
c. 0.3 microlitres per minute
d. 0.4 microlitres per minutes
e. 0.5 microlitres per minutes
Q.12 The total volume of aqueous humour in anterior and posterior chambers is approximately:
a. 0.20 ml
b. 0.31 ml
c. 0.40 ml
d.0.50 ml
e. 0.60 ml
67
Q.13 While viewing the angle of anterior chamber, the order in which structures are seen, starting from
the cornea are:
a. Scleral spur, schwalbe’s line, trabecular meshwork, ciliary body
b. Scleral spur, irs process, trabecular meshwork, schwalbe’s line
c. Schwalbe’s line, trabecular meshwork,canal of schlemm, sclera spur.
d. Scleral spur, trabecular meshwork, iris processes and ciliary body
e. Trabecular meshwork, ciliary body. Sclera spur, canal of schlemm
Q.14 The normal pressure difference between the anterior chamber and episcleral veins is:
a. 2 mm of Hg
b. 4 mm of Hg
c. 5 mm of Hg
d. 6 mm of Hg
e. 8 mm of Hg
Q.15 The outflow of aqueous humour apart from drainage passages also depends upon:
a. Blood aqueous barrier
b. Blood retinal barrier
c. Intraocular pressure
d. Pressure in episcleral veins
e. Systemic blood pressure
Q.16 The bulk out flow of aquous humour takes place through:
a. Iris surface
b. Iris and ciliary body surfaces
c. Uveoscleral route
d. Trabecular meshwork
e. Trans-vitreal route
Q.17 The trabecular meshwork is a sieve like structure and consists of three parts:
a. The inner most portion is called corneoscleral meshwork
b. The intermediate portion is called uveal meshwork
c. The outermost most portion is called juxtacanalicular meshwork
d. The meshwork communicates directly with the aquous veins
e. The inner most part is the main site of obstruction in CSG
Q.18 The aqueous drainage through uveoscleral route is approximately:

a. 10 %
b. 15 %
c. 20 %
d. 25 %
e. 30 %
Q.19 In glaucoma, the raised IOP causes:

a. Damage to the photoreceptors
b. Damage to optic nerve
c. Ganglion cell death with loss of retinal nerve fibers and optic atrophy
d. Loss of bipolar cells
e. Loss of retinal nerve fibers and optic atrophy
68
Q.20 The major disadvantage of schiotz tonometer is that:

a. It is difficult to perform
b. It gives false readings with low or high scleral rigidity
c . It is expensive`
d. It requires a slit lamp
e. Difficul to carry
Q.21 The schiotz tonometery is based on:

a. Boyle;s law
b. Imbert-Fick’s law
c. Lincoff’s law
d. Stock’s law
e. The principle that a soft eye is indented more than a hard eye
Q.22 The Goldman’s applanation tonometery is based on:

a. Boyle’s law
b. Imbert-Fick’s law
c. Lincoff’s law
d. Stock’s law
e. The principle that a soft eye is indented more than a hard eye
Q.23 The most common type of glaucoma in our country is:

c. Lens induced glaucoma
d. Pigmentary glaucoma
e. Steroid induced glaucoma
Q.24 Normal diurnal variation is about 5 mm of Hg. It is considered abnormal if this value is:
a. 6-8 mm of Hg
c. 8-10 mm of Hg
d. 10-12 mm of Hg
e. 12-14mm of Hg
e. 14-15 mm of Hg
Q.25 A one month old baby is presented in ophthalmic clinic with findings of cloudyness and
enlargement of both cornea, photophobia and excessive lacrimation. What is the probable diagnosis ?
a. Congenital rubella infection
b. Congenital cataract
c. Congenital glaucoma
d. Megalocornea
e. Mucopolysaccharidosis
Q.26 The cause of congenital glaucoma is usually the result of:

a. A congenital anamoly at the angle of AC
b. A maternal deficiency disease
c. High venous pressure in episcleral veins
d. High myopia
e. Increased formation of aqueous humour
69
Q.27 Buphthalmos is the condition in which the eyeball is enlarged if the IOP remains raised:
a. During intrauterine life
b. Prior to the age of 1 year
c. Prior to the age of 2 years
d. Prior to the age of 3 years
e. Prior to the age of 5 years
Q.28 Haab’s striae are curvilinear lines which represent healed breaks in descemet’s membrane, are seen in:
a. Birth trauma
b. Blunt trauma
d. Keratoconus
e. Stromal corneal dystrophies
Q.29 Enlargement of corneal diameter is the cardinal sign of congenital glaucoma. It is diagnostic if the
diameter after the age of 1 year is:
a. 10 mm
b. 11 mm
c. 12 mm
d. 13 mm
e. 14 mm
Q.30 A one month old baby was presented in ophthalmic clinic with findings of cloudyness and
enlargement of both cornea, photophobia and excessive lacrimation. The baby was diagnosed to be
having congenital glaucoma. In your opinion what is the treatment of choice in this case?
a. Goniotomy
b. Iridectomy
c. Trabeculotomy
d. Trabeculectomy
e. Topical antiglaucoma medications
Q.31 Dark room prone test is a provocative test carried out to investigate:
a. Angle closure glaucoma
b. Absolut glaucoma
c. Chronic congestive glaucoma
d. Chronic simple glaucoma
e. Ocular hypertension
Q.32 In the dark room prone test the patient is placed in prone position in a dark room for half an hour. The
IOP is measured before and after the test. How much rise in IOP is considered to be positive?
a. > 2 mm of Hg
b. >4 mm of Hg
c. >6 mm of Hg
d. >8 mm of Hg
e. >10 mm of Hg
Q.33 Severe pain is a characteristic feature of which type of glaucoma?
a. Acute angle closure glaucoma
b. Chronic congestive glaucoma
d. Primary open angle glaucoma
e. Steroid induced glaucoma
70
Q.34 The eyes which are vulnerable to develop an attack of angle closure glaucoma are:
a. Emetropic eyes
b. Eyes with high astigmatic error
c. Eyes with deep anterior chamber
d. Myopic eyes
e. Small hypermetropic eyes
Q.35 A patient complains of episodes of seeing halos around lights, diminished vision and headache for
some months. On examination the IOP is normal but the anterior chamber is shallow. On the basis of
this scenerio, what is the most likely diagnosis ?
a. Acute angle closure glaucoma
c. Chronic congestive glaucoma
d. Latent angle closure glaucoma
e. Intermittent angle closure glaucoma
Q.36 Cause of seeing coloured halos in angle closure glaucoma is:

a. Fluid entry into the corneal stroma
b. Lenticular sclerosis
d. Vitreous haemorrhage
e. Vitreous detachment
Q.37 In acute angle closure glaucoma resistance to aqueous out flow resulting in increased intraocular
pressure occurs mainly due to:
a. Occlusion of the anterior chamber angle by the peripheral iris.
b. Odema of ciliary body
c. Pupillary meiosis
d. Schlemm’s canal
e. Trabecular meshwork changes
Q.38 In acute angle closure glaucoma the:

a. Angle is closed gonioscopically.
b. AC is of normal depth
c. IOP is about 30 mm of Hg
d. Pupil is normal in size
e. KPs are seen on slit lamp examination
Q.39 Peripheral iridectomy should be performed ideally at which stage of the angle closure glaucoma?
a. Acute congestive stage
b. Absolute glaucoma stge
c. Chronic congestive stage
d. Intermittent angle closure glaucoma stage
e. Latent stage
Q.40 The surgical treatment of subacute angle closure glaucoma is:

a. Laser iridotomy
b. Laser trabeculoplasty
c. Posterior lip sclerotomy
d. Trabeculotomy
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e. Trabeculectomy
Q.41 A 50 years old female comes to eye OPD and is found to have IOP of 60 mm of Hg, severe pain and
redness of left eye. The first line of treatment should be?
b. Beta-blocker eye drops
c. Hyper osmotic agents
d. Trabeculectomy
e. Prostaglandin analogues
Q.42 The most commonly used hyperosmotic agent to lower IOP in an attack of acute congestive
glaucoma is:
a. I/V hypertonic saline solution
b. Oral Glycerol solution
c. Oral isosorbide solution
d. 20% Mannitol solution i/v
e. 30% Urea solution i/v
Q.43 After the controle of acute attack, the treatment of angle closure glaucoma depends upon the
gonioscopy results. If more than 50% angle is closed, the treat of choice is?
a. Antiglaucoma medication
b. Cyclocryopexy
c. Medical treatment
d. Peripheral iridectomy
e. Trabeculectomy
Q.44 Pain in absolute glaucoma is best relieved by :

a. Analgesics
b. Non steroidal anti inflammatory eye drops
c. Miotics
d. Retrobulbar injection of alcohol
e. Trabeculectomy
Q.45 The main site of obstruction in POAG is at the level of :

a Aqueous veins
b. Canal of schlemn
c. Collecting channels
d. Episcleral veins
e. Juxtacanalicular trabecular meshwork
Q.46 On perimetery, the earliest visual field defect in primary open angle glaucoma (POAG) is:
a. Arcuate scotoma
b. Central scotoma
c. Centrcoecal scotoma
d. Isolated paracentral scotoma
e. Ring scotoma
Q.47 In practice, the earliest damage caused by raised IOP can be detected by:
a. Optical coherence tomography (OCT)
b. Ophthalmoscopy
c. Tonometery
d. Ultrasonography
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e. Visual field analyser
Q.48 Which of the following investigations is most valuable for the assessment of progressive optic nerve
damage in POAG :
a. Corneal thickness
b. Gonioscopy
c. Ophthalmoscopy
d. Tonometry
e. OCT
Q.49 End stage visual field defects in glaucoma comprise of:

a. Arcuate scotoma
b. Central or temporal islands
c. Peripheral breakthrough
d. Paracentral scotomaa
e. Seidel’s scotoma
Q.50 On fundoscopy, the earliest clinical sign of POAG is:

a. Nasalization of optic disc vessels
b. Localized or diffuse nerve fiber layer defects
c. Optic disc cupping
d. Retinal or optic disc haemorrhages
e. Thinning of the neuroretinal rim
Q.51 Delayed dark adaptation and frequent changes of near vision glasses are the symptoms of:
a. Cataract formation
b. Narrow angle glaucoma
c. Open angle glaucoma
d. Ocular hypertension
Q. 52 Ocular hypertension is the term applied to the patients having raised IOP:
a. WIth optic disc cupping
b. Without optic disc cupping
c. With visual field defects
d. Without visual field defects
e. Without optic disc changes or field defects
Q.53 Primary open angle glaucoma is generally a bilateral but not symmetrical disease. It is characterized
by:
a. An IOP >21 mm Of Hg, optic disc changes and VF defects
b. AC angle grade-2or less
c. Altitudinal visual field defect
d. Central scotoma
e. Primary optic atrophy
Q.54 A 75 years old lady with long standing H/O asthma treated with oral steroids, presents in the eye
clinic for decreased vision. She is found to have posterior subcapsular (PSC) lenticular opacity as well
as IOP of 28 mm of Hg. Which one of the following antiglaucoma medicines should be prescribed ?
a. Alpha-2 adrenergic agonist (Alphagan) eye drops
b. Latanoprost eye drops
c. Oral carbonic anhydrase inhibitors
d. Pilocarpine
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e. Timolol
Q.55 Carbonic anhydrase inhibitors (Acetazolamide) lower intraocular pressure by:

a. Decreasing aqueous production
b. Decreasing episcleral venous pressure
c. Increasing the outflow facility
d. Increasing uveoscleral outflow
e. Their diuretic effect
Q.56 Pilocarpine is:

a. A parasympathomimetic drug
b. An anticholinergic drug
c. Mainstay of glaucoma treatment
d. Used as 5 % eye drops
e. Reduces production of aqueous humour
Q.57 In chronic simple glaucoma, pilocarpine lowers IOP by:

b. Decreasing episcleral venous pressure
c. Facilitating drainage by opening angle of anterior chamber
e. Increasing outflow facility at trabecular meshwork
Q.58 Beta blocker eye drops have been the 1st drug of choice in POAG.The mechanism of their action is that
they:
a. Cause meiosis and help drainage by opening the angle of AC
b. Decrease aqueous production by ciliary epithelium
c. Decrease episcleral venous pressure
d. Increase uveoscleral outflow
e. Increase outflow facility at trabecular meshwork
Q.59 0.005% Latanoprost eye drops act by :

a. Increasing uveoscleral outflow
b. Increasing outflow facility at trabecular meshwork
c. Reducing aqueous producing
d. Reducing aqueous production and increasing uveoscleral outflow
e. Reducing aqueous production and increasing the conventional aqueous outflow
Q.60 2% Bromidine eye drops are used as second drug of choice alone or in combination with other drugs in
the treatment of chronic simple glaucoma. It lowers IOP by:
b. Decrease production and increase facility of outflow at trabecular meshwork
c. Increasing facility of outflow
e. Increasing uveoscleral outflow & decreasing aqueous production
Q.61 The risk of developing steroid-induced glaucoma is increased in?

b. Myopes
c. Hypermetropes
d. History of angle closure glaucoma
e. Steroid responders
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Q.62 Which one of the following drugs lowers intraocular pressure by increasing out flow facility at
trabecular meshwork ?
a. Brimonidine eye drops
b. Dorzolamide eye drops
c. Latanoprost eye drops
d. Timolol eye drops
e. Pilocarpine eye drops
Q.63 Surgical treatment of choice in a case of primary open angle Glaucoma is:
a. Laser Peripehral Iridotomy
b. Laser trabeculoplasty
c. Surgical iridectomy.
d. Trabeculectomy
e. Trabeculotomy
Q.64 What is the most effective drug treatment among the following options in a patient having
neovascular glaucoma?
b. Beta blocker & cycloplegic eye drops
c. Latanoprost eye drops
d. Pilocarpine eye drops
Q.65 A female with uncontrolled diabetes mellitus presents with painful red eye and reduced visual acuity.
On examination, the Intraocular pressure is raised and there are new blood vessels on the surface of iris
and angle of anterior chamber. The drug contraindicated in this situation is:
a. Atropine
b. Beta blockers
c. Steroids
d. NSAID
e. Pilocarpine
Q.66 Which one of the following is a selective beta -1 antagonist:

a. Betoxalol
b. Carteolol
c. Levobunolol
d. Metipranolol
e. Timolol eye drops
Q.67 Pharmacologically 2% Brimonidine (Alphagan) eye drops are :

a. Adrenergic drops
b. Alpha-2 adrenergic agonist
c. Beta blockers
d. Cholinergic drops
e. Prostaglandin analogue drops
Q.68 Rise in IOP with severe pain, circumcorneal congestion, corneal odema and flare in AC develops in a
patient having senile cataract for quite some time. In which type of cataract this complication
develops?
a. Complicated cataract
b. Cortical cataract
c. Phacolytic glaucoma
d. Intumescent cataract
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e. Morgagnian cataract
Q.69 Phacolytic glaucoma is a type of secondary open angle lens induced glaucoma due to:
a. A swollen cataractous lens
b. Anterior dislocation of the cataractous lens
c. Inflammatory reaction of uveal tissue excited by ruptured lens proteins
d. Obstruction of trabecular meshwork by macrophages containing lens proteins leaked from
hypermature cataract
e. Obstruction of trabecular meshwork by lens material
Q.70 The treatment of phacolytic glaucoma is by:

a. Antiglaucoma drugs
b. Cataract extraction surgery
c. Laser iridotomy
d. Laser trabeculoplasty
e. Trabeculectomy
Q.71 Phacomorphic glaucoma is :

a. Associated with swelling of cataractous lens
b. Associated with chronic postoperative endophthalmitis
c. A type of inflammatory glaucoma
d. Caused by proteins released from a ruptured lens
e.. More common in pseudophakic eyes
Q.72 Ghost cell glaucoma is due to obstruction of drainage passage by:

a. Degenerated RBCs after vitreous haemorrhage in an aphakic eye
b. Inflammatory cells in uveitis
c. Inflammatory exudates
d. Red blood cells after hyphaema
e. Tumour cells
Q.73 The neovascular glaucoma occurs as a complication of rubeosis iridis and its most frequent cause is:
a. Central retinal vein occlusion
b. Central retinal artery occlusion
c. Hypertensive retrinopathy
d. Long standing anterior uveitis
Q.74 A 65 years old lady with uncontrolled diabetes mellitus presents with H/O loss of vision several
months before and painful red eye of recent onset. On examination the IOP was raised and there were
new vessels on the iris surface and angle of AC. What is the diagnosis?
b. Chronic congestive glaucoma
c. Neovascular glaucoma
d. Phacolytic glaucoma
e. Phacomorphic glaucoma
Q.75 A male of 65 years presented with H/O progressive visual deterioration in both the eyes. Examination
revealed IOP of 26 mm of Hg in the right and 32 mm of Hg in the left eye and snowflak like
material on anterior lens surface.The possible diagnosis in this case would be :
a. Chronic simple glaucoma
b. Pigmentary glaucoma
c. Pigment dispersion syndrome
d. Pseudoexfoliative glaucoma
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e . Neovascular glaucoma
Q.76 The rise in IOP in pseudoexfoliative glaucoma is due to :

a. Deposition f pigment in angle of AC
b. Increased aqueous production
c. Narrow AC angle
d. Obstruction of trabecular meshwork by exfoliative material
e. Pupillary block
Q.77 The percentage of patients of pigmentary dispersion syndrome who are likely to develop pigmentary
glaucoma is:
a. 15%
b. 20%
c. 25%
d. 30%
e. 35%
Q.78 Krukenberg’s spindle of pigment is seen in pigment dispersion syndrome on the:

a. Anterior surface of the lens
d. Iris surface
e. Posterior surface of the lens
Q.79 A patient presents with H/O pain and disturbance of vision in one eye and trauma to the same eye 4
months ago. First investigation of choice in this case is:
a. B- scan ultrasonography
b. Ophthalmoscopy
c. Perimetry
d. Retinoscopy
e. Tonometry
Q.80 A patient with H/O blunt trauma in his one eye presents in an eye clinic with raised IOP after a few
months. What type of glaucoma he is probably having?
b. Angle recession glaucoma
c. Chronic simple glaucoma
d. Pigmentary glaucoma
e. Pseudoexfoliation glaucoma
Q.81 Failure of accommodation leading to frequent change of glasses in open angle glaucoma occurs due to:
a. Ciliary muscle atrophy on account of raised IOP
b. Change in refractive index of the lens
c. Decreased blood supply to ciliary muscles
d. Defect in nerve supply to the ciliary muscles
e. Optic disc changes
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Ke y
Q.1 d Q.13 c Q.25 c Q.37 a Q.49 b Q.61 e Q.73 a
Q.2 d Q.14 c Q.26 a Q.38 a Q.50 b Q.62 e Q.74 c
Q.3 b Q.15 d Q.27 d Q.39 d Q.51 c Q.63 d Q.75 d
Q.4 a Q.16 d Q.28 c Q.40 a Q.52 e Q.64 b Q.76 d
Q.5 a Q.17 c Q.29 d Q.41 c Q.53 a Q.65 e Q.77 a
Q.6 a Q.18 c Q.30 a Q.42 d Q.54 a Q.66 a Q.78 c
Q.7 d Q.19 c Q.31 a Q.43 e Q.55 a Q.67 b Q.79 e
Q.8 b Q.20 b Q.32 d Q.44 d Q.56 a Q.68 c Q.80 b
Q.9 c Q.21 e Q.33 a Q.45 e Q.57 e Q.69 d Q.81 a
Q.10 b Q.22 b Q.34 e Q.46 d Q.58 b Q.70 b
Q.11 c Q.23 b Q.35 e Q.47 a Q.59 a Q.71 a
Q.12 b Q.24 a Q.36 a Q.48 e Q.60 e Q.72 a
Chapter- 9
The Retina
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Q.1 The retina develops from:

a. Endoderm
b. Mesoderm
c. Neuroectoderm
d. Optic vesicle
e. Surface ectoderm
Q.2 The retina varies in thickness. It is thickest:

a. At fovea
b. At equqtor
c. Around optic nerve
d. In the parafoveal region
e. Ora serrata
Q.3 The ora serrata is the:

a. Part of retina which contains maximum photoreceptors
b. Part of retina around optic nerve
c. Peripheral most part of retina continuous forward as non pigmented epithelial layer of ciliary body
d. Thickest part of retina
e. Thickest part of retina
Q.4 The retinal pigment epithelium is a single layer of hexagonal cells which:
a. Acts as outer blood retinal barrier
b. Acts as inner blood retinal barrier
c. Develops from inner layer of optic cup
d. Is the inner most retinal laye
e. Is loosely attached with bruchs membrane
Q.5 The axons of ganglion cell layer terminate in:

a. Bipolar cells
b. Edinger westphal nucleus
c. Lateral geniculate body
d. Pretectal nucleus
e. Visual cortex
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Q.6 Regarding rod photoreceptors:

a. Are more in number than cones
b. More populated in the macular region
c. Subserve photopic vision
d. Subserve scotopic vision
e. Subserve colour vision
Q.7 The cone receptors:

a. Are most populated in the area around optic nerve
b. Are less in number than rod receptors
c. Subserve scotopic vision
d. subserve photopic vision
e. Synapse with neurons of ganglion cells
Q.8 Optic disc is the pink coloured circular area where all retinal nerve fibers converge to form the optic
nerve. Its approximate diameter is:
a. 0.5 mm
b. 1.0 mm
c. 1.5 mm
d. 2.0 mm
e. 3 mm
Q.9 The macula lutea is an oval area in the posterior pole. It measures about:
a. 1 mm
b. 2 mm in diameter
c. 4 mm in diameters
d. 5 mm in diameter
e. 6 mm in diameter
Q.10 The foveola is the central part of the fovea. It:

a. Contains single layer of ganglion cells
b. Contains only cone receptors and subserves the most acute vision
c. Is the thinnest part of retina which contains only rods
d. Is supplied by the vessels from superior and inferior temporal arcade
e. Is about 1 disc diameter in size
Q.11 The outer retinal layers are supplied by:

b. Central retinal artery
c. Diffusion from choriocapillaris
d. Long posterior ciliary arteries
Q.12 The outer retinal layers are drained by:

a. Anterior ciliary veins
b. Central retinal vein
c. Inferior ophthalmic vein
d. Superior ophthalmic vein
e. 4- Vortex veins
Q.13 The inner retinal layers are supplied by

b. Central retinal artery
c. choriocapillaris
d. Long posterior ciliary arteries
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Q.14 In chorioretinal coloboma the retina and choroid fail to develop. It is usually situated in the:
a. Inferotemporal quadrant
b. Inferonasal quadrant
c. Superior nasal quadrant
d. Superior temporal quadrant
e. Temporal half
Q.15 The axons of ganglion cells form nerve fiber layer of the retina which:
a. Constitutes the Henle layer in fovea centralis
b. Consists of medulated nerve fibers
c. Forms the inner most layer of retina
d. Is a non- medulated nerve fibers layer
e. Terminate in superior colliculus
Q.16 Fundus examination is done with the help of :

a. Distant direct ophthalmoscopy
c. Retinoscopy
d. Slitlamp biomicroscope
e. Ultrasonography
Q.17 The direct ophthalmoscopy is done to see fundus details. The image seen is:
a. 5 times magnified
b. 10 times magnified
c. 15 times magnified
d. 20 times magnified
e. Real and inverted
Q.18 The distant direct ophthalmoscopy is done to:

a. Determine refractive error of the eye
b. Measure the anteroposterior length of eyeball
c. See the fundus details in close approximation
d. See the fundus details from distance
e. See the clarity of refractive media
Q.19 While examining the fundus by the direct ophthalmoscope, the image seen is:
a. Real, inverted and magnified
b. Real and erect
c. Virtual and erect
d. Virtual and inverted
e. Virtual and laterally reversed
Q.20 While examining the fundus by the indirect ophthalmoscope, the image seen is 3 times magnified
(with + 20 D lens) and it is:
a. Real , inverted and larerally reversed
b. Real and erect
c. Real and inverted
d. Virtual and erect
e. Virtual and inverted
Q.21 The electro- oculogram (EOG) records the activity of:

a. Bipolar and ganglion cells
b. Ganglion cells to visual cortex
c. Photoreceptors and bipolar cells
d. Retinal pigment epithelium and photoreceptors
e. Rods and coned
Q.22 The electro-retinogram (ERG) records the activity of :

81
a. Bipolar and ganglion cells

e. Rods and cones
Q.23 The visual evoked potential (VEP) records the activity of :

a. Bipolar cells and ganglion cells
e. Rods and cones
Q.24 FFA is done to study the abnormalities of retinal vasculature. The dye used in this procedure is:
a. Alcian blue
c. Methylene blue
d. Rose Bengal
e. Trypan blue
Q.25 In FFA, the dye after injection reaches the retinal circulationin (Arm to retina time) in:
a. 2-3 seconds
b. 4-6 seconds
c. 6-8 seconds
d. 8-11 seconds
e. 11-12 seconds
Q.26 Optical coherence tomography (OCT) is a relatively newer technique and used to study the :
a. Abnormalities of dioptric system of the eye
b. Defects of visual fields
c. Details of anterior segment of the eye
d. Diseases of the choroid
e. Diseases of the retina and optic nerve
Q.27 Optical coherence tomography (OCT) is a non invasive imaging technique which uses:
a. Electrical current to produce two dimensional pictures of retina and optic nerve
b. Electrmagnetic rays to produce pictures of retina and optic nerve
c. Light waves to take cross-sectional pictures of the retina and optic nerve
d. Light waves to take three dimensional pictures of eyeball
e. High-frequency sound waves to produce images of retina and optic nerve
Q.28 The best visual function is at the level of:

a. Equator
b. Fovea centralis
c. Macula
d. Optic disc
e. Ora serrata
Q.29 The cardinal symptom of early macular disease is:

a. A negative scotoma
b. Abnormal pupillary reactions
c. Blurring of central vision
d. Defect in peripheral field of vision
e. Photopsia
Q.30 In periphlebitis retinae the perivascular changes are associated with?

82
a. Hard exudates
b. Retinal neovascularization
c. Retinal odema
d. Soft exudates
e. Signs of anterior uveitis
Q.31. A young man with periphlebitis retinae develops sudden loss of vision. What is the most likely cause?
a. Macular odema
b. Optic disc odema
d. Vitreous haemorrhage
e. Vitreous detachment
Q.32 The most serious complication of periphlebitis retinae due to vitreous haemorrhage is?
a. Open angle glaucoma
b. Optic atrophy
c. Rhegmatogenous retinal detachment
d. Tractional retinal detachment
e. Vitreous liquification
Q.33 The treatment of severe vitreous haemorrhage in periphlebitis retinae is:

a. Early vitrectomy and PRP
b. Intrvitreal antiVEGF injections
c. Photocoagulation
d. Systemic steroids
e. Vitrectomy after six months
Q.34 The visual field defect in macular disease is?

a. A negative central scotoma
b. A positive central scotoma
c. A peripheral visual field defect
d. Arcuate defect
e. Centrocecal defect
Q.35 Micropsia, macropsia and metamorphopsia are the clininical features of:
b. Macular disease
c. Optic neuritis
d. Posterior vitreous detachment
e. Retinal detachment
Q.36 In which of the following conditions macular odema is the cause of loss of central vision?
a. Central retinal artery occlusion
b. Dry maculopathy
c. Diabetic maculopathy
d. Hypertensive retinopathy
Q.37 Age related macular degeneration (AMD) also called Senile macular degeneration is a leading cause of
blindness in old age:
a. Average age of onset is about 40 years
b. Dry or non exudative type is more common
c. Peripheral visual loss is the main symptom
d. Visual loss is reversible
e. Wet or exudative type is more common
Q.38 Colloid bodies or drusens are the excrescences of:

83
a. Bruch’s membrane
b. Bowman’s membrane
c. Descemet’s membrane
d. External limiting membrane
e. Internal limiting membrane
Q.39 Drusens are considered to be secreted from:

a. Choriocapillaris
b. Choroidal neovascular membrane
c. Bruch’s membrane
d. Photoreceptor cells
e. Retinal pigment epithelium
Q.40 The source of fluid in exudative AMD is from:

a. Choriocapillaris
b. Degenerative vitreous
b. Retinal blood vessels
d. Subretinal neovascular membrane (SRNVM)
e. Suprachoroidal space
Q.41 The detection of subretinal neovascular membrane (SRNVM) in exudative age related mcular
degeneration is done by;
a. A-scan ultrasonography
b. B-scan ultrasonography
c. OCT
d. Ophthalmoscopy
e. Slit lamp biomicroscopy
Q.42 The best treatment of SRNVM in exudative age related macular degeneration is:
a. Agon laser photocoagulation
b. Diode laser
c. Eximer laser
d. Intravitreal injections of AVEGF
e. Yag laser
Q.43 A young man got up in the morning with blurring of central vision in the right eye. He had similar
episode in the same eye two years ago which recovered spontaneously without treatment. The most
likely diagnosis is:
a. Age related maculopathy
b. Branch retinal vein occlusion
c. Central serous choroido retinopathy
d. Diabetic maculopathy
e. Optic neuritis
Q.44 Central serous chorioretinopathy (CSCR) is a common idiopathic disorder which usually affects young
individuals. The diagnosis is confirmed by:
a. B- scan ultrasonography
c. Indirect ophthalmoscopy
d. Fundus fluorescene angiography
e. Slit lamp biomicroscopy
Q.45 The commonest cause of Cystoid macular degeneration among the followings is:
a. Anterior uveitis
b. Diabetic Retinopathy
c. Hypertensive retinopathy
d. Retinal artery occlusion
e. Senile macular degeneration
Q.46 The most common cause of True macular hole formation among the following is:
84
b. Idiopathic
c. Myopia
d. Trauma
e. Solar retinopathy
Q.47 New vessels on the surface of retina and optic disc are found in which of the following condition?
a. Hypertensive retinopathy
b. Background diabetic retinopathy
c. Optic neuritis
d. Proliferative diabetic retinopathy
e. Preproliferative diabetic retinopathy
Q.48 The diabetic retinopathy (DR) is a microangiopathy which affects:

a. Precapillary arterioles
b. Precapillary arterioles and capillaries
c. Precapillariy arterioles, capillaries and venules
d. Retinal capillaries
e. Venules
Q.49 The earliest clinically detectable lesion in DR is the appearance of:

a. Hard exudates
b. Microaneurysms
c. Macular odema
d. Retinal haemorrhages
e. Soft exudates
Q.50 Flame shaped retinal haemorrhages originate from precapillary arterioles and are located in the:
a. Ganglion cell layer
b. Inner nuclear layer
c. Inner plexiform layer
d. Nerve fiber layer
e. Outer plexiform layer
Q.51 Deep retinal haemorrhages arise from venous end of capillaries and are located in:
a. Inner nuclear and outer plexiform layer
b. Inner plexiform layer
c. Nerve fiber layer
d. Outer plexiform layer
e. Photoreceptor layer
Q.52 Cotton wool spots are found in which of the following layer?
a. Ganglion cells layer
b. Nerve fiber layer
c. Outer plexiform layer
d. Photoreceptor cells layer
e. Muller’s cells layer
Q.53 Micro- aneurysms are hallmark of which of the following diseases?

a. Central retinal artery occlusion
b. Diabetic retinopathy
d. Retinitis pigmentosa
e. Retinoblastoma
Q.54 In diabetic retinopathy (DR), the effect of microvascular leakage is:

a. Hard exudates
b. Optic disc swelling
85
c. Retinal haemorrhages
d. Retinal haemorrhages and odema
e. Soft exudates
Q.55 The hard exudates are composed of :

a. Calcium deposits in the retina
b. Cholesterol deposits in the the retina
c. Lipoproteins in the deeper retinal layers
d. Lipids in the retina and choroid
e. Lipoproteins and lipid laiden macrophages in the retinal layers
Q.56 The cause of visual deterioration in background diabetic retinopathy is due to the presence of:6
a. Hard exudates
b. Macular odema
c. Retinal haemorrhages
d. Soft exudates
Q.57 The treatment of diffuse diabetic macular odema is done by:

a. Assurance and observation
b. Good metabolic controle
c. Intravitreal injections of antiVEGF
d. Oral steroids
e. Pan retinal photocoagulation
Q.58 The progression of BGDR to Pre-proliferative diabetic retinopathy is a sign of:

a. Capillary non perfusion at macula
b. Chronic renal failure
c. Impending vitreous haemorrhage
d. Poor diabetic controle
e. Persistent high blood pressure
Q.59 In diabetic retinopathy, the new vessels formation is due to:

a. Retinal haemorrhages
b. Retinal odema
c. Retinal ischaemia
d. Retinal exudates
Q.60 In diabetic retinopathy (DR), the neovascularization is caused by vasoformative substance produced
by the hypoxic retina. It is on the:
a. Cornea
b. Iris surface
c. Optic disc
c. Retina
d. Retinal, optic disc and iris surface
Q.61 A diabetic patient develops sudden visual loss due to vitreous haemorrhage. What should be the
treatment strategy?
a. Good diabetic controle
b. Intrvitreal antiVEGF injections
c. Organ laser Photocoagulation
d. Oral steroids
e. Vitrectomy with endolaser photocoagulatio
Q.62 The treatment of proliferative diabetic retinopathy is:

a. Cryotherapy
b. Intravitreal antiVEGF injections
86
c. Intravitreal steroid injections

d. Panretinal photocoagulation (PRP)
e. Vitrectomy
Q.63 Retinal detachment is the sepatation of:

a. Internal limiting layer from rest of the retina
b. Nerve fiber layer from rest of the retina
c. Retinal layers at outer plexiform layer
d. Retinal pigment epithelium from bruch’s membrane
e. Retinal pigment epithelium from rest of the retina
Q.64 In Rhegmatogenous retinal detachment:

a. A retinal tear is not always present
b. Detached retina is immobile
c. IOP is raised
d. Retinal surface is opaque and corrugated
e. Vitreous is normal on examination
Q.65 The commonest variety of retinal detachment is:

a. Exudative retinal detachment
b. Rhegmatogenous retinal detachment
c. Tractional retinal detachment due to advanced diabetic eye disease
d. Traumatic tractional detachment
e. Tractional retinal detachment associated with rhegmatogenous detachment
Q.66 The common premonitory symptom reported by maximum number of patients with Rhegmatogenous
retinal detachment is:
a. Seeing color halos
b. Flashes of light & floaters
c. Severe pain in the eye
d. Sudden total loss of vision
e. Visual field defect
Q.67 Rhegmatogenous retinal detachment is always associated with:

b. Old age
c. Proliferative vitroretinopathy
d. Retinal breaks
e. Trauma
Q.68 The commonest site to have retinal tears in rhegmatogenous retinal detachment is:
a. Infrotemporal quadrant
b. Inferonasal quadrant
c. Macular area
d. Suprotemporal quadrant
e. Supronasal quadrant
Q.69 Predisposing factor in the development of rhegmatogenous retinal detachment in myopic individuals
is the presence of:
a. Generalised retinal thinning
b. Peripheral retinal holes in the degenerative retina
c. Pigment clumps in the retina
d. Vitreoretinal traction bands
e. Vitreous degeneration
Q.70 A patient developed sudden painless loss of vision in his right eye . He gives H/O using high myopic
glasses since childhood and seeing flashes of light for the last two weeks. What is the most probable
diagnosis?
87
a. Branch retinal artery occlusion

b. Central retinal artery occlusion
c. Rhegmatogenous retinal detachment
d. Serous retinal detachmen
Q.71 The best method to examine the fundus details in retinal detachment is;
a. Direct ophthalmoscopy
b. Gonioscopy
c. Indirect ophthalmoscopy
c. Retinoscopy
e. Slitlamp biomicroscopy
Q.72 The tractional retinal detachment (TRD) is:

a. A feature of choroidal tumours
b. Always associated with vitreoretinal traction bands and membranes
c. Associated with the presence of a retinal break
d. More common than rhegmatogenous retinal detachment
e. Preceeded by posterior vitreous detachment
Q.73 The tractional retinal detachment (TRD) is caused by vitreoretinal tractional bands . The most
common cause is:
a. chronic uveitis
b. Vitreous liquification and contraction
c. Proliferative vitreoretinopathy
d. Peripheral retinal degeneration
e. Systemic hypertension
Q.74 In Exudative retinal detachment:

a. IOP remains unchanged
b. Retinal surface is convex and corrugated
c. Retinal holes are present in periphery
d. Shifting fluid is hallmark of detachment
e. Treatment is by laser photocoagulation
Q75 The commonest cause of CRAO is:

a. An embolus from heart or carotid arteries
b. Arteriosclerosis
c. Giant cell arteritis
d. Periartrits
e. Raised intraocular pressure
Q.76 The most dangerous emboli causing occlusion of CRA or its branches are:
a. Air emboli
b. Calcific emboli
c. Cholesterol emboli
d. Fibrinoplatelet emboli
e. Fat emboli
Q.77 A 70 years old man presents with sudden loss of vision in his one eye a few hours before. On fundus
examination, cherry red spot is seen in in the posterior pole. What is the most likely diagnosis ?
88
b. Central serous retinopathy

c. Central retinal artery occlusion
d. Central retinal vein occlusion
e. Hypertensive retinopathy
Q.78 The cherry red spot seen in macula in central retinal artery occlusion is due to:
a. Choroidal haemorrhage shinning through the thinnest part of macula
b. Intraretinal haemorrhage in the macular area
c. Subretinal haemorrhage in the macular region
d. Odema in the posterior pole
e. Visible choroidal vasculature through thin retinal layers
Q.79 A 70 years old male comes with sudden onset of decreased vision on right side. On examination there
is relative afferent papillary defect, cherry red spot in the macula and bruit on carotid auscultation. To
proceed further which one of the following investigations will be most appropriate?
a. FFA
b. Carotid Doppler ultrasonography
c. MRI of the eye
d. Serum calcium
e. X-Ray of the orbit
Q.80 The effective treatment of CRAO includes:

a. Anterior chamber (AC ) paracentesis
b. Intake of beta blockers
c. Inhalation of mixture of CO2+O2
d. Injection of I/V steroids
e. Use of vasodilator drugs
Q.81 A patient presenting with superotemporal retinal branch vein occlusion has the chance of developing
visual loss due to which of the following?
b. Chronic macular odema
c. Macular haemorrhages
d. Papillitis
Q.82 Central retinal vein occlusion is usually caused by:

a. Atherosclerosis of CRA
b. Emboli from the heart
c. Giant cell arteritis
d. SLE
e. Systemic hypertension
Q.83 The most common and serious complication of Ischaemic CRVO is:
b. Neovascularization
c. Optic atrophy
d. Optic neuritis
e. Uveitis
Q.84 A patient presents with clinical signs of recent CRVO and macular odema. The treatment strategy at
this stage will be?
a. Argon laser photocoagulation
b. Intravitreal AVEGF injection
c. Intravitreal steroids
89
d. Oral steroids
e. Observation
Q.85 The development of neovascular glaucoma (Thrombotic glaucoma) in CRVO can be prevented by:
a. Antiglaucoma treatment
b. Intravitreal AVEGF injections
c. Panretinal photocoagulation (PRP)
d. Topical carbonic anhydrase inhibitors
e. Use of systemic steroids
Q.86 In CRVO the neovascular glaucoma usually develops after:

a. 1 month of the disease
b. 2 months of the disease
c. 3 months of the disease
d. 6 months of the disease
e. 1 year
Q.87 What is the early response of retinal arterioles to acute rise in blood pressure?
a. Appearance of superficial & deep retinal haemorrhages
b. Arteriolar constriction
c. Arteriolar occlusion
d. Dilatation of arterioles
e.Tortuousity of veins
Q.88 Presence of arteriosclerotic changes at AV crossings in an hypertensive individual are indicative of the
fact that systemic hypertension has been:
a. Present only for short duration
b. Present for many years
c. Treated inefficiently
d. Under controle by treatment
e. Very severe
Q.89 Fundoscopy in a case of hypertension presenting with H/O headache and blurring of vision revealed
copper wire arterioles, scattered retinal haemorrhages, hard & soft exudates and optic disc swelling.
With these findings in which grade (K-W classification) you will classify this patient?
a. Grade-0
b. Grade-1
c. Grade-2
d. Grade-3
e. Grade-4
Q.90 A premature low birth weight infant exposed to high ambient oxygen concentrations develops
proliferative vitreoretinopathy. The diagnosis is:
a. Ischaemic optic neuropathy
b. Leber’s congenital amaurosis
c. Exudative vitreoretinopathy
d. Retinopathy of prematurity
e. Sickle cell retinopathy
Q.91 The most common and severe form of Retinitis Pigmentosa (RP) is inherited as:
a. Autosomal dominant
b. Autosomal recessive
c. Mitochondrial inheritance
d. X-linked recessive
e. X-linked dominant
Q.92 The retinal pigmentary changes in RP first start in the region of:
a. Equator
b. Mid retinal periphery
90
c. Macular area
d. Periphery
e. Peripapillary area
Q.93 Bone spicular pigmentary changes at retina is a sign of :

d. Periphlebitis retinae
e. Retinitis pigmentosa
Q.94 The most serious vision threatening complication of RP is:

a. Maculopathy
b. Open angle glaucoma
c. Optic atrophy
d. Posterior subcapsular cataract
Q.95 The appearance of fundus in retinitis pigmentosa is:

a. Dark coloured
b. Normal in appearance
c. Salt and pepper
d. Tessellated
e. Tigroid fundus
Q.96 Regarding the pathology of Retinitis pigmentosa, which one of the following statements is correct?
a. It is Inflammation of the Retinal pigment epithelium
b. Only cones are affected
c. Predominently rods are affected
d. Retinal pigment epithelium and choroid both are involved
e. There is severe inflammation of the retina
Q.97 The visual field defect in typical Retinitis pigmentosa is:

a. Arcuate scotoma
b. Central scotoma
c. Enlargement of blind spot
d. Para central scotoma
e. Ring scotoma
Q.98 The common age of retinoblastoma is :

a. 2-4 years
b. 5-10
c. 15-20 years
d. 20-25 years
e. 30-35 years
Q.99 Retinoblastoma accounts for 3% of all intraocular tumours. It:

a. Arises from primitive photoreceptor cells
b. Does not metastise intracranially
c. Is a benign tumour of childhood
d. Is always bilateral
e. The only treatment is enucleation
Q. 100 The commonest presentation of retinoblastoma is:

a. Corneal enlargement
b. Conjunctival chemosis
c. Leukocoria
91
d. Ptosis
e. Red eye
Q.101 A section of an enucleated eye for retinoblastoma will show which one of the following findings on
naked eye examination?
a. Calcification
b. Haemorrhages
c. Large cavities
d. Necrosis
e. Small cysts
Q.102 When the retinoblastoma involves optic nerve, the treatment is:
a. Chemotherapy
b. Enucleation
c. Evisceration
d. External beam radiotherapy
e. Laser thermotherapy
Ke y
Q.1 c Q.18 e Q.35 b Q.52 b Q.69 b Q.86 c
Q.2 c Q.19 c Q.36 c Q.53 b Q.70 c Q.87 c
Q.3 c Q.20 a Q.37 b Q.54 d Q.71 c Q.88 b
Q.4 a Q.21 d Q.38 a Q.55 e Q.72 b Q.89 e
Q.5 c Q.22 c Q.39 e Q.56 b Q.73 c Q.90 d
Q.6 d Q.23 b Q.40 d Q.57 c Q.74 d Q.91 b

92
Q.7 d Q.24 b Q.41 c Q.58 d Q.75 a Q.92 b
Q.8 c Q.25 d Q.42 d Q.59 c Q.76 d Q.93 e
Q.9 d Q.26 e Q.43 c Q.60 d Q.77 c Q.94 c
Q.10 b Q.27 c Q.44 d Q.61 e Q.78 e Q.95 d
Q.11 c Q.28 b Q.45 b Q.62 d Q.79 b Q.96 c
Q.12 e Q.29 c Q.46 b Q.63 e Q.80 c Q.97 e
Q.13 b Q.30 b Q.47 d Q.64 d Q.81 b Q.98 a
Q.14 b Q.31 d Q.48 c Q.65 b Q.82 a Q.99 a
Q.15 d Q.32 d Q.49 b Q.66 b Q.83 b Q.100 c
Q.16 b Q.33 a Q.50 d Q.67 d Q.84 b Q.101 a
Q.17 c Q.34 b Q.51 a Q.68 d Q.85 c Q.102 b
Chapter-10
The Optic Nerve
93
Q.1 The optic nerve extends from lamina cribrosa upto the:
a. Lateral geniculate body
b. Optic foramen
c. Optic chiasma
d. Optic tract
e. Optic radiation
Q.2 The total length of optic nerve is :

a. 4 cm
b. 5 cm
c. 6 cm
d. 7 cm
e. 8 cm
Q.3 The meningeal sheaths cover the optic nerve up to the:

a. Canalicular part of optic nerve
b. Intraocular part of optic nerve
c. Lamina cribrosa
d. Orbital part of optic nerve
e. Optic foramen
Q.4 The optic nerve fibers pass through lamina cribrosa which is a sieve like structure present in the:
a. Choroid
b. Ciliary body
c. Optic foramen
d. Retina
e. Sclera
Q.5 The longest part of optic nerve is:

a. Canalicular part
b. Intraocular part
c. Intracranial part
d. Orbital part
e. Prelaminar part
Q.6 The length of orbital part of optic nerve is approximately:

a. 1.0 cm
b. 1.5 cm
c. 2.0 cm
d. 2.5 cm
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e. 4.0 mm
Q.7 The blood supply of the prelaminar intra ocular part of the optic nerve is from?
a. Central retinal artery
b. Circle of zinn
c. Choriocapillaris
d. Cilio retinal artery
e. Pial vascular plexus
Q.8 The depression in the centre of the optic disc is called optic cup. The normal cup disc ratio is:
a. 1: 1
b. 1: 2
c. 1: 3
d. 1: 4
e. 1: 5
Q.9 The optic nerve fibers are the axons of:

a. Bipolar cells
b. Ganglion cells
c. Muller cells
d. Outer nuclear layer
e. Photoreceptor cells
Q.10 The optic nerve fibers terminate in:

b. Optic chiasma
c. Pretectal neucleus
d. Superior colliculus
e. visual cortex
Q.11 Which structure is in direct contact with the optic nerve?

a. Arachnoid matter
b. Ciliary ganglion
c. Dura matter
d. Orbital wall
e. Pia matter
Q.12 In optic disc coloboma:

a. Apprantly the disc is smaller in size
b. The defect in optic disc is situated superiorly
c. The defect is caused by incomplete closure of the foetal fissure
d. There is inferior visual field defect
e. Visual acuity is usually normal
Q.13 In optic nerve disease the light brightness is:

a. Decreased and is an early sign
b. Decreased in later stage of the disease
c. Increased
d. Not affected
95
e. Variably affected
Q.14 The presence of blind spot in in the field of vision is due to:
a. Age related macular degeneration
b. Anterior ischaemic optic neuropathy
d. Central serous choroido-retinopathy
e. Optic nerve head
Q.15 Enlargement of blind spot is a sign of :

a. Optic nerve avulsion
b. Optic atrophy
c. Papillitis
d. Papillodema
Q.16 The characteristic sign of optic nerve disease is :

a. Ciliary congestion
b. Light near dissociation
c. Optic atrophy
d. Relative afferent papillary defect
e. Uveitis
Q.17 The most common cause of papillitis is:

b. Multiple sclerosis
c. Optic nerve compression
d. Viral infections
e. Temporal arthritis
Q.18 The most common cause of retrobulbar neuritis is:

a. Collagen disorders
b. Multiple sclerosis
c. Nasal sinus inflammation
d. viral infections
e. Vitamin B1, B6, B12 deficiency
Q.19 Vitreous cells are seen in:

a. Anterior ischaemic optic neuropathy
c. Papillitis
d. Papillodema
e. Retrobulbar neuritis
Q.20 In optic neuritis, common visual field defect is:

a. A central positive scotoma
b. A central negative scotoma
c. A centrocaecal scotoma
d. An altitudinal scotoma
96
e. Arcuate scotoma
Q.21 A 25 years old girl complains of rapid diminution of vision in one eye and pain on moving the eye
ball up and in. O/E RAPD is elicited but fundus is normal in appearance. What is the likely diagnosis?
b. Cataract
d. Papillodema
Q.22 A young boy complains of sudden and progressive decrease in vision. On examination, the VA is 6/60,
RAPD, defective colour perception and optic disc swelling. What can be the probable cause?
a. Central retinal artry occlusion
b. Central retinal vein occlusion
c. Papillodema
d. Papillitis
e. Retrobulber neuritis
Q.23 In papillodema there is :

a. Early onset of visual field defects
b. Impairment of colour vision
c. Raised intracranial pressure
d. Raised IOP
e. Sudden loss of vision
Q. 24 The first visual field defect to appear in papillodema is:

a. Altitudinal field defect
b. Arcuate defect
c. Central scotoma
d. Centrocaecal defect
e. Enlargement of blind spot
Q.25 In papillodema, the decompression from ophthalmological point of viw should be carried out when.
a. Blind spot appears on perimetry
b. Macular star appears
c. Papillodema becomes well established
d. Peripheral contraction of VF starts
e. Pallor of optic disc begins
Q.26 Unilateral papillodema with optic atrophy on other side is seen in:
a. Congenital Leber’s amaurosis
b. Foster-Kennedy syndrome
c. Laurence Moon-Biedl- syndrome
d. Pitutary adenomas
e. Usher’s syndrome
Q.27 A 50 years old woman comes to emergency department with H/O severe headache which is made
worse by coughing or straining, projectile vomiting and transient attacks of visual obscuration.
Fundoscopy shows swollen optic discs in both the eyes. What is the most likely diagnosis?
b. Diabetic optic neuropathy
c. Papillodema
97
d. Papillitis
e. Toxic optic neuropathy
Q.28 Fundus examination of a patient shows Neuroretinitis. Which of the following options correspond to
this condition?
a. Chronic macular odema and hard exudates
b. Macular star in the macula
c. Optic disc is swollen
d. Optic disc swelling with macular star
e. Soft exudates around the disc.
Q.29 A patient is prescribed methyl prednisolone 1 Gm daily for 3 days followed by oral prednisolone for
optic neuritis. Which of the following results is expected after the treatment of first attack?
a. Near normal (6/9) visual acuity in most of the cases
b. Normal pupillary reactions
c. Normal colour perception
d. Normal light brightness appreciation
e. Substantial decrease in visual acuity
Q.30 In papillodema the earliest visible clinical finding is:

a. Absent pupillary reactions
b. Blurring of optic disc margins
c. Haemorrhages on optic disc
d. Obliteration of optic cup
e. Optic disc pallor
Q.31 Which of the followings is a feature of optic atrophy after papilledema?

a. Optic disc hyperemia
b. Optic disc haemorrhages and large cup
c. Pale disc with blurred margins and vascular sheathing
d. Peripapillary haemorrhages
e. White optic disc with distinct margins
Q.32 An easy and sure method of diagnosing papillodema is:

a. Clinically
b. ERG
c. EOG
d. FFA
e. VEP
Q.33 The optic neuritis is best treated by:

a. Broad spectrum antibiotics
b. Improving general nutrition
c. Multivitamins
d. Non-steroidal anti inflammatory drugs
e. Systemic steroids
Q.34 Toxic optic neuropathies (Toxic amblyopias) are usually characterized by:
a. An altitudinal visual field defect
b. An arcuate scotoma
c. A central scotoma
d. A centrocaecal scotoma
e. Paracentral scotoma
98
Q.35 Toxic agent in tobacco amblyopia is:

a. Cyanide
b. Ethanol
c. Formaldehyde
d. Lead
e. Nicotine
Q.36 In tobacco amblyopia there is degeneration of:

a. Bipolar cells
b. Ganglion cells
c. Lateral geniculate bodies
d. Nerve fiber layer
e. Photoreptor cells
Q.37 The visual field defect in tobacco amblyopia is:

a. Arcuate defect
b. Altitudinal defect
c. Central field defect
d. Centrocaecal field decect
e. Paracentral defect
Q.38 Toxic agent in methyl alcohol poisoning is:

a. Cyanide
b. Carbon
c. Ethanol
d. Formaldehyde
e. Lead
Q.39 In toxic amblyopia due to methyl alcohol poisoning, there is :

a. Cherry red spot in the macula
b. Degeneration of ganglion cells in macular area
c. Degeneration of bipolar cells throughout the retina
d. Photoreceptor cells damage
e. Retinal pigment epithelial cells degeneration
Q.40 Immediate treatment of methyle alcohol poisoning is:

a. O2 inhalations
b. Ethyle alcohol (Ethanol)S
c. Gastric lavage
d. I/V steroids
e. Vit. B12 injections
Q.41 Postneuritic optic atrophy follows:

a. Choroiditis
b. Optic nerve compression
c. Papillodema
d. Retrobulbar neuritis
e. Retinitis pigmentosa
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Q.42 Bull’s eye macular sign is characteristic of:

a. Chloroquine toxicity
b. Ethambutol toxicity
c. Methyle alcohol poisoning
d. Lead poisoning
e. Oral contraceptives
Q.43 The Glioma of optic nerve:

a. Occurs in 10-12 years old children
b. Does not affect vision
c. Originates from neural tissue of the nerve
d. Presents with non-axial proptosis
e. X-Ray examination shows uniform round enlargement of optic foramina
Q.44 The earliest optic disc sign of optic atrophy is:

a. Concentric contraction of visual fields
b. Decreased visual acuity
c. Enlargement of optic cup
d. Haemorrhages on optic disc
e. Optic disc Pallor due to decrease in number of capillaries
Q.45 In optic atrophy the:

a. Afferent pupillary defect is present
b. Colour vision remains unaffected
c. Contrast sensitivity is normal
d. Light brightness remains unchanged
e. Visual field not changed
Q.46 Optic atrophy results if either the ganglion cells or their axons are damaged . In primary optic atrophy:
a. Optic disc is dirty white in colour
b. Optic cup is deep
c. RAPD is absent
d. Sheathing of blood vessels is present
e. The atrophy develops without prior swelling of the nerve head
Q.47 Which of the followings is a cause of primary optic atrophy?

b. Compression by a tumours or aneurysm
c. Papillodema
d. Papillitis
e. Pigmentary retinal dystrophy
Q.48 Secondary optic atrophy is preceded by swelling of the optic nerve head and is caused by:
a. Chronic papillodema
b. Hereditary optic neuropathy
c. Nutritional optic neuropathies
d. Retrobulbar neuritis
e. Uncontrolled chronic simple glaucoma
100
Q.49 In which of the following diseases, opticociliary shunts are seen?

b. Optic nerve glioma
c. Optic nerve sheath meningioma
d. Optic atrophy
e. papillodema
Q.50 The most common pituitary tumour in early adult or middle age producing neuro-ophthalmological
features is:
a. Acidophil tumours secreting growth harmone
b. Basophil tumours secreting ACTH
c. Chromophobe tumours secreting prolactin
d. Mixed cell tumours
e. Posterior pituitary astrocytoma
Q.51 A young man of 35 years complains of headache and blurring of vision. The radiological examination
is suggestive of pituitary tumour. On visual field test what type of defect is expected.
a. Altitudinal field defect
b. Arcuate field defect
c. Bitemporal hemianopia
d. Central scotoma
e. Homonymous hemianopia
Q.52 A carotid aneurysm causing chiasmal compression will produce a:

a. Bitemporal hemianopia
b. Binasal hemianopia
c. Centrocecal field defect
d. Enlagement of blind spot
e. Junctional scotoma
Key
Q.1 c Q.9 b Q.17 d Q.25 d Q.33 e Q.41 c Q.49 c
Q.2 b Q.10 a Q.18 b Q.26 b Q.34 d Q.42 a Q.50 c

101
Q.3 c Q.11 e Q.19 c Q.27 c Q.35 a Q.43 e Q.51 c
Q.4 e Q.12 c Q.20 b Q.28 d Q.36 b Q.44 e Q.52 b
Q.5 d Q.13 a Q.21 e Q.29 a Q.37 d Q.45 a
Q.6 d Q.14 e Q.22 d Q.30 b Q.38 d Q.46 e
Q.7 b Q.15 d Q.23 c Q.31 c Q.39 b Q.47 b
Q.8 c Q.16 d Q.24 e Q.32 d Q.40 b Q.48 a
Chapter-11
Abnormalities of pupils & Optic pathways
102
Q.1 The size of pupil is controlled by autonomic innervation through:

a. Contraction of sphincter muscles of the pupil
b. Contraction of dilator muscles
c. Contraction of ciliary muscles
d. Contraction and relaxation of both constrictor and dilator pupillae muscles
e. Relaxation of ciliary muscles
Q.2 The normal size of pupil is:

a. 1-2 mm
b. 2-3 mm
c. 2-4 mm
d. 4-5 mm
e. More than 5 mm
Q.3 The pupil is said to be dilated when its size is:

a. 3 mm
b. 4 mm
c. 5mm
d. 6 mm
e. More than 6 mm
Q.4 The pupillary light reflex (parasympathetic) is a four neuron arc. The neurons of 1st order are :
a. Edinger Westphal nucleus
b. Bipolar cells
c. Ganglion cells
d. Photoreceptor cells
e. Pretectal nuclei
Q.5 The dilator pupilae muscles are supplied by sympathetic nerve fibers. The 2nd order neuron in this
pathway is:
a. Ciliospinal nucleus of budge at C8-T2 spinal level
b. Inferior cervical ganglion
c. Middle cervical ganglion
d. Posterior hypothalamus
103
e. Superior cervical ganglion
Q.6 The 3rd order neuron in the sympathetic papillary pathway is:
a. Ciliospinal nucleus of budge at C8-T2 spinal level
b. Ciliary ganglion
c. Inferior cervical ganglion
d. Posterior hypothalamus
e. Superior cervical ganglion
Q.7 Anisocoria is the condition of an unequal size of pupils and is normally present in 20% of normal
subjects. The anisocoria is only pathological if :
a. It remains same with change in illumination
b. It varies with change in illumination
c. The difference in size of two pupils is > 1 mm
d. The difference in size of two pupils is >2 mm
Q.8 The light- near reflex dissociation is a condition in which light reflex is absent but near reflex is intact
and is a common feature of :
a. Afferent pupillary defect
b. Chiasmal lesions
c. Mid brain lesions
d. Lesions of optic tract
e. Occipital cortex lesions
Q.9 Which of the following structures is the 2nd order neuron in pupillary light reflex?
a. Edinger Westphal nucleus
b. Inferior colliculus
c. Occipital cortex
d. Pretactal nucleus
e. Superior colliculus
Q.10 In which of the following lesions, the pupillary light reflex is normal?
a. Long standing retinal detachemnt
b. Optic tract
c. Occipital cortex
d. Papillitis
Q.11 The swinging flash light test is done to detect:

a. Argyll Robertson pupil ( A-R Pupil)
b. Amaurotic pupil
c. Efferent papillary defect
d. Horner’s syndrome
e. Ralative afferent papillary defect ( Marcus- Gunn Pupil)
Q.12 In relative afferent pupillary defect (RAPD) there is:

a. Anisocoria
b. Complete conduction defect
c. Direct & consensual pupillary reactions are normal
d. Incomplete conduction defect
e. Light near dissociation
104
Q.13 In Amaurotic pupil:

a. Afferant papillary defect is complete
b. Consensual light reflex in opposite eye is present
c. Pupillary light reflex is normal
d. Pupil is dilated
e. The vision in affected eye is normal
Q.14 In Argyll Robertson Pupil (AR) :

a. Amplitude of accommodation decreases
b. Lesion is in the afferent pathway
c. Pupils are large in size
d. There is light-near dissociation
e. Vision is defective
Q.15 Holmes –Adie (Tonic) pupil is:

a. An afferent pupillary defect
b. Due to denervation of post ganglionic parasympathetic fibers to sphincter pupilla and ciliary body
c More common in males
d. Normal in size
e. Smaller in size
Q.16 In 3rd cranial nerve palsy the:

a. Accomodation remains unaffected
b. Direct & consensual light reflexes are absent
c. Defect is in afferent pupillary pathway
d. Pupil is constricted
e. Pupils are equal in size
Q.17 Horner’s syndrome is due to:

a. Damage to the ciliary ganglion
b. Damage to the inferior cervical ganglion
c. Damage to the middle cervical ganglion
d. Partial or total interruption of sympathetic chain from posterior hypothalamus to the eye
e. Third nerve palsy
Q.18 The pupil in Horner’s syndrome due to a preganglionic lesion dilates after instillation of :
a. 4% Cocain drops
b. 1% Hydroxyamphatamine drops
c. 1% Phenylephrine eye drops
d. 0.1% Pilocarpine eye drops
e. 1% Tropicamide eye drops
Q.19 The pupil in Horner’s syndrome due to a postganglionic lesion dilates after instillation of :
a. 4% Cocain drops
b. 1% Hydroxyamphatamine drops
c 1% Mydriacyle eye drops
d. 1% Phenylephrine eye drops
e. 0.1% Pilocarpine eye drops
105
Q.20 Tumours compressing the junction of chiasma and optic nerve will give rise :
b. Ipsilateral blindness
c. Central scotoma
d. Homonymous hemianopia
e. Junctional scotoma
Q.21 Lesions of optic tract cause:

b. Binasal hemianopia
c. Homonymous hemianopia
d. Ipsilateral blindness
e. Pie in the floor defect
Q.22 Lesion of the tip of the occipital lobe due to head injury causes:
a. Homonymous hemianopia
b. Homonymous macular hemianopia (Bilateral Central VF defect)
c. Pupil sparing homonymous hemianopia
d. Pie in the floor defect (Inferior quadrantic hemianopia)
e. Pie in the sky defect ( superior quadrantic hemianopia)
key
Q.1 d Q.7 b Q.13 a Q.19 d
Q.2 c Q.8 c Q.14 d Q.20 e
Q.3 e Q.9 d Q.15 b Q.21 c
Q.4 c Q.10 c Q.16 b Q.22 b
Q.5 a Q.11 e Q.17 d
Q.6 e Q.12 d Q.18 b
Chapter-12
The Orbit
106
Q.1 The anteroposterior diameter of eyeball is:

a. 18- 20 mm
b. 20-23 mm
c. 23-24 mm
d. 24-26 mm
e. 26-28 mm
Q.2 The average volume of orbit is:

a. 10 cc
b. 14 cc
c. 18 cc
d. 20 cc
e. 22 cc
Q.3 The thinnest wall of orbit is:

a. Anterior part of floor of the orbit
b. Lateral wall
c. Medial wall
d. Posterior part of floor of the orbit
e. Roof of orbit
Q.4 Proptosis is defined as the forward protrusion of eyeball passively and mechanically beyond lateral
orbital margin and is the distance in mm from the orbital margin to the corneal apex equal to or more
than ?
a. 18 mm
b. 19 mm
c. 20 mm
d. 21 mm
e. 22 mm
107
Q.5 Exophthalmos is the term used for active displacement or protrusion of eyeball associated wtih:
a. Orbital varices
b. Orbital tumours
c. Orbital malformations
d. Thyroid disease
e. Vascular malformations
Q.6 The amount of proptosis is measured by :

a. Biometer
b. Exophthalmometer
c. Focimeter
d. Keratometer
e. Pachymeter
Q.7 The most common cause of intermittent proptosis is:

b. Cavernous haemangioma
c. Carotid cavernous fistula
d. Orbital varices
e. Meningocele
Q.8 The most common cause of pulsatile proptosis with a bruit is seen in:
a. Carotid cavernous fistula
b. Encephalocele
c. Meningocele
d. Orbital cellulitis
e. Orbital varices
Q.9 The most common cause of carotid cavernous fistula is:

a. Congenital
b. Idiopathic
c. Endocrine
d. Neurofibromatosis
e. Trauma
Q.10 Enophthalmos is seen in:

a. Buphthalmos
b. Fracture floor of the orbit
c. Optic nerve glioma
d. Optic nerve meningioma
e. Thyroid ophthalmopathy
Q.11 Preseptal cellulitis is the infection of periocular tissues anterior to orbital septum. It typically affects
children and young adults and is usually due to extension of infection from:
a. Adnexa and eyelid skin
b. Cavernous sinus
b. Distant places
d. Paranasal sinuss
e. Teeth
Q.12 In children under the age of 5 years, the most common micro organism causing orbital cellulitis is:
108
a. Haemophilus influenza
b. Pseudomonas aeruginosa
c. Staphylococcus aureus
d. Streptococcus pneumonia
e. Streptococcus pyogenes
Q.13 Orbital cellulitis (post septal) is an infection of the soft tissues behind orbital septum. It is:
a. A self limiting condition
b. Commonly due to extension of infection from distant places
c. More common than preseptal cellulitis
d. More severe than preseptal cellulitis
e. Not associated with serious complications
Q.14 The most common cause of post septal orbital cellulitis in children and young adults is;
a. Extension of infection from distant places
b. Infection of paranasal sinuses
c. Preseptal cellulitis
d. Post traumatic
e. Skin lacerations
Q.15 The serious most intracranial complication of orbital cellulitis is:

a. Brain abscess
b. Cavernous sinus thrombosis
c. Cranial nerve palsies
d. Meningitis
e. Rise in ICP
Q.16 Most serious ocular complication of orbital cellulitis is:

a. Diplopia
b. Exposure keratitis
c. Occlusion of central retinal artery or vein
d. Optic neuritis
e. Rise in IOP
Q.17 A patient having unilateral proptosis, severe supraorbital pain and swelling behind the ear on the same
side. What is the probable diagnosis?
c. Cavernous haemangioma
Q.18 Odema over the mastoid process in orbital cellulitis is a diagnostic sign of :
a. Carotid cavernous fistula
c. Cerebral abscess
d. Inflammatory orbital disease
Q.19 Unilateral complete external ophthalmoplegia associated with orbital cellulitis is an important clinical
sign of:
109

b. Endophthalmitis
c. Orbital inflammatory pseudotumors
d. Panophthalmitis
Q.20 Most common cause of unilateral axial proptosis with pain and fever in childrens is:
a. Lymphoma
b. Metastasis
c. Meningioma
Q.21 Most common cause of bilateral axial proptosis in adults is:

a. Metastasis
b. Meningioma
c. Optic nerve glioma
Q.22 A young woman developed unilateral axial proptosis with no signs of thyroid disease. What is the most
probable diagnosis?
a. Cavernous haemangioma
b. Capillary haemangioma
c. Dermoid cyst
d. Optic nerve glioma
e. Optic nerve meningioma
Q.23 The first muscle to get involed in thyroid ophthalmopathy is:

a. Inferior rectus
b. Lateral rectus
c. Levator palpebrae superioris
d. Medial rectus
e. Superior rectus
Q.24 Von Graefe’s sign is present in:

a. Chronic alcoholism
b. Diabetes mellitus
c. Hypothyroidism
d. Hyperthyroidism
e. Hypertension
Q.25 The drug of choice for symptomatic relief of lid retraction in thyroid ophthalmopathy is:
b. 1% Cyclopentolate eye drops
c. 5% Guanethadine eye drops
d. 1% Phenylephrine eye drops
e. 2% Pilocarpine eye drops
Q.26 Surgical intervention in orbital cellulitis is indicated in the:

a. Brain abscess
110
b. Children below the age of 5 years

c. Presence of orbital or subperiosteal abscess
d. Patients above the age of 60 year
e. Severe infection
Q.27 Most common type of paranasal mucocele arises from :

a. Ethmoidal sinus
b. Frontal sinus
c. Maxillary sinus
d. Sphenoidal sinus
Q.28 The optic nerve glioma is a slow growing benign tumor of the optic nerve. Its peak incidence is
between :
a. 1-2 years
b. 2-5 years
c. 6-8 years
d. 8-10 years
e. 10-15 years
Q.29 An orbital meningo-encephalocele is the herniation of meninges and brain tissue in to the orbit through
a congenital defect in the orbital bones. It usually presents in:
a. Inferomedial angle of the orbit
b. Infrolateral angle of he orbit
c. Superomedial angle of the orbit
d. Superomedial angle of the orbit
e. The roof of the orbit
Q.30 Rhabdomyosarcoma is an extremely malignant orbital tumor, presents with rapidly progressive
proptosis and arises from:
a. Connective tissue
b. Non striated muscles
c. Nasal sinuses
d. Orbital nerves
e. Striated muscles
Q.31 Rhabdomyosarcoma arises from striated muscles in the orbit and occurs in:
a. 1st. decade of life
b. 2nd decade of life
c. 3rd decade of life
d. 4th decade of life
e. 5th decade of life
Key
Q.1 c Q.9 e Q.17 b Q.25 c
Q.2 c Q.10 b Q.18 b Q.26 c
Q.3 c Q.11 a Q.19 d Q.27 b

111
Q.4 d Q.12 a Q.20 d Q.28 b
Q.5 d Q.13 d Q.21 e Q.29 c
Q.6 b Q.14 b Q.22 a Q.30 e
Q.7 d Q.15 b Q.23 a Q.31 a
Q.8 a Q.16 c Q.24 d
Chapter-12
Ocular Injuries
112
Q.1 A corneal foreign body in a child of 3 years is removed under:

a. General anaesthesia
b. Peribulbar block
c. Retrobulbar block
d. Topical anaesthesia
e. Without anaesthesia
Q.2 The most common complication of hyphaema is:

a. Anterior uveitis
b. Cataract formation
c. Corneal opacification
d. Glaucoma
e. Siderosis bulbi
Q.3 A patient developed hyphaema after blunt trauma with a tennis ball, it is:
a. Blood in anterior chamber
b. Blood in vitreous
c. Blood in subconjunctival space
d. Pus in anterior chamber
e. Proteins in anterior chamber
Q.4 Post traumatic mydriasis is due to:

a. Iridodialysis
b . Paralysis of ciliary body
c. Paralysis of pupillomotor fibers
d. Rupture of sphincter papillae muscles
e. Stimulation of sympathetic supply to dilator papillae muscle
Q.5 ‘D’-Shaped pupil after trauma to the eye is due to :

a. Dislocation of lens
b. Iridodialysis
c. Iridocyclitis
d. Subluxation of lens
Q.6 Vossius ring on anterior surface of the lens is seen in :
a. Blunt trauma to the eye
b. Congenital cataract
c. Chalcosis
d. Iridocyclitis
e. Siderosis bulbi
113
Q.7 Rossette shape cataract is associated with :

a. Choroiditis
b. Concussion injury to the eye
d. Diabets mellitus
e. Iridocyclitis
Q.8 In ocular injuries, sudden loss of vision is due to:

a. Corneal abrasion
b. Traumatic uveitis
c. Vitreous haemorrhage
d. Vitreous liquification
e. Vitreous Collapse
Q.9 Commotio retinae (Berlin’s odema) is due to:

a. Blunt trauma to the eye
b.Toxoplasmosis
c. Toxocariasis
d. Pars planitis
e. Tuberculosis
Q.10 Sunflower cataract appears as yellowish brown opacities in the subcapsular cortex of the lens in
pupillary zone with petal like spokes that extend towards the equator and is characteristic of:
a. Argyrosis
b. Chalcosis
d. Chronic uveitis
e. Siderosis
Q.11 The most serious complication of a penetrating injury is:

a. Anterior uveitis
b. Commotio retina
c. Endophthalmitis
d. Panophthalmitis
Q.12 Kayser-Fleischer ring is seen in hepatolenticular degeneration due to deposition of copper in :

a. Angle of anterior chamber
d. Crystalline lens
e. Descemet’s membrane peripherally
Q.13 The first clinical sign of sympathetic ophthalmitis is the presence of cells in:
a. Anterior chamber
b. Anterior vitreous
c. Posterior chamber
d. Posterior vitreous
e. Retrolental space
114
Q.14 Diagnostic sign in sympathetic ophthalmitis is the presence of :

a. Busaca noules
b. Dallen Fuch’s nodules
c. Koppe’s nodules
d. Mutton fat Kps
e. Vitreous snow ball opaccities
Q.15 Chalcosis is a condition in which there is deposition of:

a. Aluminium in the ocular tissues
b. Copper in the ocular tissues
c. Iron in ocular structures
d. Silver in the ocular tisues
e. Zn in ocular structures
Q.16 Which of the following foreign bodies is not required to be removed when retained inside the eye?
a. Copper
b. Iron
c. Silver
d. Wood
e. Zinc
Q17 An intraocular foreign body which causes the most severe inflammatory reaction is:
a. Aluminium
b. Gold
c. Iron
d. Lead
e. Silver
Q.18 A retained metallic intraocular foreign body is best localised by:

a. A-Scan ultrasonogrphy
b. B- scan USG
c. CT Scan axial and coronal
d. MRI
e. Plain X-Ray orbit
Q.19 Photokeratitis or Welding flash keratitis is:

a. Always associated with photoretinitis
b. Best treated by steroid eye drops
c. Caused by exposure to infra- red rays
d. Caused by exposure to ultra- violet rays
e. Developed soon after exposure
Q.20 In alkali burns :

a. Damage caused is less severe than acid burns
b. Limbal ischemia is not a prominent feature
c. There is saponification of lipids in corneal epithelium
d. There is precipitation of tissue proteins
e. The visual prognosis is not bad
115
Q.21 In acid burns:

a. Cataract formation is a common complication
b. Damage caused is more severe than alkali burns
c. The tissue proteins are precipitated which create barrier to deep damage
d. The lipids in conjunctival and corneal epithelium are converted in to soluble compounds
e. Vision is not affected
Q.22 The immediate treatment of chemical burns is?

a. Admission in hospital
b. Copious irrigation to neutralize pH
c. Lubricant eye drops
d. Steroid eye dropos
e. To use broad spectrum antibiotic drops
Q. 23 A blow out fracture is caused by a striking object the diameter of which is greater than:
a. 2 cm
b. 3 cm
c. 4 cm
d. 5 cm
e. 7 mm
Q.24 A pure blow out fracture of the orbit is defined as fracture of the floor of orbit and:
a. Does not involve the orbital rim
b. Fracture of the rim of orbit
c. Fracture of the medial wall of orbit
d. Fracture of the lateral wall of the orbit
e. Perforation of the eyeball
Q.25 In blow out fracture the commonest bone to fracture is:

a. Ethmoidal bone
b. Frontal bone
c. Lacrimal bone
d. Maxillary bone
e. Zygomatic bone
Q.26 In blow out fracture there is:

a. Diplopia in up-gaze
b. Diplopia in down- gaze
c. Enophthalmos
d. Proptosis
e. Pseudoproptosis
Q.27 The most important feature of orbital floor fracture is:

a. Damage to supraorbital nerve
b. Diplopia in up and down gaze (Double diplopia)
c. Numbness in lateral canthal area
d. Haziness of ethmoidal sinuses on plain x-ray
e. Proptosis
116
Q.28 Trap door deformity on radiological investigation is seen in:

a. Blow out fracture of the orbit
b. Fracture apex of the orbit
c. Fracture base of the skull
d. Fracture medial wall of the orbit
e. Optic nerve meningioma
Q.29 Tear drop sign on CT scan orbit is diagnostic of:

a. Blow-out fracture
b. Fracture apex of the orbit
c. Nasolacrimal duct obstruction
d. Orbital apex syndrome
e. Orbital dermoid
Q.30 Surgery in a blow- out fracture is indicated if enophthalmos is more than:

a. 1 mm
b. 2 mm
c. 3 mm
d. 4 mm
e. 5 mm
key
Q.1 a Q.9 a Q.17 a Q.25 d
Q.2 d Q.10 b Q.18 c Q.26 c
Q.3 a Q.11 d Q.19 d Q.27 b

Q.4 d Q.12 e Q.20 c Q.28 a
Q.5 b Q.13 e Q.21 c Q.29 a
Q.6 a Q.14 b Q.22 b Q.30 b
Q.7 b Q.15 b Q.23 d
Q.8 c Q.16 c Q.24 a
Chapter-14
The ocular motility & Strabismus
117
Q.1 All the rectus muscles originate from :

a. Common annular tendon of Zinn
b. Floor of orbit
c. Medial wall of orbit
d. Optic foramina
e. Roof of the orbit
Q.2 The 3rd cranial nerve supplies :

a. Dilator pupillae
b. Inferior oblique
c. Lateral rectus
d. Orbiculais occuli
e. Superior oblique
Q.3 The vertical recti form an angle with the optical axis equal to:
a. 10 degrees
b. 15 degrees
c. 23 degrees
d. 45 degrees
e. 51 degrees
Q.4 The superior and inferior oblique muscles are so inserted on the globe that they make an angle with the
optical axis equal to:
a. 25 degrees
b. 35 degrees
c. 45degrees
d. 51 degrees
e. 55 degrees
Q.5 The action of superior rectus muscle when the eye is in 23 degree abduction is purly :
a. Adductor
b. Abductor
c. Elevator
d. Depressor
e. Intorsion
118
Q.6 The secondary action of superior rectus muscle in 67 degrees adduction is:
a. Adduction
b. Abduction
c. Elevation
d. Extorsion
e. Intorsion
Q.7 The primary action of superior oblique in primary position is:

a. Adduction
b. Abduction
c. Depression
d. Extortion
e. Intorsion
Q.8 When the eyeball is adducted by 51 degrees, the prime depressor of eye is:
a. Inferior rectus
b. Inferior oblique
c. Inferior rectus & inferior oblique
d. Superior oblique
e. Superior rectus
Q.9 All the rectus muscles are adductors except:

a. Inferior rectus
b. Lateral rectus
c. Medial rectus
d. Superior rectus
Q.10 Both the inferior muscles are :

a. Adductors
b. Abductors
c. Elevator
d. Extortors
e. Intortors
Q.11 Both the superior and inferior oblique muscles are :

a. Adductors
b. Abductors
c. Elevator
d. Extortors
e. Intortors
Q.12 The cardinal positions of gaze are :

a. 4
b. 6
c. 7
d. 8
e. 9
119
Q.13 The total positions of gaze are :

a. 4
b. 6
b. 7
c. 8
d. 9
Q.14 The Hirschberg test is done to see:

a. A corneal opacity
b. Angle of deviation in malalignment of eyes
c. Near reflex
d. Pupillary light reflex
e. RAPD
Q.15 The accurate measurement of the angle of deviation is done by:

a. Hirschberg test
b. Krimsky test
c. Prism cover test
d. Worth four dot test
e. Hess charting
Q.16 The principle of cover test is based on:

a. Occlusion of the eye
b. Prevention of fusion
c. Suspension of binocular vision temporarily
d. Supression of image in one eye
e. Avoiding diplopia by covering one eye
Q.17 In the treatment of esophoria:

a. Glasses are of no help
b. Prisms are prescribed base in
c. Prisms are prescribed base out
d. prisms are prescribed base up
e. prisms are prescribed base down
Q18 A mother brings her 9 months old daughter with complaint of malalignment of eyes. The pregnancy,
labour and developmental history is normal. Examination reveals flat nasal bridge and symmetrical
corneal reflex. The findings are most consistent with:
a . Accommodative esotropia
b. Congenital exotropia
c . Inconcommitant squint
d. Infantile esotropia
e. Pseudo strabismus
Q.19 In concomitant squint :

a. Angle of deviation is different in different positions of gaze
b. Angle of deviation remains same in all positions of gaze
c. Angle of deviation is different when fixating with different eyes
d. Diplopia is the prominent feature on presentation
e. VA is not affected
120
Q.20 In concommitant squint the:

a. Afferent pathway is intact
b. Afferent pathway is defective
c. Afferent and efferent pathways are intact
d. Binocular functions are normally developed
e. Efferent pathway is defective
Q.21 In inconcomitant squint:

a. Both afferent and efferent pathways are defective
b. The afferent pathway is intact
c. The efferent pathway is defective
d. The afferent pathway is defective
e. The efferent pathway is intact
Q.22 In Paralytic squint:

a. Primary deviation is more than secondary deviation
b. Primary and secondary deviations are same
c. Secondary deviation is more than primary deviation
d. The ocular movements are unaffected
e. Visual acuity is markedly reduced
Q.23 In paralytic squint:

a. Angle of deviation is different in different positions of gaze
b. Angle of deviation remains same in all positions of gaze
c. Angle of deviation is same when fixating with different eyes
d. Diplopia is not the prominent feature on presentation
e. Ocular movements are full
Q.24 In which of the following conditions secondary deviation is more than primary deviation?
a. Alternating deviations
b. Accommodative esotropia
c. Congenital esotropia
d. Intermittent exotropia
e. Paralytic squint
Q.25 A boy of 8 years is brought in eye OPD with H/O eye strain, headache and diplopia after prolonged
close work. Based on the history what is the most probable diagnosis?
a. Apparent squint
b. Accommodative esotropia
c. Intermittent exotropia
d. Inconcomitant squint
e. Latent squint
Q.26 The Maddox rod test is done to diagnose:
a. Hetrotropia
b. Hetrophoria at distance
c. Hetrophoria at near
d. Intermittant exotropia
e. Orthophoria
121
Q.27 The madox wing is an instrument used to determine :

a. Angle of deviation in tropias
b. Angle and type of deviation at near in phorias
c. Angle of deviation in alternatig tropias
d. Angle of deviation in intermittent tropias
e. Binocular functions in tropias
Q.28 Esotropia is the inward deviation of eyes and is more common in :

a. Anisometropia
b. Astigmatism
c. Hypermetropia
d. Myopia
e. Presbyopia
Q.29 Exotropia is outward deviation of eyes and is more common in:

a. Astigmatism
b. Anisometropia
c. Hypermetropia
d. Myopia
e. Presbyopia
Q.30 Esotropia is the inward deviation of eyes and is:

a. Associated with accommodation reflex
b. A manifest convergent squint
c. A Manifest divergent squint
d. A latent divergent squint
e. A Latent convergent squint
Q.31 Exophoria is inward deviation of eyes and is:

a. Associated with accommodation reflex
b. A manifest divergent squint
c. A manifest convergent squint
d. A Latant convergent squint
e. A latent divergent squint
Q.32 A 65 years old diabetic patient presented with paralysis of extraocular muscles with ptosis. In your
opinion the patient is suffering from which cranial nerve palsy.
a. Facial nerve
b. Oculmotor nerve
c. Trochlear nerve
d. Trigeminal nerve
e. Abducent nrve
Q.33 A patient having diplopia in right lateral rectus palsy will:
a. Turn his face towards right
b. Turn his face towards left
c. Raise his chin upwards
d. Tilt his head on right
e. Tilt his head on left
122
Q.34 In the paralysis of vertical muscles, the chin is raised or depressed:

a. In the direction opposite to the action of paralytic muscle
b. To compensate for the defective main action of the paralytic muscle.
c. To counteract the torsional effect of the paralytic muscle
d. To counteract the secondary action of the paralytic muscle
e. To counteract the action of ipsilateral antagonist
Q.35 In the paralysis of oblique muscles, the head tilt towards right or left is:
a. In the direction of the paralytic muscle
b. To compensate for the defective vertical action of the paralytic muscle.
c. To compensate for the overacting contralateral agonist
d. To counteract the torsional effect of the paralytic muscle
e. To counteract the torsional effect of contralateral antagonist
Q.36 A 60 years old hypertensive man presents with sudden onset of vertical diplopia. On examination the
chin is elevated, face turned towards right and head tilted towards right shoulder. In your opinion
which one of the following extraocular muscles is involved.
a. Lt. Inferior rectus
b. Lt. Inferior oblique
c. Medial rectus
d. Rt. Superior rectus
e. Rt. Superior oblique
Q.37 Binocular Single Vision (BSV) is a conditional reflex which is not present at birth and develops in:
a. First few weeks
b. First few weeks
c. First few months
d. First few years of lifs
e. Second decade of life
Q.38 In alternating deviations

a. All grades of binocular functions are present
b. Ggrade-1 binocular functions are present
c. Grade-1 &2 binocular functions are present
d. Grade -3 binocular functions are present
e. The binocular functions are not present at all
Q.39 The 3rd grade of binocular single vision is;

a. Centric fixation
b. Fusion
c. Simultaneous foveal perception
d. Steropsis
e. Suppresion
Q.40 When the BSV breaks down, confusion results due to the:
a. Abnormal retinal correspondence
b. Stimulation of fovea of both the eyes.
c. Stimulation of the fovea of one eye and extrafoveal point of the other eye.
d. Suppresion of the extrafoveal image by the squinting eye.
e. Presence of amblyopia.
123
Q.41 When the BSV breaks down, diplopia results due to :

a. Abnormal retinal correspondence
b. Stimulation of fovea of both the eyes.
c. Stimulation of the fovea of healthy eye and extrafoveal point of the affected eye.
d. Suppresion of the extrafoveal image by the squinting eye.
e. Presence of amblyopia
Q.42 Refraction in a 5 years old child having ‘‘Partial Amblyopia” in one eye revealed a refractive error of
+2.0 D Sph in the Rt. and +3.5 0 D Sph in the Lt. Eye.What type of amblyopia is in the Lt. eye.
a. Anisometropic amblyopia
b. Isoametropic amblyopia
c. Refractive amblyopia
d. Stimulation deprivation amblyopia
e. Strabismus amblyopia
Q.43 In the treatment of amblyopia, the occlusion is applied:

a. Intermittently on both the eyes
b. On the normal straight eye
c. On the squinting eye
d. Simultaneously on both the eyes
e. Till the age of 15 years
Q.44 The orthoptic exercises to achieve and improve range of binocular functions are done with:
a. Madox wing
b. Ophthalmoscope
c. Retinoscope
d. Slitlamp biomicroscope
e. Synoptophore
Q.45 In strabismus amblyopia, the suppression of image by the squinting eye is at:
b. Macula
b. Optic chiasma
d. Optic radiation
e. Visual cortex
Q.46 In diplopia charting, the images are dissociated by wearing red- green goggles. The maximum
separation of the images is:
a. In the direction of action of the paretic muscle
b. In the direction opposite to the action of the paretic muscle
c. In the direction of action of ipsilateral antagonist
d. In the direction of action of contralateral antagonist
e. In the primary position
Q.47 Worth’s four dot test is done to determine:

a. Diplopia
b. Fusion
c. Hetrotrpias
d. Latent squint
e. Steropsis
124
Q.48 In worth four-dot test if all four lights are seen in the absence of a manifest deviation, the interpretation
is that:
a. BSV is present
b. Diplopia is present
c. Harmonious ARC is present
d. Suppression
e. Unharmonious ARC is present
Q. 49 In worth four-dot test if all four lights are seen in the presence of a manifest deviation, the
interpretation is that:
a. BSV is present
b. Diplopia is present
c. Harmonious ARC is present
d. Suppression
e. Unharmonious ARC is present
Q.50 A 5 years old healthy looking boy having normal VA and straight eyes for distance develops esotropia
while concentrating on near objects. In your opinion what is the diagnosis:
a. Mixed accommodative esotropia
b. Non refractive accommodative esotropia.
c. Non- accommodative esotropia
d. Refractive accommodative esotropia
e. Stress esotropia
Q.51 A 3 years old healthy looking boy has esotropia which is more for the near than at distance. In your
opinion what is the diagnosis?
a. Childhood esotropia
b. Mixed accommodative esotropia
c. Non refractive accommodative esotropia.
d. Non- accommodative esotroia
e. Refractive accommodative esotropia
Q.52 Parents of a 4 years old child complain of inward deviation of right eye while seeing at near objects.
After examination, the diagnosis of non-refractive accommodative esotropia was made. This
esotropia is associated with:
a. Normal AC/A ratio
b. High AC/A ratio
c. Low AC/A ratio
d. High Hypermetropia
e. High myopia
Q.53 In Alternate deviations, the treatment of choice is:

a. Cosmetic squint surgery
b. Orthoptic exercises
c. Prescription of glasses
d. Prescription of prisms
e. Refractive surgery
Q.54 In the treatment of paralytic squint, the occlusion is applied :

a. Intermittently on both the eyes
b. On the squinting eye
c. On neither eye
d. Simultaneously on both the eyes
e. The normal straight eye
125
Q.55 In the surgery on an extraocular muscles, 1mm recession/resection corrects about:

a. 1 degrees of deviation
b. 2 degrees of deviation
c. 3 degrees of deviation
d. 4 degrres of deviation
e. 5 degrees of deviation
Q. 56 Surgery on extraocular muscles in paralytic squint is carried out:

a. 3 months after the paralysis.
b. 6 months after the paralysis.
c. 9 months after the paralysis.
d. 12 months after the paralysis
e. 15 months after the paralysis
Key
Q.1 a Q.11 b Q.21 c Q.31 e Q.41 c Q.51 b
Q.2 b Q.12 b Q.22 c Q.32 b Q.42 a Q.52 b
Q.3 c Q.13 d Q.23 a Q.33 a Q.43 b Q.53 a
Q.4 d Q.14 b Q.24 e Q.34 b Q.44 e Q.54 b
Q.5 c Q.15 c Q.25 e Q.35 d Q.45 e Q.55 b
Q.6 e Q.16 c Q.26 b Q.36 d Q.46 a Q.56 b
Q.7 e Q.17 c Q.27 b Q.37 d Q.47 a
Q.8 d Q.18 c Q.28 c Q.38 e Q.48 a
Q.9 b Q.19 b Q.29 d Q.39 d Q.49 c
Q.10 d Q.20 b Q.30 b Q.40 b Q.50 b
Chapter-15
The Light & Refractive Errors

126
Q.1 The visible spectrum of light is between

a. 200 – 500 nm
b. 200-400 nm
c. 3oo- 600 nm
d. 400-700 nm
e. 500- 800 nm
Q.2 In reflection of light by a plane mirror :

a. The angle of incidence is > angle of refraction
b. The angle of incidence is < angle of refraction
c. The angle of incidence is = angle of refraction
d. The incident ray, the emergent ray & normal lie on different planes
e. The image produced is real and inverted
Q.3 When light rays strike an angulated glass surface :

a. Neither the velocity decreases nor the rays are bent
b. The velocity decreases & rays are bent
c. The velocity of light decrease to 1/2
d. The rays pass straight and undeviated
e. The velocity of light remains same
Q.4 In refraction by a prism :

a. Light rays are refracted equally irrespect of their wavelengths
b. Refraction by prisms The light rays with longer wavelength are refracted more
c. The light rays with shorter wavelength are refracted less
d. The light rays with shorter wavelength are refracted more
e. The light rays with medium wave length are refracted more
Q.5 The major refracting surface of the eyeball is :

a. Anterior surface of cornea
b. Anterior surface of lens
c. Posterior surface of cornea
d. Posterior surface of lens
e. Vitreous
127
Q.6 I mm change in axial length of the eyeball leads to a refractive error of:
a. 1diopter
b. 2 diopters
c. 3 diopters
d. 4 diopters
e. 5 diopters
Q.7 1 mm change in radius of curvature of the cornea leads to a refractive error of:
a. 2 diopters
b. 3 diopters
c. 4 diopters
d. 5 diopters
e. 6 diopters
Q.8 The most common cause of reduced vision in the world is:
a. Corneal opacities
d. Refractive errors
e. Trachoma
Q.9 According to WHO definition, a person is considered blind when:

a. Vision in better eye is < 2/60 or VF is <30 degrees in the better eye
b. Vision in better eye is < 3/60 or VF is < 30 degrees in the better eye
c. Vision i s < 3/60 and VF is < 20 degrees in the bettr eye
d. Vision is < 3/60 and VF is < 40 degrees in the better eye
e. Vision is not > HM
Q.10 Retinoscopy is done to:

a. Determine the refractive error of an eye
b. Determine the axial length of the eye
a. See the retinal details
d. See opacities in the media
e. Determine the power of IOL
Q.11 In retinoscopy, with movement of the fundus glow means:

a. Astigmatism
b. Emetropia
c. Hypermetropia, emetropia or myopia < 1D
d. Myopia 1D
e. Myopia >1D
Q.12 In retinoscopy, the against movement of the funds glow means:

a. Hypermetropia >1D
b. Myopia of 1D
c. Myopia >1D
d. Myopia < 1D
e. Emetropia
128
Q.13 In retinoscopy , no movement of the funds glow means:

a. Astigmatism
b. Hypermetropia >1D
c. Myopia = 1D
d. Myopia >1D
e. Emetropia
Q.14 Colour vision is tested by:

a. Anomaloscope
b. Amblyoscope
c. Gonioscope
d. Ophthalmoscope
e. Snellen’s test type
Q. 15 Congenital colour blindness is due to absence of red, green or blue cones. The red- green deficiency is
most common in males and transmitted as:
a. Autosomal recessive
b. Autosomal dominant
c. Mitochondrial inheritance
d. X-linked recessive
e. X- linked dominant
Q.16 The biconcave lenses are used to correct :

a. Hypermetropic astigmatism
b. Hypermetropia
c. Myopia
d. Myopic astigmatism
e. Presbyopia
Q.17 A biconcave lens when moved in front of the eyes, the objects:
a. Appear larger than normal in size
b. Appear distorted
c. Move against the movement of lens
d. Move with the movements of the lens
d. Objects appear larger in size
e. Size of objects remains unchanged
Q.18 In mixed astigmatism :

a. Both foci are in front of retina
b. Both foci are behind the retina
c. One focus is in front of and other behind the retina
d. One in front of and other on the retina
e. One on the retina and other behind the retina
Q.19 Myopia in an adult individual is best treated by:

a. Contact lenses
b. Clear lens extraction and intraocular lens implantation
c. LASEK
d. Prescription of glasses
129
e. RK
Q.20 The hard contact lenses are made up of:

a. Acrylic
b. Glass material
c. HEMA (Hydroxyethyle methacrylate)
d. PMMA (Polymethyle methacrylate)
e. Silicon
Q.21 The soft contact lenses are made up of

a. Acrylic
b. HEMA
c. Methyle cellulose
d. PMMA
e. Silicon
Q.22 The most common complication in contact lens users is:

a. Conjunctival allergy to preservative in cleansing solutions
b. Corneal ulceration
c. Corneal vascularization
e. Uveitis
Q.23 Circumpapillary crescent is usually seen in which type of refractive error:

a. Astigmatism
b. Hypermetropia
c. Simple myopia
d. Pathological myopia
e. Presbyopia
Q.24 In accommodation, there is :

a. Decrease in size of eyeball
b. Increase in size of pupil
c. Increase in power of the cornea
d. Increase in power of the lens
e. Relaxation of ciliary muscles
Q.25 Manifestation of presbyopia in hypermetropes :

a. Does not occurs at all
b. Is called asthenopia
c. Occur at an earlier age than normal
d. Occurs at a later age than usual
e. Occurs at usual age of 40 years
Q.26 In testing VA, the Snellen’s test type is kept at a distance of :

a. 4 meter
b.5 meter
c. 6 meter
d. 8 meter
e. 10 meter
130
Q.27 In Snellen’s test type, the angle subtended at nodal point of eye by each letter is equal to:
a. 1 min angle
b. 2 min angle
c. 3 min angle
d. 4 min angle
e. 5 min angle
Q.28 Refraction was done in a 10 years old boy and prescribed +2.0 D. Sph / -1 D.cyl at 160 degrees . In
your opinion which type of refractive error the individual is having ?
a. Compound astigmatism
b. Irregular astigmatism
c. Hypermetropic astigmatism
d. Mixed astigmatism
e. Simple myopic astigmatism
Q.29 Hypermetropia is a refractive state in which:

a. Axial length of the eyeball is large
b. Correction is done with concave lenses
c. Parallel rays of light are focused behind the retina when the eye is at rest
d. Parallel rays of light are focused in front of the retina when the eye is at rest
e. The near vision is alright
Q.30 Most of the infants are born with :

a. Astigmatism
b. Anisometropia
c. Hypermetropia
d. Emetropia
e. Myopia
Q31. The small children are born with hypermetric refractive error because the :
a. Axial length of eyeball is small
b. Curvature of cornea is less
c. Curvature of anterior surface of lens is more
d. Heriditary and genetically determined
e. Refractive index of lens is high
Q.32 Myopia is a refractive state in which:

a. Axial length of eyeball is short
b. Corneal curvature is less
c. Convex lenses are prescribed
d. Patient can see far objects clearly when he exerts accommodation
e. The image forms in front of the retina when the eye is at rest
Q.33 Myopia is the condition which is:
a. Also called far sightedness
b. Corrected by concave glasses
c. Corrected by convex glasses
d. Corrected by cylinder glasses
e. Les common than hypermetropia
131
Q.34 Myopia of less than 6 diopters should be:

a. Fully corrected
b. Left as such till the age of adolescence
c. Over corrected
d. Treated surgically
e. Under corrected
Q.35 Myopia of more than 6 diopters should be:

a. Fully corrected
b. Left as such till the age of adolescence
c. Over corrected
d. Treated surgically
e. Under corrected
Q.36 The most accepted etiology in the development of myopia is:

a. Deficiency of essential nutrients
b. Excessive use of accommodation and convergence
c. Endocrine disturbances
d. Heriditary and genetically determined
e. Vascular congestion of eyes due to dependent position of the head
Q.37 Circumpapillary crescent is usually seen in which type of refractive error:

a. Astigmatism
b. Hypermetropia
b. Simple myopia
d. Pathological myopia
e. Presbyopia
Q.38 The type of staphyloma most commonly seen in pathological myopia is:
a. Anterior staphyloma
b. Ciliary staphyloma
c. Equatorial staphyloma
d. Intercalary stsphyloma
e. Posterior stsphyloma
Q.39 A 25 years old female presents with decreased visual acuity while reading books. On retinoscopy at 1
meter, the neutralization is at + 3.50 DS in all meridians.. The most probable diagnosis is :
a. Hypermetropic astigmatism
b. Hypermetropia
c. Myopia
d. Myopic astigmatism
e. Presbyopia
Q.40 A 55 years old male complains of gradual decrease in distant vision during the last few years. O/E the
distant VA is 6/24 in both the eyes but he can read news paper at 25 cm without presbyopic
correction. What is the most probable explanation for his problem?
a. Astigmatism
b. Age related macular degeneration
c. Hypermetropia
d. Lenticular myopia
132
Q.41 A young boy of 16 years presents with H/O gradual deterioration of VA in both the eyes. On
retinoscopy there was high myopic astigmatism. What is the likely diagnosis.
a. Buphthalmos
b. Cornea plana
c. Keratoglobus
d. Keratoconus
e. Megalocornea
Q.42 In refractive errors visual acuity improves with pinhole. The best explanation of this phenomenon is
that:
a. A single ray of light passes through it and reaches the optic disc
b. Central rays passing through the nodal point converge to reach fovea
c. Central rays passing through the nodal point to reach fovea centralis undeviated
d. Central rays passing through the nodal point diverge to reach fovea
e. Central rays pass through nodal point and focus behind the eye
Q.43 A young boy of about 13 years presents with history of dimness of far and near vision. Retinoscopy
revealed simple myopic astigmatism. In simple myopic astigmatism:
a. One image is formed at the retina and the other in front of it.
b. One image is formed on the retina and the other behind it
c. One image in front of and other behind the retina
d. The error is corrected by prescribing convex lenses.
e. The error is corrected by prescribing concave lenses.
Q.44 An old man operated for cataract is having aphakia in his one eye. Which one of the following options
is the best way to correct this condition?
a. Contact lenses
b. High powered Concave lenses
c. High powered Convex lenses
d. Lasik
e. Secondary Intra ocular lens implantation
Q.45 when the radius of curvature of anterior surface of cornea is less than normal, it will be associated with
which type of refractive error ?
a. Astigmatism
b. Ametropia
c. Hypermetropia
d. Myopia
e. Presbyopia
Q.46 Which one of the following diseases has an association with hypermetropia?
a. Buphthalmos
b. Cornea plana
c. Hypertension
d. Primary open angle glaucoma
e. Secondary open angle glaucoma
Q.47 Which type of refractive error is associated with nuclear cataract?

a. Axial myopia
133
b. Index myopia
c. Axial hypermetropia
d. Index hypermetropia
e. Presbyopia
Q.48 An anisometropic patient was prescribed +4.00 D.Sph in one eye and -2.0 D.Sph in the other eye by a
house surgeon. After a few days the patient reported in OPD again. What might be the most annoying
problem with that patient?
a. Diplopia
b. Glare
c. Headache
d. Photophobia
e. Tunnel vision
Q.49 The maximum retinal image size disparity between the two eyes to maintain binocular single vision is:
a. 2%
b. 3%
c. 4%
d. 5%
e. 10%
Q.50 Retinoscopy is the method to determine refractive error of a patient. It is done in a dark room at a
distance of;
a. ½ meter
b. 1 meter
c. 2 meter
d. 3 meter
e. 6 meter
Q.51 On retinoscopy, when the two eyes have different refractive errors, the condition is called :
a. Anisokonia
b. Anisometropia
c. Ametropia
d. Astigmatism
e. Emetropia
Q. 52 A 45 years old man complains of defective near vision. O/E the unaided distant vision is 6/6 and near
vision N12. What is the type of refractive error called ?
a. Astigmatism
b. Emetropia
c. Hypermetropia
d. Myopia
e. Presbyopia
Q.53 Refraction in a 2 years old child is done under cycloplegia. In clinical practice we use which of the
following eye drops for this purpose?
b. 1% cyclopentolate eye drop
c. 0.5 % Cyclopentolate eye dops
d. 10 % Penyle ephrine eye drops
e. 1% Tropicamide eye drops
134
Q.54 In irregular astigmatism there are so many irregularities in the curvature of the cornea and on
retinoscopy, no geometrical figure is formed. This state is better corrected by:
a. Cylindrical lenses
b. Corneal refractive procedures
c. Hard contact lenses
d. Simple spherical glasses
e. Spherocylindrical corrective lenses
Q.55 Common early complication of photorefractive surgery is:

a. Corneal haze
b. Glare
c. Pain
d. Uveitis
e. Watering
Q.56 The most recent, predictable and frequently performed refractive procedure is:
a. Clear lens extraction and IOL implantation
b. Laser in situ keratomileus (LASIK)
c. Laser epithelial keratomileus (LASEK)
d. PRK (Photorefractive keratectomy)
e. RK ( Radial keratectomy)
Key
Q.1 d Q.9 b Q.17 d Q.25 c Q.33 b Q.41 d Q.49 d
Q.2 c Q.10 a Q.18 c Q.26 c Q.34 a Q.42 c Q.50 b
Q.3 b Q.11 c Q.19 c Q.27 e Q.35 e Q.43 a Q.51 b
Q.4 a Q.12 c Q.20 d Q.28 d Q.36 d Q.44 e Q.52 e
Q.5 a Q.13 c Q.21 a Q.29 c Q.37 d Q.45 d Q.53 c
Q.6 c Q.14 a Q.22 a Q.30 c Q.38 e Q.46 b Q.54 c
Q.7 e Q.15 d Q.23 d Q.31 a Q.39 b Q.47 b Q.55 b
Q.8 d Q.16 c Q.24 d Q.32 e Q.40 d Q.48 a Q.56 c

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1

Dr.Col (R) Iftikhar Ahmed

Rahbar Medical & Dental College, Lahore

6 The uveal tract 46

10 The optic nerve 93

11 Abnormalities of pupil & optic pathways 102

12 The Orbit 106

13 The Ocular injuries 112

14 The ocular motility & strabismus 117

15 The light & refractive errors 126

Q.1 The eyelids develop from:

Q.2 The eyelids remain united with each other until:

Q.3 The glands associated with eye lash follicles include:

Q.4 Meibomian glands are:

Q.5 The lymphatics of eyelid drain in to:

Q.6 Levator palpebrae superioris ( LPS) muscle is supplied by:

Q.7 Chalazion is a painless nodular swelling of eyelid. It is:

Q.10 Hordeolum internum is the acute suppurative infection of :

Q.17 The most important complication of trichiasis is:

Q.21 Lagophthalmos is the condition in which there is:

d. A fold of skin in the medial canthus

Q.23 Ankyloblephron is the condition in which;

Q.24 In seborrhoeic blephritis there is :

Q.25 Posterior blephritis is due to:

Q.27 Ectropion is the condition in which the :

Q.28 Entropion is the condition in which the:

Q.29 The commonest type of entropion in older age group is:

Q.31 Paralytic ectropion is caused by :

Q.32 Epiblephron is a rare congenital condition in which the:

Q.33 The Wies operation is done to treat:

Q.34 Mild medial ectropion is corrected surgically by:

Q.39 The commonest variety of ptosis is:

Q.43 The most common cause of congenital myogenic ptosis is:

Q.46 Severe ptosis with poor LPS action is best treated by :

d. Modified wheelers operation

Q.53 Basal cell CA of the eye lid is:

Q.59 The lesion in spreading meibomian gland carcinoma simulates:

Q.2 b Q.10 d Q.18 c Q.26 c Q.34 c Q.42 b Q.50 b Q.58 e

Q.3 b Q.11 e Q.19 c Q.27 d Q.35 a Q.43 a Q.51 c Q.59 d

Q.4 c Q.12 d Q.20 b Q.28 c Q.36 b Q.44 d Q.52 e

Q.5 c Q.13 a Q.21 d Q.29 c Q.37 b Q.45 b Q.53 e

Q.6 c Q.14 c Q.22 b Q.30 a Q.38 d Q.46 e Q.54 e

Q.7 b Q.15 c Q.23 a Q.31 d Q.39 b Q.47 a Q.55 e

Q.8 b Q.16 d Q.24 c Q.32 b Q.40 e Q.48 a Q.56 a

The nasolacrimal system & Dry eyes

Q.1 The lacrimal fossa is formed by:

Q.7 Maximum drainage capacity of nasolacrimal system in a normal individual is:

Q.10 Nasolacrimal duct opens in to the:

Q.11 The narrowest part of the nasolacrimal duct is:

Q.12 The bulk of tears is secreted by:

Q.16 The basal lacrimal secretion is secreted by:

Q.18 In Conjunctival xerosis due to Vit. A deficiency (xerophthalmia) there is:

Q.21 Standard Schirmer test is performed for:

Q.26 1% rose Bengal dye used in KCS will stain :

Q. 29 The site of obstruction in congenital nasolacrimal duct block is at :

Q.39 The commonest cause of dacryoadenitis is:

Q.41 Dry eyes in Sjogren’s syndrome are usually associated with:

Q.43 The lacrimal sac swelling in nasolacrimal duct obstruction presents: