OPH Semester 2 exam
OPH Semester 2 Exam Quiz
Test your knowledge and skills with our comprehensive OPH Semester 2 Exam Quiz, designed specifically for ophthalmology students and professionals. This quiz covers a wide range of topics related to ocular health and diseases, ensuring you are well-prepared for your exams.
Whether you are looking to reinforce your learning or just challenge yourself, this quiz offers:
- Detailed multiple-choice questions
- Coverage of recent advancements and classic knowledge
- A chance to review important concepts in ophthalmology
1. Which factor is most strongly correlated with the development of choroidal effusion following panretinal photocoagulation?
systemic hypertension.
increasing age.
male gender.
total retinal surface area treated.
short axial length ( < 23 microns).
2. Which of the following is a poor prognostic sign in a patient with nonproliferative diabetic retinopathy?
numerous cotton-wool spots.
numerous microaneurysms.
extensive intraretinal microvascular abnormalities.
extensive exudate.
neovascularization (NV) of the disc.
3. Risk factors for progressive visual loss in agerelated macular degeneration (AMD) include all of the following except:
hyperopia.
smoking.
light iris color.
hypertension.
family history of visual loss caused by AMD.
4. Which laser is best for retinal photocoagulation in the setting of dense cataract or vitreous hemorrhage?
a. Xenon arc.
b. Argon blue-green.
c. Argon green.
d. Krypton red.
e. Dye yellow.
5. The finding most frequently associated with degenerative retinoschisis is:
a. Peripheral cystoid degeneration.
b. Bullous retinoschisis.
c. Reticular retinoschisis.
d. Rhegmatogenous retinal detachment (RRD).
e. Retinal dialysis.
6. The most common cause of redetachment following initially successful surgical repair of rhegmatogenous retinal detachment (RRD) is:
a. Occult retinal breaks.
b. New retinal breaks.
c. Inadequate retinopexy.
d. Proliferative vitreoretinopathy (PVR).
e. Failure to relieve vitreoretinal traction adequately.
7. The key prognostic factor in predicting postoperative visual acuity following surgical repair of rhegmatogenous retinal detachment (RRD) is:
a. The size of the largest retinal break.
b. The number of retinal breaks.
c. The presence and duration of macular detachment.
d. The presence or absence of lattice degeneration.
e. The presence or absence of myopia
8. Early sign of Retinitis pigmentosa is :
Arteriolar attenuation
RP sin pigmento
Retinitis punctata albescens
bone specules
waxy disc
9. Which of the following conditions would define a central retinal vein occlusion (CRVO) as
Nonischemic?
a. Mild vessel dilatation.
b. Mild disc edema.
c. Lack of significant parafoveal leakage on fluorescein angiography (FA).
d. Lack of significant capillary nonperfusion on FA.
e. Visual acuity better than 20/60.
10. Which is the outermost layer supplied by the central retinal circulation?
a. Ganglion cell layer.
b. Inner plexiform layer.
c. Inner nuclear layer.
d. Outer plexiform layer.
e. Outer nuclear layer.
11. Which of the following macular lesions is most likely to be associated with a complete posterior vitreous detachmetn(PVD)?
Macular epiretinal membrane
Impending (Stage 1) idiopathic macular hole
Vitreomacular traction syndrome
Diabetic traction macular detachment
Macular scar
12. Which of the following conditions is generally not associated with Purtscher’s or Purtscher like retinopathy?
a. Systemic lupus erythematosus (SLE).
b. Thrombotic thrombocytopenic purpura (TTP).
c. long-bone fractures.
d. Chronic renal failure.
e. Hepatic encephalopathy
13. A 65 year old asian man has an acute submacular haemorrhage in one eye and a serosanguinous retinal pigment epithelial detachement in the other eye . Which one of the following is the Most likely diagnosis?
Doyen’s honeycomb macular dystrophy
Macular telangiectasia
Polypoidal choroidal vasculopathy
Retinal vasculitis
Central serous chorioretinopathy
14. Which one of the following statements about asteroid hyalosis is false?
a. It is more common with aging.
b. It is more commonly bilateral.
c. It is generally associated with no decrease in visual acuity
d. The vitreous is otherwise normal.
e. The particulate matter seen clinically consists of calcium soaps.
15. Which one of these is an early pathological feature of diabetic retinopathy?
Capillary basement membrane thinning
Increased retinal blood flow
Loss of capillary pericytes
Retinal capillary closure
Increase hard exudates
16. Cigarette smoking has been most strongly associated with which manifestation of age-related macular degeneration?
a. Hard drusen.
b. Soft drusen.
c. Focal retinal pigment epithelium (RPE) hyperplasia.
d. Choroidal neovascularization.
e. Geographic atrophy.
17.What test is generally accepted as a method for determining chloroquine toxicity?
Visual acuity testing
Visual Field testing (Humphrey 10-2) with a red target
Serum chloroquine level
Total dose of chloroquine
Amsler grid anormalities
18. Nerve fibre bundle defect can not occur in patients with:
Drusen in the optic nerve head
Exophthalmos
Occlusion of the central retinal artery
Retrobulbar neuritis
Opticochiasmatic arachnoiditis
19. An individual born without red-sensitive cone pigment function (protanopia) is likely to
have poor visual acuity
confuse blue and yellow
perceive the long-wavelength portion of the spectrum as being darker than normal
manifest photophobia
be hypersensitive to green
20. Which of the following conditions would define a central retinal vein occlusion (CRVO) as nonischemic?
a. Mild vessel dilatation.
b. Mild disc edema.
c. Lack of significant parafoveal leakage on fluorescein angiography (FA).
d. Lack of significant capillary non perfusion on FA.
e. Visual acuity better than 20/60.
21. Findings in a patient with von Hippel-Lindau disease may include all of the following except:
a. café-au-lait spots.
b. Pancreatic and renal cysts.
c. Hemangioblastomas of the brainstem.
d. Renal cell carcinoma.
e. pheochromocytoma.
22. The best predictor of future contralateral visual loss in a patient with a disciform macular scar from presumed ocular histoplasmosis syndrome (POHS) is the presence or absence of:
a. A focal macular scar in the better eye.
b. Peripapillary scarring in the better eye.
c. Active vitritis in the better eye.
d. Symmetric peripheral punched-out lesions of each eye.
e. anti-Histoplasma antibodies.
23. What diagnosis should be considered in a 30-year-old man with a history of bilateral
Giant retinal tears, cleft palate, severe myopia, severe arthritis requiring a total hip replacement, and a family history of severe arthritis and blindness?
a. Ehlers-Danlos syndrome.
b. Marfan’s syndrome.
c. Stickler’s syndrome.
d. Wagner’s syndrome.
e. Weill-Marchesani syndrome.
24. Which one of the following statements about retinitis pigmentosa (RP) is false?
a. In Leber’s congenital amaurosis, the infant is typically blind at birth.
b. In Leber’s congenital amaurosis, the electroretinogram (ERG) is typically nonrecordable at birth.
c. In Leber’s congenital amaurosis, the fundus examination is typically normal at birth.
d. A variety of congenital RP is associated with macular coloboma and skeletal abnormalities.
e. The most common pattern of inheritance in congenital RP is autosomal dominant.
25. Preservation of central acuity past the age of 45 in a patient with a retinal degeneration and an X-linked inheritance pattern suggests the diagnosis of:
a. Recessive cone–rod degeneration.
b. Gyrate atrophy.
c. Refsum’s disease.
d. choroideremia.
e. Usher’s syndrome type I.
26. Regarding the Subfoveal New Choroidal Neovascularization (CNV) Study, coordinated by the Macular Photocoagulation Study, each of the following is true, except:
a. With lesions < 3.5 disc areas, eyes assigned to laser treatment lost more acuity over the short term (3 to 6 months) than untreated eyes.
b. With lesions < 3.5 disc areas, treated eyes lost less acuity over the long term (1 to 3 years).
c. With lesions <3.5 disc areas, reading speed results paralleled those for visual acuity.
d. With lesions <3.5 disc areas, contrast sensitivity results paralleled those for visual acuity.
e. At the outset of the study, patients with lesions > 3.5 disc areas or initial acuity better than 20/80 were excluded.
27. Results of the Endophthalmitis-Vitrectomy Study (EVS) are applicable to which group of patients?
a. Any patient with presumed exogenous bacterial endophthalmitis.
b. Any patient with presumed bacterial endophthalmitis within 1 year of intraocular surgery.
c. Any patient with presumed bacterial endophthalmitis within 6 weeks of cataract surgery.
d. Any patient with presumed bacterial endophthalmitis within 6 weeks of cataract or filtration surgery.
e. Any patient with presumed bacterial endophthalmitis within 6 weeks of cataract surgery or trauma.
28. Among patients with initially nonperfused (ischemic) central retinal vein occlusion (CRVO), which one of the following is not a risk factor for the development of at least 2 hours of iris or angle neovascularization (NV)?
a. > 30 disc areas of nonperfusion.
b. Male gender.
c. duration <1 month.
d. Severe intraretinal hemorrhage.
e. Cigarette smoking.
29. Argon laser photocoagulation for exudative agerelated macular degeneration (AMD) has been shown to be effective in reducing the rate of severe visual loss or preserving visual function among which categories of the disease except ?
extrafoveal (>200 microns from the center of the foveal avascular zone) choroidal neovascularization (CNV).
juxtafoveal CNV (1 to 199 microns from the center of the foveal avascular zone).
subfoveal CNV.
juxtafoveal pigment epithelial detachment.
30. The single most important physical property of perfluoropropane (C3F8) gas rendering it useful as a vitreous substitute in vitreoretinal surgery is its:
a. High interfacial surface tension.
b. High vapor pressure.
c. High specific gravity.
d. High index of refraction.
e. High viscosity.
31. Connective tissue septa in the subepithelial space are responsible for the development of which inflammatory morphology?
a. papillae.
b. follicles.
c. phlyctenules.
d. Herbert’s pits.
e. Giant papillae.
32. A corneal ulcer, recalcitrant to routine treatment, is rescraped for special staining and cultures. The Gram stain is reported as growing moderate diphtheroids. Which special stain is most likely to be of value in determining the actual diagnosis?
Ziehl-Neelsen stain.
Warthin-Starry stain.
methenamine silver stain.
Giemsa stain.
periodic acid-Schiff (PAS) stain.
33. The most common ocular manifestation of cryptococcal infection is:
a. Membranous conjunctivitis.
b. Orbital cellulitis.
c. Lid abscesses.
d. Endogenous endophthalmitis.
e. Ulcerative keratitis.
34. Which of the following disorders is most likely to respond quickly to topical antihistamine therapy?
a. Season allergic conjunctivitis.
b. phlyctenulosis.
c. Atopic keratoconjunctivitis.
d. Giant papillary conjunctivitis (GPC).
e. Vernal keratoconjunctivitis.
35. The scleritis most likely to be associated with rheumatoid arthritis is:
a. Diffuse anterior scleritis.
b. Nodular anterior scleritis.
c. Necrotizing scleritis with inflammation.
d. Scleromalacia perforans.
e. Posterior scleritis.
36. The key structure preventing local invasion of squamous cell carcinoma of the cornea is:
epithelial basement membrane.
Bowman’s zone.
corneal stroma.
Descemet’s membrane.
endothelium.
37. Which of the following corneal dystrophies is the most disabling visually?
a. Anterior membrane dystrophy.
b. Reis-Bückler dystrophy.
c. Meesman’s dystrophy.
d. Central cloudy dystrophy.
e. pre-Descemet’s dystrophy.
38. Contact lens fitting is usually most challenging for patients with:
a. keratoconus.
b. keratoglobus.
c. Pellucid marginal degeneration.
d. Posterior keratoconus.
e. microcornea.
39. Persistent epithelial defects of the donor cornea following penetrating keratoplasty (PKP) are
Likely to be seen in all of the following except:
a. Ocular cicatricial pemphigoid (OCP).
b. Alkali burns.
c. keratoconus.
d. Keratoconjunctivitis sicca.
e. Herpes zoster ophthalmicus (HZO).
40. Indications for conjunctival flap surgery include all of the following except:
a. Bullous keratopathy.
b. Chronic painful band keratopathy.
c. Neurotrophic ulceration.
d. Large perforation in the bed of an infectious corneal ulcer.
e. Severe surface disruption with pain following chemical alkali burn.
41. The patient with bilaterally narrow anterior chamber angles and normal intraocular pressure (IOP) should probably undergo which of the following tests?
a. Thymoxamine test.
b. Topical steroid challenge.
c. Oral water challenge.
d. The prone-dark room test.
e. careful, depressed, dilated examination.
42. What is the most common type of congenital cataract?
a. complete.
b. nuclear.
c. lamellar.
d. cerulean.
e. Capsular
43. Which of the following is generally not a cause of increased episcleral venous pressure?
a. Thyroid ophthalmopathy.
b. Orbital varix.
c. Superior vena cava syndrome.
d. Sturge-Weber syndrome.
e. Contralateral carotid artery stenosis.
44. Which of the following substances has the highest index of refraction?
a. air.
b. cornea.
c. Vitreous humor.
d. polymethylmethacrylate (PMMA).
e. high-index refractive lenses.
45. The dorsal midbrain syndrome is associated with all of the following except:
a. Upward gaze paresis.
b. Accommodative abnormalities.
c. light-near dissociation.
d. Lid retraction.
e. Paradoxic optokinetic nystagmus (OKN).
46. Which of the following would not normally be found in congenital nystagmus?
a. oscillopsia.
b. Normal visual acuity.
c. Paradoxic optokinetic nystagmus (OKN).
d. Amplitude dampened by convergence.
e. Amplitude increased by fixation.
47. Which visual field defect is most likely to be associated with seesaw nystagmus?
a. Central scotoma.
b. Bitemporal hemianopia.
c. Incongruous hemianopia.
d. Congruous hemianopia.
e. A visual field defect should not be associated with seesaw nystagmus.
48. Which of the following disorders is clearly associated with optic nerve drusen?
a. migraines.
b. Pseudotumor cerebri.
c. Giant cell arteritis (GCA).
d. Retinitis pigmentosa.
e. Normal tension glaucoma.
49. The management of neovascular glaucoma includes
A. Peripheral laser iridoplasty
B. Miotics
C. Selective laser trabeculoplasty
D. Cyclodestruction
E. Unaugmented filtration surgery
50. Laser trabeculoplasty is contraindicate in which of the following conditions?
A. Previous laser trabeculoplasty
B. Pseudophakia
C. Fuchs endothelium dystrophy
D. Pigmentary glaucoma
E. Inflammatory glaucoma
51. Which of the following is true regarding Acute Angle Closure Glaucoma?
A. There are no racial differences
B. Can be caused by pharmacological dilation
C. Myopia is a risk factor
D. Is more common in males
E. Is a uniocular disease
52. Which is the more common sign in normal-tension glaucoma?
A. Parapapillary atrophy
B. Disc hemorrhage
C. Arcuate retinal nerve fiber layer defect
D. Shallow cupping with optic nerve pit
E. Glaukomflaken
53. Which is correct about the stereoscopic disc photography?
A. The ability to detect change is not related to image quality
B. The interobserver variability is one of the limitations of this instrument
C. Clinical examination can detect disc hemorrhage better than the stereoscopic disc photography
D. The strereoscopic disc photography describes optic disc quantitative change
E. This technique is the gold standard for detecting generalize nerve fiber layer defect
54. What of the followings is less important for glaucoma progression evaluation?
A. Good baseline documents
B. Appropriate frequency of follow up
C. Periodically risk assessment
D. Frequent imaging by various instruments
55. What is the principle of gionoscopy?
A. Visualization of anterior chamber angle
B. Overcoming the internal reflection
C. Diagnosing the glaucoma patients
D. Estimate width of the angle approach
56. A 60-year-old woman presents with red eye, OS. She was diagnosed as secondary glaucoma, OS and start anti-glaucoma medications for 3 months. Left eye examination reveals small cystic-like nodules all over the bulbar and tarsal conjunctiva. Which of the following medication is most likely to be the cause?
A. Brinzolamide
B. Bimatoprost
C. Brimonidine
D. Betaxolol
E. Timolol
57. A 75-year-old woman has had acute attack of angle closure glaucoma on right eye for 2 days. Eye examination reveals VA: Hm right eye, 6/12 right eye and IOP 52, 14 mmHg, respectively. Right eye shows marked corneal edema, a very narrow angle with nearly flat anterior chamber and mid-dilated pupil. After given anti-glaucoma medications, what is the next step that should be performed?
Laser iridotomy
B. Laser iridoplasty
C. Paracentesis to reduce pressure
D. Trabeculectomy with mitomycin - C
E. Glaucoma shunt surgery
58. A 45-year-old man with chronic angle closure glaucoma had undergone uneventful trabeculectomy with mitomycin C. One week after the operation, he developed uniform shallow anterior chamber. The IOP was 40 mmHg. The bleb was low. Which is the most likely diagnosis in this patient?
Encapsulated bleb
Pupillary block
Expulsive suprachroidal hemorrhage
Malignant glaucoma
Steroid induced glaucoma
59. Laser trabeculoplasty is contraindicate in which of the following conditions?
Previous laser trabeculoplasty
Pseudophakia
Fuchs endothelium dystrophy
Pigmentary glaucoma
Inflammatory glaucoma
60. In modern cataract surgery, the post-operative refractive results are usually within 0.50 D of the pre-operative intention. Sometimes post-operative refractive errors are more than 1 D of pre-operative prediction, which is called “post-operative surprise”. Which of the following conditions is least likely to be the cause of “post-operative surprise”?
Pre-op dry eye
Residual astigmatism
3 mm. Clear corneal incision at 12 o’clock
0.25 mm. of IOL decentration
IOL dislocation
61. Which of the following is true regarding cataracts associated with systemic diseases?
A. Atopic dermatitis causes posterior polar cataract
B. Myotonic dystrophy causes Christmas tree cataract
C. Steroids cause anterior subcapsular cataract
D. Wilson’s syndrome causes snowflake cataract
E. Diabetes causes sunflower cataracts
62. The first day following cataract surgery, high IOP can be due to the following condition
A. Retinal detachment
B. Retained viscoelastic material
C. Descemet's detachment
D. Subconjunctival hemorrhage
E. Wound leak
63. In manual small incision cataract surgery with an unsutured wound
There is usually flattening of the cornea in the axis of the incision
There is usually steepening of the cornea in the axis of the incision
The postoperative astigmatism is unpredictable
The risk of endophthalmitis is less than it is for a sutured wound
The risk of cystoid macular oedema is less than it is for a sutured wound
64. Which of the following systemic diseases is NOT associated with ectopia lentis?
A. Homocystinuria
B. Ehlers-Danlos syndrome
C. Marfan syndrome
D. Myotonic dystrophy
E. Sulfite oxidase deficiency
65. In performing phacoemulsification through clear corneal incision, all of the followings helps to decrease the incidence of “wound burn”, EXCEPT:
Larger incision especially in the cases of hard nucleus
Decrease level of vacuum setting
Use ultrasound in pulse mode
Use phacoemulsification system with torsional or transversal ultrasound
Use balance salt solution with lower temperature
66. Cataract associated with Down’s syndrome usually presents as
A. Anterior subcapsular cataract
B. Scattered punctate cataract
C. Nuclear cataract
D. Christmas tree cataract
E. Posterior subcapsular cataract
67. During phacoemulsification, you notice that the anterior chamber is shallow. What is the management?
A. Decrease power
B. Increase vacuum
C. Decrease bottle height
D. Decrease aspiration flow rate
E. Extend the corneal incision
68. A 60 year-old women presents with eye injection and retained lens fragments 3 mm in the vitreous cavity. After phacoemulsfication for 1 month. What would be the best treatment option?
A. Continue observation
B. Aggressive topical anti-inflammation
C. Vitrectomy and removal of lens fragment
D. Intravitreal steroid injection
E. Re-operation and remove lens fragment with phacoemulsification handpiece
69. Retinitis Pigmentosa can be:
an inherited condition with a “bone spiculed” fundus appearance causing loss of central vision
a sporadic condition with a “salt and pepper” fundus appearance causing loss of peripheral vision
an inherited condition with a “bone spiculed” fundus appearance causing loss of peripheral vision
a sporadic condition with a "bone spiculed fundus" appearance causing loss of peripheral vision
an inherited condition with a “salt and pepper” fundus appearance causing loss of central vision
70. A 78 year old patient presents to accident and emergency complaining of sudden loss of the superior visual field in one eye. On ophthalmoscopy, a yellow plaque is noted in the arterioles of the inferior temporal arcade and the inferior retina appears white and swollen. The investigations most likely to identify the source of this problem are:
Carotid doppler ultrasound and echocardiography
CRP and ESR
Ocular coherence tomography (OCT)
MRI brain and orbits
Thyroid function testing
71. A 54 year old woman has had type 1 diabetes for 40 years and presents to the ophthalmology clinic for retinopathy screening by the resident. On dilated fundus examination the resident notes the patient has scattered microaneurysms, several dot haemorrhages and a small area of new blood vessels at an A-V crossing. The resident is likely to:
Diagnose no retinopathy and follow the patient up in a year
Diagnose background diabetic retinopathy and follow the patient up in a year
Diagnose clinically significant macula oedema and seek the advice of an ophthalmologist
Diagnose proliferative diabetic retinopathy and seek the advice of an ophthalmologist
Diagnose vitreous haemorrhage and seek the advice of an ophthalmologist
72. Dry (atrophic) age related macular degeneration:
Is characterised by new vessel formation at the macula
Is treatable with intravitreal injections
Is rapidly progressive, leading to loss of central vision
Is rapidly progressive, leading to loss of central and peripheral vision
Is characterised by hard drusen at the early stages
73. Wet (exudative) age related macular degeneration
May be treatable with intravitreal injections
Is slowly progressive, leading to loss of central vision over many years
Is a type of ocular diabetic complication
Commonly follows toxoplasmosis infection
Is characterised by flame shaped haemorrhages
74. Papilloedema can be associated with:
Swelling of the optic nerve head
venous dilation
absent spontaneous venous pulsation
retinal exudates
all of the above
75. Bitemporal hemianopia can be localized to:
Optic chiasm
Optic nerve
Occipital cortex
Parietal lobe
Temporal lob
76. Homonymous hemianopia can be localized to:
Optic nerve
Ipsilateral parietal lobe
Ipsilateral temporal lobe
Contralateral occipital lobe
Ipsilateral occipital lobe
77. Differential Diagnosis for proptosis in an adult would include:
Thyroid Eye Disease
Neurofibromatosis
Optic nerve glioma
Optic nerve meningioma
All of the above
78. You are in the middle of a well-child check in your rooms and note that the pupil reflex in a 13 month old child you are examining is not red but white. You think back to your Ophthalmology rotation in your final year of medical school and try to remember the possible ocular conditions that may present with a white pupil reflex. What would be the most important of the differential diagnosis to consider for leukocoria?
Retinoblastoma
Congenital cataract
Corneal scar
Toxocariasis
None of the above
79. Ocular involvement in thyroid dysfunction develops more frequently and is more severe among
Young adults
Female smokers
Diabetics
Obese adults
Males
80. Neurofibromatosis is typically
Autosomal recessive
Autosomal dominant
X linked
Mitochondrial linked
None of the above
81. The most common initial site of metastasis for a choroidal melanoma is
Bone
Brain
Lung
Liver
None of the above
82. Which is the FALSE statement? Rhabdomyosarcoma:
Is the most common orbital malignancy of childhood
Can present with sudden proptosis
Is treated with surgical resection, chemotherapy and radiation therapy
Can be confused with orbital cellulitis
Is typically very slow in onset with a gradual proptosis
83. Which of the following statements regarding topical alpha adrenergic agonists is false?
Interact with certain antidepressants
Worsen asthma attacks
Should be used cautiously in severe cardiovascular disease
Most commonly used are alpha-2-selective agents
Are prone to tachyphylaxis
84. Down syndrome is not associated with a higher risk of
Cataracts
Optic neuritis
Blepharitis
Strabismus
Amblyopia
85. Multiple Sclerosis is commonly associated with
Conjunctivitis
Scleritis
Optic neuritis
Uveitis
Iritis
86. Keratitis All of these diagnostic tests are useful in evaluation a patient with a retained magnetic intraocular foreign body except:
Indirect ophthalmoscopy
Computed tomography
Electrophysiology
Magnetic resonance imaging (MRI)
Echography
87. Sturge-Weber Syndrome?
Is usually bilateral
Is always inherited in an autosomal dominant pattern
Is more common in males
Is rarely associated with glaucoma
May be associated with glaucoma in infants
88. All of the following are risk factors for cystoid macular edema after cataract surgery except:
Diabetes mellitus
Flexible open-loop anterior chamber IOL implantation
Ruptured posterior capsule
Marked postoperative inflammation
Vitreous loss
89. Which of the following statements about cataract surgery in patients with diabetes is correct?
Patients with diabetes enrolled in the ETDRS who underwent cataract surgery did not show an immediate improvement in visual acuity.
Patients with diabetes with CSME should have cataract surgery performed prior to focal laser.
Patients with diabetes and high risk proliferative change visible through their cataract should ideally have scatter laser immediately before cataract extraction.
Patients with diabetes and high risk proliferative changes visible through their cataract should scatter laser 1 to 2 months prior to cataract extraction.
Preoperative phenylephrine drops for dilation are contraindicating in patients with diabetes undergoing cataract surgery.
90. Multiple evanescent white dot syndrome ( MEWDS) is characterized by each of the following clinical feature except:
Enlargement of the physiologic blind spot on visual field testing
Individual hyper fluorescent spots on fluorescein angiography arranged in a wreathlike patter around the fovea.
Typically presents with unilateral photopsias and loss of vision in young females with myopia.
Absence of cell in the anterior chamber
Granular appearance of the fovea
91. Which of the following statement s about strabismus secondary to thyroid ophthalmopathy is false?
It can be restrictive
It can be caused by extraocular muscle weakness
It usually is surgically corrected early after onset
It is unrelated to the degree of thyroid function
Both b and c are correct
92. A 65 years old women present with a progressively enlarging mass in the right inferior orbit. Distraction of the lower eyelid reveals a “salmon patch” appearance to the fornix. The most likely diagnosis is?
Reactive lymphoid hyperplasia
Lymphoma
Sebaceous carcinoma
Melanoma
Apocrine hidrocystoma
93. HLA-B27- associated acute anterior uveitis is associated with all except which of the following systemic disorders?
Behcet syndrome
Reiter syndrome
Psoriatic arthritis
Ankylosing spondylitis
Sturge-Weber Syndrome
94. Which is NOT a feature of Horner’s syndrome?
Enophthalmos
Miosis
Anhydrosis
Loss of ciliospinal reflex
Exophthalmos
95. Behcet syndrome is associated with all except which of the following?
Aphthous stomatitis
Arthritis
Gennital ulceration
Retinal vasculitis
Cataract
96. Congenital dacryocele?
Presents with mass above the medical canthal ligament
Usually responds to systemic antibiotics alone
Can be associated with an intranasal mucocele
Is best treated with incision and drainage through the skin
Usually indicates stenoisis of the bony nasolacrimal canal
97. Vision loss in Riley-Day syndrome is most often due to?
Cataracts
Optic nerve hypoplasia
Amblyopia
Cornea scarring
Glaucoma
98. The preferred therapy for infantile glaucoma is?
Topical beta blockers
Topical bromonidine
Trabeculotomy or goniotomy
Oral acetazolamide
laser trabeculotomy
99. Transposition: Identify the incorrect answer
[+ 1.00 / + 3.00 x 90 :+ 4.00 / - 3.00 x 180
[+ 5.00 / - 1.00 x 75 :+ 4.00 / + 1.00 x 165
[- 6.00 / + 2.50 x 125 : - 3.50 / -2.50 x 35
[– 3.00 / - 1.25 x 180 :- 4.25 / + 1.25 x 180
[+ 4.00/ - 3.00 x 180 :+1.00/ +3.00 x 90
100. Using Spherical Equivalent: Identify the incorrect answer
A. [+ 5.00 / -1.00 x 75 : + 4.50
B. [– 6.00 / + 2.50 x 125 : - 4.75
C. [– 3.00 / - 1.25 x 20 : + 1.75
D. [+ 2.00 / - 4.00 x 180 :plano
E. [+1.00 / - 2.00 x 90 :plano
101. A 9-month-old healthy full-term infant is brought in for evaluation of esotropia. The crossing started variably around 6-7 months of age and now is nearly constant. Vision is central, steady, and maintained in each eye. The deviation measures 30 ET’ by alternate cover testing. The ocular rotations show -1 limitation of voluntary abduction OU. The cycloplegic refraction is +4.0 sphere OU. The first step in treatment is:
neuroimaging
full-time alternate occlusion
glasses containing +4.00 sphere OU
glasses containing +2.00 sphere OU
glasses containing +3.00 sphere OU
102. A limbal corneal wound extends vertically on the nasal border of the cornea of the right eye of the patient. Postop course was uneventful but refraction showed the eye needed +3.00 x 180° astigmatic correction. The astigmatism may be decreased by:
placing additional sutures
removing the suture at the 180° meridian
clear lens extraction
an IOL
an Contact lens
103. Which one of the following represent a Jackson cross cylinder?
[+1.50 D -4.00 D × 180o
[+0.50 D -2.00 D × 180o
[+1.00 D -2.00 D × 180o
[+4.00 D -4.00 D × 180o
[+3.00 D -1.50 D × 180o
104. A patient’s refractive error is -2.00 D -1.00 D x 180o
How should we classify the refractive error of this patient?
A. Simple myopic astigmatism, with-the-rule
B. Simple myopic astigmatism, against-the-rule
C. Compound myopic astigmatism, with-the-rule
D. Compound myopic astigmatism, against-the-rule
E. Mixed astigmatism, with-the-rule
105. A child has a cycloplegic refraction OD +6.00 D, OS +2.00 D. What is the best way to manage the anisometropia?
A. Full correction
B. Partial correction
C. Pleoptic therapy
D. Occlusion therapy
E. Surgical management
106. The average posterior chamber intraocular lens power in an adult is
A. 35D
B. 30D
C. 25D
D. 20D
E. 15D
107. An object is 40 cm in front of a refracting surface of power +10.00 D. Which is the following is incorrect?
The object vergence is – 2.50 D
The image is 13.3 cm to the right of the lens
The image is real
The image vergence is – 7.50 D
The image is inverted
108. A prism diopter is:
A. The power needed to regard an image at infinity
The apparent displacement of a ray (in meters) at 1 cm
The apparent displacement of the image (in meters) at 1 m
The apparent displacement of a ray (in centimeters) at 1 m
The power needed to regard an image at near
109. Statements about extraocular muscles: Identify the incorrect answer
Inferior oblique is shortest
Superior oblique is longest and thinnest
Medial rectus is the largest muscle
Are approximately 40mm in length
The tendons of each are more than half the length of the muscle.
110. An exodeviation that is greater at distance than at near is known as:
basic exotropia
divergence excess exotropia
true divergence excess exotropia
simulated divergence excess exotropia
convergence insufficiency exotropia
111. Which of the following muscles does NOT originate from the annulus of Zinn?
A. Medial rectus
B. Lateral rectus
C. Superior rectus
D. Superior oblique
E. Inferior rectus
112. Each of the following is true regarding accommodative esotropia except:
always high AC/A ratio
usually intermittent at onset and becoming constant
Amblyopia is very common (>90%)
rarely develop diplopia
corrected by glasses.
113. What treatment is most appropriate as initial therapy for high accommodative convergence/accommodation (AC/A) esotropia?
A. Overminused spectacles
B. Alternate occlusion
C. Bifocal spectacles
D. base-in prism spectacles
E. base-out prism spectacles
114.At birth, the length of the average infant human eye is:
8 to 9 mm
12 to 13 mm
16 to 17 mm
20 to 21 mm
23 to 24 mm
115. The pupillary light reflex can be shown to develop at approximately what age?
20 week’s gestation
30 week’s gestation
40 week’s gestation
44 week’s gestation
39 week’s gestation
116. When used with prisms, which of the following is best suited for quantification of a tropia only, which no contribution from a phoria?
cover-uncover test.
alternate cover test
Maddox rod testing
simultaneous prism-cover test
double Maddox rod testing
117. The best way to measure the patient’s strabismus with intermittent XT is:(
Hirschberg test
Krimsky test
Maddox rod test
Prism and cover test
Bagolini lenses
118. Four weeks after bilateral medial rectus muscle recession, a patient presents with a new exotropia of 15 prism diopters. On examination, there is limited adduction of the right eye. What is the most likely diagnosis?
A. Anterior segment ischemia
B. Adherence syndrome
C. Conjunctival scarring
D. Slipped muscle
E. Lost muscle
119. Persistent hyperplastic primary vitreous is characterized by: except ()
A dehiscence in the posterior lens capsule
Secondary cataract
Glaucoma
Spontaneous intraocular hemorrhage
Bilateral occurrence
120. Leber’s optic atrophy: ()
Inheritence is AD
Primarily affects men in 2nd to 3rd decades of life
‘Salt and pepper’ appearance of fundus is a feature
Photophobia is a common symptom
Inheritence is AR
121. What is the mode of inheritance of incontinentia pigmenti? ()
A. Autosomal dominant
B. X-linked recessive
C. X -linked dominant
D. mitochondrial DNA defect
E. Autosomal recessive
122. What is the most common mode of inheritance of neurofibromatosis 1 (NF 1)? ()
A. Autosomal recessive
B. X -linked recessive
C. mitochondrial
D. Autosomal dominant
E. X-linked dominant
123. That is the most significant risk factor for developing retinopathy of prematurity? ()
A. Male sex
B. Gestational age
C. White race
D. Lung disease
E. Kidney disease
124.According to the findings from the Early Treatment for Retinopathy of Prematurity Study (ET-ROP), laser therapy should be initiated for patients with which type of ROP? (
Zone I, Stage 2
Zone I, Stage 3 with Plus disease
Zone III, Stage 1
Zone III, Stage 2
125. Which one of the following statements regarding Coats disease is true? (Answer is )
It has an autosomal dominant pattern of inheritance with variable penetrance.
It is usually bilateral
Males are affected more frequently than females.
It is usually diagnosed before 2 years of age.
X-lined recessive
126. Duane’s syndrome: What is false statement? (Answer is )
Is often acquired.
Does not resolve with time.
Type III is the rarest form.
Type I is common in the left eye of girls
Is often congenital
127. What is the most common mode of inheritance of neurofibromatosis 1 (NF1)?()
A. Autosomal recessive
B. X -linked recessive
C. Mitochondrial
D. Autosomal dominant
E. X-lined dominant
128. Risk factors related to Nasolacrimal duck obstruction, except: (Answer is )
A. Craniocynostosis
B. Down syndrome
C. Goldenhar syndrome
D. Clefting syndrome
E. Brown syndrome
129. A 54 years old man has been followed for a 2 mm thick and 8 mm wide pigmented choroidal lesion in the superotemporal quadrant. Which of the following signs may indicate malignant transformation?
A. Hyperplasia of RPE
B. Choroidal neovascularization
C. Increased in basal diameter
D. Nerve fiber layer infarction
E. Development of iris neovascularization
130. Which of the following is most helpful in the differentiation between an amelanotic melanoma and a choroidal metastatic lesion?
A. The greyish color of the tumor
B. A break through Bruch's membrane
C. Secondary subretinal neovascularization
D. Juxtapapillary location
E. The presence of subretinal fluid
131. Which one of the following conditions is associated with formation of iris granuloma?
A. Neurofibromatosis
B. Juvenile xanthogranuloma
C. Pseudoexfoliation syndrome
D. Pseudoxanthoma elasticum
E. Xanthelasma
132. Which of the followings is the location of calcium deposit in band keratopathy?
A. Basal epithelium
B. Epithelial basement membrane, Bowman’s layer & anterior stroma
C. Mid stroma
D. Posterior stroma and Descemet membrane
E. Descemet membrane and endothelium
133. Heinz body is found on cells from the anterior chamber aspiration. Which is the most likely diagnosis?
Uveitis from Herpes virus infection
Intraocular lymphoma
Ghost cell glaucoma
Siderosis
Sarcoidosis
134. A 48-year-old man has swelling medial to the inferior punctum with yellow discharge from the punctum. The punctum is red and pouting. Which of the following is the most appropriate management option?
Antibiotic and steroid eye drop
Oral antibiotic and steroid
curettage with possible incision of the punctum
dacryocystorhinostomy (DCR)
CDCR
135. A 65 years old woman presents with a progressively enlarging mass in the right inferior orbit distraction of the lower eyelid reveals a "salmon patch" appearance to the fornix. The most likely diagnosis is
A. Reactive lymphoid hyperplasia
B. Lymphoma
C. Sebaceous carcinoma
D. melanoma
E. Apocrine hidrocystoma
136. Which statement is true regard to the lacrimal gland?
A. The palpebral part is larger than the orbital part
B. Both palpebral and orbital portions have ductules that open separately into the conjunctiva
C. The ductules open into the conjunctiva at the upper border of the upper tarsus
D. Biopsy of the orbital part is more likely to impair tear production than biopsy of the palpebral part
E. Lacks of a true capsule
137. Which statement is true regard to the eyelids?
A. The tarsal plate is a continuation of the orbital septum
B. The meibomian glands secrete mucin rich secretion
C. The orifices of the meibomian glands are anterior to the root of eyelashes
D. The lower lid is supplied by the maxillary division of the trigeminal nerve exclusively
E. There are more meibomian glands in the lower than upper lids
138. A 25-year-old man, after motor vehicle accident, is evaluated in the emergency room for trauma to the left orbit. He has marked proptosis and an intraocular pressure of 45 mm Hg on the affected side. A CT scan shows intraorbital hemorrhage.
Which of the following actions would be the LEAST effective in acutely reducing intraocular pressure?
A. Lateral canthotomy and cantholysis
B. Administration of topical aqueous suppressants
C. Administration of intravenous mannitol
D. Administration of high-dose oral corticosteroids
E. Anterior chamber paracenthesis
139. Which of the following statements is true regarding the cornea?
A. Descemets membrane can regenerate
B. The Stroma is the thickest layer
C. Optical power is approximately 20 dioptres
D. The cornea does not induce astigmatism
140. A 45 year old farmer presented with a painful, watery blurred right eye one week after being hit in that eye by a tree branch. Examination conjunctival injection, an irregular corneal ulcer with stromal infiltration with feathered edges to the infiltrate.
What is the most likely diagnosis?
Viral keratitis
Fungal keratitis
Bacterial keratitis
Recurrent Corneal erosion syndrome
141. Which fat soluble vitamin is used in the treatment of xerophthalmia?
A. Vitamin A
B. Vitamin B6
C. Vitamin C
D. Vitamin D
E. Vitamin E
142. Valacyclovir is a prodrug of acyclovir used to treat herpetic keratitis. Which viral enzyme is responsible for its activation?
A. Neuraminidase
B. Haemagglutinin esterase
C. Thymidine kinase
D. RNA polymerase
143. Wound healing of the cornea takes place by
a) fibrovasculair proliferation
b) epithelial regeneration
c) the matrix dermatan glycoosaminoglycan
d). Chronic inflammation
144. The day after incision of the cornea is
a) migration of fibroblasts
b) contraction of the wound
c) degradation of glycosaminoglycans in the wound edge
d) epithelial regeneration of the wound
145. The most common tumor in adults oribta:
a malignant lymphoma
a metastasis of a tumor elsewhere
a uveamelanoom with extraocular extension
an idiopathic inflammatory pseudotumor
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