Practice Paper of NEET PG: Important Questions of OPHTHALMOLOGY

The Important Questions of for OPHTHALMOLOGY NEET PG exam:

1. Which of the following is true regarding Mittendorf dot?
A. Glial tissue projecting from optic disc
B. Obliterated vessel running forward into the vitreous
C. Associated with posterior polar cataract
D. Commonest congenital anomaly of hyaloid system

Anatomy of the eye – Hyaloid canal is visible

Correct answer : C. Associated with posterior polar cataract

  • Mittendorf dot is a remnant of the anterior end of hyaloid artery.
  • It is attached to the posterior lens capsule.
  • It is associated with posterior polar cataract.

 

2. All of the following are seen in Favre-Goldmann syndrome except?
A. Ectopia lentis
B. Retinoschisis
C. Nyctalopia
D. Pigmentary changes similar to retinitis pigmentosa

Correct answer : A. Ectopia lentis

  • Favre-Goldmann syndrome is an autosomal recessive condition.
  • It usually presents in childhood with nyctalopia.
  • Central and peripheral retinoschisis is present.
  • There is marked pigmentary changes similar to retinitis pigmentosa.

 

3. Axenfeld anomaly is seen in glaucoma associated with?
A. Aniridia
B. Phakomatosis
C. Ectopia lentis
D. Iridocorneal dysgenesis

Correct answer : D. Iridocorneal dysgenesis

Features of Axenfeld syndrome – a.Microdontia and hypodontia; b.Slit pupil and iris atrophy; c.Corectopia with iris atrophy; d,e.Posterior embryotoxon;  f.Broad peripheral anterior synechiae.

  • Axenfeld anomaly is seen in glaucoma associated with iridocorneal dysgenesis.
  • It is a posterior embryotoxon characterised by prominent Schwalbe’s ring.

 

4. Stocker’s line is seen in?
A. Pinguecula
B. Trachoma
C. Pterygium
D. Concretions

Correct answer : C. Pterygium

Pterygium extending into pupillary area

  • Pterygium is usually seen in elderly males and it presents as a triangular fold of conjunctiva which encroaches the cornea.
  • It is usually seen on the nasal side.
  • Stocker’s line is a deposition of iron seen in corneal epithelium anterior to advancing head of pterygium.

5. Cogan’s syndrome is associated with?
A. Keratitis
B. Conjunctivitis
C. Iritis
D. Myopia

Correct answer : A. Keratitis

  • Cogan’s syndrome is seen in middle aged adults.
  • The features include interstitial keratitis, acute tinnitus, vertigo and deafness.
  • Treatment is by usage of topical and systemic corticosteroids.
  • Early treatment is necessary to prevent permanent deafness and blindness.

 

6. All of the following are anterior dystrophies except?
A. Reis-Buckler’s dystrophy
B. Meesmann’s dystrophy
C. Schnyder’s dystrophy
D. Stocker-Holt’s dystrophy

Correct answer : C. Schnyder’s dystrophy

Reis-Buckler’s dystrophy – reticular opacity of the cornea

  • Anterior (superficial) corneal dystrophy affects epithelium and Bowman’s layer.
  • Examples include Reis-Buckler’s dystrophy, Meesmann’s dystrophy and Stocker-Holt’s dystrophy.
  • Schnyder’s dystrophy is a crystalline stromal dystrophy.

 

7. Which of the following is seen in Lowe’s syndrome?
A. Glaucoma
B. Choroiditis
C. Secondary cataract
D. Myopia

Correct answer : A. Glaucoma

Lowe’s syndrome has X-linked recessive inheritance.

  • Lowe’s syndrome is oculo-cerebro-renal syndrome.
  • It is an inborn error of amino acid metabolism.
  • Congenital cataract and glaucoma are the ocular features.
  • Mental retardation, dwarfism, osteomalacia and muscular hypotonia are the other features seen in this syndrome.

 

8. Gunn sign is?
A. Silver wiring of arterioles
B. Deflection of veins at arteriovenous crossing
C. Copper wiring of arterioles
D. Tapering of veins on the either side of the crossings

Correct answer : D. Tapering of veins on the either side of the crossings

Fundus picture in hypertensive retinopathy

  • Gunn sign is seen in grade III hypertensive retinopathy.
  • The other findings in grade III hypertensive retinopathy include
    • copper wiring of arterioles
    • banking of veins distal to arteriovenous crossings
    • right-angle deflection of veins
    • flame shaped haemorrhages
    • cotton wool spots
    • hard exudates.

 

9. Weiss operation is done for?
A. Cicatricial entropion
B. Senile entropion
C. Senile ectropion
D. Cicatricial ectropion

Correct answer : B. Senile entropion

  • Weiss operation is done for senile entropion.
  • An incision is placed 3mm below the lid margin extending along the whole length of the eyelid.
  • It involved the skin, orbicularis and the tarsal plate.
  • Mattress sutures are used for correcting the entropion by transpositioning the tarsus.

 

10. Bilateral granulomatous panuveitis is seen in?
A. Heerfordt’s syndrome
B. Reiter’s syndrome
C. Behcet’s disease
D. Toxoplasmosis

Correct answer : A. Heerfordt’s syndrome

  • Bilateral granulomatous panuveitis is seen in Heerfordt’s syndrome (Uveoparotid fever).
  • It is also associated with painful enlargement of parotid glands.
  • Cranial nerve palsy, fever, malaise and skin rashes are also seen.

 

11. Appendages of the eyes include all except?
A. Lacrimal gland
B. Eyelids
C. Eyebrows
D. Extraocular muscles

Correct answer : D. Extraocular muscles

 

Appendages of the eyes (adnexa of the eye / accessory visual structures) are:

  • Eyelids
  • Eyebrows
  • Conjunctiva
  • Lacrimal apparatus

 

12. Ophthalmoplegic migraine is best characterised as?
A. Recurrent headache with transient palsy of ophthalmic nerve
B. Headache associated with irreversible palsy of 3rd nerve
C. Recurrent headache with transient palsy of 3, 4 and / or 6th cranial nerves
D. Headache with optic neuritis

Correct answer : C. Recurrent headache with transient palsy of 3, 4 and / or 6th cranial nerves

OPHTHALMOPLEGIC MIGRAINE

  • It is  a rare condition which was previously considered as a type of migraine.
  • Recent studies suggest that is it likely to be an inflammatory cranial neuropathy.
  • The International Headache Classification has reclassified ophthalmoplegic migraine as a type of neuralgia from its earlier classification as a type of migraine.
  • It is characterised by transient migraine like headache associated with paresis of oculomotor, trochlear and/or abducens nerves.
  • To arrive at a diagnosis of ophthalmoplegic migraine, other causes should be ruled out by appropriate investigations (like digital subtraction angiography / magnetic resonance angiography of the brain).

 

13. False about Argyll Robertson Pupil is?
A. Accommodation reflex normal
B. Direct pupillary reflex absent
C. Indirect pupillary reflex normal
D. Visual acuity normal

Correct answer : C. Indirect pupillary reflex normal

ARGYLL ROBERTSON PUPIL (ARP)

  • It is characterised by bilateral constricted pupils.
  • Accommodation reflex (near reflex) is normal.
  • Pupillary reflex (light reflex) – both direct and indirect – are absent.
  • This feature is known as light – near dissociation.
  • ARP was first described in neurosyphilis by Douglas Moray Cooper Lamb Argyll Robertson, a Scottish Ophthalmologist.
  • It is also seen in other conditions like encephalitis, diabetic neuropathy, multiple sclerosis, stroke etc.

Site of lesion:

  • It occurs due to damage to fibers which travel from the pretectal part of midbrain to the Edinger Westphal nucleus.
  • The rostral fibers which are responsible for the light reflex are affected.
  • But the caudal fibers which facilitate the accommodation reflex are not affected.
  • Hence the light reflex is absent and accommodation reflex is present.

 

14. Which of the following is false regarding intraocular retinoblastoma?

A. 94% cases are sporadic
B. Individuals with sporadic retinoblastoma do not pass their genes to their children
C. Reese Ellsworth classification is used for predicting visual prognosis following radiotherapy
D. Tumour calcification can be detected by an ultrasound scan

Correct answer : B. Individuals with sporadic retinoblastoma do not pass their genes to their children

One third of sporadic cases of retinoblastoma are heritable. The remaining sporadic cases do not pass their genes to their children.

15. Bitemporal hemianopia is a characteristic feature of?

A. Glaucoma
B. Optic neuritis
C. Pituitary tumour
D. Retinitis pigmentosa

Correct answer : c) Pituitary tumour

Pituitary tumours compress the optic chiasma and cause bitemporal hemianopia.

 

16. Diplopia in superior oblique palsy is?

A. Vertical diplopia on downward gaze
B. Vertical diplopia on upward gaze
C. Horizontal diplopia on inward gaze
D. Horizontal diplopia on outward gaze

Correct answer : A. Vertical diplopia on downward gaze

DIPLOPIA IN SUPERIOR OBLIQUE PALSY

  • In paralysis of the superior oblique muscle (trochlear nerve palsy), maximum diplopia is experienced when the patient looks down.
  • This is especially important when the patient tries to climb downstairs and when trying to read a book.
  • The patient tries to compensate by tucking the chin towards the chest.

 

17. Which of the following is a topical NSAID for ophthalmic use?

A. Ibuprofen
B. Diflunisal
C. Nepafenac
D. Oxaprozin

Correct answer : C. Nepafenac

Nepafenac is a topically administered NSAID sold as 0.1% eye drops. It is used for the treatment of pain and inflammation in patients undergoing cataract surgery. Nepafenac is a prodrug of amfenac which has COX-1 and COX-2 inhibitor activity. Treatment is started 1 day prior to cataract surgery and is continued 2 weeks postoperatively. Side effects include foreign body sensation and decreased visual acuity.

 

18. Arden index is used for interpretation of?

A. Visual evoked response

B. Electrooculogram

C. Electroretinogram

D. Visual field charting

Correct answer : B. Electrooculogram

Arden index is used for interpretation of an electrooculogram.

 

19. All of the following are involved in endophthalmitis except?

A. Retina

B. Vitreous

C. Sclera

D. Uvea

Correct answer : C. Sclera

Endophthalmitis does not involve the scleral coat of the eye. Sclera in involved only in panophthalmitis.

 

20. Organism most commonly implicated in Late onset endophthalmitis after cataract surgery is?

A. Pseudomonas aeruginosa

B. Staphylococcus epidermidis

C. Candida albicans

D. Propionibacterium acnes

Correct answer : D. Propionibacterium acnes

Propionibacterium acnes is a gram positive, non spore forming bacillus which is most commonly implicated in Late onset endophthalmitis after cataract surgery.

 

21. An 18 year old boy comes to the eye casuality with history of injury with a tennis ball. On examination there is no perforation but there is hyphaema. The most likely source of the blood is
A. Iris vessels
B. Circulus iridis major
C. Circulus iridis minor
D. Short posterior ciliary vessels

Correct answer : B. Circulus iridis major

 

22. In Von Hippel Lindau Syndrome, the retinal vascular tumours are often associated with intracranial hemangioblastoma. Which one of the following regions is associated with such vascular abnormalities in this syndrome?
A. Optic radiation
B. Optic tract
C. Cerebellum
D. Pulvinar

Correct answer : C. Cerebellum

 

23. The mother of a one and a half year old child gives history of a white reflex from one eye for the past 1 month. On computed tomography scan of the orbit there is calcification seen within the globe. The most likely diagnosis is:
A. Congenital cataract
B. Retinoblastoma
C. Endophtalmitis
D. Coats disease

Correct answer : B. Retinoblastoma

1 1/2 year old child with white reflex and calcification in the eye is diagnostic of retinoblastoma.

 

24. Enlarged corneal nerves may be seen in all of the following except:
A. Keratoconus
B. Herpes simplex keratitis
C. Leprosy
D. Neurofibromatosis

Correct answer : B. Herpes simplex keratitis

25. Contact lens wear is proven to have deleterious effects on the comeal physiology. Which of the following statements is incorrect in connection with contact lens wear?
A. The level of glucose availability in the corneal epithelium is reduced
B. There is a reduction in hemidesmosome density
C. There is increased production of CO2 in the epithelium
D. There is a reduction in glucose utilization by corneal epithelium

Correct answer : A. The level of glucose availability in the corneal epithelium is reduced

Contact lens wear decreases gas exchange across the anterior surface of cornea resulting in hypoxia and hypercapnia. In the hypoxic state there is decrease in glucose utilisation. But there is no decrease in glucose availability as it occurs through the aqueous humour on the posterior surface of cornea. Also, there is decreased epithelial cell adhesion due to decrease in hemidesmosome density.

 

26. Which of the following statement is true regarding Acanthamoeba keratitis?
A. For the isolation of the causative agent, corneal scraping should be cultured on a nutrient agar plate
B. The causative agent, Acanthamoeba is a helminth whose normal habitat is soil
C. Keratitis due to Acanthamoeba is not seen in the immunocompromised host
D. Acanthamoeba does not depend upon a human host for the completion of its life-cycle

Correct answer : D. Acanthamoeba does not depend upon a human host for the completion of its life-cycle

 

27. A 25 year old male gives history of sudden painless loss of vision in one eye for the past 2 weeks. There is no history of trauma. On examination the anterior segment is normal but there is no fundal glow. Which one of the following is the most likely cause?
A. Vitreous haemorrhage
B. Optic atrophy
C. Developmental cataract
D. Acute attack of angle closure glaucoma

Correct answer : A. Vitreous haemorrhage

Among the options given, only vitreous haemorrhage causes sudden painless loss of vision.

 

28. A 30 year old man has 6/5 vision each eye, unaided. His cycloplegic retinoscopy is +1.0 D sph. at 1 metre distance. His complaints are blurring of newsprint at 30 cm, that clears up in about two minutes. The most probable diagnosis is:
A. Hypermetropia
B. Presbyopia
C. Accommodative inertia
D. Cycloplegia

Correct answer : C. Accommodative inertia

His distant vision is normal. He has blurring of newsprint at 30cm distance for 2 minutes. This is due to accommodative inertia. His accommodation system takes some time to focus on near objects. (Normally it should take only 1 second).

 

29. Horner’s syndrome is characterized by all of the following except:
A. Miosis
B. Enopthalmos
C. Ptosis
D. Cycloplegia

Correct answer : D. Cycloplegia

Components of horner’s syndrome –

  • Ptosis
  • Miosis
  • Anhidrosis
  • Enophthalmos
  • Loss of ciliospinal reflex

 

30. The most common second malignancy in survivors of retinoblastoma is:
A. Thyroid cancer
B. Nasopharyngeal carcinoma
C. Optic glioma
D. Osteosarcoma

Correct answer : D. Osteosarcoma

Osteosarcoma and retinoblastoma both can arise in those with RB gene mutation.

 

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