FMGE 2019 - Ophthalmology Practice Questions

Q: Evisceration is removal of which layer of eyeball?

Middle and inner. ***Middle and inner*** - **Evisceration** involves the surgical removal of the internal contents of the eyeball, which include components derived from the **middle (uveal) and inner (retinal) layers**. - The **sclera** (outermost layer) and **extraocular muscles** are preserved, allowing for a more natural prosthetic eye fit. *All the layers of eyeball* - This describes **enucleation**, where the entire eyeball is removed including all three layers (sclera, choroid/ciliary body/iris, and retina). - Enucleation is a more extensive procedure than evisceration, typically performed for intraocular tumors or severe trauma where preservation of the sclera isn't possible. *Outer and inner* - This option is incorrect because the **outer layer (sclera)** is specifically preserved in evisceration. - Removing the outer layer would lead to a more destructive procedure, inconsistent with the definition of evisceration. *Outer and middle* - This option is incorrect because the **outer layer (sclera)** is preserved during evisceration, while the entire **inner layer (retina)** is removed. - The middle layer (uvea) is removed, but this option inaccurately states the fate of the outer and inner layers.

Q: Internal hordeolum is due to inflammation of-

Meibomian glands. ***Meibomian glands (Correct)*** - An **internal hordeolum** results from acute **bacterial infection** (usually *Staphylococcus aureus*) and inflammation of a **Meibomian gland**, which are modified sebaceous glands located within the tarsal plate of the eyelid. - These glands produce the **lipid layer** of the tear film, and their blockage and infection lead to a painful, red lump on the **inner surface of the eyelid**. *Moll's gland (Incorrect)* - **Moll's glands** are modified apocrine sweat glands located near the base of the eyelashes. - Inflammation or infection of a Moll's gland would more commonly contribute to an **external hordeolum (stye)**, not an internal one. *Lacrimal gland (Incorrect)* - The **lacrimal gland** produces the watery component of tears and is located in the superotemporal orbit. - Inflammation of the lacrimal gland is called **dacryoadenitis**, which presents with swelling in the outer part of the upper eyelid and is distinct from a hordeolum. *Zeis gland (Incorrect)* - **Zeis glands** are sebaceous glands associated with the hair follicles of the eyelashes. - Similar to Moll's glands, infection of a Zeis gland is a common cause of an **external hordeolum (stye)**, which appears on the eyelid margin.

Q: Fleischer's ring is seen in?

Keratoconus. ***Keratoconus*** - **Fleischer's ring** is a brownish-yellow to greenish-brown ring of **iron deposition** (hemosiderin) in the **corneal epithelium** around the base of the cone in patients with **keratoconus**. - It is a specific sign of **keratoconus**, which is a progressive thinning and steepening of the cornea, causing it to bulge into a cone shape. *Keratoglobus* - **Keratoglobus** is a rare, non-inflammatory condition where the **entire cornea** becomes thin and globularly protrudes, unlike the localized cone in keratoconus. - It typically does not present with an isolated Fleischer's ring; other corneal findings may be present. *Keratomalacia* - **Keratomalacia** is corneal softening and necrosis caused by severe **vitamin A deficiency**. - It presents with xerosis (dryness), night blindness, and eventual corneal melting and perforation. - It does not involve iron deposition in the form of a Fleischer's ring. *Trachoma* - **Trachoma** is a chronic infectious disease of the eye caused by *Chlamydia trachomatis*, leading to scarring of the conjunctiva and cornea. - It is a leading cause of preventable blindness worldwide and is not associated with Fleischer's ring.

Question 1

Evisceration is removal of which layer of eyeball?

Accepted Answer

Middle and inner

Answer

All the layers of eyeball

Answer

Outer and inner

Answer

Outer and middle

Question 2

Internal hordeolum is due to inflammation of-

Accepted Answer

Meibomian glands

Answer

Moll's gland

Answer

Lacrimal gland

Answer

Zeis gland

Question 3

Fleischer's ring is seen in?

Accepted Answer

Keratoconus

Answer

Keratoglobus

Answer

Keratomalacia

Answer

Trachoma

FMGE 2019 — Ophthalmology