Download Neet PG Ophthalmology MCQs

Download Neet PG Ophthalmology MCQs Question Bank

1.Transducinisaproteinfoundin: a)Glomerulus b)Retina c)Skeletalmuscle d)Adrenalmedulla CorrectAnswer-BRetinaREF:Ganong22ndedition,chapter8,http://en.wikipedia.org/wiki/TransducinTransducin(alsocalledGt)isaheterotrimericGproteinthatisnaturallyexpressedinvertebrateretinarodsandcones.Mechanismofaction:HeterotrimericTransducin(alpha-beta-gammasubunits)isactivatedbyaconformationalchangeinrhodopsinduetotheabsorptionofaphotonbyrhodopsin'sactivegroupretinal.ActivationcausestheGDPboundtothealphasubunittobeexchangedwithGTPfromsolutionandresultsinactivatedalphadissociatingfrombeta-gamma.ActiveTransducin-alphathencausescyclicGMPPhosphodiesterasetoincreaseitsactivity,therebyloweringtheconcentrationofcGMP,anintracellularsecond-messengermolecule.DecreaseincGMPconcentrationleadstotheclosureofcGMP-regulatedNa+andCa2+ionchannelsandahyperpolarizedmembranepotential.Thischainofsignalingeventsisalsocalled"thevertebratephototransductioncascade"

2.Treatmentofmooren'sulceris? a)Cornealgraft b)Immunosuppressives c)Topicalsteroids d)Alloftheabove CorrectAnswer-DAlloftheaboveREF:Khurana4thedp.110MOOREN'SULCER:Severeinflammatoryperipheralulcerativekeratitis,chronicserpigenousorrodentulcerTreatment:1.Topicalcorticosteroids2.Immunosuppressiveswithsystemicsteroids,e.g.cyclosporine3.Softcontactlens4.Lamellarorfullthicknesscornealgrafting

3.Thepercentageofatropinepresentin atropinedropsascycloplegicis: a)0.5% b)1% c)4% d)2% CorrectAnswer-B1%

4.AllofthefollowingaretrueaboutKeratoconus,except: a)IncreasedcurvatureofcorneaAstigmatism b)Astigmatism c)K.Fringcornea d)Thickcornea CorrectAnswer-DThemainpathologicalchangesinKeratoconusarethinningandectasiaofthelenswhichoccurasaresultofdefectivesynthesisofmucopolysaccharideandcollagentissue.

5.Whichofthefollowingconditionisassociatedwiththedevelopmentofposterior staphyloma? a)Pathologicalmyopia b)Retinoblastoma c)Acidinjury d)Sympatheticophthalmia CorrectAnswer-APosteriorstaphyloma,theposterioroutpouchingofthewalloftheeye,isanimportantcomponentofthediagnosisofpathologicmyopia;indeed,itisoneofthehallmarksofpathologicmyopia.Withtheexceptionofinferiorstaphylomarelatedtotilteddiscsyndrome,itdoesnotoccurinpathologiesotherthanpathologicmyopia.Thus,thepresenceofstaphylomaisspecifictopathologicmyopiaandcriticallyimportantindifferentiatingsimpleschoolmyopiawithgoodbestcorrectedvisualacuity(BCVA)andpathologicmyopiathatcouldcausethelossofBCVA.

A30yearoldmanpresentstotheclinicwithpainintheeye,watering,rednessandphotophobia.Examinationofhiseyesshowscircumcornealcongestionandkeraticprecipitates. Assertion:KPsareproteinaceousdepositsoccurringinatriangularfashionintheinferiorpartofcornea. Reason:MuttonfatKPsareseeningranulomatousiridocyclitisandiscomposedofepitheloidcellsandmacrophages. a)BothAssertionandReasonaretrue,andReasonisthecorrect explanationforAssertion b)BothAssertionandReasonaretrue,andReasonisnotthe correctexplanationforAssertion c)Assertionistrue,butReasonisfalse d)Assertionisfalsebutreasonistrue CorrectAnswer-BKeraticprecipitatesareproteinaceousdepositsoccurringinatriangularfashionintheinferiorpartofcorneaduetoconvectioncurrentsintheaqueoushumor.MuttonfatKPsareseeningranulomatousiridocyclitisandiscomposedofepithelioidcellsandmacrophages.Theyareusually10-15innumber.Ref:ComprehensiveOphthalmologybyAKKhurana,4thEdition,Page142

7.TransportofAscorbicacidtolensisdonebywhichofthefollowing? a)Myoinositol b)Choline c)Taurine d)Na-KATPase CorrectAnswer-DThelensepitheliumistheprincipalsiteofenergyproductionofthelensthatisusedfortransportofinorganicionsandaminoacidsbyanactiveprocessinvolvingNaandKactivatedATPase.Ref:HistopathologyofPreclinicalToxicityStudies:InterpretationandRelevance...ByPeterGreaves,PeterGreaves(M.B.,Ch.B.),2007,Page896;TransportofvitaminCinthelens,CurrEyeRes.1987Jul;6(7):885-96;Adler'sPhysiologyoftheeye10thEdition,Page131;AscorbicacidandtheEye,AmJClinNutr1991;54:1198S-1202S.

8.Fundusfluoresceinangiographydoneinapatientfollowingcataractsurgery showsaflowerpetalpattern.WhatisheMOSTlikelysufferingfrom? a)Macularhole b)Cystoidmacularedema c)Centralserousretinopathy d)Noneoftheabove CorrectAnswer-BHeisshowingfeaturesofcystoidmacularedema.Cystoidmacularedemareferstoaconditioninwhichthereisfluidaccumulationinhoneycomblikespacesoftheouterplexiformandinnernuclearlayers.Fluoresceinangiographydoneshowsleakageoffluoresceindyefromtheperifovealretinalcapillariesandperipapillaryregion,andaccumulatinginaflower-petalpatternaroundthefovea.Itmostfrequentoccurfollowingcataractsurgery,especiallyifthesurgerywascomplicatedorprolonged.Itusuallymanifestsat4?12weekspostoperatively.Ref:FletcherE.C.,ChongN.,AugsburgerJ.J.,Corr?aZ.M.(2011).Chapter10.Retina.InP.Riordan-Eva,E.T.Cunningham,Jr.(Eds),Vaughan&Asbury'sGeneralOphthalmology,18e

9.Painfuleyemovementisafeatureof: a)Iridocyclitis b)Papilledema c)Cornealulcer d)Vernalcatarrh CorrectAnswer-AAnterioruveitis,alsoknownasiridocyclitisandiritis,istheinflammationoftheirisandanteriorchamber.Anywherefromtwo-thirdsto90%ofuveitiscasesareanteriorinlocation.Injection,photophobia,pain,andblurredvisionusuallyaccompanyiritis(anterioruveitisoriridocyclitis).Ref:BravermanR.S.(2012).Chapter16.Eye.InW.W.Hay,Jr.,M.J.Levin,R.R.Deterding,J.J.Ross,J.M.Sondheimer(Eds),CURRENTDiagnosis&Treatment:Pediatrics,21e.

10.KayserFleischerringisfoundinwhichlayerofcornea? a)Bowman'sCapsule b)Substantiapropria c)Descemet'smembrane d)Endothelium CorrectAnswer-CKayser-Fleischerringstaketheformofacrescenticrusty-browndiscolorationofthedeepestlayerofthecornea(Descemetmembrane).Inthepurelyhepaticstageofthedisease,theringsmaynotbeevident(in25percentofcases),buttheyarevirtuallyalwayspresent(ifproperlysought)oncetheneurologicsignsmanifests.Aslit-lampexaminationmaybenecessaryfortheirearlydetection,particularlyinbrown-eyedpatients,butinthemajorityofpatientswithneurologicsignstheringscanbevisualizedwiththenakedeyeorwiththeaidofanindirectophthalmoscopefocusedonthelimbus.AlsoKnow:Kayser-FleischerringsareasignofWilson'sdisease,whichinvolvesabnormalcopperhandlingbytheliverresultingincopperaccumulationinthebodyandischaracterisedbyabnormalitiesofthebasalgangliaofthebrain,livercirrhosis,splenomegaly,involuntarymovements,musclerigidity,psychiatricdisturbances,dystoniaanddysphagia.Thecombinationofneurologicalsymptoms,alowbloodceruloplasminlevelandKFringsisdiagnosticofWilson'sdisease. Ref:RopperA.H.,SamuelsM.A.(2009).Chapter37.InheritedMetabolicDiseasesoftheNervousSystem.InA.H.Ropper,M.A.Samuels(Eds),AdamsandVictor'sPrinciplesofNeurology,9e.

11.Placidodiscisusedfordiagnosingwhichofthefollowingcondition? a)Uveitis b)Keratoconus c)Retinoblastoma d)Retinaldetachment CorrectAnswer-BPlacidodiscexaminationisusedtodiagnosekeratoconus.Inacaseofkeratoconus,placidodiscexaminationshowsirregularitiesofthecircles. Placido'skeratoscopicdisc:Itisadiscpaintedwithalternatingblackandwhitecircles.Itmaybeusedtoassessthesmoothnessandcurvatureofcornealsurface.Normally,onlookingthroughtheholeinthecenterofdiscauniformsharpimageofthecircleisseenonthecornea.Distortionofthecirclesoccurwhenirregularitiesarepresentonthecornealsurface. Ref:ComprehensiveOphthalmologyByAKKhurana,4thedn,page119

12.Macularsparingisassociatedwithlesionsin: a)Opticnerve b)Lateralgeniculatebody c)Occipitalcortex d)Opticchiasma CorrectAnswer-CMacularsparing,thatis,lossofperipheralvisionwithintactmacularvision,isalsocommonwithoccipitallesionsRef:Ganong'sReviewofMedicalPhysiology23rdedition,Chapter12.

13.Allstatementsaretrueabouttrachoma except a)Trachomaiscausedbybedsonianorganismofpsittacosis- lymphogranuloma-trachoma(PLT)group. b)StrainsmainlyresponsibleareA,B,BaandC c)Markedpapillaryhyperplasiawithlimbalfolliclesareseenin stageIII d)Cornealulcerstionisacomplication CorrectAnswer-CC.i.e.MarkedpapillaryhyperplasiawithlimbalfolliclesareseeninstageIII>TrachomaiscausedbyaBedsonianorganism,theChlamydiatrachomatisbelongingtothePsittacosis-lymphogranulomatrachoma(PLT)group.>SerotypesA,B,BaandCareassociatedwithhyperendemic(blinding)trachoma,whileserotypesD-Kareassociatedwithparatrachoma(oculogenitalchlamydialdisease).>Congestionofuppertarsalandfornicealconjunctiva.2.Conjunctivalfollicles.Follicleslooklikeboiledsagograinsandarecommonlyseenonuppertarsalconjunctivaandfornix;butmayalsobepresentinthelowerfornix,plicasemilunarisandcaruncle.Sometimes,(folliclesmaybeseenonthebulbarconjunctiva(pathognomicoftrachoma).>Pannusi.e.,infiltrationofthecorneaassociatedwithvascularizationisseeninupperpart>GradingoftrachomaMcCallan'sclassificationMcCallanin1908,dividedtheclinicalcourseofthetrachomaintofollowingfourstages:StageI(Incipienttrachomaorstageofinfiltration).Itischaracterizedbyhyperaemiaofpalpebralconjunctivaandimmaturefollicles.

byhyperaemiaofpalpebralconjunctivaandimmaturefollicles.StageII(Establishedtrachomaorstageoffloridinfiltration).Itischaracterizedbyappearanceofmaturefollicles,papillaeandprogressivecornealpannus.Fig.4.14.TrachomatousHerbert'spits.AB66ComprehensiveOPHTHALMOLOGYStageIII(Cicatrisingtrachomaorstageofscarring).Itincludesobviousscarringofpalpebralconjunctiva.StageIV(Healedtrachomaorstageofsequelae).Thediseaseisquiteandcuredbutsequelaeduetocicatrisationgiverisetosymptoms.-Theclinicaldiagnosisoftrachomaismadefromitstypicalsigns;atleasttwosetsofsignsshouldbepresentoutofthefollowing:1.Conjunctivalfolliclesandpapillae2.Pannusprogressiveorregressive3.Epithelialkeratitisnearsuperiorlimbus4.Signsofcicatrisationoritssequelae.

14.Satellitenodulesareseenin a)Fungalcornealulcer b)Tuberculosis c)Sarcoidosis d)Viralulcer CorrectAnswer-AAi.e.Fungalcornealulcer

15.Herpetickeratitisistreatedby a)Analgesics b)Atropine c)Steroids d)Idoxuridine CorrectAnswer-DAns:Di.e.IdoxuridineDrugofchoiceforherpetickeratitisisAcyclovirQ(topical)OtherantiviraldrugsusedareIdoxuridineTrifluorothyrnidineVidarabine

16.Interstitialkeratitisisseeninallexcept: a)Syphilis b)Acanthamoeba c)HSVChlamydiaTrachomatis d)HZV CorrectAnswer-BBi.e.Achanthamoeba >acquiredsyphilis)Q-Herpetickeratitis(includingchickenpox; HSVisnowthemostcommoncause)Otherviralinfections(HSV, Herpeszoster,EpsteinBarr,mumps,measelsetc)-Tuberculosis, leprosy-Sarcoidosis-Trypanosomiasis,-Malaria-Cogan's syndrome(d/tchlamydinQetc)" v:shapes="_x0000_s1027">Interstitialkeratitis(IK) Interstitialkeratitis(IK)isnonsuppurativeinflammationofcornealstromawithoutprimaryinvolvementofepitheliumorendothelium.Inmostcasestheinflammationisanimmunemediatedprocesstriggeredbyanappropriateantigen.Immunestromalkeratitismanifestsasfocal,multifocalordiffusestromalopacitiesoranimmunering.Itisoftenaccompaniedbystromaledemaandmildanteriorchamberreaction,whilesparingepitheliumandendothelium.ItiscalledIKifaccompaniedbyvascularization.HSVQisnowthemostcommoncauseofIK(esp.unilateral).Unlikesyphilitic(luetic)IK,HSVneovascularizationisusuallysectoral&leadsuptostromalscar.-Syphilisrelated(congenital>>acquired)IKisusuallybilateral,althoughusuallynotsimultaneous.Itpresentswithcharacteristicsalmonpatchappearance,granulomatnusanteriorureitis,andghostvesselsandfeatherydeepstromalscarringinhealedstage.

-Cogan'ssyndromeischronicbilateraldeepnonsyphiliticIKwithvestibuloauditorychysfunction(i.e.neurosensorydeafness,vertigo&tinnitus)becauseofsystemicautoimmunevasculitis(lifethereateningin10%).Serumantibodiestovarious?infectiousagents(Lymedisease,Chalamydia,type1poliovirus)havebeenassociatedwithCogan'ssyndrome.

17.Anelderlymalewithheartdisease presentswithsuddenlossofvisioninoneeye;examinationrevealscherryredspot;diagnosisis: a)Centralretinalveinocclusion b)Centralretinalarteryocclusion c)Amaurosisfugax d)Acuteischemicopticneuritis CorrectAnswer-BBi.e.CentralRetinalArteryOcclusionCentralretinalarteryocclusioncharacteristicallypresentswithsuddenpainlesslossofvision,cherryredspot&cattle-truckappearanceQ(ofretinalveinsusually).Sourceofembolifromcarotidartery&heartdisease,andthrombusfromarteriosclerosisalongwithhypertension&arteritisarepredisposingfactors.

18.Primaryaimofretinaldetachmentsurgery a)Removalofvitreous b)Drainageofsubretinalfluid c)Vitrectomy d)Encirclage CorrectAnswer-DDi.e.EncirclageThemainobjectiveofthetreatmentofretinaldetachmentistosealandsupporttheretinalbreakQ.

19.Whichofthefollowingantiglaucoma medicationscancausedrowsiness? a)Latanoprost b)Timolol c)Brimonidine d)Dorzolamide CorrectAnswer-CCi.e.Brimonidine

20.Allaretrueregardingopticneuritis except: a)Decreasedvisualacuity b)Decreasedpupillaryreflex c)Abnormalelectroretinogram d)Abnormalvisualevokedresponseretinogram CorrectAnswer-CCi.e.AbnormalelectroretinogramElectroretinogramindicatestheactivityofretinal(esp.rods&cones)functionandhasnoroleinassessingthefunctionalintegrityoftheopticnerveQ.Soitcan'tbeabnormalinopticneuritis.

21.Vossiusringoccursin a)Lensdislocation b)Concussioninjury c)Penetratinginjury d)Extracapsularextraction CorrectAnswer-BBi.e.Concussioninjury

22.Inwhichofthefollowingconditions Berlin'sedemais a)Openangleglaucoma b)Aftercataractsurgery c)Afterconcussionaltrauma d)Diabeticretinopathy CorrectAnswer-CCi.e.AfterconcussiontraumaBlunttraumatoeyemayproduceBerlin'sedemaorcommotioretinaeQwhichisacloudyswellingcharacterizedbyagreyappaerance,mostfrequentlyinthetemporalregion.Itmayalsomanifestascherryredspotinthefovealregion.

23.Mucinlayertearflilmdeficiencyoccursin: a)Keratoconjunctivitissicca b)Lacrimalglandremoval c)Canalicularblock d)Herpetickeratitis CorrectAnswer-AAi.eKeratoconjunctivitissicca

24.Thenervewhichhasthelongest intracranialcourseis: a)Fourthcranialnerve b)Thirdcranialnerve c)Sixthcranialnerve d)Fifthcranialnerve CorrectAnswer-AAns.Fourthcranialnerve

25.Cornealsensationsaredecreasedinallof thefollowingconditionsexcept: a)Recurrentcornealerosionsyndrome b)Herpetickeratitis c)Neuroparalytickeratitis d)Leprosy CorrectAnswer-AAns.Recurrentcornealerosionsyndrome

26.Snellen'schartisusedtotest: a)Vision b)Refraction c)Presbyopia d)Colourblindness CorrectAnswer-AAns.Vision

27.AwaveinERGisduetoactivityof: a)Pigmentedepithelium b)Rodsandcones c)Ganglioncell d)Bipolarcell CorrectAnswer-BAns.Rodsandcones

28.Sturm'sconoidreferstoconfigurationof theraysrefractedthrough: a)Concavesphericalsurface b)Convexsphericalsurface c)Toricsurface d)Irregularsurface CorrectAnswer-CAns.ToricsurfaceSturmSConoidItisanopticalconditioninwhichtherefractivepoweroflensorcorneaisnotthesameinallmeridians,hencetwofocalpointsseparatedbyafocalintervalareformedwhichiscalledtheSturm'sConoid.

29.Softcontactlensesaremadeof: a)Polymethylmethacrylate b)Hydroxymethylmethacrylate c)Glass d)Silicone CorrectAnswer-BAns.Hydroxymethylmethacrylate

30.Astigmatismisconsideredtobe: a)Sphericalabberation b)Curvaturalametropia c)Axialametropia d)Indexametropia CorrectAnswer-AAns.Sphericalabberation

31.Visualaxisis a)Centerofcorneatoretina b)Objecttofovea c)Centeroflenstocornea d)None CorrectAnswer-BAns.Objecttofovea

32.Foster'sfusch'sspotsareseenin a)Hypermetropiea b)Myopia c)Astigmatism d)None CorrectAnswer-BAns.Myopia

33.Swimmingpoolconjunctivitisiscaused by a)Chlamydiatrachomatis b)Adenovirustype8 c)Adenovirustype8 d)Gonococcus CorrectAnswer-AAns.,Chlamydiatrachomatis

34.Goldenharsyndromeisassociatedwith whichprominentocularmanifestation: a)Microcornea b)Megalocornea c)Sclerocornea d)Epibulbardermoids CorrectAnswer-DAns.EpibulbardermoidsGoldenharsyndrome(oculoauriculovertebraldysplasiawithhemifacialmicrosomia)isararecongenitaldevelopmentalanomalyinvolvingthefirstandsecondbranchialarches.Theclassicfeaturesofthissyndromeincludeocularchangessuchasmicrophthalmia,epibulbardermoids,lipodermoidsandcoloboma;auralfeaturessuchaspreauriculartragi,hearinglossandmicrotia;andvertebralanomaliessuchasscoliosis,hemivertebraeandcervicalfusion.Otherocularanomaliesarerarebutincludemicrophthalmos,microcornea,anophthalmos,eyelidcolobomas,irisandchoroidcolobomas,motilitydisorders,strabismus,blepharoptosis,palpebralfissure,irisatrophy,polarcataract,anomalouslacrimaldrainagesystem,andretinalandopticnerveanomalies

35.Complicationofvernalkerato conjunctivitis: a)Cataract b)Keratoconus c)Retinaldetachment d)Vitreoushemorrhage CorrectAnswer-BAns.Keratoconus

36.Treatmentofvernalkeratoconjunctivitis includesallexcept: a)Steroids b)Chromoglycate c)Olopatadine d)Antibiotics CorrectAnswer-DAns.Antibiotics

37.Featuresofvernalconjunctivitisare: a)Shieldulcer b)Horner-Tranta'sspots c)Papillaryhypertrophy d)All CorrectAnswer-DAns.A,BandC

38.Pterygiumallaretrueexcept: a)Arisefromanypartofconjunctiva b)Cancauseastigmatism c)Surgeryistreatmentofchoice d)UVexposureisriskfactor CorrectAnswer-AAns.Arisefromanypartofconjunctiva

39.Neonatalconjunctivitisiscausedbyall except: a)Gonococcus b)Chlamydia c)Aspergillus d)Pseudomonas CorrectAnswer-CAns.Aspergillus

40.Inphotophthalmiasiteoflesionsis: a)Cornea b)Retina c)Opticnerve d)Alloftheabove CorrectAnswer-AAns.Cornea

41.Elschnig'spearlsareasignof: a)Chronicuveitis b)Secondarycataract c)Cystoidmacularoedema d)Alloftheabove CorrectAnswer-BAns.Secondarycataract

42.Rosettecataractisseendueto: a)Trauma b)Copperforeignbody c)Diabetes d)Hyperparathyroidism CorrectAnswer-AAns.Trauma

43.Achildhasgotacongenitalcataract involvingthevisualaxiswhichwasdetectedbytheparentsrightatbirth.Thischildshouldbeoperated: a)Immediately b)At2monthsofage c)At1yearofagewhentheglobebecomesnormalsized d)After4yearswhenentireocularandorbitalgrowthbecomes normal CorrectAnswer-AAns.A[Immediately]Congenitalcataract-Timingofsurgery 1. Bilateraldense-cataractrequiresearlysurgery(i.e.by6weeksof age)topreventthedevelopmentofstimulusdeprivationamblyopia 2. Bilateralpartial-cataractmaynotrequiresurgeryuntillaterifatall, incasesofdoubt,itmaybeprudenttodefersurgerymonitorlensopacity,andvisualfunctionandintervenelaterifvisiondeteriorates. 3. Unilateraldense-cataractmeritsurgentsurgery(withindays) followedbyaggressiveanti-amblyopiatherapythecataractisdetectedafter16weeksofagethensurgerycanbedelayedlittlebecauseamblyopiaisrefractory4.Partialunilateral-cataractcanusuallybeobservedortreatednonsurgicallywithpupillarydilatationandpossiblypart-timecontralateralocclusiontopreventamblyopia"Thecriticalperiodofdevelopingthefixationreflexesinbothunilateralandbilateralvisualdeprivationdisordersisbetween2and4monthsofage,anycataractdenseenoughtoimpairvisionmustbedealtwithbeforethis

ageandtheearliestpossibletimeispreferred"

44.Whichofthefollowingisthemost importantfactorinthepreventionoftheendophthalmitisincataractsurgery? a)Preoperativepreparationwithpovidoneiodine b)Oneweekantibiotictherapypriortosurgery c)Trimmingofeyelashes d)Useofintravitrealantibiotics CorrectAnswer-AAns.Preoperativepreparationwithpovidoneiodine

45.Schwalbe'sringcorrespondsto: a)Cornealendothelium b)Descemet'smembrane c)Schlemm'scanal d)Ciliarybody CorrectAnswer-BAns.Descemet'smembrane

46.Vitrectomyshouldbeconsideredifthe vitreoushaemorrhageisnotabsorbedwithin: a)1month b)3months c)6months d)2months CorrectAnswer-BAns.3months

47.Ealesdiseaseis: a)Recurrentopticneuritis b)Recurrentpappilloedema c)Recurrentperiphelbitisretinae d)None CorrectAnswer-CAns.Recurrentperiphelbitisretinae

48.Allofthefollowingaretrueforretinopathy ofprematurityexcept: a)Occursinprematureinfantsduetolatecrying b)Duetohypoxiathereoccursneovascularizationfollowedby fibroproliferation c)Endresultisbilateralblindness d)Blindnesscanbepreventedbyearlydiagnosisandablationof vascularprematureretinawithcryotherapyorphotocoagulation CorrectAnswer-AAns.Occursinprematureinfantsduetolatecrying

49.Allofthefollowingarethecausesof exudativeretinaldetachmentexcept: a)Retinopathyoftoxaemiaofpregnancy b)Retinopathyofprematurity c)ExudativeretinopathyofCoats d)Sympatheticophthalmia CorrectAnswer-BAns.Retinopathyofprematurity

50.Theearliestchangenoticedin hypertensiveretinopathyis: a)Softexudate b)Arteriolarspasm c)Venospasm d)Hardexudate CorrectAnswer-BAns.Arteriolarspasm

51.Strabismicamblyopiaismorecommonin patientswith: a)Intermittentsquint b)Alternatesquint c)Constantsquint d)Latentsquint CorrectAnswer-CAns.Constantsquint

52.Onsetofstereopsisoccursattheageof: a)3to5months b)1to2years c)5years d)7years CorrectAnswer-AAns.3to5months

53.Elevatorsofeye: a)SRand10 b)I0andSO c)IRandS d)SOSR CorrectAnswer-AAns.SRand10

54.Dalrymple'ssignofocularGraves' diseaserefersto: a)Retractionoftheupperlid b)Lidlag c)Proptosis d)Alloftheabovecombinedly CorrectAnswer-AAns.Retractionoftheupperlid

55.Bestmethodofdetectionofretainedglass intraocularforeignbodyis: a)CTscan b)Radiography c)Ultrasonography d)Tonography CorrectAnswer-AAns.CTscan

56.Inprimaryopen-angleglaucoma pilocarpineeyedropslowerstheintraocularpressurebyitsdirectactiononthe: a)Trabecularmeshwork b)Ciliaryepithelium c)Longitudinalfibresoftheciliarymuscle d)Alloftheabove CorrectAnswer-DAns.DPilocarpineaseyedropsitisusedtomanageangleclosureglaucomauntilsurgerycanbeperformed,ocularhypertension,primaryopenangleglaucoma,andtobringaboutconstrictionofthepupilfollowingitsdilation.MechanismofAction:PilocarpineisusedasamioticandinthetreatmentofglaucomaPilocarpinecontractstheciliarymuscle,causingincreasedtensiononthescleralspurandopeningofthetrabecularmeshworkspacestofacilitateoutflowofaqueoushumor.Outflowresistanceisreduced,loweringintraocularpressure(IOP).

57.Isolatedpainfulthirdnervepalsyisa featureofaneurysmsof: a)Posteriorcommunicatingartery b)Anteriorcommunicatingartery c)Vertebrobasillaryartery d)Ophthalmicartery CorrectAnswer-AAns.PosteriorcommunicatingarteryThemostcommonofallintracranialaneurysms,posteriorcommunicatingarteryaneurysmspresentwithipsilateralthirdnervepalsy(thusdilatingthepupil)Isolatedcranialnervepalsyfrequentlyinvolvesthethirdcranialnerveduetoitsanatomicsurroundingswhenleavingthebrainstem.(PCOM)isthemostcommontypeofaneurysmtoforminthebasalcistern.ThemajorityofsymptomaticaneurysmsofthePCOMpresentasanoculomotornervepalsy(ONP),whichcandevelopdirectlyviamasseffectofthegrowinganeurysmorindirectlyviaruptureoftheaneurysm

58.Allofthefollowingaregivenglobal prominenceintheVISION2020goal,expect: a)Refractiveerrors b)Cataract c)Trachoma d)Glaucoma CorrectAnswer-DAns.Glaucoma

59.Axiallengthofeyeballis: March2005 a)16mm b)20mm c)24mm d)28mm CorrectAnswer-CAns.C:24mmTheeyeofthenewbornishypermetropicandtheaverageaxiallengthisabout18mm.Attheageof3yearsitis23mmandfromage3-14yearsitincreasesby1mm.Intheemmetropiceye,theaxiallength(fromtheposteriorcornealsurfacetotheretina)variesfrom22to26millimeters.Intheemmetropiceye(whichhasnorefractiveerror),therangeofcornealrefractingpowerisbetween39and48diopters,whiletherangeoflenticularrefractingpowerisbetween15and24diopters.

60.Eyestructurewithmaximumrefractive power:March2007 a)Anteriorsurfaceoflens b)Posteriorsurfaceoflens c)Anteriorsurfaceofcornea d)Posteriorsurfaceofcornea CorrectAnswer-CAns.C:AnteriorsurfaceofcorneaTogetherwiththelens,thecornearefractslight,accountingforapproximatelytwo-thirdsoftheeye'stotalopticalpower.Inhumans,therefractivepowerofthecorneaisapproximately43dioptres.Whilethecorneacontributesmostoftheeye'sfocusingpower,itsfocusisfixed.Thecurvatureofthelens,ontheotherhand,canbeadjustedto"tune"thefocusdependingupontheobject'sdistance.

61.Pilocarpineisusedinallofthefollowing except:September2006 a)Primary,OpenAngleGlaucoma b)MalignantGlaucoma c)AcuteAngleClosureGlaucoma d)ChronicSynechialAngleClosureGlaucoma CorrectAnswer-BAns.B:MalignantGlaucomaManagementofangle-closuresecondarytociliochoroidaleffusionisdirectedattwoprocesses:Thefirstisuvealinflammation,whichistreatedwithoralsteroidstoreducetheeffusionandallowthechambertodeepenspontaneouslyastheinflammationsubsides.Thesecondisanteriorrotationofthelens-irisdiaphragm,whichisreversedwithcycloplegics.Thepressureistreatedintheacutesettingwithaqueoussuppressantsandoralcarbonicanhydraseinhibitors.Pilocarpineiscontraindicatedbecauseitwillcauseanteriorrotationofthelens-irisdiaphragm.

62.Mostcommonetiolopathogeneticcause ofglaucomais:March2012 a)Raisedpressureinepiscleriticveins b)Decreasedoutflow c)Increasedformationofaqueoushumour d)Increasedscleraloutflow CorrectAnswer-BAns:Bi.e.DecreasedoutflowAsustainedincreaseinintraocularpressuremaybeduetoincreasedformationoftheaqueoushumour,difficultyinitsexit,oraraisedpressureintheepiscleralveinsofthese,thefirst&lastrarelyoccur,anditfollowsthatraisedintraocularpressureisessentiallyduetoanincreasedresistancetothecirculationoftheaqueousatthepupiland/oritsdrainagethroughtheangleoftheanteriorchamber.

63.Posteriorstaphylomaisseenin: September2005 a)Myopia b)Hypermetropia c)Astigmatism d)Presbyopia CorrectAnswer-AAns.A:MyopiaStaphylomaisthetermgiventoaneyewhosesclero-uvealcoatsarestretched(alsoknownasectasia).Thismostcommonlyoccursposteriorly,athoughanteriorstaphylomaalsoisrecognised.PosteriorstaphylomaProgressivemyopia(ormegamyope)mostcommoncause.GlaucomaScleritisNecrotizinginfectionSurgery/traumaRadiotherapyPosteriorstaphylomaaffectstheposteriorpoleoftheeyeandislinedbythechoroid.TheectaticportionisnotvisibleexternallybutcanbedetectedbyfundoscopyandB-scanUSG.AnteriorstaphylomaThemostcommoncauseforanteriorstaphylomaissloughingcornealulcerwinchperforatesandhealswiththeformationofapseudocorneabytheorganizationofexudatesandlayingdownoffibroustissue.Differentialdiagnoses

Buphthalmos(congenitalglaucoma)AxialmyopiaMacrophthalmos:seeninneurofibromatosistypel(NF1)Coloboma

64.Allofthefollowingaretruefor sympatheticophthalmitisexcept: a)Affectstheinjuredeye b)Mostlyresultsfromapenetratingwound c)Autoimmuneetiology d)DalenFuch'snodulesmaybeseen CorrectAnswer-AAns.A:AffectstheinjuredeyeSympatheticophthalmitisisaconditioninwhichseriousinflammationattacksthesoundeyeafterinjurytotheothereye.

65.Snowflakecataractisassociatedwith: September2008 a)Hypertension b)Adultdiabetes c)Trauma d)Juvenilediabetes CorrectAnswer-DAns.D:JuvenilediabetesSnowflakeCataracts:Thistypeofcataractrepresentsdotsofvarioussizes(andsometimesvariouscolours)distributedthroughoutthecortexsurroundingthenucleusfor360?.ThisisthemostcommoncataractseeninDownSyndrome(extracopyofchromosome21alsocalledtrisomy21)andjuvenilediabetesmellitus.Theseusuallyhaveverylittleeffectonvision.Adultdiabeticcataractshowscorticaland/ornuclearand/orsubcapsular(sameasagerelated)

66.Diabeticcataractisduetoaccumulation of:March2009 a)Fructose b)Galactose c)Glucose d)Sorbitol CorrectAnswer-DAns.D)SorbitolTheenzymealdosereductase(AR)catalyzesthereductionofglucosetosorbitolthroughthepolyolpathway,aprocesslinkedtothedevelopmentofdiabeticcataract.

67.Scleritisismostcommonlyassociated with:March2005 a)Diabetes b)Osteoarthritis c)Rheumatoidarthritis d)Hypertension CorrectAnswer-CAns.C:RheumatoidarthritisScleritisisasevere,destructive,chronic,painful,andpotentiallyblindinginflammatorydiseaseoftheConjunctiva,ScleraandEpiscleratissues.Symptomsincludesrednessandsevereeyepain,whichmayradiatetoadjacentareas,theforehead,cheek,orbehindtheeye.Thisisusuallyassociatedwithlightsensitivity,teary,andinsomecases,reducedorpoorvision.Theaffectedeyeoftenhasabluishhueorbecomesanintensepurple.Thereareseveraldifferentsub-typesofScleritisNodularScleritisischaracterizedbyafocalareaofinflammation,immovable,andtender,inflamednodulesontheeye.DiffuseScleritisDiffuseAnteriorScleritisisthemostcommontype,andischaracterizedbywidespreadinflammationoftheAnteriorportionoftheSclera,thewhiteoftheeye.TheDiffusetypeofScleritisis,fortunately,themostbenignformofScleritisandthemostresponsivetotherapy.NecrotizingScleritisislikelytheworstformofthedisease,

sometimesleadingtolossoftheeyefrommultiplecomplications,severepain,oroccasionallyperforationoftheglobe.Itisoftenassociatedwithseveresystemicdiseaseandinvolvementofmultipleorgans.Anassociatedtypeofvascularinflammation,calledVasculitis,maythreatenthelivesofthosepatientsafflicted.Painwiththisconditionisusuallyextreme,anddamagetotheScleraisoftenmarked.NecrotizingscleritisalsoknownasScleromalaciaperforansischaracterizedbyseverethinningoftheScleraoftheEye,allowingforlocaloutpouchingsoftheunderlyingdarkUvealtissue.TherearelargeabnormalbloodvesselscrossingareasofScleralloss.Theconditionoccursinanotherwisewhiteand"quiet"Eye,withoutpain.ThistypeofScleritisisassociatedwithsevereRheumatoidArthritis,occasionallyseeninWegener'sGranulomatosisandRelapsingPolychondritis.PosteriorScleritisisquiterare,butusuallypresentswithpoorordoublevision,severepain,proptosis(forwarddisplacementoftheeye),Uveitis(inflammationinsidetheUveaTract),andlimitationofeyemovement.AnexudativeRetinaldetachment(fluidundertheRetina)maycauseseverevisualloss,Angle-ClosureGlaucomafromChoroidaleffusion.About50%ofScleritispatientsareassociatedwithsystemicautoimmunedisordersincludingrheumatoidarthritis,gout,wegenergranulomatosis,RelapsingPolychondritis,SystemicLupusErythematosus,PolyarteritisNodosa,AnkylosingSpondylitis,withinfections,orchemicalorphysicalinjuries.Itoccursmostofteninpeoplebetweentheagesof30and60(itisrareinchildren).Scleritismaybetheinitialoronlypresentingclinicalmanifestationofthesepotentiallylethaldisorders.

68.Laserusedtomanageaftercataract: March2005,September2009 a)Excimerlaser b)Argongreenlaser c)Diodelaser d)Nd:YAGlaser CorrectAnswer-DAns.D:Nd:YAGlaserTheNd:YAGlaserisasolidstatelaserthatusesaneodymium-dopedyttrium-aluminum-garnetcrystalasthelasingmedium.Itisopticallypumpedwithalampordiodeandmostcommonlyemitsinfraredlightat1064nm.Itcanbeusedineitherapulsedorcontinuousmode.PulsedYAGlasersaretypicallyQ-switchedtoachievehigh-intensitypulses,whichcanbefrequencydoubledtoemitlightat532nm.TherearenumerousophthalmicapplicationsforNd:YAGlasers.TheyaremostcommonlyusedtotreatposteriorcapsularopacificationaftercataractsurgeryTocreateaperipheraliridotomyinpatientswithnarrowanglesorangle-closureglaucoma.YAGlaserscanalsobeusedtocuttheanteriorcapsuleforcapsularblocksyndromeandcapsularphimosisTocutvitreousstrandsintheanteriorchamber.Inmalignantglaucoma,disruptionoftheanteriorhyaloidfaceisperformedwiththeYAGlaserInrefractoryglaucomas,theselaserscanbeusedforcyclophotoablationoftheciliarybody.

TheyhavealsobeenhelpfulfordrainingpremacularsubhyaloidhemorrhagesinpatientswithValsalvaretinopathy.Panretinalphotocoagulationcanbeperformedwithfrequency-doubledNd:YAGlasers.Otherapplicationsincludethetreatmentofrecurrentcornealerosionsandvitreousfloaters.Excimer(Argonfluoride)laserisusedinphotorefractivekeratectomy(PRK),phototherapeutickeratectomy(PTK),LASIK,LASEKArgongreenlaserisusedintrabeculoplasty,iridoplasty,pupillomydriasisandretinalphotocoagulationDiodelaserisusedinretinalphotocoagulation

69.Whichofthefollowingisnotacauseof hypermetropia:September2009 a)Shortaxiallengthoftheeyeball b)Flatcornea c)Increasedrefractiveindexofthecortexoflens d)Anteriordislocationofthelens CorrectAnswer-DAns.D:AnteriordislocationofthelensFactorsresponsibleforhypermetropia:ShortaxiallengthoftheeyeballCurvaturehypermetropiacommonlyoccursasafactorinastigmatism(cornealplana)Indexhypermetropiaaccountsforthehypermetropiaofoldageduetoincreasedrefractiveindexofthecortexofthelensrelativetothenucleussothatoverallrefractivepowerofthelensdecreases.Itmaybeassociatedwithdiabetes,tumors,microphthalmia(agrowthdysfunctionduringfetusdevelopment)andfoveahypoplasia,aconditionthataffectsthebloodvesselsintheretina.Whiletheseconditionsmayresultinhypermetropia,oneofthemostcommonlycitedcausesoffarsightednessisconsideredtobeaging.

70.Typeofcollagenpresentincornea? a)TypeI b)TypeII c)TypeIII d)TypeIV CorrectAnswer-AAns.is'a'i.e.,TypeI

71.Whichofthefollowingispresentin cornea? a)Hyaluronicacid b)Chondroitinsulfate c)Dermatansulfate d)Heparansulfate CorrectAnswer-BAns.is'b'i.e.,Chondroitinsulfate

72.Apersonwithdefectivebluecolor appreciationiscalled? a)Deuteranomalous b)Deuteranopia c)Tritanopia d)Tritanomalous CorrectAnswer-DAns.is`d'i.e.,Tritanomalous

73.Whatistheimmediatemanagementof vitreoushemorrhageineye? a)Notreatment b)Steroids c)Antibiotics d)Vitrectomy CorrectAnswer-AAns.is'a'i.e.,NotreatmentTreatmentofvitreoushaemorrhage: 1. Conervativetreatment:Bedrest,elevationofpatient'sheadand bilateraleyepatches.Thiswillallowthebloodtosettledown. 2. Treatmentofthecause:Oncethebloodsettlesdown,indirect ophthalmoscopyshouldbeperformedtolocateandfurthermanagethecausativelesionsuchasaretinalbreak,phlebitis,prolifrativeretinopathy,etc. 3. Vitrectomybyparsplanarouteshouldbeconsideredtoclearthe vitreous,ifthehaemorrhageisnotabsorbedafter3months.

74.Keratitisiscausedby? a)Bacteria b)Atopy c)Protozoa d)All CorrectAnswer-DAns.is'd'i.e.,AllCausesofkeratitis1.Infectivekeratitis a. Bacterialb. Viral c. Fungal d. Chlamydiale. Protozoal f. Spirochaetal 2.Allergickeratitis a. Phlyctenularkeratitisb. Vernalkeratitis c. Atopickeratitis 3.Trophickeratitis a. Exposurekeratitisb. Neuroparalytickeratitis c. Keratomalacia d. Atheromatousulcer 4.Keratitisassociatedwithdiseasesofskinandmucousmembrane.5.Keratitisassociatedwithsystemiccollagenvasculardisorders.6.Traumatickeratitis,whichmaybeduetomechanicaltrauma,chemicaltrauma,thermalburns,radiations.

7.Idiopathickeratitise.g., a. Mooren'scornealulcerb. Superiorlimbickeratoconjunctivitis c. SuperficialpunctatekeratitisofThygeson

75.Subconjunctivalcystisseenin? a)Toxoplasmosis b)Cysticercosis c)Leishmaniasis d)Chaga'sdisease CorrectAnswer-BAns.isbi.e.,CysticercosisParasiticcystsoccursinsubconjunctivalcysticercus,hydatidcystandfilarialcyst.

76.Parsplanitisis? a)Anterioruveitis b)Intermediateuveitis c)Posterioruveitis d)Panuveitis CorrectAnswer-BAns.isbi.e.,intermediateuveitisUveitisUveitisreferstotheinflammationofuvealtissue.However,practicallythereisalwayssomeassociatedinflammationoftheadjacentstructuressuchasretina,vitreous,scleraandcornea.Duetocloserelationshipbetweentheanatomicallydistinctpartoftheuvealtract,theinflammatoryprocessusuallyinvolvetheuveaasawholeandaregenerallynotlimitedtoasinglepart.However,theuveitisisclassifiedaccordingtothepartofuveawhichisclinicallymoreaffected.Forexample,thetermiritisisusedwhenirisappearstobemoreaffected.Anatomicalclassificationofuveitis1.Anterioruveitis.Itisinflammationoftheuvealtissuefromirisuptoparsplicataofciliarybody.Itmaybesubdividedinto-Iritis,inwhichinflammationpredominantlyaffectstheiris.Iridocyctitisinwhichirisandparsplicatapartofciliarybodyareequallyinvolved,andCyclitis,inwhichparsplicatapartofciliarybodyispredominatlyaffected.2.Intermediateuveitis.Itincludesinflammationoftheparsplanaandperipheralpartoftheretinaandunderlying`choroid'.Itisalso

called'parsplanitis'.3.Posterioruveitis.Itreferstoinflammationofthechoroid(choroiditis).Alwaysthereisassociatedinflamationofretinaandhencetheterm`chorioretinitis'isused.4.Panuveitis.Itisinflammationofthewholeuvea.

77.Brushfieldspotinirisisseenin- a)Neurofibromatosis b)Downsyndrome c)Tuberoussclerosis d)Toxoplasmosis CorrectAnswer-BAns.is'b'i.e.,DownsyndromeBrushfieldspotsarewhitespotsintheirisinpatientswithDownsyndrome.

78.Mostcommonorbitalcystinchildren- a)Neuroentericcyst b)Dermoidcyst c)Lymphoma d)Clobomatouscyst CorrectAnswer-BAns.is'b'i.e.,DermoidcystEpidermaldermoidcyst(dermoid)isbyforthemostcommonorbitalcysticlesioninchildren,accountingforover40%ofallorbitallesionsofchildhoodandfor89%ofallorbitalcysticlesionsofchildhoodthatcometobiopsyorsurgicalremoval.Mostimportantsecondarycystisamucocelethatcanoccurinchildrenwithcysticfibrosis.

79.Disscociatedverticaldeviationseenin? a)AVdissociation b)Infantileesotropia c)Congenitalesotropia d)Superiorobliquepalsy CorrectAnswer-CAns.is'c'i.e.,CongenitalesotropiaTheusualageofpresentationofcongenital(infantile)esotropiaisbetween2-4monthsofage.Presentationatbirthisveryrare.Infantileesotropiahasbeenclassicallydescribedaslargeangleconstantesotropia(notvariable).Theclassicletriadofassociatedmotorabnormaliesincongenitalesotropiaisinferiorobliqueoveraction,dissociatedverticaldeviation(DVD)andlatentnystagmus."Itseems,fromareviewofliterature,thatinfantswithesotropiahave,onaverage,refractiveerrorssimilartothenormalagematchedpopulation".--Handbook

80.Koeppe'snodulesaretypeof? a)Granulomatousuveitis b)Nongranulomatousuveitis c)Coroiditis d)Parsplanitis CorrectAnswer-AAns.is'a'i.e.,GranulomatousuveitisNodulesontheirissurface.Theseareobservedingranulomatousuveitis(Koeppe'sandBusacca'snodules),melanoma,tuberculomaandgummaoftheirisIrisnodulesTherearemanytypesofnodulesthatdeveloponirisingranulomatousuveitis:- i. Keoppenodule:-Seenatpupillarymargin. ii. Busacca'snodule:-Seenontheperipheralpartofanteriorsurface ofiris. iii. Tubercularnodules:-Scatteredthroughouttheirisandciliarybody, mostlyinstroma.Theyaremorecommonatpupillarymargin. iv. Syphiliticnodules:-Atpupillarymargin. v. Sarcoidnodules:-Atpupillarymarginorinthestromaoftheiris.

81.Causeofblindnessinpterygium? a)Astigmatism b)Lossofvisualaxis c)Cataract d)Limitationofocularmovements CorrectAnswer-AAns.is'a'i.e.,AstigmatismPtervgiumPterygiumisanon-cancerous(non-neoplastic)growthofconjunctiva,characterizedbyawing-shapedfoldofconjunctivaencroachinguponthecorneafromeithersidewithintheinterpalpebralfissure.Pterygiumisalwayssituatedinthepalpebralaperture.PathologicallyPterygiumisadegenerativeandhyperplasticconditionofconjunctiva.Thesubconjunctivaltissueundergoeselastoticdegenerationandproliferatesasvascularizedgranulationtissueundertheepithelium,whichultimatelyencroachesthecornea.Thecornealepithelium,Bowman'slayerandstromaaredestroyed.Etiology&ClinicalfeaturesPterygiumismorecommoninpeoplewithexcessoutdoorexposuretosunlight(UVrays),dryheat,highwindandabundanceofdust.Thereforeitismorecommoninthosewhoworkoutdoors.Clinicallyitpresentsasatriangularfoldofconjunctivaencroachingthecorneaintheareaofpalpebralaperture,usuallyonthenasalside.Otherfindingsarestocker'sline(depositionofiron)Ptergyiumisanasymptomaticconditionintheearlystages,exceptforcosmeticintolerance.Visualdisturbanceorcornealastigmatismmayoccur.Visualdisturbancesareduetoencroachmentof

pterygiumonpupillaryareaorcornealastigmatism.Occasionallydiplopiamayoccurduetolimitationofocularmovements.TreatmentAsymptomaticpterygiumwhichisnotprogressiveisbestleftalone.Surgicalexcisionistheonlysatisfactorytreatmentandisindicatedfor:-(1)Cosmeticreasons,(2)Continuedprogressionthreateningtoencroachontothepupillaryarea(oncethepterygiumhasencroachedpupillaryarea,waittillitcrossesontheotherside),(3)Diplopiaduetointerferenceinocularmovement.

82.Causeofblindnessintrachoma? a)Scarring b)Pannus c)Chronicdacrocystitis d)Entropion CorrectAnswer-AAns.is'a'i.e.,ScarringThelaterstructuralchangesoftrachomaarereferredtoas"cicatricialtrachoma".Theseincludescarringintheeyelid(tarsalconjunctiva)thatleadstodistortionoftheeyelidwithbucklingofthelid(tarsus)sothateyelashesrubontheeye(trichiasis).Rubbingofeyelashesofscarredeyelidsagainstthecornealeadstocornealopacitiesandscarringandthentoblindness.Thusactualcauseofblindnessiscornealopacityandscarring,whichmaybesecondarytoeyelidscarring.

83.FundusinretinitisPigmentosais? a)Whitespotswithreddisc b)Jet-blackspotswithpale-waxydisc c)Nopigmentation d)Dilatationofarterioles CorrectAnswer-BAns.is'b'i.e.,Jet-blackspotswithpale-waxydiscExaminationfindingsinretinitispigmentosaOphthalmoscopicfindingsarecharacteristicandinclude:- i. Retinalpigmentarychanges(Bonespiculeintraneuralretinal pigmentation):-Retinastuddedwithsmall,jet-blackspotsresemblingbonecorpuscleswithaspideryoutline.Thesepigmentarychangesaretypicallyperivascularandretinalveins(neverarteries)haveasheathofpigmentforpartoftheircourse.Thesechangesaffectequatorialregioninitiallysparingtheposteriorpoleandperiphery.Laterinthecourseofdiseasewholeretinaisinvolved. ii. Attenuatedandthreadlikeretinalarteriolesandveins. iii. Paleandwaxyopticdisc(consecutiveopticatrophy). iv. Thinningandatrophyofretinalpigmentepithelium(RPE)inmidand farperipheralretinawithrelativesparingofRPEatmacula.Electroretinogram(ERG)andparticularlytheelectro-oculogram(EOG)aremarkedlysubnormal.

84.Retinoblastomacanoccurbilaterallyin howmanypercentageofthecases? a)10-15% b)15-20% c)20-25% d)25-30% CorrectAnswer-DAns.is'd'i.e.,25-30%RETINOBLASTOMARetinoblastomaisthemostcommonintraoculartumorinchildren.Thetumorisconfinedtoinfancyandveryyoungchildren(1-2years).Thereisnosexpredisposition.Retinoblastomaisunilateralin70-75%ofcasesandbilateralin25-30%ofcases.EtiologyRetinoblastomagene(RBgene)islocatedon14bandonthelongarmofchromosome13(13q14).RBgeneisatumorsupressorgene.RetinoblastomadevelopswhenboththenormalallelesoftheRBgenesareinactivedoraltered.ltistypicalexampleofKnudson'stwohithypothesis.InHereditaryretinoblastomafirstgeneticchange(firsthit)inRBgeneisinheritedfromanaffectedparent,whereassecondmutation(secondhit)occursinpostnatallifeandbothallelesarelost.Innon-hereditaryretinoblastoma,bothmutations(firstandsecondhits)occurpostnataly.

85.Kayserflescherringisseenin? a)Siderosis b)Chalcosis c)Openangleglaucoma d)Chemicalinjuries CorrectAnswer-BAns.is'b'i.e.,ChalcosisChalcosisItreferstothespecificchangesproducedbythealloyofcopperintheeye.Mechanism.Copperionsfromthealloyaredissociatedelectrolyticallyanddepositedunderthemembranousstructuresoftheeye.Unlikeironionsthesedonotenterintoachemicalcombinationwiththeproteinsofthecellsandthusproducenodegenerativechanges.Clinicalmanifestations i. Kayser-Fleischerring:Itisagoldenbrownringwhichoccursdueto depositionofcopperunderperipheralpartsoftheDescemet'smembraneofthecornea. ii. Sunflowercataract:Itisproducedbydepositionofcopperunderthe posteriorcapsuleofthelens.Itisbrilliantgoldengreenincolourandarrangedlikethepetalsofasunflower. iii. Retina:Itmayshowdepositionofgoldenplaquesattheposterior polewhichreflectthelightwithametallicsheen.

86.Gazefixationtakesplaceatwhichage? a)3months b)6months c)1year d)2years CorrectAnswer-BAns.is'b'i.e.,6monthsGazeFixationstartsdevelopinginthefirstmonthandiscompletedin6months.Maculaisfullydevelopedby4-6months.Fusionalreflexes,stereopsisandaccommodationiswelldevelopedby4-6months.Corneaattainsnormaladultdiameterby2yearsofage.Lensgrowsthroughoutlife.

87.Phacoemulsificationincisionisat? a)Sclero-cornealjunction b)Cornea c)Sclera d)Noneoftheabove CorrectAnswer-AAns.is'a'i.e.,Sclero-cornealjunctionInphacoemulsificationverysmall3cmmincisionistakenatthesclerocornealjunction.PhacoemulsificationItisnothingelsebutanadvancementinthemethodofdoingECCE.Herethenucleusisconvertedintopulporemulsifiedusinghighfrequencysoundwaves,andthensuckedoutoftheeyethroughasmall(3.2mm)incision.AspecialfoldableIOListheninsertedintotheposteriorchamberthroughthesameincision.ECCEbyphacoemulsificationwithfoldableposteriorchamberIOListheprocedureofchoiceforcataract.Thestepsinphacoemulsificationinclude:(i)Corneoscleralincision,(ii)Continuouscurvilinearcapsulorrhexis,(iii)Hydrodissectionandhydrodelineation(iv)Emulsificationandaspirationofnucleusandthencortex,and(v)FoldableIOLimplantationinposteriorchamber.Recoverywithphacoemulsificationisfastestasincisionisverysmallandnosuturesaretaken.

88.GlandofMollopensin/onthe? a)Skin b)Hairfollicle c)Tarsalplate d)DuctsofMeibomianglands CorrectAnswer-BAns.is'b'i.e.,HairfollicleGLANDSOFEYELIDS: i. Meibomianglands:Thesearealsoknownastarsalglandsandare presentinthestromaoftarsalplatearrangedvertically.Theyaremodifiedsebaceousglands.Theirductsopenatthelidmargin.Theirsecretionconstitutestheoilylayerofthetearfilm. ii. GlandsofZeis:Thesearealsosebaceousglands,whichopeninto thefolliclesofeyelashes. iii. GlandsofMoll:Thesearemodifiedsweatglandssituatednearthe hairfollicle.TheyopenintothehairfolliclesorintotheductsofZeisglands.Theydonotopendirectlyontotheskinsurfaceorelsewhere. iv. AccessorylacrimalglandsofWolfring:Thesearepresentnearthe upperborderofthetarsalplate.

89.Cherryredspotisseenin? a)Niemann-Pick'sdisease b)TaySach'sdisease c)Centralretinalarteryocclusion d)Alloftheabove CorrectAnswer-DAns.is'di.e.,AlloftheaboveCausesofcherryredspotGM2gangliosidoses(Taysachs&sandhoff)Hurler'ssyndromeGM1gangliosidosesCryoglobulinemiaNiemann-Pick'sdiseaseLaber'scongenitalamaurosisGaucher'sdiseaseSialidosis(galactosialidosis)MetachromaticleukodystrophyMucopolysacharidosisVIICentralretinalarteryocclusion(CRAO)MultiplesulfatasedeficiencyTrauma(Berlin'sedema/commotioretinae)Poisoning:-Carbonmono-oxide,methanolQuinineandDapsoneShprintzen-GoldbergsyndromeFarber'sdiseaseHallervordenSpatzdiseaseGoldberg'sdiseaseRarelyinkrabbe'sdisease

90.Mostcommonmalignantintraorbital tumorinadultis? a)Lymphoma b)Rhabdomyosarcoma c)Dermoidcyst d)Sarcoma CorrectAnswer-AAns.is'a'i.e.,LymphomaAnorbitaltumorisanytumorthatoccurswithintheorbitoftheeye.Theorbitisabonyhousingintheskullthatprovidesprotectiontotheentireeyeballexceptthefrontalsurface.Itislinedbytheorbitalbonesandcontainstheeyeball,itsmuscles,bloodvessels,nervesandfat.Anintraoculartumoristhetumorwhichoccurswithintheeyeball.Mostcommonintraoculartumorinadultsismetastasis.Metastasisisparticularlycommonfromcarcinomaofbreastandlung.Mostcommonprimaryintraoculartumorinadultsisuvealmelanoma.Mostoftheuvealmalignantmelanomaariseinchoroid.Mostcommonprimaryintraoculartumorischildrenisretinoblastoma.MostcommonorbitaltumorsinadultsarebenignvasculartumorsCavernoushamangioma.MostcommonmalignantorbitaltumorinadultlymphomaMostcommonorbitaltumorsinchildrenarebenigntumorsDermoidcyst>capillaryhemangiomaMostcommonmalignantorbitaltumorinchildrenrhabdomyosarcoma.Overallmostcommonprimarymalignanttumorofeyeismalignant

melanomafollowedbyretinoblastomaMostcommonmalignanteyelidtumorBasalcellcarcinoma.MostcommonepithelialtumoroflacrimalglandPleomorphicadenoma(benignmixedtumor)OverallmostcommontumoroflacrimalglandLymphoidtumourandinflammatorypseudo-tumorsMostcommonmalignanttumorofconjunctiva&corneaSquamouscellcarcinoma.

91.Whichantiglaucomadrugdecreases aqueousformation? a)Prostaglandins b)Beta-blockers c)Mannitol d)Pilocarpine CorrectAnswer-BAns.is'b'i.e.,Beta-blockers

92.Selectivealpha2agoinstusedin glaucoma? a)Tirriolol b)Epinephrine c)Dipivefrine d)Brimonidine CorrectAnswer-DAns.is'd'i.e.,Brimonidine

93.Bilateralinferiordislocationoflensis seenin? a)Marfanssyndrome b)Homocystinuria c)WeilMarchesanisyndrome d)Trauma CorrectAnswer-BAns.is`b'i.e.,HomocystinuriaEctopialentisEctopialentisisdefinedasdisplacementormalpositionofthecrystallinelensoftheeye.Thelensisconsidereddislocated(luxated)whenitliescompletelyoutsidethelenspatellarfossa.Thelensisdescribedassubluxatedwhenitispartiallydisplacedbutcontainedwithinthelensspace.

94.AllaretrueaboutBullouskeratopathy except? a)SeeninMaculardystrophy b)Treatmentislamellarkertoplasty c)Lensescanbeprescribedforsuchpatients d)SeeninFuch'sdystrophy CorrectAnswer-AAns.is'a'i.e.,SeeninMaculardystrophyFuch'sepithelial-endothelialdystrophyFuch'sdystrophy-slowlyprogressivebilateralconditionaffectingfemalesmorethanmales.Primaryopenangleglaucomaisassociatedwiththiscondition.Stagesandclinicalfeaturesi)StageofcorneaguttataHassal-Henletypeofexcrescencesinthecentralpartofcornea.Agradualincreaseofcentralguttaewithperipheralspreadandconfluencegivesrisetothesocalled'beaten-metal'appearance.Thisstageisasyptomatic.ii)OedematousstageorStageofendothelialdecompensationEarlystromaledemaandepithelialdystrophyPatientscomplainofblurringofvision.iii)StageofBullouskeratopathyFollowslongstandingstromaledemaMarkedepithelialedemawithformationofbullae,whichwhenrupturecausepain,discomfortandirritationwithassociateddecreasedvisualacuity.iv)StageofscarringCorneabecomesopaqueandvascularized.

Maybecomplicatedbysecondaryinfectionorglaucoma.Treatment i. Edematousstage:5%Sodiumchloride(Hypertonicsaline) ii. Bullouskeratopathy:Bandagesoftcontactlenses. iii. Penetratingkertaoplasty:treatmentofchoice.

95.Mostcommonprimaryintraocular neoplasminachildis? a)Metastasis b)Retinoblastoma c)Basalcellcarcinoma d)Squamouscellcarcinoma CorrectAnswer-BAns.is'b'i.e.,Retinoblastoma

96.Followingarethesideeffectsof apraclonidineexcept? a)Liddermatitis b)Follicularconjunctivitis c)Eyelidretraction d)Wateringofmouth CorrectAnswer-DAns.is'd'i.e.,WateringofmouthApraclonidineTopicalapplicationlowerstheintraocularpressureby25%.Itdecreasesaqueousproductionbyprimaryalphalandsubsidiaryalpha2actioninciliarybody.Itching,liddermatitis,follicularconjunctivitis,mydriasis,eyelidretraction,drynessofmouthandnosearecommonsideeffects.Itsuseisrestrictedtoshorttermcontrolofspikesofintraoculartensionafterlasertrabeculolastyoriridotomy.

97.Treatmentofpresbyopiaisbyuseof whichlens? a)Convex b)Concave c)Biconcave d)Concavoconvex CorrectAnswer-AAns.is'a'i.e.,ConvexPresbvopiaPresbyopiaisavisionconditioninwhichthecrystallinelensofeyelosesitsflexibility,whichmakeitdifficulttofocusontheobjectsclosertotheeye.Presbyopiaisnotanerrorofrefractionbutaconditionofphysiologicalinsufficiencyofaccommodationleadingtoaprogressivefallinnearvision.Presbyopiaisanagerelatedproblem,thereforealsocalledeyesightofoldage.Symptomsareusuallyseenafter40yearsofage.Presbyopiaisnotadisease,ratheranaturalpartoftheagingprocessoftheeye.Thetreatmentofpresbyopiaistheprescriptionofappropriateconvexglassesfornearwork.

98.Steroidiscontraindicatedin? a)Herpetickeratitis b)Atopicdermatitis c)Fungalcornealulcer d)Exposurekeratitis CorrectAnswer-CAns.is'c'i.e.,FungalcornealulcerTopicalcorticosteroidsenhancefungalreplicationandcornealinvasionandtherefore,contraindicatedinafungalcornealulcer.Now,option'a'requiresspecificmentionhere:-Topicalcorticosteroidsarecontraindicatedinherpetickeratitis.Butnotinallformsofherpetickeratitis:- i. Epithelialherpetickeratitis(Dendriticulcer,geographiculcer)Topicla corticosteroidsarecontraindicated. ii. Stromalkeratitis(Disciform&Diffusenecrotic)Topical corticosteroidsalongwithtopicalantiviraldrugsareusedasthefirstlineoftreatment.So,myopinionforthistypeofquestionisthat:- i. Ifherpetickeratitishasgivenastheoption,thenlookatother options.Ifanyoftheotheroptionsisaclearcutcontraindicationforcorticosteroid(e.g.fungalcornealulcerinthisquestion),considerthatoptionasyouranswer.Ifnotheroptionisacontraindicationfortopicalcorticosteroid,considereherpetickeratitisastheanswer. ii. Ifexaminerhasspecificallymentioneddendriticulcerasanoption, consideritastheanswer.

99.Vitreoushemorrhageproduces? a)Suddenpainlesslossofvision b)Suddenpainfullossofvision c)Gradualpainlesslossofvision d)Gradualpainfullossofvision CorrectAnswer-AAns.is'a'i.e.,Suddenpainlesslossofvision

100.Tubularvisionseenin- a)Myopia b)Hypermetropia c)Presbyopia d)Opticneuritis CorrectAnswer-AAns.is'a'i.e.,MyopiaCausesofTubularvisionRetinitispigmentosaHighMyopiaPrimaryopenangleglaucomaCRAOwithsparingofcilioretinalartery

101.Treatmentofdacryocystitisinthree monthsoldchild? a)Dailyprobing b)Weeklyprobing c)Massaging d)Syringing CorrectAnswer-CAns.is'c'i.e.,MassagingSpontaneousrecanalizationofobstructednosolacrimalductoccursduringfirst6-8weeksandsometimesafter6-12monthsin90%ofinfants.Thereforeupto9-12monthsonlymassageandantibioticdropsareindicated.Aftertheageof12monthshighpressuresyringingisindicated.

102.Methanolattacks? a)Cones b)Rods c)Ganglioncellsofretina d)Germinalcelllayer CorrectAnswer-CAns.is'c'i.e.,GanglioncellsofretinaMethylalcoholismetabolisedveryslowlyandthusstaysforalongerperiodinthebody.Itisoxidisedintoformicacidandformaldehydeinthetissues.Thesetoxicagentscauseoedemafollowedbydegenerationoftheganglioncellsoftheretina,resultingincompleteblindnessduetoopticatrophy.

103.Retinaltearsseenmostcommonlyseen in? a)Primaryretinaldetachment b)Secondaryretinaldetachment c)Tractionalretinaldetachment d)Exudativeretinaldetachment CorrectAnswer-AAns.is'a'i.e.,PrimaryretinaldetachmentRetinaldetachmentisadisorderofeyeinwhichretinapeelsawayfromitsunderlyinglayerofsupporttissue.Usuallythereisseparationbetweentheneuroepithelium(neurosensoryepithelium)andthepigmentedlayer.Theretinalseparationisdividedinto: 1. Primary:-Rheugmatogenousretinaldetachment.2. Secondary:-Tractionalretinaldetachmentandexudativeretinal detachment.RhegmatogeneousretinaldetachmentThisisthecommonesttypeofretinaldetachment.Thisisduetoaretinalbreak/tear/holewhichallowstheliquidvitreoustoseepsintothesubretinalspaceandseparatesthesensoryretinafromthepigmentaryepithelium.Predisposingfactorsinclude:(i)Myopia,(ii)Previousintraocularsurgery:cataractextraction,(aphakia)orpseudoaphakia);(iii)Trauma;(iv)Retinaldegeneration(Latticedegeneration;Snailtrackdegeneration,Senileordegenerativeretinoschisis.TractionalretinaldetachmentItisduetopullingontheretinausuallyfromfibro-vascularbandinthevitreouscavity,i.e.,vitroretinalband.

Exudativeretinaldetachment(solidretinaldetachment)Itoccursduetotheretinabeingpushedawaybyaccumulationoffluidoraneoplasmbeneaththeretina.Thistypeofdetachmentiscausedbyinflammatorydisordersorbytumors.

104.Followingaretheclinicalfeaturesof Leberopticneuropathyexcept a)Seeninthe2ndor3rddecadeoflife b)Itisaexampleofgradualpainlessvisualloss c)Malescantransmitthedisease d)Noleakofdyeisobservedinfluoresceinangiography CorrectAnswer-CAns.is'c'i.e.,MalescantransmitthediseaseLeber'sHereditaryopticneuropathvLeber'shereditaryopticneuropathyischaracterizedbysequentialsubacuteopticneuropathyinmalesaged11-30years.Theunderlyinggeneticabnormalityisapointmutationinmitochondria!DNA.SincemitochondrialDNAisexclusivelyderivedfrommother,malesdonottransmitthediseaseandthediseaseistransmittedbycarrierfemales.Itischaracterizeedbybilateral,painless,subacutevisualfailurethatdevelopsduringyoungadultlife.Malesarefourtofivetimesmorelikelythanfemalestobeaffected.Affectedindividualsareusuallyentirelyasymptomaticuntiltheydevelopblurringaffectingthecentralvisualfieldofoneeye;Similarsymptomsappearintheothereyeanaverageoftwotothreemonthslate.Inabout25%ofcases,visuallossisbilateralatonset.Onexamination,patientsgenerallyhavebilateralimpairmentsofvisualacuity.Thereiscentrocecalscotomathatbeginsnasaltotheblindspotandextendstoinvolvefixationofbothsidesoftheverticalmeridian.Pupillaryreactionsareoftennormal.Ophthalmoscopicexaminationshowsfundusabnormalitiesinacutephaselikeswellingofthedisc,peripapillaryretinaltelangiectasia,butcharacteristically

thereisnoleakfromtheopticdiscduringfluoresceinangiography.Laterinatrophicphase,discbecomesatrophicandpale.

105.FollowingisfeatureofFusch'shetero chromiciridocyclitis? a)Heterochromiaofiris b)Keraticprecipitates c)Posteriorsubcapsularcataract d)Alltheabove CorrectAnswer-DAns.is'd'i.e.,AlltheaboveFuch'sheterochromiciridocyclitis(Fuch'suveitissyndrome)Itisaformofanteriorandintermediateuveitis.Theconditionisusuallyunilateralandchronicinnatureandischaracterizedbyachronicnon-granulomatousuveitisandeventuallyresultsinirisheterochromia(achangeinthecolourofiris).Thediseasehasfollowingcharacteristicfeatures:i)Heterochromiaofirisii)Diffusestromalirisatrophyiii)FineKPsatbackofcorneaiv)Faintaqueousflarev)Absenceofposteriorsynechiaevi)Afairlycommonrubeosisiridis,sometimesassociatedwithneovascularisationoftheangleofanteriorchamber.vii)Comparativelyearlydevelopmentofcomplicatedcataractandsecondaryglaucoma(usuallyopenangletype).Glaucomahasbeenreportedin10-59%ofcases.TreatmentFuch'sheterchromicuveitisrespondsvariabletosteroidsandcycloplegics.Thecomplicationsoflongtermuseofthesedrugsmayattimesoutweightheirpotentialbenefits.Therefore,treatmentwith

topicalsteroidsisgiventoiritiswhichissufficientlyactivetorequirethetreatment,otherwisethepatientisroutinelyfollowedwithoutgivinganytreatment.Cataractrespondswelltomostformsofintraocularsurgeries,includingthestandardIOLimplantation.Hyphemiamayoccurbecauseofrubeosisiridis(neovascularizationofiris).Glaucomacontrolmaybesomewhatmoreproblematic,withsurgicaloptionsindicatedforlaterformsofdisease

106.BSGTstandsfor? a)Bagolinistriatedglassestest b)Bagolinismoothglassestest c)Bagolinishinyglassestest d)Bagolinisecondgluetest CorrectAnswer-AAns.is'a'i.e.,BagolinistriatedglassestestBagolinistriatedglassestest,orBSGT,isasubjectiveclinicaltesttodetectthepresenceorextentofbinocularfunctionsandisgenerallyperformedbyanorthoptist.Itismainlyusedinstrabismusclinics.

107.Melanocytesinconjunctivaarederived from? a)Neuralectoderm b)Surfaceectoderm c)Mesoderm d)Neuralcrest CorrectAnswer-DAns.is'd'i.e.,Neuralcrest

108.Bitemporalhemianopiaischaracteristic of? a)Glaucoma b)Opticneuritis c)Pituitarytumor d)Retinaldetachment CorrectAnswer-CAns.is'c'i.e.,PituitarytumorCharacteristicvisualfielddefectofcentralchiasmaticlesionisbitemporalhemianopia.Pituitarytumorcausescentralchiasmaticlesion.Bitemporalhemianopiaresultsduetocentral(sagittal)lesionoftheopticchiasma,commoncausesofwhicharetumorsofthepituitarygland(mostcommon),craniopharyngioma,suprasellarmeningioma,gliomaofthirdventricle,chiasmalarachnoiditis,andthirdventriculardilatation.

109.Forcongenitalobstructionof nasolacrimalduct,probingisdoneatwhatage? a)2months b)6months c)10months d)14months CorrectAnswer-BAns.is'b'i.e.,6monthsProbingofcongenitalnasolacrimalductblockadewithBowman'sprobeItshouldbeperformed,incasetheconditionisnotcuredbytheageof3-4months.Somesurgeonsprefertowaittilltheageof6months.Itisusuallyperformedundergeneralanaesthesia.Whileperformingprobing,caremustbetakennottoinjurethecanaliculus.

110.Rightesotropiaisevidentwith? a)Leftlateralrectusparalysis b)Rightlateralrectusparalysis c)Leftmedialrectusparalysis d)Rightmedialrectusparalysis CorrectAnswer-AAns.is'a'i.e.,Leftlateralrectusparalysis

111.Diabeticischemicmaculopathyis characterizedbyallexcept? a)Itoccursduetomicrovascularblockage b)Mildvisualloss c)Areasofnonperfusionareevidentonfluoresceinangiography d)Microaneurysmsandhemorrhagesareseen CorrectAnswer-BAns.is`b'i.e.,MildvisuallossIschaemicdiabeticmaculopathyItoccursduetomicrovascularblockage.Clinicallyitischaracterisedbymarkedvisuallosswithmicroaneurysms,haemorrhages,mildornomacularoedemaandafewhardexudates.Fluoresceinangiographyshowsareasofnon-perfusionwhichinearlycasesareintheformofenlargementoffovealavascularzone(FAZ),lateronareasofcapillarydropoutsareseenandinadvancedcasesprecapillaryarteriolesareblocked.

112.Treatmentformildptosisis? a)Fasanellaservatoperation b)Levatorresection c)Frontalisslingoperation d)Everbusch'soperation CorrectAnswer-AAns.is'a'i.e.,FasanellaservatoperationFasanella-Servatoperation.Itisperformedincaseshavingmildptosis(1-5-2mm)andgoodlevatorfunction.Init,upperlidisevertedandtheuppertarsalborderalongwithitsattachedMuller'smuscleandconjunctivaareresected.

113.Cataractiscasesofdiabetesmellitusis duetoaccumulationof? a)Glycatedcrytallins b)Calcifiedcrystallins c)Glycatedfibrillins d)Calcifiedfibrillins CorrectAnswer-AAns.is'a'i.e.,GlycatedcrytallinsDiabeticcataractSenilecataracttendstodevelopatanearlierageandmorerapidlythanusualindiabeticsubjects.Thelensesofanadultdiabeticaresaidtobeinthesameconditionasanon-diabeticwhois15yearsolder.Indiabeticadults,coin-paredtonon-diabetics,cataractsaremoreprevalent,aredependentonthedurationofdiabetesandprogressmorerapidly.Themechanismsarebelievedtobeglycation,carbamylationofcrystallinsandincreasedoxidativedamage.Truediabeticcataractisarareconditionoccurringtypi-callyinyoungpeopleinwhomthediabetesissoacuteastodisturbgrosslythewaterbalanceofthebody.Alargenumberoffluidvacuolesappearundertheanterior-tdposteriorpartsofthecapsule,initiallymanifestingasmyopiaandthenproducingadiffuseopacitywhichatthisstageisreversible.Thelensthenrapidlybecomescataractous,withdense,whitesubcapsularopacitiesintheanteriorandposteriorcortexresemblingasnowstorm-'snowflake'cataract.Fine,needle-shapedpolychromaticcorticalopacitiesmayalsoform.Withappropriatetreatmenttocontrolhyperglycaemia,therapidprogressiontomature

cataractmaybearrestedatthisstage.

114.Densityofcellsinadultcorneal endothelium? a)2000cells/mm2 b)3000cells/mm2 c)4000cells/mm2 d)5000cells/mm2 CorrectAnswer-BAns.is'b'i.e.,3000cells/mm2Thecelldensityofcornealendotheliumisaround3000cells/mm2inyoungadults,whichdecreaseswiththeadvancingage.

115.Axialproptosisisproducedbytumors lyingin? a)Retrobulbarspace b)Subperiostealspace c)Tenonspace d)Peripheralspace CorrectAnswer-AAns.is'a'i.e.,RetrobulbarspaceSURGICALSPACESINTHEORBITTheseareofimportanceasmostorbitalpathologiestendtoremaininthespaceinwhichtheyareformed.Therefore,theirknowledgehelpsthesurgeoninchoosingthemostdirectsurgicalapproach.Eachorbitisdivisibleintofoursurgicalspaces.1.ThesubperiostealspaceThisisapotentialspacebetweentheboneandtheperiorbita(periosteum).2.TheperipheralspaceItisboundedperipherallybytheperiorbitaandinternallybythefourrectiwiththinintermuscularsepta.Tumourspresenthereproduceeccentricproptosisandcanusuallybepalpated.Forperibulbaranaesthesia,injectionismadeinthisspace.3.ThecentralspaceItisalsocalledmuscularconeorretrobulbarspace.ItisboundedanteriorlybytheTenon'scapsuleliningbackoftheeyeballandperipherallybythefourrectimusclesandtheirintermuscularseptaintheanteriorpart.Intheposteriorpart,itbecomescontinuouswiththeperipheralspace.Tumourslyinghereusuallyproduceaxial

proptosis.Retrobulbarinjectionsaremadeinthisspace.4.Tenon'sspaceItisapotentialspacearoundtheeyeballbetweenthescleraandthetenonscapsule.

116.InxerophthalmiaclassificationX2stage is? a)Bitotsspots b)Cornealxerosis c)Cornealulceration d)Cornealscar CorrectAnswer-BAns.isbi.e.,CornealxerosisWHOclassification(1982)Thenewxerophthalmiaclassification(modificationoforiginal1976classification)isasfollows: 1. XNNightblindness2. X1AConjunctivalxerosis3. X1BBitot'sspots4. X2Cornealxerosis5. X3ACornealulceration/keratomalaciaaffectinglessthanone-third cornealsurface. 6. X3BCornealulceration/keratomalaciaaffectingmorethanone-third cornealsurface. 7. XSCornealscarduetoxerophthalmia8. XFXerophthalmicfundus.

117.AllofthefollowinghasHLAB27 associatedwithuveitisexcept? a)Ankylosingspondylitis b)Reiterssyndrome c)Behcetssyndrome d)Noneoftheabove CorrectAnswer-CAns.is'c'i.e.,BehcetssyndromeAfewexamplesofHLA-associateddiseaseswithuveitisareasfollows:i)HLA-B27:AcuteanterioruveitisassociatedwithankylosingspondylitisandalsoinReiter'ssyndrome.ii)HLA-B5:UveitisinBehcet'sdisease.iii)HLA-DR4andDW15:VogtKoyanagiHarada'sdisease.

118.Marcusgunnjawwinkingphenomenon duetorelationbetweenwhichcranialnerves a)VII+VIII b)III+V c)V+VII d)III+VI CorrectAnswer-BAns.is'b'i.e.,III+VMarcusGunnphenomenon(a.k.a.MarcusGunnJaw-WinkingorTrigemino-oculomotorSynkineses)ITisanautosomal-dominantconditionwithincompletepenetrance,inwhichnursinginfantswillhaverhythmicupwardjerkingoftheiruppereyelid.Thisconditionischaracterizedasasynkinesis:whentwoormoremusclesthatareindependentlyinnervatedhaveeithersimultaneousorcoordinatedmovements.

119.Increasedintraoculartensioncanbe diagnosedby? a)Tonometer b)Pachymeter c)Placido'sdisc d)Keratometer CorrectAnswer-AAns.is'a'i.e.,TonometerTheexactmeasurementofintraocularpressureisdonebyaninstrumentcalledtonometer.Indentation(Schiotztonometer)andapplanation(e.g.,Goldmann'stonometer)tonometersarefrequentlyused.

120.Wernicke'shemianopicpupillaryreponse isseeninlesionsat? a)Optictract b)Opticchiasma c)Opticradiation d)Lateralgeniculatebody CorrectAnswer-AAns.is'a'i.e.,Optictract

121.`Ischemicnecrosis'inalkaliburnis? a)StageI b)StageII c)StageIII d)StageIV CorrectAnswer-AAns.is'a'i.e.,StageIAlkaliburnsareamongthemostseverechemicalinjuriestoeye.Commonalkaliesresponsibleforburnsareliquidammonia(mostharmful),lime,causticpotashorcausticsoda.oClinicalfeaturesaredividedintothreestages.1)Acuteischemicnecrosis(StageI):-Inthisstagetherearesignsinconjunctiva(edema,congestion,necrosis,copiousdischarge),cornea(sloughing,edemaandopacity)andiris(iridocyclitis).2)Reparation(StageII):-Conjunctivalandcornealepitheliumregenerate,andthereiscornealneovascularization.3)Complications(StageIII):-Symblepharon,recurrentcornealulceration,complicatedcataract,secondaryglaucoma.

122.Ganglioniccellsare,neurons? a)Firstorder b)Secondorder c)Thirdorder d)None CorrectAnswer-BAns.is'b'i.e.,Secondorder

123.NomovementofRedreflexin retinoscopy- a)Norefractiveerror b)Myopiaof3D c)MyopiaofID d)Hypermetropia CorrectAnswer-CAns.is'c'i.e.,MyopiaofIDRetinoscopyRetinoscopy,alsocalledskiascopyorshadowtest,isanobjectivemethodoffindingouttheerrorofrefractionbythemethodofneutralization.Retinoscopyisbasedonthefactthatwhenalightisreflectedfromamirrorintotheeye,thedirectioninwhichthelightwilltravelacrossthepupilwilldependupontherefractivestateoftheeye.Withthehelpofaretinoscope,lightisthrownontothepatient'seyeandthroughaholeintheretinoscope'smirrortheexaminerobservesofredreflexinthepupillaryareaofthepatient.Thentheretinoscopeismovedinhorizontaltheverticalmeridiakeepingawatchonredreflex,whichalsomoveswhentheretinoscopeismoved.

124.Maximumrefractiveindex? a)Cornea b)Air c)Lens d)Vitreous CorrectAnswer-CAns.is'c'i.e.,Lens 1. Refractiveindexofvariouseyeparts1. Cornea-1.3762. Aqueoushumor-1.3363. Lens(fromcortextocore)-1.386-1.4064. Vitreoushumor-1.3362. Howtomemorise! a.Therefractiveindexdependsupontheopticaldensity 1. Aqueousandvitreousbeingfluidshavelowdensity- havelowrefractiveindex. 2. Corneaislessopticallydensethanlens.(corneaisthinnerthan lens!)b.Soremember4values 1. i.1.336-aqueous/vitreous2. ii.1.376-cornea3. iii.1.386-cortexoflens4. iv.1.406-coreorcentroidoflens c.Alsoremember,therefractiveindexoftheanteriorsurfaceoflensisgreaterthantheposteriorsurface.

125.Primaryactionofinferioroblique? a)Abduction b)Adduction c)Extorsion d)Elevation CorrectAnswer-CAns.is'c'i.e.,Extorsion

126.Whatisthemostcommonproblem followingsurgicaltreatmentofpterygium? a)Recurrence b)Cornealulceration c)Astigmatism d)Scleralscarring CorrectAnswer-AAns.is'a'i.e.,RecurrenceSurgicalexcisionofpterygiumisitsonlysatisfactorytreatmentandisindicatedfor? 1. Cosmeticreasons2. Continuedprogressionthreateningtoencroachontothepupillary area(oncethepterygiumhasencroachedpupillaryarea,waittillitcrossesontheotherside) 3. Diplopiaduetointerferenceinocularmovements. Recurrenceofthepterygiumaftersurgicalexcisionisthemostcommonproblemafterpterigiumexcisionandisseenin30-50%ofthecases.Thepostoperativecomplicationsofpterigiumsurgeryare: 1. Recurrence(mostcommon)2. Others:Bleeding,cornealthinning,scarring,fornixloss, symblepharonformation,rectusmuscleinjury,wounddehiscence,dellenformation,graftchemosis,conjunctivalgranuloma,epithelialinclusioncysts,astigmatismetc.

127.Refsum'ssyndromeisassociatedwith? a)Retinitispigmentosa b)Xerophthalmia c)Chalcosis d)Diabetesretinopathy CorrectAnswer-AAns.is'a'i.e.,RetinitispigmentosaAssociationsofretinitispigmentosaOcularassociations:Theseincludemyopia,primaryopenangleglaucoma,microphthalmos,conicalcorneaandposteriorsubcapsularcataract.Systemicassociations:Theseareintheformoffollowingsyndromes:-i)Laurence-Moon-Biedlsyndrome:Itischaracterisedbyretinitispigmentosa,obesity,hypogenitalism,polydactylyandmentaldeficiency.ii)Cockayne'ssyndrome:Itcomprisesretinitispigmentosa,progressiveinfantiledeafness,dwarfism,mentalretardation,nystagmusandataxia.iii)Refsum'ssyndrome:Itischaracterizedbyretinitispigmentosa,peripheralneuropathyandcerebellarataxia.iv)Usher'ssyndrome:Itincludesretinitispigmentosaandlabyrinthinedeafness.v)Hallgren'ssyndrome:Itcomprisesretinitispigmentosa,vestibulo-cerebellarataxia,congenitaldeafnessandmentaldeficiency.

128.Followingisafeatureofconcomitant squint? a)Constantamountofdeviationinalldirectionsofgaze b)Associatedlimitationofocularmovements c)Differentamountofdeviationindifferentdirectionsofgaze d)Developsinthepatientsat15-20yearsofage. CorrectAnswer-AAns.is'a'i.e.,ConstantamountofdeviationinalldirectionsofgazeMANFESTSQUINT(HETEROTROPIA)Inmanifestsquintthedeviationofeyeispresentassuchandcannotbecompensatedbyfusion.Twomaintypesofmanifestsquintareconcomitantsquintandparalyticsquint.A)ConcomitantsquintInconcomitantsquinttheeyesarenotinalignmentandthedegreeofmalalignmentremainsconstantinallthedirectionsofgazeandthereisnolimitationofocularmovements.Concomitantsquintmaybeoffollowingtypes:1)Esotropia(Convergentsquint):-Itdenotesinwarddeviationofeye.Itcanbeunilateraloruniocular(thesameeyealwaysdeviatesinwards)oralternating(eitheroftheeyesdeviatesinwardsandtheothereyetakesupfixation,alternately).Concomitantesotropiaisthemostcommontypeofsquintinchildren.Followingtypesofesotropiaarethere:-i)Congenitalesotropia(infantileesotropia)Truecongenital(infantile)esotropiausuallyappearsbetweentheageof2and4months.However,rarelyitmaybepresentfrombirth.Theinwardturnoftheeyeisconstantoflargeamount,i.e.,deviation

is>35prismdiopters(17-5').Binocularvision(botheyesfixingsimultaneously)doesnotdevelop.Thereisalternatefixationinprimarygaze,i.e,whentheinfantlooksstraight,hefixesthegazewithoneeyeatatimealternately.Onlateralgazethereiscrossfixation,i.e,userighteyetofixacrossthenosetoviewtheobjectstotheleftandviceversa.Amblyopiadevelopsin25-40%ofcases.Latenthorizontalnystagmus(common)andmanyrotatorynystagmusmayoccur.Inferiorobliqueoveractionmaybepresentinitiallyordeveloplateranddissociatedverticaldeviationdevelopin80%byageof3years.Itismoredifficulttohelpthistypeofstrabismuswithnonsurgicalmethods,thus,surgeryisthetreatmentofchoice.Surgicalproceduretomakebothmedialrectiweakbyrecession.Surgeryshouldbedoneasearlyaspossibletoavoiddevelopmentofamblyopiaandforthedevelopmentofproperbinocularvision.Theusuallyrecommendedtimeisbetween6month-2yearsofage(andpreferablybefore1yearofage).Itisimportanttotreattheamblyopiabeforeperformingsurgerybypatchingofnormaleye.ii)AccommodativeesotropiaAccommodativeesotropiaoccursduetooveractionofconvergenceassociatedwithaccommodationreflex.Accommodativeesotropiaisthemostcommontypeofsquintinchildren(Previouslyitwasbelievedthatcongenitalesotropiaisthemostcommontypesquintinchildren.Howevernowitisverymuchclearthataccommodativeesotropiaisthemostcommonone).Itesotropiaisnotedaround2-3yearsofage,itismostlikelyaccommodativeesotropia.OnthebasesofAC/A(accommodativeconvergence/accomodation)ratio,accommodativeesotropiaisdividedintotwotypes:(a)Refractive(NormalAC/Aratio);(b)Non-refractive(abnormalAC/Aratio).AC/Aratiogivestherelationshipbetweentheamountofconvergencethatisgoverenedbyagivenamountofaccommodation. a. NormalAC/Aratioaccommodativeesotropia:-Thisoccursin childrenwithhypermetropia.Esotropiaisaphysiologicalresponsetoexcessivehypermetropia.Patientswithhighhypermetropiageneratelargeamountofaccommodationtoseeclearlyatnearfixation.This

excessiveaccommodationmaycauseesotropiaasaccommodationisassociatedwithconvergence.AC/Aratioisnormal. b. LargeAC/Aratioaccommodativeesotropia:-Childrenhavelarge amountsoffocusingpowerandsometimestheincreaseofaccommodationisaccompaniedbyadisproportionatelylargeincreaseofconvergence.Thisoccursinpatientwithhypermetropiabutmayoccurinmyopiaandwithoutanyrefractiveerror.AC/Aratioishigh.Usually,therearenosymptomsexceptforcosmeticembarrassmenttothepatient.Thereisnodiplopiaastheimageinthesquintingeyeisautomaticallysuppressed,i.e.,amblyopiadevelopsinsquintingeye.Themainfeatureisthefailureofbinocularvision.2)Exotropia(divergentsquint):-Itischaracterizedbyoutwarddeviationofeye.Thisisverylesscommonthanesotropia.3)Hypertropia(Verticalsquint):-Itischaracterizedbyverticaldeviationofeye.Itisalsorare.B)IncomitantsquintIncomitantsquintisasquintinwhichtheangleofdeviationdiffersdependinguponthedirectionofgazei.e,amountofdeviationvariesindifferentdirectionsofgaze.Therearemanytypeofincomitantsquints(paralytic,restrictive,'A'&'V'pattern),howeverthemostcommontypeisParalyticsquintandthewordincomitantsquintisusuallyusedforparalyticsquint.Therefore,IwillexplainparalyticsquinthereParalyticsquintisthemostcommontypeofsquintinadults.Paralyticsquintisthestrabismusresultingfromcompleteorincompleteparalysisofoneormoreextraocularmuscles.Therearemanycauseslikeneurogenic(e.g.meningitis,cranialnervepalsyetc.),myogenic(myopathies),orneuromuscularjunctionlesions.oSymptomsofparalyticsquintare:-i)Diplopia:Itisthemainsymptom.Itismostmarkedinthedirectionofactionofparalysedmuscle.Forexampleinleftrectuspalsy,themaximumdiplopiaoccurswhenpatienttriestoseehorizontallyonleftsideandinleftsuperiorobliquepalsy(causesDextrodepression)diplopiaismaximumwhenpatienttriestolookdownwardandright.Itisworthnotingherethatindiplopia,iftheimagesareseparatedhorizontallyitisprobablethateitheralateraloramedialrecutsisaffected;whentheimagesareseparatedverticallyortheimageistilted(torsion)itislikelythatoneormoreoftheverticalrectiorthe

tilted(torsion)itislikelythatoneormoreoftheverticalrectiortheobliquesareaffected.ii)Othersymptoms:Confusion,nausea&vertigo,oculardeviation,lossofstereopsis.Signsofparalyticsquintare:-i)Secondarydeviationismorethanprimarydeviation:-Primarydeviationisthedeviationintheaffectedeyeandisawayfromtheactionofparalysedmuscle.Secondarydeviationisthedeviationofnormaleyeseenundercover,whenthepatientismadetofixwiththesquintingeye.ii)Restrictionofocularmovementsiii)Compensatoryheadposture:-Patientswithaparalyticsquintmovetheirheadsuchthattheeyesoccupyapositionintheorbitwheretheangleofsquintisminimalandthiscanavoidconfusionanddiplopia.Headisturnedtowardstheactionofparalysedmuscle.Whenthehorizontalrecti(medialorlateral)areaffected,thecharacteristicpostureisaturnofthefacetorightorleft,e.g.inleftlateralrectuspalsytheheadisturnedtotheleftandinleftmedialrecutspalsytheheadisturnedtotheright.Whenaverticalrectus(superiororinferior)oranobliquemuscleisaffected,atiltoftheheadtotherightorleftwithdepressionorelevationofthechinisadoptedtoreduceboththeverticaldeviationandrotation,e.ginsuperiorobliquepalsy(dextrodepressionoflefteyeisaffected)theheadistiltedtoleftsothatthelefteyecanseedownandmedially.iv)Thereisfalseprojectionororientationv)Thereisnoamblyopiaandvisualacuityisnormalasparalyticsquintdevelopsinadultswhenvisualacuityhasalreadydeveloped.

129.Diplopiaisusuallyseenin? a)Paralyticsquint b)Non-paralyticsquint c)Bothoftheabove d)Noneoftheabove CorrectAnswer-AAns.is'a'i.e.,Paralyticsquint

130.Followingistrueaboutbehcet'sdisease except? a)Itshowspresenceofaphthousulceration,genitalulcerationand uveitis b)Uveitisisbilateral,acuterecurrentiridocyclitiswithhypopyon c)Ithasgoodvisualprognosis d)Chlorambucilcanbeusedtocontrolthedisease CorrectAnswer-CAns.is'c'i.e.,IthasgoodvisualprognosisBEHCET'SDISEASEItisanidiopathicmultisystemdiseasecharacterisedbyrecurrent,non-granulomatousuveitis,aphthousulceration,genitalulcerationsanderythemamultiforme.EtiologyItisstillunknown;thebasiclesionisanobliterativevasculitisprobablycausedbycirculatingimmunecomplexes.ThediseasetypicallyaffectstheyoungmenwhoarepositiveforHLA-B51.ClinicalfeaturesUveitisseeninBehcet'sdiseaseistypicallybilateral,acuterecurrentiridocyclitisassociatedwithhypopyon.Itmayalsobeassociatedwithposterioruveitis,vitritis,periphlebitisretinaeandretinitisintheformofwhitenecroticinfiltrates.TreatmentNosatisfactorytreatmentisavailable,andthusthediseasehasgotcomparativelypoorvisualprognosis.Corticosteroidsmaybyhelpfulinitiallybutultimateresponseispoor.Insomecasesthediseasemaybecontrolledbychlorambucil.

131.Imbert-Ficklawisassociatewith? a)Schiotztonometry b)Applanationtonometry c)Pachymetry d)Keratometry CorrectAnswer-BAns.is'b'i.e.,ApplanationtonometryApplanationtonometryTheconceptofapplanationtonometrywasintroducedbyGoldmannis1954.ItisbasedonImbert-Ficklawwhichstatesthatthepressureinsideasphere(P)isequaltotheforce(W)requiredtoflattenitssurfacedividedbytheareaofflattening(A);i.e.,P=W/A.

132.Recurrentnon-granulomatousuveitisis seenin? a)Vogtkoyanagi-Haradasyndrome b)Posner-Schlossmansyndrome c)Tuberculosis d)Sarcoidosis CorrectAnswer-BAns.is`b'i.e.,Posner-SchlossmansyndromeGlaumatocycliccrisisGlamatocycliticcrisis(Posner-Schlossmansyndrome)isaunilateralrecurrentnon-granulomatousiritisthatisassociatedwithanelevatedocularpressureduringtheattacks.Thisself-limitingconditiontendstooccurinpersonsduringthethirdtosixthdecadeandthevisualfields,theopticnervehead,andanteriorchamberanglearenormal.Amildinflammatoryreactionisveryrarelypresentasevidencedbyafewkeraticprecipitatesontheposteriorsurfaceofthecornea.Thecauseoftheglaucomaremainsunknown,butatrabeculitisissuspected.Manypatients(55%)subsequentlydevelopopenangleglaucoma.

133.Bett'sclassificationdealswith? a)Oculartrauma b)Ocularforeignbody c)Squint d)Maculopathy CorrectAnswer-AAns.is'a'i.e.,OculartraumaBETTS(BirminghamEyeTraumaClassificationSystem)Oculartraumaclassificationgrouphasorganizedeyeinjuriesusingstandardtechnologytodescribevariousformsofocularinjury.ThisiscalledBETTS-BirminghamEyeTraumaClassificationSystem.

134.Howmanyincisionsareusedinthe dividedsystemapproachofparsplanavitrectomy? a)1 b)2 c)3 d)4 CorrectAnswer-CAns.is'c'i.e.,3TechniquesofperformingvitrectomyA)Open-skyvitrectomyThistechniqueisemployedtoperformonlyanteriorvitrectomy.Openskyvitrectomyisperformedthroughtheprimarywoundtomanagethedisturbedvitreousduringcataractsurgeryoraphakickeratoplasty.B)Closedvitrectomy(Parsplanavitrectomy)Parsplanaapproachisemployedtoperformcorevitrectomy,subtotalandtotalvitrectomy.Parsplanavitrectomyisahighlysophisticatedmicrosurgerywhichcanbeperformedbyusingtwotypeofsystems: 1. Fullfunctionsystemvitrectomyisnow-a-dayssparinglyused.It employsamultifunctionsystemthatcomprisesvitreousinfusion,suction,cutterandillumination(VISC),allinone. 2. Dividedsystemapproachisthemostcommonlyemployedtechnique inmodernvitrectomy.Inthistechniquethreeseparateincisionsaregiveninparsplanaregion.Thatiswhytheprocedureisalsocalledthree-portparsplanavitrectomy.Thecuttingandaspiration

functionsarecontainedinoneprobe,illuminationisprovidedbyaseparatefiberopticprobeandinfusionisprovidedbyacarmulaintroducedthroughthethirdparsplanaincision.

135.Munson'ssignisafeatureof? a)Keratoconus b)Cornealulcer c)Pterygium d)Posteriorstaphyloma CorrectAnswer-AAns.is'a'i.e.,KeratoconusKerotoconusKeratoconusisaprogressive,noninflammatory,bilateralectaticcornealdisease,characterizedparaxia/stromalthinningandweakeningthatleadstocornealsurfacedistortion.Essentialpathologicalchangesarethinningandectasiawhichoccurasaresultofdefectivesynthesisofmucopolysaccharideandcollagentissue.Itusuallystartsatpubertyandprogressesslowly.Symptomsusuallybeginsasblurredvisionwithshadowingaroundimages.Visionbecomesprogressivelymoreblurredanddistortedwithassociatedglare,halosaroundlights,lightsensitivityandocularirritation.Visuallossoccursprimarilyfromirregularastigmatismandmyopia,andsecondarilyfromcornealscarring.oThehallmarkofkeratoconusiscentralorparacentralstromalthinning,apicalprotrusionofanteriorcorneaandirregularastigmatism.Thecorneathinsnearthecentreandprogressivelybulgesforwards,withtheapexofconealwaysbeingslightlybelowthecentreofthecornea.Importantfindingsanexaminationare-

i)Distartedwindowreflex(Cornealreflex)e.ii)Fleisher'srine.iii)Yawningreflex(Scissorreflex).iv)Oildropreflex.v)Munson'ssignsTreatmentincludes:?1)Spectaclesforregularormildirregularastigmatism.2)Rigidgaspermeablecontactlensforhigherastigmatism.3)Epikeratoplastyinpatientsintoleranttolensandwithoutsignificantcornealscarring.4)Keratoplastypenetratingordeeplamellarifthereissignificantcornealscarring.

136.Newborneyeis? a)Myopic b)Hypermetropic c)Presbyopic d)Noneoftheabove CorrectAnswer-BAns.is'b'i.e.,HypermetropicEyeatbirthAnteroposteriordiameterofeyeballisabout16.5mm(70%ofadultsize).Adultsizeisattainedby7-8years.Cornealdiameterisabout10mm.Adultsize(11.7mm)isattainedby2yearsofage.Anteriorchamberisshallowandangleisnarrow.Lensissphericalatbirth.Retina:-Apartfrommaculararea,theretinaisfullydifferentiated.Maculadifferentiates4-6monthsafterbirth.Myelinationofopticnervefibreshasreachedthelaminacribrosa.Newbornisusuallyhypermetropicby+2to+3D.Orbitismoredivergent(50?)ascomparedtoadult(45?).Lacrimalglandisstillunderdevelopedandtearsarenotsecreted.

137.Homonymoushemianopiatypeofvisual fielddefectisseeninallexcept? a)Lateralgeniculatebody b)Totalopticradiation c)Optictract d)Opticchaisma CorrectAnswer-DAns.is'd'i.e.,Opticchaisma

138.Followingistrueaboutoculocardiac reflexexcept? a)Itisalsocalledaschnerphenomenon b)Itismediatedbyocculomotorandvagusnerve c)Itischaracterizedbybradycardiafollowingtractiononextra- ocularmuscles d)Reflexismoresensitiveinneonates CorrectAnswer-BAns.is'b'i.e.,ItismediatedbyocculomotorandvagusnerveOculocardiacreflexOculocardiacreflex,isalsoknownasAschnerphenomenon,Aschnerreflex,orAschner-Dagninireflex,oItischaracterizedbydecreaseinpulserate(bradycardia)associatedwithtractionappliedtoextraocularmusclesand/orcompressionoftheeyeball.Thereflexismediatedbynerveconnectionsbetweentheophthalmicbranchofthetrigeminalcranialnerveviatheciliaryganglion,andthevagusnerveoftheparasympatheticnervoussystem.Thisreflexisespeciallysensitiveinneonatesandchildren,particularlyduringstrabismuscorrectionsurgery.However,thisreflexmayalsooccurwithadults.Bradycardia,junctionalrhythmandasystole,allofwhichmaybelife-threatening,canbeinducedthroughthisreflex.

139.Cornealendothelialcellcountis measuredby? a)Specularmicroscope b)Ophthalmoscope c)Synoptophore d)Amsler'sgrid CorrectAnswer-AAns.is'a'i.e.,SpecularmicroscopeCornealendotheliumisexaminedwithspecularmicroscope,whichallowsaclearmorphologicalstudyofendothelialcellsincludingphotographicdocumentation.Thecelldensityofendotheliumisaround3000cells/mm2inyoungadults,whichdecreaseswithadvancingage.

140.Drugkeptasalastresortinthe managementofprimaryopenangleglaucomais? a)Latanoprost b)Topicalbetablocker c)Brimonidine d)Oralacetazolamide CorrectAnswer-DAns.is'd'i.e.,OralacetazolamideTreatmentofPOAG(Primaryopenangleglaucoma)FollowingtreatmentoptionsareavailableforPOAG:Medicaltherapy:-TotalmedicaltherapyisthetreatmentofchoiceforPOAG.Topical13-blockers(Timolol,Betoxalol,Levobunolol,carteolol)arethedrugsofchoice.Topicalprostaglandinanalogues(Latanoprost,bimatoprost,travoprost)arethesecondchoicedrugs.OthertopicaldrugsforPOAGare:-LIAlphaagonists(non-selective:epinephrine,dipivefrine;andSelective-a2:apraclonidine,brimonidine)Carbonicanhydraseinhibitors(Dorzalamide,brinzolamide)Cholinomimeticdrugs(Pilocarpine,physostigmine,echothiophate,carbachol)Pilocarpirehasseveraldrawbacks,therefore,isbeingconsideredasanadjunctivetherapyonlyasalastresort. ApproachtotreatmentofPOAG StartmonotherapywithtopicalP-blockerorlatanoprost.IftargetIOTisnotattainedeitherchangeovertothealternativedrugoruseboththeaboveconcurrently.Brimonidine/dorazolamide/dipivefrineareusedonlywhenthereare

contraindicationstoPGanaloguesor13-blockers.Topicalmioticsandoralacetazolamideareaddedonlyasthelastresort.Systemictherapyisconsideredonlyasalastresort.Drugsusedforsystemictherapyare:-(i)Carbonicanhydraseinhibitors(Acetazolamide,Dichlorphenamide,methazolamide),(ii)Hyperosmoticagents(mannitol,glycerol).

141.Amsler'sgridisusedtoevaluate? a)Central10degressofvision b)Central20degreesofvision c)Peripheralvision d)Lensopacity CorrectAnswer-AAns.is'a'i.e.,Central10degressofvisionMetamorphopsiaisaphenomenonwhereinthepatientperceivesobjectstohaveanaltered,irregularcontourorshape.Forexample,graphpaperlinesmaybebentorobscuredinareas.ThiscanbereviewedforanychangesovertimeusinganAmslergrid,whichteststhecentral10?ofvision.Itisassociatedwithdiseasesaffectingthemaculasuchascentralserouschoroidopathy,age-relatedmaculardegeneration,diabeticmacularoedemaandmacularhole.

142.Styeissuppurativeinflammationof glandsof? a)Zeis b)Meibonian c)Wolfring d)Alltheabove CorrectAnswer-AAns.is'a'i.e.,Zeis

143.Objectivemethodsforcheckingthe refractiveerrorareallexcept a)Ophthalmoscopy b)Retinoscopy c)Refractometry d)Keratometry CorrectAnswer-AAns.is'a'i.e.,OphthalmoscopyTheprocedureofdeterminingandcorrectingrefractiveerrorsistermedasrefraction.Therefractioncomprisestwocomplementarymethods:?A)Objectivemethods:Objectivemethodsofrefractioninclude:-(i)Retinoscopy,(ii)Refractometry,(iii)Keratometry.B)Subjectivemethods:Theseare:-(i)Subjectiveverificationofrefraction,(ii)Subjectiverefiningofrefraction,(iii)Subjectivebinocularbalancing.

144.Lensdislocationinmarfanssyndromeis - a)Superotemporal b)Inferonasal c)Forward d)Backward CorrectAnswer-AAns.is'a'i.e.,Superotemporal

145.Safesizeofcornealgraftwithless chancesoffailureis? a)7.5mm b)6.5mm c)5.5mm d)4.5mm CorrectAnswer-AAns.is'a'i.e.,7.5mmCorrelationofcornealgraftdiameterandchancesofgraftfailureIncreasedcornealgraftsizehasbeenreportedinsomestudiestobeasignificantriskfactoreforgraftrejection.Otherstudiesrefutethisandpointtosmallergraftsizeasmorelikelytoberejected.Thereisincreasedriskofrejectionandendothelialfailureinsmallgraftswithrecipientsize<7mmandalsoincreasedriskofrejectioninlargegraftswithgraftsize>8.5mm.Thusthecornealgraftwithgraftdiameterbetween7and8.5mmhasmorechancesofsurvival.

146.Angularconjunctivitisiscausedmainly by a)Moraxellaaxenfeld b)Staphylococcusaureus c)Streptococcuspneumonae d)Pseudomonasaeruginosa CorrectAnswer-AAns.is'a'i.e.,MoraxellaaxenfeldAngularconjunctivitis(diplobacillaryconjunctivitis)Itisatypeofchronicconjunctivitischaracterizedbymildgradeinflammationconfinedtoconjunctivaandlidmarginsneartheanglesassociatedwithmacerationofthesurroundingskin.Moraxellaaxenfeld(Moraxellalacunata),adiplobacillus,isthecommonestcausativeorganism.Lesscommonly,staphylococcusaureuscanalsocauseangularconjunctivitis.Sourceofinfection:Nasaltractofhealthypeopleandthenasaldischargeofpatientswithangularconjunctivitis.Itspreadsfromthenasalcavitytotheeyebycontaminatedhandsandhandkerchief.Angularconjunctivitisrespondstotetracyclineointment,Oxytetracyclinefor10to14days.Eyedropscontainingzincinhibittheproteolyticfermentandareofgreatvaluealthoughlessrapidlyeffective,andmaybeusedinadditiontotetracycline.

147.Anterioruveitisearliestlesion? a)Aqueousflare b)Keraticprecipitates c)Circumcornealcongestion d)Blurringofvision CorrectAnswer-AAns.is'a'i.e.,AqueousflareAqueousflareistheearliestsignofacuteanterioruveitis.KeraticprecipitatesisthepathognomicsignofacuteanterioruveitisClinicalfeaturesofacuteanterioruveitisAcuteanterioruveitisisthemostcommonformofuveits,accountingfor60-70%ofcases.Itischaracterizedbysuddenonsetanddurationlessthan3months.Presentationistypicalwithsuddenonsetofunilateralpain,photophobia,redness,lacrimationandblepherospasm.Visionmaybenormalinitially.However,latertheremaybedistrubanceinvisionduetociliaryspasm(inducedmyopia),cornealhaze(duetoedema&1(13s)andaqueousturbidity.Externalexaminationshowsfollowingsigns:- i. Circumcorneal(ciliary)congestionWhichhasaviolaceoushue. ii. Cornealedema,posteriorcornealopacities. iii. Keraticprecipitates(KPs):-areproteinaceouscellulardepositsatthe backofcorneaonendothelium. iv. Anteriorchambersigns:-Aqueouscells,Aqueousflare,hypopyon, hyphaemia(inhemorrhagicuveitis),deepanteriorchamber(Ifposteriorsynachiaeoccurs). v. Irissigns:-Blurred&indistinctiris,i.e.muddyiris,insteadofbeing clearandsharplydefined. vi. Papillarysigns:-Narrow(miotic)pupil,irregularpupildueto

segmentalposteriorsynechiaewhichgivesfestoonedappearance(festoonedpupil)whendilatedwithatropine,sluggishpupillaryreaction,ectropionpupillae(evertionofpupillarymargins),occlusiopupillae(duetocompleteocclusionofpupilbyorganisedexudate).

148.MainMOAbrimonidineinglaucoma? a)Decreasedaqueoussecretion b)Increasedtrabecularoutflow c)Increaseduveoscleraloutflow d)Reducevitreousvolume CorrectAnswer-AAns.is'a'i.e.,Decreasedaqueoussecretion

149.Meibomianglandssecretewhich componentofsweat? a)Water(aqueous) b)Mucin c)Protein d)Lipid CorrectAnswer-DAns.is'd'i.e.,LipidThemajorfunctionoflacrimalapparatusistosecreteanddrainthetear.Tearfilmconsistsof3layers:- i. Mucousormucinlayer(innermost):-Secretedbyconjunctivalgoblet cells,cryptsofHenle,glandsofManz. ii. Aqueouslayer(intermediate):-Thisformsthebulkofthetear.Itis secretedbymainlacrimalandaccessorylacrimalglands. iii. Lipidlayer(outermost):-SecretedbytheMeibomionZeis,andMoll glands.

150.Quantificationofcornealsensationis doneby? a)Pachymeter b)Keratometer c)Aesthesiometer d)Tonometer CorrectAnswer-CAns.is'c'i.e.,AesthesiometerMeasurementofCornealSensitivityCornealsensitivitymaybetestedbytouchingitinvariousplaceswithawispofcotton-wooltwistedtoafinepointandcomparingtheeffectwiththatontheother,normalcornea.Thereisingeneralabriskreflexclosureofthelids.Cornealsensationsareoftendiminishedafteranygrossdisorder,butthechangeisofdiagnosticsignificanceincertaincases,particularlyherpeskeratitiswhereminimalcornealchangesareaccompaniedbyagrossdiminutionofsensation.Quantificationofthecornealsensationispossibletosomedegreebytheuseofacornealaesthesiometerinwhichasinglehorsehairofvaryinglengthisusedinsteadofawispofcotton-wool.Thelongestlengthwhichinducesblinkingisameasureofthethresholdofcornealsensitivity.

151.Subconjunctivalhemorrhagesare evidentinthefollowingcasesexcept? a)Whoopingcough b)Scurvy c)Purpura d)Pellagra CorrectAnswer-DAns.is'd'i.e.,PellagraSubconjunctivalhaemorrhageOccursduetotheruptureofsmallvessels.Thecondition,thoughunsightly,istrivial.Thiscanoccurspontaneouslyinelderlypeoplewithfragilevesselsorthosewithsystolichypertensionorafterlocaloculartraumaoreyesurgery.Veryminuteecchymoses,orpossiblythromboses,areseeninsevereconjunctivitis;largeextravasationsaccompanyseverestraining,especiallyinoldpeople,asonliftingheavyweightsorvomiting.Theyarenotinfrequentlyseeninchildrenwithwhoopingcoughandmayoccurinscurvy,blooddiseasessuchaspurpura,orinmalaria.Recurrentsubconjunctivalhaemorrhageswarrantinvestigationsforableedingdiathesesorleukaemia.ThedifferentialdiagnosisincludesKaposisarcoma.Moreseriousarethelargesub-conjunctivalecchymoseswhichseepforwardsfromthefonixfollowingheadinjuries.Theyareduetoanextravasationofbloodalongtheflooroftheorbit,secondarytoafractureofthebaseoftheskull.Infracturesofthesphenoidthebloodappearslateronthetemporalsidethanelsewhere.

Haemorrhagesalsoresultfromsevereorprolongedpressureonthethoraxandabdomen,asinpersonssqueezedinacrowdorbymachinery.Thebloodgraduallychangescolourandgetsabsorbedin1to3weekswithouttreatment.Theuseofaspirinandnon-steroidalanti-inflammatorydrugs(NSAIDs)shouldbeavoidedandifmildocularirritationispresent,artificialtearscanbeprescribedfourtosixtimesaday.

152.Pleomorphicadenomaofthelacrimal glandmovestheeyeball? a)Downwardsandoutwards b)Downwardsandinwards c)Upwardsandoutwards d)Upwardsandinwards CorrectAnswer-AAns.is'a'i.e.,DownwardsandoutwardsBenignmixedtumouroflacrimalglandIPleomorphicadenoma'Itisalsoknownaspleomorphicadenomaandoccurspredominantlyinyoungadultmales.Clinicallyitpresentsasaslowlyprogressivepainlessswellingintheupper-outerquadrantoftheorbitdisplacingtheeyeballdownwardsandoutwards.Itislocallyinvasiveandmayinfiltrateitsownpseudocapsuletoinvolvetheadjacentperiosteum.Histologically,itischaracterisedbypresenceofpleomorphicmyxomatoustissue,justlikebenignmixedtumourofsalivarygland.Treatmentconsistsofcompletesurgicalremovalwiththecapsule.Recurrencesareverycommonfollowingincompleteremoval.

153.

Opticcanalisapartof? a)Lesserwingofsphenoid b)Greaterwingofsphenoid c)Ethmoid d)Pterygoid CorrectAnswer-AAns.is'a'i.e.,LesserwingofsphenoidTheopticnerveleavestheorbitistheopticcanaltoenterthecranialvault.Theopticcanalisthemostposteriorlandmarkoftheorbit.Itmeasures10mminlength.Thethinpieceofboneseparatingtheopticcanalfromthesuperiororbitalfissureistheopticstrut.Theopticstrutandopticcanalareapartofthelesserwingofsphenoidbone.

154.Floatersareseeninfollowingexcept? a)Vitreoushemorrhage b)Retinaldetachment c)Uveitis d)Acutecongestiveglaucoma CorrectAnswer-DAns.is`d'i.e.,AcutecongestiveglaucomaFloatersAfloaterissomethinginthefluidsoftheeyethatcastsashadowontheretinaandlookslikeadarkspotorspotsfloatingaroundinthefieldofvision.Floatersareusuallydescribedbypatients,assmall,semitranslucentparticlesofvaryingshapesmovingacrossthevisualfieldwiththemovementoftheeye.Floatercanonlybeseenwiththeeyesopenandinalightedenvironment.Floatersareusuallygreyorblack,sincetheyareactuallyshadowontheretina.Causesoffloatersare:- i. Posteriorvitreousdetachment(PVD) ii. Bleeding(vitreoushemorrhage) iii. Retinaldetachment iv. Inflammationofeye(uveitis) v. Highmyopia

155.Illuminatedfrenzelglassesareusedin detecting? a)Nystagmus b)Heterophoria c)Esotropia d)Astigmatism CorrectAnswer-AAns.is'a'i.e.,NystagmusIlluminatedfrenzelgalsses(+20lenses)areusefulforabolishingfixationandthusrevealingperipheralvestibularnystagmus.

156.Followingisacauseofsecondaryangle closureglaucoma? a)Pseudophakia b)Corticosteroidinduced c)Anglerecessionglaucoma d)Congenitalglaucoma CorrectAnswer-AAns.is'a'i.e.,PseudophakiaCausesofsecondaryangleclosureglaucomaPupillaryblock:uveitis,psudophakiaAnglefibrosis:neovascularglaucoma

157.Whichgasismostcommonlyusedwith pneumaticretinopathy? a)SF6 b)C3F8 c)CO2 d)N3 CorrectAnswer-AAns.is'a'i.e.,SF6Sulfurhexafluoridegas(SF6)ismostcommonlyusedwithpneumaticretinopexy.

158.Latanoprostusedtopicallyinglaucoma primarilyactsby? a)Decreasingaqueoushumorformation b)Increasinguveoscleraloutflow c)Releasingpupillaryblock d)Increasingtrabecularoutflow CorrectAnswer-BAns.is'b'i.e.,IncreasinguveoscleraloutflowAns.is'b'i.e.,IncreasinguveoscleraloutflowLatanoprostisananalogofprostaglandinF2athatincreasesuveoscleraloutflowandinducesmiosis.AntiglaucomaDrugs:MechanismofLoweringIntraocularPressure(IOP):Drugsthatincreasetrabecularoutflow?Miotics(e.g.,pilocarpine)?Epinephrine,dipivefrine?BimatoprostDrugsthatincreaseuveoscleraloutflow?Prostaglandins(latanoprost)?Epinephrine,dipivefrine?Brimonidine?ApraclonidineDrugsthatdecreaseaqueousproduction?Carbonicanhydraseinhibitors(e.g.,acetazolamide,dorzolamide)?Alphareceptorstimulatorsinciliaryprocess(e.g.,epinephrine,dipivefrine,clonidine,brimonidine,apraclonidine)?Beta-blockersHyperosmoticagents-(e.g.,glycerol,mannitol,urea).

159.2ndPurkinjeimageis? a)Erectandmovesinsamedirection b)Invertedandmovesinsamedirection c)Erectandmovesinoppositedirection d)Invertedandmovesinoppositedirection CorrectAnswer-AAns.is'a'i.e.,Erectandmovesinsamedirection1stfromanteriorsurfac:ofcornea-->Erettanilmovesinsamedirection.2ndfromposteriorsurfaceofcornea-->Erectandmovesinsamedirection.3rdfromanteriorsurfaceoflens-->Erectandmoveinsamedirection.4thfromposteriorsurfaceoflens-->Invertedandmovesinoppositedirection

160.Axiallengthofeyeballismeasuredby? a)AmodeUltrasonography b)BmodeUltrasonography c)MmodeUltrasonography d)Bothaandb CorrectAnswer-AAns.is'a'i.e.,AmodeUltrasonographyUltrasonographvinOphthalmologyAModeTransduceriscoupleddirectlytotheeyethroughtheuseofmethylcellulose.Recordingaredoneinagraphicmode.Heightoftherecordedspikeonverticalaxisisameasureoftheamplitudeoftheecho,thepositionofthespikealongthehorizontalaxisindicatesthearrivaloftheechoonthetranducer.Diagnosisisbasedonthebasisofamplitude,position,extentandmovementoftheabnormalechoesalonwiththesoundattenuatingpropertiesoftheabnormality.Ithasaspecialroleinbiometryi.e.axiallengthwhichisveryessentialforsurgicalplanning.BmodeThetransduceriscoupledtotheeyebyeitherthegelappliedtotheclosedlidorbyasalinebathIsisadisplayoftwo-dimensionalcrosssectionalimages.TheechoesinBscanaredisplayedasspotsandthebrightnessofechoesindicatesitsamplitude.

161.Enophthalmosisseenin? a)Blowoutfractureoforbitwall b)Hyperthyroidism c)RadiationInjuries d)Diabetesmellitus CorrectAnswer-AAns.is'a'i.e.,BlowoutfractureoforbitwallEnophthalmosisseeninblowoutfractureoforbitwall.

162.Acuteangleclosureglaucomafirstline treatment? a)Ivmannitol b)Acetazolamide c)Pilocarpine d)Betablockereyedrops CorrectAnswer-AAns.is'a'i.e.,I.V.MannitolTreatmentofangleclosureglaucomaDefinitivetreatment(treatmentofchoice)issurgery.However,intiallydrugsareusedtodecreaseKWduringanacuteattack.Approachoftreatmentisasfollows:-Starti.v.mannitolori.v.acetazolamideWhenIOTstartsfalling,starttopicalpilocarpineor-blocker(timolol).Apraclonidine/latanoprostmaybeadded.OnceIOTisreduced,surgeryisdone.Topicalpilocarpine2%isthepreferredantiglaucomatousdrug.AftercontrolofIOP,Laser(Nd:YAG)peripheralirodotomyisthedefinitivemanagementofchoice.Iflaserisnotavailablesurgicalperipheraliridectomyistheprocedureofchoice.Othersurgicalproceduresusedarefilterationsurgeries(liketrabeculectomy,deepsclerotomy,Viscoanulostomy).Symptomatictreatmentduringanattackalsoincludesanalgesics,antiemeticandtopicalcorticosteroidstoreduceinflammation.Mydriatics(e.g.atropine)arecontraindicatedastheyprecipitateglaucoma.PACGisabilateraldisease,thefelloweyeisatriskofdevelopingan

acuteattackin50%casesinfuture.Thereforeaprophylacticperipherallaseriridotomyshouldbeperformedinthefelloweye.

163.Occulomotornervesuppliesall extraocularmusclesexcept? a)Superiorrectus b)Inferiorrectus c)Lateralrectus d)Medialrectus CorrectAnswer-CAns.is'c'i.e.,Lateralrectus

164.Whichbacteriapenetratesintactcornea ? a)Corynebacterium b)Pneumococcus c)Morexella d)E.coli CorrectAnswer-AAns.is'a'i.e.,CorynebacteriumBacterialcornealulcerBacterialcornealulcer,alsocalledsuppurativekeratitis,isduetoorganismsthatproducetoxinwhichcausetissuenecrosisandpusformationinthecornealtissue.Purulentkeratitisisnearlyalwaysexogenous,duetopyogenicorganism.Aslongasthecorneaishealthy,themajorityofbacteriaareunabletocrossoradheretothecornealepithelium.Thereforethetwomainpredisposingfactorsforbacterialcornealulcerare:- 1. Damagetocornealepithelium2. Infectionoftheerodedarea However,thereareafewspeciesthatarecapableofpenetratinganintactepithelium:- 1. Neisseriagonorrhoea2. Neisseriameningitidis3. Corynebacteriumdiphtheriae4. Listeriaspecies5. Haemophilusagyptus Bacteriawhichcausecornealulcer(Purulentkeratitis)afterepithelialinjuriesare:- 1. Pseudomonas

2. Pneumococcus3. Streptococcusepidermidis4. Staphylococcusaureus5. Morexella6. Enterobacterias7. Proteus,Klebsiella) Althoughtherearespecificpresentationsdependingonthebacteriainvolved,thereexistsaseriesofsymptomsandsignscommontoallthatallowforarapiddiagnosis,andthereforeearlytreatmentofcornealulcers.Themostimportantsymptomsarepain,lacrimation,foreignbodysensation,conjunctivalinjection(redeye),photophobiaandblurredvision.Thereislidswelling,blepharospasmandyellowwhiteareasofulcerwithswollenandoverhangingmarinmaybeseen.

165.Whichofthefollowingisnotafeatureof fungalcornealulcer? a)Fixedhypopyon b)Ulcerwithsloughingmargins c)Symptomsaremorepronouncedthansigns d)FungalhyphaeareseenonKOHmount CorrectAnswer-CAns.c.Symptomsaremorepronouncedthansigns

166.Congenitaldacrocystitis,theblockisat? a)Lacrimalcalnaliculi b)Nasolacrimalduct c)Punctum d)None CorrectAnswer-BAns.is'b'i.e.,NasolacrimalductCongenitaldacryocystitis(Dacryocvstitisneonatorum)Itistheinflammationoflacrimalsacinthenewborn.Itisduetocongenitalblockageofnasolacrimalduct.Congenitaldacryocystitisusuallypresentsasamildgradechronicinflammation.Itischaracterizedby:? 1. Epiphoradevelopsaftersevendaysofbirthfollowedby mucopurulentdischarge. 2. Regurgitationofmucopurulentdischargeonpressureoverthesac area,i.e.,positiveregurgitationtest 3. Swellingoverthesacarea Treatmentincludes:? 1. Massageoverlacrimalsacwithtopicalantibiotics:-Cures obstructioninabout90%ofinfantsspontaneousrecanalizationofobstructednasolacrimalductcanoccurupto9months. 2. Lacrimalsyringing:-Syringingwithnormalsalineandantibiotic solutionisperformediftheconditionisnotcureduptotheageof9-12months. 3. Probingofnasolacrimalduct:-Itisperformediftheconditionisnot curedby1-12months 4. Intubationwithsilicontube5. Dacryocystorhinostomy:-Itisperformedifthechildisbroughtvery

lateorabovedescribedproceduresfail.

167.Dacrocytorhinostomyinvolves? a)Openinguptheterminalblockedendofnasolacrimalduct b)Connectingthelacrimalsactonosebybreakingthemedialwall c)Completeexcisionoflacrimal d)Insertionofdrainagetubeinthelacrimalsac CorrectAnswer-BAns.is'b'i.e.,ConnectingthelacrimalsactonosebybreakingthemedialwallDacryocystorhinostomyisthesurgicalprocedurewhichinvolvesremovalofboneadjacenttolacrimalsac(medialwall)andincorporatingthelacrimalsacwithlateralnasalmucosa(atmiddlemeatus)inordertobypasstheobstructioninnasolacrimalduct.Advantageofdacryocystorhinostomyoverdacryocystectomyisthatthereisnoepiphoraorwateringofeyesposteoperatively.Indicationsofdacryocystorhinostomyare:- 1. Congenitaloracquirednasolacrimalductobstruction.2. Functionalobstructiontolacrimaloutflow(e.g.lacrimalpump weakness)orfacialnervepalsy. 3. Historyofdacryocystitis Dacryocystorhinostomycanbedoneeitheropen(external)approachorendonasal(endoscopic)approach.

168.Copperdepositionincornealeadsto? a)Keratoconus b)Keratoglobus c)KFring d)Siderosis CorrectAnswer-CAns.is'c'i.e.,KFringRetentionofForeignbodiesTheretentionofaforeignbodyaddsconsiderablytothedangerofapenetratinginjury.Theforeignbodiesmostlikelytopenetrateandberetainedintheeyeareminutechipsofironorsteel(accountingfor90%oftheforeignbodiesinindustry),stone,andparticlesofglass,leadpellets,copperpercussioncapsandlessfrequently,spiculesofwood.Inchippingstonewithanironchisel,itiscommonlyachipofthechiselandnotofthestonewhichenterstheeye.Chalcosisisperforatinginjurytoeyewithmetalcontainingcopper(Cu).Copperdepositioncanleadto:? 1. Grayish-green/goldenbrowndiscolorationofperipheralcornea calledKayser-Fleisherring. 2. Sunflower(Petalofflower)cataractduetodepositionofcopper undertheposteriorcapsuleofthelens. 3. Goldenplaqueatposteriorpoleoftheretina. Siderosisiscausedbyanironforeignbody.Irondepositioncancause:? 1. Characteristicandearliestmanifestationisrustydepositsofironina ringshapedmanneronanteriorsurfaceofcapsuleofthelens.Latercataractdevelops.

2. Initiallyirisisstainedgreenishandlaterbecomereddish-brown---> Heterochromiairidis. 3. Pigmentarydegenerationofretina.4. Secondaryopenangleglaucoma.

169.Habbsstriaeareseenin? a)Buphthalmos b)Keratoglobus c)Trachoma d)Keratoconus CorrectAnswer-AAns.is'a'i.e.,BuphthalmosExaminationfindingsofprimarycongenitalglaucoma(buphthalmos)FirstsigniscornealedemawithwateringofeyewithmarkedphotophobiaHaabstriae(DiscretecornealopacitiesappearaslineswithdoublecontourduetoruptureinDescemetsmembrane)Corneaishazywithfrostedglassappearance.CornealenlargementThin&bluescleraDeepanteriorchamberLensisantero-posteriorlyflatandmaybesubluxatedbackwardIridodonesis(tremulousiris)andatrophicpatchonirisLargeeye(Buphthalmosorhydrophthalmos)VariablecuppingandatrophyofdiscRaisedIOP(neitheracutenormarked)Axialmyopiaduetoincreasedaxiallengthwhichmaygiverisetoanisometropicamblyopia

170.Krukenbergspindles- a)Involvesanteriorsurfaceofcornea b)Involvesanteriorlenssurface c)Involvesposteriorsurfaceofcornea d)Involvesposteriorsurfaceoflens CorrectAnswer-CAns.is'c'i.e.,InvolvesposteriorsurfaceoffcorneaPigmentot-vglaucomaItisatypeofsecondaryopenangleglaucomawhereincloggingupoftrabecularmeshworkoccursbythepigmentparticles.Theconditiontypicallyoccursinyoungmyopicmales.Thecharacteristicfeatureisthedepositionofpigmentgranulesintheanteriorsegmentstructuressuchasiris,posteriorsurfaceofthecornea(Krukenberg'sspindle),trabecularmeshwork,ciliaryzonulesandthecrystallinelens.oGonioscopyshowspigmentaccumulationalongtheschwalbe'slineespeciallyinferiorly(Sampalesi'sline).Iristransilluminationshowsradialslit-liketransilluminationdefectsinthemidperiphery(pathognomonicfeature).Treatmentisasforprimaryopenangleglaucoma

171.Eyeofanewbornis? a)Emmetropic b)Hypermetropic c)Myopic d)Astigmatism CorrectAnswer-BAns.is'b'i.e.,HypermetropicEyeatbirthAnteroposteriordiameterofeyeballisabout16.5mm(70%ofadultsize).Adultsizeisattainedby7-8years.Cornealdiameterisabout10mm.Adultsize(11.7mm)isattainedby2yearsofage.Anteriorchamberisshallowandangleisnarrow.Lensissphericalatbirth.Retina:-Apartfrommaculararea,theretinaisfullydifferentiated.Maculadifferentiates4-6monthsafterbirth.Myelinationofopticnervefibreshasreachedthelaminacribrosa.Newbornisusuallyhypermetropicby+2to+3D.Orbitismoredivergent(50?)ascomparedtoadult(450).Lacrimalglandisstillunderdevelopedandtearsarenotsecreted.

172.Causesofexudativeretinaldetachment areallexcept- a)Toxemiaofpregnancy b)Scleritis c)Highmyopia d)Centralserousretinopathy CorrectAnswer-CAns.is'c'i.e.,HighmyopiaCause:retinaldetachment 1. Rheugmatogenous Highmyopia,Cataractextraction(Aphakia,pseudophakia),Trauma,Retinaldegeneration(1Iicedegeneration,snailtrackdegeneration,retinoschisis).Exudative 1. SystemicdiseaseToxaemiaofpregnancy,renalhypertension,blood dyscrasias&polyartetitisnodosa. 2. Oculardisease Inflammation:Harada'sdisease,sympatheticophthalmitis,posteriorscleritis&orbitalcellulitisqVascular:Centralserousretinopathy,exudativeretinopathyofcoatsNeoplasm:Malignantmelanomaofchoroid,retinoblastoma(exophytictype)Suddenhypotony:perforationofglobe,intraocularoperation 1. Othercauses:Uvealeffusionsyndrome,choroidal neovascularisation,haemangioma&metastatictumourofchoroid.TractionalPenetratinginjury,Proliferativediabeticretinopathy,sicklecellretinopathy,Retinopathyofprematurity,CRVO,Eale'sdisease,post-

hemorrhagicretinitisproliferan-Toxociasis,plasticcyclitis

173.

Commotioretinaeaffectswhichpartofretina- a)Posteriorpole b)Peripheralretina c)Inferior-nasalpart d)Superior-nasalpart CorrectAnswer-AAns.is'a'i.e.,PosteriorpoleBerlin'soedema,alsocalledcommotioretinae,occursinblunttraumatoeye.Itmanifestsasmilkywhitecloudinessinvolvingaconsiderableareaoftheposteriorpolewitha'cherry-red'spotinthefovealregion.Itmaydisappearaftersomedaysormaybefollowedbypigmentarychanges.

174.Standardinperimetry? a)GoldmantypeI b)GoldmantypeII c)GoldmantypeIII d)GoldmantypeIV CorrectAnswer-CAns.is'c'i.e.,GoldmantypeIIIProjectedstimuliinperimetryareusuallywhiteandofvariablesizeandintensity.TherearefivedifferentsizesonGoldmannscaledesignatedbyRomannumeralItoV.ThestandardusedinbothmanualandautomatedperimetryisGoldmanIII(0.05"andareaof4mm2).oFailuretorecognizetargetsizeIIInecessitatestestingwithstimulusV Goldmanscale Stimulussize(mm2)I '/4 II 1 III 4 IV 16 v 64

175.Treatmentofcongenitalptosiswithpoor elevationis a)Levatorresection b)Frontalissling c)FSoperation d)Noneofthe CorrectAnswer-BAns.is'b'i.e.,FrontalisslingSurgeriesforptosisDependingupontheLPSaction,threemaintypesoftechniquesareavailable. 1. Iflevatoractionisgood:-LPSisshortened,i.e,resectionofLPS. TheoperationsareBlaskovicsoperation,EverbuschoperationandFasanella-servatoperation.Fasanella-servatoperationisindicatedinHomersyndrome. 2. IfLPSisparalysedSuperiorrectusmuscleisusedtoliftthelid.The operationiscalledMotaisoperation. 3. IfbothLPSandsuperiorrectusareparalysedFrontalis sling/suspensionoperation(Hess'soperation)isdone.ItisindicatedinMarcusGunnjawwinkingsyndrome,blepharophimosissyndrome,total3rdnervepalsy,AberrantregenerationofYdnerve.

176.Dacrocystorhinostomy,wheretheductis opened? a)Superiormeatus b)Inferiormeatus c)Middlemeatus d)Sphenoethmoidalrecess CorrectAnswer-CAns.is'None>c'i.e.,MiddlemeatusCMVretinitisisthemostcommonophthalmicmanifestationofCMV,occuringasacongenitalinfectionininfantsoranopportunisticinfectionintheimmunocompromisedhost.Adultscommonlyaffectedincludethoseindividualswithacquiredimmunodeficiencysyndrome(AIDS),oncologypatients,andpatientsonimmunosuppresivetherapy.Thereischaracteristichemorrhagic,fullthicknessretinitis.Inearlystagethereareyellow-whiteexudates(areasofretinalnecrosis)associatedwithareasofvasculitisandretinalhemorrhage.Theremaybeexudativeretinaldetachmentandultimately,thereoccurstotalretinalatrophy.TherearethreedistinctvariantsofCMVretinitis:?1.Classical(fulminant)retinitisItisnecroticretinitisLargeareasofretinalhemorrhagealongawhitened,edematousornecroticretina,usuallyinposteriorpoleinthedistributionofnervefiberlayeralongthevasculararcades.Itisalsoknownas"Pizza-Picretinopathy"or"cottagecheesewithcatchup".2.Granular(indolent)retinitis

Withoutedema,hemorrhageorvascularsheathing,progressingalongactiveborderofretinalperiphery.3.PerivascularretinitisFrostedbranchangitiswithretinalperivasculitis. 1. AnotherfindinginCMVretinitisisawhitegranulargeographiclesion thatclearscentrallyasitenlarges,leavingaquietcentralareaofretinalatrophyandmottledpigmentepithelium.Thishasalsobeendescribedas"brush-fire"pattern. 2. Itshouldberememberedthatvitreoushemorrhage,though,isnot commoninCMVretinitis,itmayoccurafterinitiationoftreatmentofAIDS(HAART). 3. Inroutinecoursethereisnovireoushemorrhageorvitritisdueto immunocompromisedstateofthesepatients.But,oncethetreatmentofAIDSisstarted,theirimmunestatusmayimprove,andcapableofproducinginflammation.Whichmaycausevitritisandvitreoushemorrhage.

177.Blowoutfractureoforbitleadsto fracturein a)Floor b)PosteriorMedialwall c)Lateralwall d)Roofoftheorbit CorrectAnswer-BAns:B1.Ablowoutfractureoftheorbitalflooristypicallycausedbyasuddenincreaseinorbitalpressurebyastrikingobjectwhichisgreaterthan5cmindiameter,greaterthantheoritalsindiametersuchasafistortennisball.2.Thefracturemostfrequentlyinvolvestheflooroftheorbitalongthethinbonecoveringtheinfraorbitalcanal.3.Thefloorconsistsofthreebones:Zygomatic,MaxillaryandPalatine.4.Theposteromedialportionofthemaxillaryboneisrelativelyweakandmaybeinvolvedina`blowout'fracture.5.FractureoftheRoofoftheorbitknownas`blowin'fractures.6.Mostmedialwallorbitalfracturesareassociatedwithfloorfracture

178.Mostcommonsymptominbuphthalmos is? a)Lacrimation b)Pain c)Photophobia d)Itching CorrectAnswer-AAns.is'a'i.e.,LacrimationThecommonestsymptomiswatering" InBuphthalmos MostcommonsymptomWatering(lacrimation)2ndmostcommonsymptomPhotophobiaMosttroublesomesymptomPhotophobia(Childavoidslight)oFirstsignCornealedemawithwateringFrostedglassappearanceofthecornea(hazycornea)HaabstriaeLargecorneaDeepanteriorchamberLensanteroposteriorlyflat

179.Normalvisionwithabsenceofdirect& consensuallightreflex,whichnerveisinvolved? a)Optic b)Oculomotor c)Trigeminal d)Abducens CorrectAnswer-BAns.is'b'i.e.,Oculomotor Thisquestioncanbesolvedbysimplebasicknowledge:-Amongthegivenoptionsonlyoiticnerveandocculomotornewesarerelatedtolightreflex'aInopticnerveinjuryvisionisalsoimpaired(visionisnormalinthequestion)'nThusanswerisoculomotornerve Whenlightisshonetoone(e.g.left)eye.leftopticnervecaniesafferentimpulsetobrainandfrombrainefferentimpulsetoipsiplateral(left)eyecomesthroughipsilateral(left)occulomotornerye(fordirectlightreflex)andefferentforcontralatcral(right)eyecomesthroughcontralateral(right)occulmotornerveforconsensuallightreflex'Whenlightisshonetoother(right)eyc,rightopticnervecarriesafferentimpulsetobrainandfrombrain,efferentimpulsetorighteye(fordirectlightreflex)comesthroughrightocculmotornerveandeffcrentfbrlefteye(forconsensuallightreflex)comesthroughleftocculomotornerve'So:-OpticneweisresponsibtefordirectlightreJlexinipsilateraleyeand

consensuallightreflexforcontralateraleye.(lnaboveexample,afferentforrightsideddirectandleftsidedconsensuallightreflexisthroughrightopticnerve;andatl-erentforleftsideddirectandrightsidedconsensuallightreflexisthroughleftopticnerve)'Occulomotornerveisresponsiblefordirectandconsensuallightreflexinthesameeye'(lnaboveexample'efferentforrightsideddirectasrvellasconsensuallightreflexisthroughrightocculmotornerveandef'ferentforleftsideddirectaswellasconsensuallightreflexisthroughleftocculomotornerve)' Incompleteopticnervelesionofoneside(Amaurosislightreflexortotalafferentpupillaryfect)TheipsilateraldirectreflexislostTheipsilateralconscnsualreflexisintactThecontralateraldirectreflexisintactThecontralateralconsensualreflexislostInocculomotornervelesionofoneside(efferentpupillarydefectTheipsilateraldirectreflexislostTheipsilateralconsensualreflexislostThecontralateraldirectreflexisintactThecontralateralconsensualreflexisintact

180.Themostcommoncauseofvitreous hemorrhageinadultsis a)Retinalhole b)Trauma c)Hypertension d)Diabetes CorrectAnswer-DAns.is'd'i.e.,DiabetesDiabeticretinopathyisthecommonestcauseofspontaneousvitreoushemorrhageinadults".__Parson's"Mostcommoncauseofvitreoushemorrhageisdiabeticretinopathyinadults".--AtlasofophthalmologyCausesofvitreoushemorrhagePosteriorvitreousdetachmentEale'sdisease&Coat'sdiseaseRetinealtear(break)duetotraumaVasculardisorders:-Hypertensiveretinopathy,orvitreoustraction.CRVOProliferativediabeticretinopathyAcutechorioretinitis,periphlebitisoruveitisBranchedretinalveinocclusionBleedingdisorders(Polycythemia,anemia,SCA)Age-relatedmaculardegenerationNeoplasmRetinalmacroaneurysmTresonsyndrome

181.Slitlampexaminationhelpsin examinationof? a)Anterior2/3rdofchoroid b)Anterior1/3rdofchoroid c)Posterior1/3rdofchoroid d)Posteriorcapsule CorrectAnswer-DAns.is'd'i.e.,PosteriorcapsuleSlit-lampbimicroscopyisveryusefulinthediagnosisofeyediseases.oItshouldroutinelybeperformedinalmostalldiseasesoftheeye.oFollowingstructuresareexamined? 1. Eyelidsandlashes2. Conjunctiva3. Cornea4. Anteriorchamber5. Iris6. Lens:Anteriorcapsule,cortex,nucleus,posteriorcapsular7. Anteriorvitreous

182.Retinaldetachmentoccursbetween a)Layersofneurosensoryretina b)Neurosensoryretinaandpigmentepithelium c)Pigmentepitheliumandchoroid d)Noneoftheabove CorrectAnswer-BAns.is'b'i.e.,NeurosensoryretinaandpigmentepitheliumRetinahastotaltenlayersfromwithoutinward:-(i)Pigmentedepithelium,(ii)LayersofRods&cones,(iii)Externallimitingmembrane,(iv)Outernuclearlayer,(v)Outerplexiformlayers,(vi)Innernuclearlayer,(vii)Innerplexiformlayer,(viii)Ganglioniccelllayer,(ix)Nervefibrelayer,(x)InternallimitingmembraneBroadlytheselayersaresubdividedintotwolayersbasedonthefunction:?Neurosensorylayerorsensorylayer(containinglayersiitoxofabove10layers):-forvision.Pigmentedepithelium(layeri):-Providemetabolicsupporttoneurosensorylayerandactsasanantireflectivelayer.So,innerlayersareincludedinneurosensorylayerandoutermostlayerisretinalpigmentedepithelium(RPE).Retinaldetachmentisadisorderofeyeinwhichretinapeelsawayfromitsunderlyinglayerofsupporttissue.Usually thereisseparationbetweentheneuroepithelium(neurosensoryepitheliumorsensoryepithelium)andthepigmentedlayer,becausethereisapotentialspacebetweenthesetwolayerswherefluidcanaccumulatesandcancauseseparation.

183.Ocularbobbing? a)Midbrain b)Pons c)Medulla d)Cortex CorrectAnswer-BAns.is'b'i.e.,Pons Square-waveerks Notlocalizing Macrosquare-waveerks CerebellumMacrosaccadicoscillation CerebellumVoluntarynystagmus Volitional Saccadicpulses Cerebellum,lowerbrainstem Ocularflutter Cerebellum,lowerbrainstem Opsoclonus Cerebellum,lowerbrainstem Ocularbobbing Pons

184.Bilateralinferiorlenssubluxationisseen in? a)Marfansyndrome b)Homocysteinuria c)Oculartrauma d)Noneoftheabove CorrectAnswer-BAns.is`b'i.e.,Homocysteinuria

185.Retinitispigmentosaischaracterizedby ? a)Centralscotoma b)Centrocaecalscotoma c)Tubularvision d)Isoptericcontraction CorrectAnswer-CAns.is'c'i.e.,TubularvisionImportantfactsEarliestvisualfielddefectinprimaryopenangleglaucomaIsopetericcontraction.Earliestclinicallysignificantvisual.fielddefectinprimaryopenangleglaucoma-->Paracentralscotoma,VisualfielddejectinrheugmatogenousretinaldetachmentLossofperipheralfield.VisualfielddefectinretinitispigmentosaTubularvision.Mostcommonvisual,fielddefectinopticneuritisCentralorcentrocaecal.VisualfielddefectinpapilloedemaEnlargementofblindspotandprogressivecontractionofvisual_field.VisualfielddefectinLeber'sopticneuropathyCentmcaecal.Characteristicvisual.fielddefectinanteriorischemicopticneuropathyAltitudinalvisualfielddefects.

186.Scissorreflexisseenin? a)Openangleglaucoma b)Phlyctenularconjunctivitis c)Keratoconus d)Interstitialkeratitis CorrectAnswer-CAns.is'c'i.e.,KeratoconusKeratoconusisaprogressive,noninflammatory,bilateralectaticcornealdisease,characterizedparaxiastromalthinningandweakeningthatleadstocornealsurfacedistortion.Essentialpathologicalchangesarethinningandectasiawhichoccurasaresultofdefectivesynthesisofmucopolysaccharideandcollagentissue.Itusuallystartsatpubertyandprogressesslowly.Symptomsusuallybeginsasblurredvisionwithshadowingaroundimages.Visionbecomesprogressivelymoreblurredanddistortedwithassociatedglare,halosaroundlights,lightsensitivityandocularirritation.Visuallossoccursprimarilyfromirregularastigmatismandmyopia.andsecondarilyfromcornealscarringThehallmarkofkeratoconusiscentralorparacentralstromalthinning,apicalprotrusionofanteriorcorneaandirregularastigmatism.Thecorneathinsnearthecentreandprogressivelybulgesforwards,withtheapexofconealwaysbeingslightlybelowthecentreofthecornea.Importantfindingsanexaminationare-

1. Distartedwindowreflex(Cornealreflex)Q.2. Fleisher'srine.3. Yawningreflex(Scissorreflex).4. Oildropreflex.5. Munson'ssigns Treatmentincludes:? 1. Spectaclesforregularormildirregularastigmatism.2. Rigidgaspermeablecontactlensforhigherastigmatism.3. Epikeratoplastyinpatientsintoleranttolensandwithoutsignificant cornealscarring. 4. Keratoplastypenetratingordeeplamellarifthereissignificant cornealscarring.

187.Whicharefirstorderneuroninoptic pathway? a)Bipolarcells b)Ganglioniccells c)Cellsoflateralgeniculatebody d)Astrocytes CorrectAnswer-AAns.is'a'i.e.,Bipolarcells Invisualpathway Sensoryorgans Photoreceptors(Rods&cones)Neuronsoffirst -3Axonofbipolarcells(inRetina) rderNeuronsof Axonsofganglioniccell(Retinai.e.,Optic secondrder disc,Opticnerve,Opticchiasma,optictracts) Neuronsofthird Axonsfromnervecellsinlateralgeniculatebodyorder (opticadiation)

188.Trueaboutelectroretinogram? a)a'waveispositivewave b)'a'wavearisesfrompigmentedepithelium c)b'wavearisesfromrodsandcones d)'c'waveispositivewave CorrectAnswer-DAns.is'd'i.e.,'c'waveispositivewaveElectroretinogramThechangesinducedbythestimulationoflightintherestingpotentialoftheeyearemeasuredbyelectroretinography.Itisextinguishedorabsentincompletefailureoffunctionofrodsandcones,e.g.pigmentaryretinaldystrophy,completeocclutionofretinalartery,completeretinaldetachment,advancedsiderosisetc. 1. Negative'a'waverepresenttheactivityinrodsandcones.2. Positive'b'wavearisesininnerretinallayers.3. Positive'c'waveisassociatedwiththepigmentaryepithelium. Uses:? 1. Diagnosisandprognosisofretinaldisorderssuchasretinitis pigmentosa,Leber'scongenitalamaurosis,retinalischaemiaandotherchorioretinaldegenerations. 2. Toassessretinalfunctionwhenfundusexaminationisnotpossible, e.g.inthepresenceofdensecataractandcornealopacity. 3. Toassesstheretinalfunctionofthebabieswherepossibilitiesof impairedvisionisconsidered.

189.Specificforalbinism a)Redreflex b)Decreasedvisualactivity c)Photophobia d)Nystagmus CorrectAnswer-AAns.is'a'i.e.,RedreflexAllthegivenoptionsareseeninalbinism.But,redreflexisspecific.Ocularfeaturesinalbinism-aRedreflexPinkorblueirisDazzlingglarePhotophobiaDecreasedvisionNystagmusClearretinalandchoroidalvessels,separatedbyglisteningwhitespaceStrabismus(mildtomoderate)

190.Allarepartsofanteriorsegmentofeye except? a)Lens b)Cornea c)Vitreous d)None CorrectAnswer-CAns.is'c'i.e.,VitreousTheeyeballisdividedintotwosegments:?Anteriorsegment 1. Partofeyeballanteriortoposteriorborderoflensiscalledanterior segment. 2. Itconsistsoflens,andstructuresanteriortoit,i.e.,cornea,irisand twoaqueoushumor-filledspaces,i.e.,anteriorandposteriorchambers. 3. Anteriorchambers:-Itisboundedanteriorlybybackofcorneaand posteriorlybytheiris&partofciliarybody.Itcontainsaqueoushumor. 4. Posteriorchamber:-Thistriangularchamberisboundedanteriorly bytheposteriorsurfaceoftheiris&ciliarybodyandposteriorlybythelensanditzonules.Italsocontainsaqueoushumor. 5. Thus,bothanteriorandposteriorchambersarepartofanterior segmentandbothcontainaqueoushumor.Posteriorsegment 1. Partofeyeballposteriortolensiscalledposteriorsegment.2. Itconsistsofvitreoushumor,retina,choroidandopticdisc.

191.AttachementofVitreousisSrongestat a)Fovealregion b)Backoflens c)Acrossoraserrata d)Marginofopticdisc CorrectAnswer-CAns.is'c'i.e.,AcrossoraserrataAttachementofvitreousVitreousisattachedanteriorlytothelens(HyloidcapsularligamentofWieger)andciliaryepitheliuminfrontoftheoraserrata.Thepartofvitreousabout4mmacrosstheoraserrataisknownasthe"baseofvitreous"wheretheattachementisstrongestPosteriorlyvitreousisattachedtotheedgeoftheopticdiscandmaculalutea(fovealregion)formingring-shapedstructurearoundthem

192.Umbrellaconfigrationonfluorescein angiogrphyisseenin? a)Retinitispigmentosa b)Rheugmatousretinaldetachment c)Centralserousretinopathy d)Eale'sdisease CorrectAnswer-CAns.is'c'i.e.,CentralserousretinopathyCentralserousretinopathyCentralserousretinopathyiscausedbyanaccumulationoftransparentfluidattheposteriorpoleespeciallyatmaculacausingacircumscribedarearetinaldetachmentinthemacularregion.Thereisdetachmentofneurosensoryretina(layersofrodsandcones)withorwithoutretinalpigmentepitheliumdetachment.Theconditionaffectsmalesbetween20-40yearsofage.Patientpresentswithasuddenonsetofpainlesslossofvisionassociatedwithrelativepositivescotoma,micropsiaandmetamorphosia.Ophthalmoscopicfindingsincludemildelevationofmacularareademarcatedbyacircularringreflexandfovealreflexisdistortedorabsent.Thediagnosisisconfirmedbyfluoresceinangiography.Itshowsfocalleakageoffluoresceininfollowingtwopatterns:?Ink-blotpatternorenlargingdotsign:-Asmallhyperfluorescentspotwhichgraduallyincreasesinsize.Smoke-stackpattern:-Smallhyperfluorescentspotwhichascendsverticallylikeasmokestackandgraduallyspreadslaterallytotakeamushroomorumbrellaconfigration

193.Epithelialxerosisofconjunetivais causedby? a)Trachoma b)Diphtheria c)Xerophthalmia d)Pemphigus CorrectAnswer-CAns.is'c'i.e.,XerophthalmiaXerosisofconjunctivareferstoaconditionwheretheconjunctivabecomesdryandlusterless.Dependingupontheetiology,conjunctivalxerosiscanbedividedintotwogroups:?Parenchymatousxerosis:-Itoccursfollowingcicatricialdisorganizationofconjunctivaduetolocalcauseswhichcanbe:? 1. Trachoma2. Diphthericmembranousconjunctivitis3. Stevens-Johnsonsyndrome4. Pemphigus5. Thermal,chemicalorradiationalburn6. Lagophthalmosduetosymblepheron. Epithelialxerosis:-Itoccursduetovitamin'A'deficiency(Xerophthalmia).

194.Cicatrisingtrachomaisseenin? a)Stage-1 b)Stage-2 c)Stage-3 d)Stage-4 CorrectAnswer-CAns.is'c'i.e.,Stage-3McCalIan'sclassification-McCallanin1908dividedtheclinicalcourseoftrachomainto4stages Stage1(Incipient Stage2 Stage3 Stage4(Healed trachoma) (Established (Cicatrising trachoma) Hyperaemia tracoma) trachoma) ofpalpebral Appearanceofmature Diseaseiscured Immature Scarringof follicle& orisnot follicle palpebralconjunctiva conjunctiva markable papillae Mild Progressive Scarsareeasily Sequelaeto superfecial corneal visibleaswhite cicatrisationcause punctate pannus bandsNecrosis symptoms keratopathy Stage2isfurthersubdividedinto:-2a(Ha):-Presenceofmaturefolliclesb(Hb):-Markedpapillaryhyperplasia

195.Non-sterilehypopyonisseenin? a)Pneumococcusinfection b)Pseudomonasinfection c)Fungalinfection d)Gonococcalinfection CorrectAnswer-CAns.is'c'i.e.,FungalinfectionHypopyonreferstoaccumulationofpolymorphonuclearleucocytesinthelowerangleofanteriorchamber.Manypyogenicorganisms(Staphylococcus,streptococci,gonococci,Moraxella)andfungimayproducehypopyonbutbyfarthemostdangerousarepseudomonaspyogeneaandpneumococcus.Thus,anycornealulcermaybeassociatedwithhypopyon,however,itiscustomarytoreservetheterm'hypopyoncornealulcer'forthecharacteristiculcercausedbypneumococcusandtheterm'cornealulcerwithhypopyon'fortheulcersassociatedwithhypopyonduetoothercauses.Thecharacteristichypopyoncornealulcercausedbypneumococcusiscalled"ulcusserpens".Itisworthnotingthatthehypopyoninbacterialcausesissterilesincetheoutpouringofpolymorphonuclearcellsisduetotoxinandnotduetoactualinvasionbybacteria.Ontheotherhand,hypopyoninfungal(mycotic)cornealulcerisnon-sterileasthereisdirectinvasionbyfungi.

196.Normallevelofvisualacuityisattained atwhichage a)6months b)1year c)3years d)6years CorrectAnswer-CAns.is'c'i.e.,3years[RefKhurana4thEyeinpostnatalperiodFixationstartsdevelopingby4-6weeks.Criticalperiodfordevelopmentoffixationreflexis2-4months.Developmentoffixationiscompletedby6months.Sotherearethreepointstoremember:?Fixationstartsdeveloping4-6weeks(1-11/2months).Criticalperiodfordevelopment2-4months. 1. Fixationdevelopmentiscompleted6months.2. Maculaisfullydevelopedby4-6months.3. Fusionalreflex,stereopsisandaccomodationiswelldevelopedby 4-6months.Corneaattainsnormaladultdiameterby2yearsofage.Lensgrowsthroughoutlife.Fullvisualacuity(6/6)isattainedby3yearsofage.AgeVisualacuityNewborn6/240Imonth6/180-6/904-6months6/18-6/93Years6/6

197.Duannesyndromeinvolves? a)Superioroblique b)Inferioroblique c)Lateralrectus d)Superiorrectus CorrectAnswer-CAns.is'c'i.e.,Lateralrectusretractionsyndromerepresentsthemostfrequentandmostprominentcongenitalcranialdysinnervationdisorder(CCDD).ItisduetofibrosisofthelateralrectusoraninnervationalanomalywithCo-contractionofthelateralandmedialrecti.Thereisdeficiencyofabduction,associatedwithimpairedadduction,contractionofpalpebralfissureandobliquemovementsoftheeye.

198.Birdshotretinopathyischaracterizedby allexcept? a)Commoninfemales b)Unilateral c)HLA-A29positive d)Creamyyellowspots CorrectAnswer-BAns.is'b'i.e.,UnilateralBird-shotretinochoroidopathyItisarare,idiopathic,bilaterallysymmetricalchronicmultifocalchorioretinitischaracterisedbynumerousflatcreamy-yellowspotsduetofocalchorioretinalhypopigmentation,resemblingthepatternof"bird-shortscatterfromashotgun".Thedisease,morecommoninfemalesthanmales,typicallyaffectsmiddle-agedhealthypersonswhoarepositiveforHLA-A29.Itrunsalongchroniccourseofseveralyears.Treatmentwithcorticosteroidsisusuallynoteffective

199.Treatmentofchoiceforanisoeikonia? a)Orthopticexercise b)Spectacles c)Surgery d)Contactlens CorrectAnswer-DAns.is'd'i.e.,ContactlensAnisoeikoniaAnisoeikoniaisdefinedasaconditionwhereintheimagesprojectedonthevisualcortexfromthetworetinaeareabnormallyunequalinsizeorshape.CausesmaybeOpticalaniseikonia:-Whenthedifferencebetweenrefractiveerroroftwoeyesisofhighdegree,theimageofanobjectmaybeofdifferentsizeorshapeintwoeyes.Sothedefectisatrefractivestructureslevel.Retinalaniseikonia:-Defectisatretinallevelandoccursduetodisplacementofretinalelementstowardsthenodalpointinoneeyeduetostretchingoredemaoftheretina.Corticalaniseikonia:-Defectisathighercentrallevel.Thereisasymmetricalsimultaneousperceptioninspiteofequalsizeofimagesformedonthetworetinae.Upto5percentaniseikoniaiswelltolerated.Forhighdegreeofaniseikonia,treatmentofchoiceiscontactlenses.

200.Maximumcorrectionofmyopiacanbe doneby? a)Radialkeratotomy b)LASIK c)Photorefractivekeratotomy d)Orthokeratology CorrectAnswer-BAns.is'b'i.e.,LASIKAmongstthegivenoptions,maximumcorrectioncanbeachievedbyLASIK. Surgicalocedure Myopiaorrection Radialkeratomy -2to-6D Photorefractivekeratotomy -2to-6DLASIK Upto-12D Extractionoflens -16to-18D PhakicIOL >-12D Interconaealring(ICR 1-6D Orthokeratology upto-5D

201.MarcusGunnpupilisdueto? a)Totalafferentpupillarydefect b)Relativeafferentpupillarydefect c)Efferentpathwaydefect d)Cerebrallesion CorrectAnswer-BAns.is'b'i.e.,RelativeafferentpapillarydefectMarcusGunnpupilMarcusGunnpupilisseeninrelativeafferentpathwaydefect(RAPD)Anincompleteopticnervelesionorretinaldiseasecauseit(incontrasttoamauroticlightreflex,wherethereistotalafferentpathwaydefect).Itisbesttestedbyswingingflashlighttest.Toperformthistest,abrightflashlightisshonetoonepupilandconstrictionofthatpupilisnoted.Thentheflashlightisquicklymovedtothecontralateralpupilandtheresponseinthatpupilisnoted.Thisswingingtoandfrooftheflashlightisrepeatedseveraltimeswhilethepupillaryresponseisobserved.Normally,bothpupilsconstrictequallyandthepupiltowhomlightistransferredremainstightlyconstricted.Inthepresenceofrelativeafferentpupillarydefectinoneeye,boththepupilwilldilatewhentheflashlightismovedfromthenormaltotheabnormaleye.Thisisaparadoxicalresposne.ThisiscalledMarcusGunnpupilandistheearliestindicatorofopticnervediseaseeveninthepresenceofanormalvisualacuity.Relativeafferentpapillarydefect(RAPD)orMarcusGunnpupilisa

reliableandobjectvesignofunilateralorassymmetricdiseaseoranylesioninafferentpapillarypathway,i.e.,retina,opticnerve,opticchiasma,optictractormidbrain(pretectalnucleus).However,RAPDismostcharacteristicoflesionsintheopticnerve.

202.Distanceofmedialrectusfromlimbus- a)4.5mm b)5.5mm c)7.0mm d)10mm CorrectAnswer-BAns.is'b'i.e.,5.5mm Muscle Distanceofinsertionfromlimbus Medialrectus 5.5mmInferiorectus 6.5mmLateralrectus 6.9mmSuperiorectus 7.7mm

203.Allnerveareinvolvedinsuperiororbital fissuresyndromeexcept? a)1t b)3rd c)4'h d)6th CorrectAnswer-AAns.is'a'i.e.,1"SuperiororbitalfissuresyndromeThesuperiororbitalfissureisacleftbetweenthelesserandgreaterwingofsphenoid.Thestructurespassedthroughsuperiororbitalfissureare3rd,4th,6rnnerve,ophthalmicdivisionofSthnerve,superior&inferiordivisionofophthalmicveinandsympatheticfibres.Thereforesymptomsofsuperiororbitalfissuresyndromearesameasincavernoussinusthrombosis,i.e.,painfulophthalmoplegia:-Pain(retro-orbitalpain)andsensorydisturbancesintheV1(ophthalmicdivisionof5thnerve)distributionIpsilateralophthalmoplegiaOrd4thand6thnerveinvolvement).

204.Posteriorlenticonusisseenin? a)Alport'ssyndrome b)Lowe'ssyndrome c)Marfansyndrome d)Homocystinuria CorrectAnswer-BAns.is'b'i.e.,Lowe'ssyndromeLenticonusreferstocone-shapedelevationoftheanteriorpole(anteriorlenticonus)orposteriorpole(posteriorlenticonus)ofthelens.AnteriorlenticonusisseeninAlport'ssyndrome.PosteriorlenticonusisseeninLowe'ssyndrome.Ondistantdirectophthalmoscopy,lenticonuspresentasanoilglobulelyinginthecenterofredreflex.Slit-lampexaminationconfirmsthediagnosis.

205.Thickestportionofsclerais? a)Anteriortorectusmuscleinsertion b)Posteriortorectusmuscleinsertion c)Posteriorpole d)Limbus CorrectAnswer-CAns.is'c'i.e.,PosteriorpoleoThethicknessofthescleravariesaccordingtolocation:?Atthelimbus,thesclerais0.8mmthick.Anteriortotherectusmuscleinsertions,itis0.6mmthick.Posteriortotherectusmuscleinsertions,itis0.3mmthick(Thinnestportion).Attheequator,itis0.5to0.8mmthick.Attheposteriorpole,itisgreatestthan1mmthick.

206.Reis-Bucklerdystrophyaffectswhich layerofcornea a)Epithelium b)Stroma c)Bowman'smembrane d)Endothelium CorrectAnswer-CAns.is'c'i.e.,Bowman'smembrane

207.Down-beatnystagmusisseeninlesion of? a)Brainstem b)Cerebellum c)Basalganglia d)Hippocampus CorrectAnswer-BAns.is'b'i.e.,CerebellumCentralvestibularnystagmusmaybeoffollowingtypes?Up-beatnystagmusInprimarypositionofgaze,thefastcomponentisupward.Itisseeninlesionsofcentraltegmentumofbrain-stem.Down-beatnystagmusInprimarypositionofgaze,thefastcomponentisdownward.Itisusuallyassociatedwithposteriorfossadiseaseandistypicalofcompressionatthelevelofforamenmagnum.ItisacommonfeatureofcerebellarlesionsandArnold-chiarysyndrome.PeriodicalternativenystagmsItisajerknystagmuswhichshowsfluctuationsinamplitudeanddirection.Itmayoccurduetovascularordemyelinatingvascularorbrainstem-cerebellarlesions.

208.VonHerickanglegrade'3'ofanterior chamberdenotes a)Wideopenangle b)Moderatelyopenangle c)Moderatelynarrowangle d)Closedangle CorrectAnswer-BAns.is'b'i.e.,Moderatelyopenangle

209.Foldablelensismadeupof? a)PMMA b)Silicon c)Hydrogel d)None CorrectAnswer-BAns.is'b'i.e.,SiliconDependingonthematerialofmanufacturing,followingtypesofIOLsarethere:-RigidIOLs:-Madeentirelyfrompolymethylmethacrylate(PMMA).Foldable10Ls:-Areusedafterphacoemulsificationandaremadeofsilicon,acrylic,hydrogelandcollamer.Rollable10Ls:-UltrathinIOLsandaresuedafterphokonittechnique(micro-incision:lmm).Thesearemadeofhydrogel.

210.Arcuatefielddefectakintoglaucomais seenin? a)Pituitarytumor b)Occipitallobeinfarct c)Opticnervelesion d)Noneoftheabove CorrectAnswer-CAns.is'c'i.e.,OpticnervelesionAnarcuatevisualfielddefectusuallyresultsfromdamagetoretinalnervefibersorganglioncellsinthesuperiororinferiorarcuatenervefiberbundles.Insuchcasesthereisacentralfielddefectthatisnotcircularbutinsteadislimitedaboveorbelowbythehorizontalmeridian.Thisvisualfielddefectmayoccurinpatientswithocclusionofbloodsupplyofthesuperiororinferiorportionofmaculaorinpatientswithglaucoma.Inbothsettings,thescotomaisassociatedwithnormalvisualacuity,sinceitdoesnotcompletelyaffectthemacula.Virtuallyanylesion,whetherischemic,infiltrativeorcompressive,cancausearcutefielddefect,andmaybelocatedineithertheretinaoropticnerve.Importantcausesofarcuatescotomaare:- 1. Glaucoma2. Opticneuritis3. Anteriorischemicopticneuropathy(AION)4. Branchretinalvascularocclusion(arteryorvein)5. Opticnervedrusen

211.Thinnestportionofsclera? a)Anteriortorectusmuscleinsertion b)Posteriortorectusmuscleinsertion c)Posteriorpole d)Limbus CorrectAnswer-BAns.is.b,PosteriortorectusmuscleinsertionThinnestportionofscleraPosteriortoinsertionsofrectusmuscle.ThickestportionofscleraPosteriorpole.

212.Duringretinoscopyofa30yearsold male,whichcycloplegicisusedroutinely a)Atropine1%ointment b)Cyclopentolate1%drop c)Homatropine2%drop d)Noneoftheabove CorrectAnswer-DAns.is'd'i.e.,NoneoftheaboveThereisnoneedforcycloplegiaasaroutineinadults(20-40years).CvcloplegicinretinoscopyCycloplegicsaredrugswhichcauseparalysisofciliarymuscles(accommodation)anddilatationofpupil.Theuseofcycloplegicsisusefulinrefractionandtherearecertainsituationswheretheyareindicated.Becauseoftheirstrongaccommodativereserve,veryyoungpeople(<16years)shouldalwaysberefractedaftertheuseofcyclopleagics:- 1. <5yearsofage:-Atropine1%ointmentisthedrugofchoice.2. 15-20years:-Homatropine(2%drop),cyclopentolate(1%drop) ortropicamide(5%,10%drop)areused.Atropinemustbeusedifthepatienthasaconvergentsquintorhashighhypermetropia.Thereisnoneedforcycloplegiaasaroutineinadults(20-40years).Howevercycloplegicsareindicatedinfollowingsituations:-Accommodationisabnormallyactive(e.g.,spasmofaccommodation). 1. Objectivefindingsbyretinoscopydonotagreewiththepatient's

subjectiverequirement. 2. Symptomsofaccommodativeasthenopiaarepresent.3. Ifthepupilissmall. Ifthepatientisabove40years,cycloplegiaisrarelynecessary.Onlymydriatic(10%phenylephrine)maybeneededwhenthepupilisnarrowormediaisslightlyhazy.

213.Insenilenuclearcataractwhattypeof myopiaisseen? a)Curvaturemyopia b)Indexmyopia c)Axialmyopia d)Positionalmyopia CorrectAnswer-BAns.is'b'i.e.,IndexmyopiaNuclearchangesofaginginduceamodificationofrefractiveindexoflensandproduceanindexmyopia."Nuclearcataractscauseageneraldecreaseinthetransperancyofthelensnucleus.Theyareassociatedwithindexmyopia"--OphthalmicstudyguideCausesoferrorsofrefractionPossiblecausesofametropiaare:?1)AxialItisthecommonestformofametropia(bothmyopiaandhypermetropia).Inhypermetropia,thereisanaxialshorteningofeyeball.So,imageisformedbehindtheretina.Inmyopia,thereisanaxiallengtheningofeyeball.So,imageisformedinfrontoftheretina.1mmchangeinaxiallengthleadstoametropiaof3D.Forexample1mmshorteninginaxiallengthcauseshypermetropiaof3D.2)CurvatureChangeinthecurvatureofcorneaorlenswillcauseametropia.Inhypermetropia,thecurvatureofcorneaorlensislesserthannormal.Inmyopia,thereisincreaseincurvatureofcorneaorlens./mm

changeincornealcurvatureleadsto6-7Dametropia.3)IndexIfrefractiveindexofopticalsystemislow,itwillresultinhypermetropiaandhighrefractiveindexwillresultinmyopia.4)Positional(Duetorelativepositionofthelens),Aforwardshiftoflenscausesmyopia,backwardshiftresultinhypermetropia.Absenceoflens(aphakia)causeshypermetropia.5)ExcessiveaccommodationExcessiveaccommodationduetospasmofaccommodationcausesmyopia.

214.Panophthalmitisinvolves? a)Innercoatofeyeball b)Innerandoutercoatbutsparingtenon'scapsule c)Allstructureofeyeballincludingtenon'scapsule d)Noneoftheabove CorrectAnswer-CAns.is'c'i.e.,Allstructureofeyeballincludingtenon'scapsule Endophthahnitis Panophthalmitis Endophthalmitisisdefinedas Panopthalmitisisdefinedas inflammationwithintheanterior inflammationwithintheanterior segment(aqueous)orposterior (aqueous)segmentand'or segment(vitreous)orbothtogether posterior(vitreous)segmentwithpartialthicknessinvolvementof togetherwithinflammationoftheadjacentoccularwall(oneor allthreecoatsoftheeye. moreinnercoatsoftheeye) Panophthalmitisoftenstartsas Inflammationcharacteristically anendophthalmitisthatthen involvesthetheinnerstructuresof involvesthesclera,tenon's theeyeballLe.,uvealtissue capsuleandmayalsoinvolve (iris/ciliarybody/choroid)andRetina theorbitaltissue.(Scleraisspared).

215.Cataractiscausedby? a)Hypoparathyroidism b)Cigratesmoking c)Non-ionizingradiation d)Alloftheabove CorrectAnswer-DAns.is'd'i.e.,Alloftheabove

216.Ameboidulcerisafeatureof a)Parasiticcornealulcer b)Mycoticcornealulcer c)Herpeticcornealulcer d)Bacterialcornealulcer CorrectAnswer-CAns.isci.e.,HerpeticcornealulcerHerpeticKeratitisMostoftheocularinfectionarecausedbyHSV-1exceptinneonateswhereeyeinfectioncanbecausedbyHSV2throughinfectedgenitaliaofmother.OcularinvolvementbyHSVmayoccurintwoforms:- Primaryherpes:-Typicallyisaunilateral blepharoconjunctivitiswhichischaracterizedbyvesiclesontheskin oflids,follicularconjunctivitis,preauricularsadenopathyand sometimespunctatekeratitis. Recurrentocularherpes:-Afterprimaryinfection,recurrentdiseasemayinvolveanyoralllayersofthecornea.Recurrentherpatickeratitisisdividedinto:?1)Epithelialkeratitis:-Manifestationsofepithelialkeratitisinclude:- 1. Cornealvesicles:-Vesiclescoalesceanderupttoformdendriticor geographiculcer. 2. Superficialpunctatekeratitis3. Dendriticulcer:-Itisthemostcommonpresentationandisatypical lesionofherpeskeratitis.Thereisanassociatedmarkeddiminutionofsensation. 4. Geographiculcer(amoeboidulcer)

2)Stromalkeratitis:-Stromalkeratitismaybeoftwotypes:- 1. Disciformkeratitis:-Thisisduetodamagetoendothelialcells asaresultofhypersensitivityreactiontotheHSVantigen. 2. Diffusestromalnecrotickeratitis:-Causedbyactiveviral invasionandtissuedestruction.3)Metaherpatickeratitis(Epithelialsteriletrophiculceration):-Itisnotanactivedisease,butisamechanicalhealingproblematthesiteofpreviousherpeticulcer.

217.Mostcommonsiteofdistantmetastasis inintraorbitalmalignantmelanomais? a)Brain b)Lung c)Liver d)Lymphnodes CorrectAnswer-CAns.is`ci.e.,LiverMalignantmelanomamostlyariseinuveaanduvealmalignantmelanomaisthemostcommonprimaryintraoculartumor.Themostcommonsitefordistantmetastasisofuvealmelanomaisliver.Theliveristhemostcommonsiteofmetastasisofuvealmelanoma"--ClinicaloncologyTheliveristhemostcommonsiteofmetastatisfromprimaryocularmelanoma"--Smith&Nesi'sUvealmelanomaUvealmelanomaisthemostcommonprimaryintraoculartumorinadults.Mostofthe(85%)uvealmelanomasariseinthechoroid.So,choroidalmelanomaisthemostcommonprimaryintraoculartumorinadults.Tumorarisesfromdendriticmelanocytes(neuralcrest,neuroectodermalorigin).Histologicallychoroidalmelanomacanbedividedinto:-Spindlecellmelanomas:-Thesemelanomascontainpredominantlyspindlecells.ThesemelanomasarefurthersubdividedintoSpindleAorSpindleB

dependinguponthetypeofcells.Epitheloidcellmelanomas:-Containepitheloidlikecells.Mixedcellmelanomas:-Containbothspindlecellsandepitheloidcells.Choroidalmelanomapresentsasasessileordomeshapedmasslocateddeeptothesensoryretina.Asecondarynon-rheugmatogenousretinaldetachmentfrequentlyoccurs.Involvementofvortexveinbytumorresultsinglaucoma.Withcontinuedgrowth,achoroidalmelanomacanruptureBruch'smembaneandassumeamushroomshape.Whenthatoccurs,tumorhasatendencytobleed,andvitrealorsubretinalhemorrhagemayoccur.

218.Shorteningof2mmofaxiallengthofeye ballcauses? a)3Dmyopia b)6Dmyopia c)3Dhypermetropia d)6Dhypermetropia CorrectAnswer-DAns.is.d.,6DhypermetropiaChangeinaxiallengthcancauserefractiveerror.Itisthecommonestformofametropia(bothmyopiaandhypermetropia).Inhypermetropia,thereisanaxialshorteningofeyeball.So,imageisformedbehindtheretina.Inmyopia,thereisanaxiallengtheningofeyeball.So,imageisformedinfrontoftheretina.1mmchangeinaxiallengthleadstoametropiaof3D.Forexample1mmshorteninginaxiallengthcauseshypermetropiaof3D.

219.Drugofchoiceforintermediateuveitis? a)Atropine b)Antibiotics c)Topicalsteroids d)Systemicsteroid CorrectAnswer-DAns.is'd'i.e.,Systemicsteroids Drugsusedinacuteanterioruveitis(iridocyclitis)Topicalsteroids(Drugsofchoice)Mydriatic-cycloplegics:Atropine(Drugof2"choice),Homatropine,cyclopentolate,tropicamide,rnydricain(mixtureofatropine,adrenaline&procaine)SystemicsteroidsNSAIDsSystemicimmunosuppressivescyclosporine,methotrexate,cyclophosphamideIntermediateuveitisSystemicsteroidsarethedrugofchoicePosterioruveitis(choroiditis)Systemicsteroidsarethedrugofchoice

220.InvertedimageinPurkinjetestisformed from? a)Anteriorsurfaceofcornea b)Posteriorsurfaceofc c)Anteriorsurfaceoflens d)Posteriorsurfaceoflens CorrectAnswer-DAns.is'd'i.e.,PosteriorsurfaceoflensPurkinjeimagestestNormally,whenastrongbeamoflightisshowntotheeye,fourimages(Purkinjeimages)areformedfromthefourdifferentreflectingsurfaces:-1"fromanteriorsurfaceofcorneaErectandmovesinsamedirection.2ndfromposteriorsurfaceofcorneaErectandmovesinsamedirection.3'dfromanteriorsurfaceoflensErectandmoveinsamedirection.4thfromposteriorsurfaceoflensInvertedandmovesinoppositedirectionFirstthreereflectingsurfacesareconvexandproduceerectimages,while4thsurfaceisconcave,thereforeproducesinvertedimage.Presenceofallfourimagesindicatespresenceofaclearlens.Inaphakia3rd&4thimagesareabsentandonlyfirsttwoimagesarepresent.Incataract4thimageisabsentandfirst3imagesarepresent.

221.Forcedductiontestistofindout? a)Ocularmusclepalsy b)Ocularmusclespasm c)Angleofdeviation d)Refractiveerror CorrectAnswer-AAns.is'a'i.e.,OcularmusclepalsyForcedductiontestItisperformedtodifferentiatebetweentheincomitantsquintduetoparalysisofextraocularmuscleandthatduetomechanicalrestrictionoftheocularmovements.FDTispositive(resistanceencounteredduringpassiverotation)incasesofincomitantsquintduetomechanicalrestrictionandnegativeincasesofextraocularmusclepalsy.

222.Redkeraticprecipitatesareseenin? a)Granulomatousuveits b)Hemorrhagicuveitis c)Oldhealeduveitis d)Acuteanterioruveitis CorrectAnswer-BAns.is.bi.e.,HemorrhagicuveitisKeraticprecipitates(KPs)KPsareproteinaceouscellulardepositsoccurringatthebackofcornea(cornealendothelialdeposits).Keraticprecipitatesareformedbytheaggregationofpolymorphonuclearcells,lymphocytes,andepitheloidcells.Inthesettingofuveitis,thebimicrosopicappearanceofKPmayyeildimportantdiagnosticcluesfortheidentificationoftheunderlyinginflammatorydisorder:?MuttonfatKP:-Large,yellowishKPs,arecharacteristicofgranulomatousuveitis.Thesearecomposedofepitheloidcellsandmacrophages.Theyarelarge,thickfluffy,lardaceousKPs,havingagreasyorwaxyappearance.SmallormediumKPs(granularKPs):-Thesearecomposedoflymphocytesandarecharacteristicofnon-granulomatousuveitis.Thesearesmall,roundandwhitishprecipitatesRedKPs:-ComposedofRBCsandinflammatorycells.Theseareseeninhemorrhagicuveitis.OldKPs:-Inhealeduveitis.TheabovedescribedKPsshrink,fade,becomepigmentedandirregularinshapewithcrenatedmargins.

223.Hardoleuminternumis? a)AcuteinfectionofZeisgland b)AcuteinfectionofMollgland c)AcuteinfectionMeibomiangland d)ChronicinfectionofZeisgland CorrectAnswer-C.Ans.is'c'i.e.,AcuteinfectionMeibomianglandAcuteinfectionofZeis(Moll)glandStye(Hardoleumexternum).Acuteinfectionoftarsalgland(Meibomiangland)HardoleuminternumoChronicinfectionoftarsalgland(Meihoniumgland)ChalazionDifferencesbetweenstye(Hordeolumexternum),chalazionandHordeoluminternum Stye Hordeolum (Hordeolum Chalazion internum externum) Onset Acute Chronic Acute Gland Zeis'sgland Meibomiangland Meibomiangland Typesof Suppurative Lipogranulomatous Suppurative inflammation Acutepainand Painless Symptoms swelling disfigurement Severepain Localized,hard Hardnontender Yellowpointseen Signs andtender swelling on swellingnearthe awayfromlid evertingthelid lidmargin margin Hotfomentation, Drainageby Incisionand Treatment Antibiotics incision drainage

Antibiotics incision drainage andremovalof andcurettage Antibioticsand eyelash Intralesional analgesic steroidDiathermy,antibiotic

224.Snowbankingisseenin? a)Whitecoatsdisease b)Ealesdisease c)Diabeticnephropathy d)Intermediateuveitis CorrectAnswer-DAns.isdi.e.,IntermediateuveitisParsplanitis(Intermediateuveitis)denotestheinflammationofparsplanapartofciliarybodyandmostperipheralpartoftheretina.Mostcommonsymptomisfloaters;defectivevisionmayalsooccur.Fundusexaminationinparsplanitisrevealswhitishexudatespresentneartheoraserrataintheinferiorquadrant.Thesetypicalexudatesarereferredassnowballopacities.Thesemaycoalescetoformagreywhitepiquecalledsnowbanking.

225.Retrobulbarinjectionisgivenin a)Insidemusclecone b)Outsidemusclecone c)Subtenonspace d)Subperiosteum CorrectAnswer-AAns.is'a'i.e.,InsidemuscleconeRetrobulbarinjection:-Injectioninretrobulbarspaceinsidethemusclecone.Peribulbarinjection:-Injectioninperibulbar/retrobulbarspaceoutsidethemusclecone.Sub-Tenoninjection:-Injectionbeneaththetenoncapule,i.e.insubtenonspace.Itisalsocalledparabulbarblock.

226.Basalcellcarcinomaisseeninmost commonlyinwhicheyelid? a)Uppermedial b)Upperlateral c)Lowermedial d)Lowerlateral CorrectAnswer-CAns.is'c'i.e.,LowermedialBasalcellcarcinomaisthecommonestmalignanttumorofthelids(90%)usuallyseeninelderlypeople.Itislocallymalignantandinvolvesmostcommonlylowerlid(50%)followedbymedialcanthus(25%),upperlid(10-15%)andoutercanthus."Basalcellcarcinomaisseeninthelowerlidneartheinnercanthususually"RenuJogi

227.Allareophthalmologicalemergencies except? a)CRAO b)CRVO c)Acutecongestiveglaucoma d)Endophthalmitis CorrectAnswer-BAns.is'b'i.e.,CRVOOcularemergenciesincludethoseconditionsthatresultinacute,severepaininassociationwithsuddenvisionloss,orthatmayleadtovisionlossifleftuntreated;andtraumaticconditionsthataffectglobeoradnexa.Comonophthalmicemergenciesare:- 1. Acutecongestiveglaucoma2. Ulcerativeortraumaticcornealdiseases3. Hyphema4. Acuteblindness5. Eyelidorconjunctivallaceration6. Anteriorlenssubluxation7. Rupturedglobe8. Opticneuritis9. Endophthalmitis 10. Orbitalcellulitis11. Centralretinalarterialocclusion(CRAG)12. Retinaldetachment

228.Diagnosisofallismadebyfluorescein angiographyexcept? a)Diabetesretinopathy b)Hypertensiveretinopathy c)Centralserousretinopathy d)Choroidalneovascularization CorrectAnswer-BAns.is'b'i.e.,Hypertensiveretinopathy

229.Lacrimalpunctumofupperandlower eyelidsare? a)Theyareopposed b)Norelation c)Upperpunctumismedial d)Upperpunctumislateral CorrectAnswer-AAns.is'a'i.e.,Theyareopposed

230.Downbeatnystagmusisseenin? a)Arnoldchiarimalformation b)Brainstemdamage c)Pontinehemorrhage d)Labyrinthinedamage CorrectAnswer-AAns.is'a'i.e.,ArnoldchiarimalformationDown-beatnystagmusareseenincerebellarlesionandArnold-chiarymalformation

231.NottrueaboutFuch'scornealdystrophy ? a)Posteriordystrophy b)Endothelialdystrophy c)Unilateralcondition d)Occursinoldage CorrectAnswer-CAns.is'c'i.e.,UnilateralconditionCornealdystrophiesarebilateral.Fuch'sepithelialendothelialdystrophyFuchsdystrophyisfrequentlyseenasaslowlyprogressivebilateralconditionaffectingfemalesmorethanmales,usuallybetweenfifthandseventhdecadeoflife.Primaryopenangleglaucomaisitscommonassociation.Clinicalfeaturescanbedividedintofollowingfourstages:? 1. Stageofcorneaguttata.Itischaracterisedbythepresenceof Hassal-Henletypeofexcrescensesinthecentralpartofcornea.Agradualincreaseofcentralguttaewithperipheralspreadandconfluencegivesrisetothesocalled'beaten-metal'appearance.Thestageisasymptomatic. 2. Oedematousstageorstageofendothelialdecompensationis characteirsedbytheoccurrenceofearlystromaloedemaandepithelialdystrophy.Patientscomplainsofblurringvision. 3. Stageofbullouskeratopathy.Thisstagefollowslong-standing stromaloedemaandischaracterisedbymarkedepithelialoedemawithformationofbullae,whichwhenrupturecausepain,discomfortandirritationwithassociateddecreasedvisualacuity. 4. Stageofscarring.Inthisstageepithelialbullaearereplacedbyscar

tissueandcorneabecomesopaqueandvascularized.Theconditionmaysometiemsbecomplicatedbyoccurrenceofsecondaryinfectionorglaucoma.

232.Positiveforcedductiontestisseenin? a)Extraocularmusclepalsy b)Mechanicalrestrictionofocularmovement c)Concomitantsquint d)None CorrectAnswer-BAns.is'b'i.e.,Mechanicalrestrictionofocularmovementforcedductiontest:Resistanceencounteredduringpassiverotationandisseeninincomitantsquintduetomechanicalrestriction.Negativeforcedductiontest:Noresistanceduringpassiverotationandisseeninextraocularmusclepalsy

233.Immuneringisafeatureof? a)Interstitialkeratitis b)Fungalcornealulcer c)Bacterialcornealulcer d)Herpessimplexkeratitis CorrectAnswer-BAns.is'b'i.e.,FungalcornealulcerClinicalfeaturesoffungal(mycotic)cornealulcerSymptomsaresimilartobacterialcornealulcersbutingeneraltheyarelessmarkedthantheequalsizedbacterialulcer.Ontheotherhandsignsareveryprominent,i.e.signsaremoreprominentthansymptoms.Followingsignscanbeseen:- 1. Greyish-whitedrylookingulcerwiththeelevatedrolledoutfeathery &hyphatemargins. 2. Featheryfingerlikeextensionintosurroundingstromaunderintact epithelium. 3. Asterileimmunering(yellowline)ofWesseley.4. Multiplesmallsatellitelesions.5. Non-sterile(infected)hypopyon(Pseudohypopyon).6. Perforationisrareandcornealvascularizationisconspicuously absent.

234.Inspecularmicroscopyendothelial densityismeasuredby? a)Opticaldoubling b)Fixedframeanalysis c)Opticalfocusing d)None CorrectAnswer-BAns.is'b'i.e.,FixedframeanalysisEndothelialcelldensityinspecularmicroscopyiscountedbyfixedframeanalysisandvariableframeanalysis. Celldensity(ceIlsimrn2)=Cellcountinframe

235.Mostcommontypeofscleritis? a)Non-necrotizing b)Necrotizing c)Posterior d)None CorrectAnswer-AAns.is'a'i.e.,Non-necrotizingSCLERITISScleritisreferstoachronicinflammationofthescleraproper.Itisacomparativelyseriousdiseasewhichmaycausevisualimpairmentandevenlossoftheeyeiftreatedinadequately.Itusuallyoccursinelderlypatients(40-70years)involvingfemalesmorethanthemales.Classification:I.Anteriorscleritis(98%)1.Non-necrotizingscleritis(85%)(a)Diffuse(b)Nodular2.Necrotizingscleritis(13%)(a)withinflammation(b)withoutinflammation(scleromalaciaperforans)II.Posteriorscleritis(2%)1.Non-necrotizinganteriordiffusescleritis.Itisthecommonestvariety,characterisedbywidespreadinflammationinvolvingaquadrantormoreoftheanteriorsclera.Theinvolvedareaisraisedandsalmonpinktopurpleincolour.

236.Whichofthefollowingindicatesactivity ofanterioruveitis? a)Cellsinanteriorchamber b)Circumcornealcongestion c)Keraticprecipitate d)Cornealedema CorrectAnswer-AAns.is'a'i.e.,CellsinanteriorchamberActivityofacuteanterioruveitisisindicatedbypresenceofcells(aquouscells)andflareinanteriorchamberGradingisdoneonthesetwo. Grade Aquouscells Grade Aquousflare 0cells 0 noflare +_ 1-5cells +1 Justdetectable +1 6-10cells +2 Moderateflare +2 11-20cells +3 Markedflare +3 21-50cells +4 Intenseflare +4 >50cells

237.Normalaqueousproductionrate- a)2ml/min b)5ml/min c)21/min d)51/min CorrectAnswer-CAns.is'c'i.e.,2l/minTheciliaryprocessesarethesiteofaqueousproduction.Theaqueoushumorisprimarilyderivedfromtheplasmawithinthecapillarynetworkoftheciliaryprocess.Threemechanismsplayapartinaqueousformationatdifferentlevels:-(i)Activesecretion(70%),(ii)ultrafiltration(20%),(iii)Diffusion/osmosis(10%).ActivesecretionoccursbythehelpofNa+ICATPasesystemandbicarbonatesystemmediatedbycarbonicanhydrase(convertCO2&H20intocarbonicacid).Thenormalaqueousproductionis2.3microlit/min.Totalvolumeofaqueousisabout0.31ml(0.25m1inanteriorchamberandabout0.06mlintheposteriorchamber).Asitisderivedfromplasmaithassimilarconstituentsasplasma,butatdifferentconcentrations:-i)Constituentshavingconcentrationlessthanplasma:-ProteinNat,IC+,Ca',Mg',Urea,glucose.ii)Constituentshavingconcentrationmorethanplasma:-Cl-,HCO3-,Lactate,Pyruvate,Ascorbate.Aqueoushumorisimportantinprovidingfollowingfunctions:- 1. Maintenanceofintraocularpressure(I0P):-Normalisbetween10 -21mmHg(mean16?2.57mmHg. 2. it)Nutritionalfunction:-Aqueousplaysanimportantrolebyproviding

substrateandbyremovingmetabolitesfromavascularcorneaandlens. 3. Opticalfunction:-Maintainsopticaltransparency4. Clearingfunction:-Aqueousservesasamechanismtoclearblood, macrophages,remnantsoflensmatterandproductsofinflammationfromtheanteriorchamber(takesplaceoflymphthatisabsentwithintheeyeball).

238.Drugofchoiceforopenangleglaucoma - a)Acetazolamide b)Latanoprost c)Timolol d)Brimonidine CorrectAnswer-CAns.is'c'i.e.,Timolol ImportantactsAngleclosureglaucomaTreatmentofchoiceforacutecongestiveglaucomaLaseriridotomy(1"choice),Peripheraliridectency(2"choice)DrugofchoiceforacutecongestiveglaucomaPilocarpineInitiallyIOPiscontrolled(firstdrugused)SystemicmannitoloracetazolamideOpenangleglaucomaTreatmentofchoiceTopicalantiglaucomadrugsDrugofchoice/3-blocker(Timolol,betaxolol,levobunalol)SurgeryofchoiceArgonordiodelasertrabeculoplasty

239.Superficialcornealvascularizationis causedby? a)Contactlens b)Graftrejection c)Chemicalburn d)Interstitialkeratitis CorrectAnswer-AAns.is'a'i.e.,Contactlens&'to'i.e.,GraftrejectionSuperficialDeep Interstitial Superficialcorneal keratitis ulcer Disciforrn Contactlensuser keratitis Trachoma Deepcorneal Rosaceakeratitis ulcer Phlyctenular Chemicalburns keratoconjunctivitiso Sclerosing Corneagraftrejection keratitis Viralinfectioncancausesuperficialcornealulceraswellasdisciformkeratitis.

240.Choroidalvascularizationisseenin? a)Myopia b)Hypermetropia c)Presbyopia d)Astigmatism CorrectAnswer-AAns.is'a'i.e.,Myopia 1. Causesofchoroidalneovascularization Age-relatedmaculardegeneration(ARMD)-mostsignificantChorioretinalscarsAngioidstreaksIntraocularinflammationChoroidalrupture(trauma)ChorioretinaldystrophyPathologicalmyopia

241.ContraindicationofLASIK? a)>20years b)Keratoconus c)Normalcornea d)Myopiaof-8D CorrectAnswer-B Ans.is'b'i.e.,Keratoconus PatientselectioncriteriaforLASIKPatientsabove20yearsofageStablerefractionforatleast12monthsMotivatedpatientsMyopiaupto-12DAbsenceofcornealpathologyCornealthickness>500ContraindicationsofLASIKMonocularpatientInfectionsegconjunctivitis,GlaucomaAutoimmunediseaseThincornea(<450micronKeratoconusPoorendothelialcellcountincornea(<1500)DryeyeDiabeticretinopathy YokeMuscles RightsuperiorrectusLeftinferioroblique Movement LeftsuperiorrectusRightinferioroblique DextroelevationLevoelevation RightinferiorrectusLeftsuperioroblique Dextrodepression LeftinferiorrectusRightsuperioroblique

Levodepression Rightlateralrectusleftmedialrectus Dextroversion Levoversion LeftlateralrectusRightmedialrectus YokeMuscles RightsuperiorrectusLeftinferioroblique LeftsuperiorrectusRightinferioroblique RightinferiorrectusLeftsuperioroblique LeftinferiorrectusRightsuperioroblique Rightlateralrectusleftmedialrectus LeftlateralrectusRightmedialrectus

242.Binocularsinglevisionistestedby? a)Amslergrid b)Synoptophore c)Maddoxrod d)Cardboardtest CorrectAnswer-BAns.is'b'i.e.,SynoptophoreGradesofbinocularsinglevisionTherearethreegradesofbinocularsinglevision,whicharebesttestedwiththehelpofasynoptophore.1.Grade-I-SimultaneousperceptionItisthepowertoseetwodissimilarobjectsstimultaneously.Itistestedbyprojectingtwodissimilarobjects(whichcanbejoinedorsuperimposedtoformacompletepicture)infrontofthetwoeyes.Forexample,whenapictureofabirdisprojectedontotherighteyeandthatofacageontothelefteye,anindividualwithpresenceofsimultaneousperceptionwillseethebirdinthecage.2.Grade-II-FusionItconsistsofthepowertosuperimposetwoincompletebutsimilarimagestofromonecompleteimage.Theabilityofthesubjecttocontinuetoseeonecompletepicturewhenhiseyesaremadetoconvergeordivergeafewdegrees,givesthepositiveandnegativefusionrange,respectively.3.Grade-III-StereopsisItconsistsoftheabilitytoperceivethethirddimension(depthperception).Itcanbetestedwithstereopsisslidesinsyno

243.Inaphakiapurkinjeimagesabsentare? a)1&3' b)2nd&4m c)2nd&3rd d)3rd&4th CorrectAnswer-CAns.is'c'i.e.,2nd&3rd

244.Keratitisincontactlensweareriscaused byallexcept? a)Pseudomonas b)Pneumococcus c)Aspergillu d)Chlamydia CorrectAnswer-BAns.is'd'i.e.,ChlamydiaEctopialentisoEctopialentisisdefinedasdisplacementormalpositionofthecrystallinelensoftheeye.Thelensisconsidereddislocated(luxated)whenitliescompletelyoutsidethelenspatellarfossa.Thelensisdescribedassubluxatedwhenitispartiallydisplacedbutcontainedwithinthelensspace.Causesarei)Homocystinuriaii)Marfansyndromeiii)Weil-Marchesanisydromeiv)EhlerDanlossyndromev)Hyperlysinemiavi)Sulphiteoxidasedeficiencyvii)Sticklersyndromeviii)Traumaix)Consecutive/spontaneous(Hypermaturecataract,buphthalmos,highmyopia)

245.Phlyctenularconjunctivitisiscausedby- a)Chlaymydia b)Staphylococcus c)Pneumococcus d)Aspergillus CorrectAnswer-BAns.is'b'i.e.,StaphylococcusPhlyctenularkeratoconjunctivitisPhlyctenularconjunctivitisisanallergicresponseoftheconjunctivalandcornealepitheliumtosomeendogenousallergensandcharacterizedbyformationofthephlyctens.Phlyctensaregrey,yelloworpinkishwhitenodulesslightlyraisedabovethesurface,areseenonthebulbarconjunctiva,generallynearthelimbus.Peakagegroupis3-15yearswithslightfemalepreponderance.

246.Allareseeninnon-proliferativediabetic retinopathyexcept? a)Microaneurysm b)Neovascularization c)Hardexudates d)Macularedema CorrectAnswer-BAns.is'b'i.e.,NeovascularizationClassificationofDiabeticretinopathy Nonproliferative Proliferative Backgroundretinopathy 1. Microaneurysm2. Dotandblothemorrhage(deep Neovasculorizationofthedisc hemorrhage) (NVD) 3. Hardexudate 1. Neovasculaizationelsewhereinthe 4. Macularedema retina(NVE) B)Preproliferative 2. Viffeoushemorrhage retinopathy 3. Fibrovascularproliferation 1. Cotton-woolspots(soft 4. Trsctionretinsldetachment exudates) 5. Irissurfaceneovascularization 2. Venousbeading (rubeosisiridisor 3. Extensivehemorrhage neovascularglaacoma) 4. lntraretinalintravascularabn ormalities(IRMA

247.Surgeryofchoiceforchronicacquired dacryocystitis a)Dacryocystorhinostomy b)Dacryocystectomy c)Conjunctivo-cystorhinostomy d)None CorrectAnswer-AAns.is'a'i.e.,Dacryocystorhinostomy Treatmentofchronicdacryocystitis CongenitalAdult(acquired)MassageoverlacrimalsacwithantibioticeyedropsConservative:-Massage,antibioticdrops,probing,Syringing(irrigation)withnormalsaline&syringingantibioticsolutionDacryocystorhinostomy(DCR):-SurgeryofhoiceProbingofnasolacrimalductDactyocystectomy(DCT)IntubationwithsiliconetubeConjunctivocystorhinostomDacryocystorhinostomy(DCR)

248.Posner-schlossmansyndromeis? a)Ipsilateralopticatrophywithcontralateralpapilloedema b)Unilateralglaucomatouschangeswithmildanterioruveitis c)Granulomatousuveitiswithirisheterochromia d)Noneoftheabove CorrectAnswer-B.Ans.is'b'i.e.,Unilateralglaucomatouschangeswithmildanterioruveitis

249.Antigaucomatousdrugcausingspasmof accommodation a)Timolol b)Pilocarpine c)Dorazolamide d)Latanoprost CorrectAnswer-BAns.is'b'i.e.,PilocarpineOcularsideeffectsoftopicalagentsforPOAG13-blocker:Allergicblepheroconjunctivitis,cornealhyposthesia,blurredvision,dryeye,superficialpunctatekeratitis.Cholinomietics(pilocarpine):Blurredvision,miosis,accommodativespasm,browache.SympathomimeticsNon-selective(Dipivefrine):Follicularconjunctivities,reboundcongestion,macularedemainaphakicApraclonidine:Allergies,lidretraction,follicularconjunctivitis,fluctuationinvisualacuityBrimonidine:Ocularallergy,conjuntivalblanching.Carbonicanhydraseinhibitors(Dorzolamide,brinaolamide):Punctatekeratitis,ocularallergies.Prostaglandinanalogues(Latanoprost):Punctatekeratitis,irispigmentation.

250.Besidesitspropertiesofdecreasing intraocularpressure,timololispreferredinthetreatmentofglaucomabecauseit a)Producesnomiosis b)Possessmembranestabilizingactivity c)Increasesoutflowofaqueoushumor d)Isaselectivebeta-adrenoceptorblocker CorrectAnswer-AAns.is'a'i.e.,ProducesnomiosisAdvantagesoftopicaln-blockers(timolol)overmiotics(pilocarpinelNochangeinpupilsize(nomiosis)NofluctuationinI.O.T.NoinducedmyopiaConvenientonce/twicedailyapplicationsNociliaryspasm(nospasmofaccomodation)Fewsystemicsideeffects.

251.Rigidgaspermeablelensaremadeof- a)Plymethymethacrylate b)Hydroxymethylmethacrylate c)CopolymerofPMMA,Siliconcontainingmonomer&cellulose acetylbutyrate d)CelluloseacetaeButyrate CorrectAnswer-C1.Hardlenses:Madeofpokymethylmethacrylate(PMMA)2.Rigidgaspermeable(RGP)lenses:CopolymerofPMMA,siliconcontainingvinylmonomer&celluloseacetatebutyrate(CAB)areusedtomanufactureRGPlenses.3.Softlenses:Thesearemadeupofhydroxymethymethacrylate(HEMA)

252.Whatisregularastigmatism? a)Astigmatisminwhichtheprincipalmeridiansareparallel b)Astigmatisminwhichtheprincipalmeridiansareperpendicular c)Asymptomaticastigmatism d)Astigmatismasaresultofcataractsurgery CorrectAnswer-BRegularstigmatismPrincipalmeridiansarependicularIrregularastigmatismPrincipalmeridiansarenotperpendicular.

253.Chemotherapyagentsfor retinoblastoma: a)vincristine,carboplatinandetoposide b)vinblastine,etoposideandbleomycin c)vinblastine,vincristineandetoposide d)vinblastine,vincristineandcisplatin CorrectAnswer-AAnswer.A.Vincristine,carboplatinandetoposideChemotherapyforRetinoblastomaChemotherapy(chemo)istheuseofanti-cancerdrugstotreatcancer.Chemocanbegivenindifferentwaystotreatretinoblastoma.Someofthechemodrugsusedtotreatretinoblastomainclude: 1. Carboplatin2. Cisplatin3. Vincristine4. Etoposide5. Cyclophosphamide6. Topotecan7. Doxorubicin Mostoften,2or3drugsaregivenatthesametime.Astandardcombinationiscarboplatin,vincristine,andetoposide,althoughforverysmalltumors,onlycarboplatinandvincristinemaybeenough.Otherdrugsmightbeusedifthesearenoteffective.

254.Drugusedinacutecongestiveglaucoma are: a)Atropine b)Pilocarpine c)Acetazolamide d)BothB&C CorrectAnswer-DAnswer.D.BothPilocarpine&AcetazolamideManagementofangleclosureglaucomaAcutecongestiveglaucomaalsoisknownasacuteangleclosureglaucoma.ImmediatemedicaltherapyinacuteACconsistsofcommencingIOP-loweringeyemedicationssuchastopical?-blocker,a2-agonistandevenprostaglandinanaloguesassoonaspossible.OncetheIOPissufficientlyreducedtoallowirisreperfusion,pilocarpineisinstilledtoinducemiosisinanattempttowidentheanteriorchamberanglesandreestablishaqueousoutflow.Mydriaticdrugssuchasatropine,cyclopentolate,tropicamideandphenylephrineareprecipitatingfactorforangleclosureglaucoma,sonotused(contraindicated)initstreatment.

255.WhichistheMostcommonocular findinginmyastheniagravis? a)Ptosis b)Lagophthalmos c)Proptosis d)Enophthalmos CorrectAnswer-AAnswer.A.PtosisInmorethanhalfthepeoplewhodevelopmyastheniagravis,theirfirstsignsandsymptomsinvolveeyeproblems,suchas: 1. Droopingofoneorbotheyelids(ptosis).2. Doublevision(diplopia),whichmaybehorizontalorvertical,and improvesorresolveswhenoneeyeisclosed.

256.InRetinitispigmentosadecreasedlevel of? a)Arachidonic b)Trielonic c)Thromboxane d)Docosahexanoicacid CorrectAnswer-DAnswer.D.Docosahexanoicacid

257.Whatisagainsttherulecorrectionin astigmatism: a)-1.25cyl90 b)-2spherical180 c)-3cyl180 d)+2cyl180 CorrectAnswer-A:DTypesofregularastigmatismDependingupontheaxisandtheanglebetweenthetwoprincipalmeridia,regularastigmatismcanbeclassifiedintothefollowingtypes:1.With-the-ruleastigmatism.Inthistypethetwoprincipalmeridiaareplacedatrightanglestooneanotherbuttheverticalmeridianismorecurvedthanthehorizontal.Thus,correctionofthisastigmatismwillrequiretheconcavecylindersat180??20?orconvexcylindricallensat90??20?.Thisiscalled'with-the-rule'astigmatism,becausesimilarastigmaticconditionexistsnormally(theverticalmeridianisnormallyrendered0.25Dmoreconvexthanthehorizontalmeridianbythepressureofeyelids).2.Against-the-ruleastigmatismreferstoanastigmaticconditioninwhichthehorizontalmeridianismorecurvedthantheverticalmeridian.Therefore,correctionofthisastigmatismwillrequirethepresciptionofconvexcylindricallensat180??20?orconcavecylindricallensat90??20?axis.***WEHAVETOMUGTHISUP:Aplusat90,orminusat180accountsfor"withtheruleastigmatism***

258.Morbidfearofdarknessknownas: a)Claustrophobia b)Xenophobia c)Mysophobia d)Nyctophobia CorrectAnswer-DAnswer.D.NyctophobiaNyctophobiaisanextremefearofnightordarknessthatcancauseintensesymptomsofanxietyanddepression.Afearbecomesaphobiawhenit'sexcessive,irrational,orimpactsyourday-to-daylife.Claustrophobiaisaformofanxietydisorder,inwhichanirrationalfearofhavingnoescapeorbeingclosed-incanleadtoapanicattack.xenophobia.:fearandhatredofstrangersorforeignersorofanythingthatisstrangeorforeign.Mysophobia,alsoknownasverminophobia,germophobia,germaphobia,bacillophobiaandbacteriophobia,isapathologicalfearofcontaminationandgerms.

259.Whichdrugcausesocularhypotension withapneainaninfant? a)Latanoprost b)Timolol c)Brimonidine d)Dorzolamide CorrectAnswer-CAnswer.C.BrimonidineBrimonidineisarelativelyselectivealpha-agonist,whichreducesintraocularpressure(IOP)bydecreasingaqueousproductionandincreasinguveoscleraloutflow.Brimonidinepassesthroughtheblood-brainbarrier,potentiallycausingcentralnervoussystem(CNS)toxicity.Therehavebeenreportsofbradycardia,hypotension,hypothermia,hypotonia,andapneaininfantsaftertopicalbrimonidine.

260.Achildhasptosisandpoorlevator function.Whatsurgerywillyoudo? a)Levatormuscleresection b)Mullerectomy c)FasanellaServatsurgery d)Frontalissuspensionsurgery CorrectAnswer-DAnswerD.FrontalissuspensionsurgeryMullermuscleresectionsaretypicallyusedforrepairofminimalptosis(2mm)andaregenerallyconsideredsuperiortotheFasanella-Servatprocedure(tarsoconjunctivalmullerectomy)inmaintainingeyelidcontourandpreservingthetarsus.Whenlevatorfunctionispoor,thesurgeonshouldconsiderutilizingtheaccessoryelevatorsoftheeyelidinptosisrepair.Thistypeofsurgeryismostcommonlyrequiredincongenitalptosiswithpoorlevatorfunctionorinvariousformsofneurogenicptosiswithpoorlevatorfunction.Frontalissuspensionsurgeryperformedwhenlevatorfunctionispoororabsent,theeyelidissuspendeddirectlyfromthefrontalismusclesothatmovementofthebrowisefficientlytransmittedtotheeyelid.Thus,thepatientisabletoelevatetheeyelidbyusingthefrontalismuscletoliftthebrow.Frontalissuspensioncanbeperformedtranscutaneouslyortransconjunctivally.Thissurgeryconnectstheeyelidtothebrowwithaslingmaterialandutilizesthepowerofthefrontalismuscletoelevatethepoorlyfunctioningeyelid.

261.Esotropiaisusuallyassociatedwith: a)Myopia b)Hypermetropia c)Astigmatism d)Presbyopia CorrectAnswer-BAns.B.HypermetropiaAccommodativeesotropiaisoneofthemostcommontypesofstrabismusinchildhood.Theincidenceisestimatedat2%ofthepopulation.Itisusuallyfoundinpatientswithmoderateamountsofhyperopia.Asthepatientaccommodatesorfocusestheeyes,theeyesconverge.

262.Cornealulcerresemblingfungalulceris seenininfectionwithwhichoftheagents? a)Nocardiaasteroides b)Mycobacterium c)Klebsiellapneumoniae d)Chlamydiatrachomatis CorrectAnswer-AAns:A.Nocardiaasteroides(Ref:Yanoff&Duker4Iep219;SmolinandThoft's'TheCornea4Iep248)KeratitiscausedbyNocardiaasteroides,whichisafilamentousbacteria,closelyresemblesthemorphologyofcornealulcerscausedbyfungi.CornealinfectionswithNocardia,Actinomyces,andStreptomycestypicallyfollowanindolentclinicalcourse,whichmaysimulatemycotickeratitiswithhyphaledges,satellitelesions,andelevatedepitheliallesions.Theulcerischaracteristicallysuperficial,withawreath-shapedgray-whiteinfiltrateandanunderminednecroticedge.Thebasemightassumeacrackedwindshieldappearance.Nocardiakeratitisoftenresemblesfungalinfection,withafilamentousappearingborderandsatellitelesions.Infectionappearstobeindolent;theanteriorchamberreactionisoftenminimal.However,rarely,moresevereanteriorchamberreactionandhypopyonseen.

263.AnisocoriainHorner'ssyndromeisdue to a)Oculosympatheticpalsy b)Oculoparasympatheticpalsy c)Oculomotornervepalsy d)Abducensnervepalsy CorrectAnswer-AAnswer-A.OculosympatheticpalsyAnisocoriaisaconditioncharacterizedbyanunequalsizeoftheeyes'pupils.Itcanbeanentirelyharmlessconditionorasymptomofmoreseriousmedicalproblems.Anisocoriahasvariouscauses:Physiologicalanisocoria:About20%ofnormalpeoplehaveaslightdifferenceinpupilsizewhichisknownasphysiologicalanisocoria.Inthiscondition,thedifferencebetweenpupilsisusuallylessthan1mm.[3]Horner'ssyndromeHorner'ssyndromeisoculosympatheticpalsy.Horner'ssyndromeconsistsofclassicaltriadofipsilateral:- 1. Ptosis,2. Miosis,3. Anhydrosis(lossofsweating) Otherfeaturesare:-Lossofcilio-spinalreflex,Enophthatnos,Heterochromia(ipsilateralirisisoflightcolour),thepupilisslowtodilate,slightelevationofinferioreyelid,normalpupillaryreflex.

264.Dioptericpowerisrelated- a)Directlytosquareoffocallength b)Inverselytofocallength c)Directlytofocallength d)Inverselytosquareoffocallength CorrectAnswer-BAnswer-B.InverselytofocallengthOpticalpower(alsoreferredtoasdioptricpower,refractivepower,focusingPower,orconvergencePower)isthedegreetomirror,orotheropticalsystemconvergesordivergeslight.

265.AllareseeninCMVretinitisexcept a)Immunosuppresion b)Brush-fireappearancePattern c)Crackmudappearance d)Perivasculitis CorrectAnswer-CAnswer-C.CrackmudappearanceCMVretinitisisthemostcommonophthalmicmanifestationofCMV.Thereischaracteristichemorrhagic,fullthicknessretinitis.Occuringasacongenitalinfectionininfantsoranopportunisticinfectionintheimmunocompromisedhost.CMVretinitisisawhitegranulargeographiclesionthatclearscentrallyasitenlarges,leavingaquietcentralareaofretinalatrophyandmottledpigmentepithelium.Thishasalsobeendescribedas"brush-firepattern.Perivascularretinitis-Frostedbranchangitiswithretinalperivasculitis.

266.Opticvesicleisderivedfrom- a)Endoderm b)Mesoderm c)Neuroectoderm d)SurfaceEctoderm CorrectAnswer-CAnswer-C.NeuroectodermAnoutgrowthfromprosencephalonformsopticvesicle(neuroectodermalstructure).ProximalpartofopticvesiclebecomesconstrictedandelongatedtoformopticstalkGrowingopticvesiclecomesincontactwithsurfaceectodermwhichisthickenedtoformlensplacode.

267.Gobletcellsareseenin- a)Cornea b)Conjunctiva c)Retina d)Vitreous CorrectAnswer-BAnswerB.ConjunctivaGobletcellswithintheconjunctivalepitheliumarespecializedcellsthatsecretemucinsontothesurfaceoftheeye.HistologyofconjunctivaTheepitheliumisnon-keratinizingandaroundfivecell-layersdeep.Mucin-secretinggobletcellsarelocatedwithintheepithelium,andtheyaremostdenseinferonasally(nasal>inferior)andinthefornices.Thestroma(substantiapropria)consistsofrichlyvascularized,looseconnectivetissue.TheaccessorylacrimalglandsofKrauseandWolfringarelocateddeepwithinthestroma.Conjunctiva-associatedlymphoidtissue(CALT)iscriticalintheinitiationandregulationofocularsurfaceimmuneresponses.

268.Neovascularizationinuvealtissue [RubeosisIridis]ismostcommonlycausedby a)DiabeticRetinopathy b)CRVO c)CRAO d)Choroidalmelanoma CorrectAnswer-AAnswer-A.DiabeticRetinopathyItisasecondaryangleclosureglaucomawhichresultsduetoformationofneovascularmembraneovertheirisi.e.,neovascularizationofiris(rubeosisiridis).Causesofrubeosisiridisare:-Common:-Diabeticretinopathy(mostcommoncause),centralretinalveinocclusion),Eale'sdisease,sickle-cellretinopathy.

269.Allofthefollowingarecausesof posteriorsubcapsularcataractexcept- a)Myotonicdystrophy b)Wilson'sDisease c)Ionizingradiation d)Congenitalcataract CorrectAnswer-DAnswer-D.CongenitalcataractMyotoicdystrophyWilson'sdiseaseAtopicdermatitisCorticosteroidsTraumaGalactosemiaInfrared/heatcataract(glass-blower'sorglassworker)

270.Ectopialentisis/areassociatedwith: a)Homocystinuria b)Alportsyndrome c)Lowesyndrome d)Marfansyndrome e)Sulphiteoxidasedeficiency CorrectAnswer-A:D:EAnswer-(A)Homocystinuria(D)Marfansyndrome(E)SulphiteoxidasedeficiencyMarfansyndromeHomocystinuriaWeil-MarchesanisyndromeSulfiteoxidasedeficiencyHyperlysinemia

271.Allaretrueregardingcorneaexcept: a)Endotheliumhelpinmaintainingdehydratedstate b)Oxygenismostlyderivedbyepitheliumdirectlyfromtheair throughtearfilm c)Glucosesupplyforcornealmetabolismismainlyderivedfrom theaqueous d)Cornealthicknessismoreatcenterthanperiphery e)Richlyvascular CorrectAnswer-D:EAnswer-(D)Cornealthicknessismoreatcenterthanperiphery(E)RichlyvascularOuter&fibrouscoatofEYEBALL.Transparent,anterior1/6thsegmentofeyeball.Non-vascularMostoftherefractionineyeoccuratanteriorsurfaceofcornea(air-tearinterface),i.e.,Anteriorsurfaceofcorneaisthemostimportantrefractivestructureofeye.Themostactivelymetabolisinglayersofthecorneaareepithelium&endothelium.

272.Feature(s)ofInfantileglaucomais/are except: a)Aniridiamaybeassociated b)Treatmentincludestrabeculotomy c)Buphthalmoscanoccur d)Corneaisthin&clear e)MaybeassociatedwithSturge-webersyndrome CorrectAnswer-DAnswer-D.Corneaisthin&clearAnswer-D.Corneaisthin&clearPrimaryinfantileglaucomaisararedevelopmentaldefectintheiridocornealfiltrationangleoftheanteriorchamberthatpreventsaqueousfluidfromproperlydrainingfromtheeye.Thisobstructionincreasestheintraocularpressure,which,ifuntreated,damagestheopticnerve.Infantileglaucomacancausecompleteblindnessifleftuntreated.Glaucomacanalsooccurininfantsaftertraumaorintraocularsurgery(eg,cataractextraction).Glaucomaassociatedwithanotheroculardisorder,suchasaniridia,Lowesyndrome,orSturge-Webersyndrome,iscalledsecondaryglaucoma.Buphthalmos(blueandthinsclera,strechedlimbus)isseen.Treatment:Trabeculotomy,Goniotomy,combinedtrabeculotomyandtrabeculotomy+/-MMC(Mitomycin)

273.InSnellen'schart,eyesubtendsanangle ofhowmanyminuteswithlettersonSnellen'schart? a)1minofarc b)5minofarc c)10minofarc d)15minofarc CorrectAnswer-BAns.is'b'i.e.,5minofarcIndications:Toprovideabaselinerecordingofvisualacuity(VA)ToaidexaminationanddiagnosisofeyediseaseorrefractiveerrorFormedico-legalreasonsEquipment:Multi-letterSnellenchartEorCSnellenchartorachartwithillustrationsforpatientswhocannotreadorspeakPlainoccluder(notessential)PinholeoccluderTorchorflashlightPatient'sdocumentationProcedure:Atthegivendistance,eachlettersubtendsanangleof5minatthenodalpointoftheeyeSnellenchartisusedfordistantvision.Thepatientshouldreadthechartatadistanceof6m.Principle:

ltconsistsoflettersarrangedinlines,withprogressivelydiminishingsize.Eachlettersubtendsanangleof5minutesatthenodalpointofaneyewhenviewedfromitsrespectivedistanceEachletterissoconstructedthatthewidth(ofeachstroke)subtendsanangleof1minute=MAR.Interpretation:Normalvisualacuityforfaris6/5Bestvisualacuityforfaris6/3MinimumrecordableVAonSnellen'schartis1/60.Snellen'schart:

274.Listersperimeterisusedfor a)KineticVisualfieldtesting b)StaticVisualfieldtesting c)Bothkineticandstaticvisualtesting d)Noneofthese CorrectAnswer-AAns.is'a'i.e.,KineticVisualfieldtesting[RefKanski's8th/echapter10,p.325]Staticperimetry:Amethodofassessingfields,usuallyautomated,inwhichthelocationofastimulusremainsfixed,withintensityincreaseduntilitisseenbythesubject(thresholdisreached)ordecreaseduntilitisnolongerdetected.Kinetic(dynamic)perimetryisnowmuchlesscommonlyperformedthanstaticperimetry.Astimulusofconstantintensityismovedfromanon-seeingareatoaseeingareaatastandardizedspeeduntilitisperceived,andthepointofperceptionisrecordedonachart;pointsfromdifferentmeridiaarejoinedtoplotanisopterforthatstimulusintensity.Stimuliofdifferentintensitiesareusedtoproduceacontourmapofthevisualfield.Kineticperimetrycanbeperformedbymeansofamanual(Goldmann)oranautomatedperimeterifthelatterisequippedwithanappropriatesoftwareprogram.

275.WhatisthetypeofGoldmantonometry? a)ApplanationTonometry b)Dynamiccountourtonometry c)Reboundtonometry d)Impressiontonometry CorrectAnswer-AAns.is'a'i.e.,ApplanationTonometry[RefAnatomy&physiologyofeye2"1/ep.79]Measurementofintraocularpressure(10P)MeasurementofIOPisdoneby:?A)Manometry:-ItistheonlydirectmeasureofIOP.B)Tonometry:-ItisanindirectmethodofmeasurementofIOP.Followingtypesoftonometersarethere:- 1. Indentation(impression)tonometer:-Thesearethemostcommonly usedtonometers.ExampleisSchiotztonometer. 2. ApplanationtonometerGoldmannapplanationtonometeristhemost accuratetonometer.Othertypesofapplanationtonometersareperkin'stonometer,pneumatictonometer,air-pufftonometer,Pulseairtonometer,Tonopen

276.Spasmofaccommodationmimics a)Myopia b)Hypermetropia c)Amblyopia d)Presbiopia CorrectAnswer-AAns.is'a'i.e.,Myopia[RefKhuranailth/ep.42]PseudomyopiaSpasmofaccommodationoccursduetoexcessivecontractionoftheciliarymuscles.Thismakesthezonuleslooseandhencethelensbecomesmoreconvex.Thisleadstotheimagebeformedinfrontoftheretinatherebtmimickingmyopia.Thisiscalledpseudomyopia.

277.Subretinalhaemorrhageatthemaculain myopiaisknownas? a)Lacquercracks b)FosterFuchsspot c)Staphyloma d)Macularretinoschisis CorrectAnswer-BAns.is'b'i.e.,FosterfuchsspotDegenerativemyopia:Refractiveerrormayincreaseupto20-25Dwithdegenerativechangesineye.Temporalmyopiccrescentisafeatureofpathological/degenerativemyopia.Itisawhitecrescentatthetemporalborderofthedisc.Someofthemosttypicalfeaturesofdegenerativemyopiaare:VitreousliquefactionandposteriorvitreousdetachmentPeripapillaryatrophyappearingastemporalchoroidalorscleralcrescentsorringsaroundtheopticdiscLatticedegenerationintheperipheralretinaTiltingormalinsertionoftheopticdisc,usuallyassociatedwithmyopicconusThinningoftheretinalpigmentepitheliumwithresultingatrophicappearanceofthefundusEctasiaofthescleraposteriorly(posteriorstaphyloma)BreaksinBruch'smembraneandchoriocapillaris,resultinginlinesacrossthefunduscalled"lacquercracks"FosterFuch'sspotinthemaculararea.

278.Dispersiveprismfunctionsfor a)Splittinglightintodifferentwavelengths b)Reflectinglight c)Polarizinglight d)None CorrectAnswer-AAns.is'a'i.e.,Splittinglightintodifferentwavelengths[Ref"TheDiscoveryoftheSpectrumofLight".]"Prismsmaybeusedforpolarisingandreflectinglightbutdispersiveprismslikethecommonlyusedtriangularprismsplitthelightintodifferentcoloursbasedonwavelengths"Inoptics,aprismisatransparentopticalelementwithflat,polishedsurfacesthatrefractlight.Atleasttwooftheflatsurfacesmusthaveananglebetweenthem.Theexactanglesbetweenthesurfacesdependontheapplication.Thetraditionalgeometricalshapeisthatofatriangularprismwithatriangularbaseandrectangularsides.Lightchangesspeedasitmovesfromonemediumtoanother(forexample,fromairintotheglassoftheprism).Thisspeedchangecausesthelighttoberefractedandtoenterthenewmediumatadifferentangle(Huygensprinciple).Thedegreeofbendingofthelight'spathdependsontheanglethattheincidentbeamoflightmakeswiththesurface,andontheratiobetweentherefractiveindicesofthetwomedia(Snell'slaw).Therefractiveindexofmanymaterials(suchasglass)varieswiththewavelengthorcolorofthelightused,aphenomenonknownasdispersion.Thiscauseslightofdifferentcolorstoberefracteddifferentlyandtoleavetheprismatdifferentangles,creatinganeffectsimilartoarainbow.

279.Cornealepithelialrepairincludesallof thefollowingphasesexcept a)Cellproliferation b)Cellmigration c)Celladhesion d)Cellfusion CorrectAnswer-DAns.is'd'i.e.,Cellfusion[RefCornealEpithelialwoundhealing:BJO1994,78;401-408]CornealepithelialrepairTheprocessesinvolvedinthehealingofcornealepithelialwoundscanbedividedintothreedistinctcomponents:cellmigration,cellproliferation,andcelladhesion.Allthreecomponentsarepartofacontinuousprocessbutthecontributionofeachcanvarydependingonthesizeanddepthofthewoundandnatureofinjury.

280.Conjunctivalstainingisdonebyall except a)Fluoroscein b)Indiaink c)RoseBengal d)Lissamine CorrectAnswer-BAns.is'b'i.e.,Indiaink[RefCanJOphthalmol.2015Aug;50(4):273-7.doi:10.1016/j.jcjo.2015.05.007.]Commondyesusedforconjunctivalstaining:RoseBengal,FluorosceinandLissamine.

281.Pseudogerontoxonisseenin a)Vernalkeratopathy b)Choroidalmelanoma c)Trachoma d)Retinoblastoma CorrectAnswer-AAns.is'a'i.e.,Vernalkeratopathy[RefKanski8'1*Chap.5,p.138]

282.A50yearoldmalepresentswith cicatricialentopionofupperandlowereyelid.Oneversionofuppereyelid,linearconjunctivalscars-Arltlineareseen.Whatisthediagnosis? a)Trachoma b)Springcatarrah c)Ligneousconjunctivitis d)Parinaudoculoglandularsyndrome CorrectAnswer-AAns.is'a'i.e.,Trachoma[RefKanski8th/eChap.5,p.138]Arltlineisafeatureoftrachoma.SignsofTrachomaConjunctivalsigns:-Congestion,conjunctivalfollicles(boiledsagograinlike),Papillaryhyperplasia,conjunctivalscarring(Arlesline),concretion.Cornealsigns:-Superficialkeratitis,Herbertfollicles,Pannus,Cornealulcer,Herbertpits,Cornealopacity.

283.Painisoutofproportiontosignsin whichcornealulcer? a)Herpessimplexkeratits b)Acanthamoebakeratitis c)Fungalkeratitis d)Pneumococcalkeratitis CorrectAnswer-BAns.is'b'i.e.,Acanthamoebakeratitis[RefKanski8thleChap.6,p.197]Inhuman,acanthamoebacauses:-(i)Keratitis;(ii)Granulomatousencephalitis,(iii)FulminantmeningoencephalitisPatientpresentswithveryseverepain(whichisoutofproportiontothedegreeofclinicalsigns),watering,photophobia,blurredvisionandblepherospasm.Onexamination,followingcharacteristicfeaturesareseen:? 1. Initiallesions(Epitheliallesions):-InitiallytheAcanthamoeba keratitisshowstypicalreticularpatternduetoradialkeratoneuritis(Radialperineuritis).Atthisstageitiscommonlymistakenforherpessimplexkeratitisbecauseofpseudodentriticepitheliallesion(dentriticulcermorphology). 2. Advancedcases(Stromalinvolvement):-Overaperiodofweeks stromalsignsdevelopwithcentralorparacentralringshapedlesionwithstromalinfiltrateandanoverlyingepithelialdefect,ultimatelypresentingasringabscess.Theremayberadialperineuritis,Wessely(inflammatory)ringandhypopyon.

284.Oblateellipsoidappearanceofcorneais seeninwhichofthefollowingconditions? a)PostmyopicLASIKsurgery b)Withtheruleastigmatism c)Bi-obliqueastigmatism d)Obliqueastigmatism CorrectAnswer-AAns.is'a'i.e.,PostmyopicLASIKsurgery[RefQualityofvision:EssentialOpticsforthecataractandrefractivesurgeon,chap.3,p.30]Thecorneaisathreedimensionalprolateellipsoid,likeabulletoratulip.Itissteeperinthecentreandflatterintheperiphery.AfterrefractivesurgerieslikemyopicLASIK,corneaisconvertedtooblateellipsoid,whichissteeperintheperipheryandflatterinthecentre.

285.Whichofthefollowing Glycosaminoglycansarenotpresentincornea a)Keratinsulfate b)Chondroitinsulfate c)Chondroitin d)Heparinsulfate CorrectAnswer-DAns.is'd'i.e.,Heparinsulfate[RefKhuranaAnatomyandPhysiologyofEyes,?die,chapter2,p.26)GAGs(Glycosaminoglycans)orsocalledacid-mucopolysaccharidesrepresent4-4.5%ofthedryweightofthecornea.CorneacontainsthreemajorGAGfractionsnamely:Keratansulfate(50%),chondroitinsulfate(25%)andchondroitin(25%)-presentexclusivelyincornea.TheGAGarepresentintheinterfibrillarspaceofthecornealstromaandaccountforthe`stromalswellingpressure'(normal-60mmHg)ie.Itstendencytoimbibewaterandthusplaysanimportantroleinthemaintenanceofcornealhydrationlevelandtransparency.AnabnormalaccumulationofGAGoccursinthecornealstromaofthepatientsaffectedbytheinbornerrorsofGAGmetabolismknownasmucopolysaccharidosis.

286.Irondepositionlineatedgeofpterygium oncornealepitheliumisknownas? a)Stocker'sline b)KFRing c)Fleischerring d)Ferrysline CorrectAnswer-AAns.is'a'i.e.,Stocker'sline[Ref:Khurana4'5/ep.80;Parson21"/ep.181;Yanoff&DuckerOphthalmologyydlep

287.Whichorderneuronisopticnerveinthe visualpathway? a)Firstorder b)Secondorder c)Thirdorder d)Noneofthese CorrectAnswer-BAns.is'b'i.e.,Secondorder[RefKhurana4th/ep.286-289;Concisetextbookofphysiology2"/ep.336]SensoryorgansPhotoreceptors(Rods&cones)NeuronsoffirstorderAxonofbipolarcells(inRetina)NeuronsofsecondorderAxonsofganglioniccell(Retinai.e.,Opticdisc,Opticnerve,Opticchiasma,optictracts)NeuronsofthirdorderAxonsfromnervecellsinlateralgeniculatebody(opticradiation)

288.Purkinjeimagetestisusedin a)Keratomoter b)Retinoscopy c)Opticalcoherencetomography d)Pachymeter CorrectAnswer-DAns.is'd'i.e.,Pachymeter[RefElkington'sclinicaloptics3rd/echapter14,p.207]Pachymetryisthemeasurementofcornealthickness.Pachymetersemployeitheropticalorultrasoundprinciples.OpticalpachymetersusethePurkinje-Sansonimagesformedbytheanteriorandposteriorsurfacesofthecornea(imagesIandII)tomeasurecornealthickness,andthePurkinje-Sansonimagesformedbytheposteriorsurfaceofthecorneaandtheanteriorsurfaceofthelens(imagesIIandIII)tomeasurethedepthoftheanteriorchamber.

289.

Whichofthefollowingisnotapartofuveal a)Iris b)Ciliarybody c)Choroid d)Retina CorrectAnswer-DAns.is'd'i.e.,Retina[RefKhurana's2"/eChap.3,p.44]Uvealtissueconstitutesthemiddlevascularcoatoftheeyeball(Innercoatisretinaandoutercoatiscornea&sclera).Fromanteriortoposterioritcanbedividedintothreeparts:-Iris,ciliarybodyandchoroid.Irisandanteriorpart(2mm)ofciliarybody(parsplicata)areconsideredasanterioruvealtissues.Posteriorpart(4mm)ofciliarybody(parsplana)andadjacentchoroidareconsideredasintermediateuvealtissue.Choroidisconsideredasposterioruvealtissue.Theentireuvealtractisdevelopmentally,structurallyandfunctionallyoneindividualstructure.

290.AllexceptonearetrueforScleromalacia perforans a)Itisnoninflammatoryscleritis b)Itaffectsonlymales c)Perforationoftheglobeisextremelyrare d)Visionisunaffected CorrectAnswer-BAns.is'b'i.e.,Itaffectsonlymales[RefKanski'sClinicalOphthalmology8"Vechapter8,p.259]ScleromalaciaperforansScleromalaciaperforans(5%ofscleritis)isaspecifictypeofprogressivescleralthinningwithoutinflammationthattypicallyaffectselderlywomenwithlongstandingrheumatoidarthritis,buthasalsobeendescribedinassociationwithothersystemicdisorders.Despitethenomenclature,perforationoftheglobeisextremelyrareasintegrityismaintainedbyathinlayeroffibroustissue.Differentialdiagnosisisfromtheinnocuousscleralhyalineplaqueandsenilescleromalacia.

291.Bluedotcataractiscausedby a)Diabetes b)Wilson'sdisease c)Atopicdermatitis d)Chalcosis CorrectAnswer-CAns.is'c'i.e.,Atopicdermatitis[RefParson's21"/ep.259]Bluedotcorticalcataractiscausedbymyotonicdystrophyandatopicdermatitis.

292.Whichofthefollowingiscomplicationof prolongeduseofcorticosteroideyedrops? a)PosteriorSubcapsularcataract b)Nuclearcataract c)Capsularcataract d)Corticalcataract CorrectAnswer-AAns.is'a'i.e.,PosteriorSubcapsularcataractCausesofposteriorsubcapsularcataract: Myotoicdystrophy Down'ssyndrome Ionizingradiation Wilson'sdisease Corticosteroids Galactosemia DM Busulfan Senilecataract Infrared/heatcataract Chloroquine Trauma (glass-blower'sorglassworker) Atopicdermatitis

293.Falseabouttreatmentofcataractin childrenis a)ECCEisthetreatmentofchoice b)Incaseofbilateralcataractimparingvisionsurgerymustbe doneby4-6weeksofage c)Lensectomyisnotoneofthemethodsofextracapsular extraction d)Intraocularlensimplantationmustbedoneonlyafter2yearsof age CorrectAnswer-CAns.is'c'i.e.,Lensectomyisnotoneofthemethodsofextracapsularextraction[RefTextbookofpediatriccataractsurgeryp.194]Thecriticalperiodfordevelopingthefixationreflexinbothunilateralandbilateralvisualdeprivationdisordersisbetween2-4monthsofage.Anycataractdenseenoughtoimpairvisionmustbedealtwithbeforethisageandtheearliestpossibletimeispreferred.

294.Whatisthenewadvanceincataract surgery? a)FemtosecondLaser b)NeodymiumLaser c)NanosecondLaser d)PicosecondLaser CorrectAnswer-AAns.is'a'i.e.,Femtosecondlaser[RefFemtosecondlaser-assistedcataractsurgery:KendallE.Donaldson,RosaBraga-Mele,FlorenceCabot,fortheASCRSRefractiveCataractSurgerySubcommittee]Femtosecondlaser-assistedcataractsurgeryprovidessurgeonsanexcitingnewoptiontopotentiallyimprovepatientoutcomesandsafety.Inthissurgeryafemtosecondlaserisusedforvariousstepslikelensfragmentationandcapsulotomy.Althoughtheresultshavebeengoodthetechnologyiscurrentlyveryexpensive.

295.Whichofthefollowingstepisnotdone duringphacoemulsificationsurgeryforcataract? a)Irrigationanddrainageofcortex b)Continuouscurvilinearcapsulorrhexis c)FoldableIOLimplantation d)Sclerocornealtunnel CorrectAnswer-DAns.is'd'i.e.,Sclerocornealtunnel[RefPhacoemulsificationbyvajpayee]Thestepsinphacoemulsificationinclude:(i)Corneoscleralincision,(ii)Continuouscurvilinearcapsulorrhexis,(iii)Hydrodissectionandhydrodelineation,(iv)Emulsificationandaspirationofnucleusandthencortex,(v)FoldableIOLimplantationinposteriorchamber.

296.Phacoemulsificationuses a)Highfrequencysoundwaves b)Infraredwaves c)Ultravioletrays d)Noneofthese CorrectAnswer-AAns.is'a'i.e.,Highfrequencysoundwaves[RefKanski's8th/echapter9,p.281]InPhacoemulsification,lensnucleusisemulsifiedusinghighfrequencysoundwaves.

297.Postoperativecomplicationsofcataract areallexcept? a)Aftercataract b)Endophthalmitis c)Glaucoma d)Scleritis CorrectAnswer-DAns.is'd'i.e.,Scleritis[RefOphthalmologybyDuker2"d/ep.484]Therearesomanycomplicationsofcataractsurgery,Hereareonlyimportantones:?Aftercataract(opacificationofcapsule)RetinaldetachmentVitreousprolapse&lossNeovascularglaucomaCystoidmacularedemaAnterioruveitis(iridocyclitis)EndophthalmitisIrisprolapseAphakicglaucomaStriakeratopathy&PseudophakicbullouskeratopathyFibrous&endothelialgrowthCornealendothelialdamage

298.Hemeralopiaisseenin a)Retinaldetachment b)Retinitispigmentosa c)Opticneuritis d)Subcapsularcataract CorrectAnswer-DAns.is'd'i.e.,Subcapsularcataract[RefKanski8th/eChap.9,p.270]Hemeralopiaistheinabilitytoseeclearlyinbrightlight(alsoknownasdayblindness)andistheexactoppositeofnyctalopia(nightblindness).SubcapsularcataractAnteriorsubcapsularcataractliesdirectlyunderthelenscapsuleandisassociatedwithfibrousmetaplasiaofthelensepithelium.Posteriorsubcapsularopacityliesjustinfrontoftheposteriorcapsuleandhasagranularorplaque-likeappearanceonobliqueslitlampbiomicroscopy,buttypicallyappearsblackandvacuolatedonretroillumination;thevacuolesareswollenmigratorylensepithelialcells(bladderorWedl),similartothosecommonlyseenpostoperativelyinposteriorcapsularopacification.Duetoitslocationatthenodalpointoftheeye,aposteriorsubcapsularopacityoftenhasaparticularlyprofoundeffectonvision.Patientsarecharacteristicallytroubledbyglare,forinstancefromtheheadlightsofoncomingcars,andsymptomsareincreasedbymiosis,suchasoccursduringnearvisualactivityandinbrightsunlight(dayblindness).

299.Whichofthefollowingisagooddyeis usedforlensincataractsurgery? a)TrypanBlue b)Fluoroscein c)Indiaink d)None CorrectAnswer-AAns.is'ATrypanbluedyeforanteriorsegmentsurgeriesTrypanbluehasbeenusedasanadjunctforimprovingvisualizationoftheanteriorcapsuleduringphacoemulsificationofmaturewhitecataractsforthepastfewyears.Surgeonshavelonguseddyeslikeindocyaninegreen,fluorescein,andtrypanbluetostaintheanteriorcapsuleinordertofacilitatethesurgicalprocedure.studiescomparingthese3dyeshaveconcludedthattrypanblueprovidessignificantlymoreintensivestainingoftheanteriorlenscapsulethantheothersTrypanblueiseasiertousethanindocyaninegreen,becauseitcomesinapremixedsolution,anditisavailableatamoreeconomicalprice.

300.Whichofthefollowingisalayerbetween choroidandretina? a)Bruch'smembrane b)Descemet'smembrane c)Photoreceptors d)Ganglioncelllayer CorrectAnswer-AAns.is'a'i.e.,Bruch'smembrane[RefParson's21"/ep.321]Bruch'smembraneistheinnermostlayerofthechoroid.Itisalsocalledthevitreouslamina,becauseofitsglassymicroscopicappearance.Itis2-4thick.Itliesbetweenchoroidandtheretina.

301.100dayglaucomaiscausedby a)CRVO b)CRAO c)Buphthalmos d)Agerelatedmaculardegeneration CorrectAnswer-AAns.is'a'i.e.,CRVO100-dayglaucomaistypicallyseeninIschemicCRVO.Followingcentralretinalveinocclusion,flame-shapedhaemorrhagesdevelopinthenervefiberlayeroftheretina,especiallyaroundtheopticdisc,asaresultofthehighintravascularpressurethatdilatestheveinsandcollateralvessels.Edemaoftheopticdiscandretinaoccurbecauseofimpairedabsorptionofinterstitialfluid.Visionisgenerallypoorbutmayrecoversurprisinglywell,consideringtheseverityofthefunduscopicchanges.Intractableclosed-angleglaucoma,withseverepainandrepeatedhaemorrhages,commonlyoccurs2to3monthsaftercentralretinalveinocclusion(100-dayglaucoma';'thromboticglaucoma'),owingtoneovascularizationoftheirisandadhesionsbetweentheirisandtheanteriorchamberangle(peripheralanteriorsynechiae).

302.KeethWagnerclassificationisfor a)Hypertensiveretinopathy b)Diabeticmaculpathy c)CRVO d)CRAO CorrectAnswer-AAns.is'a'i.e.,Hypertensiveretinopathy[RefRobartW.Schrier8"/ep.1377]

303.Inwhichofthefollowing,intraocular pressureisveryhighandinflammationisminimum? a)Glaucomatocycliccrisis b)Acuteiridocyclitis c)Hypetensiveuveitis d)Angleclosureglaucoma CorrectAnswer-AAns.is'a'i.e.,Glaucomatocycliccrisis[RefKhurana4th/ep.160]GlaumatocycliccrisisGlamatocycliticcrisis(Posner-Schlossmansyndrome)isaunilateralrecurrentnon-granulomatousiritisthatisassociatedwithanelevatedocularpressureduringtheattacks.Thisself-limitingconditiontendstooccurinpersonsduringthethirdtosixthdecadeandthevisualfields,theopticnervehead,andanteriorchamberanglearenormal.Amildinflammatoryreactionisveryrarelypresentasevidencedbyafewkeraticprecipitatesontheposteriorsurfaceofthecornea.Thecauseoftheglaucomaremainsunknown,butatrabeculitisissuspected.Manypatients(55%)subsequentlydevelopopenangleglaucoma

304.CellbodiesofMuller'sCellsarepresent inwhichlayerofretina? a)Innerlimitingmembrane b)Outernuclearlayer c)Retinalpigmentepithelium d)Ganglioncelllayer CorrectAnswer-AAns.is'a'i.e.,Innerlimitingmembrane[RefHistologyoftheEye,editedbyWilliamKrause,Dept.PathologyandAnatomicalscience,UniversityofMissouriSchoolofMedicine]Innerlimitingmembrane-basementmembraneelaboratedbyMullercells.Nervefibrelayer-axonsoftheganglioncellnuclei(notethatathinlayerofMullercellfootplatesexistsbetweenthislayerandtheinnerlimitingmembrane).Ganglioncelllayer-containsnucleiofganglioncells,theaxonsofwhichbecometheopticnervefibresformessagesandsomedisplacedamacrinecells.Innerplexiformlayer-containsthesynapsebetweenthebipolarcellaxonsandthedendritesoftheganglionandamacrinecells.Innernuclearlayer-containsthenucleiandsurroundingcellbodies(perikarya)oftheamacrinecells,bipolarcellsandhorizontalcells.Outerplexiformlayer-projectionsofrodsandconesendingintherodspheruleandconepedicle,respectively.Thesemakesynapseswithdendritesofbipolarcells.Inthemacularregion,thisisknownastheFiberlayerofHenle.Outernuclearlayer-cellbodiesofrodsandcones.Externallimitingmembrane-layerthatseparatestheinnersegment

portionsofthephotoreceptorsfromtheircellnucleus.Layerofrodsandcones-layerofrodcellsandconecells.Retinalpigmentepithelium-singlelayerofcuboidalcells.Thisisclosesttothechoroid.

305.Whichofthefollowingistrueabout signsofangleinclosureglaucomaexcept a)Verticalsemidialtedpuil b)Edematouscornea c)Multipleirisnodules d)Edematousandhyperemicopticdisc CorrectAnswer-CAns.is'c'i.e.,Multipleirisnodules[RefParson's21"/ep.290]ClinicalfeaturesofangleclosureglaucomaConjunctivaischemosedandcongested(bothconjunctival&ciliaryvesselsarecongested).CorneaisoedematousandinsensitiveAnteriorchamberisveryshallow&withaqueousflareAngleofanteriorchamberisclosed(ongonioscopy)IrisisdiscolouredPupilissemidilated,verticallyovalandfixed.Itisnonreactivetobothlightandaccommodation.IOPismarkedlyraised(40-70mmHg)Opticdiscisoedematous&hyperemicFelloweyeshowsshallowanteriorchamberandanarrowangle.

306.Whichofthefollowingisfalsestatement aboutvitreous? a)Anatomically,vitreousispresentinanteriorsegment b)Vitreouslargelycontainwaterandhyaluronicacid c)Strongestattachmentofvitreousbaseisatoraserrata d)Vitreousisattachedanteriorlytothelens CorrectAnswer-AAns.is'a'i.e.,Anatomically,vitreousispresentinanteriorsegment[RefKanski8thieChap.17,p.722]Vitreousispresentinposteriorsegmentofeye.Vitreoushumorisajellylikefluidliquidthatfillsmost(80%)oftheeye(fromthelensback,i.e.,intheposteriorsegment).Thevitreousconsistslargelyofwater(99%),anetworkofcollagenfibrils,largemoleculesofhyaluronicacid,peripheralcells(hyalocytes),andmucopolysaccharides,formingagel-likematerial.Thereisapotentialspacebetweenvitreousandretina,calledsubhyaloidspace.Asweage,vitreouschangesfromageltoaliquidandgraduallyshrinksseparatingfromtheretina.Thisiswhenpeoplestartseeingfloaters(blackspotsinfrontoftheeye).

307.Phacodonesisisseeninallexcept a)Traumaticinjurytotheeye b)Hypermaturecataract c)Pseudoexfoliation d)Diabetesmellitus CorrectAnswer-DAns.is'd'i.e.,Diabetesmellitus[RefKanski8thiep.300]Phacodonesisisthetremulousnessorvibrationofthelenswitheyemovement.Itisseenin: 1. Trauma2. Pseudoexfoliationsyndrome3. Hypermaturecataract4. Ectopialentis

308.Whichofthefollowingistrueabout divergentsquint a)Itisalsocalledexotropia b)Itismorecommonthanconvergentsquint c)Itisafeatureof6thnervepalsy d)Allofthefollowing CorrectAnswer-AAns.is'a'i.e.,Itisalsocalledexotropia[RefPediatricstrabismus4th/ep.218-224]Divergentsquintisalsocalledasexotropia.Itlesscommonthanconvergentsquint(esotropia).6thnervepalsycausesconvergentsquint.

309.Crossedeyefixationispositivein- a)Esotropia b)Exotropia c)Hypertropia d)Hypotropia CorrectAnswer-AAns.is'a'i.e.,Esotropia[RefInternet]Crossfixationistheuseoftherighteyetoviewtheleftvisualfieldandtheuseofthelefteyetoviewtherightvisualfield.Thisbehaviorisverycommoninchildrenwithinfantileesotropia.Crossfixationoftencausestheappearanceofnotlookingdirectlyatatargetandparentsoftenwonderifvisionisreduced.

310.Partialptosisisoculomotornerveinjury isduetointact- a)Supplyfromoppositeoculomotornerve b)Sympatheticinnervation c)Parasympatheticinnervation d)Actionoforbicularisoculi CorrectAnswer-BAns.is'b'i.e.,Sympatheticinnervation[RefTextbookofophthalmicreconstructivesurgeriesp.786]Motornervesupplyoflidisthroughthreesources:? 1. Facialnervesupplyingorbicularisoculi,(closingoflid)2. Oculomotorsupplyinglevatorpalpebraesuperioris;3. Sympatheticfibressupplyingmuller'smuscle.4. BothLPSandMullermusclefunctiontoretractthelid,henceonly partialptosisisseeninoculomotornervepalsy.

311.Retinoblastomasshowallofthe followingexcept a)Smallroundcells b)Necrosis c)PseudorosettesandFleurettes d)None CorrectAnswer-DAns.'d'isNone(Allareseen)[RefKhurana4thiep.281]HistologyofretinoblastomasThetumorarisesfromsmallroundcellswithlargenuclei,i.e.,itisatumorofagroupcalledsmallroundbluecelltumors.MicroscopicfeaturesofawelldifferentiatedtumorincludeFlexnerwintersteinerrosettes(specificforretinoblastoma),HomerWrightrosettes,pseudorosettesandfleurettesformation.

312.Whichofthefollowingismostcommon visualdefectinpapilloedema a)Amourosisfugax b)Homonymoushemianopia c)Homonymousquadrantopia d)Glare CorrectAnswer-AAns.is'a'i.e.,Amourosisfugax[RefClinicalopthalmology2"d%p.349,350]InitiallythesymptomsofpapilloedemaareduetoincreasedICT,e.g.headache,nausea,projectilevomitingandpapilloedema.Visionisnormalinitially.In25%ofpatientsvisualsymptomsoccuronlyinadvancedseverepapilloedema,whenopticatrophysetsin.Typically,thereisrecurringbriefepisodes(transient)ofvisualobscurations(Amaurosisfugax)lastinglessthen30seconds,inwhichvisionturnsgreyorblacks,sometimesdecribedasifaveilhasfallenovertheeyes.Thesymptomsusuallyaffectbotheyesatonceaspapilloedemaisbilateral.Centralvisionisaffectedlateinthedisease.Initiallythereisenlargementofblindspotandprogressivecontractionofthevisualfield(visualfieldbecomessmaller).Completeblindnesssetsineventually.Thus,characteristicallythereisgraduallyprogressivepainlesslossofvision

313.Whatisthetreatmentofmeibomianitis? a)Cleansingthelidedges b)Applicationofmoistheat c)Localantibiotics d)Alloftheabove CorrectAnswer-DAns.is'd'i.e.,Alloftheabove[RefFosterCS.Theeyeinskinandmucousmembranedisorders.In:TasmanW,JaegerEA,eds.Duane'sOphthalmology.15thed.Philadelphia,Pa:LippincottWilliams&Wilkins;2009:chap27]MeibomianitisMeibomianitisisinflammationofthemeibomianglands,agroupofoil-releasing(sebaceous)glandsintheeyelids.CausesAnyconditionthatincreasestheoilysecretionsofthemeibomianglandswillallowexcessoilstobuildupontheedgesoftheeyelids.Thisallowsfortheexcessgrowthofbacteriathatarenormallypresentontheskin.Theseproblemscanbecausedbyallergies,hormonechangesduringadolescence,orskinconditionssuchasrosaceaandacne.Meibomianitisisoftenassociatedwithblepharitis,whichcancauseabuildupofadandruff-likesubstanceatthebaseoftheeyelashes.Insomepeoplewithmeibomianitis,theglandswillbepluggedsothatthereislessoilbeingmadeforthenormaltearfilm.Thesepeopleoftenhavesymptomsofdryeye.

314.Mostcommonsiteofbasalcell carcinomaoftheeyeis a)Eyelid b)Conjunctiva c)Cornea d)Lacrimalapparatus CorrectAnswer-AAns.is'a'i.e.,Eyelid[RefRenuJogi4th/ep.420;Khurana4th/ep.360]Basalcellcarcinomaisthecommonestmalignanttumorofthelids(90%)usuallyseeninelderlypeople.Itislocallymalignantandinvolvesmostcommonlylowerlid(50%)followedbymedia!canthus(25%),upperlid(10-15%)andoutercanthus."Basalcellcarcinomaisseeninthelowerlidneartheinnercanthususually

315.Ankyloblepheronisdefinedas a)Adhesionofthelidtotheeyeballs b)Adhesionofthelidmarginstoeachother c)Inturnedeyelash d)Inflammationofthelidmargin CorrectAnswer-BAnsis'b'i.e.,Adhesionofthelidmarginstoeachother[Ref:Kanski8thlep.52]DisordersoftheeyelidsBlepharitis:-Chronicinflammationoflidmargin.Blephritisacarica:InflammationoflidmargincausedbyDemodexfolliculorum.Madarosis:-Lossofeyelashes.Trichiasis:-Misdirectedeyelasheswhichrubagainsttheeyeballinnormalpositionoflidmargin.Distichiasis:-anabnormalextrarowofciliatakingplaceofmeibomianglands.Entropion:-Inwardrollingorinturningoflidmargin.Ectropion:-Outrollingoroutwardturningoflidmargin.Symblepharon:-Adhesionofthelidstoeyeball.Ankyloblepharon:-Adhesionofmarginsoftwoeyelids.BlepharophimosisPalpebralfissureappearstobecontractedattheoutercanthus.Lagophthalmos:-Incompleteclosureofthepalpebralaperturewheneyesareshut.Tylosis:-Thickeningoflidmargin.Basalcellcarcinoma:-MostcommonmalignanttumorofeyelidClobomaoflid:-Triangulargapinnasalsideofupperlid

316.Theglobeisdisplacedtowhichsidein lacrimalglandtumour? a)Inferotemporal b)Inferonasal c)Superotemoral d)Nasal CorrectAnswer-BAns.is'b'i.e.,Inferonasal[RefBernardiniFP,DevotoMH,CroxattoJO.Epithelialtumorsofthelacrimalgland:anupdate.CurrOpinOphthalmol2008;19:409-13]Alllacrimalglandtumorstypicallysharethefollowingsymptoms:facialasymmetryduetodisplacementoftheglobe,diplopia,ptosis,limitedocularmotility,andenlargementofthelacrimalgland.Epitheliallesionstendtodevelopmostlyintheorbitallobeofthelacrimalglandandareprincipallyunilateral.Theinitialsignisusuallyinferiorandnasaldisplacementoftheglobeandproptosis,duetothesuperotemporallocationofthelacrimalglandintheanterioraspectoftheorbit.

317.'D'shapedpupilisseenin a)Glaucoma b)Dislocationoflens c)Iridodialysis d)Iridocyclitis CorrectAnswer-CAns.is'c'i.e.,Iridodialysis[RefKhurana4thiep.404]Iridodialysisisdetachmentofirisfromitsrootattheciliarybody.ItresultsinDshapedpupilandalackbiconvexareaseenattheperiphery.

318.Investigationofchoiceforopticneuritis is? a)MRIBrainandorbit b)CtscanBrainandorbit c)Vitreousbiopsy d)Electooculogram CorrectAnswer-AAns.is'a'i.e.,MRIBrainandorbit[RefKanski8th/eChap.19,p.784]MagneticResonanceImaging(MRI)isfarmoresuperiorforthestudyofsofttissueandthus,formostneuro-ophthalmicconditions,MRIistheinvestigationofchoice.

319.Ocularfindingsindiabetesareallexcept - a)Retinopathy b)Earlysenilecataract c)Neovascularglaucoma d)Blepharophimosis CorrectAnswer-DAns.is'd'i.e.,Blepharophimosis[RefKanski's8`Vechapter13,p.520]

320.Whichofthefollowingisalongterm sideeffectofphakic10Ls a)Chronicglaucoma b)Retinaldetachment c)Opticneuritis d)None CorrectAnswer-AAns.is'a'i.e.,Chronicglaucoma[RefChenLI,etal.Metaanalysisofcataractdevelopmentafterphakicintraocularlenssurgery.JCataractRefractSurg2008;34:1181-200.]Phakicintraocularlenses(pIOLs)areartificiallensesthatareinsertedeitherontopoftheirisorinbetweentheirisandthenaturallens.Theyareusedtotreatrefractiveerrorwithoutremovingcorneatissueorthelens.LongtermrisksofphakicIOLSChronicintraocularpressureelevationcanproduceindolentvisiondamagefromangleclosureglaucoma.Thesurgicalprocedureitselfalsoinducessomeendothelialcelldamageandiftheprostheticisincloseproximitytothecornea,chroniclosscouldbeinduced.Finally,chronicinflammationorprosthetic-lenstouchcaninducecataractformation

321.Mostcommonprotozoancausing keratitisis a)Plasmodium b)Acanthamoeba c)Toxoplasma d)W.bancrofti CorrectAnswer-BAns.is`b'i.e.,Acanthamoeba[RefKanski8th/ep.197]"Acanthamoebakeratitisisthemostcommonkeratitiscausedbyaprotozoanespeciallyincontactlensusers".

322.Mostcommonprotozoancausing keratitisis a)Plasmodium b)Acanthamoeba c)Toxoplasma d)W.bancrofti CorrectAnswer-BAns.is`b'i.e.,Acanthamoeba[RefKanski8th/ep.197]"Acanthamoebakeratitisisthemostcommonkeratitiscausedbyaprotozoanespeciallyincontactlensusers".

323.Treatmentofacutedacrocystitisinstage ofcellulitisis? a)Antibiotics b)Abscessdrainage c)DCT d)DCR CorrectAnswer-AAns.A.AntibioticsTreatmentofacutedacyrocystitisDuringcellulitisstageItconsistsofsystemicandtopicalantibioticstocontrolinfection;andsystemicanti-inflammatoryanalgesicdrugsandhotfomentationtorelievepainandswelling.

324.Whatisthecorrectsequenceof xerophthalmia a)Nightblindness4Conjunctivalxerosiscornealxerosis- cornealulcer b)Conjunctivalxerosiscornealxerosiscorneal ulcerNightblindness c)Cornealxerosiscornealulcer4Nightblindness Conjunctivalxerosis d)CornealulcerNightblindnessConjunctivalxerosis-3 cornealxerosis CorrectAnswer-AAns.A.Nightblindness4Conjunctivalxerosiscornealxerosis-cornealulcer

325.Whicheyemusclehasradial, longitudinalandcircularfibres? a)SphinctorPupillae b)DilatorPupillae c)LevatorpalpebraeSuperioris d)Ciliarymuscle CorrectAnswer-DAns.D.CiliarymuscleTheciliarymuscleisaringofsmoothmuscleintheeye'smiddlelayer(vascularlayer)thatcontrolsaccommodationforviewingobjectsatvaryingdistancesandregulatestheflowofaqueoushumourintoSchlemm'scanal.Itchangestheshapeofthelenswithintheeye.Theciliaryfibershavecircular,longitudinal(meridional)andradialorientations.

326.RequiredforIOLpowercalculation? a)Cornealtopography b)Gonioscopy c)IndirectOphthalmoscopy d)Keratometry CorrectAnswer-DAns,D.KeratometryIOLpowercalculationrequireskeratometryandbiometry(axiallengthofeyeball).

327. Immediatetreatmentofacute dacryocystitisis? a)Antibioticsanddrainageofabscesssifpresent b)Dacryocystorhinostomy c)Dacryocystectomy d)Nasaldecongestants CorrectAnswer-AAns.A.Antibioticsanddrainageofabscesssifpresent

328.Trueaboutimagingspectrometryis? a)Allowssimultaneousmeasurementsofreflectancespectra alongaline b)Isusefulindiagnosingagainsttheruleastigmatism c)Spectrometryisanessentialinvestigationbefore trabeculectomy d)ItisbasedontheprincipleofSturm'sConoid CorrectAnswer-AAns.A.Allowssimultaneousmeasurementsofreflectancespectraalongaline'ImagingsPectrometryisanewtechniquethatpermitssimultaneousmeasurementsofreflectancespectraatdifferentlocationsalongaline.Resultsarethree-dimensionalimages,whosecoordinatesarelocation,wavelength,andreflectance.Aconventionalfunduscameraisadaptedtoaspectrographandanintensifiedchargecoupleddevice(CCD)matrixdetectorsystem.ConsideringtheradiationtransPortinsinglefunduslayers,thelocaldistributionoftheconcentration-thicknessproductofxanthophyll,melanin,andchoroidalbloodcanbecalculated'

329.Theprincipleoftotalinternalreflectionis usedby? a)Gonioscope b)Pachymeter c)Ophthalmoscope d)Lensometer CorrectAnswer-AAns.AGonioscopyisanessentialdiagnostictoolandexaminationtechniqueusedtovisualizethestructuresoftheanteriorchamberangle.Masteringthevarioustechniquesofgonioscopyiscrucialintheevaluationofglaucomapatients.Gonioscopyisrequiredtovisualizethechamberanglebecauseundernormalconditionslightreflectedfromtheanglestructuresundergoestotalinternalreflectionatthetear?airinterface.Atthetear?airinterface,thecriticalangle(approximately46?)isreachedandlightistotallyreflectedbackintothecornealstroma.Thispreventsdirectvisualizationoftheanglestructures.Allgonioscopylenseseliminatethetear?airinterfacebyplacingaplasticorglasssurfaceadjacenttothefrontsurfaceoftheeye.Thesmallspacebetweenthelensandcorneaisfilledbythepatient'stears,salinesolution,oraclearviscoussubstance.Dependingonthetypeoflens

330.Refractoryerrormeasuredbyallexcept ? a)Keratometry b)Retinoscopy c)Refractometry d)Spectrometry CorrectAnswer-DAns.D.SpectrometryTheprocedureofdeterminingandcorrectingrefractiveerrorsistermedasreftaction.Therefractioncomprisestwocomplementarymethods:- 1. Objectivemethods:Objectivemethodsofrefractioninclude:-(i) Retinoscopy,(ii)Refractometry,(iii)Keratometry, 2. Subjectivemethods:Theseare:-(i)Subjectiveverificationof refraction,(ii)Subjectiverefiningofrefraction,(iii)Subjectivebinocularbalancing.

331.Ansiokoniais? a)Projectionofdifferentcolouredimagesintovisualcortex b)Projectionofdifferentshapedimagesintovisualcortexoftwo retinae c)Changeinthevelocityofperceivedobjects d)Partialintermittentvisualloss CorrectAnswer-BAns.B.ProjectionofdifferentshapedimagesintovisualcortexoftworetinaeAnisoeikoniaisdefinedasaconditionwhereintheimagesprojectedonthevisualcortexfromthetworetinaeareabnormallyunequalinsizeorshape-

332.Parasitosisofextraoculareyemusclesis seenin? a)Trichinosis b)Cysticercosis c)Amoebiasis d)Ascariasis CorrectAnswer-AAns,A.Trichinosis'Althoughmanyparasitescantheoreticallyinvolvetheextraocularmusclethemostfrequentformofparasiticinfestationofextraocularmusclesistrichinosis'

333.Mostpowerfulrefractorysurfaceofeye is- a)Conjunctiva b)Cornea c)Vitreous d)Lens CorrectAnswer-BAns.B.CorneaThecornea,withtheanteriorchamberandlens,refractslight,withthecorneaaccountingforapproximatelytwo-thirdsoftheeye'stotalopticalpower.Inhumans,therefractivepowerofthecorneaisapproximately43dioptres.Thedioptericpowerofreducedeyeis+5OD,ofwhich+44Discontributedbycorneaand+16Dbythecrystallinelens.Totaldiaoptericpowerofschematiceyeis+58D,ofwhichcorneacontributes+43Dandthelens+15D.

334.Astigmatismisdefinedas? a)Refractoryerrorwhereinrefractionvariesalongdifferent meridians b)RefractoryerrorduetolongAPlengthofeyeball c)Varyingrefractoryerrorinbotheyes d)VaryingShapeperceptionbybotheyes CorrectAnswer-AAns.A.RefractoryerrorwhereinrefractionvariesalongdifferentmeridiansAstigmatismisatypeofrefractiveerrorwhereintherefractionvariesinthedifferentmeridia.Consequently,theraysoflightenteringintheeyecannotconvergetoapointfocusbutformfocallines.Therefractiveerroroftheastigmaticeyestemsfromadifferenceindegreeofcurvaturerefractionofthetwodifferentmeridians(i.e.,theeyehasdifferentfocalpointindifferentplanes).Forexample,theimagemaybeclearlyfocusedonretinainthehorizontalplane,butnotintheverticalplane.Themostcommoncauseofastigmatismisabnormalityofcornealcurvature.Otherlesscommoncausearelenticular(curvatureabnormalityoflens,obliquepositionoflens)andretinal(obliqueplacementofmacula).

335.CHARGEsyndromeincludesallexcept? a)EyeColoboma b)Congenitalheartdisease c)Urinarytractdefects d)EsophagealAtresia CorrectAnswer-DAns,D.EsophagealAtresiaCHARGESYNDROMEC-Colobomaoftheeye,centralnervoussystemanomalies.H-Heartdefects.A-Atresiaofthechoanae.R-Retardationofgrowthand/ordevelopment.G-Genitaland/orurinarydefects(Hypogonadism,undescendedtesticles,besideshypospadias).E-Earanomaliesand/ordeafrressandabnormallybowl-shapedandconcaveears,knownas'lopears".

336. Anteroposteriorchangeinlengthofeye iscalled? a)Anisokonia b)Curvaturalanisotropia c)AxialAmetropia d)Emmetropia CorrectAnswer-CAns.C.AxialAmetropiaAmetropia(aconditionofrefractiveerror)isdefinedasastateofrefraction,whereintheparallelraysoflightcomingfrominfinityarenotfocusedonretina,ratherfocusedeitherinfront(inmyopia)orbehind(inhypermetropia)thesensitivelayerofretina.AxialAmetropia:Itisthecommonestformofametropia(bothmyopiaandhypermetropia).Inhypermetropia,thereisanaxialshorteningofeyeball.So,imageisformedbehindtheretina.Inmyopia,thereisanaxiallengtheningofeyeball.So,imageisformedinfrontoftheretina.1mmchangeinaxiallengthleadstoametropiaof3D.Forexample1mmshorteninginaxiallengthcauseshypermetropiaof3D.

337.FeaturesofUsher'sSyndromeincludeall except? a)NightBlindness b)VisualImpairment c)MultipleNeurofibromas d)Hearingdeficit CorrectAnswer-CAns.C.MultipleNeurofibromasUshersyndromeUshersyndromeisarelativelyraregeneticdisordercausedbyamutationinanyoneofatleastIIgenesresultinginacombinationofhearinglossandvisualimpairment,andisaleadingcauseofdeafblindness.Ushersyndromeisincurableatpresent.OthernamesforUshersyndromeincludeHallgrensyndrome,Usher-Hallgrensyndrome,retinitispigmentosadysacusissyndrome,anddystrophiaretinaedysacusissyndrome.Thissyndromeischaracterizedbyhearinglossandagradualvisualimpairment.Thehearinglossiscausedbyadefectiveinnerear,whereasthevisionlossresultsfromretinitispigmentosa(RP),adegenerationoftheretinalcells.Usually,therodcellsoftheretinaareaffectedfirst,leadingtoearlynightblindnessandthegraduallossofperipheralvision.Inothercases,earlydegenerationoftheconecellsinthemaculaoccurs,leadingtoalossofcentralacuity.Insomecases,thefovealvisionisspared,leadingto'doughnutvision";centralandperipheralvisionareintact,butanannulusexistsaroundthecentralregioninwhichvisionisimpaired.

338.Inacaseofmyopia,LASIKwillprovide correctionupto? a)20D b)12D c)6D d)4D CorrectAnswer-BAns.B.12D SurgicalProcedure Myopiacorrection RadialKeratomy -2to-6D Photorefractivekeraotomy 2to6DLASIK Upto-12D Extractionoflens -16to-18D PhakicIOL >-12D Intercornealring(ICR) 1-6D

339.Whatisthemostcommoneyelesionin HIV? a)KaposiSarcomaofLid b)CMVRetinitis c)Cottonwoolspots d)Choroiditis CorrectAnswer-CAns.C.CottonwoolspotsThemostcommonabnorrnalfindingonfundoscopicexaminationiscofton-woolspots.

340.Whatisreversehypopyon? a)Collectionofpusinthevireous b)Collectionofemulsifiedsiliconoilinanteriorchamber c)Abscessintheorbit d)Seenincornealulcerclosetobeingruptured CorrectAnswer-BAns,B.CollectionofemulsifiedsiliconoilinanteriorchamberReversehypopyonCollectionofsiliconoilintheanteriorchambermayleadtotheappearanceofareversehypopyon.Thisisduetotheemulsifiedoilbeinglessdenserthantheaqueouslayer

341.Silkretinaisseenin? a)Hypermetropia b)Myopia c)Astigmatism d)Presbyopia CorrectAnswer-AAns.A.HypermetropiaClinicalfindingsofhypermetropia 1. Smalleyeballandcornea2. Shallowanteriorchamber3. Fundusshowspseudopapillitisandshotsilkappearance.4. Degenerativeretinoschisis

342.Allofthefollowingdrugsincreasethe riskofpostoperativenauseaandvomitingaftersquintsurgeryinchildrenexcept? a)Halothane b)Opiods c)Propofol d)NitrousOxide CorrectAnswer-CAns,C.PropofolStrabismussurgeryonchildrenisanindependentriskfactorforpostoperativenauseaandvomiting.PropofolIsUsedInPredisposedIndividualsAsItHasVeryLessEmetogenecity

343.Allofthefollowingarecomplicationsof traumatichyphemaexcept? a)Rebleeding b)PupillaryBlock c)CornealUlcer d)Posteriorsynechiae CorrectAnswer-CAns.C.CornealUlcerComplicationsoftraumatichyphema 1. Obstructionoftrabecularmeshworkwithassociatedintraocular pressureelevation 2. Peripheralanteriorsynechiae(PAS)3. Posteriorsynechiae4. Cornealbloodstaining5. Rebleeding:Canoccurwhentheinitialclotretractsandlyses allowingforasecondepisodeofbleeding.Rebleedsaregenerallymoreseverethantheinitialbleed,morelikelytoleadtoglaucoma,cornealbloodstaining,andsynechiaeformation.Ithasbeenreportedtooccur3.5%to38%ofthetimeandprobably5-10%overall. 6. Pupillaryblock7. Amblyopia(pediatricpatients)

344.Pseudopapilitiswithsilkshot appearanceisseenin? a)Hypermetropia b)Myopia c)Astigmatism d)Presbyopia CorrectAnswer-AAns.A.HypermetropiaClinicalfindingsofhypermetropia 1. Smalleyeballandcornea2. Shallowanteriorchamber3. Fundusshowspseudopapillitisandshotsilkappearance.4. Degenerativeretinoschisis

345.1mmchangeaxiallengthoftheeyeball wouldchangetherefractingpoweroftheeyeby? a)1D b)2D c)3D d)4D CorrectAnswer-CAns.C.3D1mmchangeinaxiallengthleadstoametropiaof3D.ForexampleImmshorteninginaxiallengthcauseshypermetropiaof3D.

346.DShapedpupilisseenin? a)Iridodialysis b)Iridodonesis c)AnteriorUveitis d)Anteriorsynechiae CorrectAnswer-AAns.,A.IridodialysisIridodtalysisisdetachmentoflrisfromitsrootattheciliarybody.ItresultsinDshapedpupilandablackbiconvexareaseenattheperiphery.

347.Lensometerdetects? a)Correctpowerofapairofglasses b)Cornealtopography c)Biochemicalconstitutionoflens d)PowerofIOL CorrectAnswer-AAns.A.CorrectpowerofapairofglassesLensometerAlensmeterorlensometer,alsoknownasafocimeterorvertometer,isanophthalmicinstrument.Itismainlyusedbyoptometristsandopticianstoverifythecorrectprescriptioninapairofeyeglasses,toproperlyorientandmarkuncutlenses,andtoconfirmthecorrectmountingoflensesinspectacleframes.Lensmeterscanalsoverifrthepowerofcontactlenses,ifaspeciallenssupportisused.

348.Sixthcranialnervepalsycausesofleft eyecauses? a)Accomodationparesisinleftgaze b)Ptosisoflefteye c)Adductionweaknessoflefteye d)Diplopiainleftgaze CorrectAnswer-DAns.D.DiplopiainleftgazeSixthnervesupplieslateralrectus,thereforeitspalsyresultsinabductionweakness(notadductionweakness).Inleftgaze,thereisabductionoflefteyeandadductionofrighteye.Ifthereisparalysisoflateralrectusoflefteye(66nerveparalysis),abductionoflefteyewillnotbepossibleinleftgaze,whileadductionofrighteyeisnormal.Therefore,therewillbediplopiainleftgaze.

349.Allofthefollowingaretreatmentsof myopiaexcept? a)LASIK b)Phakicintraocularlens c)RadialKeratotomy d)Holmiumlaserthermoplasty CorrectAnswer-DAns.D.HolmiumlaserthermoplastyRefractivesurgeriesformyopiaRadialkeratotomyLaserinsitukeratomileusis(LASIK)Phakicintraocularlens(IOL)OrthokeratologyPhotorefractivekeratotomy(PRK)Extractionoflens(Fucala'soperation)Intercornealringimplantation

350.

Pupillaryreflexpathway-Allofthefollowingareapartexcept? a)EdingerWestphalnucleus b)Pretectalnudes c)Medialgeniculatebody d)Retinalganglioncell CorrectAnswer-CAns.C.MedialgeniculatebodySensoryefferent)componentoflightrfiex=Optic(1st)nerveMotor(efferent)componentoflightreflex=Occulomotor(3rd)nerve

351.Indexmyopiaisseenin? a)Nuclearcataracts b)Chorioretinitis c)Choroidalmelanoma d)Posterioruveitis CorrectAnswer-AAns.A.NuclearcataractsNuclearchangesofaginginduceamodificationofrefractiveindexoflensandproduceanindexmyopia.'Nuclearcataractscauseageneraldecreaseinthetransperancyofthelensnucleus.Theyareassociatedwithindexmyopia"

352.Suddenpainlesslossofvision-Allare causesexcept? a)CRAO b)CSR c)Acutecongestiveglaucoma d)VitereousHemorrhage CorrectAnswer-CAns.C.Acutecongestiveglaucoma

353. Themostcommontypeofstrabismus seeninmyopesis? a)IntermittentExotropia b)IntermittentEsotropia c)Esotropiahypotropiacomplex d)ExoptropiaHypotropiacomplex CorrectAnswer-AAns.A.IntermittentExotropiaMyopiaandIntermittentexoptropiaTraditionally,itisbelievedthatthepresenceofmyopiamaybeassociatedwithadecreaseddemandforaccommodationandhencelowerconvergence.ThismaypredisposetoanincreasedriskofdevelopingexotropiaAlternately,itishypothesizedthatintermittentexotropiamayleadtodevelopmentofrnyopiaduetoincreasedaccommodativedemandandincreasedconvergencemaybenecessarytocontroltheexodeviationthatcancontributetoincreasedacommodationandmyopiainintermittentdistanceexotropia.

354.Muscaevolitantesisseenin? a)Vitreousdetachment b)VitreousHemorrhage c)Remainsofprimitivehyaloidvasculatur d)Eale'sdisease CorrectAnswer-CAns,C.RemainsofprimitivehyaloidvasculaturMuscaevolitantesarephysiologicalvitreousopacitiesandrepresenttheresiduesofprimitivehyaloidvasculature.

355.AllofthefollowingarecausesCrystal keratopathyexcept? a)Cystinosis b)Schnyder'sDystrophy c)Bietti'sDystrophy d)Diabetes CorrectAnswer-DAns.D.DiabetesCausesofCrystallineKeratopathy:-Infections,Schnydercornealdystrophy,Bietticorneoretinaldystrophy,Cystinosis,Lymphoproliferativedisorders,Medication-induced.

356.Mostcommonagerelatedchangein vitreous? a)Anteriorvitreousdetachment b)Posteriorvitreousdetachment c)Vitreoushemorrhage d)Vitritis CorrectAnswer-BAns.B.PosteriorvitreousdetachmentYanoffWrites(Mostcommonagerelatedeventinvitreousisposteriorvitreousdetachment'

357.Whatistrueaboutretinalhemorrhagein newborn? a)Morecommonininstrumenteddeliveries b)Resolvein6-8months c)Commonlyunilateral d)Associatedwithintrauterineinfection CorrectAnswer-AAns.A.MorecommonininstrumenteddeliveriesBirth-rdatedRHininfantsoccursinone-quarterofnormaldeliveriesandarefarmorecommonafterinstrumentaldeliveries.Commonlybilateral,theywerepredominantlyintraretinal,posterior,resolvedrapidly,andveryrarelypersistedbeyond6weeks.

358.Subhyaloidhemorrhageis? a)Boatshaped b)Crescentshaped c)Round d)Flameshaped CorrectAnswer-AAns,.A.BoatshapedRetrohyaloid(subhyaloid)hemorrhage('Boat-shapedorscaphoid):-Locatedanterior(internal)totheretina,withintheretrohyoidspace.(note-thetermhyaloidreferstohyaloidbody,anothernameforvitreoushumor).

359.Prutchnersretinopathyinassociated with- a)DiabetesMellitus b)Wilson'sdisease c)Headtrauma d)Rheumatoidarthritis CorrectAnswer-CAns.C.HeadtraumaPurtscher'sretinopathyNear-confluentcotton-woolspotsclusteredaroundanotherwisenormalopticnerveheadinaneyeofapatientwhohadsustainedaseverebluntinjurytotheheadandchest.Later,itwasdiscoveredtobeassociatedwithseveralnon-traumaticsystemicdiseases.Conditionsassociated:Severehead,chest&longbonediseases.Fatembolismsyndrome.AmnioticfluidembolismActuepancreatitits.SLE

360.Snowballappearanceisseenin? a)Posterioruveitis b)Sarcoidosis c)Anterioruveitis d)VitreousHemorrhage CorrectAnswer-BAns.B.SarcoidosisCausesofintermediateuveitis,thusSnowballOpacitiesofVitreous?CandidiasisTB,syphilisSarcoidosisMultiplesclerosisLymedisease.

361.Unilateralfrontalblisterswithupperlid edemawithconjunctivitisisseenin? a)AcanthamoebaKeratits b)HerpesSimplex c)HerpesZosterOphthalmicus d)NeuroparalyticKeratitis CorrectAnswer-CAns.C.HerpesZosterOphthalmicusOcularlesions:Combinationof2ormoreofthefollowingwithsubsidenceofskineruptions:-i)Conjunctivitis(Mostcommonocularlesion)ii)Zosterkeratitis:Punctatekeratitis,Microdendriticcornealulcer(PseudodendriticKeratitis.),nummularanteriorstromalkeratitis,Disciformkeratitis,neuroparalyticulceration,exposurekeratitis,mucousplaquekeratitis,Keratouveitiswithendothelitis,Sclerokeratitis(leastcommon).Theendotheliumisafavouredsiteofattackandacuteendothelialcelllossoccursduringherpeszosterkeratouveitis.iii)Episcleritis/Scleritis,Iridocyclitis(Uveitis).iv)Acuteretinalnecrosis,anteriorsegmentnecrosis,phthisisbulbi.v)Secondaryglaucoma.

362.WhatisfalseaboutEale'sdisease amongstthefollowwing? a)Retinaldetachmentmayoccur b)AKTisgiven c)Opticneuritis d)VitreousHemorrhage CorrectAnswer-CAns.C.Opticneuritis

363.A44yearoldwomanpresentsSudden painlesslossofvisionwithhistoryofprevioussimilarepisodefundoscopyshowsnoglow.Whatcouldbethepossiblediagnosis? a)VitreousHemorrhage b)RhegmatogenousRetinalDetachment c)Acutecongestiveglaucoma d)FungalKeratitis CorrectAnswer-AAns.,A.VitreousHemorrhageVitreoushemorrhagereferstobleedingintothevitreouschamberoraspacecreatedbyvitreousdetachment.Patientspresentwithsuddenonsetoffloaters(blackspotsinfrontoftheeye)wherethehemorrhageissmall,andtheremaybesuddenpainlesslossofvisionifthehemorrhageislarge.

364.Glaucomadrainagedevices? a)Drainaqueoushumourtotheposteriorsegment b)Drainaqueoushumourtoanexternaldevice c)Openthetrabeculaemechanically d)Reducetheaqueoussecretionbycompressingtheciliary epithelium CorrectAnswer-BAns.B.DrainaqueoushumourtoanexternaldeviceGlaucomadrainagedevicesaredesignedtodivertaqueoushumorfromtheanteriorchambertoanexternalreservoir,whereafibrouscapsuleformsabout4-6weeksaftersurgeryandregulatesflow.Thesedeviceshaveshownsuccessincontrollingintraocularpressure(IOP)ineyeswithpreviouslyfailedtrabeculectomyandineyeswithinsufficientconjunctivabecauseofscarringfrompriorsurgicalproceduresorinjuries.Theyalsohaveshownsuccessincomplicatedglaucomas,suchasuveiticglaucoma,neovascularglaucoma,andpediatricanddevelopmentalglaucomas,amongothers.

365. Whatisthecauseofglaucomain retinoblastoma? a)Blockgeoftrabecularnetwork b)Neovascularisation c)Masseffectofthetumour d)Lysisofthelens CorrectAnswer-BAns.B.NeovascularisationRetinoblastomaisacauseofneovascularglaucoma,

366.Mioitcsaretreatmentofchoicefor? a)Angleclosureglaucoma b)Openangleglaucoma c)Buphthalmos d)SympatheticOphthalmia CorrectAnswer-AAns.A.Angleclosureglaucoma

367.Whichorganismcanpeneteratecorneal endothelium? a)Aspergillusfumigatus b)StaphylococcusAureus c)NeisseriaeGonorrhae d)Hemophilusinfluenza CorrectAnswer-AAns.A.AspergillusfumigatusFungi-CanpenetrateintactcornealendotheliumNeisseriasp,C.Diptheriae,H,Aegyptus,Listeria-Canpenetrateintactcornealepithelium

368.Earliestsignofprimarycongenital glaucoma? a)Cornealedemawithwatering b)Haab'sStriae c)Bluesclera d)Myopia CorrectAnswer-AAns.,A.CornealedemawithwateringMostcommonsymptom-Watering(lacrimation)2dmostcommonsymptom-PhotophobiaMosttroublesomesymptom-Photophobia(Childavoidslight)Firstsign-Cornealedemawithwatering

369.Thezonulessuspendingthelensare attachedtothe? a)Rootofiris b)Ciliarybody c)Anteriorvitreous d)Limbus CorrectAnswer-BAns.B.CiliarybodyTheciliaryzonules(Zonulesofzinnorsuspensoryligamentsoflens)holdthelensinpositionandenabletheciliarymuscletoactonit.Theseconsistessentiallyofaseriesoffibreswhichrunfromtheciliarybodyandfuseintotheouterlayerofthelenscapsulearoundtheequatorialzone.

370.Descemetmembranebreachisseenin? a)Angleclosureglaucoma b)Buphthalmos c)AcuteIridocyclitis d)Subconjunctivalhemorrhage CorrectAnswer-BAns.B.BuphthalmosHaabstriaearediscretecornealopacitiesappearaslineswithdoublecontourduetoruptureinDescemet'smembrane.

371.Lensattachedtociliarybodyvia? a)Limbus b)Zonules c)VitreousHumour d)Rootofiris CorrectAnswer-BAns.B.Zonules

372.Whatisnottrueaboutcongenital glaucomaofeye? a)Photophobiaismostcommonsymptom b)Haab'sStriaemaybeseen c)Thinandbluescleraseen d)Anteriorchamberisshallow CorrectAnswer-AAns.A.Photophobiaismostcommonsymptom

373.Theintraocularlensincataractsurgery isplacedin? a)Surfaceofiris b)Capsularbag c)Overthefaceofviterous d)Aroundthelimbus CorrectAnswer-BAns.B.CapsularbagAsaclikestructureremainingwithintheeyefollowingextracapsularcataractextractionorPhacoemulsification.Theimplantedintraocularlensisplacedwithinthisstructuretorecreatetheusualphakicstate.

374.Nonfoldablelensismadeof- a)Silicon b)Acrylic c)PMMA d)Hydrogel CorrectAnswer-CAns.C.PMMATypesofIOLDependingonthematerialofmanufacturing,followingtypesofIOLsarethere 1. RigidIOLs:-Madeentirelyfrompolyrnethylmethacrylate(PMMA).2. FoldableIOLs:-Areusedafterphacoemulsificationandaremadeof silicon,acrylic,hydrogelandcollamer. 3. RollableIOIs:Ultra-thinIOLsandaresuedafterphokonittechnique (micro-incision:1mm).Thesearemadeofhydrogel.

375.WhatisthetypeofGalactosemia cataract? a)Snowflake b)Oildrop c)Bluedot d)Polychromaticlustre CorrectAnswer-BAns,B.Oildrop

376.Inheadinjuryunilateraldilatationof pupilisseendueto? a)Occulomotornervecompression b)OphthalmicN.compression c)TrizeminalN.compression d)None CorrectAnswer-AAns.A.OcculomotornervecompressionPupildilationisthoughttobetheresultofuncalherniationcausingmechanicalcompressionofIIIrdcranialnerveandsubsequentbrainstemcompromise,

377.ThejunctionbetweenRetina&Ciliary bodyis?? a)Equator b)Parsplicata c)Parsplana d)Oraserrata CorrectAnswer-DAns.D.OraserrataOraserrataistheserratedperipheralmarginwheretheretinaends'Hereretinaisfirmlyattachedbothtovitreousandchoroid.Parsplana(ofciliarybody)extendsanteriorlyfromoraserrata.

378."Bread-crumb"appearanceisseenin? a)Diabeticcataract b)Toxoplasmosis c)CMVretinitis d)Complicatedcataract CorrectAnswer-DAns.D.Complicatedcataract

379.Yokemuscleforleftsuperiorrectusis? a)Rightsuperiorrectus b)Leftinferiorrectus c)Rightinferioroblique d)Rightsuperioroblique CorrectAnswer-CAns.C.RightinferiorobliqueYokemuscles(contralateralsynergists).Itreferstothepairofmuscles(onefromeacheye)whichcontractsimultaneouslyduringversionmovements.Forexample,rightlateralrectusandleftmedialrectusactasyokemusclesfordextroversionmovements.OtherpairofyokemusclesarerightMRandleftLR,rightLRandleftMR,rightSRandleftIO,rightSOandleftIRandrightIOandleftSR.

380.Downwardandoutwardmomentofeye iseffectedininjuryof? a)3rdnerve b)4thnerve c)5thnerve d)6thnerve CorrectAnswer-BAns.B.4thnerveDownwardandoutwardmovementiscausedbysuperioroblique,suppliedbyuochlear(4snerve).

381.Irregularpupilisseenin? a)Glaucoma b)Trauma c)Occulomotorpulsy d)Retinaldetachment CorrectAnswer-BAns,B.TraumaIrregular:-Itisjaggedlookingandoccursmostoftenafterorbitaltrauma.

382.Lowastigmatismindimlightisdue? a)Pupilconstriction b)Pupildilatation c)Increasedcurvatureoflens d)Decreasedcurvatureoflens CorrectAnswer-BAns.B.Pupildilatation

383.Disciformkeratitisisseen? a)HSV b)HIV c)HBV d)Rubella CorrectAnswer-AAns.A.HSV

384.Cornealdystrophy,trueis- a)Inflammatory b)Neovascularization c)Bilateral d)All CorrectAnswer-CAns.C.BilateralCornealdystroPhyisagroupofdisorders,characterizedbyanon-inflammatory,inherited,bilateralopacityofthecornea.Thereisnovascularizationofcornea.Dystrophiesareclassifiedaccordingtotheanatomicalinvolvement.

385.Followingcornealtransplantation,most commoninfectionoccur? a)Staphepidermidis b)Streptococcus c)Klebsiella d)Pseudomonas CorrectAnswer-AAns.A.StaphepidermidisPneumococcusandstaphylococcusaureushavebeenfoundtobethecommonestmicroorganismsinthedevelopedworld,whereasstaphepidermidisisthecommonestindevelopingcountries,forcausinginfectiouskeratitisaftercornealtransplantations.

386.1stsignofanterioruveitis? a)Keraticprecipitate b)Aqueousflare c)Hypopyon d)Miosis CorrectAnswer-BAns.B.Aqueousflare

387.1stsignofiridocyclitis? a)Retrolentalflare b)KP c)Congestion d)Trichiasis CorrectAnswer-AAns.A.Retrolentalflare

388.Mostcommoncauseofanterioruveitis? a)CMV b)Ankylosingspondylitis c)Toxoplasma d)None CorrectAnswer-AAns,A.CMV

389.Iritisinyoungpatientwithjointpain- a)Gout b)RA c)AS d)Toxoplasma CorrectAnswer-CAns,C.AS

390.Commonestcomplicationofparsplanitis ? a)Glaucoma b)Cataract c)Retinaldetachment d)Vitreoushemorrhage CorrectAnswer-BAns.B.CataractThemostcommoncomplicationofintermediateuveitis(persptanitis)iscystoidmacularedema,whichmaydecreasethevisualacuity.2ndmostcommoncomplicationiscomplicatedcataract'Othercomplicationincludesretinaldetachment.

391.Metamorphopsiaisseenin? a)Anterioruveitis b)Posterioruveitis c)Cataract d)Glaucoma CorrectAnswer-BAns.B.PosterioruveitisMatamorphopsiaisaconditioninwhichpatientsperceivedistortedimagesoftheobject.ItoccursinPosterioruveitisduetoalterationinretinalcontour'

392.Recurrentanterioruveitiswithincreased intraoculartensionisseenin? a)Posnerschlossmansyndrome b)Fosterkennedysyndrome c)Vogt-koyanagi-haradasyndrome d)None CorrectAnswer-AAns.A.PosnerschlossmansyndromeGlamatocycliticcrisis(posner-Schlossmansyndrome)isaunilateralrecurrentnon-granulomatousiritisthatisassociatedwithanelevatedocularpressureduringtheattacks'

393. Congenitalcataractcommonly associatedwithvisualdefect? a)PunctateCataract b)Bluedotcataract c)Zonularcataract d)Fusiformcataract CorrectAnswer-CAns.C.ZonularcataractLamellar(Zonular)cataractisthemostcommontypeofcongenitalcataractpresentingwithvisualimpairment.Itisusuallybilateralandfrequentlycausesserverevisualdefects'

394.Decreasedreadingabilityisseenin? a)Fusiformcataract b)Zonularcataract c)Bluedotcataract d)Punctatecataract CorrectAnswer-BAns,B.Zonularcataract

395.Lenssubluxatesinhomocystinuria? a)Inferotemporal b)Inferonasal c)Superonasal d)Superotemporal CorrectAnswer-BAns.B.Inferonasal

396.Secondsightisseenin? a)Nuclearcataract b)Corticalcataract c)Zonularcataract d)Punctatecataract CorrectAnswer-AAns.A.NuclearcataractWhenanuclearcataractdevelops,itcanbringaboutatemporaryimprovementinnearvision,called'secondsight'.

397.Congenitalcataractwithvisual disturbancessurgeryshouldbedone? a)Immediately b)After2months c)After4months d)After1year CorrectAnswer-AAns.A.Immediately

398.Mostcommontypeofcongenital cataractis? a)Capsular b)Zonular c)Coralliform d)Bluedot CorrectAnswer-DAnsD.BluedotMostcommontypeofcongenitalcataract=punctate(bluedot)cataract.Mostcommontypeofcataractwhichisclinically(visually)significant+zonularorlamellarcataract.

399. Treatmentoftraumaticcataractin children? a)ECCE+IOL b)Lensectomy c)Contactlens d)Glasses CorrectAnswer-AAns.A.ECCE+IOLTraumaticcataractinchildrenisacommoncauseofunilaterallossofvision.Penetratinginjuriesareusuallymorecommonthanbluntinjuries.Atthetimeofpresentationaftertraumatoeye,primaryrepairofthecornealorscleralwoundisusuallypreferred,CataractsurgeryGCCE)withIOLimplantationsisperformedlaterfollowingcompleteevaluationofdamagetotheintraocularstructuresbyancillarymethodssuchasB-scanultrasonography.

400.Jackinboxscotomaisseenafter correctionofAphakiaby? a)IOL b)Spectacles c)Contactlens d)None CorrectAnswer-BJack-in-the-boxphenomenonisseeninthecorrectionofaphakiabyspectaclesduetotheprismaticeffectsattheedgeofthelens.Otherdifficultiesinthecorrectionofaphakiabyspectaclesincludethefollowing:Imagemagnificationby25?30%.PinCushiondistortion-asphericalaberrationduetothickspectacles.RestrictedfieldwithJackintheBoxphenomenona/RovingRingscotoma-aprismaticaberration.Cosmetically,theeyeslookenlarged(Frogeyes)behindthethickspectacles.Physicalinconvenience.Treatmentofchoice:correctionisobtainedbyintraocularlens(IOL).

401.Falseaboutphacolyticglaucoma? a)Duetocontactofiristolens b)Openangleglaucoma c)Seeninhypermaturestageofcataract d)Lensinducedglaucoma CorrectAnswer-AAns.A.DuetocontactofiristolensPhacolyticglaucomaisanopenangleglaucomainhypermaturestageofcataractduetoblockageoftrabecularmeshworkbyswollenmacrophages.Glaucomaduetocontactofiristolens(pupillaryblockglaucoma)isseeninphacomorphicglaucoma.

402.Neovascularglaucomaisseeninall except? a)Diabetes b)CRVO c)Eale'sdisease d)Openangleglaucoma CorrectAnswer-DAns.D.OpenangleglaucomaItisasecondaryangleclosureglaucomawhichresultsduetoformationofneovascularmembraneovertheirisi.e.,neovascularizationofiris(rubeosisiridis).

403.Laseriridotomyisdonein? a)Angleclosureglaucoma b)Openangleglaucoma c)Pigmentoryglaucoma d)None CorrectAnswer-AAns.A.AngleclosureglaucomaTreatmentofchoiceforPACGisperipherallaseriridotomy.

404.Inacuteangleclosureglaucoma,primary mechanismofpathogenesisis? a)Increasedsecretion b)Increasedabsorptionbutincreasedsecretion c)Outflowobstruction d)None CorrectAnswer-CAns,C.OutflowobstructionInacuteangleclosureglaucoma,riseinIOPoccursduetoblockageofaqueousoutflowbyclosureofanarrowerangleofanteriorchamber.

405.Notariskfactorforangleclosure glaucoma? a)Smalleye b)Hypermetropia c)Smallcornea d)Smalllens CorrectAnswer-DAns.D.SmalllensPredisposingfactorsforPACG:-i)Shallowanteriorchamber,ii)Shorteye(shortaxiallensth),i1i)Smallercornealdiameter,iv)Anteriorlocationofiris-lensdiaphragm,v)Hlpermetropiceye,vi)Largelens(oldercataractous).

406.Staphlyomainvolvement? a)Iriswithconjunctiva b)Conjunctivawithcornea c)Choroidwithretina d)Iriswithcornea CorrectAnswer-DAns.D.IriswithcorneaStaphylomaisanabnormalprotrusionofuvealtissue(irisorciliarybodyorchoroid)throughaweekandthinportionofcorneaorsclera.So,staphylomaislinedinternallybyuvealtissue(irisorciliarybodyorchoroid)andexternallybyweakcorneaorsclera.

407.Bestdrugforopenangleglaucoma? a)Latanoprost b)Pilocarpine c)Physostigmine d)Apraclonidine CorrectAnswer-AAns.A.LatanoprostMedicaltherapy:-TotalmedicaltherapyisthetreatmentofchoiceforPOAG.Topicalp-blockers(Timolol,Betoxalol,Levobunolol,carteolol)arethedrugsofchoice.Topicalprostaglandinanalogues(Iatanoprost,bimatoprost,travoprost)arethesecondchoicedrugs.

408.Cornealtattooingisdoneby? a)Goldchloride b)Silverchloride c)Titaniumchloride d)Aluminiumchloride CorrectAnswer-AAns.A.GoldchlorideFortattooingIndianblackinkgoldchlorideorplatinummaybeused.

409.Broadestneuroretinalrimisseenin- a)Suppole b)Infpole c)Nasalpole d)Temporallobe CorrectAnswer-BAns.,B.InfpoleTheneurorentinalrimistheareaofopticdiscwhichcontainsneuralelementsandislocatedbetweentheedgeoftheopticdiscandthephysiologicalcup.TheneuroretinalrinisbroadestInferiorly,followedbySuperior,NasalandTemporalregionsindecreasingorderofthickness(theISNT)rule.

410.Enucleationisindicatedin? a)Acutecongestiveglaucoma b)Panophthalmitis c)Retinoblastoma d)None CorrectAnswer-CAns,C.RetinoblastomaIndicationsofEnucleationAbsolute=Retinoblastoma,malignantmelanoma.Relative=Painfulblindeye,mutilatingocularinjury,anteriorstaphyloma,phthisisDalEi,endophthalmitis,congenitalanophthalmiaorseveremicrophthalmia.

411.Retinitispigmentosaisduetodefectin whichgene- a)Scotopsin b)Rhodopsin c)Pigmentedepithelium d)None CorrectAnswer-BAns.B.RhodopsinSeveraldifferentrhodopsingenemutationshavebeenidentifiedinthepedigreeswithautosomaldominantretinitispigmentosa.

412.Irisclobomaismostcommonin? a)Inferotemporal b)Soperotemporal c)Inferonasal d)Soperonasal CorrectAnswer-CAns.C.InferonasalAllclobomas(includingiris)aremostlyinferonasal.

413.Ealesdiseaseis? a)Recurrentopticneuritis b)Recurrentpappilloedema c)Recurrentperiphelbitisretinae d)None CorrectAnswer-CAns,C.RecurrentperiphelbitisretinaeEale'sdiseaseisanidiopathicinflammatoryvenousocclusion(phelbitis)thatprimarilyeffectstheperipheralretinai.e.,periphelbitisandischaracterizedbyrecurrentbilateralvitreoushemorrhage.

414.Shaffer'ssignisseenin? a)Retinitispigmentosa b)Retinaldetachment c)CRVO d)CRAO CorrectAnswer-BAns.B.RetinaldetachmentVitreousshowpigmentintheanteriorvitreous(tobaccodustingorshaffersign),withposteriorvitreousdetachement.

415.Depositinretinalmaculardegeneration? a)Iron b)Drusen c)Lipochrome d)Hemosiderine CorrectAnswer-BAns.B.DrusenDryformofARMDbeginswithcharacteristicyellowdepositsinthemaculacalleddrusenbetweentheretinalpigmentepitheliumandtieunderlyingchoroid

416.Vitreoushemorrhageindiabetic retinopathy? a)Non-proliferativediabeticretinopathy b)Proliferativediabeticretinopathy c)Both d)None CorrectAnswer-BAns.B.Proliferativediabeticretinopathy

417.Headlightinfogappearanceisseenin? a)Syphilis b)Toxoplasmoss c)Toxocara d)Herpes CorrectAnswer-BAns.B.ToxoplasmossOnfundoscopicexamination,thereisdiffuse"headtightinthefogappearance,incongenitaltoxoplasmosis.Thisisduetocombinationofactiveretinallesioninthecenterwithdepigmentation(theheadlight)andseverevitreousinflammation(thefog).

418.Coloboma,mostcommonsite? a)Superotemporal b)Inferonasal c)Inferotemporal d)Superonasal CorrectAnswer-BAns.B.InferonasalAcolobomaisaholeinoneofthestructuresofeye,suchasiris,retina,choroidoropticdisc.Theeyedevelopsintheembryo,fromtheopticcupandopticfissure.Theopticfissurefusesat5-7weeksdevelopment.Failureofthisfusionleadstoagapinoculartissueknowascoloboma,typicallylocatedintheinferonasalquadrant.

419.Salt&pepperfundus? a)Congtoxoplasmosis b)Conghistoplasmosis c)Congenitalsyphilis d)None CorrectAnswer-CAns.C.Congenitalsyphilis

420.Expulsivehemorrhageincataract surgeryisfrom? a)Vortexvein b)Ciliaryartery c)Choroidalvein d)None CorrectAnswer-BAns,B.CiliaryarteryExpulsivehemorrhageaftercataractextractionorglaucomasurgery=Ruptureofciliaryartery.ExpulsivehemorrhageinRetinal/Vitrousoperation=Directtraumatochoroidalorvortexvein.

421.Cattletrackappearence? a)CRVO b)CRAO c)Diabeticretinopathy d)Syphiliticretinopathy CorrectAnswer-BAns.B.CRAO

422.Eale'sdiseaseis? a)Retinalhemorrhage b)Vitreoushemorrhage c)Conjunctivalhemorrhage d)Choroidalhemorrhage CorrectAnswer-BAns.B.VitreoushemorrhageEale'sdiseseisanidiopathicinflammatoryvenousocclusionthatprimarilyaffectstheperipheralretinaofyoungadult(20-30yrs)male.Itischaracterizedbyrecurrentbilateralvitreoushemorrhage;therefore,alsoreferredtoasprimaryvitreoushemorrhage.

423.Extraretinalfibrovascularproliferationat ridgeis? a)Normal b)StageIROM c)StageIIROM d)StageIIIROM CorrectAnswer-DAns.D.StageIIIROMDiseaseSeverity(Stage)PriortothedevelopmentofROPintheprematureinfant,vascularizationoftheretinaisincompleteor"immature"(Stage0).Stage1:DemarcationLine:Thislineisthinandflat(intheretinaplane)andseparatestheavascularretinaanteriorlyfromthevascularizedretinaposteriorly.Stage2:Ridge:Theridgearisesfromthedemarcationlineandhasheightandwidth,whichextendsabovetheplaneoftheretina.Theridgemaychangefromwhitetopinkandvesselsmayleavetheplaneoftheretinaposteriortotheridgetoenterit.Smallisolatedtuftsofneovasculartissuelyingonthesurfaceoftheretina,commonlycalled"popcorn"maybeseenposteriortothisridgestructureanddonotconstitutethedegreeoffibrovasculargrowththatisanecessaryconditionforstage3.Stage3:ExtraretinalFibrovascularProliferation:Neovascularizationextendsfromtheridgeintothevitreous.Thisextraretinalproliferatingtissueiscontinuouswiththeposterioraspectoftheridge,causingaraggedappearanceastheproliferationbecomesmoreextensive.Stage4:PartialRetinalDetachment:Stage4,intheinitialclassificationwasthefinalstageandinitiallyknownasthecicatricial

classificationwasthefinalstageandinitiallyknownasthecicatricialphase.Itwaslaterdividedintoextrafoveal(stage4A)andfoveal(stage4B)partialretinaldetachments.Stage4retinaldetachmentsaregenerallyconcaveandmostarecircumferentiallyoriented.Retinaldetachmentsusuallybeginatthepointoffibrovascularattachmenttothevascularizedretinaandtheextentofdetachmentdependsontheamountofneovascularizationpresent.Stage5:TotalRetinalDetachment:Retinaldetachmentsaregenerallytractionalandusuallyfunnelshaped.Theconfigurationofthefunnelitselfisusedforsubdivisionofthisstagedependingiftheanteriorandposteriorportionsareopenornarrowed

424.Allareseenin3'nervepalsy? a)Mydriasis b)Lossoflightreflex c)Lossofabduction d)Ptosis CorrectAnswer-CAns.C.Lossofabduction

425.Swinginglighttestispositivein? a)Conjunctivitis b)Glaucoma c)Retrobulbarneuritis d)Keratoconus CorrectAnswer-CAns.C.RetrobulbarneuritisSwingingflashlightisusedforrelativeefferentpathwaydefect(RAPD)whichismostcharacteristicofIesionsintheopticnerve.Thusitispositiveinretrobulbarneuritis.

426.Optictractlesioncauses? a)Wernicke'shemianopicpupil b)Amauraticpupil c)Amauraticpupil d)None CorrectAnswer-AAns,A.Wernicke'shemianopicpupilWernicke'shemianopicpupilisseenincompletelesionofoptictract.

427.Amblyopiaiscausedby? a)Methylalcohol b)Penicillin c)Propranolol d)None CorrectAnswer-AAns.A.MethylalcoholToxicamblyopiaischronicretrobulbarneuritiswhichresultsfromthedamagetoopticnervebytheexogenouspoisons.Thetoxicagentsinvolvemaybe:Tobacco,ethylatcohol,ethyleneglycol,Iead,arsenic,cannabisindica,carbondisulphidevariousdrugs

428.VitaminB12deficiencycauses? a)Centrocaecalscotoma b)Binasalhemianopia c)Constrictionofperipheralfield d)Bitemporalhemianopia CorrectAnswer-AAns.,A.CentrocaecalscotomaVitaminB12deficiencycausesopticneuritis.Mostcommonvisualfielddefectinopticneuritisiscentralorcentrocaecalscotoma.

429.Causeofbilateralopticatrophy? a)Traumatoopticnerve b)Intracranialneoplasma c)CRAO d)Opticneuritis CorrectAnswer-BAns.B.Intracranialneoplasma

430. Earliestmuscletoinvolveinthyroid ophthalmopathy? a)MR b)LR c)IR d)SR CorrectAnswer-CAns.C.IR

431.Whichofthefollowingislongest extraocularmuscle? a)SR b)MR c)SO d)IO CorrectAnswer-CAns.C.SOThesuperiorobliqueisthelongest,thinnestextraocularmuscle.

432.Treatmentofchoiceforamblyopiais? a)Convergentexercises b)Spectacles c)Surgery d)Conventionalocclusion CorrectAnswer-DAns.D.ConventionalocclusionThetreatmentofamblyopiashouldbeginasearlyaspossible.TheamblyopiceyefailstodevelopvisionandvisualimpairmentremainsPermanentunlessitistreatedbeforetheageof7years.Amblyopictherapyworksbestwhenintitiatedinyoungchildrenunder3yearsofage.

433.Alkalicauses? a)Symblepharon b)Papilloedema c)Opticneuritis d)Retinaldetachment CorrectAnswer-AAns,A.Symblepharon

434.Unilaterallacrimalglanddestructionmay becausedby? a)Inferiororbitalfissurefracture b)Fractureofroofoforbit c)Fractureoflateralwall d)Fractureofsphenoid CorrectAnswer-BAns.B.FractureofroofoforbitDamagetothesuperiororbitalstructures,infractureofroofoforbit,cancausediplopia,ptosis,opticneuropathy,ptosis,neuroPathyandlacrimalglandinjury.

435.Aftertrauma,Apersoncannotmoveeye outwordbeyondmidpoint.Thenerveinjuredis? a)2nd b)3rd c)4th d)6th CorrectAnswer-DAns,D.6thAlltheextraocularmusclesaresuppliedby3rdcranial(occulomotor)nerveexceptforsuperiorobliqueandlateralrectus.superiorobliquemuscleissuppliedby4thcranial(trochlear)nerve,andlateralrectusmuscleissuppliedby6thcranial(abducent)nene.Besidetheseextraocularmuscles,occulomotor(3rd)nervealsosupplieslevatorpalpebraesuperioris,sphinctorpupillae(causespupillaryconstriction),andciliarymuscle(causesaccommodation).

436.Bilateralptosisisseeninallexcept? a)Hyperthyroidism b)Congenital c)Trauma d)Myotonicdystrophy CorrectAnswer-CAns,C.Trauma

437.Angleofsquintismeasuredby? a)Gonioscopy b)Prism c)Retinoscopy d)Keratometry CorrectAnswer-BAns.B.Prism

438.Mostcommoncauseofintermittent proptosis? a)Orbitalvarix b)Thyroidophthalmopathy c)Neuroblastoma d)Retinoblastoma CorrectAnswer-AAns.A.OrbitalvarixIntetmittentproptosis:-Proptosisdevelopingintermittentlyandrapidlyinoneeyewhenvenousstasisisinducedbyforwardbendingorloweringthehead,turningtheheadforcibly,hyperextensionoftheneck,coughing,forcedexpirationwithorwithoutcompressionofthenostrils,orpressureonjugularveins.Themostimportantcasueisorbitalvarix(varicocele).

439.Mostcommoncauseofophthalmoplegia ? a)Aneurysm b)Infection c)Mystheniagravis d)None CorrectAnswer-AAns.A.AneurysmThemostcommonindentifiableetiologiesareischemia,aneurysm,tumorandttauma;some20%remainunexplained.

440.Massagingofnasolacrimalductisdone in? a)Acutedacryocystitis b)Congenitaldacryocystitis c)Conjunctivitis d)None CorrectAnswer-BAns.B.CongenitaldacryocystitisMassageoverlacrimalsacisthemainstayoftreatmentincongenitaldacryocystitis.

441.Ataxia,nystagmusandophthalmoplegia isseenin- a)Mystheniagravis b)Chronicprogressiveexternalophthalmoplegia c)3rdnervepalsy d)None CorrectAnswer-BAns.B.ChronicprogressiveexternalophthalmoplegiaThemostcommonidentifiableetiologiesareischemia,aneurysm,tumorandtrauma,some20%remainunexplained.

442.Abnormallyeccentricplacedpupilis called? a)Polycoria b)Corectopia c)Corectopia d)Ectopialentis CorrectAnswer-BAns.B.Corectopia

443.Childwithmildsquint.Intrauterine,birth history,developmentalhistorytilldateallnormal.Cornealreflexnormal.Allothereyeparametersnormalexceptexaggeratedepicanthalfold.Diagnosis? a)Pseudostrabismus b)Accommodativesquint c)Exophoria d)Esophoria CorrectAnswer-AAns,A.PseudostrabismusPseudoesotropia(apparentconvergentsquint-Duetoprominentepicanthalfold.Pseudoexotropia(apparentdivergentsquint-Duetohypertelorism.

444.Madarosisisseenin? a)Addison'sdisease b)Hypothyroidism c)Acromegaly d)None CorrectAnswer-BAns.B.HypothyroidismMadarosismaYbeseenin-RubellaCongenitalSyphilisCongenitalleberamaurosisMayousBattendiseaseThioridazinetoxicity

445.MCorbitaltumor? a)Nervesheathtumor b)Hemangioma c)Lymphoma d)Meningioma CorrectAnswer-BAns.B.HemangiomaMostcommonorbitaltumor-Cavernoushemangioma.Mostcommonmalignantorbitaltumor?Lymphoma.

446.Lossofeyelashesis? a)Tylosis b)Madarosis c)Trichiasis d)Ectropion CorrectAnswer-BAns.B.MadarosisMadarosisrefertolossofeyelashesandsometimesalsoeyebrows

447.Fusionofpalpebralandbulbar conjunctivais- a)Symblepharon b)Trichiasis c)Ectropion d)Tylosis CorrectAnswer-AAns.A.SymblepharonAdhesionofthelidstoeyeballiscalledsymblepharon.Itoccursduetofusionofpalpebralconjunctiva(coveringinnersurfaceoflid)tobulburconjunctiva(coveringoutersurfaceofeyeball).

448. Mostcommonorbitaltumorhasits originfrom? a)Bloodvessels b)Nerves c)Muscle d)Lymphnode CorrectAnswer-AAns,A.BloodvesselsMostcommonorbitaltumorsarebenignvasculartumors-Cavernoushemangioma.

449.Retinalastrocytomaisseenin? a)Tuberoussclerosis b)Sturgewebersyndrome c)VonHippel-Lindausyndrome d)None CorrectAnswer-AAns.A.Tuberoussclerosis

450.Mostcommonmalignanttumourof eyelidis? a)Sebaceousglandcarcinoma b)Basalcellcarcinoma c)Squamouscellcarcinoma d)Malignantmelanoma CorrectAnswer-BAns,b.BasalcellcarcinomaBasalcellcarcinomaisthemostcommonmalignanttumouroftheeyelidsandconstitutes85-90%ofallmalignantepithelialeyelidtumours.

451.Mostcommoncarcinomaofconjunctiva ? a)SquamouscellCa b)Basalcellca c)Melanoma d)Lymphoma CorrectAnswer-AAns.A.SquamouscellCaSquamouscellcarcinomaisthemostcommonmalignantlesionoftheconjunctiva"

452.Astigmatisminemmetropiceyeof elderlypersoncontributeto: a)+1d b)+2D c)+3d d)+4d CorrectAnswer-CAnswerC.+3dLaservisionenhancementsWhenplanningpresbyopia-correctingIOL(Intraocularlens)surgeryinapatientwithahighlevelofpre-existingastigmatism(ie,morethan3D),abiopticsapproach(ie,IOLfollowedbylaservisionenhancement)maybeneeded.LRIsaloneareunlikelytocorrecttheastigmatismcompletely.LimbalRelaxingIncisions(LRI)arearefractivesurgicalproceduretocorrectminorastigmatismintheeye.Thereareseveraldifferentstrategiesfortheseplannedlaservisionenhancements.Thefirstistoperformthepresbyopia-correctingIOLsurgeryfollowedbyLASIKorPRK.

453.100dayGlaucomaseeninwhichofthe followingcondition: a)Centralretinalveinocclusion(CRVO) b)Neovascularglaucoma c)Centralretinalarteryocclusion(CRAO) d)SteroidinducedGlaucoma CorrectAnswer-AAnswer-A,Centralretinalveinocclusion(CRVO)100daysglaucomaisaneovascularglaucomaoccurringinCRVO.CentralRetinalveinocclusion(CRVO)1.Predisposingfactors:-Increasingage?seenin6th-7th-decadesoflife.Systemichypertensionisthemostcommoncause.Blooddyscrasias?hyperviscosityduetochronicleukemiasandpolycythemiaRaisedIOP(POAG)Periphlebitis?sarcoidosis,Beh?et'sdisease2.ClassificationofCRVO:-Non?IschemicIschemic3.ClinicalFeatures:-TortuosityanddilationofretinalveinsFlameshapedhemorrhage?developinthenervefiberlayeroftheretina,especiallyaroundtheopticdisc,asaresultofthehighintravascularpressurethatdilatestheveinsandcollateralvessels.Cotton?woolspotsandappearanceofcollateralsattheopticdiscareitsprominentdiagnosticsigns.

Opticdiscedemaandhyperemiaareseen.4.Complications:-Rubeosisiridisandneovascularglaucoma(NVG)occurinmorethan50percentcaseswithin3months(soalsocalledas90daysglaucoma),afewcasesdevelopvitreoushemorrhageandproliferativeretinopathy.5.Treatment:-Panretinalphotocoagulation(PRP)orcryo-application,ifthemediaishazy,mayberequiredtopreventneovascularglaucomainpatientswithwidespreadcapillaryocclusion.Photocoagulationshouldbecarriedoutwhenmostoftheintraretinalbloodisabsorbed,whichusuallytakesabout3-4months.100-dayglaucomaorNVGresultsfromconditionswhichleadtoneovascularizationintheeyeeg.PDR,CRVO,RetinalmalignanciesandrarelyinCRAO.Hemorrhagicglaucomaisalsoknownas100dayglaucomabecauseitstarts3monthsaftertheepisodeofcentralretinalveinocclusion.

454.QRothspotsisseenin: a)Uvealmelanoma b)Acuteleukaemia c)Botha&b d)Noneoftheabove CorrectAnswer-BAnswer-B.AcuteleukaemiaRoth'sspotsareretinalhemorrhageswithwhiteorpalecenters.Composedofcoagulatedfibrinincludingplatelets,focalischemia,inflammatoryinfiltrate,infectiousorganisms,orneoplasticcells.Roth'sspotsmaybeobservedinleukemia,diabetes,subacutebacterialendocarditis,perniciousanemia,ischemicevents,hypertensiveretinopathyandrarelyinHIVretinopathy.Roth'sspotsarenamedafterMoritzRoth.

455.Yokemuscleofrightlateralrectus: a)Ltmedialrectus b)Ltsuperiorrectus c)Ltlateralrectus d)Ltinferioroblique CorrectAnswer-AAnswer-A.LtmedialrectusContralaterallypairedextraocularmusclesthatworksynergisticallytodirectthegazeinagivendirection.Forexample,indirectingthegazetotheright,therightlateralrectusandleftmedialrectusoperatetogetherasyokemuscles.YokeMuscles:2Muscles(1ineacheye)thataretheprimemoversoftheirrespectiveeyesinagivenpossitionoofgazeFor-Example-whentheeyesmoveintorightgaze(dextroversin),therightlateralrectus&theleftmedialrectusmuscleareyokemuscles.

456.SevereConjunctivitiscausedby: a)Neisseria b)Staphylococcus c)Streptococcus d)Haemophilus CorrectAnswer-AANSWER-A.NeisseriaThemostcommoncausesofacutebacterialconjunctivitisareStaphylococcusaureus,Streptococcuspneumoniae,andHaemophilusinfluenzae.HyperacutecasesareusuallycausedbyNeisseriagonorrhoeaeorN.meningitidis.Chroniccasesofbacterialconjunctivitisarethoselastinglongerthan3weeks,andaretypicallycausedbyStaphylococcusaureus,Moraxellalacunata,orgram-negativeentericflora.Neisseriagonorrhoeaecausesgonococcalconjunctivitis,whichusuallyresultsfromsexualcontactwithapersonwhohasagenitalinfection.Theincidenceratesofgonococcalconjunctivitisincreaseduringspringandsummer.Thisisapotentiallydevastatingocularinfection,becauseN.gonorrhoeaecancausesevereulcerativekeratitis,whichmayrapidlyprogresstocornealperforation.

457.WhichisexampleoftheSimpleMyopic Astigmatismamongtheprescriptionsgivenbelow: a)Rx(+)sphere b)Rxwillbeplano(-) c)Rxwillbe(-)sphere d)(-)(+)(+)(-)onboth90and180degreeaxis CorrectAnswer-BAnswer-B.Rxwillbeplano(-)Wheneyewearprescriptionsarewritten,theycanbeclassifiedintodifferentareasdependingonthepowerorrefractiveerror.Therearesevencategoriestowhichprescriptionscanfall: 1. SimpleHyperopia,theRxwillbe(+)sphere2. SimpleMyopia,theRxwillbe(-)sphere3. SimpleMyopicAstigmatism,theRxwillbeplano(-)4. SimpleHyperopicAstigmatism,theRxwillbe(+)5. CompoundHyperopicAstigmatism,majormeridianpowerwillbe (+)(+)onboth90and180degreeaxis 6. CompoundMyopicAstigmatism,majormeridianpowerwillbe(-) (-)onboth90and180degreeaxis 7. MixedAstigmatism,majormeridianpowerswillbeopposites(-) (+)(+)(-)onboth90and180degreeaxis

458.Blowoutfractureoforbitinvolves: a)Floor b)Medialwall c)Lateralwall d)Roof CorrectAnswer-AAnswer-A.FloorOrbitalfloorfracture,alsoknownas"blowout"fractureoftheorbit.Blowoutfractureoforbitinvolves: 1. Fracturesoftheorbitalfloorarecommon:itisestimatedthatabout 10%ofallfacialfracturesareisolatedorbitalwallfractures(themajorityofthesebeingtheorbitalfloor),andthat30-40%ofallfacialfracturesinvolvetheorbit. 2. Theanatomyoftheorbitalfloorpredisposesittofracture.3. Theinferiororbitalneurovascularbundle(comprisingtheinfraorbital nerveandartery)courseswithinthebonyflooroftheorbit;theroofofthisinfraorbitalcanalisonly0.23mmthick,andtheboneoftheposteriormedialorbitalflooraverages0.37mmthick. 4. Bycontrast,theboneofthelateralportionoftheorbitalfloor averages1.25mmthick,over5timesthethicknessoftheboneovertheneurovascularbundle.Asonemightsuspect,itisthisverythinareaoftheorbitalflooroverlyingtheneurovascularbundlewhereisolatedorbitalfloorfracturesinvariablyoccur.

459.Adiabeticpatient2daysafterpost cataractsurgerydevelopsdevelopshypopyon.Whatwillbethemanagement? a)Intravitrealantibiotics b)Eyedrops c)Surgery d)Notreatmentrequired CorrectAnswer-AAns.A.Intravitrealantibiotics

460.

WhatistheThinnestpartofneuro-retinalrimaccordingtoISNTrule? a)Inferior b)Superficial c)Temporal d)Medial CorrectAnswer-CAns.C.TemporalTheISNTruleisaneasywaytorememberhowtheopticnerveissupposedtolookinanormaleye.Normallytheneuro-retinalrimisthickestInferiorlyandthinnestTemporally.Withglaucoma,however,youbegintoseeverticalthinning,withatrophyalongtheinferiorandsuperiorrims.

461.Whatcausesshiftingfluid? a)ExudativeRetinaldetachment b)TractionalRetinalDetachment c)Rhegmatogenousretinaldetachment d)Retinodialysis CorrectAnswer-AAns.a.ExudativeRetinaldetachment.>Inexudativeretinaldetachment,thesubretinalfluidmaybeconfinedtoalocalizedarea,usuallytheposteriorpole,ormayextendtotheperiphery,evenformingbullousretinaldetachment.>Thecharacteristicfeatureofasignificantexudativeretinaldetachmentisthepresenceofshiftingsubretinalfluid.>Thefluidshiftstothemostdependentlocationwhenpatientschangebodyposition.https://clinicalgate.com/nonrhegmatogenous-retinal-detachment/

462.Conjunctivalinjection,pharyngeal injection,polymorphicrash,cervicallymphadenopathycanbeseenin a)Kawasakisyndrome b)Measles c)Thrombocytopenia d)Mumps CorrectAnswer-AAns:a.Kawasakisyndrome.>Kawasakidiseaseisageneralizedvasculitisthataffectsmedium-sizedarteries.>Itischaracterizedbysystemicinflammationthatmanifestsaspersistentfever,erythemaofthemucousmembranes,bilateralnonexudativeconjunctivitis,rash,swellingandrednessofthehandsandfeet,andcervicallymphadenopathyRef:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3034467/

463.IncongruousHomonymoushemianopia withWernicke'shemianopiapupilisseenwiththelesionof a)Opticradiation b)Lateralgeniculatebody c)Optictract d)Anterioroccipitalcortex CorrectAnswer-CAns:c.Optictract>AnterioroptictractlesionproducesIncongruousHomonymoushemianopia,decreasedvisualacuity,afferentpupildefect(Wernicke'shemianopiapupil)andatrophyofopticdiscswithcharacteristicBow-tieatrophyarecontralateral.>AcompleteHomonymoushemianopiaresultsfromposterioroptictractlesions.Ref:https://books.google.co.in/books?id=bDpI9n4q3e0C&pg=PA376&lpg=PA376&dq=Incongruous+Homonymous+hemianopia+with+Wernicke%27s+hemianopic+pupil&source=bl&ots=36lTWDpqEI&sig=ACfU3U1mJNezirKF_11Ku5xpqqmWX6mdQw&hl=en&sa=X&ved=2ahUKEwio2-fCi_bmAhUoxzgGHf56An8Q6AEwFXoECAoQAQ#v=onepage&q=Incongruous%20Homonymous%20hemianopia%20with%20Wernicke's%20hemianopic%20pupil&f=false

464.Thepatientcamewithproptosis, restrictionofeyemovements,andwasEuthyroid.Whatcouldthisbefrom? a)OrbitalCellulitis b)OrbitalLymphoma c)Orbitalpseudotumor d)Thyroidophthalmopathy CorrectAnswer-CAns:C.Orbitalpseudotumor>Proptosisandrestrictedeyemovementismostcommonlyassociatedwiththyroidophthalmopathy>ButinquestionaskedisEuthyroid.>So,thebestoptiontoselectisOrbitalpseudotumor(Idiopathicorbitalinflammatorysyndrome)Ref.ComprehensiveOphthalmologybyAKKhurana-6thEditionPageno335

465.Prerequisiteforsympathetic ophthalmitis a)Penetratinginjurytotheeye b)Bluntoculartumor c)Chemicalinjury d)Urinarytractinfection CorrectAnswer-AAns:a.Penetratinginjurytotheeye.>Sympatheticophthalmiaisararetypeofuveitisthatcausessmallabnormalclumpsofcells(granulomas)toform.>Thisdisorderoccursintheuninjuredeyeafterapenetratinginjury(suchaswhenapencil,pen,orstickpuncturestheeye)orsurgerytotheother(injured)eye.Ref:https://www.msdmanuals.com/en-in/home/eye-disorders/uveitis-and-related-disorders/sympathetic-ophthalmia.

466.Photostresstesttodifferentiate a)Lensandcornea b)ThemaculaandOpticnervediseases c)Cataractandglaucoma d)Retinalandvitreousdiseases CorrectAnswer-BAns:b.ThemaculaandOpticnervediseases.>Todistinguishopticnerveconductiondefectsfromthemaculardiseaseinpatientswithotherwiseunexplainedlossofcentralvisionwefirstdeterminedthebestvisualacuitywithcorrectionatdistanceinunilateraldefects.>Thenormaleyewastestedfirstandphotostressedfortensecondsbylookingatanordinarypenlightheld2to3cmfromtheeye.>ThetimerequiredtoreadthreelettersonthreeSnellentestlinesjustlargerthanthebestacuitywasusedastheendpoint.>Recoverytimewillbeprolongedwithmaculopathy.>Prolongedrecoverytimewillnotbeobservedinpatientswhohaveopticnervedisease.https://www.ncbi.nlm.nih.gov/pubmed/836667

467.Whichlayerofcorneahelpsinthe hydrationofstromaofcornea a)Endothelium b)Epithelium c)Descemetmembrane d)Stroma CorrectAnswer-AAns:a.Endothelium>Thecornealendotheliumisresponsibleformaintainingthehydrationofthecornea.>Thisisthrougha"Pump-Leak"mechanismwheretheactivetransportpropertiesoftheendotheliumrepresentthe"Pump"andthestromalswellingpressurerepresentsthe"Leak"Ref:https://www.researchgate.net/publication/51238307_Molecular_Mechanisms_Underlying_the_Corneal_Endothelial_Pump

468.A65oldmalewithahistoryof hypertensionanddiabetes,presentstotheOPDwithcomplaintsofdiplopiaandsquint.Onexamination,thesecondarydeviationismorethantheprimarydeviation.Whichofthefollowingismostlikelydiagnosis a)concomitantsquint b)paralyticsquint c)Restrictivesquint d)Pseudosquint CorrectAnswer-BAns:b.paralyticsquint.>Paralyticorincomitantsquintoccurswhenthereisanacquireddefectofthemovementofaneye.>Thesquint(anddoublevision)ismaximallydemonstratedbylookinginthedirectionofactionoftheweakenedmuscle.>ParalyticsquintsoccurduetodiseaseoftheIII,IVandVIcranialnerves.Ref:https://www.gponline.com/basics-strabismus/ophthalmology/article/1055827

469.Esotropiaiscommonin a)Myopia b)Hypermetropia c)Emmetropia d)Astigmatism CorrectAnswer-BAnd:B.Hypermetropia>Patientswithrefractiveesotropiaaretypicallyfarsighted(hyperopic).>Thismeansthattheeyesmustworkhardertoseeclearly,particularlywhentheobjectofregardisupclose.https://aapos.org/glossary/accommodative-esotropia

470.Anextrarowofciliaposteriortothegrey line a)Distichiasis b)Tylosis c)Madarosis d)Trichiasis CorrectAnswer-AAnd:a.Distichiasis>Distichiasisisararedisorderdefinedastheabnormalgrowthoflashesfromtheorificesofthemeibomianglandsontheposteriorlamellaofthetarsalplate.Ref:https://emedicine.medscape.com/article/1212908-overview

471.Thepatientcamewithunilateral ProptosisandbilateralAbducentnervepalsy.Thiscouldbefrom a)Cavernoussinus b)Orbitalcellulitis c)Orbitalpseudotumor d)Orbitallymphoma CorrectAnswer-AAns:a.Cavernoussinus>Proptosisisinitiallyseenunilaterallyultimatelybecomesbilateral.>6thcranialnerve(Abducent)passesthroughthecavernoussinus.soincavernoussinusthrombosisbilateralabducenspalsyisseen.Parson'sDiseasesoftheEye-Ed.22Pg497

472.Thecharacteristicfindingoffungal ulcers? a)Satellitelesions b)Dendriticulcer c)Ringabscess d)Whitehypopyon CorrectAnswer-AAnd.a.Satellitelesions>Fungalkeratitisorkeratomycosisreferstoaninfectiveprocessofthecorneacausedbyanyofthemultiplepathologicfungicapableofinvadingtheocularsurface.>whentheepithelialintegrityisbrokeneitherduetotraumaorocularsurfacediseaseandtheorganismgainsaccessintothetissueandproliferates.>Multifocalstromalinfiltratesor"satellitelesions"havebeenconsideredacharacteristicfeatureoffungalkeratitis.Ref:https://eyewiki.aao.org/Fungal_Keratitis

473.Adrugusedinapatientwithincreased IOPandopticdiscchanges,ciliarycongestionfordecreaseIOPactsbyincreasinguveoscleraloutflowis a)Latanoprost b)Pilocarpine c)Dorzolamide d)Timolol CorrectAnswer-AAns:a.Latanoprost>LatanoprostselectivelystimulatestheprostaglandinF2alphareceptorandthisresultsinadecreasedintraocularpressure(IOP)viatheincreasedoutflowofaqueoushumor,whichisoftenimplicatedincasesofelevatedintraocularpressure.Ref:https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.drugbank.ca/drugs/DB00654&ved=2ahUKEwicmYHW5PjmAhU94HMBHZG6ADcQFjANegQIAxAB&usg=AOvVaw34z-Nz08_cOFzeYemAzeWf&cshid=1578651404060

474.ApatientdiagnosedwithRheumatoid arthritiswasonmedications.After2years,hedevelopedablurringvisionandwasfoundtohavecornealopacity.Whichdrugismostlikelytocausethis? a)Sulfasalazine b)Chloroquine c)Methotrexate d)Leflunomide CorrectAnswer-BAns:B.ChloroquineInlong-termchloroquinetherapyOcularcomplicationswereobserved>Thistherapyisusuallyusedinpatientswithrheumatoidarthritis,lupuserythematosus,sarcoidosis,discoidlupus,andotherchronic"collagendisease".>Retinalchanges,cornealopacifications,blurringofvisionaresomecomplicationsseeninlongtermuseofChloroquine.Ref:https://www.ncbi.nlm.nih.gov/pubmed/1427503

This post was last modified on 23 November 2021