National Programs for Eye Care — MCQs
Which of the following is NOT a core component of the WHO's global STI control strategy?
A patient complains of an inability to read a newspaper, particularly in bright sunlight. What is the most likely diagnosis?
If blindness is surveyed using schools as compared to population surveys, then estimation of prevalence of blindness will have?
Which of the following procedures is not typically covered by the National Programme for Control of Blindness (NPCB) for reimbursement of surgery done by a non-governmental organization (NGO) eye hospital?
All of the following are the targets for National Programme for Control of Blindness (NPCB), EXCEPT:
Target interventions of National AIDS Control Organisation include all, except?
Under NTEP, what is the honorarium given to a DOTS provider after the completion of treatment?
As per the National Tuberculosis Elimination Program (NTEP), HIV TB prevalence of what percentage would deem a district a high priority district?
Vision 2020 "The right to sight" includes all except-
The golden period of eye donation is
National Programs for Eye Care Indian Medical PG Practice Questions and MCQs
Question 1: Which of the following is NOT a core component of the WHO's global STI control strategy?
- A. Case management
- B. Universal mandatory screening (Correct Answer)
- C. Strategic information systems
- D. Prevention services
Explanation: ***Universal mandatory screening*** - While screening is part of STI control, **universal mandatory screening** for all STIs in the general population is not a core component of the WHO's strategy due to feasibility, cost, and ethical considerations. - The strategy emphasizes **targeted screening** for at-risk populations and opportunistic screening. *Case management* - **Case management**, including accurate diagnosis and effective treatment, is a critical component for managing current infections and preventing further transmission. - This involves syndromic or etiologic approaches to treatment and partner notification. *Strategic information systems* - **Strategic information systems** are essential for monitoring trends, evaluating interventions, and informing policy decisions related to STI control. - This includes surveillance data, program monitoring, and research. *Prevention services* - **Prevention services** are a cornerstone of the WHO's strategy, aiming to reduce the incidence of new infections. - These services encompass health education, condom promotion and distribution, vaccination, and pre-exposure prophylaxis (PrEP).
Question 2: A patient complains of an inability to read a newspaper, particularly in bright sunlight. What is the most likely diagnosis?
- A. Nuclear cataract
- B. Cortical cataract
- C. Posterior subcapsular cataract (Correct Answer)
- D. Congenital cataract
Explanation: ***Posterior subcapsular cataract*** - This type of cataract causes significant **glare** and **photophobia**, making it difficult to read in bright light due to opacities located at the **posterior lens capsule**. - The patient experiences worsening vision in **bright light** conditions because the constricted pupil directs more light through the **central posterior opacity**, which lies directly in the visual axis. *Nuclear cataract* - Patients with **nuclear cataracts** typically experience **myopic shift** and improved near vision (second sight) due to increased refractive power of the lens. - Vision is usually worse in **dim light** conditions because of pupillary dilation, which allows more light to pass through the central opacity. *Cortical cataract* - Characterized by **spoke-like opacities** that start in the periphery and extend inward. - While it can cause glare, vision often remains good until the opacities encroach upon the **visual axis**, and it doesn't specifically cause worsening vision in bright light to the same degree as PSC. *Congenital cataract* - Present at birth or shortly after, and symptoms depend on the density and location of the opacity. - While it affects vision, the specific complaint of difficulty reading in bright sunlight is not a typical distinguishing feature of **congenital cataracts**.
Question 3: If blindness is surveyed using schools as compared to population surveys, then estimation of prevalence of blindness will have?
- A. Underestimation (Correct Answer)
- B. Cannot be compared
- C. Overestimation
- D. Remains same
Explanation: ***Underestimation*** - School surveys only capture the prevalence of blindness among the **school-going population**, excluding pre-school children and adults. - Many causes of blindness (e.g., **cataract, glaucoma, diabetic retinopathy, age-related macular degeneration**) are more common in older adults, who are not included in school-based surveys, leading to an **underestimation of overall prevalence**. - The majority of blindness burden lies in the **adult and elderly population**, which is completely missed in school surveys. *Overestimation* - An overestimation would occur if the survey sample contained a disproportionately high number of blind individuals compared to the general population, which is unlikely in a school setting. - School surveys tend to exclude populations with higher rates of blindness, making overestimation improbable. *Cannot be compared* - Both school surveys and population surveys can be compared as they are both epidemiological survey methods. - While they survey different populations and serve different purposes, their results can be compared to understand **sampling bias** and **representativeness**. *Remains same* - The prevalence would only remain the same if the demographic and disease characteristics of the school-going population perfectly mirrored those of the general population. - For blindness, this is not the case as the **age distribution** of blindness is heavily skewed toward older ages, which are not represented in school surveys.
Question 4: Which of the following procedures is not typically covered by the National Programme for Control of Blindness (NPCB) for reimbursement of surgery done by a non-governmental organization (NGO) eye hospital?
- A. Cataract surgery
- B. Pan retinal photocoagulation for diabetic retinopathy
- C. Syringing and probing of the nasolacrimal duct (Correct Answer)
- D. Trabeculectomy surgery
Explanation: ***Syringing and probing of the nasolacrimal duct*** - While important for lacrimal drainage issues, procedures like **syringing and probing** are generally considered minor and less vision-restoring compared to the major surgeries targeted by the **NPCB**. - The **NPCB** focuses on interventions for leading causes of blindness, primarily **cataract** and other significant vision-threatening conditions, which this procedure typically isn't. *Cataract surgery* - **Cataract surgery** is a cornerstone of the **NPCB's** efforts, as cataracts are the leading cause of reversible blindness. - Reimbursement for **cataract surgery** is a primary objective to improve access and reduce the burden of blindness. *Pan retinal photocoagulation for diabetic retinopathy* - **Diabetic retinopathy** is a major cause of preventable blindness, and **pan retinal photocoagulation (PRP)** is a key intervention to preserve vision. - The **NPCB** includes procedures for **diabetic retinopathy** management due to its significant public health impact. *Trabeculectomy surgery* - **Trabeculectomy** is a surgical procedure for **glaucoma**, which is another significant cause of irreversible blindness. - The **NPCB** includes interventions for **glaucoma** given its severe vision-threatening nature and the need for surgical management in many cases.
Question 5: All of the following are the targets for National Programme for Control of Blindness (NPCB), EXCEPT:
- A. Development of 50 pediatric ophthalmic units
- B. Increase cataract surgery rate to 450 operations per lakh population
- C. Intraocular lens implantation in more than 80 percent cataract surgery cases
- D. 100% coverage of vitamin A prophylaxis doses from 9 months to 3 years of age (Correct Answer)
Explanation: ***100% coverage of vitamin A prophylaxis doses from 9 months to 3 years of age*** - This objective is typically associated with the **Reproductive and Child Health (RCH) program** and efforts to combat **Vitamin A deficiency**, not directly with the core targets of the National Programme for Control of Blindness (NPCB). - While vitamin A deficiency can lead to blindness, the NPCB's primary focus has historically been on treatable causes of blindness such as **cataract** and **refractive errors**. *Development of 50 pediatric ophthalmic units* - The NPCB aims to **strengthen ophthalmic services**, and the development of specialized pediatric units is a crucial component to address childhood blindness. - This target aligns with the program's focus on **preventing and treating blindness** across all age groups, including children. *Increase cataract surgery rate to 450 operations per lakh population* - **Cataract** is the leading cause of blindness in India, and increasing the **cataract surgery rate** is a key strategic objective of the NPCB to reduce the burden of preventable blindness. - This specific numerical target reflects the program's commitment to **scaling up surgical interventions**. *Intraocular lens implantation in more than 80 percent cataract surgery cases* - The NPCB emphasizes not just the quantity but also the **quality of cataract surgeries** performed. - Promoting **intraocular lens (IOL) implantation** in a high percentage of cases ensures better visual outcomes and rehabilitation for patients.
Question 6: Target interventions of National AIDS Control Organisation include all, except?
- A. Detection & treatment for sexually transmitted infections
- B. Abscess prevention & management in injecting drug users
- C. Condom promotion & distribution
- D. Provision of lubricants to Injecting drug users (Correct Answer)
Explanation: ***Provision of lubricants to Injecting drug users*** - The provision of lubricants is primarily relevant for **safe sexual practices** to prevent friction and condom breakage, not directly for injecting drug users to mitigate injection-related risks. - While **harm reduction** is a key focus, this specific intervention does not align with the direct prevention of HIV transmission routes typically targeted for injecting drug users, such as shared needles or inadequate sterile practices. *Detection & treatment for sexually transmitted infections* - **STIs** increase the risk of HIV transmission by causing genital lesions and inflammation, thus their detection and treatment are crucial for HIV prevention. - This intervention is a cornerstone of National AIDS Control Organisation (NACO) programs to reduce HIV vulnerability in high-risk populations. *Abscess prevention & management in injecting drug users* - **Abscesses** are common complications of injecting drug use, often resulting from unsterile practices or shared needles, which are also routes for HIV transmission. - Addressing these complications is part of a broader **harm reduction strategy** aimed at minimizing health risks among injecting drug users, including HIV. *Condom promotion & distribution* - **Condom promotion and distribution** is a fundamental intervention for preventing sexual transmission of HIV by providing a physical barrier. - This is a central component of NACO's strategy to promote safer sexual practices among the general population and high-risk groups.
Question 7: Under NTEP, what is the honorarium given to a DOTS provider after the completion of treatment?
- A. 150 INR
- B. 500 INR (Correct Answer)
- C. 1000 INR
- D. 250 INR
Explanation: ***500 INR*** - Under the **National Tuberculosis Elimination Programme (NTEP)**, a **DOTS provider** receives an honorarium of **INR 500** upon the successful completion of tuberculosis treatment for a **new TB patient**. - This incentive, revised from the earlier amount of INR 250, aims to recognize the crucial role of DOTS providers in ensuring treatment adherence and successful outcomes. - The increased honorarium reflects the government's commitment to incentivizing community participation in TB elimination. *150 INR* - This amount is **significantly lower than the stipulated honorarium** for a DOTS provider upon treatment completion under current NTEP guidelines. - The correct incentive for successful completion of treatment is INR 500 for new TB cases. *250 INR* - This was the **earlier honorarium amount** under the previous NTEP guidelines, which has since been **revised upward**. - Under the current NTEP incentive structure, the honorarium for treatment completion has been increased to INR 500. *1000 INR* - This amount is **higher than the designated honorarium** for a DOTS provider upon treatment completion under NTEP. - While this figure may apply to other incentive schemes or different milestones, the standard honorarium for new TB case completion is INR 500.
Question 8: As per the National Tuberculosis Elimination Program (NTEP), HIV TB prevalence of what percentage would deem a district a high priority district?
- A. >15 %
- B. >20 %
- C. >10 % (Correct Answer)
- D. >12 %
Explanation: ***>10%*** - As per the **National Tuberculosis Elimination Program (NTEP)** guidelines, a district is categorized as a **high-priority district** for HIV-TB co-infection if the prevalence of HIV among TB patients is **greater than 10%**. - This threshold helps in identifying regions that require enhanced focus and resources for **integrated HIV and TB care** and prevention strategies. - This is the specific cut-off defined by NTEP for prioritizing districts for targeted interventions. *>15%* - While 15% would also indicate a high prevalence, the specific threshold set by NTEP for deeming a district high priority is **>10%**, not >15%. - Districts with prevalence between 10% and 15% would already be classified as high priority at the >10% threshold. *>20%* - A prevalence of >20% would certainly indicate a severe problem, but the **NTEP's definition** for a high-priority district is specifically **>10%**. - Using a higher threshold like 20% would delay interventions in districts that already face significant challenges with HIV-TB co-infection. *>12%* - The NTEP guidelines use a specific cut-off of **>10%** for defining high-priority districts for HIV-TB co-infection. - While 12% exceeds the 10% threshold, it is not the defining threshold mentioned in the official guidelines for this classification.
Question 9: Vision 2020 "The right to sight" includes all except-
- A. Measles induced blindness (Correct Answer)
- B. Onchocerciasis
- C. Trachoma
- D. Cataract
Explanation: ***Measles induced blindness*** - Vision 2020 primarily targets conditions that are either preventable or treatable with *cost-effective interventions* and contribute significantly to *avoidable blindness*. - While measles can cause blindness, the specific program focuses on a defined list of priority diseases for intervention, and measles-related blindness is generally addressed through broader public health initiatives (vaccination) rather than direct "right to sight" surgical or direct medical interventions for established blindness. *Onchocerciasis* - **Onchocerciasis** (river blindness) is a major focus of Vision 2020 due to its profound impact on sight, particularly in endemic areas. - It is a **preventable** and **treatable** cause of blindness through mass drug administration. *Trachoma* - **Trachoma** is recognized as one of the leading infectious causes of blindness globally and is explicitly targeted by Vision 2020 through the **SAFE strategy** (Surgery, Antibiotics, Facial cleanliness, Environmental improvement). - It is a highly **preventable** and **treatable** condition, fitting the program's objectives. *Cataract* - **Cataract** is the leading cause of blindness worldwide and is highly **treatable** through a relatively simple and cost-effective surgical procedure. - Providing cataract surgery is a cornerstone of the Vision 2020 initiative to restore sight.
Question 10: The golden period of eye donation is
- A. 24 hours
- B. 12 hours
- C. 18 hours
- D. 6 hours (Correct Answer)
Explanation: ***6 hours*** - The **golden period** for eye donation, specifically for the removal of the **cornea**, is ideally within **6 hours** of death. - This timeframe is critical to ensure the **viability and quality** of the corneal tissue for successful transplantation, as cellular degradation begins rapidly after cessation of circulation. *24 hours* - While some tissues can be recovered up to 24 hours post-mortem, the **cornea's viability** for transplantation significantly decreases after the initial 6-hour window. - Beyond 6 hours, the risk of **cellular damage** and reduced graft success rate increases considerably. *12 hours* - A 12-hour window is generally considered too long for optimal **corneal tissue viability**. - While tissue might still be recoverable, the **quality and success rate** of the transplant are significantly lower compared to donation within 6 hours. *18 hours* - An 18-hour period is far beyond the recommended timeframe for **corneal donation**. - At this point, the **cellular integrity** of the cornea is highly compromised, making it unsuitable for transplantation.
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