Test I (for final FRCOphth / MRCOphth)

1. Gorlin's syndrome:

a. Is an inherited ondition !. Is asso iated "ith m#ltiple !asal ell ar inoma . In reases the in iden e of atara t d. Is asso iated "ith li$er ar inoma e. In reases the ris% of retinal deta hment

&. 'osterior polymorpho#s dystrophy : a. Is present at !irth !. Ca#ses ore topia . Is inherited in an a#tosomal re essi$e fashion d. Ca#ses !lindness in o$er ()* of s#fferers e. Can !e treated "ith lamellar orneal +rafts

,. Crystalline deposits in the on-#n ti$a may !e fo#nd in: a. .myloidosis !. Cystinosis . Gold treatment d. Conta t lens "ear

e. /raemia

0. The histolo+y of ptery+i#m in l#des: a. My1oid de+eneration !. 2pithelial in l#sion !odies . 're an ero#s han+es d. 34#amo#s metaplasia of the epithlei#m e. 2lastoti de+eneration

5. The follo"in+ may !e fo#nd in on-#n ti$a in %erato on-#n ti$itis si a a. 6ysplasia of the epitheli#m !. 7eratinisation . 2osinophils d. 8#mero#s +o!let ells e. 9ympho yti infiltrates

:. Mer%el ell ar inoma: a. Is most ommon in the !#l!ar on-#n ti$a !. Is asso iated "ith +ood pro+nosis . Is an .'/6 ell t#mo#r

d. Is asso iated "ith #ltra$iolet e1pos#re e. 'rod# es orneal pi+mentation

;. <istolo+i al han+es in lens ind# ed #$eitis in l#de: a. Ghost ells !. Giant ell rea tion . .myloid in the ornea d. =as #litis e. 8on> aseatin+ +ran#loma

?. @eroderma pi+mentosa is asso iated "ith: a. Intrao# lar t#mo#rs !. Meta!oli disorders . 'hotosensiti$ity d. .#tosomal re essi$e inheritan e e. 34#amo#s ell ar inoma

(. 'atholo+i al han+es in thyroid ophthalmopathy in l#des: a. 9ympho yti infiltrates !. Giant ell rea tion

. M# opolysa harides d. Fat ells e. Fi!ro!last proliferation

1). In histolo+i al stains: a. Chlamydia in l#sion !odies stain "ith Giemsa !. Osmi#m tetro1ide is the stain #sed in ele tron mi ros opy . F#n+i stain "ith F#el+in's stain d. 2osin stains the n# lei !l#e e. <aemato1ylin stains the n# lei pin%

Cli % for ans"ers

11. 3ympatheti ophthalmitis a. Is hara terised !y 6ellen>F# hs' nod#le !. 're$ented !y remo$al of the e1 itin+ eye "ithin : "ee%s of in-#ry . 'i+ment laden ma ropha+es are dia+nosti d. Is asso iated "ith poliosis and $itili+o e. Is a ommon a#se of $is#al loss in tra#mati eye in-#ry

1&. .!normal material "hi h may !e present in the $itreo#s in l#de: a. 21foliation !. 9ipof#s in . <aemosiderin d. .myloidosis e. Cal i#m

1,. In +iant ell arteritis: a. <istolo+i al dia+nosis is !ased on fra+mentation of the internal intimal !. C>rea ti$e protein is al"ays raised . Giant ell is needed for dia+nosis d. .nterior ere!ral artery is often in$ol$ed e. .naemia is a feat#re

10. The follo"in+ onditions are pre>mali+nant: a. On o ytoma of the ar#n le !. . tini %eratosis . Ao"en's disease d. 34#amo#s papilloma e. 3yrin+oma

15. <ypo1i dama+e in dia!eti mellit#s is s#++ested !y: a. 8er$e fi!re layers haemorrha+e !. Iris neo$as #larisation . .nterior #$eitis d. =as #lar loop e. 6e reased hard e1#date

1:. The follo"in+ !iopsy report may !e fo#nd "ith rhe#matoid arthritis: a. 'osterior s leritis !. 9oss of +o!let ells in the on-#n ti$a . 2pis leral ne roti tiss#e d. Giant ell rea tion e. =as #litis

1;. The follo"in+ report is asso iated "ith in reased mortality in an en# leated eye "ith retino!lastoma: a. In$ol$ement of the opti ner$e !. 'resen e of al ifi ation "ithin the t#mo#rs . 8e rosis "ithin the t#mo#rs d. 21ophyti retino!lastoma e. 'resen e of retinal deta hment

1?. 6ia!eti mi roan+iopathy in l#de: a. 2ndothelial $as #lar proliferation !. 'roliferation of peri ytes asso iated "ith mi roane#rysms . 6eposition of al i#m in the intima d. Thi %enin+ of the !asement mem!rane e. 8e rosis of the endotheli#m

1(. Opti ner$e +lioma: a. Is asso iated "ith ne#rofi!romatosis type I !. In reased in iden e after ,) years old . Ma-ority is of pilo yti astro ytoma d. Rarely infiltrate the perine#ral tiss#e e. Mortality of 0)*

&). M#tton fat %erati pre ipitates are seen in: a. /$eal eff#sion syndrome !. T#!er #losis . F# h's hetero hromia y litis d. 3ar oidosis e. F#n+al infe tion

Cli % for ans"ers

&1. .l!inism: a. <air !#l! for tyrosine positi$ity test is #sef#l only "hen the hild is 5 years old !. Is asso iated "ith platelets a!normality espe ially "ith aspirin . Complete de #ssation is in$aria!le in all al!inism d. Is asso iated "ith throm!osis #nder +eneral anaesthesia e. Ca#ses ma #lar hypoplasia

&&. Infanitle +la# oma is asso iated "ith: a. .niridia !. 3t#r+e>Be!er syndrome . .l!inism d. .1ial iris stromal a!normality e. =on <ippel>9inda#'s syndrome

&,. The follo"in+ are tr#e a!o#t nysta+m#s: a. 3ee>sa" nysta+m#s is asso iated "ith homonymo#s hemianopia !. 6o"n>!eat nysta+m#s is asso iated "ith lesion in the foramen ma+n#m

. Manifest latent nysta+m#s o #r in #nilateral on+enital atara t d. GaCe>e$o%ed nysta+m#s is spe ifi for ere!ellar lesion e. Con$er+en e retra tion nysta+m#s is asso iated "ith mid>!rain t#mo#rs

&0. Melano ytoma: a. Contains pl#mp !la % nae$#s ells !. Metastasises to the !rain . Is ommoner in temperate than tropi al o#ntries d. 6oes not a#se opti ner$e ompression e. Is asso iated "ith renal t#mo#r

&5. Retino!lastoma: a. Is inherited in 5)* of ases !. Is a#sed !y deletion of 11410 . Rosettes s#++est +ood pro+nosis d. There is an in reased in iden e of osteosar oma e. Ca#ses death in :)* of s#fferers in the /7

&:. Corneal dystrophy may ontain the follo"in+ s#!stan es: a. M# opolysa harides

!. Cholesterol . .myloidosis d. /roprophyrin e. /rate

&;. 9a rimal +land t#mo#r of the adeno yti type: a. <as a pea% in iden e of aro#nd :) years !. <as "ell>defined aps#le . 3pread thro#+h perine#ral tiss#e d. Metastasise to the !rain early e. Ca#ses mortality in o$er ()* of ases in the /7

&?. 6isso iated $erti al de$iation: a. <yperde$iation on a!d# tion and add# tion !. Ae+an at & to , years old . 'oor !ino #lar sin+le $ision d. Inferior re ession is the treatment of hoi e e. <i+hest in iden e "ith on+enital esotropia

&(. 6#ane type .:

a. Ca#ses limited a!d# tion and add# tion !. Bidenin+ of the palpe!ral fiss#re on a!d# tion . 3i1th ner$e palsy is an asso iated pro!lem d. Ca#ses head tilt more ommonly than other types e. Is asso iated "ith si1 ranial ner$e n# le#s aplasia

,). Retinos hisis: a. 3ho#ld !e treated "ith laser to pre$ent pro+ression !. Ca#ses a!sol#te s otoma . Is asso iated "ith "ater mar% d. Is !ilateral in the ma-ority of ases e. 6oes not a#se retinal deta hment

Cli % for ans"ers

,1. Medi ations for +la# oma: a. Aeta>!lo %er is ontraindi ated in primary heart !lo % !. Aeta>!lo %er is ontraindi ated in those on nifedipine . . etaColamide is ontraindi ated in aller+y to s#lphonamide d. . etaColamide needs potassi#m s#pplement e. 9atanoprost is ontraindi ated in patient "ith #$eitis

,&. 6endriti #l ers may !e treated !y: a. .r+on laser !. Iodination . Topi al a y lo$ir d. 3ystemi a y lo$ir e. Tarsorrhaphy

,,. In horoidaemia: a. 'i+mentary han+es o #rs in arriers !. Carriers may ha$e a!normal 2OG . The mode of inheritan e is a#tosomal dominant d. .r+inine free diet is !enefi ial e. Central $ision is lost early

,0. 6eafness is asso iated "ith: a. Co %ayne's syndrome !. .lstrom's syndrome . .lport's syndrome d. /sher's syndrome e. .!etalipoproteinaemia

,5. 'rominent orneal ner$es are seen in : a. 2 todermal dysplasia !. I hythyosis . Refs#m's syndrome d. Ma #lar dystrophy e. . anthoamoe!a %eratitis

,:. The follo"in+ are re o+nised asso iation: a. .!etalipoproteinaemia and a antho ytosis !. Refs#m's disease is asso iated "ith ere!ellar ata1ia . 3pino ere!ellar ata1ia in Friedri h's ata1ia d. <omo ystin#ria and re #rrent deep $ein throm!osis e. 'a+et's disease and deafness

,;. 7erato on#s is asso iated "ith: a. 6o"n's syndrome !. 2hlers>6anlos' syndrome . Marfan's syndrome d. /sher's syndrome e. .topi %erato on-#n ti$itis

,?. In a 4#ired syphilis: a. Interstitial %eratitis is a re o+nised feat#re !. The infe tion is most infe tio#s in the se ondary sta+e . Ca#ses se ondary #$eitis d. Treatment is "ith pro aine peni illin e. May present "ith a rash "hi h is hi+hly infe tio#s

,(. Red# ed !lin% refle1 o #rs in: a. .l ohol into1i ation !. 'ar%insonism . 'ro+ressi$e s#pran# lear palsy d. Myasthenia +ra$is e. <ypothyroidism

0). In hetero hromi

y litis:

a. :)* of patients de$elop +la# oma !. 3ho" a +ood response "hen treated "ith steroids . 9ens implantation follo"in+ atara t s#r+ery is ontraindi ated d. <yphaema d#rin+ atara t s#r+ery is d#e to iris neo$as #lariCation

e. Is asso iated "ith iris transill#mination

Cli % for ans"ers

01. Retinal dialysis: a. Is asso iated "ith posterior $itreo#s deta hment !. Is asso iated "ith myopia . <as a mo!ile posterior flap d. Can !e treated !y ryotherapyD en ir lement and a lo al s leral !# %le e. Is ommonest in the s#perior temporal 4#adrant

0&. O #lar !o!!in+: a. Is asso iated "ith pontine haemorrha+es !. Is only seen in omatose patients . Is asso iated "ith loss of doll's head mo$ement d. Is asso iated "ith +lio!lastoma e. O #rs in !ilateral ere!ral infar tion

0,. The follo"in+ tests may !e #sef#l in the assessment of a patient "ith sar oidosis: a. Chest @>ray !. .C2

. Con-#n ti$a !iopsy d. 3er#m al i#m e. Galli#m s an

00. In <olmes>.die p#pil: a. There is a!sent or retarded p#pil rea tions to li+ht and near !. Most ases are !ilateral . Commoner in male than female d. Ca#ses red# ed or a!sent a ommodation e. Constri ts "ith &.5* metha holine

05. . fi1ed dilated p#pil "hi h does not rea t to dire t or onsens#al li+ht stim#l#s o#ld !e a#sed !y: a. Opti ner$e a$#lsion !. 6#e to !l#nt tra#ma . Or!ital ape1 syndrome "ith third ner$e palsy d. Topi al appli ation of atropine e. 3iderosis !#l!i

0:. 9e!er's opti ne#ropathy: a. Typi ally presents in the fo#rth de ade of life

!. Males do not transmit the disease . /s#ally affe t the males more than the females d. Is inherited in a#tosomal @>lin% fashion e. The opti dis is pale early in the disease

0;. In a #te .M''2: a. Ailateral in the ma-ority of ases !. <ypofl#ores en e in early sta+e of fl#ores ein an+io+raphy . 3pontaneo#s re o$ery is ommon d. ?)* of patients ha$e e1#dati$e $as #litis e. .nterior #$eitis is a prominent feat#re

0?. In entral sero#s retinopathy: a. .!normalities re orded on the .msler's hart are #n ommon !. Often sho"s fo al lea%a+e on fl#ores ein f#nd#s photo+raphy . . ma #lar hole is a ommon end res#lt d. The ima+e per ei$ed !y the patient on the affe ted side in #nilateral ases is !i++er than on the normal side e. . dense entral s otoma is the most ommon presentation

0(. 7ayser>Fleish her's rin+s:

a. Ca#sed !y opper in the Ao"man's mem!rane !. <as !ro"n>+reenD +rey or oran+e olo#r . 6e reases "ith 6>peni llamine treatment d. Can o #r "ith opper intrao #lar forei+n !ody e. 3tarts at , and ( O' lo %

5). Corneal +rafts ha$e: a. <ost epitheli#m !. <ost endotheli#m . <ost %erato ytes d. <ost !asement and des emet's mem!rane e. <ost ner$es

51. =ernal %erato on-#n ti$itis: a. Is #s#ally #nilateral !. 2osinophil is ommon in the papillae . Can !e of lim!al type alone d. Is ommoner in ad#lt than hildren e. Ca#ses orneal melt

5&.The follo"in+ onditions are inherited in an a#tosomal re essi$e patterns: a. 'rotanopia !. Con+enital retinos hisis . 3t#r+e>Be!er's syndrome d. 8e#rofi!romatosis type II e. Al#e one a hromatopsia

5,. Coat's disease: a. <as e4#al se1 in iden e !. Ca#sed !y peripheral neo$as #lariCation . Is inherited in an a#tosomal dominant pattern d. Ca#ses rhe+mato+eno#s deta hment e. Can !e treated "ith laser

50. Bith re+ard to laser: a. @anthophll a!sor! +reen li+ht !. 6iode laser penetrate $itreo#s haemorrha+e . .r+on !l#e>+reen is ommonly #sed for +rid laser d. E.G laser prod# es red olo#r e. Ophthalmi laser is lassified as type I laser

55. Roth's spots ontain: a. 'ositi$e staphylo o #s !a teria !. '#r#lent e1#dates . =as #lar o l#sion d. 9ympho!lasts e. 2osinophils

5:. Area%s in des emet's mem!rane o #r in: a. 7erato on#s !. F# h's dystrophy . . #te +la# oma d. 9atti e dystrophy e. Con+enital +la# oma

5;. . #te +la# oma is s#++ested !y: a. 3phin ter paralysis !. Catara t . 2 topia #$ea d. 'osterior s#! aps#lar atara t e. Re #rrent orneal erosion

5?. In !lo">o#t fra t#re: a. . step on the or!ital rim is palpa!le !. .dd# tion pro!lem o #r . 3#r+i al emphysema is a re o+nised feat#re d. Immediate treatment is important e. 6e reased sensation at the tip of the nose is ommon

5(. 'ersistent hyperplasti primary $itreo#s: a. Ca#sed elon+ated iliary m#s les !. .n+le los#re +la# oma is a re o+nised feat#re . Opti dis a!normality is seen d. Ca#ses mi rophthalmi eye e. =is#al pro+nosis is +ood if treated early

:). 'ars planitis: a. Is fre4#ently asso iated "ith retinal deta hment !. Ca#ses $itreo#s haemorrha+e . <as poor $is#al pro+nosis d. Ca#ses y liti mem!rane e. <as a pea% in iden e at the fifth de ade

'aper I (ans"ers) 1. a.T !.T .F d.F e.F

Gorlin's syndrome (!asal ell nae$#s syndrome)

rareD a#tosomal dominant and m#ltisystem disorder hara terised !y m#ltiple !asal ell ar inomaD -a" ystsD s%eletal anomaliesD e topi al ifi ation of the fal1 ere!ri and pittin+ of the hand and feet o #lar feat#res also in l#de hypertelorismD lateral displa ement of the medial anthi and prominent s#praor!ital rid+es

&.

a.T

!.T

.F

d.F

e.F

'osterior polymorpho#s dystrophy:

a !ilateral dominantly inherited dystrophy $esi #lar polymorpho#s deposits "ith lear halos in 6es emet's mem!rane #s#ally asymptomati D rarely endotheli#m de ompensation re4#irin+ penetratin+ orneal +raft the a!normal endotheli#m may e1tend into the tra!e #lar mesh"or% and iris +la# oma an o #r as a res#lt of tra!e #lar mesh"or% in$ol$ement iris in$ol$ement an lead to ore topia and e topia sim#latin+ irido orneal endothelial syndrome e1 ept that the later is #nilateral

,.

a.T

!.T

.T

d.F

e.T

Crystalline deposits o #rs "ith:

myloidosis as in m#ltiple myeloma ystinosis treatment "ith +old #ri a id from #raemia

0.

a.T

!.F

.F

d.F

e.T

'tery+i#m:

fi!ro$as #lar o$er+ro"th of the !#l!ar on-#n ti$a the stroma sho"s !asophili de+eneration (elastoti ) of olla+en the epitheli#m is often thin !#t may sho" hyperplasia or dysplasia it is not re+arded as pre an ero#s

5.

a.T

!.T

.F

d.T

e.T

7erato on-#n ti$itis si

a (dry eyes):

a#ses dysplasia of the epitheli#m "hi h may e$ent#ally !e ome %eratinise the +o!let ells may in rease d#e to hroni irritation from dry eyes in 3-o+ren's syndromeD there is lympho yti infiltration of the la rimal and a essory +lands

:.

a.F

!.F

.T

d.F

e.F

Mer%el ell ar inoma:

an a++ressi$e primary t#mo#r of the s%inD arisin+ from papillary dermis #s#ally presents as a firm non>tender solitary s%in nod#le on the fa e and ne % early metastasis thro#+h the lymphati hannels

ontains .'/6 (amine pre #rsor and #pta%e de ar!o1ylation) ells

;.

a.F

!.T

.F

d.F

e.T

9ens>ind# e #$eitis: > three types

ha oanalphyla ti endophthalmitis

> se$ere +ran#lomato#s inflammation "hen the lens protein is e1posed > Conal +ran#lomato#s rea tion s#rro#ndin+ the e1posed lens material. The inflammation in l#de ne#trophilsD epihtelioid ellsD ma ropha+es and +iant ells pha oto1i #$eitis

> non+ran#lomato#s inflammation "hen the lens protein is e1posed. > non>spe ifi inflammation "ith lympho ytesD ma ropha+es and o asional +iant ells pha olyti +la# oma

> o #rs "hen the hypermat#re atara t lea%s o#t protein

> ma ropha+es laden "ith eosinophili lens materials are seen in the anterior ham!er and the tra!e #lar mesh"or%

a.F

!.F

.T

d.T

e.T

@eroderma pi+mentosa:

inheritan e is a#tosomal re essi$e mar%ed sensiti$e of s%in to s#nli+ht mali+nant s%in t#mo#rs in l#din+ s4#amo#s ell t#mo#rD !asal ell ar inoma and fi!rosa orma main defe t is d#e to the ina!ility of the ells to repair dama+ed 68. follo"in+ #ltra$iolet e1pos#re

(.

a.T

!.F

.T

d.T

e.T

'atholo+y of thyroid ophthalmopathy:

there is enlar+ement and inflammation of or!ital tiss#e espe ially the e1trao #lar m#s les histolo+i ally there is interstitial oedema and inflammatory ell infiltration (mainly lympho ytesD plasma ells and sometimes mast ells) the ondition tend to in$ol$e the nontendino#s part of e1trao #lar m#s le the endomysial fi!ro!lasts prod# es m# opolysa haride espe ially hyal#roni a id the m#s les are initially inflammed and at later sta+e #nder+oes fi!rosis and sho"s fatty infiltrate

1).

a.T

!.T

.T

d.F

e.F

<istolo+i al stainin+:

Giemsa stain an demonstrate in l#sion !ody s# h as hlamydia osmi#m tetro1ide is #sed to fi1 and stain myelin for ele tron mi ros opy yeast and f#n+i an !e stained "ith F#el+in's stainD '.3D 9#1ol !l#e fast and Gomori methenamine sil$er eosin stains the ytoplasm pin% "hereas haemato1ylin stains the n# lei !l#e

11.

a.T

!.F

.F

d.T

e.F

3ympatheti ophthalmitis

a #n ommon !ilateral +ran#lomato#s pan#$eitis "hi h o #rs after penetratin+ o #lar in-#ry or intrao #lar s#r+ery the inflammation #s#ally !e+ins 0 to ? "ee%s after the in-#ry 6ellen>F# h's nod#les are seen at the le$el of Ar# h's mem!rane and represent a++re+ates of epitheloid ellsD it is not dia+nosti as the nod#les also o #r in =7< syndrome may ha$e systemi manifestation identi al to =o+t>7oyana+i><arada syndrome "ith ere!rospinal fl#id pleo ytosisD minin+ism#sD alope iaD $itili+o and poliosis pre$ention is only #sef#l if the in-#red eye "ere remo$ed "ithin the first & "ee%s after in-#ry

1&.

a.T

!.F

.T

d.T

e.T

.!normal material in the $itreo#s in l#de:

pse#doe1foliation in pse#doe1foliation syndrome

haemosiderin from $itreo#s haemorrha+e amyloidosis in familial amyloidosis al i#m in asteroid hyalosis

1,.

a.T

! .T

.F

d.F

e.T

Giant ell arteritis:

disease of the elderly s#ddenD painless and profo#nd $is#al loss female more s#s epti!le than male head a heD lo" +rade fe$erD anore1iaD "ei+ht lossD tenderness #pon !r#shin+ hair and -a" la#di ation 23R and C>rea ti$e proteins are al"ays raised !#t not dia+nosti of the ondition dia+nosis is !ase on !iopsy "hi h re$eal fra+mentation of the internal elasti lamina and +iant ell infiltration of the t#ni a media of the artery. <o"e$erD +iant ells are not essential for dia+nosis.

10.

a.F

!.T

.T

d.F

e.T

The follo"in+ onditions are pre>mali+nant:

a tini %eratosis is the res#lt of metaplasia d#e to #ltra$iolet li+ht Ao"en's disease On o ytoma of the ar#n le res#lts from metaplasia of the a essory +land and is not tho#+ht to !e pre>mali+nant 34#amo#s papilloma is !eni+n hyperplasia of the s%in 3yrin+oma is !eni+n t#mo#r of the s"eat +lands

15.

a.T

!.T

.T

d.T

e.F

<ypo1i dama+e in dia!eti mellit#s is s#++ested !y:

otton>"ool spots e1tensi$e IRM. $as #lar !eadin+ e1tensi$e retinal haemorrha+es iris neo$as #lariCation

1:.

a.T

! .F

.T

d.F

e.T

Aiopsy report in rhe#matoid arthritis in l#de

posterior s leritis epis leral ne roti tiss#e $as #litis The dry eye in rhe#matoid arthritis is a#sed !y a4#eo#s defi ien y and not +o!let ell dysf#n tion

1;.

a.T

!.F

.F

d.F

e.F

The pro+nosis of retino!lastma is detemined !y:

e$iden e of e1ternal spread s# h as opti ner$e in$ol$ement siCe of the t#mo#rs

ell differentiation Cal ifi ation and ne rosis are ommon in retino!lastoma.

1?.

a.F

!.F

.F

d.T

e.F

Mi roan+iopathy in dia!etes mellit#s is hara terised !y:

mi ro$as #lar o!str# tion and non>perf#sion of apilaries retinal apillary mi roane#rysms a!sent mem!rane thi %enin+ loss of peri ytes intraretinal mi ro$as #lar a!normality

1(.

a.T

!.F

.T

d.T

e.F

Opti ner$e +lioma:

asso iated "ith type I ne#rofi!romatosis most ommon type is pilo yti (hair>li%e) astro ytoma the a+e of onset is #s#ally !efore the a+e of 1) lo">+rade and rarely infiltrate the perine#ral tiss#e rea ti$e menin+eal hyperplasia +ood lon+>term s#r$i$al

&)

a.F

!.T

.F

d.T

e.T

M#tton fat %erati pre ipitates: > o #rs in hroni +ran#lomato#s #$eitis and seen in

t#!er #losis f#n+al leprosy syphilis sar oidosis -#$enile 1antho+ran#loma histio ytosis @ sympatheti ophthalmia =o+t>7oyana+i><arada syndrome to1oplasmosis

&1.

a.F

!.T

.F

d.F

e.T

.l!inism:

an !e of o #lo #taneo#s or o #lar types o #lo #taneo#s types an !e di$ided into tyrosinase>positi$e and tyrosinase>ne+ati$e types. <air !#l! test is #sef#l to differentiate the t"o "ithin the first three years of life is asso iated "ith a!normal platelet a++re+ation in <ermans%y>'#dla% syndrome poor $ision is #s#ally d#e to ma #lar hypoplasia

&&.

a.T

!.T

.F

d.T

e.F

Con+enital +la# oma: > may !e primary > se ondary to:

aniridia 3t#r+e>Be!er's syndrome anterior ham!er an+le lea$a+e syndrome s# h as 'eter's anomaly or .1enfeld's syndrome

&,.

a.F

!T

.T

d.F

e.T

8ysta+m#s:

see>sa" nysta+m#s is seen "ith !itemporal hemianopia do"n>!eat nysta+m#s o #rs "ith lesion in the er$i o>med#llary -#n tion at the foramen ma+n#m manifest latent nysta+m#s is a type of horiContal -er% nysta+m#s "hi h in reases in amplit#de "hen one eye is o$ered. It o #rs in stra!ism#sD am!lyopia or #nio #lar patholo+y s# h as atara t +aCe>e$o%ed potential is not spe ifi for ere!ellar lesionD it o #rs "hen the eyes are #na!le to maintain an e entri +aCe position thro#+h "ea%ness of m#s le tone in the a+onist m#s le on$er+en e retra tion nysta+m#s o #rs "ith mid>!rain t#mo#rs s# h as pinealoma

&0.

a.T

!.F

.F

d.F

e.F

Melano ytoma:

!eni+nD hi+hly pi+mented t#mo#r arisin+ from melano ytes

most ommonly fo#nd in opti ner$e head histolo+i ally sho"s pl#mp polyhedral ells e4#ally se1 in iden e ommoner in !la % pop#lation #s#ally asymptomati !#t may sho" enlar+ement of !lind spots 5)* ha$e asso iated horoidal nae$#s rarely the t#mo#r sho"s ne rosisD $as #lar o!str# tion and opti ner$e ompression

&5.

a.F

!.F

.T

d.T

e.F

Retino!lastoma:

most ases are d#e to ne" +ene m#tation only 1)* is inherited a#sed !y deletion of 1,410 rosettese s#++ests ell differentiation and therefore !etter pro+nosisF ho"e$er other fa tors s# h as siCe and opti ner$e in$ol$ement may !e more important has in reased ris% of osteosar om (the on o+ene of "hi h is also lo ated on hromosome 1,) pro+nosis is +enerally +ood at aro#nd ()*

&:.

a.T

!. T

.T

d.F

e.F

Corneal dystrophy: > inherited and !ilateral onditions > the follo"in+ a!normal s#!stan e are do #mented:

ly oamino+ly an (ma #lar dystrophyD fle % dystrophy)

yaline de+eneration (+ran#lar dystrophy) amyloid (latti e dystrophy) lipid (fle % dystrophy) holesterol ( entral rystalline dystrophy)

&;.

a.T

!.F

.T

d.T

e.T

.deno ysti

ar inoma of the la rimal +land:

the most ommon mali+nant t#mo#r of the la rimal +land has no "ell>defined aps#le in$ade perine#ral tiss#e a#sin+ pain and metastasise early to the !rain 5 histolo+i patterns: ri!riform (3"iss heese and of lo"er +rade)D solid (!asaloid)D s lerosin+D omedo ar inomato#s and t#!#lar (d# tal) treatment is "ith or!ital e1enternation and remo$al of in$ol$ed !one the pro+nosis is $ery poor

&?.

a.F

!.T

.T

d.F

e.T

6isso iated $erti al de$iation:

refers to the phenomenon in "hi h the eye ele$ates "hen the amo#nt of li+ht enterin+ it is red# ed #s#ally !e+ins !et"een & to , years of a+e asso iated "ith infantile esotropia the !ino #lar $ision is #s#ally poor

s#r+ery of hoi e is either s#perior re t#s re ession or Faden's pro ed#re

&(.

a.T

!.T

.F

d.F

e.T

6#ane type .:

Aro"n's lassifi ation

Type .: limited a!d# tion and less mar%ed add# tion limitation Type A: limited a!d# tion and normal add# tion Type C: limitation of add# tion e1 eeds the limitation of a!d# tion "idenin+ of the palpe!ral fiss#re on a!d# tion +lo!e retra tion and palpe!ral narro"in+ on add# tion fa e t#rns to the affe ted side is ommon a#sed !y inner$ation of the lateral re t#s !y a !ran h of third ner$e in pla e of a!sent si1th ner$e si1th ner$e n# le#s aplasia has !een do #mented

,).

a.F

!.T

.F

d.T

e.F

Retinos hisis:

presents in 5* of the pop#lation and is a#sed !y the splittin+ of the ne#rosensory retinal in the o#ter ple1iform layer often !ilateral arises from oales en e of peripheral ystoid de+eneration asso iated "ith hypermetropia

asymptomati !#t an a#se a!sol#te s otoma ( f "ith retinal deta hment "hi h a#ses relati$e s otoma) does not a#se "ater mar% "hi h is a feat#re of retinal deta hment and is d#e to transformation of es aped retinal pi+ment epithelial ells renal !rea%s on the internal layer is ommon !#t if asso iated "ith !rea%s in the o#ter layerD there is a ris% of retinal deta hment

,1.

a.F

!.F

.T

d.T

e.T

.nti>+la# oma medi ations:

!eta>!lo %er a#ses slo"in+ of heart rate !#t is not ontra>indi ated in primary heart !lo % ( prolon+ed 'R inter$al) !eta>!lo %er sho#ld !e a$oided in patients ta%in+ entrally a tin+ al i#m hannel !lo %er s# h as $erapamil. 8ifedipine a ts peripherally a etaColide ontains str# t#re similar to s#lphonamide and sho#ld !e a$oided in those "ho is aller+i to it a etaColamide a#ses di#resis and loss of potassi#mD s#pplement may !e needed latanoprost is ontraindi ated in patients "ith intrao #lar inflammation

,&.

a.F

!.T

.T

d.T

e.F

6endriti #l er of the ornea an !e treated "ith:

iodination de!ridement topi al or systemi a y lo$ir

,,.

a.T

!.F

.F

d.F

e.F

Choroidaemia:

@>lin%ed re essi$e disorder hara terised !y pro+ressi$e de+eneration of the horio apillaris and R'2 typi ally affe ts male onset is in the first de ade "ith ni+ht !lindness entral $ision is affe ted late 2RG sho"s red# ed a and ! "a$es female arriers may sho"s peripheral pi+mentary han+es

,0.

a.T

!.T

.T

d.T

e.F

6eafness o #rs in:

Co %ayne's syndrome: premat#re a+ein+D d"arfismD !ird li%e fa ies and retinal de+eneration .ltroem's syndrome: retinitis pi+mentosaD deafnessD o!esity and dia!etes mellit#s .lport's syndrome: haemat#riaD sensorine#ral deafnessD anterioir lenti on#s /sher's syndrome: ne#rosensory deafnessD retinitis pi+mentosa

,5.

a.T

!.T

.T

d.F

e.T

2nlar+ed orneal ner$es o #r in:

m#ltiple endo rine adenomatosis %erato on#s

i hthyosis Refs#m's disease F# hs' orneal dystrophy ne#rofi!romatosis leprosy tra#ma on+enital +la# oma failed orneal +raft %erato on-# nti$itis si a ad$an ed a+e a anthoamoe!a %eratitis

,:.

a.T

!.T

.T

d.F

e.T

The follo"in+ asso iation are tr#e:

a!etalipoproteinaemia "ith a antho ytosis Refs#m's disease "ith ere!ellar ata1ia Friedri h'a ata1ia "ith spino ere!ellar de+eneration 'a+et's disease and deafness <omo ystin#ria a#ses re #rrent aterial throm!osis

,;.

a.T

!.T

.T

d.F

e.T

7erato on#s o #rs in:

onne ti$e tiss#e disorders s# h as 2hlers>6anlos's syndrome and Marfan's syndrome atopi eye onditions s# h as atopi %erato on-#n ti$itis 6o"n's syndrome

,?.

a.F

!.F

.T

d.T

e.F

. 4#ired syphilis:

a#ses painless #l er in the primary sta+e "hi h is hi+hly infe tio#s in the se ondary sta+eD the patient may de$elop a rash "hi h is non>infe tio#s #$eitis an o #r in the se ondary sta+e treatment is "ith peni illin Interstitial %eratitis is a feat#re of on+enital syphilis

,(.

a.T

!.T

.T

d.F

e.F

Red# ed !lin%in+ o #rs in:

'ar%inson's disease pro+ressi$e s#pran# lear palsy al ohol into1i ation ne#rotrophi %eratitis onta t lens "ear

0).

a.F

!.F

.F

d.T

e.T

<etero hromi

y litis:

hroni #$eitis asso iated "ith atara t and +la# oma +la# oma de$elops in &)* of patients iris atrophy a#ses transill#mination .msler's si+n o #rs d#rin+ atara t e1tra tion and is d#e to "ispy iris $essels "hi h e1tends from the iris to the tra!e #lar mesh"or% and do not a#se anterior syne hiae is resistant to steroid treatment

01

a. F

!.F

.F

d.T

e.F

Retinal dialysis:

a#sed !y f#ll hi %ness separation of the retina at the ora serrata tra#mati dialysis is most often fo#nd in the s#peronasal 4#adrant idiopathi dialysis is most often in the inferotemporal 4#adrant an !e losed "ith ryotherapy to the !ase of the dialysis follo"ed !y lo al s leral !# %le

0&.

a.T

!.F

.T

d.T

e.F

O #lar !o!!in+:

on-#+ate in$ol#ntary re #rrent do"n"ard mo$ement of the eyes rapid do"n"ard mo$ement "ith a slo"er ret#rn to the ne#tral position a!sent horiContal mo$ements o #rs in patients "ith a #te pontine lesion "ho are either omatose or lo %ed>in state an o #r "ith t#mo#r in the pontine

0,.

a.T

!.T

.T

d.T

e.T

In$esti+ation of sar oidosis:

hest @>ray typi ally sho"s !ilateral hilar lymphadenopathyD there may also !e interstitial infiltrate .C2 on entration is in reased on-#n ti$al !iopsy may sho" non> aseatin+ +ran#loma ser#m al i#m may !e raised in sar oidosis +alli#m s an sho"s in rease in parts of !ody affe ted !y sar oidosis

00.

a.T

!.F

.F

d.T

e.T

<olme>.die's p#pil:

there is li+ht>near disso iation ho"e$er there may !e delayed or a!sent p#pil rea tion to !oth the ondition is #s#ally #nilateral "omen are affe ted more often than men d#e to paralysis of the iliary m#s leD the a ommodation is impaired dener$ation hypersensiti$ity is demonstrated !y onstri tion to &.5* metha holine and ).1* pilo arpine

05.

a.F

!.T

.T

d.T

e.T

.!sent of p#pil response to dire t and onsens#al li+ht response:

> o #r "hen the iris of the affe ted eye is paralysed and this o #r in

!l#nt tra#ma third ner$e palsy atropine siderosis !#l!i

0:.

a.F

!.T

.T

d.F

e.F

9e!er's opti ne#ropathy:

a mito hondrial inherited disease !ilateral loss of entral $ision "hi h is se$ere and painless typi ally in the se ond de ade of life lassi early pi t#re sho"s a triad of ir #mpapillary telan+ie tati mi roan+iopathyD pse#doedema of the dis and a!sent fl#ores ein stainin+

0;.

a.T

!.T

.T

d.F

e.F

.M''2:

typi ally affe ts healthy yo#n+ ad#lts "ho presents "ith s#dden onset entral or para entral $is#al loss after a fl# li%e illness s atteredD pat hy reamy lesions at the le$el of the retinal pi+ment epitheli#m layers the lesions fade after one to t"o "ee%s lea$in+ !ehind +ran#lar pi+mentary han+es fl#ores ein an+io+raphy sho"s early !lo %a+e of horoidal ir #lation !y these lesions !#t in the late phase the lesions sho" late stainin+

other findin+s: #$eitisD sero#s retinal deta hmentD ere!ral $as #litisD ere!rospinal fl#id pleo ytosisD heada heD hearin+ loss and tinnit#s spontaneo#s resol#tion is ommon and systemi steroid has not !een sho"n to !e #sef#l

0?.

a.F

!.T

.F

d.F

e.F

Central sero#s retinopathy:

the patient #s#ally presents "ith distorted $ision "itho#t si+nifi ant entral $is#al loss .msler's hart testin+ #s#ally sho"s distortion of lines or s otoma the ima+e appears smaller than the #naffe ted eye

0(.

a.T

!.T

.T

d.T

e.F

7ayser>Fleish er's rin+:

o #rs in Bilson's disease and intrao #lar opper forei+n !ody the rin+ is a#sed !y opper deposited in 6es emet's mem!rane "hi h may !e oran+eD !ro"nD +reen> !ro"n or +rey in olo#r it !e+ins s#periorly then inferiorly and finally ir #mferentially re+resses "ith 6>peni illamine treatment

5).

a.T

!.F

.T

d.F

e.T

In orneal +raft:

the epithli#mD %erato ytesD ner$es and epitheli#m "ill e$ent#ally !e repla ed !y the host tiss#e the endotheli#m does not re+enerate and therefore "ill remains that of donor. the des emet's mem!rane is prod# ed !y the endotheli#m and "ill therefore remains that of donor

51.

a.F

!.T

.T

d.F

e.F

=ernal %erato on-#n ti$itis:

affe ts mainly yo#n+ people an aller+i inflammatory ondition hara terised !y +iant papillae in the tarsal on-#n ti$a the lim!al type is fo#nd ommonly in !la % "ith typi al <orner>Trantas' dots "hi h are +iant papillae ontainin+ eosinophils a#ses %eratitis and orneal #l er / s arrin+ treatment is a$oidan e of aller+ensD mast ell sta!ilisers and short o#rse of steroid in a #te phase

5&.

a.F

!.F

.F

d.F

e.T

The follo"in+ onditions are inherited as:

@>lin%ed in protanopia (red>+reen olo#r !lindness) and -#$enile retinos hisis a#tosomal dominant in ne#rofi!romatosis a#tosomal re essi$e in !l#e one a hromatopsia non>inherited in 3t#r+e>Be!er's syndrome

5,.

a.F

!.F

.F

d.F

e.T

Coat's disease:

non>hereditaryD #nilateral on+enital disorder hara terised !y a!normal telan+ie tati and ane#rysmal retinal $essels in the peripheral retina male o#tn#m!er female !y , to 1 presents "ith le#%o oria and stra!ism#s. /ntreated an lead to e1#dati$e retinal deta hmentD +la# oma and pthisi al eye laser is #sef#l in destroyin+ the a!normal !lood $essels

50.

a.F

!.T

.F

d.F

e.F

9aser:

+reen li+ht is not a!sor!ed !y 1anthophyll and therefore it is theoreti ally more ad$anta+eo#s to #se +reen laser in the ma #lar area diode laser penetrate $itreo#s haemorrha+e "ell and is therefore ideal in $itreo#s haemorrha+e E.G laser is olo#rless and therefore re4#ire neodymi#m to +i$e it red olo#r for tar+etin+ #sed in ophthalmi pra ti e is lassified as type I= laser

55.

a.T

!.T

.F

d.T

e.F

Roth's spots:

many a#ses in l#din+ s#!a #te !a terial endo arditisD le#%aemiaD anaemia et

ontain "hite areas in the entre of retinal haemorrha+e the "hite areas may ontain imm#no omple1D lympho!lasts or p#r#lent e1#dates in s#!a #te !a terial endo arditisD the "hite entres may ontain or+anismsD altho#+h the ma-ority are sterile and onsists mainly of "hite !lood ells and fi!rin throm!#s at the site of e1tra$asation of !lood

5:.

a.T

!.F

.F

d.F

e.T

Area%s in 6es emet's mem!rane o #rs in:

tra#ma as in for ep deli$ery %erato on#s on+enital +la# oma

5;.

a.T

!.T

.F

d.F

e.F

3ti+ma of a #te an+le los#re +la# oma:

iris atrophy sphin ter paralysis d#e to is haemia pi+ment dispersion +la#%omfle %en "hi h is "hite opa ities on the anterior s#rfa e of the lens a#sed !y ne rosis of the anterior lens aps#le

5?.

a.T

!.T

.T

d.F

e.F

In !lo">o#t fra t#re:

the or!ital rim may !e fra t#re or inta t. In the former a step an !e felt o #r only "hen the air sin#ses ha$e de$elop s#r+i al emphysema is a feat#re altho#+h typi ally a#se pro!lem "ith #p+aCeD the horiContal re ti ha$e onne ti$e tiss#e that e1tends to the or!ital floor and therefore horiContal mo$ement may !e impaired to some e1tent the infraor!ital ner$e is in$ol$ed !#t the ner$e does not s#pply the tip of the nose "hi h is !y naso iliary ner$e 5(. a.T !.T .T d.T e.T

'ersistent hyperplasti primary $itreo#s:

a#sed !y a!normal re+ression of primiti$e hyaloid $as #lar system typi ally there is a fi!ro$as #lar stal% e1tendin+ from opti dis and form a retrolental mem!rane the mem!rane e1tend to the iliary pro ess and if ontra t an lead to elon+ation of the iliary pro esses a#ses shallo" anterior ham!er and a #te +la# oma in #ntreated ases the pro+nosis is +ood if treated early espe ially if the retina "ere normal :). a.F !.T .F d.T e.F

'ars planitis:

ommonly affe t yo#n+ ad#lt and hildren presents "ith folater or de reased $is#al a #ity d#e to ystoid ma #lar oedema ?)* !ilateral lini al e1amination sho"s inflammatory ells and sno"!all opa ity in $itreo#s main ompli ations are atara t and ystoid ma #lar oedema. <o"e$erD the $is#al pro+nosis is #s#ally +ood

rare ompli ation in l#de !and %eratopathyD +la# omaD $itreo#s or+anisationD tra tional retinal deta hment and $itreo#s haemorrha+e. treatment is indi ated only "ith de reased $is#al a #ity from CMO and se$ere inflammation treatment in l#de: perio #lar steroidD ryotherapy to $itreo#s !aseD par plana $itre tomy and #se of imm#nos#ppresi$e a+ents.

Test t"o (for final FRCOphth/MRCOphth)

1. Opti ne#ropathy ha$e !een reported "ith:

a. etham!#tol !. peni illin . hlorampheni ol d. isoniaCid e. to!#ltamide

&. The follo"in+ are %no"n feat#res of o #lar hypotony:

a. opti oedema !. atara t . retinal deta hment

d. orneal oedema e. horoidal is haemia

,. Tr#e statements a!o#t an%ylosin+ spondylitis in l#de: a. <9.>A&; is fo#nd in ()* of s#fferers !. #$eitis is fo#nd in 15 to &)* of s#fferers . the ondition is ommoner in female d. female s#fferers ha$e a more se$ere o#rse than male e. the radiolo+i al han+es an o #r in the spine !efore symptoms

0. In s leritis: a. s leromala ia perforans are more ommonly asso iated "ith systemi diseases than posterior s leritis !. pain is not a prominent feat#re . retinal deta hment is a %no"n ompli ation d. systemi steroid is indi ated in all s leritis e. +la# oma is a %no"n ompli ation

5. The follo"in+ parasites an a#se o #lar pro!lems: a. Tri hinella spiralis !. 3 histosoma haemolyti a . .s aris l#m!ri oides d. 9oa loa

e. 9eishmania dono$ani

:. In #$eal melanoma: a. the ondition is more ommon in Ca# asian than other ra es !. the in iden e is hi+her in female than males . the opti ner$e is ommonly infiltrated !y the t#mo#r d. epithelioid ell type has poorer pro+nosis than other ell type e. a!dominal CT s annin+ is more sensiti$e than !lood test in dete tin+ hepati metastasis

;. Con ernin+ Marfan's syndrome: a. the ondition is inherited in a#tosomal dominant manner !. it is a#sed !y defe t in the formation of type I olla+en . the lens typi ally sho"s #pper nasal s#!l#1ation d. the patients ha$e a hi+her in iden e of hypermetropi refra ti$e error e. the s#fferers tend to !e mentally s#!normal

?. The follo"in+ are tr#e a!o#t measles: a. it is an R8. $ir#s !. a#ses 7opli%'s spots on the on-#n ti$a . a #te atarrhal on-#n ti$itis is a %no"n feat#res

d. a#ses !lindin+ %eratitis in the presen e of $itamin . defi ien y e. a#ses s#!a #te s lerosin+ panen ephalitis

(. Cy losporin .: a. is a f#n+al meta!olite !. has poor tiss#e penetration "hen applied topi ally . is the dr#+ of hoi e in Aeh et's disease d. a#ses hepatoto1i ity as the main side effe ts e. hirs#tism and +in+i$al hyperplasia are %no"n side effe ts

1). 'hly ten#lar on-#n ti$itis: a. the most ommon a#se is t#!er #losis !. the lesions are typi ally fo#nd near the lim!#s . sho#ld not !e treated "ith steroid d. predominantly affe ts hildren e. is a type I= hypersensiti$ity rea tion

11. The follo"in+ are tr#e a!o#t thiamine defi ien y: a. e1ternal ophthalmople+ia is a typi al feat#re !. fail#re of the p#pils to respond to li+ht

. the ondition is fo#nd in patients "ith +astri

ar inoma

d. post>mortem re$eals peri$as #lar haemorrha+es in the re+ion of the fo#rth $entri le and a4#ed# t e. the ondition responds to hi+h dose $itamin A1&

1&. Feat#res of tentorial herniation in l#de:

a. $omitin+ !. deterioration of ons io#sness . dilated p#pil d. impaired respiration e. hemiparesis

1,. Feat#res of 9a"ren e>Moon>Aiedle's syndrome in l#de: a. hypo+onadism !. o!esity . polyda tyly d. mental retardation e. pi+mentary retinopathy

10. 3ar oidosis: a. is asso iated "ith <9. A1

!. is ommoner in elderly people . a#ses aseatin+ +ran#loma d. prod# es !ilateral hilar lymphadenopathies in the a!sen e of p#lmonary symptoms e. a#ses lympho ytosis

15. Bith re+ard to si %le ell disease: a. &5* of the !la % pop#lation ha$e si %le ell disease !. the most se$ere form of si %le ell retinopathy is asso iated "ith 33 disease . opti dis is the first site of neo$as #lariCation in patient "ith se$ere retinal is hamia d. salmon pat hes are the res#lt of is haemia e. horoidal is haemia is the main a#se of $is#al loss

1:. .lport's syndrome is asso iated "ith: a. ne#ro>sensory deafness from !irth !. posterior lenti on#s . retinal deta hment d. peripheral retinal fle % e. haemorrha+e nephritis

1;. Corneal deposits are seen in:

a. <#rler's syndrome !. Mor4#io's syndrome

. myeloma d. ystinosis e. 3anfilippo's syndrome

1?. The follo"in+ are tr#e a!o#t entral retinal artery o l#sion: a. it is a ommon a#se of r#!eosis iridis !. an a#se neo$as #larisation of the retina . is a re o+niCed ompli ation of atrial fi!rillation d. fl#ores en e an+io+raphy typi ally sho"s delayed hyperfl#ores en e of the horoidal ir #lation e. a#ses opti atrophy "ithin the first "ee%

1(. In a ommodati$e esotropia: a. there is an in reased in iden e of hypermetropia !. the patients typi ally presents after the a+e of 1? months . !ifo al +lasses are ommonly pres ri!ed for these patients in the /nited 7in+dom d. the !ino #lar f#sion is #s#ally poor e. inferior o!li4#e o$era tion is a ommon feat#re

&). Bith re+ard to the #se of phopholine iodide in the treatment of esotropia: a. it an !e #sed to orre t hypermetropi a ommodati$e esotropia !. it is #sed in patients "ith esotropia d#e to hi+h .C/. ratio

. it an a#se iris ysts the in iden e of "hi h an !e red# ed "ith on #rrent treatment "ith phenylephrine d. it a#ses retinal deta hments e. it sho#ld !e stopped in patients a!o#t to #nder+o stra!ism#s s#r+ery

&1. In infantile esotropia:

a. am!lyopia is #n ommon !. the ma-ority of patients ha$e asso iated ne#rolo+i al defi it . a hi+h refra ti$e error is ommon d. disso iated $erti al de$iation is fo#nd in ;5* of ases e. mono #lar opti o%ineti asymmetry is a feat#re

&&. The follo"in+ an o #r "ith

on+enital nysta+m#s:

a. there is in$erse opti o%ineti nysta+m#s !. the nysta+m#s is "orse "ith on$er+en e . the nysta+m#s is "orse "hen one eye is o$ered d. os illopsia is a ommon omplaint e. parado1i al p#pillary onstri tion to dar%ness

&,. In Aro"n's syndrome:

a. there is do"nshootin+ of the ipsilateral eye on add# tion !. there is asso iated s#perior re t#s o$era tion in the ontralateral eye

. may resol$e spontaneo#sly d. an !e treated !y inferior re t#s re ession in the ontralateral eye e. an !e treated !y inferior o!li4#e re ession in the ipsilateral eye

&0. /nilateral intern# lear ophthalmople+ia is asso iated "ith: a. red# ed add# tion on the affe ted side !. red# ed on$er+en e . nysta+m#s on a!d# tion in the affe ted side d. diplopia an o #r e. there is a!normal opti o%ineti nysta+m#s

&5. The follo"in+ are feat#res of a!errant third ner$e re+eneration: a. red# ed a!d# tion of the ipsilateral eye !. p#pillary onstri tion on a!d# tion . y lotorsion on ele$ation d. ele$ation of the ontralateral lid on lateral +aCe e. ele$ation of the lid on ipsilateral add# tion

&:. The follo"in+ are tr#e a!o#t <olme>.die's p#pil: a. the dia+nosis an !e onfirmed "ith edrophoni#m

!. females are more ommonly affe ted than males . a#ses pro!lem "ith readin+ that an !e orre ted "ith pl#s lenses d. onstri tion of p#pil an o #r e. partial relati$e afferent p#pillary defe t is seen in 5)* of ases

&;. .n+ioid strea%s o #r in: a. 3t#r+e>Be!er's syndrome !. 3i %le ell disease 33 . pse#doe1foliation syndrome d. septo>opti dysplasia e. 2hlers>6anlos syndrome

&?. The follo"in+ are tr#e a!o#t latanaprost: a. it is a prosta+landin inhi!itors !. it red# es the intrao #lar press#re !y in reasin+ the #$eal s leral o#tflo" . it has a +reater effe t than !eta !lo %ers in red# in+ the intrao #lar press#re d. hypertri hosis is a %no"n side effe ts e. it is ontra>indi ated in patients "ith orneal +raft re-e tion

&(. Feat#res of pi+mentary +la# oma in l#de:

a. it is ommoner in females than males !. it is a feat#res of Chandler's syndrome . the press#re an !e ontrolled "ith ar+on laser tra!e #loplasty d. there is se torial iris transill#mination e. the intrao #lar press#re may rise sharply follo"in+ e1er ise

,). In !eni+n intra ranial hypertension: a. there is a restri tion of #p+aCe !. normal $entri les is fo#nd in 5)* of ases . !rain s an is important in yo#n+ "oman to e1 l#de sa++ital sin#s throm!osis d. opti ner$e fenetration sho#ld !e performed early !efore the $ision is affe ted e. $entri #lar>peritoneal sh#nt is indi ated in the ma-ority of patients

,1. The follo"in+ medi ations may interfere "ith onta t lens "ear: a. rifampi in !. ontra epti$e pill . oral peni illin d. erythromy in e. di+o1in

,&. Go#t:

a. is a#sed !y p#rine meta!olism disorder !. a#ses s leritis . a#ses tophi in the e1trao #lar m#s le tendon d. is dire tly related to al ohol ons#mption e. #ri rystals may !e fo#nd in the deep stroma

,,. The follo"in+ are tr#e a!o#t iron deposition in the ornea: a. Fleis her's rin+ is fo#nd at the ape1 of %erato on#s !. <#dson>3tahli line is fo#nd in re #rrent erosion syndrome . 3to %er's line is asso iated "ith ptery+i#m d. Ferry's line is fo#nd at the front of a tra!e #le tomy !le! e. iron deposition o #rs in radial %eratotomy

,0. The follo"in+ are tr#e a!o#t orneal +rafts:

a. Ceno+rafts refers to transplant !et"een different spe ies !. iso+rafts refers to transplant !et"een the same spe ies . lamellar %eratoplasty is #sef#l in patient "ith F# h's dystrophy d. pre$io#s !lood transf#sion in reases the in iden e of re-e tion e. !ro%en orneal s#t#re an eli it re-e tion

,5. Feat#res of Goldenhar's syndrome in l#de:

a. #nilateral epi!#l!ar dermoids !. presen e of prea#ri #lar s%in ta+ . presen e of synda tyly d. in reased in iden e of an+le los#re +la# oma e. loss of pi+ments on eyelashes

,:. Red>+reen olo#r defe t is fo#nd in: a. opti ne#ritis !. 3tar+ardt's disease . to!a o am!lyopia d. ma #lar de+eneration e. primary open an+le +la# oma

,;. The follo"in+ lini al feat#res are s#++esti$e of a a$erno#s sin#s lesion in a patient "ith #nilateral third ner$e palsy:

a. dilatation of the p#pil !. impaired ipsilateral orneal refle1 . onstri tion of p#pil d. fail#re of the eye to a!d# t e. hearin+ loss

,?. Feat#res of arotid> a$erno#s fist#la in l#de: a. dilated s#perior ophthalmi $ein on CT s an !. !lood in the 3 hlemmn's anal . proptosis of ontralateral eye s#++ests !ilateral arotid> a$erno#s fist#la d. d#ral fist#la is the ommonest type seen follo"in+ head in-#ry e. tra#mati fist#la rarely lose spontaneo#sly

,(. The follo"in+ onditions are @>lin%ed:

a. Fa!ry's disease !. Refs#m's disease . 8orries's disease d. horoideremia e. rod mono hromatism

0). In mesodermal dys+enesis: a. .1enfeld's syndrome has posterior em!ryoto1on and iris hypoplasia !. .1enfeld's syndrome is inherited as an a#tosomal re essi$e disorder . Rie+er's anomaly is asso iated "ith dental and fa ial hypoplasia d. 'eter's anomaly is asso iated "ith !ilateral orneal opa ities e. 'eter's anomaly is asso iated "ith +la# oma in 5)* of ases

01. In latti e de+eneration: a. ?* of the pop#lation ha$e the ondition !. photo oa+#lation is re ommended for e1tensi$e ases . holes sho#ld !e treated d. it has a hi+her in iden e amon+st hi+h myopes e. &5* of retinal deta hment is d#e to latti e de+eneration

0&. The indi ation for s#!retinal fl#id draina+e in l#de: a. immo!iliCed retina !. !#llo#s lesion "here tear annot !e identified . hypotony d. s#perior retinal deta hment e. presen e of !lood in the $itreo#s

0,. The follo"in+ are tr#e a!o#t intra$itreal in-e tion: a. it an a#se se ondary retinal tear !. it an a#se atara t . C,F? has a lon+er half life than 3F: d. 3F: is more e1pansile than C,F? e. 3F: a#ses less in rease in the intrao #lar press#re than C,F?

00. In ptosis operation:

a. !ro" s#spension is the treatment of hoi e in se$ere on+enital ptosis !. Fasa$ella>3er$ant is the treatment of hoi e in patients "itho#t le$ator f#n tion . posterior approa h is the re ommended pro ed#re in patient "ith pre$io#s ptosis s#r+ery d. ma1imal rese tion is re ommended in patients "ith mito hondrial myopathy e. Aell's phenomenon and orneal sensation sho#ld !e aref#lly assessed !efore s#r+ery

05. Fo#rth ner$e palsy an !e treated "ith: a. ipsilateral s#perior re ession !. ipsilateral inferior o!li4#e re ession . ontralateral inferior re t#s rese tion d. ipsilateral s#perior o!li4#e t# %in+ e. ipsilateral inferior re t#s re ession

0:. The follo"in+ are tr#e a!o#t orneal !lood stainin+:

a. it o #rs in a!o#t 5* of hyphema !. it is related to the se$erity of the hyphaema . it is ommoner in de ompensated ornea d. it is a#sed !y red !lood ells mi+ratin+ into the stroma e. spontaneo#s learin+ of the hyphema typi ally !e+ins entrally

0;. In a #te !a terial endophthalmitis follo"in+ atara t operation:

a. 3taphylo o #s a#re#s is the most ommon patho+en !. presents "ithin 0? ho#rs of s#r+ery in the ma-ority of ases . topi al and systemi anti!ioti are #s#ally ade4#ate to ontrol the infe tion d. steroid is ontraindi ated e. it is often diffi #lt to differentiate !a terial from my oti a#ses

0?. In peripheral iridotomy "ith laser:

a. dar% olo#r iris responds poorly to ar+on laser iridotomy !. more ener+y is needed for ar+on laser than E.G laser for a +i$en siCe iridotomy . steroid pre>treatment is effe ti$e in de reasin+ the intrao #lar press#re d. presen e of red refle1 d#rin+ the pro ed#re indi ate the iridotomy is patent e. si+nifi ant atara t de$elops in 5)* of ases follo"in+ treatment

0(. /ns#ita!le donor for orneal +raft in l#de:

a. a history of on-#n ti$itis !. history of hepatitis . . less than 1) years old d. endothelial ell o#nt of less than &))) per s4#are mm e. senile dementia

5). In ar+on laser tra!e #loplasty: a. the s# ess rate is proportional to the ener+y #sed !. the res#lts are !etter in the elderly than the yo#n+ . the intrao #lar press#re is red# ed d#e to de reased a4#eo#s prod# tion d. typi ally prod# e a drop in the intrao #lar press#re of !et"een 1) and 15 mm<+ e. it is #sed as an ad-#n ti$e treatment to ma1imal medi al therapy

51. In refra ti$e s#r+eryF a. radial %eratotomy may !e #sed in myopes of 1)6 or more !. radial %eratotomy is a "ell>esta!lished safe te hni4#es "ith predi ta!le res#lt . post>operati$e asti+matism may !e red# ed !y remo$in+ the s#t#re alon+ the a1is of the lar+est pl#s ylinders d. post>operati$e asti+matism may !e red# ed !y remo$in+ s#t#res in the flatter a1is e. %eratomile#sis in$ol$es #sin+ a donor ornea

5&. The follo"in+ te hni4#es are #sef#l in red# in+ post>operati$e asti+matism: a. pha oem#lsifi ation rather than e1tra aps#lar te hni4#e !. the #se of folda!le lens . a lim!al in ision rather than a orneal in ision d. s#perior orneal approa h rather than temporal approa h e. di$ide and on4#er te hni4#e d#rin+ pha oem#lsifi ation rather than pha o> hop

5,. The follo"in+ are tr#e a!o#t anterior aps#le remo$al in atara t s#r+ery:

a. aps#lorrhe1is prod# es a stron+er ed+e than an>opener aps#lotomy !. aps#lorrhe1is re4#ires less $is oelasti than an>opener aps#lotomy . displa ement of the intrao #lar lens is less ommon "ith aps#lorrhe1is than an> opener aps#lotomy d. hydrodisse tion of the lens is not re4#ired "ith aps#lorrhe1is e. aps#lorrhe1is is an easier te hni4#e to master than an>opener aps#lotomy

50. Inferior o!li4#e re ession: a. need aref#l prism meas#rement !. is performed in ipsilateral fo#rth ner$e palsy to remo$e y lotorsion . is performed in =>pattern esotropia d. is performed in ontralateral s#perior re t#s palsy e. is easier to perform than inferior o!li4#e mye tomy

55. In #nre o$ered si1th ner$e palsy:

a. s#r+ery an speed #p re o$ery !. !ot#lin#m to1in in-e tion into the ipsilateral medial re t#s speeds #p re o$ery . rese tion/re ession is in appropriate d. no more than t"o m#s les sho#ld !e operated

e. an !e treated "ith Faden's pro ed#re on the ontralateral medial re t#s

5:. The follo"in+ are tr#e a!o#t ystoid ma #lar oedema: a. it a#ses $is#al impairment in 1)* of #n ompli ated e1tra aps#lar atara t operation !. the in iden e of ystoid ma #lar oedema is hi+her in intra aps#lar atara t e1tra tion than e1tra aps#lar atara t operation . the ris% of ystoid ma #lar oedema is in reased in patients "ho ha$e post>operati$e orneal oedema d. $itreo#s prolapsed is a %no"n pre ipitatin+ fa tor for ystoid ma #lar oedema e. malpositioned of intrao #lar lens is a re o+niCed fa tor for ystoid ma #lar oedema

5;. The follo"in+ are tr#e a!o#t the lassifi ation of retinopathy of premat#rity: a. 3ta+e 1: normal retina !. 3ta+e &: presen e of demar ation lines that protr#de into the $itreo#s . 3ta+e ,: presen e of fi!ro$as #lar proliferation in the peripheral retina d. 3ta+e 0: total retinal deta hment e. 3ta+e 5: proliferati$e $itreo#s retinopathy

5?. The follo"in+ are tr#e a!o#t pse#doe1foliation syndrome: a. the a+e "hen +la# oma de$elops is older than primary open an+le +la# oma !. the intrao #lar press#re al"ays responds !etter to medi al treatment than primary

open an+le +la# oma . asymmetri al +la# oma is more ommon than primary open an+le +la# oma d. there is an in reased pi+ment deposition in the tra!e #lar mesh"or% e. tra!e #le tomy is less s# essf#l in ontrollin+ the press#re than in primary open an+le +la# oma.

5(. In radiation retinopathy:

a. the main patholo+y is o l#si$e mi roan+iopathy !. the lo"est dose of radiation re4#ired to a#se radiation retinopathy is 11 Gy . the photore eptors are more sensiti$e to radiation than the retinal $as #lar ells d. patients on hemotherapy are more $#lnera!le to radiation retinopathy e. hyper!ari o1y+en is #sef#l in pre$entin+ the pro+ression of radiation retinopathy

:). The follo"in+ are tr#e a!o#t lo al anaesthesia: a. peri!#l!ar anaesthesia re4#ires a lon+er time than retro!#l!ar anaesthesia to a hie$e a%inesia !. li+no aine re4#ires a shorter time than mar aine to a hie$e anaesthesia . li+no aine has a lon+er d#ration of a tion than mar aine d. topi al ametho aine is inade4#ate for iris anaesthesia e. retro!#l!ar haemorrha+e in reases the ris% of e1p#lsi$e haemorrha+e .ns"ers to Test T"o

1.

a.T

!.F

.T

d.T

e.T

Many dr#+s ha$e !een impli ated in opti ne#ropathyD the follo"in+ are the !etter %no"n:

anti>t#!er #lo#s: etham!#tol and isoniaCid hlorampheni ol di+italis oral hypo+ly aemi a+ents: hlopropamide and tol!#tamide hloro4#ine dis#lfir#m 6>peni illamine

&.

a.T

!.T

.F

d.T

e.F

<ypotony:

o #rs "hen the intrao #lar press#re is s#ffi ient lo" to ompromise the o #lar f#n tion #s#ally !elo" : mm<+ may !e a#sed !y de reased a4#eo#s prod# tion or e1 essi$e a4#eo#s draina+e an res#lts in:

> orneal oedema > atara t formation > #$eal eff#sion > ma #lar oedema > dis oedema > horoidal folds

> horoidal deta hment

,.

a.T

!.T

.F

d.F

e.T

.n%ylosin+ spondylitis:

inflammatory disorders of spinal -oints ()* ha$e the <9.>A&; halotype systemi feat#res in l#de peripheral arthritisD #$eitisD aorti $al$e in ompeten e and hroni inflammatory !o"el disease the ondition is ommoner and more se$ere in males than females in the spineD the inflammation !e+ins at the site "here li+aments are atta hed to $erte!ral !one (the entheses)D ho"e$erD si+ns may o #r !efore the patients omplain of any symptoms.

0.

a.T

!.F

.T

d.F e.T

3 leritis:

many $arieties and some ha$e a hi+her in iden e of systemi asso iation than other. In de reasin+ order: ne rotiCin+ s leritis "itho#t inflammation ie. s leromala ia perforans (o$er G()*)D nod#lar and ne rotiCin+ s leritis (5)*)D diff#se s leritis (,)*) and posterior s leritis (1)*) se$ere pain is ommon sero#s retinal deta hment is a %no"n ompli ation espe ially "ith posterior s leritis in mild to moderate s leritisD oral non>steroidal anti>inflammatory a+ents s# h as di oflena are #sef#l in s#ppressin+ the inflammation +la# oma o #rs in 5* of ases and is related to: steroid #seD in reased epis leral $eno#s press#re and rarely an+le los#re +la# oma d#e to horoidal eff#sion

5.

a.T

!.F

.F

d.T

e.F

O #lar parasites:

Tri hinella spiralis a#ses tri hinosis "hi h is an infestation of striated m#s le !y the lar$a. They are a 4#ired thro#+h eatin+ #nder oo%ed por%. The or!it and the #pper lid an !e ome infested leadin+ to inflammation and pain on eye mo$ement. 9oa loa is a 4#ired thro#+h !ites from Man+o flies . The patients presents "ith pr#riti s#! #taneo#s s"ellin+. O #lar manifestation in l#de mi+ration of "orms #nder the on-#n ti$aD in the anterior ham!er and the $itreo#s 9eishmania dono$ani an a#se either #taneo#s or / and $is eral leishmaniasis. It is transmitted !y the !ite of sandfly. In #taneo#s formD the eyelids may !e ome in$ol$ed and #ntreated an lead to interstitial %eratitis.

:.

a.T

!.F

.F

d.T

e.F

/$eal melanoma:

o #r mainly in the "hite pop#lation the in iden e sho"s little differen e !et"een the se1es #nli%e retino!lastoma the opti ner$es are seldom infiltrated epithelioid ell type is asso iated "ith poor pro+nosis !lood test is more sensiti$e than CT s annin+ in re$ealin+ hepati metastasis

;.

a.T

!.F

.F

e.F

e.F

Marfan's syndrome:

a#tosomal dominant ondition a#sed !y in orre t e1pression of a +ene prod# t for ,5)%6 +ly oprotein %no"n as fi!rillin "hi h is responsi!le for the e1tra ell#lar mi rofi!rol net"or%. Type I olla+en a!normality is seen in osteo+enesis imperfe ta ?)* ha$e lens s#!l#1ation "hi h is typi ally displa ed #p and o#t lenti #lar myopia "ith normal a1ial len+th is a feat#re #nli%e homo ystin#riaD the patient is mentally normal

?.

a.T

!.T

.T

d.T

e.T

Measles:

is a paramy1o$ir#s ontainin+ R8. a#ses 7opli%'s spots on the on-#n ti$a and ar#n le a#ses a #te atarrhal on-#n ti$itis a#ses p#n tate %eratitis "hi h is self>limitin+ in de$eloped o#ntries !#t in the presen e of maln#trition espe ially $itamin . defi ien yD !lindin+ %eratitis an o #r s#!a #te s lerosin+ panen ephalitis tends to o #r in hildren "ho a 4#ire measles !efore one year of a+e. It is hara teriCed !y pro+ressi$e ne#rolo+i al defi it "ith dementiaD myo lon#s and fo al si+ns a#sin+ death.

(.

a.T

!.T

.T

d.F

e.T

Cy losporin .:

is the prod# t of the f#n+#s Tolypo ladi#m inflat#m inhi!its T ell a ti$ation !y stoppin+ the e1pression of re eptors on T lympho ytes that re o+niCe the 6R anti+en fo#nd on anti+en presentin+ ells has poor tiss#e penetration "hen applied topi ally

is the dr#+ of hoi e in patients "ith Aeh et's disease a#ses nephroto1i ity as the main side effe t "hi h is dose>dependent

other side effe ts in l#de: hypertensionD hypertri hosisD +astrointestinal #psetD +in+i$al hyperplasiaD anaemia and raised 23R

1).

a.F

!.T

.F

d.T

e.T

'hly ten#lar on-#n ti$itis: is a type I= imm#ne response to some sensitiCed anti+en typi ally !a teria anti+en t#!er #losis is a %no"n a#se !#t it is more often asso iated "ith 3taphlo o #s a#re#s often o #rs near the lim!#s ommoner in hildren topi al steroid is the treatment of hoi e

11.

a. T

!.F

.T

d.T

e.F

Thiamine defi ien y

ommon in hroni al oholi s and in those "ith lon+>standin+ diseases of the #pper +astrointestinal tra t s# h as pepti #l er or +astri ar inoma a#ses Berni %e's en epholopathy "ith memory impairmentD ata1iaD peripheral ne#ropathy. O #lar si+ns in l#de e1ternal ophthalmople+ia and nysta+m#s there is hara teristi peri$as #lar haemorrha+es in the re+ion of the fo#rth $entri le and a4#ed# t and also in the mamillary !odies treatment of hoi e is "ith intra$eno#s thiamine ($itamin A1)

1&.

a.T

!.T

.T

d.T

e.T

Tentorial herniation:

o #rs "hen a mass lesion ma%es one ere!ral hemisphere too lar+e for its ompartment and a#se the infero>medial part of the ere!ral hemisphere to !e p#shed thro#+h the tentorial hiat#s ( "hi h separates the ere!r#m from the ere!ell#m) the in reased press#re a#ses $omitin+ deterioration of ons io#sness o #rs d#e to dist#r!an e of the reti #lar formation ompression on the third ner$e res#lts in dilated p#pilD o #lar palsy and ptosis res#lts in onin+ "ith the "hole !rainstem !ein+ p#shed do"n"ard. This interfere "ith the $ital f#n tions of respiration ( ontrolled !y med#lla o!lon+ata)

ompression of the pyramidal fi!res res#lt in hemiparesis

1,.

a.T

!.T

.T

d.T

e.T

9a"ren e>Moon>Aiedle's syndrome ha$e the follo"in+ feat#res:

mental retardation o!esity hypo+enitalism polyda tyly spasti paraple+ia retinitis pi+mentosa

10.

a.F

!.F

.F

d.T

e.F

3ar oidosis:

a systemi disorder of #n%no"n ori+in tends to affe t people in their &)s and ,)s prod# es non> aseatin+ +ran#loma !ilateral hilar lymphadenopathies are ommon e$en in the a!sen e of hest symptoms a#ses red# ed n#m!er of ir #latin+ lympho ytes

15.

a.F

!.F

.F

d.F

e.F

3i %le ell disease:

si %le ell trait o #rs in ?* of the pop#lation altho#+h 33 disease has the most se$ere systemi manifestationD retinopathy is most se$ere "ith 3C and 3>thal diseases neo$as #lariCation typi ally o #rs in the peripheral retina salmon pat hes are the res#lt of pre>retinal or internal linin+ mem!rane haemorrha+es the main a#se of $is#al loss is $itreo#s haemorrha+e and rhe+mato+eno#s retinal deta hment.

1:.

a.T

!.F

.F

d.T

e.T

.lport's syndrome:

a disease "ith ne#rosensory hearin+ loss and haemorrha+i nephritis only 15* ha$e o #lar a!normalities and this in l#de anterior lenti on#s and peripheral

retinal fle % inheritan e may !e dominant (most ommon)D @>lin%ed and re essi$e

1;.

a.T

!.T

.T

d.T

e.F

Corneal deposits:

the m# opolysa haradosis is a +ro#p of stora+e disease a#sed !y an error of ar!ohydrate meta!olism. Corneal deposits are seen in all types e1 ept in 3anfilippo's (type III) and the ma-ority of <#nter's (type II) syndrome myeloma an lead to amyloidosis of ornea

ystinosis is an a#tosomal re essi$e ondition hara teriCed !y "idespread ystine rystal deposits in l#din+ the ornea

1?.

a.F

!.T

.T

d.F

e.F

Central retinal artery o l#sion: r#!eosis iridis o #rs in a!o#t 1)* of patients rarely retinal neo$as #lariCation is seen atrial fi!rillation is a a#se of em!ol#s "hi h may lead to retinal artery o l#sion delayed hyperfl#ores en e of horoidal ir #lation is a feat#re of ophthalmi artery o l#sion opti atrophy o #rs d#e to loss of +an+lion ell layers and these may ta%e months to de$elop

1(.

a.T

!.T

.F

d.F

e.F

. ommodati$e esotropia:

there is o$er on$er+en e asso iated "ith a ommodation most patients ha$e a hypermetropia of H&.)) dioptres or more a+e of presentation is !et"een 1? months and 0 years !ino #lar f#sion is #s#ally +ood #nli%e infantile esotropiaD inferior o!li4#e o$era tion is not a feat#re

&).

a.T

!.T

.T

d.T

e.T

'hospholine iodide:

is an a etyl holinesterase inhi!itor "hi h is #sed as a mioti a+ent an help patient "ith hypermetropi a ommodati$e esotropia and patient "ith a hi+h .C/. ratio a#ses ontra tion of iliary m#s le and iris sphin ter res#ltin+ in an in reased a ommodation for a +i$en a ommodati$e effort and therefore less on$er+en e side effe ts in l#de: iris ysts (red# ed "ith on #rrent treatment "ith phenylephrineD atara tD retinal deta hment and an+le los#re +la# oma in ad#lts. has systemi effe t and an prolon+ the a tion of s# inyl holine. ThereforeD patients sho#ld not ha$e s# inyl holine or ha$e to stop the drops at least si1 "ee%s prior to s#r+ery

&1.

a.T

!.F

.F

d.T

e.T

Infantile esotropia:

the patients typi ally present in the first si1 months of life there is a lar+e an+le esotropia asso iated feat#res in l#de: inferior o!li4#e o$era tion (;)*)D 6=6 (;5*) and latent nysta+m#s (5)*) a mild to moderate hypermetropia is ommon (H&.)) to H,.)) dioptres) mono #lar asymmetri al O78 is seen "ith poor response "hen the dr#m is rotated from the nasal to temporal dire tion

&&.

a.T

!.F

.T

d.F

e.T

Con+enital nysta+m#s:

may !e sensory d#e to a!normality in$ol$in+ the afferent $ision or motor the nysta+m#s is "orse "hen one eye is o$ered the nysta+m#s is red# ed on on$er+en e and this may res#lt in nysta+m#s !lo %a+e syndrome "ith esotropia a!o#t &/, of the patients ha$e parado1i al in$ersion of the opti o%ineti response (the dire tion of the 4#i % re o$ery phase is the same as that of the dr#m rotation instead of in the opposite dire tion) os illopsia is not a feat#re parado1i al p#pillary onstri tion may o #r "ith the p#pil initially onstri t "hen the room li+ht is dimmed

&,.

a.T

!.T

.T

d.F

e.T

Aro"n's syndrome:

a#sed !y a ta#t s#perior o!li4#e tendon sli+ht do"nshootin+ on add# tion is ommon and "idenin+ of the palpe!ral fiss#re on

add# tion the ondition may resol$e spontaneo#sly and therefore s#r+ery is not #s#ally indi ated

s#r+ery in l#de s#perior o!li4#e tenotomy "ith sili one e1pander or s#perior o!li4#e tenotomy "ith ipsilateral inferior o!li4#e re ession to pre$ent post>operati$e inferior o!li4#e o$era tion

&0.

a.T

!.F

.F

d.T

e.T

/nilateral intern# lear ophthalmople+ia:

res#lts from a lesion in the medial lon+it#dinal fas i #l#s !et"een the si1th ner$e and third ner$e n# lei a#ses fail#re of the ipsilateral medial re t#s to add# t on horiContal +aCe there is nysta+m#s of the ontralateral a!d# tin+ eye ( a#sed !y e1 essi$e inner$ation to the normal lateral re t#s in a ordan e "ith <erin+'s la") diplopia is a feat#re

d#e to a!normal sa ade the O78 is a!normal

&5.

a.F

!.F

.F

d.F

e.T

.!errant re+eneration of the third ner$e (o #lomotor syn%inesis):

feat#res of on+enital third ner$e palsies and those a#sed !y t#mo#rsD ane#rysms and tra#ma !#t not those d#e to is haemi ophthalmople+ia %no"n feat#res in l#de: ele$ation of the #pper lid on attempted add# tion or depression of the eyeD retra tion of the +lo!e on attempted depression or ele$ation of the eye

onstri tion of the p#pil on attempted add# tion or depression

&;.

a.F

!.T

.F

d.F

e.T

.n+ioid strea%s o #r in many onditions in l#din+:

pse#do1anthoma elasti #m 2hlers>6anlos syndrome si %le ell disease

'a+et's disease

&?.

a.F

!.T

.T

d.T

e.T

9atanaprost:

is a prosta+landin analo+#e more potent than !eta>!lo %er in red# in+ the intrao #lar press#re "or%s !y in reasin+ the #$eal s leral o#tflo" side effe ts in l#de: on-#n ti$al in-e tionD in reased iris pi+mentationD hypertri hosis and o #lar inflammation

&(.

a.F

!.F

.T

d.F

e.T

'i+mentry +la# oma:

typi ally seen in yo#n+ myopi males

raised press#re is !elie$ed to !e d#e to !lo %a+e of the tra!e #lar mesh"or% !y the pi+ments there is radial iris transill#mination hi+h intrao #lar press#re follo"in+ e1er ise is a feat#re

,).

a.F

!.F

.T

d.F

e.F

Aeni+n intra ranial hypertension:

the eye mo$ement is #s#ally normal !#t there may !e si1th ner$e palsy the CT s an sho#ld !e normal in yo#n+ "omen on ontra epti$e pillD !rain s an is important to e1 l#de sa++ital sin#s throm!osis "hi h may presents "ith similar pi t#res opti ner$e fenestration is indi ated if there "ere e$iden e of opti ner$e dysf#n tion the ondition an !e treated "ith di#reti and repeated l#m!ar p#n t#re. =entri #lar> peritoneal is rarely re4#ired.

,1.

a.T

!.T

.F

d.F

e.F

Medi ation and onta t lenses:

ontra epti$e pill may a#se poor tear se retion and interfere "ith onta t lens "ear rifampi in a#ses dis oloration of se retion in l#din+ the tear "hi h may stain the onta t lens

,&.

a.T

!.T

.T

d.F

e.F

Go#t:

is the res#lt of p#rine meta!olism may !e asso iated "ith e1 ess al ohol ons#mption !#t not a dire t lin% a#ses on-#n ti$itis and s leritis if the #ri on-#n ti$a or s lera rystals "ere to !e ome deposited in the

may a#se #ri a id rystals deposition in the ornea typi ally in the interpalpe!ral fiss#re !#t the rystals are typi ally s#!epithelial

,,.

a.F

!.F

.T

d.T

e.T

Iron deposition in the ornea:

Fleis her's rin+ o #rs at the !ase of %erato on#s <#dson>3tahli's line is a normal a+ein+ han+e 3to %er's line is fo#nd in front of a ptery+i#m Ferry's line is fo#nd in front of a !le! iron deposition is ommonly seen near in isions of radial %eratotomy

,0.

a.T

!.F

.F

d.F

e.T

Corneal +rafts:

Ceno+rafts refer to transplant !et"een t"o different spe ies iso+rafts refer to transplant !et"een t"o identi al t"ins lamellar %eratoplasty is not s#ita!le for F# h's dystrophy "here the endotheli#m is non> f#n tionin+

!lood transf#sion does not appear to affe t +raft s#r$i$al. In some transplant li%e renalD pre$io#s transf#sion a t#ally has a positi$e effe t !ro%en s#t#re an eli it neo$as #lariCation leadin+ to in reased re-e tion

,5.

a.T

!.T

.F

d.F

e.F

Goldenhar's syndrome:

is a type of hemifa ial mi rosomia sporadi o #rren e fa ial asymmetry "ith mandi!#lar hypoplasia prea#ri #lar appenda+esD malformation of the earD hearin+ loss a#sed !y e1ternal ear lesions o #lar feat#res: epi!#l!ar dermoidsD lim!al dermoidsD eyelid olo!omas and s#! #taneo#s dermoids of the lids

,:.

a.T

!.F

.T

d.F

e.T

Colo#r defe t:

ma #lar pro!lems #s#ally a#se loss of !l#e/yello" olo#r dis rimination opti ner$e defe ts tend to res#lt in red / +reen olo#r defe t

,;.

a.F

!.T

.T

d.T

e.F

Ca$erno#s sin#s lesion in a patient "ith #nilateral third ner$e palsy:

in$ol$ement of other ner$es in the a$erno#s sin#s s# h as fo#rth ner$eD si1th ner$eD fifth ner$e ( a#sin+ red# ed orneal refle1 and de reased fa ial sensation)D and sympatheti ner$e (p#pil onstri tion).

,?.

a.T

!.T

.F

d.F

e.T

Carotid> a$erno#s fist#la:

dilated s#perior ophthalmi $ein an !e seen on CT s an d#e to on+estion !lood in the 3 hlemmn's anal o #rs d#e to raised epis leral press#re as the t"o a$erno#s sin#ses are inter onne tedD #nilateral fist#la an a#se ontralateral proptosis there are t"o types of fist#la: the hi+h flo" in "hi h there is dire t onne tion !et"een the internal arotid artery and the a$erno#s sin#s this is seen in the tra#mati ases. The lo" flo" is the d#ral fist#la "hi h res#lts from a onne tion !et"een the menin+eal !ran hes of the internal arotid or e1ternal arotid artery and the a$erno#s fist#la. The lo" flo" is typi ally seen in post>menopa#sal "omen "ith history of atheros lerosis or hypertension hi+h flo" fist#la rarely lose spontaneo#sly "hereas the lo" flo" loses spontaneo#sly in a!o#t 5)* of ases

,(.

a.T

!.F

.T

d.T

e.F

@>lin%ed ondition:

Fa!ry's disease is an @>lin%ed re essi$e disorder a#sed !y the defi ien y of the enCyme +ala tosidase Refs#m's disease is an re essi$e ondition in "hi h there is a defe t in the fatty a id meta!olism and res#lt in in reased le$els of phytani a id 8orrie's disease is an @>lin%ed re essi$e disorder "ith o #lar dys+enesis "ith pro+ressi$e a#ditory and mental impairment. Choroideremia is an @>lin%ed re essi$e disorder "ith !ilateral pro+ressi$e de+eneration of the horio apillaris.

Rod mono hromatism (a hromatopsia is an a#tosomal re essi$e disorder "ith red# ed $isionD nysta+m#sD photopho!ia

and a!sent olo#r $ision

0).

a.F

!.F

.F

d.T

e.T

Mesodermal dys+enesis:

.1enfeld's syndrome is asso iated "ith posterior em!ryoto1on and iris strands e1tendin+ onto the ornea. Iris hypoplasia is a feat#re of Rei+er's anomaly .1enfeld's syndrome is an a#tosomal dominant disorder Rie+er's anomaly is asso iated "ith posterior em!ryoto1onD prominent iris pro esses and iris stroma atrophy. Rie+er's syndrome is Rie+er anomaly pl#s s%eletalD fa ialD ranial and dental anomalies peter's anomaly onsists of !ilateral entral orneal opa ity d#e to defe ts in the posterior stroma. 5)* of ases ha$e +la# oma

01.

a.T

!.F

.F

d.T

e.T

9atti e de+eneration:

fo#nd in ?* of the pop#lation a#ses &5* of the retinal deta hment has a hi+her in iden e amon+st the hi+h myopes retinal deta hment #s#ally o #rs d#e to tear at the periphery of the de+eneration rather than d#e to the hole "ithin the latti e e1tensi$e ases are !etter treated "ith ryotherapy

0&.

a.T

!.T

.F

d.F

e.T

Indi ations for s#!retinal fl#id draina+e in l#de:

!#llo#s deta hment ma%in+ hole or tear identifi ation diffi #lt immo!iliCed retina raised intrao #lar press#re inferior retinal deta hment

0,.

a.T

!.T

.T

d.F

e.F

Intra$itreal +as in-e tion:

an a#se retinal tear and atara t C,F? has a lon+er half life than 3F: and also more e1pansile. C,F? typi ally e1pands to 0 times its $ol#me "here as 3F: only & to , times and therefore C,F? also a#ses more si+nifi ant in rease in intrao #lar press#re than 3F:

00.

a.T

!.F

.F

d.F

e.T

In ptosis s#r+ery:

!ro" s#spension allo"s the frontalis to perform #pper lids ele$ation and is therefore re ommended in se$ere on+enital ptosis Fasa$ella>3er$ant is reser$ed for mild ptosis pre$io#s ptosis res#lts in distortion of the normal lid anatomy ma%in+ posterior approa h #ns#ita!le in mito hondrial myopathy poor Aell's phenomenon is often a feat#re and ma1imal

rese tion an res#lt in orneal e1pos#re assessment of Aell's phenomenon and orneal sensation are essential prior to s#r+ery to a$oid e1pos#re %eratitis

05.

a.F

!.T

.F

d.T

e.F

Fo#rth ner$e palsy an !e treated !y three s#r+i al approa hes:

stren+thenin+ of the ipsilateral s#perior o!li4#e s# h as t# %in+ "ea%enin+ of ipsilateral inferior o!li4#e (mye tomy or re ession) "ea%enin+ of the ontralateral inferior re t#s (re ession)

0:.

a.T

!.T

.T

d.F

e.F

Corneal !lood stainin+:

seen in 5* of hyphaema a#sed !y passa+e of erythro yte !rea%do"n prod# t into the stroma it is ommoner in: re #rrent hyphaemaD lar+e hyphaemaD presen e of endothelial dysf#n tion and ele$ated intrao #lar press#re learin+ of the stainin+ typi ally !e+ins peripherally and mo$e entrally. This may ta%e months or years

0;.

a.F

!.F

.F

d.F

e.F

In a #te !a terial endophthalmitis:

3taphylo o #s epidermidis is the most ommon patho+en a ordin+ to the 2ndophthalmitis =itre tomy 3t#dyD the ma-ority of patients present at : days after operation the 3t#dy also sho"s systemi anti!ioti is of no $al#e and treatment sho#ld in l#de intra$itreal anti!ioti s the role of steroid is ontro$ersial !#t not ontraindi ated my oti a#ses tend to ta%e lon+er to de$elop

0?.

a.F

!.T

.F

d.F

e.F

9aser iridotomy:

dar% olo#r iris a!sor!s ar+on laser "ell and therefore respond !etter than li+ht olo#r iris less ener+y is #s#ally re4#ired for E.G than ar+on laser raised intrao #lar press#re may !e red# ed "ith anti>+la# oma treatment s# h as iodipine patient iridotomy is indi ated "hen pi+ment is seen flo"in+ o#t of the hole atara t may o #r !#t is #s#ally lo aliCed and of no $is#al si+nifi ant.

0(.

a.F

!.F

.F

d.T

e.F

Corneal +raft donor:

history of hepatitis A or <I= are ontraindi ated lo" endothelial ell o#nt ontri!#te to early orneal de ompensation

5).

a.F

!.T

.F

d.F

e.T

.r+on laser tra!e #loplasty:

hi+h po"er an lead to si+nifi ant inflammation and anterior syne hiae is !etter in those o$er 5) years of a+e red# ed press#re is d#e to alternation of the a4#eo#s o#tflo" prod# es a drop of press#re of !et"een 5 to 1) mm<+ is #sed "hen the patient is not responsi$e to ma1imal medi al therapy for +la# oma

51.

a.F

!.F

.T

d.F

e.F

Refra ti$e s#r+ery: radial %eratomy is s#ita!le only for myopes "ith less than ?6 of myopia. 9on+ term sta!ility is a pro!lem in !et"een 15 to ,)* of patients "ith hypermetropi shift and there are ompli ations asso iated "ith the pro ed#res in l#din+ loss of !est orre ted $is#al a #ityD +lareD di#rnal fl# t#ation of $is#al a #ity and et . remo$al of s#t#re alon+ the a1is of the lar+est pl#s ylinder is #sef#l in red# in+ asti+matism %eratomile#sis in$ol$es remo$al of the anterior part of the orneal tiss#e "hi h is then ar$ed on its posterior stromal s#rfa e to alter its radi#s of #r$at#re !efore repla in+ it.

5&.

a.T

!.T

.T

d.F

e.F

Red# tion of post>operati$e asti+matism: red# ed !y small in ision red# ed !y in ision far from the entre of the ornea and therefore lim!al !etter than orneal approa h and temporal orneal approa h !etter than s#perior approa h (the

horiContal diameter of the ornea is +reater than the $erti al diameter)

5,.

a.T

!.F

.T

d.F

e.F

.nterior aps#le remo$al: aps#lorrhe1is is a more diffi #lt te hni4#e to master than aps#lotomy !#t prod# es a stron+er ed+e and a#ses less displa ement of the lens d#e to more e4#al distri!#tion of for e sho#ld the aps#le #nder+oes fi!rosis

50.

a.F

!.F

.T

d.T

e.F

Inferior o!li4#e re ession: a "ea%enin+ pro ed#re is performed in the follo"in+ sit#ation: primary inferior o!li4#e o$era tion as in =>pattern esotropia or se ondary inferior o$era tion as in ipsilateral s#perior o!li4#e palsy or ontralateral s#perior re t#s palsy is more diffi #lt to perform than mye tomy as the m#s le needs to !e reatta hed posteriorly

55.

a.F

!.F

.F

d.T

e.T

/nre o$ered si1th ner$e palsy: !ot#lin#m to1in in-e tion red# es the pro!lem of medial re t#s ontra t#re !#t does not speed #p re o$ery

rese tion/re ession of the affe ted eye an mo$e the eye into the primary position and red# es diplopia in this position operation on more than t"o m#s les is asso iated "ith anterior se+ment is haemia Faden's pro ed#re on the ontralateral medial re t#s prod# es pro+ressi$e "ea%enin+ on add# tion "hi h mat hes the poor a!d# tion of the affe ted eye

5:.

a.F

!.T

.F

d.T

e.T

Cystoid ma #lar oedema: $is#ally insi+nifi ant CMO o #rs in a!o#t 15* of patients #nder+oin+ e1tra aps#lar atara t e1tra t as demonstrated !y fl#ores ein an+io+raphy. =is#ally si+nifi ant CMO only o #rs in a!o#t 1* of these patients the ris% of CMO is hi+her in intra aps#lar atara t e1tra tion than e1tra aps#lar e1tra tion other ris% fa tors in l#de: prolapsed $itreo#sD malpositioned of the intrao #lar lens and post>operati$e endophthalmitis.

5;.

a.F

!.T

.T

d.F

e.F

The lassifi ation of retinopathy of premat#rity is as follo": 3ta+e 1: presen e of demar ation line 3ta+e &: presen e of demar ation line that protr#des into the $itreo#s 3ta+e ,: presen e of peripheral retina fi!ro$as #lar proliferation 3ta+e 0: s#!total retinal deta hment 3ta+e 5: total retinal deta hment

5?.

a.F

!.F

.T

d.T

e.F

'se#doe1foliation syndrome: ompare "ith primary open an+le +la# omaD the intrao #lar press#re is more diffi #lt to ontrol "ith medi ation and there is +reater in iden e of asymmetry of +la# oma. Other"iseD the a+e ran+e is identi al and the s# ess rate of tra!e #le tomy is not different there is presen e of pi+ments in the tra!e #lar mesh"or% alled the 3ampaolesi's line

5(.

a.T

!.T

.F

d.T

e.F

Radiation therapy:

the patholo+y appears similar to dia!eti retinopathy "ith o l#si$e mi roan+iopathy se ondary to loss of endothelial ell and apillary los#re the lo"est report dose is 11 Gy the photore eptors are more resistant than the $as #lar ells the dama+e of "hi h is the main a#se of radiation therapy patients "ho are on hemotherapyD hypertensi$e and dia!eti are more $#lnera!le to radiation therapy hyper!ari o1y+en is of #npro$en !enefit

:).

a.T

!.T

.F

d.T

e.T

9o al anaesthesia:

peri!#l!ar anaesthesia relies on diff#sion of the anaestheti a+ents into the m#s le one to a hie$e anaesthesia "hereas "ith retro!#l!ar anaesthesiaD the anaestheti a+ents are in-e ted dire tly into the m#s le one

li+no aine "or%s faster than mar aine !#t the d#ration of a tion is shorter topi al ametho aine an a hie$e ade4#ate anaesthesia of ornea and on-#n ti$a !#t no the iris retro!#l!ar haemorrha+e in reases the or!ital press#re and therefore the ris% of e1p#lsi$e haemorrha+e

M#ltiple Choi e I#estions on Medi al Retina ( li % the n#m!er for the ans"ers)

1. Tr#e statements a!o#t e1#dati$e $itreoretinopathy in l#de:

a. it is an a#tosomal re essi$e disorder !. it has a f#ndal appearan e similar to patients "ith retinopathy of premat#rity

. the main a#se of $is#al loss is retinal deta hment

d. peripheral retinal neo$as #lariCation is a ommon feat#res

e. the ondition has a relentless pro+ression leadin+ to se$ere $is#al loss.

&. In .JOOR (a #te Con#lar o #lt o#ter retinopathy):

a. photopsia is a re o+niCed feat#re !. $is#al loss is a#sed !y retinal ne rosis

. fl#ores ein an+io+ram is #sef#l for dia+nosis

d. most affe ted patients are o$er the a+e of 0)

e. oral prednisolone is the treatment of hoi e

,. In 'IC (primary idiopathi

horiodopathy):

a. myopia is an asso iation !. more male than female are affe ted

. $itritis is ommon

d. $iral prodrome is ommon

e. !oth eyes are affe ted in &5* of ases

0. The follo"in+ are tr#e a!o#t I'C= (idiopathi polypoidal horiodal $as #lopathy): a. it is seen e1 l#si$ely in patients of .fri an ori+in. !. it a#ses re #rrent $itreo#s haemorrha+e

. it has a !etter $is#al pro+nosis than a+e>related ma #lar de+eneration

d. the ondition is hara teriCed !y dilated horoidal is !est seen "ith indo yanine +reen an+io+raphy

e. the lesions respond "ell to laser treatment.

5. 3ti %ler's syndrome: a. is an a#tosomal dominant ondition !. is asso iated "ith retinal deta hment in &)* of the patients

. sho"s a!normal #$#la

d. is asso iated "ith pi+mentation alon+ the peripheral retinal $essels

e. has a!normal type II olla+en

:. The differen es !et"een .R8 (a #te retinal ne rosis) and 'OR8 (pro+ressi$e o#ter retinal ne rosis) in l#de: a. .R8 is asso iated "ith herpes simple1 $ir#s !#t not 'OR8 !. .R8 has a "orse $is#al pro+nosis than 'OR8

. .R8 is asso iated "ith .I63 !#t not 'OR8

d. retinal deta hment is ommon in .R8 !#t not in 'OR8

e. $itritis is more se$ere in .R8 than in 'OR8

;. Tr#e statements a!o#t $i+a!atrin in l#de: a. it is the first line of treatment in patient "ith petit mal !. it is a G.A. transaminase inhi!itors

. it a#ses $orte1 %eratopathy

d. it a#ses $is#al field defe t in ,)* of #sers

e. stoppin+ the $i+a!atrin an re$erse the $is#al field loss

?. O+# hi's disease: a. is an a#tosomal dominant ondition !. is hara teriCed !y stationary ni+ht !lindness

. is asso iated "ith olo#r !lindness

d. is hara teriCed !y MiC#o>8a%am#ra phenomenon

e. a#ses si+nifi ant $is#al loss !efore the a+e of 5)

(. Retinal rystals are seen in the #se of: a. tamo1ifen !. hydro1y hloro4#ine

. antha1anthin

d. desferrio1amine

e. ma+nesi#m sili ate

1). In retinopathy a#sed !y sha%en !a!y syndrome: a. the patient is #s#ally !et"een the a+e of , and 5 years of a+e !. the retinopathy may resem!le entral retinal $ein o l#sion

. ne#rolo+i al dama+e is ommon

d. s%#ll fra t#re is al"ays present

e. the $is#al pro+nosis is +ood

11. The follo"in+ si+ns fa$o#r the dia+nosis of entral retinal artery o l#sion rather than ophthalmi artery o l#sion:

a. the presen e of herry red spot !. the presen e of relati$e afferent p#pillary defe t

. red# tion of !oth a and ! "a$e on the ele troretino+ram (2RG)

d. delayed horoidal ir #lation in fl#ores ein an+io+raphy

e. a!sen e of pi+mentary han+es in the posterior se+ment

1&. The follo"in+ onditions an +i$e rise to the lini al appearan e of ystoid ma #lar oedema !#t "itho#t fl#ores ein an+io+raphi e$iden e of late fl#ores ein lea%a+e: a. epiretinal mem!rane !. Ir$ine>Gass syndrome

. -#$enile retinos hisis

d. ni otini a id ma #lopathy

e. Goldman>Fa$re syndrome

1,. The follo"in+ retinal findin+s are asso iated "ith rhe+mato+eno#s retinal deta hment: a. pa$in+ stone de+eneration !. ysti retinal t#ft

. pars plana yst

d. on+enital hypertrophy of retinal pi+ment retinal epitheli#m

e. meridonal folds

10. Feat#res of a #te ma #lar ne#roretinopathy in l#de: a. para entral s otoma !. mild $itritis

. presen e of a trian+#lar shape dar% lesion in the ma #la

d. a!normal ele troretino+ram

e. profo#nd $is#al loss "ith only 5* re o$er :/,: $ision

15. In $on <ippel>9inda#'s disease:

a. retinal an+ioma is seen in 5)* of the patients !. an+ioma of the dis may mimi horoidal neo$as #lariCation.

. any retinal an+ioma sho#ld !e treated early as spontaneo#s re+ression is rare

d. treatment of the retinal an+ioma an +i$e rise to s#!retinal

e1#dation

e. the main a#se of $is#al loss is e1#dati$e ma #lopathy

1:. Tr#e statements a!o#t 3tar+ardt's disease in l#de: a. the ma-ority of the ases are inherited in an a#tosomal dominant pattern !. the ondition is symptomati in the first or se ond de ade of life

. a!normal red>+reen olo#r $ision is ommon

d. histopatholo+y re$eals the presen e of s#!retinal lipof#s in s#!stan e

e. ma #lar oedema is a ommon a#se of $is#al loss

1;. In By!#rn>Mason's syndrome: a. is an @>lin%ed inheritan e !. the f#ndal appearan e is a#sed !y arterio$eno#s omm#ni ation

. e1#dati$e ma #lopathy is the main a#se of $is#al loss

d. s%#ll @>ray re$eals tram>line al ifi ation

e. $is#al field defe t o #rs in one third of the patient

1?. The follo"in+ statements are tr#e:

a. ele troretino+ram is dia+nosti of 3tar+ardt's disease !. amplit#de of ele troretino+ram is red# ed in arriers of horoideremia

. ele tro>o #lo+ram li+ht pea% to dar% tro#+h ratio is normal in ad#lt onset fo$eoma #lar dystrophy

d. ele troretino+ram is dia+nosti of 9e!er's on+enital ama#rosis

e. ele troretino+ram is #sef#l in dete tin+ arrier of @>lin%ed retinitis pi+mentosa

1(. Aietti's rystalline dystrophy:

a. is ommoner in females than males !. a#ses horoidal atrophy

. has a!normal rystalline deposits in the ornea and lympho ytes

d. prod# es rystalline deposits in all layers of the retina

e. is asso iated "ith a!normal ele troretino+ram

&). The follo"in+ m# opolysa haridosis are asso iated "ith pi+mentary retinopathy:

a. <#nter's syndrome !. 3anfilippo's syndrome

. 3 heie's syndrome

d. Moratea#1>9amy's syndrome

e. 3ly's syndrome

&1. The follo"in+ onditions are asso iated "ith an opti ally empty $itreo#s and peripheral pi+mentary han+es:

a. Kansen's disease !. Ba+ner's disease

. @>lin%ed retinos hisis

d. Fa$re>Goldmann's syndrome

e. 7earn>3ayre's syndrome

&&. The follo"in+ statements are tr#e a!o#t Kansen's disease and Ba+ner's disease: a. !oth onditions ha$e a#tosomal dominant inheritan e !. !oth onditions are asso iated "ith in reased retinal deta hment rate

. the 2RG are red# ed in !oth onditions

d. the 2OG are normal in !oth onditions

e. hi+h myopia are ommon in !oth onditions

&,. Feat#res of ma roane#rysms in l#de:

a. more ommon in "omen than men !. more ommon in the temporal ar ade than the nasal ar ade

. retinal artery o

l#sion

d. o #rs in IR=.8 syndrome

e. pro+ressi$e enlar+ement and therefore early treatment "ith treatment "ith laser photo oa+#lation is re ommended

&0. In ar inoma asso iated retinopathy (C.R): a. the ondition is a paraneoplasti syndrome !. olo#r $ision and ni+ht !lindness are typi al presentation

. melanoma is the most ommon type of ar inoma seen

d. a#toanti!odies are seen in the !lood

e. plasmaphoresis is #sef#l in restorin+ the $is#al f#n tion

&5. 6eafness and pi+mentary retinopathy are seen in the follo"in+ onditions: a. /sher's syndrome

!. on+enital r#!ella

. on+enital syphilis

d. <#nter's syndrome

e. Refs#m's syndrome

&:. 8orrie's disease has the follo"in+ feat#res: a. mental retardation !. histolo+y of the retina re$eals rosette formation

. @>lin%ed inheritan e

d. deafness

e. le#%o oria "hi h may !e mista%en for retino!lastoma

&;. In @>lin%ed retinos hisis: a.the splittin+ of the retina o #rs at the le$el of inner ple1iform layer !. ele trophysiolo+y re$eals ne+ati$e 2RG

. the main a#se of $is#al loss is re #rrent retinal deta hment

d. 68. analysis is #sef#l in dete tin+ arrier of the ondition

e. myopia is ommon

&?. In 2T6R3 (2arly Treatment 6ia!eti Retinopathy 3t#dy) si+nifi ant ma #lar oedema is defined as: a. hard e1#dates "ithin 5))#m of the fo$ea !. retinal thi %enin+ "ithin 5))#m of the fo$ea

. ma #lar stainin+ in fl#ores ein an+io+raphy

d. retinal thi %enin+ +reater than one dis area in siCe and "ithin one dis diameter of the entre of the fo$ea

e. ma #lar haemorrha+e "ithin 5))#m of the fo$ea

&(. The follo"in+ are tr#e re+ardin+ the re ommendations of the Aran h Retinal =ein O l#sion 3t#dy for patient "ith !ran h retinal $ein o l#sion: a. fl#ores ein an+io+raphy sho#ld !e performed "ithin fo#r "ee%s of the onset of !ran h retinal $ein o l#sion

!. presen e of more than 5 dis diameter of is haemia sho#ld !e treated "ith pan>photo oa+#lation . ma #lar oedema sho#ld !e treated "ithin & months of the onset of !ran h retinal $ein o l#sion

d. ma #lar laser is #sef#l in patient "ho has ma #lar is haemia

e. ,)* of !ran h retinal $ein o l#sion de$elops neo$as #lariCation

,). The follo"in+ are the findin+s from the 6ia!etes Control and Compli ations Trial: a. ti+ht +ly aemia ontrol red# es the pro+ression of dia!eti retinopathy in !oth ins#lin and non>ins#lin dependent dia!eti !. the need for ma #lar laser treatment is de reased in "ell> ontrolled +ro#p

. "orsenin+ of the retinopathy an o #r d#rin+ the initial phase of ti+ht ontrol

d. atta % of hypo+ly aemia is in reased in ti+htly ontrolled +ro#p

e. the in iden e of atara t is red# ed.

.ns"ers on Medi al Retina ( li % on the n#m!er to ret#rn to the 4#estions)

1.

a.F !.T

.T

d.T

e.T

Familial e1#dati$e $itreoretinopathy

F2=R is normally an a#tosomal dominantly inherited disease !#t @>lin%ed inheritan e has !een des ri!ed. altho#+h !oth eyes are affe tedD the de+ree of in$ol$ement

may !e $ery asymmetri al. the f#nd#s appearan es may !e onf#sed "ith retinopathy of premat#rity (RO') it is hara teriCed !y peripheral areas of a$as #larity in the peripheral retinaD almost indistin+#isha!le from RO'. The la % of history of premat#re !irthD lo" !irth "ei+htD or o1y+en therapy differentiates this ondition from retinopathy of premat#rity. dra++in+ of the retina temporally "ith $essel strai+htenin+D s#!retinal e1#dationD i atriCation and retinal deta hment are all feat#res of this ondition. Compli ations in l#de neo$as #larisation in the peripheral retina. treatment "ith ryotherapy to neo$as #lar areasD and s leral !# %lin+ and $itre tomy pro ed#res for tra tional deta hments ha$e all !een #sed in the treatment.

relentless pro+ression is #n ommon. =is#al impairment tends to o #r early and it is rare to lose $ision after the a+e of ,) #nless the patient de$elops tra tional retinal deta hment.

&.

a.T

!.F

.F

d.F

e.F

. #te Conal o #lt o#ter retinopathy (.JOOR):

an idiopathi onditions "hi h may !e pre ipitated !y p#n tate inner horoiodapthy ('IC)D m#ltifo al horoiditis (MIC) or m#ltiple e$asnes ent "hite dot syndrome (M2B63) it is hara teriCed !y a rapid loss of $is#al field "hi h

annot !e e1plained !y the ophthalmos opi

han+es

ma-ority of the s#fferers are healthy yo#n+ "hite myopi females.

initial presentation is "ith photopsia and in reased !lind spot in the presen e of normal $is#al a #ity. 9aterD the $is#al field is de reased "ith de reased $is#al a #ity. fl#ores ein an+io+raphy is not helpf#l as it is normal or mi+ht only sho" the pre ipitation ondition initially. In ele trophysiolo+yD the ele tro>o #lo+ram (2OG) li+ht rise is often red# ed and the 2RG is #s#ally $ery a!normal. there is no effe ti$e treatment. In some patientsD the $ision ret#rns spontaneo#sly.

,.

a.T

!.F

.F

d.F

e.F

'#n tate idiopathi

horiodopathy ('IC)

is ommoner in myopi "omen in their ,)s and 0)s.

patients presents "ith !l#rred $isionD para entral s otoma and photopsia.

the ondition is !ilateral in the ma-ority of the patients

the a #te lesions are small yello" lesions "ith sli+htly f#CCy !orders. there are no ells or other si+ns of inflammation in the $itreo#s or anterior ham!er. the lesions +rad#ally e$ol$e into "ell defined s ars and

slo"ly !e ome more pi+mented.

$iral prodrome is not asso iated "ith 'IC the $is#al pro+nosis of eyes "ith that do not de$elop s#!fo$eal C8= is $ery +ood.

0.

a.F

!.T

.T

d.T

e.T

Idiopathi polypoidal horoidal $as #lopathy (I'C=) is also %no"n as posterior #$eal !leedin+ syndrome and m#ltiple re #rrent serosan+#ineo#s R2' deta hment syndrome. altho#+h ori+inally des ri!ed in !la % hypertensi$e females in middle a+e. It is no" !een re o+niCed in other ra es. the hara teristi lesion appears to !e an inner horoidal $as #lar net"or% of $essels endin+ in an ane#rysmal !#l+e or o#t"ard pro-e tion. re #rrent and m#ltiple R2' deta hments "ith or "itho#t the asso iated s#!retinal !leedin+ (posterior #$eal !leedin+ syndrome) may then o #r. the a!sen e of dr#senD retinal $as #lar disease and intrao #lar inflammation is hara teristi of the ondition. =itreo#s haemorrha+e may also o #r.

the lesions "ere ori+inally des ri!ed to !e peripapillary in lo ationD !#t p#re ma #lar lesions ha$e also !een reported.

indo yanine +reen an+io+raphy is most helpf#l in identifyin+ polyps.

it has a !etter pro+nosis than other a#ses of haemorrha+i deta hments of the retina. 6ire t laser therapy to the

lesion appears to arry a !etter pro+nosis in I'C= ompared to laser therapy of C8= in .M6 patients.

5.

a.T

!.F

.T

d.T

e.T

3ti %ler's syndrome:

a#tosomal disorders

asso iated "ith a!normal prod# tion of type II olla+en

o #lar feat#res in l#de myopiaD atara tsD stra!ism#sD and opti ally>empty $itreo#s $itreo#s tra tion and latti e de+eneration m#ltiple retinal !rea%s o #rs in more than ;5* of the patients. systemi manifestation in l#de ma1illary and mandi!#lar hypoplasiaD left palateD a!normal #$#laD ne#rosensory hearin+ loss and s%eletal a!normalities "ith -oint hypere1tensi!ilityD and marfanoid ha!it#s :. a.F !.F .F d.T e.T

6ifferen e !et"een .R8 and 'OR8: !oth onditions are asso iated "ith herpes $ir#s hiefly herpes simple1 and Coster !oth onditions an lead to retinal deta hment .R8 is seen !oth in healthy and imm#no ompromised patients "hereas 'OR8 is seen e1 l#si$ely in .I63 or imm#no ompromised patients $itritis is often se$ere in .R8 !#t is #s#ally minimal or a!sent in 'OR8

.R8 responds to intra$eno#s a y lo$ir !#t 'OR8 responds poorly and 'OR8 patients

#s#ally ha$e poorer e$ent#al $is#al o#t ome

;.

a.F

!.T

.F

d.T

e.F

=i+a!atrin:

indi ated only "hen all other appropriate antiepilepti dr#+ om!inations ha$e pro$ed ineffe ti$e or poorly tolerated is an G.A. transaminase inhi!itor indi ated as first line therapy only in infantile spasm a!o#t 1/, of epilepsy patients #sin+ it ha$e hara teristi $is#al field defe ts "hi h an $ary from asymptomati to se$ere and disa!lin+ the defe t is not re$ersi!le e$en "ith essation of the therapy the a#se of the $is#al field loss is #n%no"n

not re ommended in patients "ith pre>e1istin+ $is#al field defe ts

?.

a.F

!.T

.F

d.T

e.F

O+# hi disease:

is a form of on+enital stationary ni+ht !lindness is hara teriCed !y a +olden/+rey>"hite dis oloration of the retina +i$in+ a metalli sheen to the !a % of the eye. This disappeared "hen the f#nd#s "as $ie"ed after some time in the dar% and has !e ome %no"n as the MiC#o>8a%am#ra phenomenon. $is#al a #ityD olo#r $ision and $is#al fields are #s#ally normal in O+# hi disease. t"o +enes in$ol$ed in O+# hi disease ha$e !een identified

and in l#de: arrestinD a +ene lo ated in the re+ion of the distal arm of hromosome &4D and rhodopsin %inase. The arrestin m#tations are more ommon in Kapanese O+# hi diseaseD and rhodopsin %inase in 2#ropean O+# hi disease.

patients are asymptomati in li+htD !#t are ni+ht !lind. dar% adaptation sho"s e1tremely retarded rod f#n tion.

(.

a.T

!.F

.T

d.F e.F

Retinal rystals are seen in:

dr#+>ind# ed: tamo1ifen antha1anthin tal metho1yfl#rane meta!oli disorders ysintonosis primary o1alosis type 1 others Aietti retinal dystrophy

3-or+ren>9arsson syndrome

1).

a.F

!.T

.T

d.F

e.F

3ha%en !a!y syndrome:

typi ally o #rs in hildren less than , years of a+e and res#lts from $iolent sha%in+ there is no e1ternal eye in-#ry !#t the posterior se+ment sho"s retinal haemorrha+es (!oth intra and s#!retinal) and $itreo#s haemorrha+e s%#ll fra t#re is #n ommon !#t CT s an re$eals s#!ara hnoid or intra ere!ral haemorrha+es $omitin+D lethar+y and fo al ne#rolo+i findin+s are ommon the $is#al pro+nosis is poor d#e to ma #lar s arrin+D $itreo#s haemorrha+e and retinal deta hment

11.

a.F

!.F

.F

d.T

e.T

In entral retinal artery o l#sion and ophthalmi artery o l#sion:

!oth +i$e herry>red spot in the a #te phase !oth a#ses relati$e afferent p#pillary defe t in ophthalmi artery o l#sionD the a and ! "a$es on the 2RG are a!normal d#e to ins#lt to the o#ter and inner retina in ophthalmi artery o l#sionD !oth the horoidal and retinal ir #lation are delayed

in ophthalmi artery o l#sionD the R2' is dist#r!ed res#ltin+ in pi+mentary han+es at a later date

1&.

a.F

!.F

.T

d.T

e.T

Cystoid ma #lar oedema "itho#t fl#ores ein lea%a+e o #rs in:

some ases of retinitis pi+mentosa @>lin%ed -#$enile retinos hisis Goldman>Fa$re syndrome

ni otini a id ma #lopathy

1,.

a.F

!.T

.F

d.F

e.T

Rhe+mato+eno#s retinal deta hment is asso iated "ith:

posterior $itreo#s deta hment latti e de+eneration ysti retinal t#ft meridonal folds "hite "itho#t press#re

10.

a.T

!.F

.T

d.F

e.F

. #te ma #lar ne#roretinopathy:

an #n ommon ondition "hi h a#ses para entral s otoma in yo#n+ ad#lt f#ndos opy re$eals dar% lesion in the ma #la "hi h is typi ally trian+#lar in shape other"ise the f#nd#s is normal the lesion is onfined to the ma #la and therefore the 2RG is normal the $is#al loss is mild and spontaneo#s re o$ery is ommon

15.

a.T

!.T

.T

d.T

e.T

$on <ippel>9inda#'s syndrome: is an a#tosomal dominant ondition "ith $aria!le penetran e 5)* of the patients has an+iomatosis retinae "hi h may !e fo#nd in the opti dis or the periphery those in the opti dis or -#1tapapillary may mimi horoidal neo$as #lariCation

the an+ioma enlar+es slo"ly leadin+ to $is#al loss mainly thro#+h e1#dati$e ma #lopathy and also $itreo#s haemorrha+eD tra tional retinal deta hment or epiretinal mem!rane 1:. a.F !.T .T d.F e.F

3tar+ardt's disease:

is #s#ally inherited in an a#tosomal re essi$e inheritan e it is re+arded as a type of f#nd#s fla$ima #lat#s lipof#s in s#!stan e is fo#nd "ithin the R2' ells "hi h +i$e rise to dar% horoid d#rin+ fl#ores ein an+io+raphy olo#r $ision defe t alon+ the red>+reen a1is is ommon in late sta+e the ma #la an ass#me !#ll's eye ma #lopathy

most patients !e ome symptomati "ithin the first or se ond de ade of life

1;.

a.F

!.T

.F

d.F

e.T

By!#rn>Mason's syndrome:

a type of pha%omatoses sporadi ondition

hara teriCed !y arterio$eno#s omm#ni ations of the retina and !rain !e+innin+ in adoles en e the arterio$eno#s omm#ni ations of the retina +i$es rise to ra emose ane#rysm of the retina #nli%e $on <ippel 9inda# syndromeD e1#dati$e ma #lopathy is #n ommon instead the $is#al loss is d#e to the loss of apillary !ed or o$erlyin+ of the $essels o$er the ma #la tram>line al ifi ation seen in s%#ll @>ray is hara teristi of 3t#r+e>Be!er's syndrome $is#al field defe t is seen in one>third of the patient d#e to the $as #lar a!normalities 1?. a.F !.F .T d.T e.T

2le trophysiolo+y:

2OG is #sef#l in dete tin+ Aest's disease !#t is normal in ad#lt onset fo$eoma #lar dystrophy ele troretino+ram is a!normal in arrier of @>lin%ed retinitis pi+mentosa and is dia+nosti in 9e!er's on+enital ama#rosis in 3tar+ardt's diseaseD the 2RG is $aria!le and is therefore not #sef#l for dia+nosis arrier of horoideremia has normal 2RG despite han+es in the peripheral retina 1(. a.F !.T .T d.T e.T

Aietti's rystalline dystrophy:

it is an a#tosomal re essi$e disorders is hara teriCed !y rystalline deposits in all layers of the retinaD ornea and also in the lympho ytes the rystals are made #p of holesterol and lipid R2' and horoidal atrophy are ommon feat#res patients present "ith ni+ht !lindness and pro+ressi$e $is#al loss 2RG and 2OG are a!normal &). a.T !.T .T d.F e.F

M# opolysa haridosis asso iated "ith pi+mentary retinopathy in l#de: Type I>< (<#rler) Type I>3 (3 heie) Type II (<#nter) Type III (3anfilippo's) Type I= (Mor4#io's)

Type =I (Marotea#1>9amy's syndrome) and type =II (3ly's syndrome) are not asso iated "ith pi+mentary retinopathy

&1.

a.T

!.T

.F

d.T

e.F

Opti ally empty $itreo#s (d#e to $itreo#s li4#efa tion) and peripheral retinal pi+mentary han+es o #r in:

3ti %ler's syndrome Kansen's disease Ba+ner's disease Goldmann>Fa$re disease

&&.

a.T

!.F

.T

d.T

e.T

Kansen's disease and Ba+ner's disease:

!oth onditions are a#tosomal dominant hi+h myopiaD atara t and +la# oma are ommon in !oth onditions the 2RG are a!normal in !oth onditions the 2OG are normal in !oth onditions the main distin+#ishin+ feat#re is the in reased ris% of retinal deta hment in Kansen's disease "hi h is not seen in Ba+ner's disease &,. a.T !.T .T d.T e.F

Ma roane#rysms:

are more ommon in "omen than men fo#nd mainly alon+ the temporal ar ade a#ses retinal artery o l#sionD retinal haemorrha+es and $itreo#s haemorrha+es

symptomati only if it !leeds or a#ses e1#dati$e ma #lopathyD spontaneo#s los#re is ommon d#e to throm!osis IR=.8 syndrome is made #p of Idiopathi Retinal =as #litisD .ne#rysms and 8e#roretinitis. It is hara teriCed !y !ilateral m#ltiple !ilateral ma roane#rysms &0. a.T !.T .F d.T e.F

Car inoma asso iated retinopathy (C.R):

is a paraneoplasti syndrome olo#r $ision defe tD ni+ht !lindness and rapid $is#al loss are typi al presentation the ondition may present !efore the dia+nosis of the primary t#mo#r "hi h is typi ally oat ell ar inoma of the l#n+ a#toanti!odies are ommonly seen in the !lood !oth rod and one 2RG are a!normal

there is no effe ti$e treatment &5. a.T .T .T d.T e.T

6eafness and pi+mentary retinopathy are seen in the follo"in+ onditions:

Con+enital syphilis Con+enital r#!ella /sher's syndrome Co %aryne's syndrome .lstroms syndrome 9e!er's ama#rosis .lport's syndrome <#nter's syndrome (M' II)

3an Fillipo's disease (M' III)

&:.

a.T

!.T

.T

d.T

e.T

8orrie's disease:

a rare @>lin%ed disorders !ilateral !lindness "ith a!normal retina de$elopment rosette formation is ommon in retina histolo+y 1/, has hearin+ a!normality retrolental masses are ommon "hi h may !e mista%en for retino!lastoma

&;.

a.F

!.T

.F

d.T

e.F

@>lin%ed retinos hisis:

splittin+ of the retina o #rs at the ner$e fi!re layer ele trophysiolo+y re$eals ne+ati$e 2RG "ith normal a "a$e !#t red# ed ! "a$e the main a#se of $is#al loss is entral ma #lar a!normalities other a#ses of $is#al loss in l#de retinal deta hment and $itreo#s haemorrha+e hypermetropia is an asso iation 68. analysis is #sef#l in dete tin+ the arrierD the a!normal +ene is lo ated at @9R31+ene on the short arm of the @> hromosome &?. a.F !.T .F d.T e.F

3i+nifi ant ma #lar oedema as defined !y 2T6R3 are:

retinal thi %enin+ "ithin 5)) mi rons of the entre of the fo$ea hard e1#date "ithin 5)) mi rons of the entre of the fo$ea "ith ad-a ent retinal thi %enin+ one dis area of retinal thi %enin+D any part of "hi h is "ithin 1 dis diameter of the entre of the fo$ea

&(.

a.F

!.F

.F

d.F

e.F

Aran h Retinal =ein O l#sion 3t#dy:

no treatment for ma #lar oedema for at least , months fl#ores ein an+io+raphy is not #sef#l at the time of presentation d#e to retinal haemorrha+esD it is only #sef#l "hen the haemorrha+es lear laser treatment is #sef#l in patients "ith $ision of :/1& or less and "itho#t e$iden e of ma #lar is haemia on fl#ores ein an+io+raphy altho#+h se torial panphoto oa+#lation is #sef#l in red# in+ the ris% of $itreo#s haemorrha+e in those patients "ho ha$e more than 5 dis diameter of is haemiaD the re ommendation is for the 'R' to !e performed only in the presen e of neo$as #lariCation and not !ased on is haemia of more than 5 dis diameter as the ma-ority of the eyes do not de$elop neo$as #lariCation ,). a.F !.T .T d.T e.F

Findin+s of the 6ia!etes Control and Compli ations Trial are: intensi$e ins#lin treatment res#lted in a statisti ally si+nifi ant red# tion in in iden e and pro+ression of 6R and the need for ma #lar laser panphoto oa+#lation or 'R'

these only apply to ins#lin dependent dia!eti initial "orsenin+ d#rin+ the first year "as noted in some eyesD !#t after , years there "as a !enefi ial effe t on pro+ression of 6R se$ere hypo+ly aemia "as more ommon in the ti+ht ontrol +ro#p

MCIs on O #lar Motility ( li % the 4#estion n#m!er for the ans"ers)

. ? year>old +irl "as referred "ith a history of sore eyes "hen "at hin+ T= and readin+ the !la %!oard. <er parents omplained that her eye appeared to "onder o#t at times. The $is#al a #ity "as :/: in !oth eyes. .lternate o$er test re$ealed e1ophoria "ith slo" re o$ery "ith the an+le of de$iation meas#rin+ ,5 prism dioptre at distan e and 1) prism dioptre at near. Follo"in+ a pat h testD she meas#red ,5 prism dioptre at distan e and 15 dioptre at near. (I#estions 1 > ,)

1. The follo"in+ are tr#e re+ardin+ this patient:

a. the patient has intermittent e1otropia of the di$er+en e e1 ess type !. !ino #lar sin+le $ision may !e s#ppressed for distant fi1ation !#t normal "ith near fi1ation

. pat hin+ of the eye s#spend the toni f#sional on$er+en e

d. a =>pattern de$iation is ommon on #p+aCe

e. spontaneo#s resol#tion is ommon as the patient a+es

&. The follo"in+ treatments are appropriate:

a. tinted +lasses !. o$er min#s +lasses if refra tion re$ealed myopia

. orthopti e1er ise

d. mioti

e. !ase>in prisms

,. Operation "as arried o#t "ith !ilateral lateral re t#s re ession. One day post>operati$eD the patient meas#red 1) prism dioptres of onse #ti$e esotropia. The follo"in+ are tr#e: a. pat hin+ of the +ood eye sho#ld !e arried o#t !. pres ri!e prism to maintain !ino #lar f#sion

. the eye sho#ld !e e1plored for slipped lateral re t#s

d. o$er orre tion of e1otropia is desira!le and the patient sho#ld !e reass#red

e. the esotropia "ill lessen "ith time

. : year>old +ird "as referred ha$in+ mo$ed into yo#r area. 3he "as pre$io#sly #nder the are of another hospital and had s4#int operation for a on$er+ent s4#int "hi h "as present sin e infan y. <er $is#al a #ity "as :/( in the ri+ht eye and :/: in the left. Co$er test re$ealed a small ri+ht e1otropia of 5 prism dioptres. The o$ered eye sho"ed ele$ation and nysta+m#s "as o!ser$ed "hen either eye "as o$ered.The nysta+m#s "as a!sent "hen !oth eyes "ere #n o$ered. (I#estions 0 > :) 0. The follo"in+ are tr#e:

a. the esotropia prior to the s#r+ery "as li%ely to !e more than ,) prism dioptres !. the patient is li%ely to ha$e hi+h hypermetropia in the ri+ht eye

. !ino #lar sin+le $ision is #s#ally !etter than :) de+rees of ar

d. asymmetri al opto%ineti nysta+m#s is ommon

e. f#rther s#r+ery is li%ely to !e needed.

5. Tr#e statements a!o#t ele$ation of the o$ered eye in l#de:

a. it is a#sed !y inferior o!li4#e m#s le o$era tion

!. the eye demonstrates Aiel ho"s%y phenomenon

. the ele$ation in reases on add# tion

d. the ele$ated eye #s#ally demonstrate e1tortion as it ele$ates

e. the ondition is #s#ally !ilateral !#t may !e asymmetri al

:. Bith re+ard to the nysta+m#s:

a. it is termed manifest latent nysta+m#s !. the fast phase is to"ard the side of the #n o$ered eye

. the intensity of the nysta+m#s in reases on a!d# tion

d. the nysta+m#s has a similar "a$eform to on+enital nysta+m#s

e. it is a#sed !y ere!ellar dysf#n tion

. 5 year>old hild is referred the orthopti !e a#se of stra!ism#s. The findin+s in l#de an esotropia of &) prism dioptre in the primary position "ith limited a!d# tion of the ri+ht eye. On add# tionD there is narro"in+ of the lid fiss#re and #pshootin+ ot he ri+ht. The

ri+ht eye "as normal. (I#estions ; > () ;. The follo"in+ is tr#e:

a. the hild is li%ely to !e male than female !. the patient is li%ely to ha$e a ri+ht fa e t#rn

. the narro"in+ of the lid is a#sed !y a!errant re+eneration of the third ner$e

d. am!lyopia is fo#nd in ()* of patients "ith this ondition

e. the dia+nosis is type II 6#ane's retra tion syndrome

?. The follo"in+ may !e asso iated "ith this ondition: a. Mar #s G#nn Ka" "in%in+ !. ro odile tears

. +la# oma

d. atara t

e. mi rophthalmos

(. Tr#e statements of this ondition in l#de:

a. the stra!ism#s is on omitant !. s#r+ery is #sef#l to restore normal o #lar motility

. s#r+ery is indi ated in patient "ith a!normal head post#re

d. rese tion of the m#s les may "orsen narro"in+ of the lid

e. Faden pro ed#re an red# e the #pshoot

. &0 year>old man "as referred to the eye as#alty !e a#se of intermittent $erti al diplopia. .lternatin+ o$er test re$ealed a $erti al phoria and "hen loo%in+ at a "hite dot thro#+h Maddo1 rods thro#+h !oth eyes he des ri!ed the lines as follo":

(I#estions 1) > 1,) 1). The follo"in+ are tr#e if the patient had a fo#rth ner$e palsy:

a. the patient has a ri+ht fo#rth ner$e palsy !. "hen the $erti al diplopia is presentD the left eye may !e hyperde$iated

. "ith the first step of the three step testsD the ri+ht eye "ill sho" hyperphoria

d. "ith the se ond step of the three step testD the left eye "ill sho" hyperphoria in left +aCe

e. "ith the third step of the three step testD the ri+ht eye "ill

sho" hyperphoria "ith ri+ht head tilt

11. The follo"in+ feat#res fa$o#rs a on+enital to an a 4#ired fo#rth ner$e palsy: a. a!sen e of y lotorsion

!. a!normal head post#re . = pattern on #p+aCe

d. $erti al f#sional amplit#de +reater than 0 prism dioptre

e. a!sen e of !ino #lar sin+le $ision

1&. The follo"in+ fa$o#rs a !ilateral to an #nilateral fo#rth ner$e palsy:

a. e1torsion of more than 1) de+rees

!. an a!normal head post#re onsists mainly of hin depression . positi$e Aiel ho"s%y head tilt test to either side

d. si+nifi ant hyperde$iation in the primary position

e. lar+e = pattern

1,. 3#r+i al treatment in this patient may in l#de: a. ri+ht inferior o!li4#e re ession !. ri+ht s#per re t#s re ession

. left inferior re t#s re ession

d. ri+ht <arada>Ito pro ed#re

e. Faden's pro ed#re of the ri+ht s#perior o!li4#e m#s le

. :0 year>old man omplains of horiContal diplopia "hi h is "orse on ri+ht +aCe. (I#estions 10 > 1;) 10. The follo"in+ are tr#e if he had a si1th ner$e palsy:

a. a ri+ht esotropia "hi h is "orse for distan e than near !. a fa e t#rn to the left

. impro$ed ri+ht eye mo$ement "hen the left eye is losed

d. = pattern on #p+aCe

e. #pshootin+ of the ri+ht eye on left +aCe

15. The follo"in+ m#s le se4#elae may o #r if he had a si1th ner$e palsy: a. ontra tion of the ri+ht lateral re t#s !. ontra tion of the ri+ht medial re t#s

. inhi!itional palsy of the left lateral re t#s

d. o$era tion of the left medial re t#s

e. ontra tion of the left lateral re t#s

1:. The follo"in+ additional si+ns and the lo ation of the lesion are tr#e:

a. !ilateral s"ollen dis > posterior fossa t#mo#r !. ri+ht miosis and ptosis > a$erno#s sin#s lesion

. fo#rth ner$e palsy > or!ital lesion

d. ri+ht fa ial ner$e palsy and anal+esia and loss of taste to anterior t"o third of the ton+#e > dorsal pon

e. left hemiple+ia > $entral pon

1;. Treatment of this patient may in l#de: a. in-e tion of !ot#lin#m to1in into the ri+ht medial re t#s !. !ase o#t Fresnel prism o$er the ri+ht eye

. Faden operation of the left medial re t#s

d. re ession of the left medial re t#s and rese tion of the ri+ht lateral re t#s

e. re ession of the ri+ht medial re t#s and rese tion of the left lateral re t#s

1?. Tr#e statements a!o#t mi rotropia in l#de:

a. it may res#lt from operation for on+enital esotropia !. the an+le of de$iation is typi ally !et"een 15 and &) prism dioptres

. stereopsis is #s#ally a!sent

d. anisometropia is a ommon feat#re

e. a !ase o#t 0 dioptre prism an !e #sed to dete t entral s otoma

1(. 3pasm#s n#tans: a. #s#ally !e+ins at , years of a+e !. is asso iated "ith head noddin+

. has -er%y and lar+e amplit#de nysta+m#s

d. is rarely asso iated "ith ne#rolo+i al disorders

e. #s#ally resol$es spontaneo#sly.

&). The follo"in+ are tr#e a!o#t a ommodati$e esotropia:

a. #s#ally !e+ins aro#nd the a+e of & years !. may !e a#sed !y a hi+h .C/. ratio

. there is #s#ally hypermetropia of more than H ,.)) 6

d. diplopia is rare

e. am!lyopia is #n ommon.

MCIs on /$eitis 1. The mat hin+ of the follo"in+ diseases and their <9. asso iation are tr#e:

a. sympatheti ophthalmitis !. par planitis <9.>6R&

<9.>.11

. i atri ial pemphi+oid

<9.>A5

d. 'osner>3 hlosmann syndrome

<9.>AB5

e. =o+t>7oyana+i><arada

<9.>A&&

&. 3e$ere $itritis is a feat#re of:

a. ytome+alo$ir#s retinitis

!. serpi+iono#s horoidpathy

. pres#med o #lar histoplasmosis

d. a #tre retinal ne rosis

e. to1oplasma retino horoidopathy

,. In o #lar to1o arisis:

a. a history of $is eral lar$a mi+rans is al"ays present !. e1amination of the patient's stool is #sef#l in dia+nosin+ the disease

. !ilateral o #lar in$ol$ement sho#ld ma%e one do#!t the a #ra y of the dia+nosis

d. #ltraso#nd of the +ran#loma typi ally sho"s al ifi ation

e. oral thia!endaCole is #sef#l

0.In -#$enile hroni arthritis>related #$eitis:

a. the #$eitis is #s#ally +ran#lomato#s !. the eyes are typi ally "hite

. the #$eitis #s#ally pre edes arthritis

d. it is asso iated "ith positi$e rhe#matoid fa tor

e. ystoid ma #lar oedema is an important a#se of poor $ision

5. The follo"in+ are tr#e "ith re+ard to atara t in -#$enile hroni arthritis:

a. atara t sho#ld not !e performed !efore the patients is ? year>old !. operation sho#ld !e performed only "hen the anterior ham!er is free of flare

. remo$al of the atara t sho#ld !e om!ined "ith anterior $itre tomy

d. hypotony is a %no"n post>operati$e ompli ation in these patients

e. only heparin> oated intrao #lar lens sho#ld !e implanted.

:. The follo"in+ are tr#e a!o#t ytome+alo$iral retinitis:

a. it is rarely seen in patients "ith a C6 0H o#nts of more than 5) ells/#l !. it a#ses f#ll thi %ness retinal ne rosis

. frosted !ran h retinitis is a %no"n lini al feat#re

d. spontaneo#s resol#tion in a!o#t ,)* of patients "itho#t treatment

e. anti>CM= anti!ody is #sef#l for dia+nosis

;. In the treatment of CM= retinitis:

a. +an i lo$irD fos anet and idofo$ir are all $irostati !. +an i lo$ir a#ses !one marro" s#ppression

. fos anet is asso iated "ith renal impairment

d. idofo$ir is asso iated "ith hepati dysf#n tion

e. re #rrent CM= retinitis is rare in patients on a maintenan e dose of +an i lo$irD fos anet or idofo$ir

?.Tr#e statements a!o#t <..RT (hi+hly a ti$e anti>retro$iral therapy) in l#de:

a. it red# es the re #rrent rate of CM= retinitis !. it is #sef#l in maintainin+ a hi+h le$el of C6 0H o#nts

. it is #sef#l in treatin+ a #te retinal ne rosis

d. it a#ses in reased $itritis

e. there is an in reased ris% of ystoid ma #lar oedema

(. In .I63 patients "ith to1oplasma retinitis:

a. !rain a!s ess o #rs in 0)* of ases !. the retinitis is more se$ere than imm#no ompetent patients

. treatment is only needed in patients "ith impaired $ision

d. retinal deta hment is a ommon a#se of $is#al loss

e. steroid is ontraindi ated

1). . pre+nant "oman de$elops to1oplasmosis in her first trimester of pre+nan y. The follo"in+ are tr#e:

a. there is a 0)* han e of the fet#s a 4#irin+ the infe tion !. s#!se4#ent offsprin+s are at ris% of infe tions

. the I+ M anti!ody "ill !e raised

d. a!ortion is ad$ised d#e to the hi+h ris% of fetal malformation

e. s#lphadiaCine is the preferred treatment than lindamy in

11. Tr#e statements a!o#t pars planitis in l#de:

a. it is asso iated "ith m#ltiple s lerosis in 5* of ases !. sheathin+ of the $ein is a#sed !y peri$as #lar #ffin+ of lympho ytes

. sno"!an%in+ is the res#lt of hard e1#date

d. $itreo#s !alls are omposed of epitheloid ells and m#ltin# leated +iant ells

e. $itreo#s haemorrha+e is the most ommon a#se of $is#al loss

1&. . &) year>old man omplains of de reased ri+ht $ision. Fo#r "ee%s earlierD he had #nder+one an e1tensi$e !o"el operation for Crohn's disease and had re ei$ed hyperalimentationa dn intra$eno#s anti!ioti s sin e the operation. On f#ndal e1aminationD a fl#ffy "hite horoidal lession is seen near the ma #la. There is minimal $itritis. The follo"in+ are tr#e a!o#t the or+anisms most li%ely to !e responsi!le for this ondition:

a. #lt#re of the !lood is #s#ally positi$e !. altho#+h ommonly seen in the respiratory tra tD it rarely a#ses pne#monia

. this or+anism "ill +ro" on the 3a!o#ra#d's #lt#re "ithin 0? ho#rs

d. the or+anism rarely in$ade the retina

e. intra$eno#s $an omy in is the treatment of hoi e

1,. In serpi+ino#s horoiditis:

a. there is loss of retinal pi+ment epitheli#m and the horoid !. the lesion typi ally !e+ins near the opti dis

. $is#al loss is a#sed hiefly !y ystoid ma #lar oedema

d. fl#ores ein an+io+raphy in the a #te phase re$eals early hyperfl#ores en e of the lesions

e. systemi

y losporine is the treatment of hoi e

10. Tr#e statements a!o#t .'M''2 (a #te posterior m#ltifo al pla oid pi+ment epitheliopathy)

a. females are more ommonly affe ted than males !. re #rren e does not o #r

. in the later phase of the fl#ores ein an+io+raphyD the lesions appears hyperfl#ores ent

d. pi+mentary dist#r!an e is ommon in the re o$ery phase

e. most patients maintain normal $ision on re o$ery

15. The follo"in+ dr#+s are %no"n to a#se anterior #$eitis:

a. topi al alpha+an !. rifa!#tin

. rifampi in

d. di+o1in

e. alpha> hymotrypsin

1:. In 3 h"artC's syndrome:

a. there is raised intrao #lar press#re !. the #nderlyin+ a#se is rhe+mato+eno#s retinal

deta hment

. +ran#lomato#s #$eitis is a feat#re

d. there is for"ard mo$ement of the lens>iris diaphra+m

e. ma #lar oedema is a main a#se of $is#al loss

1;. In F# h's hetero hromi

y litis:

a. 7oeppe's nod#les are seen !. a!normal $essels are seen !rid+in+ the an+le of the tra!e #lar mesh"or%

. atara t is seen in 5)* of the ases

d. +la# oma is seen in 15* of the ases

e. there is an in reased $itreo#s loss d#rin+ pha oem#lsifi ation

1?. 'osner>3 hlossman syndrome:

a. is painless

!. does not a#se +la# omato#s field loss

. is asso iated "ith hypopyon in the ma-ority of ases

d. is a self>limitin+ ondition

e. sho#ld !e treated "ith systemi steroid

1(.The follo"in+ imm#nos#pprassants and their side>effe ts are tr#e:

a. y lophophamide > haemorrha+i

ystitis

!. y losporine > !one marro" dysplasia

. aCathioprine > nephroto1i ity

d. methotre1ate > hepati fi!rosis

e. ta rolim#s (F75):) > hyper+ly aemia

&). . &5 year>old man from the Middle 2ast omplains of !l#rred ri+ht $ision. On e1aminationD he "as fo#nd to ha$e a small hypopyon in the ri+ht anterior ham!er. 'osterior se+ment of the ri+ht eye re$eals sheathin+ of the !lood $essels "ith retinal haemorrha+es. <e +a$e a past history of painf#l lesions in his mo#th and his +enitals. The follo"in+ are tr#e a!o#t this ondition:

a. histopatholo+y of the painf#l lesion re$eals patho+nomoni feat#re !. p#n t#rin+ the s%in "ith an hypodermi needle may !e #sef#l in dia+nosis

. the posterior se+ment patholo+y is a#sed !y inflammation of the retina and horoid

d. oral steroid alone is #s#ally effe ti$e in pre$entin+ relapse of the o #lar inflammation

e. #nless treated a++ressi$elyD the o #lar inflammation "ill !e ome hroni

Gla# oma 1. The follo"in+ $is#al field defe ts are typi ally seen in primary open an+le +la# oma:

a. entro e al s otoma !. nasal step

. entral s otoma

d. para entral s otoma

e. altit#dinal field loss

&. 2arly si+ns of +la# omato#s dama+e in l#de: a. splinter haemorrha+e of the opti dis !. +la# ofle %en

. $erti al elon+ation of the #p

d. loss ner$e fi!re layer

e. peripapillary atrophy

,. 3tati perimetry in l#de: a. 9ister perimeter !. Goldmann perimeter

. tan+ent s reen

d. O top#s

e. <#mphrey

0. The follo"in+ are dire t +onio lenses: a. 7oeppe !. Goldmann

. Thorpe

d. Jeiss

e. Aar%an

5. In pi+mentary dispersion syndrome:

a. the pi+ments is a#sed !y the release of melanin from the anterior s#rfa e of the iris !. the in iden e of affe ted male to female is 5:1

. perip#pillary retroill#mination is a feat#re

d. hetero hromia an o #r

e. latanoprost sho#ld !e a$oided as it in reases the release of pi+ments

:. Alood in 3 hlemm's anal is seen in:

a. 3t#r+e>Be!er's syndrome !. arotid> a$erno#s fist#la

. an+le re ession +la# oma

d. hypotony

e. ne#rofi!romatosis

;. The follo"in+ are tr#e a!o#t lens ind# ed +la# oma:

a. laser iridotomy is ineffe ti$e a+ainst phar omorphi +la# oma !. pha olyti +la# oma is hara teriCed !y !lo %a+e of the tra!e #lar mesh"or% !y protein laden mar opha+es

. pha olyti +la# oma typi ally o #rs follo"in+ atara t e1tra tion

d. pha olyti +la# oma is asso iated "ith Mor+a+nian

atara t

e. pha oanaphyla ti +la# oma is asso iated "ith +ran#lomato#s inflammation

?. In a patient "ith an+le re ession +la# omaD +onios opy may re$eal:

a. separation of the iliary !ody from its atta hment to the s leral sp#r !. in reased $isi!ility of the s leral sp#r

. torn iris pro ess

d. mar%ed $ariation in the iliary !ody "idth in different 4#adrant of the same eye

e. ne" $essels at the an+le

(. In primary on+enital +la# oma:

a. the in iden e is 1:1&D5)) !irths !. the orneal diameter is #s#ally +reater than ? mm

. +onios opy re$eals iris hypoplasia

d. the #p: dis ratio is +reater than ).,

e. males are more ommonly affe ted than females

1). 3ampaolesi's line:

a. is a pi+mented line anterior to 3 h"al!e's line !. o #rs in pse#doe1foliation syndrome

. is seen in pi+ment dispersion syndrome

d. o #rs in iris melanoma

e. is seen in siderosis !#l!i

11. In #$eiti +la# oma:

a. pilo arpine is the treatment of hoi e in patient "ho an not ta%e !eta !lo %ers !. +irls "ith pa# iarti #lar -#$enile rhe#matoid arthritis are

more li%ely to de$elop +la# oma than their male o#nterpart

. simple tra!e #le tomy is asso iated "ith hi+h fail#re rate

d. irido y litis is often asso iated "ith lo" rather than hi+h intrao #lar press#re

e. iris !om!e is a ommon ompli ation of 'osner>3 hlossman syndrome

1&. In <#mphrey a#tomated perimeterD the follo"in+ definition are tr#e:

a. a false>ne+ati$e response: fail#re to respond to a s#prathreshold stim#l#s at a lo ation that the patient "o#ld !e e1pe ted to see !. fi1ation loss: o #rs "hen the patient responds to a tar+et sho"n at his !lind spot

. hi+h positi$e rate is seen in tri++er happy patient

d. short term $ariation is +reater in +la# omato#s than normal pop#lation

e. short term $ariation refers to han+e in sensiti$ity "hen the same area is retested.

1,. The follo"in+ +la# oma are asso iated "ith !ilateral primary a!normalities of the orneal endotheli#m:

a. .1enfeld's anomaly !. 'eter's anomaly

. Co+an>Reese syndrome

d. posterior polymorpho#s mem!raneo#s dystrophy

e. essential iris atrophy

10. Tr#e statements a!o#t topi al !eta !lo %ers in l#de:

a. 1)* of patients do not sho" therape#ti response !. therape#ti response is red# ed in patients on systemi !eta>!lo %ers #se

. the additi$e effe t on +la# oma is in reased if it is om!ined "ith topi al adrenaline than "ith topi al a etaColamide

d. !eta1olol is more effe ti$e than timolol in lo"erin+ intrao #lar press#re

e. !rady ardia is less "ith arteolol than timolol

15. The ris% of de$elopin+ steroid>ind# ed +la# oma is in reased in the follo"in+ onditions:

a. myopes !. patients "ith a history of primary open an+le +la# oma

. history of an+le los#re +la# oma

d. dia!etes mellit#s

e. posterior syne hiae

1:. The follo"in+ are tr#e a!o#t laser peripheral iridotomies:

a. 8d:E.G laser re4#ires fe"er appli ation ompared "ith ar+on laser !. !leedin+ is less ommon "ith ar+on than 8d:E.G laser

. late los#re of the iridotomies is ommoner "ith ar+on than 8d:E.G laser

d. iris oedema is ommoner "ith ar+on than 8d:E.G laser

e. p#pillary distortion is ommoner "ith ar+on than 8d:E.G laser

1;. Tr#e statements a!o#t systemi a etaColamide in l#de:

a. it sho#ld !e a$oided in patients aller+i to s#lphonamides !. it is asso iated "ith meta!oli a idosis

. it is asso iated "ith renal al #li

d. it a#ses transient myopia

e. it sho#ld !e a$oided in patient "ith hepati

en ephalopathy

1?. The follo"in+ are tr#e a!o#t a4#eo#s draina+e de$i es:

a. all ontain a sili one t#!e atta hed to a syntheti plate !. orneal de ompensation is a %no"n ompli ation

. Molteno's t#!e ontains press#re sensiti$e de$i e

d. post>operati$e hypotony is ommoner "ith .hmed's $al$e than Molteno's t#!e

e. 7r#pin's $al$e ontains press#re sensiti$e $al$e

1(. Re+ardin+ anti>meta!olites:

a. they are applied to the s leral flap d#rin+ tra!e #le tomy !. they in rease the in iden e of post>operati$e endophthalmitis

. they inhi!it 68. synthesis and therefore ell#lar proliferation

d. 5>fl#oro#ra il is more li%ely to a#se hypotony than mitomy in C

e. mitomy in C is asso iated "ith a hi+her in iden e of "o#nd lea% than 5>fl#oro#ra il

&). .pra lonidine:

a. is an alpha & a+onist !. a#ses on-#n ti$al hyperaemia

. a#ses in reased #$eos leral o#tflo"

d. prod# es miosis

e. a#ses lid retra tion

Gla# oma 1. The follo"in+ $is#al field defe ts are typi ally seen in primary open an+le +la# oma:

a. entro e al s otoma !. nasal step

. entral s otoma

d. para entral s otoma

e. altit#dinal field loss

&. 2arly si+ns of +la# omato#s dama+e in l#de: a. splinter haemorrha+e of the opti dis !. +la# ofle %en

. $erti al elon+ation of the #p

d. loss ner$e fi!re layer

e. peripapillary atrophy

,. 3tati perimetry in l#de: a. 9ister perimeter !. Goldmann perimeter

. tan+ent s reen

d. O top#s

e. <#mphrey

0. The follo"in+ are dire t +onio lenses: a. 7oeppe !. Goldmann

. Thorpe

d. Jeiss

e. Aar%an

5. In pi+mentary dispersion syndrome:

a. the pi+ments is a#sed !y the release of melanin from the anterior s#rfa e of the iris !. the in iden e of affe ted male to female is 5:1

. perip#pillary retroill#mination is a feat#re

d. hetero hromia an o #r

e. latanoprost sho#ld !e a$oided as it in reases the release of pi+ments

:. Alood in 3 hlemm's anal is seen in:

a. 3t#r+e>Be!er's syndrome !. arotid> a$erno#s fist#la

. an+le re ession +la# oma

d. hypotony

e. ne#rofi!romatosis

;. The follo"in+ are tr#e a!o#t lens ind# ed +la# oma:

a. laser iridotomy is ineffe ti$e a+ainst phar omorphi +la# oma !. pha olyti +la# oma is hara teriCed !y !lo %a+e of the tra!e #lar mesh"or% !y protein laden mar opha+es

. pha olyti +la# oma typi ally o #rs follo"in+ atara t e1tra tion

d. pha olyti +la# oma is asso iated "ith Mor+a+nian atara t

e. pha oanaphyla ti +la# oma is asso iated "ith +ran#lomato#s inflammation

?. In a patient "ith an+le re ession +la# omaD +onios opy may re$eal:

a. separation of the iliary !ody from its atta hment to the s leral sp#r !. in reased $isi!ility of the s leral sp#r

. torn iris pro ess

d. mar%ed $ariation in the iliary !ody "idth in different 4#adrant of the same eye

e. ne" $essels at the an+le

(. In primary on+enital +la# oma:

a. the in iden e is 1:1&D5)) !irths !. the orneal diameter is #s#ally +reater than ? mm

. +onios opy re$eals iris hypoplasia

d. the #p: dis ratio is +reater than ).,

e. males are more ommonly affe ted than females

1). 3ampaolesi's line:

a. is a pi+mented line anterior to 3 h"al!e's line !. o #rs in pse#doe1foliation syndrome

. is seen in pi+ment dispersion syndrome

d. o #rs in iris melanoma

e. is seen in siderosis !#l!i

11. In #$eiti +la# oma:

a. pilo arpine is the treatment of hoi e in patient "ho an not ta%e !eta !lo %ers !. +irls "ith pa# iarti #lar -#$enile rhe#matoid arthritis are more li%ely to de$elop +la# oma than their male o#nterpart

. simple tra!e #le tomy is asso iated "ith hi+h fail#re rate

d. irido y litis is often asso iated "ith lo" rather than hi+h intrao #lar press#re

e. iris !om!e is a ommon ompli ation of 'osner>3 hlossman syndrome

1&. In <#mphrey a#tomated perimeterD the follo"in+ definition are tr#e:

a. a false>ne+ati$e response: fail#re to respond to a s#prathreshold stim#l#s at a lo ation that the patient "o#ld !e e1pe ted to see !. fi1ation loss: o #rs "hen the patient responds to a tar+et sho"n at his !lind spot

. hi+h positi$e rate is seen in tri++er happy patient

d. short term $ariation is +reater in +la# omato#s than normal pop#lation

e. short term $ariation refers to han+e in sensiti$ity "hen the same area is retested.

1,. The follo"in+ +la# oma are asso iated "ith !ilateral primary a!normalities of the orneal endotheli#m:

a. .1enfeld's anomaly !. 'eter's anomaly

. Co+an>Reese syndrome

d. posterior polymorpho#s mem!raneo#s dystrophy

e. essential iris atrophy

10. Tr#e statements a!o#t topi al !eta !lo %ers in l#de:

a. 1)* of patients do not sho" therape#ti response !. therape#ti response is red# ed in patients on systemi !eta>!lo %ers #se

. the additi$e effe t on +la# oma is in reased if it is om!ined "ith topi al adrenaline than "ith topi al a etaColamide

d. !eta1olol is more effe ti$e than timolol in lo"erin+ intrao #lar press#re

e. !rady ardia is less "ith arteolol than timolol

15. The ris% of de$elopin+ steroid>ind# ed +la# oma is in reased in the follo"in+ onditions:

a. myopes !. patients "ith a history of primary open an+le +la# oma

. history of an+le los#re +la# oma

d. dia!etes mellit#s

e. posterior syne hiae

1:. The follo"in+ are tr#e a!o#t laser peripheral iridotomies:

a. 8d:E.G laser re4#ires fe"er appli ation ompared "ith ar+on laser !. !leedin+ is less ommon "ith ar+on than 8d:E.G laser

. late los#re of the iridotomies is ommoner "ith ar+on than 8d:E.G laser

d. iris oedema is ommoner "ith ar+on than 8d:E.G laser

e. p#pillary distortion is ommoner "ith ar+on than 8d:E.G laser

1;. Tr#e statements a!o#t systemi a etaColamide in l#de:

a. it sho#ld !e a$oided in patients aller+i to s#lphonamides !. it is asso iated "ith meta!oli a idosis

. it is asso iated "ith renal al #li

d. it a#ses transient myopia

e. it sho#ld !e a$oided in patient "ith hepati en ephalopathy

1?. The follo"in+ are tr#e a!o#t a4#eo#s draina+e de$i es:

a. all ontain a sili one t#!e atta hed to a syntheti plate !. orneal de ompensation is a %no"n ompli ation

. Molteno's t#!e ontains press#re sensiti$e de$i e

d. post>operati$e hypotony is ommoner "ith .hmed's $al$e than Molteno's t#!e

e. 7r#pin's $al$e ontains press#re sensiti$e $al$e

1(. Re+ardin+ anti>meta!olites:

a. they are applied to the s leral flap d#rin+ tra!e #le tomy

!. they in rease the in iden e of post>operati$e endophthalmitis

. they inhi!it 68. synthesis and therefore ell#lar proliferation

d. 5>fl#oro#ra il is more li%ely to a#se hypotony than mitomy in C

e. mitomy in C is asso iated "ith a hi+her in iden e of "o#nd lea% than 5>fl#oro#ra il

&). .pra lonidine:

a. is an alpha & a+onist !. a#ses on-#n ti$al hyperaemia

. a#ses in reased #$eos leral o#tflo"

d. prod# es miosis

e. a#ses lid retra tion

9ens and atara t

1. The follo"in+ are tr#e a!o#t atara t: a. it is the most ommon a#se of !lindness in the "orld !. n# lear s lerosis red# es the distant $ision more than near

. posterior s#! aps#lar atara t is more li%ely to a#se pro!lem "ith distant $ision than near

d. more females than males ha$e atara t s#r+ery

e. o#tdoor "or%ers are more li%ely to de$elop atara t than indoor "or%ers

&. Tr#e asso iation in l#de:

a. Bilson's disease > s#n>flo"er atara t !. myotoni dystrophy > Christmas tree atara t

. amiodarone > anterior aps#lar atara t

d. .lport's syndrome > posterior lenti on#s

e. 6o"n's syndrome > er#lean (!l#e>dot) atara t

,. The follo"in+ are tr#e a!o#t mi rospheropha%ia:

a. it is asso iated "ith myopia !. it an a#se p#pillary !lo % +la# oma "hi h sho#ld !e treated "ith mydriati

. it is asso iated "ith short stat#re and stiff -oints

d. anterior dislo ation is a %no"n ompli ation

e. it an !e an a#tosomal re essi$e disorder.

0. The follo"in+ meta!oli disorders are asso iated "ith atara t:

a. hyperlysinemia !. hyper al emia

. hypo al emia

d. hypo+ly aemia

e. #raemia

5. 6r#+>ind# ed atara t in l#de:

a. phenothiaCine !. e hothiopate

. aspirin

d. lo$astatin

e. systemi !eta>!lo %ers

:. Tr#e statements a!o#t the o #lar effe ts of on+enital r#!ella in l#de:

a. eye defe t typi ally o #rs "ith infe tion d#rin+ the first trimester of pre+nan y !. lamellar atara t is the most ommon type of atara t seen in on+enital r#!ella

. $iral parti les #s#ally remain in the lens parti le lon+ after !irth

d. myopia is ommon

e. on+enital r#!ella a#ses pro+ressi$e horioretinitis.

;. The follo"in+ are tr#e a!o#t !l#nt tra#ma on the lens:

a. =ossi#s rin+ is a#sed !y the imprint of the p#pillary pi+ment on the lens !. =ossi#s rin+ a#ses de reased $ision in the ma-ority of patients

. =ossi#s rin+ is a permanent si+n

d. ont#sion atara t is #s#ally rosette>shaped

e. ont#sion atara t typi ally in$ol$es the anterior orte1

?. In on+enital atara t:

a. patients "ith se$ere !ilateral atara t sho#ld ha$e the

atara ts remo$ed !efore three months of a+e !. intrao #lar lens sho#ld !e #sed

. the posterior aps#le is #s#ally left inta t

d. post>operati$e $is#al a #ity is #s#ally !etter in patients "ith #nilateral atara t than !ilateral atara t

e. $is#al pro+nosis is poor in patients "ho de$elop nysta+m#s

(. Bith re+ard to the materials #sed in intrao #lar lens:

a. 'MM. is the most ommon material #sed in ma%in+ folda!le lens !. 'MM. transmits a !roader spe tr#m of li+ht than nat#ral lens

. sili one is asso iated "ith in reased aps#lar fi!rosis

d. sili one lens tends to !e thinner than 'MM. for the same dioptre po"er

e. hydro+el lens has a lo"er tensile stren+th than 'MM.

1). Re+ardin+ eye drops #sed in atara t s#r+ery:

a. fl#r!iprofen is #sed to dilate p#pil !. fl#r!iprofen pre$ents post>operati$e inflammation

. phenylephrine stim#lates the alpha re eptors

d. phenylephrine sho#ld !e a$oided in patients on monoamine o1idase inhi!itors

e. y lopentolate a ts on the onstri tor m#s le of the iris

11. <omo ystin#ria:

a. is an a#tosomal re essi$e ondition !. a#ses inferonasal s#!l#1ation of the lens

. is asso iated "ith raised ser#m methionine

d. is asso iated "ith mental retardation

e. a#ses osteoporosis

1&. The histolo+i al feat#res of the follo"in+ are tr#e:

a. 2ls hni+ pearls > proliferation of lens epitheli#m onto the posterior aps#le !. posterior s#! aps#lar atara t > !ladder ells

. orti al atara t > mor+a+nian +lo!#les

d. +la# ofle %en > Bedl ells

e. 3oemmerrin+ rin+ > se4#estration of proliferatin+ lens fi!res in the e4#atorial re+ion of the aps#le

1,. In a : month old !a!y "ith !ilateral atara tD #rine test is #sef#l in:

a. homo ystin#ria !. +ala tosemia

. 9o"e's syndrome

d. a!etalipoproteinemia

e. ystinosis

10. In +ala tosemia:

a. the ondition is a#tosomal dominant !. the most ommon form is a#sed !y +alatose>a>phosphate #ridyl transferase defi ien y

. mental retardation is a feat#re in #ntreated ases

d. the atara ts #s#ally ass#me oil droplet appearan e

e. early atara ts are re$ersi!le "ith dietary restri tion

15. Fa tors that an in rease intra$itreal press#re d#rin+ pha oem#lsifi ation in l#de:

a. e1 essi$e peri!#l!ar anaesthesia !. patient ta%in+ deep !readth

. press#re from the spe #l#m

d. horoidal haemorrha+e

e. a hi+h !ottle hei+ht

1:. Bith re+ard to $is oelasti s:

a. they are leared in an #nmeta!olised state !y filtration thro#+h the tra!e #lar mesh"or% !. sodi#m hyal#ronate has a hi+her pse#doplasti !eha$io#r than hondroitin s#lphate

. they are to1i to the endotheli#m if not remo$ed at the end of the s#r+ery

d. methyl ell#lose is heaper than sodi#m hyal#ronate

e. =is oat is made #p sodi#m hyal#ronate and hondroitin s#lphate

1;. 'se#doe1foliation syndrome:

a. is ommonly seen in +lass !lo"ers !. is most ommonly in the fifth de ade of life

. a#ses mid>periphery transill#mination

d. a#ses iridonosis

e. is asso iated "ith poor p#pillary dilatation

1?. The ad$anta+es of aps#lorrhe1is o$er aps#lotomy in l#de:

a. easier deli$ery of the n# le#s d#rin+ e1tra aps#lar atara t operation !. holds the n# le#s in the aps#lar !a+ d#rin+ pha oem#lsifi ation

. !etter entration of the intrao #lar lens

d. less li%elihood of aps#lar ontra tion

e. less li%elihood of anterior aps#lar tear e1tendin+ into the posterior aps#le

1(. Catara t e1tra tion in an eye that had pre$io#s par plana $itre tomy is asso iated "ith an in reased ris% of :

a. Con#lar dehis en e !. s#pra horoidal haemorrha+e

. posterior aps#le r#pt#re

d. +lo!e ollapse

e. ystoid ma #lar oedema

&). Tr#e statements a!o#t the aspiration systems #sed in pha oem#lsifi ation in l#de:

a. diaphra+m p#mp prod# es the slo"est !#ild #p of $a ##m !. peristalti p#mp allo"s linear ontrol of $a ##m

. =ent#ri p#mp is asso iated "ith the hi+hest ris% of inad$ertent en+a+ement of #n"anted tiss#e

d. =ent#ri p#mp +i$es the most rapid rise in $a ##m

e. hi+h aspiration is needed d#rin+ the early sta+e of pha oem#lsifi ation