Ophthalmology UQU 2012

Ophthalmology
 Ophthalmology UQU 2012
1. male patient developed corneal ulcer in his right eye after trauma what is the management:
a) Topical Antibiotic & analgesia
b) topical steroid

2. Old diabetic patient with mild early cataract and retinal pigmentation o Drusen formation. , u prescribed anti
oxidant what to do next :
a) urgent ophthalmology appointment
b) routine ophthalmology referral
c) cataract surgery
d) see him after One month to detect improvement

3. a picture of Snelling chart the q was how far should the patient stand :
a) 3m
b) 6m
c) 9m

4. Which of the following is not a sign or symptom of central retinal artery occlusion?
a) Painful loss of vision
b) Painless loss of vision
c) Previous transient loss of vision
d) Dilated pupil with sluggish reaction to light

5. female pt with right eye pain and redness with watery discharge, no history of trauma, itching, on examination
there is diffuse congestion in the conjunctiva and watery discharge what you'll do:
a) give Ab
b) give antihistamineby exclusion
c) topical steroid
d) refer her to the ophthalmologist
e) No need for further management

6. pt c/o pain when moving the eye, fundoscopy normal:

a) optic neuritis
b) Papillodema

7. Child with large periorbital hemangioma , if this hemangioma cause obstruction to vision , when will be
permanent decrease in visual acuity After obstruction by one day
a) By 1 week
b) By 3 months
c) By 6 months

8. 50 year old Man presented to ER with sudden headache, blurred of vision and eye pain. The diagnosis is:
a) Acute glaucoma
b) Acute conjunctivitis
c) Corneal ulcer

9. Open globe injury, treatment is:

a) Continuous antibiotic drops
b) Continuous water and NS drops
c) Continuous steroids drops
d) Sterile cover and the refered
 Ophthalmology UQU 2012
10. 2 yrs old boy with coryza, cough and red eyes with watery discharge (a case of measles). Most likely diagnosis
of the red eyes is:
a) Conjunctivitis
b) Blepharitis

11. SCA patient , the macula is cherry red , and absence of afferent papillary light reflex
a) Retinal artery occlusion

12. Patient has decrease visual acuity bilateral, but more in right side, visual field is not affected, in fundus there is
irregular pigmentations and early cataract formation. what you will do
a) Refer to ophthalmologist for laser therapy
b) Refer to ophthalmologist for cataract surgery
c) see the patient next month

13. A patient have tender, redness nodule on lacrimal duct site. Before referred him to ophthalmologist what you
will do:
a) Topical steroid
b) Topical antibiotics
c) Oral antibiotics
d) Nothing

14. male came to you complaining of sudden progressive decreasing in vision of left eye over last two/three days,
also pain on the same eye, on fundoscopy optic disk swelling was sees , Dx :
a) central retinal artery occlusion
b) central retical vein occlusion
c) optic neuritis
d) macular degeneration

15. Gardener has recurrent conjunctivitis. He can’t avoid exposure to environment. In order to decrease the
symptoms in the evening, GP should advise him to:
a) Cold compression
b) Eye irrigation with Vinegar Solution
c) Contact lenses
d) Antihistamines

16. Patient, medically free came with eye watery discharge, cloudy ant. Chamber with red conjunctiva , Dx:
a) Keratitis
b) Uveitis (red eye, injected conjunctiva, pain and decreased vision. Signs include dilated ciliary vessels, presence
of cells in the anterior chamber)
c) Retinitis (Night-blindness-Peripheral vision loss-Tunnel vision-Progressive vision loss)
d) Corneal laceration

17. 30 years old pts presented with eye stocking on the morning what the cause?
a) Viral
b) Bacterial
c) Fungal

18. initial treatment of acute angle glaucoma:

a) IV acetazolamide, topical pilocarpin and B blocker
 Ophthalmology UQU 2012
19. Patient with lateral and vertical diplobia, he can’t abduct both eyes, the affected nerve is:
a) II
b) III
c) VI
d) V

20. Photophobia, blurred vision, keratic ?? behind cornea and cells in anterior chamber, the best treatment is :
a) Topical antifungal
b) Topical Acyclovir
c) Antibiotic

21. Patient with trachoma in eye. for prevention you should

a) water sanitation
b) water sanitation & eradication of organism
c) mass treatment

22. Pt come with history of flue like symptoms for many days & complain of periorbital edema , DX
a) Viral conjunctivitis
b) Bacterial conjunctivitis
c) Keratitis.

23. Pterygium ( in ophthalmology TTT :

a) surgery

24. ptosis ( nerve :

a) Nerve (3rd cranial nerve (oculomotor nerve)

25. pt. comes with sudden painless loss of vision before going to lose the vision see flashes and high lights asking
for diagnosis:
a) Retinal detachment

26. pt. with URTI when he couphs or sneez see lashs asking the possible causes:
a) Mechanical stimuli to retina, erritation of optic disc

27. question about optic neuritis , MS , painful loss of vision

28. hazy vision with subcortical of keratenizing deposition asking for management
a) Systemic steroid

29. Pt with pain in ophthalmic division of trigeminal nerve & vesicle(I'm not sure) , which of the following is used
to decrease post herpetic neuralgia:
a) Local steroid.
b) systemic acyclovir & steroid
c) acyclovir

30. male pt developed corneal ulcer in his right eye after trauma what is the Mx:
a) Topical antibiotic & analgesia
b) Topical steroid
c) Antibiotic, cycloplgia and refer to ophthalmology
 Ophthalmology UQU 2012
31. blow out fracture eyelid swelling , redness other symptoms
a) Present air fluid level
b) Enophthalmos ‘posterior displacement of the eye”

32. 70 yrs old man c/o fever, vesicular rash over forehead management
a) IV antibiotic
b) IV antiviral

33. attack rate for school children whom developed pink eye , first day 10 out of 50 , second day 30 out of 50
a) 20
b) 40
c) 60
d) 80

34. Pt came with trauma to left eye by tennis ball examination shows anterior chamber hemorrhage you must
exclude?
a) Conjunctivitis
b) Blepharitis
c) Foreign body ( most likely )
d) Keratitis

35. Acute angle glaucoma, you can use all of the following drug except?
a) B blocker
b) Acetazolamide
c) Pilocarpine

36. Pt with foreign body sensation in the eye, after the removal of the foreign body it was insect ttt?
a) Local antibiotic
b) Local steroid
c) Systemic antibiotic
d) Systemic steroid

37. mucopurulent discharge :

a) bacterial conjunctivitis
 The mainstay of medical treatment of bacterial conjunctivitis is topical antibiotic therapy: Sodium
sulfacetamide, gentamicin, tobramycin, neomycin, trimethoprim and polymyxin B combination, ciprofloxacin,
ofloxacin, gatifloxacin, and erythromycin
 Systemic antibiotics are indicated for N gonorrhea infant (penicillin G), mother and high risk contacts
(ceftriaxone) and chlamydial infections: infant (erythromycin) mother and at-risk contacts (doxycycline).

38. Patient with hypertensive retinopathy grade 2 AV nicking, normal BP, no decrease in vision, with cupping of
optic disc, what will do to the patient:
a) Reassurance , the problem is benign
b) Convert him to ophthalmologist
c) Laser Operation

39. patient with open angle glaucoma and k/c of COPD and DM ttt:
a) Timelol
b) betaxolol
c) Acetazolamid
 Ophthalmology UQU 2012
40. Anterior uveitis is a character of the following except:
a) R.A.
b) Sarcoidosis.
c) Behcet disease.
d) Riter'ssyndrome.
e) Ankylosingspondolitis.
 Causes of Iritis (anterior uveitis): “idiopathic, seronegative spondyioarthropathies (e.g. Riter's syndrome,
Ankylosing spondolitis), IBD, diabetes mellitus, granulomatous disease(e.g. Sarcoidosis), infection(e.g.gonococal,
syphilis, toxoplasmosis, brucellosis, T.B.), Behcet disease. Eye involvement of R.A. episcleritis, scleritis,
keratoconjunctivitis”

41. A 30 years old male present to E.R. complaining of visual deterioration for 3 days of Rt. Eye followed by light
perception, the least cause is:
a) Retinal detachment.
b) Centralretinalarterialembolism.
c) Vitreous hemorrhage.
d) Retro-orbitalneuritis.
e) Retinitispigmentation.

42. Pt with bilateral eye discharge , watery , red eyes, corneal ulceration what is the most common cause :
a) Dust & pollen
b) Hypertension
c) Ultra-violet light & stress

43. 70y/o female say that she play puzzle but for a short period she can't play because as she develop headache
when playing what u will exam for
a) astigmatism
b) glaucoma

44. 54 y old patient , farmer , coming complaining of dry eye , he is smoker for 20 years and smokes 2 packs/ day ,
your recommendation :
a) advise him to exercise
b) stop smoking
c) wear sunscreen

45. patient is wearing contact lenses for vision correction since ten years , now coming c/o excessive tearing when
exposed to bright light , what will be your advice to him :
a) wear hat
b) wear sunglasses
c) remove the lenses at night
d) Saline eye drops 4 times / day

46. Diabetic patient have neovascularization and vitreous hemorrhage , next step :
a) Refer to ophthalmologist

47. Patient complains of dry eyes, a moisturizing eye drops were prescribed to him 4 times daily. What is the most
appropriate method of application of these eye drops?
a) 1 drop in the lower fornix
b) 2 drops in the lower fornix
c) 1 drop in the upper fornix
 Ophthalmology UQU 2012
48. patient with open angle glaucoma and k/c of COPD and DM ttt:
a) Timelol
b) betaxolol
c) Acetazolamide

49. 17 yrs. old school boy was playing foot ball and he was kicked in his Rt. eye... Few hours later he started to
complain of double vision & ecchymoses around the eye, The most likely Dx. Is :
a) cellulites
b) orbital bone fracture
c) global eye ball rupture
d) subconjunctival hemorrhage

50. 35 yrs old female pt. C/O : acute inflammation and pain in her Lt. eye since 2 days .. she gave Hx of visual
blurring and use of contact lens as well … O/E : fluorescence stain shows dentritic ulcer at the center of the
cornea .. the most likely diagnosis is :
a) corneal abrasion
b) herpetic central ulcer
c) central lens stress ulcer
d) acute Episcleritis
e) acute angle closure glaucoma

51. Patient present with corneal abrasion Treatment:

a) Cover the eye with a dressing
b) Antibiotic ointment put it in the home without covering the eye?

52. Patient with subconjunctival hemorrhage. What you will do for him:
a) Reassurance
b) Send him to the ophthalmologist

53. patient with recent history of URTI ,develop sever conj. Injection with redness, tearing ,photophobia ,

So, what is treatment?
a) Topical antibiotic
b) Topical acyclovir
c) Oral acyclovir

d) Topical steroid

54. Patient presented with constricted pupile, ciliary flushing and cloudy anti. Chamber .there is no abnormality
In eye lid, vision and lacrimal duct:
a) Uveitis
b) Central vein thrombosis

c) Central artery embolism

d) Acute angle closure glaucoma

55. newborn with eye infection :

a) Oral antibiotic
b) Oral steroid
c) Topical antibiotic

56. man who bought a cat and now developed watery discharge from his eyes he is having:
a) Allergic conjunctivitis
b) Atopic dermatitis
c) cat scratch disease
 Ophthalmology UQU 2012
57. How to differentiate between Uveitis and Keratitis in red eye
a) Redness of the eye
b) Blurred vision
c) photophobia
d) Dark, floating spots along the visual field in Uveitis
e) Ciliary vessel dilatation
f) Eye pain

58. Hypertensive came to ophalmology doctor by exam show increase cup when asking the pt he did not complain
of anything. What is the diagnosis
a) Hypertensive retinopathy
b) Diabetic neuropathy
c) Acute open angle glaucoma
d) Acute closed angle glaucoma
e) Retinal detachment

59. Long use of topical corticosteroid lead to:

a) rise intra ocular pressure
b) Cataract
c) Ptosis
d) keratoconus

60. By covering test done to child the other eye turn laterally, diagnosis is
a) Exotropia strabismus

61. female pt wear glass since 10 years , she diagnosed recently type 2 DM , she should screen or examine her
eyes every :
a) 6m
b) 12m
c) 2y
d) 5y

62. child with led mass obstructing his vision , when to do the surgery
a) Within 3 m
b) 6 m
c) 12 m

63. Picture ( fundus of eye) “ glaucoma”

a) Increase Cup to disc ratio more than ½

64. Diabetic patient want your advice to decrease the risk of developing Diabetic retinopathy ?
a) Decrease HTN and Obesity
b) Decrease HTN and smocking
c) Decrease Smocking and Obesity

65. Patient came to you after Trauma complaining of loss of the abduction of his (left or right) eye. So which
cranial nerve affected?
a) III
b) IV
c) V
d) VI
 Ophthalmology UQU 2012
66. boy 3 day after flue symptom develop conjunctivitis with occipital and nick L.N enlarged so diagnosis is
a) adenoviruses
b) streptococcus
c) HSV

67. Child came to ophthalmology clinic did cover test, during eye cover , his left eye move spontaneously to left,
the most complication is:
a) Strabismus
b) Glaucoma
c) Myobloma

68. Patient with HX of URTI & flash of light when he sneeze the causePatient with HX of URTI & flash of light
when he sneeze the cause is>>>>
a) chemical/ mechanical irritation of retena

69. 45 year old male presented to the ER with sudden headache, blurriong of vision, excruciating eye pain and
frequent vomiting: 

a) Acute glaucoma
b) Acute conjunctivitis
c) Acuteiritis
d) Episcleritis

e) Corneal ulceration
 These are typical features of closed angle glaucoma which presents acutely with red painful eye, nausea and
vomiting, halos around light, hazy cornea, mid dilated non-reactive pupil and extremely high intraocular pressure.
Closed angle glaucoma represents 5% of glaucoma. The rest is open angle glaucoma which presents insidiously
with bilateral (the previous was unilateral), progressive loss of peripheral visual field. Iritis= anterior uveitis
presents with photophobia and ciliary flush (redness around the iris see Toronto notes). Corneal ulcer presents
with photophobia, foreign body sensation and decreased visual acuity (if central). Episceritis is asymptomatic may
present with mild pain and red eye. Causes a sectroal or diffuse injection of vessels which is radially directed.
Conjunctivitis presents with red itchy eye, foreign body sensation, discharge and crusting of eyelashes in the
morning.

70. patient came to you complaining of gradual loss of vision & now he can only identify light.which of the
following is the LEAST cause of his problem:
a) retinal detachment

b) central retinal artery
c) retinitis pigmentosa
d) retrobulbar neuritis

71. 30 years old patient complaining of 1 day history of ptosis & he noticed his eye coming outward, on
examination his pupil reflex was normal
a) carotid aneurysm
b) 3rd nerve palsy
c) 4th nerve palsy
d) 6th nerve palsy
e) strabismus

72. what is the management of Uveitis

a) Topical or oral steroid
 Ophthalmology UQU 2012
73. All the following may cause sudden unilateral blindness EXCEPT:
a) Retinitis pigmentosa.
b) Retrobulbar neuritis.
c) Retinal detachment.
d) Vitreous hemorrhage.
e) Central retinal artery embolism.
 Retinitis pigmentosa. It causes gradual night blindness

74. All are true about congenital squint except:


a) There is no difference of the angle of deviation of squint eye between far& near vision.
b) squint(strabismus)
 Strabismus is a condition one eye deviates away from the fixation point .under normal condition both the eyes are
in proper alignment. The presence of epicanthus and high errors of refraction stimulate squint and this is called
apparent squint but in fact there is no squint.
 In a non paralytic squint the movements of both eyes are full but only one eye is directed towards the fixated
target, the angle of deviation is constant and unrelated to direction of gaze .
Paralytic squint there is underaction
of one or more of the eye muscles due to nerve palsy, extraocular muscles that tether of the globe.

75. retinal detachment, all true except: 


a) More common in hypermtropic patient than myopic
 This is a condition in which there is separation of the two retinal layers, the retina proper and the pigmentary
epithelium by the subretinal fluid.
 Causes are:
Vitreous hemorrhage, toxemia of pregnancy that results in accumulation of exudates in the
subretinal space, weakness of the retina such as lattice degeneration that increases the probability of a tear
forming, highly myopic people, those who had undergone cataract surgery, detached retina in the fellow eye and
recent severe eye trauma.

76. Acute glaucoma, all are true EXCEPT:

a) Refer to ophthalmologist.
b) Give miotic before referral
c) Can present with headache.
d) Can present with abdominal pain.
e) Pupil size in acute glaucoma is larger than normal.
 Acute (closure angle) glaucoma
 Initial Rx is aimed primarily at lowering IOP through systemic medication. This is b/c, when the IOP is more than
50, the iris sphincter is usually ischemic & paralysed, so that, intensive miotic therapy is seldom effective in pulling
the peripheral iris away from the angle.
 It can present with eye pain, headache, nausea & vomiting.

 In acute glaucoma, the pupil is mid-dilated.

77. Congenital squint, all are true EXCEPT:


a) If you cover the non-squint eye, the squint eye will move to the opposite side.

b) angle of deviation is fixed for near & far vision
 The cover-uncover test: is a mono-ocular test designed to test for the presence of heterotropia. It should be
performed both NEAR AND FAR DISTANCE. If the left eye shows a displacement of the corneal light reflex, the
examiner should cover the opposite right eye (non-squint eye) and search for any movement of the left eye.
 Ophthalmology UQU 2012
78. patient has painful red left eye associated with photophobia , what is the DX
a) glaucoma
b) Uveitis
c) other

79. TB patient suffer from painful red eye photobi

a) Glucoma
b) Uvitis
c) Bact.conjctivitis
d) Viral conjuctivites

80. Regarding Stye infection of the lower eyelid, all true except:-
a) Is infection of gland in the lower eye lid
b) Can be treated by topical antibiotics
c) Can be treated by systemic antibiotics
d) Needs ophthalmology referral “ though sometimes referral is needed, but it is never the first option”
 A hordeolum (ie, stye) is a localized infection or inflammation of the eyelid margin involving hair follicles of the
eyelashes (ie, external hordeolum) or meibomian glands (ie, internal hordeolum).
 A chalazion is a painless granuloma of the meibomian glands.
 Management
 Warm soaks (qid for 15 min) are the mainstays of treatment o
 Drainage of a hordeolum, Hordeola usually are self-limited even without drainage Most hordeola eventually
point and drain by themselves Drainage of pointed lesions speeds the healing process
 Antibiotics are indicated only when inflammation has spread beyond the immediate area of the hordeolum.
Topical antibiotics may be used for recurrent lesions and for those that are actively draining. Topical antibiotics
do not improve the healing of surgically drained lesions. 
Systemic antibiotics are indicated if signs of
bacteremia are present or if the patient has tender preauricular lymph nodes 

 Surgical
If the lesion points at a lash follicle, remove that one eyelash
 Consultations:
If the patient does not respond to conservative therapy (ie, warm compresses, antibiotics)
within 2-3 days, consult with an 
ophthalmologist
Consultation is recommended prior to drainage of large
lesions

81. Which of the following is true is true regarding red eye:

a) more redness occur in corioscleral "suggest iritis"
b) if associated with fixed mid –fixed dilated pupil suggest anterior uvitis
c) in case of glaucoma treatment is mydratics

82. Picture of Snellin chart, 70 years old pt. can only read to the 3rd line , what is his visual acuity :
a) 20\100
b) 20\70
c) 20\50
d) 20\40
 Note that the numbers on the side was erased from the chart

83. this pt. see letters at 20 feet , where normal person see it:
a) At 70 feet.
 Ophthalmology UQU 2012
84. 24 y/o female newly diagnosed type 2 DM, she is wearing glasses for 10 years, how frequent she should follow
with ophthalmologist:
a) Every 5 years
b) Annually
 For type 1 diabetic: retina screening annually beginning 5 years after onset of diabetes, general not before onset
of puberty.
 for type 2 diabetic : screening at the time of diagnosis then annual

85. Contraindicated in acute glaucoma management:

a) Pilocarpine
b) Timolol
c) B-blockers, CA inhibitors, NSAID, Mannitol

86. flu like symptoms since two days and now has red eye, what is the diagnosis:
a) Viral conjunctivitis
b) bacterial conjunctivitis
c) c.uvitis
d) glaucoma

87. The most dangerous red eye that need urgent referral to ophthalmologist
a) associated with itching
b) presence of mucopurulant discharge
c) bilateral
d) associated with photophobia

88. Patient with pterygium in one eye, the other eye is normal, what's correct to tell:
a) It's due to vitaminosis A.
b) It may affect vision
c) It's a part of a systemic disease.
d) I forgot the rest answers