Ophthalmology - Topical Past Papers (2005-2020)

OPHTHALMOLOGY – PAST QUESTIONS (2005-2020)
(Compiled by Shahroze Ahmed, N-66, Nishtar Medical University)
▪ EYELIDS
Chalazion
1. A young man has reported in Eye OPD with a painless swelling on his right upper
eyelid for the last three months. The size of the swelling has now increased and he
has noticed blurring of vision in that eye.
a) What is your diagnosis?
b) Write down the complications of this disease.
c) How will you treat this patient? Write detail of treatment.
[Annual 2016]
2. A 20 years old university student is told by her friend that she has right upper eyelid
small swelling. The swelling is located on the outer part of the lid away from the lid
margin. It is felt better than seen and is nontender and firm in consistency. Now that
she is aware and conscious of it, she wants proper management for the problem.
a) What is the diagnosis?
b) What refractive error it can cause if left untreated?
c) What is the treatment of choice at this stage of the ailment? Give steps.
[Supple 2014 held in 2015]
3.
a) What is chalazion?
b) What is the treatment of this condition?
c) Name two differentiating points from stye.
[Annual 2007]
4. Describe treatment of chalazion. [Supple 2006]
Hordeolum Externum (Stye)
1. A young girl is presented with progressive painful upper eyelid swelling with a pus
points yellowish spot at the outer lid margin.
a) What do you think is the diagnosis?
b) Enlist few D/D.
2. Name two differentiating points of chalazion from stye. [Annual 2007]
Blepharitis
1.
a) What is blepharitis?
b) How is it treated?
c) What are the complications?
Trichiasis
1. What are the causes of trichiasis? [Supple 2006]
Entropion
1. A 60-year-old female with inward rolled margin of the lid presents with recurrent
corneal ulcers. Eversion of the lid reveals a white band of subtarsal fibrosis 2-3 mm
behind the lid margin.
a) What is the most likely diagnosis?
b) What are two principles of treatment?
c) What are the conditions that can cause such condition?
[Annual 2011]
2. A 4-year-old girl developed inward turning of her right eye soon after she started
going to school.
b) What investigations are necessary?
c) What are the serious complications that can happen?
d) What are the causes of entropion of lower eyelid in a man of 70 years?
[Supple 2010]
3. What are the causes of entropion of lower eyelid in a man of 70 years?

[Annual 2009]
Ectropion
1. A 60-year-old male presents with watering of his right eye. On examination, there is
outward turning of the lower lid margin.
a) What is the most probable diagnosis? (1)
b) Give two reasons why this condition occurs. (2)
c) How will you treat this patient? (2)
[Annual 2019]
2. A 30-year-old patient got acid burn on her right lower lid 5 months ago. Now she
presents with epiphora and pulling of her lower lid downward.
a) What is most probable diagnosis? (1)
b) Give the classification of this condition. (2)
[Annual 2017]
3. A 30-year-old patient involved in a chemical burn of face presents with eversion of

right eyelid margin. The patient complains of epiphora and cosmetic deformity of
face.
b) What is the most important complication of this disease?
c) What is the treatment option for mild and severe disease?
d) Name another cause of disease.
Ptosis
1. A 5-year-old boy comes in the eye department with difficulty in lifting his right upper
eyelid for the last three years. His pupils are visible in primary gaze and he is
emmetrope.
a) What is the clinical diagnosis? (1)
b) Write relevant clinical examinations. (3)
c) What are the indications for surgery in these cases? (1)
2. A 7-year-old child presented with moderate drooping of upper eyelid since birth.
a) What is this condition called? (1)
b) What causes can lead to this condition? (2)
c) Enlist surgical treatment options to treat this condition. (2)
3. A 65-year-old diabetic female presents with history of ptosis of right eye for the last
3 days. On opening of eyelid, eyeball was deviated outward and downwards. Right
pupil was dilated and non-reactive to light.
a) What is your diagnosis? (2)
b) How will you manage this case? (3)
4. A 5-year-old boy has reported in eye OPD with history of drooping of upper eyelid of
left eye since birth.
a) Write the relevant clinical tests.
b) What are possible causes of the ptosis in the boy?
5. A 2-year-old child is brought by her parents with a drooping upper eyelid on the right
side. On examination, there is 3 mm levator function and the upper eyelid is covering
the central corneal light reflection.
a) Describe the classification of this disease.
b) What condition will develop if the problem is not corrected at this age and why?
c) What is the most appropriate treatment for this patient?
[Annual 2015]
6. A 60-year-old diabetic male presents with sudden drooping of left upper lid. His left
eye is deviated outwards and downwards.
b) How will you investigate and treat this case?
[Supple 2014]
7. An 85-year-old patient reports with gradual onset of bilateral drooping of upper

eyelids. On examination, there was high upper lid crease in both the eyes with intact
levator function. Th gentleman was healthy otherwise.
b) Name three surgical procedures to correct this condition.
c) What is the marginal reflect distance?
[Annual 2013]
8.
a) What is ptosis?
b) Enumerate the causes of acquired ptosis.
c) What is the treatment of congenital ptosis?
[Annual 2012]
9.
a) What is ptosis?
b) Enumerate the causes of acquired ptosis.
c) What is the treatment of congenital ptosis?
[Annual 2010]
10. Give management of ptosis. [Annual 2006]
11. Define and classify ptosis. Name two common surgical procedure to correct
moderate ptosis. [Supple 2006]
▪ LACRIMAL SYSTEM
Anatomy and Physiology
1. You are a drop of steroids placed in the conjunctival sac.

a) Name the structures through which you have passed before reaching the nose.
b) Write down common indications and complications of using these eye drops.
[Annual 2018]
Congenital Nasolacrimal Duct Obstruction
1. A three months old baby is brought to Eye OPD by his parents with a chief complaint
of watering and discharge from his left eye since birth. On examination, regurgitation
test was positive.
a) What is the most likely diagnosis? (1)
b) What are its complications? (1)
c) Outline its treatment plan. (3)
2. A 4-week-old baby is brought to you with watery eye & purulent discharge since
birth.
b) At what age will you surgically intervene?
c) How will you treat?
[Annual 2010]
Chronic Dacryocystitis
1. A 45-year-old female presents with a medial canthal swelling and epiphora. The
regurgitation test is positive.
a) What is the diagnosis? (2)
b) What investigations can you perform? (2)
c) What complications can result if left untreated? (1)
▪ CONJUNCTIVA
Viral Conjunctivitis
1. A 45-year-old male patient presented with burning and redness in both eyes for last
three days. On examination, there is watery discharge, follicular conjunctival
reaction and painful preauricular lymphadenopathy.
c) What complication can occur? (1)
2. A 19 years old female presented with severe irritation, redness, watering and
photophobia in both eyes after upper respiratory tract infection. Her elder brother
had similar episode 1 week earlier.
b) Name other clinical signs to look for in this case. (2)
c) Name treatment options for this case. (2)
3. A 20-year-old girl presents with acute onset of watering and redness in both eyes.
On examination, her visual acuity is 6/6 in both eyes. There is mild chemosis, follicle
formation in the inferior fornixes and pre-auricular lymphadenopathy.
b) What other complications can be seen in her?
c) What are the different types of presentation of this disease?
[Annual 2015]
4. A 20-year-old boy developed pain, redness, and watering in both eyes one after the
other. His younger brother had same condition 3-4 days ago which he incurred at
school.
b) What is the treatment of this condition?
c) How can you prevent this condition from spreading?
[Annual 2012 + Supple 2010]
Pharyngoconjunctival Fever
1. A 15-year-old boy presents with sudden onset of bilateral pink eye with fever and
pharyngitis. On examination, his visual acuity is 6/6 and there are follicles present in
the inferior fornix in association with diffuse conjunctival congestion. Corneal
examination shows punctate keratitis bilaterally.
a) What is most likely diagnosis?
b) What organism causes this disease?
c) Why should the child be advised to stay at home?
d) What is the most appropriate treatment?
[Annual 2011]
Trachoma
1. A 30 years old man of low socio-economic group presents within turned lashes of
upper lid. Lid eversion shows a significant white horizontal line involving the
conjunctiva and tarsal plate.
b) Give the most recent staging of this disease. (2)
c) Enumerate the treatment strategies in this condition. (2)
[Annual 2017]
2. A 3 years old child is brought to you with mixed follicular/papillary conjunctivitis with
mucopurulent discharge and superior pannus formation.
b) What are the sequelae of this disease?
c) How will you treat this patient?
[Annual 2016]
3.
a) Write down the WHO classification of Trachoma.
b) What is the treatment of trachoma?
[Supple 2014]
4.
a) Describe the clinical features of trachoma.
b) What are the complications and treatment of this disease?
[Supple 2009]
5.
a) Enumerate four complications of trachoma.
b) Name drugs used in the treatment of trachoma.
[Annual 2006]
Neonatal Conjunctivitis (Ophthalmia Neonatorum)
1. A 3 days old child is seen in the eye outpatient department. There is mucopurulent
discharge with lid swelling. Pseudo-membrane is also seen.
b) Give two most important organisms responsible for this condition. (2)
c) What medications will you use to treat this condition? (2)
[Annual 2019]
2. A 2-week-old baby girl has swelling and sticking of eye lids. On examination, there is
mucopurulent discharge and conjunctival congestion most marked in the fornixes.
b) What organism is associated with this problem?
c) How would you treat her?
[Annual 2014]
3. A newborn child who is 48 hours old is brought to accident emergency with bilateral
severe purulent discharge. On opening the eye with retractor, ulceration of cornea is
seen in the right eye.
a) What is most probable diagnosis?
b) Which organism is most likely the cause of this condition?
c) What investigation would you perform?
d) What is most appropriate treatment?
[Supple 2011]
Acute Allergic Conjunctivitis
1. A young man presents with itchy, swollen red eyes with clear watery discharge
following exposure to dust.
b) What drugs can be used to treat?
c) What complications can develop in cornea?
d) What is the n natural course of disease if left untreated?
[Annual 2010]
Vernal Keratoconjunctivitis (Spring Catarrh)
1. A 12 years old boy complains of severe irritation in his both eyes and stringy mucus
discharge from the last 4 years. He tells that these symptoms decrease in winter and
aggravate in summers.
b) Enumerate classification.
c) Write down its treatment.
2. A 15 years old boy presents in OPD with complains of mucoid discharge from both
eyes. Examination revealed hyperemia, chemosis, and giant papillae on the palpebral
conjunctiva on both sides.
a) What is your diagnosis for this case?
b) Enumerate four causative factors.
c) How will you manage this case?
[Supple 2014]
3. A 15 years old girl comes to eye OPD complaining of intense itching and mild
photophobia in both eyes. History reveals it is to be seasonal. On examination, her
visual acuity in both eyes is 6/6 + N5. Eyes show mild redness and cobble stone
appearance on eversion of upper eyelids.
b) What are the different types of this conditions?
c) What is the treatment?
[Annual 2014]
4. During month of summer, principal of school reported that half of his secondary
class has red, painful and watery eyes associated with the itching. He wants to have
your expert opinion about.
a) What is diagnosis?
b) What clinical findings will help you in reaching at the diagnosis?
c) How will you manage this situation?
d) How can you prevent this situation?
[Annual 2013]
5. A 15-year-old male presents with severe itching and burning of both eyes. The
condition gets aggravated in summer. His eyes show conjunctival redness, a
gelatinous mass all around the cornea and flat-topped nodules on the upper tarsal
conjunctiva. Visual acuity is 6/6 of both eyes.
b) What are the likely complications?
[Supple 2013]
6. A 9-year-old boy presents with burning, itching and thick ropy discharge. The
symptoms get aggravated in summer season and respond well to topical
medications.
b) What is the etiology of the disease?
c) What are treatment options?
[Annual 2009]
7. A young boy of 13 years was noted for excessive rubbing of both eyes associated
with redness and thick discharge collected at the inner corners of eye. He started
these symptoms some years ago which were more marked during summer season.
Diagnosed as a case of atopy and vernal catarrh or seasonal allergy, he was managed
accordingly.
a) What type of hypersensitivity reaction is involved in this type?
b) What would happen if the patient is moved to a cooler environment?
c) How an attack of allergic conjunctivitis is treated?
[Annual 2008]
8. A ten-year-old presents with red itchy eyes at the beginning of spring.

b) Name two drugs used in its treatment.
c) What are the complications of severe disease?
[Annual 2007]
9. A 10-year-old boy presents with red itchy eyes at the beginning of spring.
b) Name two drugs used in its treatment.
c) What are complications of severe disease?
[Annual 2006]
10. Describe the symptoms, signs and management of spring catarrh. [Annual 2005]
Ocular Cicatricial Pemphigoid
1. A 65 years old lady has low grade itching in the eyes and whole body for last three
years. She is a known case of ocular cicatricial pemphigoid.
a) Write four clinical signs of the disease. (2)
b) What are ocular complications of this disease? (2)
c) What is the ocular treatment of the disease? (1)
Pterygium
1. A 60 years old farmer came to eye OPD with triangular growth on the medial side of
both eyes in the inter-palpebral area. The growth was encroaching the cornea and
reaching the pupillary area. The eye was otherwise normal.
a) What is the most probable diagnosis? ((2)
b) What are the indications for treating this condition and how will you treat it? (3)
[Annual 2018]
Vitamin A deficiency
1. List ocular manifestations of Vitamin A deficiency. [Annual 2008]
▪ CORNEA
Anatomy and Physiology
1.
a) Describe the optical functions of cornea with reference to its refractive power
and refractive index.
b) Enlist the reasons for corneal transparency. [Annual 2008]
Keratitis
1.
a) Classify keratitis.
b) Describe the treatment of each type of keratitis.
[Supple 2011 held in 2012 + Supple 2010]
Bacterial Corneal Ulcer
1. A 19-year-old boy presented with pain and redness in his left eye. There is a central
haze which stains with fluorescein.
b) What complication can occur if the above condition remains untreated?
[Annual 2014]
2. A 30-year-old man presents with metallic foreign body in his cornea during work. The
foreign body is removed with a needle and no medication is prescribed by mistake.
The patient presented with reduced visual acuity and whiting around the foreign
body bed.
b) How will you perform investigations?
c) What is most important treatment?
d) What is most serious complication?
[Annual 2011]
3.
a) What are the etiological causes of corneal abscess?
b) What laboratory tests are necessary?
[Supple 2011]
4. A 6-year-old boy presents with pain, redness, purulent discharge and a whitish lesion
on the cornea with a history of corneal trauma.
a) What is diagnosis?
b) How would you treat the patient?
[Annual 2007]
5. What are the complications of perforated corneal ulcer? [Annual 2006]
6. Discuss the treatment of cornea ulcer. [Annual 2005]

Hypopyon Ulcer
1. A young man sustained injury to the right cornea with finger nail followed by intense
pain, irritation and visual deterioration in the eye. Patient did some self-medication
without consulting and presented with severe pain, intense redness and significant
visual deterioration. Examination revealed circumcorneal congestion, mild corneal
edema and hypopyon along with pupil in the eye.
a) What is hypopyon?
b) Name the bacteria capable of producing hypopyon.
c) Describe the mechanism of hypopyon in intact corneal epithelium without
perforation.
[Annual 2008]
Fungal Keratitis/Keratomycosis
1. A 30-year-old farmer presents with redness in the right eye after a foreign body
went in his eye one week ago. On examination, there is intense redness around the
cornea with 4 mm yellowish lesion in the center of the cornea. There is also loss of
epithelium in that area.
a) What other clinical features will be present with progression of the disease?
b) How will you investigate this case?
c) What will be the local treatment for his eye?
[Annual 2015]
Herpes Simplex Keratitis
1. A 40 years old female having rheumatoid arthritis on immune modulator presented

with reduction in vision, irritation, redness and photophobia in her right eye.
Examination shows dendritic corneal ulcer stained with fluorescein.
a) What is the most common causative organism? (1)
b) Name treatment options for this case with reason. (3)
c) What is mechanism of corneal involvement? (1)
2. A 35-year-old laborer who recently had typhoid fever of 2 weeks starts complaining
of pain, watering, redness, photophobia from the right eye. His vision of right eye is
6/18. Fluorescein stain shows a branching type of area on the cornea.
a) What is the diagnosis? Also gives its differential diagnosis.
b) What are different morphological types of this ulcer?
[Annual 2013]
3. A 40-year-old female is using steroid or rheumatoid arthritis and she presents with
pain, photophobia and redness of right eye. The vision is reducing to 6/24 and there
is linear ulcer with branching pattern in the inferior cornea.
b) Which stain would be used to help the diagnosis?
c) Which other corneal signs swill be present?
d) What is most appropriate treatment?
[Supple 2011]
4. A young boy who has recently recovered from the complains of painful left red eye.
he has branching type of lesion on the cornea with fluorescein staining.
b) What is etiology?
c) How will you treat this condition?
[Annual 2009]
Herpes Zoster Ophthalmicus (HZO)
1. An elderly lady has developed macular-papular-pustular eruptions on the forehead,

upper eyelid and tip of the nose for the last two weeks in the right side of the face.
She has also developed severe lids swelling, conjunctival redness and photophobia of
right eye; her vision in the affected eye is 6/24 with no improvement with pinhole.
b) Write the ocular manifestations of this disease? (2.5)
c) What is the systemic and ocular treatment of this disease? (1.5)
Exposure Keratopathy
1. A 30-year-old male diabetic presents with sudden onset deviation of the face to right
side and inability to close he lids on the left side. He later presents with a painful red
eye and whitening of the inferior cornea.
a) What is the most probable diagnosis?
b) Enumerate the clinical features of the disease.
c) How will you manage this condition?
[Annual 2017]
Keratoconus
1. A 26-year-old patient wearing glasses comes to your OPD and complains of

decreased vision in both eyes. He has a history of frequent change of glasses. He also
has a history of allergic conjunctivitis during his teenage. Retinoscopy shows scissors
reflex.
b) Enumerate four sings of this disease. (2)
c) What are the treatment options? (2)
2. A 20-year-old male presents with decreased vision in both eyes. His visual acuity is
6/60 in the right and 6/36 in the left eye. On examination, Munson sign is positive.
b) Give four ocular signs of this condition. (2)
c) Give four treatment options to manage this condition. (2)
[Annual 2019]
3. A 20 years old came to eye OPD with history of frequent change of glasses over the
last two years. On examination, you found cone-shaped cornea.
b) Which tests will help you in confirming the diagnosis? (4)
[Annual 2018]
4. A girl is known case of myopia. She is not comfortable with her contact lenses as well
as glasses. She also gives the history of frequent change in power of her glasses. On
retinoscopy, there is scissor reflex.
b) Write down four signs of this disease.
[Annual 2016]
5. A 20 years old girl presents with decreased vision in both eyes. There is history of
frequent change in refraction. On examination, VA is 6/60 in right eye and Finger
Count (FC) at 2 meters in left eye. There is a positive Munson sign and decreased
thickness of cornea on both sides.
a) What is your probable diagnosis?
b) What is the pathophysiology of this disease?
c) What investigations will you perform?
▪ SCLERA
Scleritis
1. Give clinical features of scleritis. [Annual 2006]
▪ LENS
Congenital (Developmental) Cataract
1. A mother notes a white spot in center of black portion of her child’s right eye.
a) Write common causes of leukocoria. (3)
b) What investigations are required in this case? (2)
[Annual 2019]
2. A 5-year-old child is brought to you with developed of a white pupillary reflex. On

examination, the pupillary light reflex is brisk and B-scan ultrasound shows no
shadows in the vitreous and the retina is flat.
b) What will happen if the surgery is delayed till 15 years of age?
c) How will you treat him so that he completely recovers his vision?
[Annual 2015]
3. A mother brings a 6 months old child complaining of right white pupil since birth.
a) What is the differential diagnosis? (4)
b) How will you investigate this case? (1)
Acquired Cataract
1. Name four common causes of cataract. (2) [Annual 2010]
Senile Cataract (Age Related)
1. A middle-aged man known diabetic with HbA1C 11.9 has reported in the eye out
patient department with history of gradual painless decrease in vision in both eyes.
Right eye vision is finger counting at one meter and left eye vision is 6/12. Right eye
pupillary area shows a white opacity.
b) What are the clinical tests which you can do in the eye department? (2)
c) What is the treatment of the patient? (1)
d) Write three early complications of the treatment. (1)
2. A 60 years old male presented with gradual painless reduction of vision for last 3
years which is not correctable with glasses. On examination, his visual acuity was
6/18 in each eye. His anterior and posterior segment examination was unremarkable
except opacification in his crystalline lens.
a) Name surgical procedures for treating this condition. (2)
b) Which is the best surgical procedure and what are its merits? (3)
3. An elderly gentleman presents to you with the history of gradual and painless
reduction in vision for the last 6 months. His best corrected visual acuity in the right
eye is 6/60 and in the left eye is 6/12. He complains of further reduction of vision in
bright light.
b) Enlist the investigations that you would like to perform. (2)
c) What are the treatment options? (2)
[Annual 2017]
4. A 60 years old man gives the history of painless gradual blurred vision in his right
eye. He feels difficulty in driving. He does not have a refractive error. Surgery has
been offered.
b) Write down complete workup of your patient.
c) What are complications if surgery is done?
[Annual 2016]
5. A 25-year-old lady has developed gradual painless decrease of vision in her both eyes
for the last 4 years. Her vision in right eye is only projection of light and there is a
white opacity in the pupillary area. Her left eye vision is 6/36 and there is also grey
opacity in the pupillary area.
b) What are relevant clinical as well as laboratory investigations?
c) What is the treatment for her eyes?
6. A 60-year-old diabetic male presents with gradual loss of vision in both eyes. His
visual acuity is 6/36 in both eyes. On examination, cataract is seen in both of his
eyes. How will you manage this patient? (5) [Supple 2014 held in 2015]
7. An 80 years old male has hypermature cataract in his right eye. He refuses operation.
a) What are the likely complications which can occur? (3)
b) What are the signs of hypermature cataract? (2)
8. A seventy years old male presented with gradual progressive painless visual
deterioration in both eyes. On examination there was no conjunctival congestion
and there is diminished red glow in both the eyes with distant direct
ophthalmoscope.
b) Name the surgical procedures available to handle this condition with reference to
new technology available now a days. (3)
c) Give an account of the complications it can cause if left untreated. (1)
[Annual 2013]
9. A 60 years old man complains of gradual painless loss of vision in right eye. He has
been operated for cataract in his left eye 2 years ago.
b) What ocular examinations are required before surgery?
c) What is your operation of choice? (2)
[Annual 2009]
Traumatic Cataract
1. A 30 years old gardener presents in eye OPD with the history of painless gradually
decreasing vision in his left eye. He had penetrating thorn injury 3 months back while
working in rose bushes. On examination, visual acuity in his right eye is 6/6 and in
left eye is 6/24. On slit lamp examination, a small opacity in the cornea and briskly
reacting pupil with white pupillary reflex are present.
b) What important complications can occur with penetrating trauma? (3)
[Annual 2014]
2. A 20-year-old presents with self-healing penetrating injury of right cornea and the
lens. His visual acuity is 6/60 in that eye. Examination shows collection of whitish
material in the inferior angle of the eye. B-scan shows no vitritis.
a) What will be the changes in the lens due to this type of injury?
b) What is the material in the angle of the eye?
c) What will be the management if the posterior capsule is intact?
[Annual 2011]
Types of Cataract Extraction
1. A 40-year-old female has unilateral cataract in the right eye. She undergoes
intracapsular cataract extraction and anterior vitrectomy but an intraocular lens
could not be implanted.
a) How will you rehabilitate patient visually until second surgery? (1)
b) What complications can develop in this patient? (2)
c) What will be the second procedure? (2)
2.
a) Name surgical methods used for cataract removal (1.5)
b) What are advantages of phacoemulsification? (1.5)
[Annual 2010]
3.
d) What is a cataract?
e) Name any one operation used for its treatment.
[Annual 2007]
4.
a) Define cataract.
b) Name different methods of cataract extraction.
Complications of Cataract Surgery
1. A 65-year-old patient complains of gradual, painless decrease in vision in left eye

since last two months. He has been operated for cataract in left eye six months ago.
Surgery was uneventful within the bag IOL implantation. Distant direct
ophthalmoscopy shows media opacity.
a) What is the possible diagnosis? (2)
b) Enumerate the peri-operative complications of cataract surgery. (3)
2. Discuss early and late postoperative complications of cataract extraction.
3. Discuss early and late complications of extra-capsular cataract extraction.

[Annual 2005]
Aphakia
1. Enumerate the signs of aphakia.
[Annual 2007]
Ectopia Lentis
1.
a) What is Marfan’s syndrome? (1)
b) What are its ocular manifestations? (4)
▪ GLAUCOMA
Diagnosis of Glaucoma
1. Define perimetry. What are the normal dimensions of perimetry?

Glaucomatous Visual Field Defects
1. Write down different visual field defects in primary open angle glaucoma.
Primary Open Angle Glaucoma (POAG)
1. A 60 years old male with gradual painless reduction of vision was diagnosed with
primary open angle glaucoma.
a) What are the parameters for this diagnosis? (1.5)
b) Name medical treatment options for such a case. (2.5)
c) Name surgical treatment options for this case. (1)
2. Give account of:
a) Primary open angle glaucoma (2)
b) Beta-blockers as a treatment of choice for open angle glaucoma. (1.5)
[Annual 2013]
3. A middle-aged lady was treated with maximum topical anti-glaucoma treatment for
open angle glaucoma but the intraocular pressure still remained at upper limit with
progressive field loss. What options do you have for this patient to control the
glaucoma and the field loss? [Annual 2008]
4. Discuss the clinical features and treatment of primary open angle glaucoma.
[Annual 2005]
Primary Angle Closure Glaucoma (PACG)
1. A 42-year-old woman complains of right painful red eye with gross decrease of
vision. On examination, eye is red and painful with edematous cornea. Visual acuity
is 6/60. The eye is stony hard on digital tonometry with narrow anterior chamber
and dilated sluggishly reacting pupil.
b) What further clinical tests are required to confirm this diagnosis? (2)
c) What is the surgical treatment? (1)
[Annual 2014]
2. A 50-year-old female presents with severe ocular pain, decreased vision,

photophobia, watering and redness of eye. On examination, her intraocular pressure
(IOP) is 45 mm Hg in right eye.
b) How will you investigate and manage this patient? (4)
[Supple 2014]
Congenital (Infantile) Glaucoma
1. A mother brings her 1-year old baby with watery eyes and white corneas. On
examination, corneal diameters are 13 mm.
b) How will you investigate this child? (2)
c) How will you treat him? (2)
[Supple 2014]
Secondary Glaucoma
1. A 60-year-old male presented to you with history of severe pain in his right eye and
loss of vision. On examination, there is hyper-mature cataract and anterior chamber
is shallow. Intra-ocular pressure (IOP) is 48 mm Hg.
▪ UVEA
Uveitis
1. Classify uveitis. Discuss the role of cycloplegics in management of uveitis.

[Annual 2008]
Acute Iridocyclitis (Acute Anterior Uveitis)
1. A 30-year-old male presents with redness, pain and decreased vision in the right eye.
On examination, VA is 6/18 in right eye and 6/6 in the left eye. On slit lamp
examination, there are 4+ cells in the anterior chamber. IOP is 16 mm Hg.
a) What is the likely diagnosis? (1)
b) What other clinical signs will you look for in Slit Lamp Examination? (2)
c) What treatment options are available? (2)
Endophthalmitis
1. A 50-year-old male known diabetic underwent cataract surgery for right eye. On first
postoperative day he complains of severe pain, redness, decrease vision right eye. O
examination he had VA HM along with hypopyon, cornea edema and poor fundal
view. B-scan showed vitreous echogenic shadows.
b) What are causative organisms? (2)
[Annual 2019]
2. A 60 years old patient came to OPD with history of severe pain and sudden dimness
of vision in right eye, two days after cataract surgery. On examination there was
severe eye congestion and hypopyon. Retinal glow was absent and B-scan showed
extensive vitreous echoes.
[Annual 2018]
3. What are the differences between endophthalmitis and panophthalmitis?

[Annual 2010 & Annual 2012]
4. An old man was operated for cataract extraction and IOL implantation in left eye.
Postoperatively, patient complains of pain redness and visual deterioration in that
eye. Examination revealed intensely inflamed eye with swelling and conjunctival
chemosis ad hypopyon along with pupillary membrane. Anterior chamber aspirate
was obtained and found to contain pseudomonas aeruginosa upon culture.
a) Which antibiotic is most appropriate for this condition?
b) Which route of antibiotic therapy will provide the best result?
c) What is the natural course of illness if left untreated?
[Annual 2008]
5.
a) What is endophthalmitis?
b) How is it different from panophthalmitis?
c) How do you treat acute post-operative endophthalmitis?
[Annual 2008]
Panophthalmitis
1. What are the differences between endophthalmitis and panophthalmitis?

[Annual 2010 & Annual 2012]
▪ RED EYE
1. List four common and important causes of painful red eye. [Supple 2006]
2. What is the cause of red eye? [Annual 2005]

▪ VITREOUS
Vitreous Hemorrhage
1. Describe the management of vitreous hemorrhage. [Supple 2006]
2. An old lady of sixty-five years, a known diabetic and hypertensive complained of

sudden visual deterioration in left eye. The visual drop was sudden not associated
with pain and tenderness. On examination cornea, anterior chamber and lens were
normal to look at. However, the vitreous was not clear and showed a diffuse
hemorrhage in the vitreous body, obscuring the view of retina in that eye.
a) What are the causes of acute vitreous hemorrhage?
b) What is the surgical management to remove hemorrhage from the vitreous
which has gained tremendous popularity in the recent time?
c) How important is the examination of other eye and what findings do we expect in
the fellow eye in a case of acute vitreous hemorrhage?
[Annual 2008]
▪ RETINA
Diabetic Retinopathy
1. Write a short note on cotton wool spots. [Supple 2018 held in 2019]
2. A 30-year-old non-insulin dependent diabetic presents with hard exudates in the

posterior pole. His visual acuity is 6/60 in the right and 6/36 in the left eye.
a) What is the pathogenesis of this finding? (1)
b) Give two investigations with justification. (2)
c) Give four treatment options for this patient. (2)
[Supple 2019]
3. A 65 years old poorly controlled diabetic patient presented with gradual painless
reduction of vision in both eyes which was not improved with glasses. His ocular
examination revealed both eyes with proliferative diabetic retinopathy.
a) Name three serious complications of this condition. (1.5)
b) Name three ocular treatment options for this condition. (1.5)
c) Name two ocular investigations for evaluation of this condition. (2)
4. A 30 years old insulin-dependent diabetic presents with new vessels at the disc in
right eye. He also has multiple hard exudates at the macular area. His visual acuity is
6/60 in that eye.
b) What is pathogenesis of this condition? (2)
c) Give atleast 4 risk factors which aggravate this condition. (2)
[Annual 2017]
5. A 30 years old insulin dependent diabetic presents with decreased vision in both
eyes. His best corrected visual acuity is 6/24 in both eyes. On examination there are
few hard exudates on the posterior pole with scattered microaneurysms. There are
fine arborizing vessels on the optic disc and crescent shaped pre-retinal hemorrhage
along the inferior temporal vessels.
a) Name the risk factors which aggravate this condition.
b) Name the stage of disease seen in this patient.
[Annual 2016]
6.
a) Write the classification of diabetic retinopathy. (3)
b) What are the treatment options in case of proliferative diabetic retinopathy? (2)
7. A middle-aged lady presents with history of uncontrolled Diabetes Mellitus for the
last 15 years. She gives the history of blurring of near vision.
a) Classify diabetic retinopathy.
b) Write down the signs of pre-proliferative diabetic retinopathy.
8. A 40-year-old insulin dependent diabetic patient presents with progressive decrease

in vision in his right eye. On examination, there are microaneurysms and hard
exudates in the posterior pole. His visual acuity is 6/36 in that eye.
b) Name two investigations which will be done to assess this patient.
c) What are the two most important treatment strategies for this disease?
[Annual 2015]
9.
a) What are the causes of visual loss in diabetic retinopathy? (4)
b) What are the treatment options? (1) [Supple 2009 held in 2010]
10. Describe the features of diabetic retinopathy. [Supple 2006 held in 2007]
11. Enlist four important ophthalmoscopic signs of pre-proliferative diabetic retinopathy.

[Annual 2006]
12. Discuss pathogenesis and clinical features of diabetic retinopathy. [Annual 2005]
Hypertensive Retinopathy
1. A 56-year-old woman comes with the history of gradual painless loss of vision in
both eyes. On examination, her visual acuity is 6/60 in both eyes; retina shows
arterio-venous nipping, macular star, flame-shaped hemorrhages and optic disc
swelling.
b) How will you classify this retinopathy? Describe the signs. (3)
[Annual 2014]
Central Retinal Vein Occlusion (CRVO)
1. A 65-year-old known hypertensive patient presents with sudden painless loss of

vision in his left eye. Fundus examination shows dilated veins & flame-shaped
hemorrhages in all quadrants.
c) What are its complications? (2)
2. A sixty-year-old male with history of diabetes mellitus and hypertension presents

with sudden deterioration of left eye of two days duration. On examination, his left
eye appeared normal to look at with no pupillary abnormalities, the media was clear
and retina showed extensive hemorrhage all over obscuring the retinal vasculature
and macular anatomy.
a) What is most likely diagnosis? (0.5)
b) How will you proceed to confirm your diagnosis and how will you manage this
case? (4) [Annual 2013]
3. A 50-year-old patient presents with sudden loss of vision in the right eye. His visual
acuity is reduced to 6/60 in that eye. Retinal examination shows the presence of
dilated veins and diffuse retinal hemorrhage with a few cotton wool spots.
b) Which investigations you use to diagnose the case?
c) What will be the cause of secondary glaucoma in this patient?
d) What are the risk factors for this disease?
[Annual 2011]
4. A 70-year-old man presents with sudden painless visual loss in the right eye. Fundus
examination shows dilated veins & hemorrhage all over the retina.
a) What is probable diagnosis? (1)
c) What are the likely complications? (2)
[Annual 2009]
Central Retinal Artery Occlusion (CRAO)
1. A 67 years old lady is a known case of essential hypertension for the last 25 years.
She is also taking medicine for cardiac disease. She has given the history of sudden
painless loss of vision of her left eye for the last one day. She also gives history of
amaurosis fugax for the last one week. Her vision in the left eye is no light perception
and direct ophthalmoscopy shows pale optic disc, thread-like blood vessels and
cherry red spot.
b) Write down the detail of pupillary light reflex of this patient. (3)
c) Write three relevant investigations for confirmation of the diagnosis. (1)
2. A 60-year-old male presents with sudden painless loss of vision in his right eye. His
visual acuity is PL (perception of light) in right eye and 6/9 in left eye. On
fundoscopy, a cherry red spot is seen on the retina.
a) Give the differential diagnosis of cherry-red spot on the macula. (2)
b) How will you manage the patient? (3)
3.
a) What are clinical features of central retinal artery occlusion in 65 years old male?
b) What systemic investigations are required?
[Annual 2010]
4. A 70-year-old man presents with sudden painless loss of vision in the right eye.
Retinal examination revealed cherry red spots at the macula.
b) What relevant history points are important?
c) What investigations will you advise for this patient?
Age-related Macular Degeneration (ARMD)
1. Write short note on age-related macular degeneration. (1.5)

2. Write a short note on age-related macular degeneration. [Annual 2016]
Retinal Detachment
1. A 35 years old male presents with history of flashes and floaters in his right eye two
week back after a blunt trauma to the eye. It was followed by the sudden onset of
seeing a black shadow in the same eye. On examination, visual acuity was finger
counting and retina appeared gray on ophthalmoscopy. Left eye was normal.
[Annual 2018]
2. Write briefly on rhegmatogenous retinal detachment. (2.5) [Annual 2017]
3. Write a short note non-rhegmatogenous retinal detachment. [Annual 2016]
4.
a) What is retinal detachment? (1)
b) Discuss the type of retinal detachment. (1)
c) How do you treat rhegmatogenous retinal detachment? (3)
[Annual 2012]
5. A 30-year-old patient develops with flashes and floaters a few days following blunt
trauma to his eye. He presents in the outpatient with a black curtain in front of his
eye and his vision is reduced to 6/36 in that eye.
a) What is the most appropriate diagnosis? (1)
b) What technique will be used to examine this case? (1)
c) What is treatment of this condition? (2)
d) How long should you wait before doing surgery? (1)
6.
a) What is retinal detachment? (1)
b) Discuss the types of retinal detachment. (1)
c) How do you treat rhegmatogenous retinal detachment? (3)
7.
a) What is rhegmatogenous retinal detachment?
b) Name the steps in the surgical management.
[Annual 2007]
8.
a) Define rhegmatogenous retinal detachment. List four important causes of
rhegmatogenous retinal detachment. [Annual 2006]
Retinitis Pigmentosa (RP)
1. Write a short note on Retinitis Pigmentosa. [Supple 2019 held in 2020]
2. Write a short note on tunnel vision. [Supple 2018 held in 2019]
3. A 19-year-old boy presents to the OPD with a complaint of night blindness. On fundal
examination bony spicules were present in all four quadrants. He gave similar history
of night blindness in other siblings.
b) What are the other associations of this condition?
c) How you are going to counsel this patient?
4. A 30 years old male presents with visual acuity of 6/60 in both eyes. On examination,
there are pigmentary bone corpuscles in the peripheral retina. His vision is markedly
reduced at night and he has a ring scotoma on visual field examination.
a) What is most likely diagnosis in this patient?
b) Name other features seen in the posterior segment in this patient.
c) How you are going to counsel this patient?
[Annual 2016]
5. A 15-year-old boy presents with poor vision at night. On examination, there is waxy
pallor of the disc. His visual acuity is 6/18 in both eyes.
a) Name two other clinical features present in this disease.
b) What will be the findings on visual fields of this patient?
c) What features will be seen in carriers of this disease?
[Annual 2015]
6. A 39-year-old factory worker complains of difficulty in seeming things passing by his

sides. History reveals that he has night blindness since childhood. On examination,
his visual acuity is 6/18 in both eyes. Visual fields are tubular. Fundus shows waxy
pale disc, attenuated vessels and bone corpuscle type of pigment dispersion in the
mid-peripheral fundus.
b) What is your advice to him? (2)
[Annual 2014]
7. A 20 years old male c/o night blindness since birth, his visual acuity has been
gradually reducing especially in the dark, his visual acuity at present is 6/12 both
eyes and he wears -2.5 diopter glasses both eyes. His maternal uncles have the same
problem but his female siblings are all right.
a) What will be the visual field changes? (2)
b) What will be the fundus findings? (2)
c) What is the advice? (1)
8. A two year is brought to the outpatient department with leukocoria and esotropia in
the right eye. The parents have noticed that the disease is progressing rapidly and
they are very concerned as his elder brother died few years ago at the same age.
b) What investigation will you perform? (1)
c) What is the management in early disease? (2)
d) What is the most common inheritance pattern of this disease? (1)
9. A 40-year-old female presents with progressive loss of night vision. Her grandfather
also had similar condition. Her visual acuity is still 6/12 uncorrected in both eyes and
her IOP is 16 mm Hg with no cupping of disc.
a) What is the most appropriate diagnosis?
b) Name three retinal signs characteristic of this disease.
c) Which investigation can you perform?
[Annual 2011s]
10. A 20 years old man presents with night blindness since birth.
b) What would be the sign in retina? (3)
c) What photoreceptors are affected? (1)
11. A young man presents with history of night blindness since birth.
b) What vitamin deficiency can cause the same? (1)
c) What genetic transmission is possible? (1.5)
d) What retinal signs are present? (1.5)
[Annual 2010]
12. A 1 years old boy complains of night blindness which is progressive in nature. His
father & uncle have difficulty at night vision. On examination fundus shows bony
spicules (pigment bone corpuscles) with pale disc & narrow vessels.
b) What is most likely hereditary pattern? (2)
c) What advice will you give to the patient? (2)
[Annual 2009]
13. You see an 18 years old boy with the history of night blindness from birth.
b) What are the expected findings on fundus examination?
[Annual 2007]
Retinoblastoma
1. Write a short note on retinoblastoma. (2.5) [Supple 2019 held in 2020]
2. Write short note on retinoblastoma. (1.5) [Supple 2018 held in 2019]
3. A mother brings her two years old child in eye OPD with leukocoria of right eye. B-
scan shows intraocular mass with calcification. Left eye also had white pupil for
which it was enucleated months back after extensive investigations.
b) Write down four differentials for leukocoria in this age group. (4)
[Annual 2018]
4. Write briefly on retinoblastoma. (2.5) [Annual 2017]

▪ OPTIC NERVE
Papilledema
1. A 40-year-old married female comes with the history of severe headache and
projectile vomiting. She has a history of primary amenorrhea, galactorrhea and
infertility. On examination, refractive media is clear and there is bilateral optic disc
swelling. Visual fields show bitemporal hemianopia.
b) How will you investigate the case?
[Annual 2019]
2. A 30-year-old patient with headache for one month presents with intermittent
obscuration of his vision. His visual acuity is 6/6 in both eyes and fundus examination
shows swelling of the optic disc of both sides. No intracranial pathology has been
found on investigation.
a) What is most probable diagnosis of this patient? (1)
b) What will be result on visual field examination in early and late stages of this
condition? (2)
c) What investigations will you perform in this case? (2)
[Annual 2017]
3. A 35 years old lady presents with severe headache, vomiting and blurring of vision
for 15 days. CT scan shows space occupying lesion. Visual acuity is 6/6 partial in both
eyes.
a) What are the most important ocular investigations? (2)
b) What will be fundus findings? (2)
c) What ocular complications can occur if untreated? (1)
[Supple 2013]
4. A 30-year-old female presents with severe headache, nausea and vomiting. She
complains of transient loss of vision while standing but her visual acuity I s 6/6 in
both eyes. Visual fields show enlarged blind spots on both sides.
a) What is the investigation of choice?
b) What changes are likely to be seen in the optic nerve of the patient?
c) Name three differential diagnoses.
[Annual 2011]
5.
a) What are the causes of papilledema? (4)
b) What will be the field changes in papilledema? (1)
6.
a) What is papilledema?
b) What are its causes?
c) How will you investigate?
[Annual 2009]
Optic Neuritis
1. A 30-year-old female patient presented with drop of vision in the left eye. On
examination, visual acuity was 6/6 in the right eye and 6/60 in the left eye. Fundus
examination showed blurred edges of the left optic disc.
a) What is your clinical diagnosis? (1)
c) Enumerate the causes. (2)
2. A patient met a road traffic accident and remained admitted in neurosurgery

department for his head injury. He was discharged after one week. He reported in
eye department with left sided visual disturbance. His distant visual acuity is 6/6 in
both eyes. His pupillary life reflex is normal in both eyes. Optic nerve head is normal
in both eyes.
a) What clinical method you do to confirm the ocular symptoms of the patient?
(2.5)
b) How radiology department will help you? (1.5)
c) What is your diagnosis? (1)
3. A 20 years old female presented with sudden loss of vision in her right eye. She
complained of pain on moving her eye and her color vision was disturbed in the
same eye. There was right Marcus-Gunn pupil and right optic disc was swollen on
fundus examination. Left eye was normal.
a) What is most likely diagnosis? (1)
b) How will you treat this patient? (4)
[Annual 2018]
4. A 30-year-old female presents with sudden painful loss of vision in the right eye. On
examination, there is decreased light brightness and positive relative afferent
pupillary defect. Her visual acuity is 6/60 and fundus examination is normal. She
complains of numbness in her finger with a history of similar episode before.
a) What is most probable clinical diagnosis and name the underlying disease?
b) What type of visual field defect will be present in this condition?
[Annual 2015]
5. A 30-year-old female presents with unilateral loss of vision and pain on eye
movement. A diagnosis of optic neuritis is made.
a) What are the signs to be expected? (3)
b) What is the treatment? (1)
c) What is the prognosis? (1)
[Annual 2012]
6. A 20 years old female presents with sudden loss of vision in the right eye only. There
is slight pain on extraocular movements and afferent pupillary defect is present on
that side. Rest of the eye examination is within normal limits.
b) Which other clinical test would you like to perform? (1)
c) What investigations would you like to perform if all blood tests are normal? (1)
d) What is the most common cause of this condition? (1)
e) What is the most appropriate treatment? (1)
7. A 30 years old female presents with unilateral loss of vision and pain on eye
movement. A diagnosis of optic neuritis is made.
a) What are the signs to be expected? (3)
b) What is the treatment? (1)
c) What is the prognosis? (1)
8.
a) What are the clinical features of optic neuritis? (2.5)
b) What is the treatment? (1.5)
[Annual 2010]
9.
a) What is optic neuritis?
b) Name one associated neurological disease.
c) Enumerate its clinical signs.
[Annual 2007]
10. Discuss causes of optic neuritis. [Supple 2006 held in 2007]
11. Describe signs, symptoms, causes and treatment of optic neuritis. [Annual 2006]
Optic Neuropathy
1. An 80 years old male has been complaining of headache and sudden loss of vision in
right eye. He has tenderness in both temples and one can feel rope like structures at
both temples.
a) What investigations will you do in this case? (2)
b) What is the likely diagnosis? (1)
c) What will fundus look like? (1)
d) What is the treatment? (1)
▪ ORBIT
Proptosis
1. A 40-year-old lady presents in the outdoor clinic with bilateral proptosis.

a) What is the differential diagnosis?
b) What investigations would you like to do for this patient inorder to confirm the
diagnosis?
2. List four causes of proptosis. [Annual 2006]
Orbital Cellulitis
1. A 19 years old boy presents with painful protrusion of left eyeball. There is a recent
history of acute sinusitis. On examination, ocular motility is restricted and painful.
There is conjunctival chemosis & vision is also reduced. Fundus examination reveals
disc edema.
b) What are its complications?
2. A 7-year-old boy with an upper respiratory tract infection develops violaceous lid
swelling and pain around right eye. The right eyelids are diffusely tender to touch
and he is not able to open the eye completely. The eye is severely congested an
there is restriction of extraocular movements in this eye.
[Annual 2018]
3. A 45 years old female is on heavy dose of oral steroids for her acute kidney disease.
She reports in emergency with 3 days history of painful swelling in left eye on
temporal sclera followed by sudden severe swelling of the orbit, lid closure and
inability to move the eyeball in any direction.
a) Give most likely diagnosis. (1)
b) Give three relevant investigations. (1.5)
c) How will it be treated? What are its complications? (2.5)
[Annual 2017]
4. A 6-year-old child presents with severe right orbital pain, swelling of eyelids and
bulging of eyeballs after an episode of flu.
b) How will you investigate this patient?
[Supple 2014]
5. An ill looking poorly nourished young girl presents with painful progressive proptosis
of left eye for four days. She had sinusitis a week ago and now she has this proptosis
and is febrile. Her V.A on this side is reduced to 6/18 and she has afferent pupillary
defect.
b) What is the most important complication?
6. A 20-year-old male presents with a painful progressive proptosis of right eye for 2
days. He has got fever and history of chronic sinusitis. His visual acuity is reduced to
6/18 and there is positive relative afferent pupillary defect on the same side.
b) What is the most important complication?
c) What investigation will you perform?
d) What is the treatment?
[Annual 2011]
7. A five-year-old child is brought with fever, right proptosis and swollen eyelids.
b) How will you manage?
[Annual 2010]
8.
a) What is orbital cellulitis?
b) Name three clinical signs.
c) How is it treated?
[Annual 2007]
Thyroid Eye Disease (TED)/Graves Ophthalmopathy
1. A 30-year-old young lady presents with mild ocular pain and staring and frightened
appearance of eyes. There is history of profuse sweating, palpitations and weight
loss. Visual acuity is 6/6 in both eyes and there is congestion of conjunctiva.
b) How will you examine and investigate this case? (2)
c) What is management at this stage of the disease? (2)
[Annual 2019]
2. A 20 years old female with Grave’s disease presented with bilateral axial proptosis.
a) Name ocular signs to look for in this case.
b) Name two vision threatening complications of this condition. (1)
c) Enlist treatment options. (2)
3. A middle-aged lady reports in eye department with a history of protrusion of her

right eye ball. In ten days duration, she has swollen lids with incomplete closure of
palpebra fissure along with decrease in vision.
a) Write down differential diagnosis.
b) Write down investigations which you can do in order to reach diagnosis.
4. A 30 years old female presents with axial proptosis of the right eye. On examination,
the Von Graefe sign is positive and there is upper lid retraction on straight gaze.
Extraocular movements are restricted in all directions of gaze. The visual acuity is
6/18 in the affected eye.
b) Give two other most important differential diagnosis in this patient.
c) Name two most important investigations you would order and justify your choice
of investigations.
[Annual 2016 + Annual 2015]
5. A 30-year-old female presents with painless proptosis of slow onset.

[Annual 2012]
6. A 30-year-old female presents with painless axial proptosis of the right side. Her
visual acuity is 6/6 unaided both sides. There is upper lid retraction and lid lag on
down gaze. She is not complaining of sudden onset diplopia.
b) What are the findings on CT scan of this orbit?
c) What is the cause of diplopia?
d) How will you manage acute stage of this disease?
7. A 20-year-old female has thyroid enlargement and complains of bilateral

prominence of eyes.
b) What are the likely ocular signs?
8. A young lady presents with bilateral prominence of eye noticed recently by the
relatives. There was no history of diplopia or ocular restriction or squint.
a) What D/D you have in mind for this patient? Also give the appropriate diagnosis.
b) How will you investigate this patient?
[Annual 2008]
▪ OCULAR INJURIES
Extraocular Foreign Body
1. A welder develops sudden foreign body sensation, severe photophobia lacrimation

and blepharospasm in his right eye.
a) What is the immediate measure to the taken to see the foreign body?
b) What type of injury has happened?
c) What are the delayed effects of this injury?
Contusion Injuries (Blunt Trauma)
1. A 20 years old boy comes to you with decreased vision in right eye after trauma. His
cornea is clear and fundus examination is within normal limits. There is
tremulousness of the iris and iridodialysis in superior quadrant. He complains of
uniocular diplopia on the right side.
a) What can the cause of this condition?
b) What other complications of trauma can be seen in this patient?
c) How will you manage this patient?
[Annual 2016]
Intraocular Foreign Body
1. Give principles of management of intraocular foreign body. [Annual 2006]
Penetrating Injuries
1. A 20-year-old male presets with self-healing penetrating injury to the right cornea
and the lens. His VA is 6/60 in that eye. Examination shows collection of whitish
material in the inferior angle of eye. B-scan shows no vitritis.
a) What will be the changes in the lens due to this type of injury?
b) What is the material in the angle of eye?
c) What will be the management if posterior capsule is intact?
[Annual 2011]
Chemical Injury (Acid and Alkali Burns)
1.
a) A young laborer has come to an eye clinic with history of lime burn to the eye
while white-washing the roof of room followed by intense pain, redness and
watering from eyes.
b) What emergency steps would you go for inorder to manage the case?
[Annual 2008]
Blow-out Fracture
1. A young motorcycle driver had a fight with a car driver after a road traffic accident,
after a few hours the motorcycle driver feels double vision in the up-gaze along with
impaired sensations in the right cheek along with surgical emphysema in the lids of
right eye.
a) Write relevant investigation; give details for investigations for diplopia. (3)
b) What is the diagnosis? (1)
c) What is the initial treatment? (1)
2. In a match a cricketer is hit by a ball on his right eye while batting and missing
bouncer, he now complains of double vision on upward gaze.
b) What investigation will confirm your diagnosis?
[Annual 2014]
3. Give an account of the following:

a) Blowout fracture
b) Management of blowout fracture
c) What happens if condition is left untreated?
[Supple 2014]
4. Give an account of
a) blowout fracture.
b) Cavernous hemangioma. s
[Annual 2013]
5. A young boy playing cricket has been hit with a ball on the right side of face. He
complains of diplopia and crepitations around the orbit.
b) What sign will you seen on X-ray of face?
[Annual 2009]
▪ ERRORS OF REFRACTION
Myopia
1. A 22 years old female presented with gradual painless reduction of far vision. On
examination her visual acuity was 6/24 in right eye and 6/18 in left eye which
improved with pinhole test to 6/6 in each eye. Her near vision was normal in both
eyes unaided. She was prescribed concave lenses for correction of far vision.
a) What refractive error she has? (1)
b) Name treatment options for her. (2)
c) Name most modern methods to correct her refractive error. (2)
2. A 22-year-old girl presents with -6 myopia. Discuss the various options for correction
of myopia in this patient. [Supple 2014]
3. A 20 years old boy presented with history of decreased far vision. On examination
his visual acuity is 6/8 and improves to 6/6 with concave lens.
b) Where image forms before and after correcting with lens?
c) Other modalities to correct vision?
[Annual 2013]
Anisometropia
1. A 5 years old child is found to have 6/6 vision in his right eye and 6/24 in the left eye
on routine school eye examination. His anterior and posterior segment examination
is normal. His eyes are straight on Hirschberg test.
b) Give the classification of this condition. (2)
c) How will you manage this patient? (2)
[Annual 2017]
▪ STRABISMUS (SQUINT)
Amblyopia
1. What is amblyopia? (1) [Supple 2018 held in 2019]
Heterophoria (Latent Squint)
1. A 6 years old child has come in OPD with history of headache mostly while doing his
homework. The mother has noticed that the boy has difficulty in watching TV from a
proper distance along with occasional misalignment of his eyes.
a) Write down detailed clinical examination.
b) What is your diagnosis on the basis of your clinical work?
[Annual 2016]
Concomitant Convergent Squint/Esotropia
1. A 5-year-old child presents with 6/36 vision in the right and 6/18 in the left eye. On
examination, he is found to have 30 prism diopters inward deviation for distance
which increases to 45 prism diopters for near. A correction of +5 diopters in both
eyes improves the squint.
b) Enumerate four ways to assess the patient. (2)
c) Give three basic steps of managing this patient. (2)
[Annual 2019]
2. A 5-year-old child has started his class one; the school teacher has called the parents
for his poor performance and persistent headache while writing on his copy along
with inward deviation of eyes. His unaided vision is 6/18 in both eyes.
a) Write complete clinical work-up of the boy. (3)
b) What is the diagnosis? (1)
3. A 3 years old child was brought by his mother with inward deviation of left eye when
he focuses on near objects. Examination revealed normal extraocular movements,
anterior and posterior segments. Refraction revealed high hypermetropic refractive
error in left eye.
b) Name clinical tests for evaluation of this case. (2)
c) Name treatment options. (2)
4. A mother brings her 4-year-old child with inward deviation of eyes since birth. How
will you clinically investigate this patient? (5) [Annual 2018]
5. A 2-year-old child is brought by his mother with a complaint of deviation of eyes. On

examination, there is alternate ET (esotropia) of 40D. cycloplegic refraction reveals
hypermetropia of +6.0 DS (Diopteric Spherical) both eyes. Fundi are within normal
limits. With +5.0 DS glasses, the patient becomes orthophoric.
a) What is the diagnosis? (20
b) What is the differential diagnosis? (1)
c) How will you manage this case? (2)
6. A 3 years old child is brought with deviation of the right eye since birth. On
examination, the corneal light reflection falls on the lateral limbus when a light is
shown from the front. Cycloplegic examination shows no refractive error.
b) What will happen if treatment is not done at this stage?
c) What are the principles of treatment in this patient?
[Annual 2015]
7. A mother brings her 5-year-old child with complains of deviation of both eyes since
birth.
b) How will you clinically evaluate this child?
8. A 3-year-old boy is brought to eye OPD. Mother says that the child turns his eyes
inward especially when looking near objects.
a) How will you investigate this case?
b) What is likely refractive error the child has?
9. A six-month-old baby presented with alternating esotropia. On examination, there

was no significant refractive error, media is clear and extraocular movements were
normal with normal looking fundus. Forced duction test was negative.
a) What is the differential diagnosis and final diagnosis?
b) What is your management plan for the diagnosis you have made?
c) What is the appropriate time for management?
[Annual 2013]
10. The parents of four-year-old child have noticed inward deviation of the right eye.
The deviation is present in all directions of the gaze and worsens on near fixation.
b) What findings are likely to be seen on retinoscopy?
c) What are the three steps in the treatment of this case?
11. A 4-year-old girl developed inward turning of her right eye soon after she started
going to school.
12.
a) What is accommodative squint?
b) How would you manage a two-year-old with accommodative esotropia?
[Annual 2010]
13. A 1-year old girl presents with large convergent squint.

a) What is the differential diagnosis?
b) How will you examine and investigate this case?
[Annual 2009]
14. A child of 2 years is brought by the parent for inward deviation of right eye
(convergent squint). How will you manage such patient? [Supple 2007 held in 2018]
15. Write down management plan for the case of esotropia. [Annual 2007]
16. A 3-year-old child has presented with history of squint. On corneal reflection test
(Hirschberg test), corneal reflection is in the center of right eye pupil. Corneal
reflection is on the temporal side of limbus in the left eye. What is the diagnosis?
What is the principle of treatment of such patient?
[Annual 2006]
Paralytic Squint (non-concomitant)
1. A 60-year-old male presents with sudden onset of double vision which worsens on
right gaze. Examination shows he has inward deviation of the right eye on distant
fixation.
a) What is the type of squint in this case? (1)
b) Enumerate tests performed to diagnose this condition. (2)
c) What is the treatment of diplopia? (2)
2. A 65-year-old patient gives the history of double vision in right gaze. He does not
have refractive error. To avoid diplopia, he turns his face towards right side.
b) What clinical examination/tests you would do?
c) What are laboratory investigations you will ask?
3. A middle-aged lady having diabetes mellitus suddenly developed horizontal diplopia

in left gaze. Examination showed inward deviation of left eye.
a) What is the probable diagnosis?
b) Which type of squint is present?
c) How will you confirm your diagnosis clinically?
d) What should be the initial management?
[Annual 2014]
4. A 50-year-old diabetic male presents with sudden onset of double vision which
worsens on right gaze. Examination shows he has an inward deviation of the right
eye on distant fixation.
a) What type of squint is present in this case?
b) What is the cause of this condition?
c) What test can be performed to diagnose this condition?
d) What is the treatment in mild diplopia?
[Annual 2011]
5. What are the signs and symptoms of paralytic squint? [Supple 2009 held in 2010]
Third Cranial Nerve Palsy
1. A middle-aged lady having diabetes suddenly developed horizontal diplopia in left

gaze. Examination showed inward deviation of left eye.
a) What is the probable diagnosis?
b) Which type of squint is present?
c) How will you confirm your diagnosis?
Miscellaneous
1.
a) What is the difference between comitant and incomitant squint?
b) What is meant by recession and resection of extraocular muscles?
c) If a patient has right esotropia, which extraocular muscle will you resect and
which one will you recess?
2. How will you evaluate a case of squint? [Supple 2006 held in 2007]

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OPHTHALMOLOGY – PAST QUESTIONS (2005-2020)

(Compiled by Shahroze Ahmed, N-66, Nishtar Medical University)

4. Describe treatment of chalazion. [Supple 2006]

Hordeolum Externum (Stye)

1. What are the causes of trichiasis? [Supple 2006]

3. What are the causes of entropion of lower eyelid in a man of 70 years?

3. A 30-year-old patient involved in a chemical burn of face presents with eversion of

7. An 85-year-old patient reports with gradual onset of bilateral drooping of upper

10. Give management of ptosis. [Annual 2006]

Anatomy and Physiology

1. You are a drop of steroids placed in the conjunctival sac.

Congenital Nasolacrimal Duct Obstruction

Neonatal Conjunctivitis (Ophthalmia Neonatorum)

Vernal Keratoconjunctivitis (Spring Catarrh)

8. A ten-year-old presents with red itchy eyes at the beginning of spring.

Ocular Cicatricial Pemphigoid

1. List ocular manifestations of Vitamin A deficiency. [Annual 2008]

Anatomy and Physiology

Bacterial Corneal Ulcer

5. What are the complications of perforated corneal ulcer? [Annual 2006]

6. Discuss the treatment of cornea ulcer. [Annual 2005]

Herpes Simplex Keratitis

1. A 40 years old female having rheumatoid arthritis on immune modulator presented

Herpes Zoster Ophthalmicus (HZO)

1. An elderly lady has developed macular-papular-pustular eruptions on the forehead,

1. A 26-year-old patient wearing glasses comes to your OPD and complains of

Congenital (Developmental) Cataract

2. A 5-year-old child is brought to you with developed of a white pupillary reflex. On

1. Name four common causes of cataract. (2) [Annual 2010]

Senile Cataract (Age Related)

Types of Cataract Extraction

Complications of Cataract Surgery

1. A 65-year-old patient complains of gradual, painless decrease in vision in left eye

3. Discuss early and late complications of extra-capsular cataract extraction.

1. Define perimetry. What are the normal dimensions of perimetry?

Glaucomatous Visual Field Defects

Primary Open Angle Glaucoma (POAG)

Primary Angle Closure Glaucoma (PACG)

2. A 50-year-old female presents with severe ocular pain, decreased vision,

Congenital (Infantile) Glaucoma

1. Classify uveitis. Discuss the role of cycloplegics in management of uveitis.

Acute Iridocyclitis (Acute Anterior Uveitis)

3. What are the differences between endophthalmitis and panophthalmitis?

1. What are the differences between endophthalmitis and panophthalmitis?

2. What is the cause of red eye? [Annual 2005]

1. Describe the management of vitreous hemorrhage. [Supple 2006]

2. An old lady of sixty-five years, a known diabetic and hypertensive complained of

2. A 30-year-old non-insulin dependent diabetic presents with hard exudates in the

8. A 40-year-old insulin dependent diabetic patient presents with progressive decrease

11. Enlist four important ophthalmoscopic signs of pre-proliferative diabetic retinopathy.

Central Retinal Vein Occlusion (CRVO)

1. A 65-year-old known hypertensive patient presents with sudden painless loss of

2. A sixty-year-old male with history of diabetes mellitus and hypertension presents

Central Retinal Artery Occlusion (CRAO)

Age-related Macular Degeneration (ARMD)

1. Write short note on age-related macular degeneration. (1.5)

2. Write a short note on age-related macular degeneration. [Annual 2016]

2. Write briefly on rhegmatogenous retinal detachment. (2.5) [Annual 2017]

3. Write a short note non-rhegmatogenous retinal detachment. [Annual 2016]

Retinitis Pigmentosa (RP)