st

Ophthalmology 1 LE feedback (2015 A)

1. The site of the detailed for central vision is:
a. Optic nerve
b. Pars plana
c. Ora Serrata
d. Macula
2.

The aqueous humor is formed by secretion and diffusion of ciliary processes. Its
functions are:
a. To maintain the intraocular pressure
b. Provides metabolism to the lens
c. Provide nutrition to the posterior cornea
d. all of the above

3.

the aqueous layer of the tear film is mainly derived from

a. Lacrimal glands
b. Meibomian glands
c. Goblet cells
d. All of the above

4.

The anterior liquid layer of the tear film is mainly derived from
a. Accessory lacrimal gland of Krause and Wolfring
b. Crypts of Henle
c. Meibomian glands
d. All of the above

5.

The thin mucin layer of the tear film:

a. Maintains stability of the tear film
b. Contains glucose immunoglobulins
c. Prevents evaporation
d. Provides water tight seal

6.

The main source of nutrition of the sclera

a. Cornea
b. Aqueous Humor
c. Choriocapillaries
d. Episclera

7.

The process by which light absorbed by the photoreceptors is converted to electrical

energy:
a. Photosynthesis
b. Accommodation
c. Visual Transduction
d. None of the above

8.

The electrophysiologic test used to evaluate the optic nerve

a. Electrooculography
b. Electroretinography
c. Visual Evoked Response
d. All of the above

9.

The simultaneous movement of the eye directed to an object in the mid body plane
a. Version
b. Duction
c. Vergence
d. Torsion

10. The muscle responsible for abduction:

a. Medial rectus
b. Lateral rectus
c. Superior rectus
d. Inferior rectus
11. The muscle responsible for intorsion:
a. Superior rectus
b. Superior oblique
c. Inferior oblique
d. Inferior rectus
12. In the elucidation of the patients chief complaint:
a. It should be stated in the physicians words using concise medical terminology
b. The complaints of lesser importance should not be cited along with the chief
complaint
c. It should document the patients point of view, which may be distinct from the
physician
d. It may include three or more complaints with their respective duration
13. Which of the following are considered general categories for complaints?
a. Ocular pain and discomfort
b. Abnormal appearances
c. Abnormal ocular secretions
d. All of the above
14. In taking the history of present illness (HPI)
a. An ocular complaint which is bilateral can give the physician an idea that the
problem may have a systemic etiology or genetic predisposition
b. Clarifying complaints will uselessly lengthen the process
c. The physicians medical terminology should be used for uniformity, to represent
what the patient said
d. Negative symptomatology should always be ignored and not included in the
documentation of the HPI

15. The chief complaint was blurring of vision on the right eye (OD). The history of a 58
y/o man diabetic, non hypertensive patient states that there is a gradual painless
blurring of vision which is worsened b exposure to sunlight, but has better vision at
night. The clue in the patients history that may connote that it may be a non
emergency is the
a. Better vision at nighttime
b. Worsening of vision when exposed to sunlight
c. Painless blurring of vision
d. Gradual progression of the blurring of vision
16. The patient consults at the emergency room after being doused by an acid solution in
her face and eyes. The first thing to do at the emergency room is:
a. Get a good history to make sure of the kind of chemical injury and perform a
proper PE specifically visual acuity first for medicolegal documentation
b. Call the ER resident for immediate management
c. Irrigate the eye immediately with normal saline solution
d. Instill anesthetic to the eye to ease the ocular pain the patient feels
17. A 65 years old nervous lady who came to your clinic has a chief complaint of double
vision of two days duration. You must ask for her:
a. Social history
b. Family history
c. Past medical history including medications
d. All of the above
18. The mnemonic COLDER in taking the history of present illness (HPI) includes all of
the following EXCEPT:
a. Chief complaint
b. Location
c. Onset
d. Duration
19. Visual acuity charts (eg. Snellen Chart) are normally placed
a. 10 feet from the patient
b. 15 feet from the patient
c. 20 feet from the patient
d. 30 feet from the patient
20. If a patient reads 20/200 line in the distance visual acuity chart (unaided) and later
reads 20/25 with pinhole, the patient has:
a. Retinal problem
b. Error of refraction
c. Glaucoma
d. Mature cataracts
21. MarcusGunn pupil is best observed using which of the following eye maneuver?
a. Swinging flashlight test
b. Coveruncover test
c. Confrontation test
d. Prismcover test

22. Peripheral visual field testing in the clinic can be simply done by the:
a. Confrontation test
b. Amsler Grid test test for macula
c. Octopus Test operated perimetry
d. Frequency doubling perimeter
23. Steeper corneal curvatures are associated with
a. Hyperopia
b. Myopia
c. Presbyopia accommodation problem
d. Metamorphopsia problem with macular degeneration
24. Correction for hyperopia is accomplished with:
a. Minus lenses
b. Plus lenses
c. Combination of concave and cylindrical lenses
d. Flat lenses
(M myopia, mahaba, minus lens; H hyperopia, Hindi Mahaba)
25. One of the following cannot be used to correct astigmatism
a. Presbyopic reading glasses
b. Toric contact lenses
c. Cylindrical spectacle lenses ideal lens
d. Cataract extraction with toric intraocular lens implantation
26. Farsighted individuals
a. have long eyeballs
b. have to bring objects closer to see them clearly
c. have narrow slitlike palpebral fissures
d. have short eyeballs Hyperopia
27. individuals with astigmatism
a. see better with convex lenses
b. see better with concave lenses
c. see better through pinholes
d. see better at night
28. A condition characterized by difficulty in reading fine print resulting from loss of
crystalline lens:
a. cataract
b. presbyopia
c. myopia
d. astigmatism
rd
29. A 3 year medical student complains of sudden blurry vision on both eyes rendering
him unable to read since 2 hours ago. Examination showed fully dilated, nonreactive
pupils on both eyes. The rest of the eye and physical examination showed normal
findings. It is likely that:
a. Visual acuity by pinhole will show no improvement in vision
b. Stronger light will constrict the pupil back to normal
c. The patient is malingering
d. The patient was pharmacologically dilated

30. Myopia is likely present when:

a. A person needs to hold his cellphone very close to his eyes to real his text
message
b. A person needs to hold his cellphone at arms length to read his text message
c. A person needs to squint and make his palpebral fissure small to read his text
message
d. A person needs to turn his head to the right and look through the corner of his
eyes to read his text message
31. Myopic correction is accomplished with
a. Convex lenses
b. Concave lenses
c. Toric lenses
d. Cylinders
32. The focal point in an uncorrected myopia is located
a. before the retina
b. after the retina
c. On the retina
d. before and after the retina
33. A 41 year old insurance executive complains of temporal headaches noted usually in
the late afternoon after a day of heavy computer work relieved by sleep. She claims
to have had perfect vision all her life and never had to wear glasses. She was advised
by her boss to consult a neurologist but wanted to have her eye checked first. Your
primary consideration is:
a. Glaucoma
b. Systemic hypertension
c. Psoriasis
d. Presbyopia
34. A blowout fracture of the orbit occurs when an external force strikes the orbital
cavity. Which of the following walls is fractured the most?
a. Orbital roof
b. Orbital floor
c. Medial wall
d. lateral wall
35. An ophthalmic surgery that involves removal of the whole globe is called?
a. evisceration
b. enucleation
c. exenteration
d. excision
36. A 62 year old female sought consult due to foreign body sensation and eye redness
on the left eye. On examination, the left lower eyelid margin was noted to turn
inward causing eyelashcorneal touch. The most probable diagnosis is?
a. Ectropion
b. Entropion
c. Blepharoptosis
d. Blepharitis

37. A small abscess caused by an acute staphylococcal infection of the meibomian gland
is called
a. internal hordeolum Most commonly caused by staphylococcus
b. external hordeolum
c. blephritis not abscecss
d. chalazion
38. A 6 year old male was noted to have a waxy and nodular lesion with central
umbilication at the eyelid margin. What is the moste likely diagnosis?
a. Xanthelasma
b. Molluscum contagiosum
c. Cutaneous horn
d. Seborrheic keratosis
39. A 60 year old farmer sought consult due to a pigmented lesion on the left lower
eyelid. It was described to like a rodent ulcer what is the most likely diagnosis?
a. Basal cell carcinoma
b. Squamous cell carcinoma
c. Sebaceous adenocarcinoma
d. Kaposis sarcoma
40. The eyelid malignancy may arise spontaneously or from areas of solar injury and
actinic keratosis. It is usually metastasize through the lymphatics, blood or direct
extension
a. Sebaceous adenocarcinoma
b. Basal cell carcinoma
c. Squamous cell carcinoma
d. Kaposis sarcoma
41. A 35 y/o patient previously diagnosed with AIDS presented with a reddish dermal
mass in the left lower eyelid. The most likely diagnosis is:
a. Basal cell carcinoma
b. Kaposis sarcoma
c. Malignant Melanoma
d. Sebaceous adenocarcinoma
42. In congenital nasolacrimal duct obstruction, there is usually a membranous block at:
a. Common canaliculus
b. Inferior puncta
c. Valve of Rosenmuller
d. Valve of Hasner most common site (70 80% resolve in 6 months)
43. What is the most common pathogen seen in patients with Canaliculitis?
a. Staphylococcus aureus
b. Streptococcus sp.
c. Actinomyces israelii
d. Pseudomonas Aeroginosa

44. A 42 year old female sought consult due to chronic tearing on the right eye for 5
years. She was diagnosed with acquired nasolacrimal duct obstruction. What is the
most common cause?
a. Nasoorbital trauma
b. Chronic sinus disease
c. Dacryocystitis
d. Involution stenosis

51. A clinical clerk referring a patient to an ophthalmology resident describes the redness
seen in the eye of a 24 y/o patient complaining of eye redness and photophobia as
ciliary injection This redness is most likely due to:
a. Adenovirus conjunctivitis
b. Allergic conjunctivitis
c. Iridocyclitis give atropine to relieve pain
d. Pterygium

45. The single layer of cells which keeps the cornea in a relative state of
dryness/dehydration is the:
a. Corneal epithelium
b. Bowmans membrane
c. Descemets membrane
d. Corneal endothelium sodium potassium pump

52. One of the leading causes of irreversible blindness due to infectious disease in the 3
world is:
a. Cataract
b. Glaucoma
c. Fungal Keratitis
d. Trachoma

46. The cornea is avascular and therefore gets its nutrition from the:
a. Limbal blood vessels
b. Aqueous humor
c. Tears
d. All of the above

53. Munsons Sign is pathognomonic for:

a. Trachoma
b. Keratomalacia
c. Keratoconus
d. Pinguecula

47. Physiology and Biochemistry, respectively is the study of the

processes in living matter:
a. Function
b. Organization
c. Formation
d. Terminology

and chemical

54. The term keratomalacia is synonymous to:

a. Dry eyes
b.
Asian corneas
c.
Corneal melting
d.
Corneal leukomas
55. No picture, not audible (sorry guys)

48. Among the following ocular signs which may be seen in patients presenting with a red
eye, which would most likely suggest a viral form of conjunctivitis?
a. Water discharge
b. Purulent discharge
c. Eye tenderness
d. Stringy discharge
49. Among the following ocular signs which may be seen in patients presenting with a red
eye, which would most likely suggest bacterial conjunctivitis?
a. Water discharge
b. Purulent discharge
c. Eye tenderness
d. Stringy discharge
50. Among the following ocular signs which may be seen in patients presenting with a red
eye, which would most likely suggest vernial conjunctivitis?
a. Water discharge
b. Purulent discharge
c. Eye tenderness
d. Stringy discharge

56. One of the ff is not a major function of the crystalline lens:

a. Maintain its own clarity
b. Absorb UV light
c. Refractive power of 30 OD
d. Accomodation
57. The ff is not a major component of the crystalline lens:
a. capsule (anterior & posterior)
b. lens endothelium
c. lens epithelium
d. cortex and nucleus
58. Second Sight myopic shift is related to what type of cataract?
a. Subcapsular
b. Cortical
c. Lamellar
d. Nuclear

rd

59. Which of the ff chemistry of the normal crystalline lens is not true?
a. Adult lens contains approximately 66% water and 33% protein
b. Lens cortex is less hydrated than the lens nucleus
c. Lens dehydration is maintained by an active Na, K ion water pump
d. Lens contains most K ion and less Na ions

66. The changing of the crystalline lens shape during accommodation is controlled by?
a. Zonular fiber
b.
Ciliary body
c.
Ciliary muscle
d.
Vitreous body

60. One of the ff is not associated with ectopia lentis:

a. Marfan Syndrome
b. Well Marhesam Syndrome
c. Rubella Syndrome
d. Homocystonuria

67. The uveal layer of the human eye is composed of the:

a. Cornea and sclera
b. Iris, ciliary body, and choroid
c. Sclera and uvea
d. Retina and Choroid

61. This layer of the crystalline lens is responsible for changing the shape of the lens
during accommodation?
a. Cortex
b. Nucleus
c. Lens Capsule where zonular fibers are attached
d. Lens epithelium

68. Features of the sclera include w/c of the ff?

a. It covers the of the total eyeball
b. It serves as the insertion of the extracapsular muscles
c. It is opaque, white, fibrous tissue. Composed of different types of collagen
and is almost acellular
d. The optic nerve runs through its equator

62. Which of the ff symptoms is/are associated w/ posterior subcapsular cataract?

a. Good near vision but blurred far vision
b. Good distance vision but typically have blurred near vision because it is
near the macula
c. Good far and near vision
d. Good near vision cycle

69. Which of the ff is false regarding episcleritis?

a. It is more common in males in their 20s and 30s
b. It is characterized by engorgement of episcleral vessels which run in radial
direction
c. It may be localized and benign or does not signify and underlying systemic
disease
d. Tenderness, discomfort and sometimes neuralgia are sometimes present

63. Which type of cataract surgery is ideal for most senile (age related) cataract?
a. Intracapsular cataract extraction
b. Extracapsular cataract extraction
c. Aspiration lensectomy done in soft lens (senile and babies)
d. Phacoemulsification
64. A 65 y/o female complained of painful blurring of vision in her right eye of 5 days
duration. Right eye examination revealed a hazy cornea, shallow AC, middilated pupil
and intermittent lens. What is the most likely diagnosis?
a. Phacolytic glaucoma
b. Phacomorphic glaucoma morphologically block aqueous outflow
c. Phacoanaphylactic glaucoma
d. Neovascular glaucoma
65. Type of cataract that results from the development of vacuoles and water clefts in the
lens. Fibers giving rise to a pearl like appearance:
a. Nuclear Cataract
b. Polar Cataract
c. Cortical Cataract earliest sign is the formation of water vacuoles
d. Posterior Subcapsular Cataract

70. A patient presented with a circumscribed mass as large as a lentil about 23 mm away
from limbus in the temporal area of the eye. It was hard, tender and immovable with
the conjunctiva moving freely over it. It is traversed by deeper episcleral vessels
hence purple in color and is not bright red. There is mild tenderness and discomfort.
This patient most likely has:
a. Nodular scleritis
b. Nodular episcleritis
c. Diffuse scleritis
d. Diffuse episcleritis
71. A 36 y/o woman came in with a red eye with profound pain and some photophobia.
The eye is violecious red which does not blanch with the application of epinephrine.
This patient most likely has:
a. Episcleritis
b. Uveitis
c. Scleritis
d. Staphyloma

72. The patient came in with sclera necrosis characterized by severe thinning and melting
of sclera. His eye is red painful and has worsening of symptoms as days progress.
There is associated anterior uveitis and was diagnosed by her dermatologist to have
Wegeners Granulomatosis. The condition is best managed by?
a. Oral NSAIDs and topical ?????
b. Oral NSAIDs, topical Prednisolone and abundant lubrication
c. Oral prednisone at 1mg/kg/day, topical Prednisolone, and oral
immunosuppressants
d. Surgical management with sclera patch graft
73. Which of the ff is NOT an accepted treatment for posterior scleritis
a. IV methylprednisolone
b. Subconjunctival triameionolone injections
c. Antibiotics for infectious sclera disorders
d. Oral prednisone at 1 mg/kg BW
74. A patient presents with an ocular staphyloma. Examination reveals iris incarceration.
This patient has:
a. Anterior staphyloma
b. Ciliary staphyloma
c. Interciliary staphyloma
d. Posterior staphyloma
75. A congenital development anomaly in the development of the iris, resulting to an
absence of the inferior portion of the iris revealing a key hole pupil called:
a. Iris coloboma
b. Aniridia
c. Rubeosis iridis
d. Heterochromia iridis
76. Exudation of proteinaceous material in the anterior chamber of the eye produces
which clinical age of anterior uveal inflammation?
a. Anterior chamber cells
b. Anterior chamber flare
c.
Nodules
d.
77. The currently used classification used in uveitis disease is:
a. International Uveitis Study Group (IUSG) Classification
b.
??? Classification
c.
MEEI Harvard School Classification
d.
Standardization of Uveitis Nomenclature (SUN)
Classification
78. Which of the ff is not a primary determinant of IOP?
a. Rate of aqueous humor incretion
b. Pupil dilation in myopia
c. Aqueous humor outflow faculty
d. Episcleral venous pressure

Working

Group

79. The mean value for outflow faculty in normal eyes is?
a. 0.05 uL/min/mmHg
b.
0.15 uL/min/mmHg
c. 0.28 uL/min/mmHg
d. 0.48 uL/min/mmHg
80. Conjunctival hyperemia, growth of eyelashes, ocular pruritus, ocular dryness, visual
disturbance, ocular burning, foreign body sensation, eye pain, pigmentation of the
periocular area, blepharitis, cataract, eyelid erythema, eyelash darkening, are
ADVERSE REACTIONS associated with this antiglaucoma medication:
a. Betaxolol
b. Bimatoprost
c. Brinzolamide
d. Pilocarpine
81. Which of the ff best characterizes primary open angle glaucoma (POAG)?
a. POAG usually presents with higher pressures compared to normal tension
glaucoma
b. POAG is a gradually progressive irreversible blinding disease
c. POAG presents with higher eye pressures compared to congenital glaucoma
d. POAG is usually seen in hyperopia
82. One of the following is a risk factor for development for glaucoma
a. Prolonged use of computers
b. Intake of oral steroids even topical steriods
c. Prolonged exercise
d. Intake of antihypertensive medications
83. A 60 y/o Asian female complains of difficulty in driving characterized as inability to
see the sidewalk for the past 6 months. Past health history is significant for diabetes
of 5 years. She claims to have a sister who is blind. Eye examinations showed a visual
acuity of 20/20 on both eyes, eye pressure <30mmHg, open angle on gonioscopy on
both eyes, and cup disk ratio of 0.7 on both eyes with rim notching . The diagnostic
procedure that will most likely check the diagnosis of glaucoma would be
a. Blood Pressure measurement
b. CBC
c. Corneal thickness measurement
d. Visual field exam functional test for detecting glaucoma
84. The diagnostic test that would identify the mechanism of glaucoma
a. Gonioscopy to know if open or close or pupillary block
b. Fundoscopy progression
c. Visual field examination
d. Corneal topography
85. The most preferred firstline treatment for newly diagnosed mild open angle
glaucoma
a. Trabeculectomy
b. Lantanoprost
c. Diode transscleral cyclophotocoagulation
d. Observation

86. In the treatment of glaucoma, timolol maleate should not be given to patients with
a. Hemorrhoids
b. Psoriasis
c. Systemic HPN precaution but not contraindicated
d. Bronchial Asthma more common

93. A scotoma located 5 degrees from fixation is a lesion in?

a. Papilomacular nerve fiber bundle
b. Temporal arcuate nerve fiber bundle
c. Nasal radiating nerve fiber bundle
d. Horizontal raphe

87. Aqueous fluid exits the eye through?

a. Lacrimal duct
b. Vitreous collagenous channels
c. Na K pump of the corneal endothelial cells
d. Trabecular meshwork

94. What is the most common chart used to check color vision?
a. Farnsworth color test more sensitive
b.
c. Ishihara test chart most common
d.

88. The most common mechanism identified in patients with primary angle closure
glaucoma is?
a. Pupillary block
b.
c. Angle recession
d. Retinal detachment

95. What is the importance of swinging flashlight test?

a. Shows how pupil constricts with light stimulus
b. Show equality of pupillary light reaction
c. Will distinguish between Horners syndrome and Tonic pupil
d. Will distinguish between optic nerve lesion and retinal problem

89. A patient complaining of poor vision in one eye is subjected to a pinhole test. What is
true in the ff statements?
a. Error of refraction if vision is improved
b. Patient is not looking thru pinhole if vision is not improved
c. You need corrective glasses to look thru pinhole
d. Pathological if vision is improved
90. What is the importance of doing a cover and uncover test in a patient that has
intermittent double vision?
a. To break the fusion of vision
b. To check for any blurring of vision
c. Look for nystagmus not cause double vision
d. Check how straight the eyes are
91. What is the single most important feature of a visual field defect that tells you central
vision vs. optic nerve lesion?
a. If visual field defect respects the horizontal meridian raphe
b. If field defect respects the vertical meridian hemianopsia present
c. If the visual fields look the same on both eyes
d. If visual fields are congruous
92. Where is the lesion in a patient with temporal wedge shaped scotoma in one eye?
a. Temporal arcuate nerve fiber bundle
b. Optic Chiasm bitemporal hemianopsia
c. Nasal radiating nerve fiber bundle
d. Papilioma nerve fiber bundle

96. A lesion affecting the nerve fibers of optic radiation will give what kind of visual field
defect?
a. Homonymous hemianopsia
b. Heteronymous hemianopsia
c. Junctional scotoma
d. Pie in the sky phenomenon
97. What specific visual field defect would point specifically to an occipital lobe lesion?
a. Homonymous hemianopsia
b. Central homonymous hemianopsia
c. Inferior altitudinal defect
d. Temporal island of vision in area of visual field defect
98. What is a red glass test? for patients with diplopia
a. Test for fusion of vision
b. Part of color vision test
c. Test for red desaturation
d. Test for retina function
99. A junctional scotoma is a sign of?
a. Optic nerve compression
b. Optic chiasmatic cord compression
c. Temporal lobe lesion
d. Parietal lobe lesion
100. What is the importance of congruity in a Visual Field Defect (VFD)?
a. The more congruous the VFD the closer it is to the temporal lobe
b. The more congruous the VFD the closer it is to the visual cortex
c. It implies that the mass lesion is in the optic tract.
d. It measures the angle of field defect in a patient with optic

FIRST LONG EXAM FEEDBACK

Dr. Imperial

1.The study that treats light as rays

a. Quantum optics interaction of light and matter;
absorption and generation of light source
b. Physical optics physical properties of light
c. Geometric optics
d. Refractive optics
1. When light travels from a medium of higher
refractive index to a medium of lower refractive
index:
a. It bends away from the normal.
b. It bends towards the mirrorized surface.
c. It bends away from the mirrorized surface.
d. It bends towards the normal. light travels from
the medium of lower refractive index to a medium of
higher refractive index
2. Prisms bend light
a. Towards the base
b. Away from the base
c. Towards the apex
d. Away from the mirrorized surface
3. The focal length of a convex lens with a refractive
power of 2.00 D
a. 0.25 meter
b. 0.50 meter
c. 0.75 meter
d. 1.0 meter
Formula = 1/dioptre(meters) = 1 / 2 = 0.50 meter
4. Most common types of myopia
a. Corneal
b. Axial
c. Lenticular
d. Peripheral
6. Myopic non-invasive correction that provides the
best quality of vision
a. Contact lens Better optically because it moves
with your eye and is better cosmetically.

July 24, 2013

b. LASIK
c. Glasses
d. Clear lens extraction with intraocular lens
implantation
7. Myopic correction is accomplished with
a. Convex lenses for hyperopic correction
b. Concave lenses this should be the answer???
c. Toric lenses for astigmatism
d. Cylinders
8. The focal point in an uncorrected myope is located
a. before the retina
b. after the retina - hyperopia
c. On the retina
d. before and after the retina
9. Flat corneal curvatures are associated with
a. hyperopia
b. myopia cornea is steep
c. presbyopia
d. metamorphopsia
10. Correction for hyperopia is accomplished with
a. minus lens - myopia
b. plus lens
c. combination of concave and cylindrical lenses
d. flat lenses
11. One of the following cannot be used to correct
astigmatism
a. Presbyopic reading glasses for presbyopia
b. Toric contact lenses
c. Cylinder spectacle lenses
d. Cataract extraction with toric intraocular lens
implantation
12. Far-sighted individuals
a. have long eyeballs near-sighted individuals
b. have to bring objects closer to see them clearly near-sighted individuals
c. have narrow slit-like palpebral fissures
d. have short eyeballs

13. individuals with astigmatism

during accommodation

a. see better with convex lenses - hyperopia

b. see better with concave lenses - myopia
c. see better through pinholes
d. see better at night

a. Lens epithelium responsible for continuous

growth of the lens
b. Lens capsule
c. Cortical fibers
d. Nucleus

14. Astigmatism
a. is characterized by having multiple focal points
b. cannot be corrected with contact lenses
c. can result from conjunctival redness
d. treated best with clear lens extraction with
accommodative intraocular lens implantation

20. Phacolytic glaucoma is associated with?

a. Intumescent lens
b. Hypermature cataract
c. Incipient lens
d. Ectopia lentis

15. A condition characterized by difficulty in reading

fine print resulting from loss of crystalline lens:

In phacolytic glaucoma, there is hypermaturity of the

lens that would lead to shrinkage of the lens.

a. cataract clouding of the lens of the eye or of its

surrounding transparent membrane that obstructs the
passage of light
b. presbyopia
c. myopia cornea is too steep, eyeball is to long, light
focus in front of the retina
d.astigmatism having multiple focal points

21. Which of the following is a disadvantage of

phacoemulsification?
a. Less astigmatism
b. Less risk of expulsive hemorrhages
c. Small incision
d. Machine dependent

16. Which of the following is FALSE about the

Human crystalline lens?
a. Located behind the iris and pupil
b. Avacular
c. Biconcave structure Lens is clear, transparent and
biconvex
d.Held in place by the zonular fibers
17. which of the following is NOT TRUE about the
adult lens?
a. Approximately 9.5 10mm in diameter
b. Dehydrated structure
c. Slow growth
d. The lens capsule becomes more elastic
Lens are very elastic in young age.
18. Which of the following chemical changes occur in
MATURE CATARACT?
a.Decreases in Na+ ion + water, increases in K+ and
soluble proteins
b. Increases in Na+ ion + water, losses of K+ ions +
soluble proteins
c. Increases in Na+ ion + water, decreases in K+ ions +
soluble proteins
d. No disruption of lens chemistry
19. Responsible for changing the shape of the lens

Questions 22-23
22. A 90 year old male was diagnosed to have
Bilateral mature nuclear cataract. Visual acuity are
light perception. Which of the following pre-operative
test is not recommended?
a. A-scan Biometry
b. Ultra sonography (B-scan)
c. Specular microscopy
d. Ocular coherent tomography (OCT)
23. In the above mentioned case, what type of cataract
operation is recommended?
a. ICCE (Intracapsular cataract extraction) with
ACIOL implantation
b. ECCE (Extracapsular cataract extraction) w/
PCIOL implantation.
c. Phacoemulsification with PCIOLimplantation
d. Lensectomy + pars plana vitrectomy
Anterior capsule, nucleus and cortex is removed, leaving
behind the posterior capsule to support the intraocular lens
that will be placed in the empty capsular bag.

24. Which of the following is not associated with

anterior subcapsular cataract?
a. Chronic anterior uveitis
b. Acute congestive angle closure glaucoma
c. Blunt eye trauma

d. Prolong used of corticosteroid associated with

posterior subcapsular cataract; other associations are
DM, trauma, inflammation and irradiation
Anterior subcapsular cataract is associated with
increased IOP.
25. A 75 year old male comes in complaining of
difficulty in driving caused by decreased distance
vision. He claims that his near vision improved. This
is more consistent with?
a. Anterior subcapsular cataract near vision is
affected, good far vision
b. Posterior subcapsular cataract near vision is
affected, good far vision
c. Nuclear sclerotic cataract - far vision is affected,
good near vision
d. Cortical cataract late blurring of vision
26. Which of the following is not associated with
ectopia lentis?
a. Marfans syndrome
b. Homocystinuria
c. Lowes syndrome
d. Weill-Marchesani syndrome
Causes of ectopia lentis can be either 1. Familial
Marfans and Homocystinuria or 2. Eye disease and
trauma(blunt or surgical - Iridodonesis
27. The following are ocular features of Marfans
syndrome, except:
a. Retinal detachment
b.Lenticular Myopia
c. Lens subluxation which is typically downwards
d. Hypoplasia of the dilator papillae
In

Marfans syndrome it should be vertical

displacement/ upward subluxation of lens

28. The most common systemic disease associated

with episcleritis is:
a. Rheumatoid arthritis
b. Inflammatory bowel disease
c. Lupus
d. Herpes zoster virus
29. For a patient with recurrent episcleritis, one
should:
a. Give topical lubricating eyedrops

b. Apply topical vasoconstrictors

c. Consider systemic work-up for infectious or
autoimmune diseases
d. Prescribe topical NSAIDS
letter (b) apply topical vasoconstrictors is given if
symptomatic ; letter (a) give topical lubricating eyedrops
and fluoromethalone eye drops being weak topical steroids
are given to mild to moderate cases. For severe form give
stronger steroids as Prenisolone Acetate eye drops

30.

Complications of necrotizing scleritis with

inflammation include(s):

a. Glaucoma
b. Cataract
c. Sclerosing keratitis
d. All of these
Complication also includes sclera melting. In necrotizing
scleritis, there is sclera necrosis with thinning and melting of
the sclera. With inflammation indicates red, painful eye,
with whitish patch of necrotizing area of sclera (thin and
imperforate), associated with anterior uveitis, autoimmune
disorder.

31. A patient presents with decreased vision and

proptosis with minimal to no pain. Review of systems
does not point to any systemic disease. On
examination, there are restricted ocular movements.
Fundoscopy reveals posterior vitritis, optic disc
edema and exudative retinal detachment. B-scan
ultrasound shows a thickened sclera. One should
suspect:
a. Posterior uveitis
b. Anterior staphyloma
c. Thyroid orbitopathy
d. Posterior scleritis
Findings are consistent with Posterior scleritis, which
is the inflammation with thickening of the posterior
sclera. Restricted ocular movements, proptosis,
posterior vitritis , optic disc edema, macular edema.
Fundoscopy visualizes edema and hemorrhage.
32. Which of the following is NOT an accepted
treatment for posterior scleritis
a. Intravenous methylprednisolone
b. Subconjunctival triameinolone injections
c. Antibiotics for infectious sclera disorders
d. Oral Prednisone (steroids)

Subconjunctival injections are CONTRAINDICATED for

posterior scleritis, these are only effective for anterior
scleritis

33. Which of the following is NOT TRUE regarding

treatment outcomes in cases of scleritis?
a. Rapid response to therapy is expected
b. Visual loss may happen in 10-85% of cases
c. Glaucoma and cataracts may occur as complications
in up to 20% of cases
d. Corneal melting is common in these cases
34. A patient presents with an ocular staphyloma.
Examination reveals iris incarceration. This
patient has:

Iritis or iridocyclitis is under anterior uveitis and is the most

common type of uveitis.

37. In observing anterior chamber cells, one can note

that the cells closer to the iris and the lens moves
upward and those close to the corneal endothelium
move downward. This is due to:
a. The aqueous humor drainage mechanism
b. Convection currents, since it is warmer at the
back of the eye
c. The relatively lighter weight of the white blood
cells as opposed to the red blood cells
d. The inflammatory process in the choroid of the eye
38. A condition that may appear as or masquerade as
uveitis is:

a. Anterior staphyloma
Staphyloma is characterized by an ectasia of the outer coats
(cornea, sclera or both) with an incarceration of uveal tissue.
Caused by weakening of outer wall and raised IOP.
Equatorial staphyloma, is located at the equator behind the
limbus. Posterior Staphyloma is commonly seen near optic
nerve and produces choroidal atrophy and subretinal
neovascularizaton.

35. Of the following congenital and developmental

anomalies involving the iris, which is commonly
associated with anterior uveitis?
a. Aniridia this is the incomplete formation of the
iris
b. Congenital ectropion uvea linked withy
appearance of progressive open-angle
glaucoma due to angle dysgenesis
c. Rubeosisiridis abnormal redness of iris,
d. Heterochromia iridis
Heterochromia iridis refers to difference in coloration of the
eye due to excess or lack of melanin. Patient would complain
of redness, pain and photophobia with blurring of vision.
Remember that uveitis would include symptoms of eye pain,
photophobia, decreased/blurred vision and seeing floaters in
field of vision

36. The most common type of uveitis is:

a. Iritis or iridocyclitis
b. Intermediate uveitis
c. Posterior uveitis back of the eye
d. Panuveitis - uveitis affecting all three layers of retina

a. Lymphoma
b. Pigmentary dipersion
c. Hyphema
d. Vitreous hemorrhage
39. Which of the following is NOT TRUE of Pediatric
Uveitis?
a. A cause is found in almost 50-65% of cases of
pediatric uveitis
b. According to anatomic location, the incidence of
pediatric uveitis is highest in the posterior
uvea of children
c. Juvenile Rheumatoid Arthritis (JRA) is the most
common identified cause, accounting for almost
12% of all uveitis cases in children
d. Toxoplasmosis is the most commonly identified
infectious cause of uveitis in children
JRA is the most common identified cause, but accounts for
40% of total uveitis in children.

40. The most common intraocular malignancy in

adults is:
a. Retinoblastoma
b. Melanoma
c.Lymphoma
d. Metastatic Carcinoma
41. The simultaneous movement of the eyes is called:
a. version
b.vergence

c. abduction movement of eye temporally

d. adduction- movement of eye nasally
42. The simultaneous movement of the eyes directed
to an object in the mid body plane:
a. version
b. vergence
c.abduction
d. adduction
43. Electro-oculography or EOG:
a. used to evaluate the condition of the retinal
pigment epithelium and photoreceptors
b. used to evaluate the condition of the outer layers of
the retina
c. Used to evaluate the response of the macula and the
optic nerve
d. all of the above
44. Electroretinography or ERG
a. used to evaluate the condition of the retinal
pigment epithelium and photoreceptors
b. used to evaluate the condition of the outer layers
of the retina
c. Used to evaluate the response of the macula and the
optic nerve
d. all of the above
45. Visual Evoked Response or VER
a. used to evaluate the condition of the retinal
pigment epithelium and photoreceptors
b. used to evaluate the condition of the outer layers of
the retina
c. Used to evaluate the response of the macula and
the optic nerve
d. all of the above
46. Electromagnetic radiation consisting of massless
particles absorbed by the rods and cones:
a. neutrons
b. electrons
c. photons
d. atoms
photons with energy corresponding to wavelength of
400-700nm pass through cornea, lens and vitreous
until absorbed by rods and cones. Red light (570nm)
green light (535nm) Blue light (440nm)

47. Photopic vision is mainly due to

a. rods
b. cones
c. both rods and cones
d. none of the above
48. Scotopic vision is mainly due to:
a. rods
b. cones
c. both rods and cones
d. none of the above
49. The process by which light absorbed by the
photoreceptors is converted to electrical
energy:
a. Photography
b. Visual transduction
c. propagation of energy
d. bleaching
This potential is amplified and modulated in the retina and
propagated to the brain via optic nerve.

50. The main source of nutrition of the sclera:

a. tears
b. cornea
c. episclera
d. conjunctiva
Sclera, is the fibrous outer layer of the eye made up of
collagen, dead tissue and serves as protective shell for
intraocular contents. Episclera covers sclera and protect
structures of the eyes, it is made of a thin layer of fine elastic
tissue which contains blood vessels.

51. The cornea is transparent because of its:

a. avascularity
b. deturgescence
c. both of the above
d. none of the above
52. Functions of the aqueous humor:
a. maintains intraocular pressure
b. provides metabolism to the lens
c. keeps the posterior cornea healthy
d. all of the above
53. The primary function of the lens is to focus light
rays upon the retina. Its transparency is due to:
a. acellularity
b. same refractive index

c. all of the above

d. none of the above
54. Vitreous humor makes up the largest volume of
the eye. It consists of:
a. 99% water and 1% collagen and
hyaluronic acid
b. 1% water and 99% collagen and
hyaluronic acid
c. 50% water and 50% collagen and
hyaluronic acid
d. 95% water and 5% collagen and
hyaluronic acid
55. The site of detailed vision in the retina:
a. ora serrata
b. macula
c. retinal pigment epithelium
d. none of the above
56. The entrance height of the orbit is:
a. 30 mm
b. 35 mm
c. 40 mm
d. 45 mm
57. The strongest orbital wall is:
a. roof
b. medial
c. floor
d. lateral
58. A 38 year old male sought consult due to gradual,
non-tender, proptosis of the right eye. You suspect a
mass behind the eye. What is the most valuable
imaging procedure to request for in this case?
a. orbital x-ray
b. orbital CT scan
c. orbital ultrasound
d. orbital MRI
59. A 7 y/o female was brought for consult due to
swelling of the left upper eyelid. The mother claims
that it started out as a pimple in the left upper lid.
Upon examination, a soft, diffuse, erythematous,
tender swelling was noted on the left upper lid.
Vision was not affected, extraocular movements were
intact. What is your most probable diagnosis?
a. chelazion
b. blepharitis
c. pre-septal cellulitis
d. orbital cellulitis
If the extraocular movements and vision were affected, the
answer would be D.
60. The most common clinical sign in Thyroid
Orbitopathy is
a. proptosis
b. lid retraction
c. exposure keratopathy

d. compressive optic neuropathy

A is the most common clinical sign of Graves
61. A 52 year old male sought consult due to bilateral
swelling of both upper eyelids. On CT scan,
enlargement of both lacrimal glands were present.
What is the most likely diagnosis?
a. dermoid cyst
b. dacryoadenitis
c. dacrocystitis
d. pre septal cellulitis
C would be inflammation of the lacrimal sac, not the glands
62. What is the most common benign neoplasm of the
orbit in adults
a. capillary hemangioma
b. cavernous hemangioma
c. optic nerve glioma
d. optic nerve meningioma
63. A blow-out fracture of the orbit occurs when an
external force like a fist or a hard object hits the
orbital rim. Which of the following walls of the orbit
is most likely to be fractured first?
a. roof
b. medial
c. floor
d. lateral
64. Anophthalmos or absence of the globe is usually
due to surgical removal of the eye due to trauma,
tumors of a blind painful eye. This procedure entails
removal of the whole eye only.
a. excision
b. evisceration
c. enucleation
d. exenteration
65. A 66 year old male complained of FB (foreign
body) sensation on the left eye. Upon examination,
the left lower eyelid margin was noted to turn inward
causing irritation to the cornea. What is the most
likely diagnosis?
a. entropion
b. ectropion
c. ptosis
d. dermatochalasis
A is inward motion, outward motion is ectropoin
66. A small abscess caused by an acute staphylococcal
infection of the meibomian gland is called
a. anterior blephritis
b. chalazion
c. external hordeolum
d. internal hordeolum
Meibomian gland = internal

67. What is the most common eyelid malignancy

a. basal cell carcinoma
b. squamous cell carcinoma
c. sebaceous gland carcinoma
d. malignant melanoma

74. The first step in history taking is

a. getting the chief complaint
b. getting the identifying data of the patient
c. establishing rapport
d. getting the details of the problem

68. A 48 year old male sought consult due to multiple

yellowish plaques in the medial canthal areas of both
eyelids. Patient disclosed that he has high cholesterol
levels. What is the most likely diagnosis
a. seborrheic keratosis
b. molluscum contagiosum
c. dermal nevus
d. xanthelesma

75. The mnemonic C-O-L-D-E-R in history taking

includes:
a. limitation
b. onset
c. complications
d. reason for visit

69. What is the average length of the canaliculi

a. 1-2 mm
b. 3-6 mm
c. 8-12 mm
d. 12-15 mm
70. A 34 year old male sought consult due to purulent
discharge on the left eye. On examination, the
punctum appears erythematous and pouting.
Purulent discharge is also noted. The most common
pathogen involved
a. Staphylococcus aureus
b. Sreptococcus sp
c. Actinomyces israelii found in the
canaliculi
d. Neisseria gonorrhoea
71. All of the following are components of the ocular
history, except
a. Chief complaint
b. History of present illness
c. Family history
d. None
72. If the patient for interview is a child, the examiner
a. should interview the child alone
b. may talk to the guardian or parent for
history taking
c. should not continue with the history
taking
73. The chief complaint includes:
a. main problem of the patient, laterality,
and duration of symptoms
b. 3 symptoms of the patient, duration and
minimal history
c. only the main problem of the patient
d. complete details of the problem

76. The mnemoic C-O-L-D-E-R in history taking

includes:
a. Limitation
c. Complications
b. Onset
d.
Reason for visit
Character (quality, severity, associated s/sx)
Onset (sudden, gradual, morning or nighttime)
Location/Laterality
Duration (approximation of existence of symptoms)
Exacerbation
Relief

77. Importance of the Review of Systems include:

a. To be able to review other symptoms
b. Enables the physician to catch more clues
c. To be able to get details that the physician may
have missed during the HPI
d. all of the above
78. Intake of which medication may cause optic
neuropathies?
a. Diamicron
b. Prednisone
c. Ethambutol
d. Metoprolol
Ethambutol has the following side effects:allergic reactions
(difficulty breathing; closing of the throat; swelling of the lips,
tongue, or face; or hives); vision changes (e.g., blurring, redgreen color blindness); a rash; numbness or tingling in your
fingers, toes, hands, or feet; confusion, disorientation, or
hallucinations; or fever.

79. Instillation of which medication may cause lens

opacities?
a. Atropine
b. Steroids
c. Anti-glaucoma medications
d. Antibiotic ointments

80. Instillation of which medication may cause

increase in intraocular pressure?
a. Atropine
b. Steroids
c. Anti-glaucoma medications
d. Antibiotic ointments
81. The 8 elements of HPI include all, except:
a. Diagnosis
b. Quality
c. Severity
d. Location
Location, Quality, Severity, Duration, Timing, Context,
Modifying Factors, Associated signs & symptoms
82. In taking the Past Ocular History, it is important
to note the:
a. Previous refraction/use of glasses
b. Previous eye trauma
c. Previous eye surgery
d. All of the above
83. Your patient complains of proptosis of both eyes.
One of the things you should be asking about our
patient is:
a. Family history of cataract
b. Family history of glaucoma
c. History of thyroid problem
d. History of hypertension
Most common cause of unilateral/bilateral proptosis
inadults, so when you see proptosis, think of the thyroid
first!
84. Which of the following eye conditions may be
hereditary?
a. Myopic eye of refraction
b. Glaucoma
c. Optic Neuropathy
d. All of the above
85. Amiodarone causes which of the following ocular
complications?
a. Corneal opacity
b. Lens opacity
c. Optic Neuropathy
d. All of the above

Side effects of Amiodarone: The most commonly affected

ocular structure is the cornea with punctuate opacities
occurring in 69% to 100% of patients. Lenticular changes
may include anterior, subcapsular, small, yellow-white
punctuate opacities.
86. The main purpose of the most anterior tear film
layer is to:
a. Product of antibodies
b. Prevent the evaporation of the aqueous layer of
the tear film
c. Act as the primary refractive media of the eye
d. Promote adhesion of the tear film to the microvilli
in the surface of the cornea
87. The mucin secretion of the goblet cells by the
conjunctiva forms the:
a. Anterior layer of the tears
b. Middle layer of the tears
c. Inner layer of tears
d. Sub-epithelial layer of the tears
88. The tear film composition, from the anterior to the
posterior layer, is arranged anatomically and
functionally as follows:
a. Hydrophobic hydrophilic hydrophobic
b. Hydrophilic hydrophobic hydrophilic
c. Hydrophilic hydrophilic hydrophobic
d. Hydrophobic hydrophobic hydrophilic
89. The average volume of tears produced per minute
in a normal individual is:
a. 1 microliter
b. 1.5 milliliters
c. 2 microliters
d. 2.5 milliliters
90. The most anterior portion of the human visual axis
is/are the:
a. Eyelashes
b. Eyelids
c. Cornea
d. Tear film
91. The aqueous layer of the tear film is produced by
the lacrimal gland and the accessory glands of Krause
and:
a. Wolvering
b. Wolfring
c. Wolling
d. Wolning

92. The lipid layer of the tears is produced by the

meibomian glands and the accessory glands of Zeiss
and:
a. Mole
b. Mohr
c. Moll
d. Avascularity
94. In the human visual axis, the highest refractive
power is seen in the:
a. Tear film
b. Cornea
c. Aqueous humor
d. Lens
The cornea is the principal refractive tissue (2/3 of the total
refractive power of the eye)
95. The strongest layer of the cornea is its:
a. Epithelium
b. Bowmans layer
c. Descements membrane
d. Corneal stroma
96. Types of inflammation of the eyelids include:
a. Meibomianitis
b. Seborrheic blepharitis
c. Demodactic blepharitis
d. All of these
97. Diffuse redness from blood vessels that is usually
more prominent peripherally, tending to fade as the
limbus is approached is called:
a. Conjunctival injection
b. Ciliary injection

c. Chemosis
d. Chalazion
98. Which of the following is a secretion of globlet
cells seen as a sticky clear material seen on the ocular
surface?
a. Tears
b. Mucus
c. Mucopus
d. Purulent discharge
99. An amaurotic pupil is a patient with RAPD is
recorded as having a:
a. 1+defect
b. 2+defect
c. 3+defect
d. 4+defect
Grading Scale: RAPD
Grade 1+: A weak initial pupillary constriction followed by
greater redilation
Grade 2+: An initial pupillary stall followed by greater
redilation
Grade 3+: An immediate pupillary dilation
Grade 4+: No reaction to light Amaurotic pupil
100. If macular disease is suspected, visual fields are
tested using:
a. Snellens chart for visual acuity (far vision)
b. Jaegar chart for visual acuity (near vision)
c. Amsler grid - a grid of horizontal and vertical lines
used to monitor a person's central visual field
d. Allen chart pediatric chart for measuring visual
acuity