Ophthalmology Questions and Answers





1. Regarding Steroid injection for treatment of chalazion :
a) Is not preferable if chalazion is close to the lacrimal punctum
b) Between 0.2 and 2 ml of 5 mg /ml triamcinolone diacetate aqueous suspension
c) 0.2 and 2 ml of 5 mg /ml dexamethasone
d) The success rate following one injection is about 50%

Answer: b

2. Which of the following is not a differential diagnosis of squamous cell papilloma ?
a) Viral wart
b) Seborrhoeic keratosis
c) Intradermal naevus
d) Chalazion

Answer: d

3. which of the following is not a synonym of Basal cell papilloma ?
a) Seborrhoeic keratosis
b) Seborrhoeic wart
c) Actinic keratosis
d) Senile verruca

Answer: c

4. Actinic keratosis
a) Is typically affect young people
b) Is common rapid – growing lesion
c) It affects individuals who have been exposed to excessive sunlight
d) It has high potential for transformation into squamous cell carcinoma

Answer: c

5. Capillary haemangioma :
a) Is rare tumor of infancy
b) The female to male ratio is 7: 1
c) It have predilection for the lower lid
d) It blanches on pressure and may swell on crying

Answer: d

6. Ocular features of sturge – weber syndrome include all of the following except one:
a) Ipsilateral glaucoma
b) Iris haemangioma
c) Iris heterochromia
d) Diffuse choroidalheamangioma

Answer: b

7. Young patients who suffer from the following conditions have no potential to develop eyelid malignancies :
a) Xeradermapigmentosum
b) Gorlin – Goltz syndrome
c) Muir – Torre syndrome
d) Neurofibromatosis

Answer: d

8. Regarding basal cell carcinoma :
a) 90% of cases occur in the head and neck and about 30% of these involve the eyelid
b) It most frequently arises from the upper eyelid , followed in relative frequency by medial canthus , lower eyelid and lateral canthus
c) It most frequently affects young patients
d) The tumor is slow – growing and locally invasive but not metastasizing

Answer: d

9. Regarding squamous cell carcinoma :
a) SCC is typically less aggressive tumor than BCC
b) It metastasis to regional lymph nodes in about 50%
c) SCC accounts for 20% of eyelid malignancies
d) The tumor may exhibit perineural spread to the intracranial cavity via the orbit

Answer: d

10. Clinical types of SCC include all of the following except :
a) Nodular SCC
b) Noduloulcerative SCC
c) Ulcerating SCC
d) Cutaneous horn

Answer: b

11. The clinical types of sebaceous gland carcinoma include all of the following except:
a) Nodular SGC
b) Spreading SGC
c) Sclerosing SGC
d) Pagetoid spread

Answer: c

12. Radiotherapy in the treatment of malignant eyelid tumors is contraindicated in all the following except:
a) Medial canthalBCC
b) Upper eyelid tumors
c) Aggressive tumors such as sclerosing BCC ,SCC and SGC
d) Kaposi sarcoma

Answer: d

13. The causes of acquired trichomegaly include all of the following except:
a) Malnutrition
b) AIDS
c) Hyperthyroidism
d) Familial

Answer: c

14. which one of the following is not ocular cause of polliosis:
a) Chronic anteriorblepharitis
b) Sympathetic ophtlalmitis
c) Idiopathic uveitis
d) Vitiligo

Answer: d

15. Chronic blepharitisis not associated with:
a) Tear film instability
b) Chalazion formation
c) Viral keratitis
d) Contac lens intolerance

Answer: c

16. The classification of ptosis include all of the following except :
a) Neurogenic
b) Myogenic
c) Aponeurotic
d) Pesudoptosis

Answer: d

17. The age related changes that contribute toinvolutionalectropioninclude all of the following except:
a) Vertical lid laxity
b) Lateral canthal tendon laxity
c) Medial canthal tendon laxity
d) Disinsertion of lower lid retractors

Answer: a

18. Which treatment modality is not considered in the treatment of over – riding in involutionalentropion :
a) Transvers everting sutures
b) Wies procedure
c) Lateral canthal sling or a full–thickness wedge excision
d) Jones procedure

Answer: c

19. The causes of lid retraction include all of the following except:
a) Myogenic
b) Neurogenic
c) Mechanical
d) Congenital

Answer: a

20. Regarding bleplarochalasis:
a) Conman condition
b) Characterized by recurrent episodes of painful , non – pitting oedema of both upper lids
c) Usually resolves spontaneouslyafter few months
d) Treatment involves blepharoplasty for redundant upper lid skin and correction of ptosis

Answer: d

21. The associations with floppy eyelid syndrome include all the following except :
a) Keratoconus
b) Skin hyperelasticity
c) Joint hypomobility
d) Obstructive sleep apnoea

Answer: c

22. Contrast dacryocystogrophy :
a) To confirm the site of lacrimal drainage obstruction , especially , prior to surgery
b) Not used to diagnose diverticuli , fistula and filling defects caused by stones or tumors
c) The test is not usually performed on both sides simultaneously
d) It should be performed in patient with acute dacryocystitis

Answer: a

23. The treatment options in secondary punctual stenosis include all the following except:
a) Ziegler cautery
b) Medial conjunctivoplasty
c) Lower lid tightening
d) Upper lid tightening

Answer: d

24. The causes of nasolacrimal duct obstruction include all the following except :
a) Idiopathic stenosis is rare
b) Noso – orbital trauma and previous nasal and sinus surgery
c) Granulomatous disease
d) Infiltration by nasopharyngeal tumours

Answer: a

25. The advantages of endoscopic DCR over conventional DCR include all the following except :
a) Lack of a skin incision
b) Shorter operating time
c) Minimal blood loss
d) High risk of cerebrospinal fluid leakage

Answer: d

26. The ophthalmoplegia caused by all the following except :
a) An orbital mass
b) Splinting of the optic nerve by an optic nerve sheath meningioma
c) Tethering of extra ocular muscles or fascia in a blow – out fracture
d) Non –restrictive myopathy

Answer: d

27. The pathogenesis of lid retraction include all the following except :
a) Fibrotic contracture of levator
b) Secondary over action of levator – superior rectus complex
c) Humorally – induced overaction of Muller muscle
d) 6th nerve palsy

Answer: d

28. The surgical procedures for lid retraction include all the following except :
a) Mullerotomy
b) Radiotherapy
c) Recession of lower lid retractors
d) Botulinum toxin injection

Answer: b

29. The most common causative organisms for bacterial orbital cellulitis include all the following except :
a) S. pneumonia
b) S. aureus
c) Diphetheria
d) H . influenzae

Answer: c

30. The ocular complication of bacterial orbital cellulitis include all the following except :
a) Exposure keratopathy
b) Ocular hypotony
c) Occlusion of the central retinal artery or vein
d) Endophthalmitis

Answer: b

31. Intracranial complications of bacterial orbital cellulitis (all true except) :
a) Meningitis
b) Brain abscess
c) Cavernous sinus thrombosis
d) Sub periosteal abscess

Answer: d

32. Regarding Tolosa‐ Hunt syndrome (all true except ):
a) is a diagnosis of exclusion
b) It is a common condition
c) Caused by non – specific granulomatous inflammation of the cavernous sinus ,superior orbital fissure and/ or orbital apex
d) Its clinical course characterized by remissions and recurrences

Answer: b

33. Lymphangiomas are :
a) Neoplasms
b) Functional
c) Malignant
d) Vascularmalformations

Answer: d

34. The types of classification of carotid – cavernous fistulae include all the following except:
a) Aetiological
b) Hemodynamics
c) Pathological
d) Anatomical

Answer: c

35. Regarding direct carotid – cavernous fistula :
a) Representing80% of all cases
b) Also called dural shunt
c) Trauma is responsible for 10% of cases
d) Middle – aged hypertensive women are at particular risk

Answer: d

36. Regarding superficial dermoid cyst :
a) Painful nodule
b) Most commonly located in the inferotemperal part of the orbit
c) C T shows a homogenous well – circumscribed lesion
d) Treatment is by excision in toto

Answer: d

37. Associations with encephalocele (all true except):
a) Broad nasal bridge and cleft palate
b) Microphthalmos
c) Neurofibromatosis
d) Morning glory syndrome

Answer: c

38. Regarding capillary haemangioma :
a) Boys are affected more commonly than girls
b) Is the least common tumor of the orbit and periorbital areas in childhood
c) The tumor is composed of anastomosing small vascular channels without true encapsulation
d) Present only as a small isolated lesion of minimal clinical significance

Answer: c

39. The indications of treatment of capillary haemangioma include all the following except:
a) Amblyopia secondary to induced astigmatism , anisometropia and occlusion
b) Optic nerve compression
c) Exposure keratopathy
d) Painand tenderness

Answer: d

40. Regarding cavernous haemangioma:
a) Is avascular malformation that occurs in children
b) It has a female preponderance of 40%
c) Although it may develop anywhere in the orbit , it most frequently occurs within the medial part of the muscle cone just behind the globe
d) It's histologyshows endothelial – lined vascular channels of varying size separated by fibrous septae

Answer: d

41. Pleomorphic lacrimal gland adenoma:
a) Also called malignant mixed – cell tumor
b) Presentation is in the 1st decade with painful slowly progressive proptosis
c) Treatment involve surgical excision
d) Prognosis is poor even if the excision is complete and without disruption of the capsule

Answer: c

42. Regarding lacrimal gland carcinoma (all true except) :
a) Is a rare tumor which carries a high morbidity and mortality
b) Presentation is in the 4th – 5th decades with a history shorter than that of a benign tumour
c) CT shows a globular lesion with irregular serrated edges , often with contiguous erosion or invasion of bone
d) Biopsy is not necessary to establish the histological diagnosis

Answer: d

43. Optic nerve glioma:
a) Histology shows spindle – shaped pilocytic astrocytes and glial filaments
b) Presentation is most frequently in the 2nd decade( median age 14 years )
c) Proptosis often axial
d) MR may be not useful in showing intracranial extension

Answer: a

44. Optic nerve sheath meningioma :
a) Presentation is with sudden unilateral visual impairment
b) The classical triad is visual loss , optic atrophy and opticociliary shunt vessels
c) CT shows fusiform enlargement of optic nerve
d) Prognosis for life is very poor in adults

Answer: b

45. Enculation ( removal of the globe) is indicated in the following circumstances ( all true except ):
a) Primary intraocular malignancies
b) After sever trauma
c) Blind painful or unsightly eyes
d) Orbital mucormycosis

Answer: d

46. Crouzon syndrome :
a) Inheritance is usually AR
b) The gene (F G F R 2) has been isolated to chromosome 10
c) Proptosis due to shallow obits is rare conspicuous feature
d) Cataract and glaucoma not associated with it

Answer: b

47. Apert syndrome (all true except ) :
a) Inheritance is AD
b) Also called acrocephalosyndactyly
c) Is the most severe of the craniosynostose and may involve all the cranial sutures
d) Ocular associations include blue sclera , coloboma and megalo cornea

Answer: d

48. The causes of meibomian gland dysfunction include all the following expect :
a) Anterior blepharitis
b) Rosacea
c) Atopic kertaconjunctivitis
d) Congenital meibomian gland absence

Answer: a

49. The Causes of lagophthalmos include all thefollowing except :
a) Severeproptosis
b) 3rd nerve palsy
c) Eyelid scarring
d) Following blepharoplasty

Answer: b

50. Sjogren syndrome :
a) Characterized by infection of lacrimal and salivary glands
b) Primary Sjogren syndrome affects males more commonly than females
c) Presentation is in adult life with qrittiness of the eyes and dryness of mouth
d) Diagnostic tests include schirmer test and biopsy of lacrimal gland

Answer: c

51. Schirmer test :
a) The test involves measuring the amount of witting of a special (no.40 what man) filter paper , 5 mm wide and 70 mm long
b) The filter paper removed from the eye after 1 minute
c) Less than 10 mm of wetting after 5 minute , without anesthesia and less than 6 mm with anesthesia is considered abnormal
d) Single schirmer test used as the sole criterion for diagnosing dry eye

Answer: c

52. Conjunctival discharge
a) Watery discharge occurs in acute viral or chronic allergic conjunctivitis
b) Mucoid discharge is typical of acute allergic conjunctivitis and dry eye
c) Mucopurulent discharge typically occurs in acute viral conjunctivitis
d) Severe purulent discharge is typical of gonocococal infection

Answer: d

53. The causes of true conjunctival membrane include all the following except
a) Severe adenoviral conjunctivitis
b) Gonococcal conjunctivitis
c) Ligneous conjunctivitis
d) Chronic Stevens ‐ Johonsan syndrome

Answer: d

54. The most common isolates in Acute bacterial conjunctivitis are (all true except ) :
a) S. pneumonia
b) S. aureus
c) Strep. Cocci
d) H. influenza

Answer: c

55. Incubation period of chlamydia trachoma's is about :
a) 1 week
b) 2 week
c) 5 days
d) 20 days

Answer: a

56. Trachoma is associated principally with infection by serovars (all true except )
a) A
b) B
c) Ba
d) D – K

Answer: d

57. Antibiotics used in management of trachoma include all the following expect
a) A single dose of azithromycin (20mg/kg up to1g )
b) Erythromycin 500mg b.d for 14 days in an alternative forwomen for Child bearing age
c) Doxycycline 100mg b.d for 10 days
d) Topical 1% tetracycline ointment for 6 weeks

Answer: c

58. The percentage of silver nitrate that use as prophylaxis for neonatal conjunctivitisis
a) Silver nitrate 1% solution
b) Silver nitrate 2% solution
c) Silver nitrate 3% solution
d) Silver nitrate 4% solution

Answer: a

59. The presentation of adenoviral conjunctivitis include all the following except :
a) Non – specific ocule follicular conjunctivitis
b) Pharyngoconjunctival fever
c) Epidemic keratoconjunctivitis
d) Acute / relapsing adenoviral conjunctivitis

Answer: d

60. Pharnygoconjunctival fever is a caused by adenovirus serovars (all true expect ):
a) 3
b) 4
c) 17
d) 7

Answer: c

61. Epidemic keratoconjunctivitis is caused by adenovirus serovars (all true except) :
a) 8
b) 17
c) 19
d) 37

Answer: b

62. Incidence of keratitis in epidemic keratoconjunctivitis is:
a) 50%
b) 60%
c) 80%
d) 20%

Answer: c

63. Peak incidence of molluscumcontagiosum conjunctivitis is between the age :
a) 2 and 4 years
b) 10 and 14 years
c) 5 and 10 years
d) 20 and 25 years

Answer: a

64. Keratopathy associated with vernal keratoconjunctivitisoccur in the fallowing forms : (all true except )
a) Epithelial macroerosions
b) Plagues and shield ulcers
c) Subepithlial scares
d) Inferior punctate epithelial erosions

Answer: d

65. Recurrance of pterygium after simple excision( bare sclera technique) is about :
a) 60%
b) 80%
c) 40%
d) 20%

Answer: b

66. The adult corneal endothelial cell density is about
a) 1000 cells /mm2
b) 1500 cells /mm2
c) 2500 cells /mm2
d) 4000 cells /mm2

Answer: c

67. The number of cornel endothelial cells decreases per year at about :
a) 0.2%
b) 0.6%
c) 0.9%
d) 1 %

Answer: b

68. The causes of interpalpebral punctate epithelial erosions include all the following expect :
a) Dry eye
b) Reduced corneal sensation
c) Ultra violet keratopathy
d) Toxicity to drops

Answer: d

69. Causes of corneal filaments are ( all true expect ):
a) Superior limbic keratoconjunctivitis
b) Neurotrophic keratitis
c) Long – term ocular patching
d) Herpes zoster keratitis

Answer: d

70. The bacteria that are able to penetrate a normal cornealepitheliuminclude all the following expect :
a) N. gonorrhea
b) Pseudomonas aeruginosa
c) N. meningitides
d) C. diphtheria

Answer: b