FMGE 2018 - Ophthalmology PYQs Practice Questions

Q: Argon laser trabeculoplasty is done in:

Open angle glaucoma. ***Open angle glaucoma*** - **Argon laser trabeculoplasty (ALT)** is primarily used in **open-angle glaucoma** to improve aqueous humor outflow through the **trabecular meshwork**. - It creates **small burns** in the trabecular meshwork, increasing permeability and lowering **intraocular pressure (IOP)**. *Secondary glaucoma* - This is a broad category of glaucoma caused by other eye conditions or systemic diseases, and the specific treatment depends on the underlying etiology. - While ALT might be considered in some types of **secondary open-angle glaucoma**, it is not a primary or universal treatment for all secondary glaucomas. *Angle recession glaucoma* - This type of glaucoma occurs after blunt trauma to the eye, causing a tear in the **ciliary body** and widening of the **ciliary body band**. - ALT is generally **ineffective** in angle recession glaucoma because the damage to the trabecular meshwork is structural and not amenable to laser modification. *Angle closure glaucoma* - In **angle-closure glaucoma**, the iris blocks the drainage angle, preventing aqueous outflow. - Treatment typically involves **laser peripheral iridotomy** to create a hole in the iris, or surgical procedures, to open the angle, rather than laser trabeculoplasty. [Practice more Ophthalmology PYQs on OnCourse]

Q: NOT a feature of trachoma:

Chalazion. ***Chalazion*** - A **chalazion** is a **lipogranulomatous inflammation** of a **meibomian gland** and is not directly caused by *Chlamydia trachomatis* infection, though chronic inflammation could theoretically predispose to it. - While chronic inflammation of the eyelids in trachoma can cause various complications, a chalazion is a distinct condition related to meibomian gland dysfunction and is not a direct, defining feature of trachoma. *Entropion* - **Entropion**, the **inward turning of the eyelid margin**, is a severe late complication of trachoma caused by conjunctival scarring and contraction. - This inward turning leads to **trichiasis** (**misdirected eyelashes**), which abrades the cornea. *Corneal opacity* - **Corneal opacity** is a common and serious consequence of chronic trachoma, resulting from repeated **corneal abrasions** by misdirected eyelashes (trichiasis) and chronic inflammation. - This scarring can lead to **severe vision impairment** and **blindness**. *Herbert's pits* - **Herbert's pits** are characteristic depressions on the **limbus** (corneoscleral junction) formed after the resolution of **limbal follicles** in chronic trachoma. - They are a diagnostic sign of past or present trachomatous infection. [Practice more Ophthalmology PYQs on OnCourse]

Q: Constantly changing refractive error is seen in:

Diabetic cataract. ***Diabetic cataract*** - Fluctuating blood glucose levels in diabetes can cause changes in the **osmolarity of the aqueous humor**, which in turn affects the hydration of the lens and its refractive power. - This leads to a **constantly changing refractive error**, where a person's prescription might change rapidly over short periods of time. *Morgagnian cataract* - This is a type of **hypermature cataract** where the cortex has liquefied, allowing the nucleus to sink within the capsular bag. - While vision is severely impaired, it doesn't typically present with a constantly changing refractive error, but rather a stable, significant vision loss. *Intumescent cataract* - An **intumescent cataract** is a mature or hypermature cataract where the lens has become significantly swollen due to water absorption. - This swelling causes the anterior capsule to stretch, but it results in a fixed and profound vision loss, not a fluctuating refractive error. *Traumatic cataract* - A **traumatic cataract** develops as a result of blunt or penetrating ocular injury, causing damage to the lens fibers. - While the specific type of refractive error can vary depending on the trauma, it typically presents as a stable visual impairment rather than a constantly changing refractive error. [Practice more Ophthalmology PYQs on OnCourse]

Q: The eye in the newborn is:

Hypermetropia. ***Hypermetropia*** - The newborn eye is typically **shorter in axial length** (approximately 16-17 mm vs. 24 mm in adults), leading to a state of **physiological hypermetropia** (farsightedness) of about **+2 to +4 diopters**. - This is a **universal finding** in newborns and represents the most fundamental refractive characteristic of the newborn eye. - The eye gradually grows and typically reaches emmetropia (normal vision) by about **6-7 years of age**. *Myopia* - **Myopia** (nearsightedness) occurs when the eye is too long or the refractive power is too strong, causing light to focus in front of the retina. - Myopia is **not the physiological state** of the newborn eye and is uncommon at birth. - When present in newborns, it may indicate pathology or very premature birth. *Hypermetropic with regular astigmatism* - While **most newborns do have some degree of astigmatism** (0.5-2D) in addition to hypermetropia, typically "against-the-rule" astigmatism that decreases during the first year, the question asks for the **primary refractive characteristic**. - **Hypermetropia alone** is the universal and defining feature, whereas the amount of astigmatism varies considerably between individuals. - In standard clinical terminology, when describing the typical newborn eye, "hypermetropic" is the complete answer. *Hypermetropic with irregular astigmatism* - **Irregular astigmatism** is uncommon and is typically associated with corneal pathology, trauma, or surgery. - It is **not a physiological finding** in the normal newborn eye and would indicate an underlying abnormality if present. [Practice more Ophthalmology PYQs on OnCourse]

Q: Pupil in acute iritis is:

Constricted. ***Constricted*** - In acute iritis, the pupil is typically **constricted (miotic)** due to ciliary muscle spasm and release of inflammatory mediators like prostaglandins. - This constriction helps to **reduce photophobia** and pain by limiting the amount of light entering the eye. *Dilated* - A dilated pupil (mydriasis) is usually seen in conditions like **acute angle-closure glaucoma** or due to certain medications, not iritis. - In iritis, the inflammatory process *actively* causes constriction. *Normal* - A normal pupil size would not be expected in acute iritis, as inflammation always causes some degree of **miosis** or other pupillary abnormality. - Acute iritis presents with significant symptoms that affect pupillary function. *Vertically oval* - A vertically oval pupil can be seen in specific conditions such as **acute angle-closure glaucoma** in some individuals, particularly with high intraocular pressure. - It is not a characteristic feature of iritis. [Practice more Ophthalmology PYQs on OnCourse]

Question 1

Argon laser trabeculoplasty is done in:

Accepted Answer

Open angle glaucoma

Answer

Secondary glaucoma

Answer

Angle recession glaucoma

Answer

Angle closure glaucoma

Question 2

NOT a feature of trachoma:

Accepted Answer

Chalazion

Answer

Entropion

Answer

Corneal opacity

Answer

Herbert's pits

Question 3

Constantly changing refractive error is seen in:

Accepted Answer

Diabetic cataract

Answer

Morgagnian cataract

Answer

Intumescent cataract

Answer

Traumatic cataract

Question 4

The eye in the newborn is:

Accepted Answer

Hypermetropia

Answer

Myopia

Answer

Hypermetropic with regular astigmatism

Answer

Hypermetropic with irregular astigmatism

Question 5

Pupil in acute iritis is:

Accepted Answer

Constricted

Answer

Dilated

Answer

Normal

Answer

Vertically oval

Question 6

What is the true statement about retinoscopy with a plane mirror?

Accepted Answer

Retinoscopy is done at 1 meter away from the patient.

Answer

In myopia, the red glow moves in the same direction.

Answer

In hypermetropia, the red glow moves in the opposite direction.

Answer

In emmetropia, the red glow moves in the opposite direction.

Question 7

In dacryocystorhinostomy (DCR), Lacrimal sac opens into:

Accepted Answer

Middle meatus

Answer

Supreme meatus

Answer

Inferior meatus

Answer

Superior meatus

Question 8

Cause of sudden loss of vision in a diabetic is due to:

Accepted Answer

Vitreous hemorrhage

Answer

Central retinal vein occlusion

Answer

Neovascular glaucoma

Answer

Central retinal artery occlusion

Question 9

Obstacles in concomitant squint are:

Accepted Answer

All of the options

Answer

Sensory obstacles

Answer

Motor obstacles

Answer

Central obstacles

Question 10

Keratometry is done to assess:

Accepted Answer

Curvature of cornea

Answer

Corneal thickness

Answer

Corneal sensation

Answer

Corneal endothelium

FMGE 2018 — Ophthalmology