INI-CET 2023 - Ophthalmology PYQs Practice Questions

Q: Which of the following lens is used in direct gonioscopy?

Koeppe. ***Koeppe*** - The **Koeppe lens** is designed for direct gonioscopy, providing a wide-angle view of the **anterior chamber angle**. - It is typically used with the patient in a **supine position** and requires a coupling solution to be placed directly on the cornea. *Goldmann* - The **Goldmann lens** (3-mirror lens) is used for **indirect gonioscopy** and is characterized by mirrors that reflect the image of the angle. - It is used at a **slit lamp** and provides a magnified view as the light is reflected through the mirrors. *Richardson* - The **Richardson-Shaffer lens** is another direct gonioscopy lens, similar to the Koeppe lens. - However, the question asks for "**the**" lens used in direct gonioscopy, and **Koeppe** is the most commonly recognized and frequently used direct gonioscopy lens. - Richardson-Shaffer is less commonly used in modern practice compared to Koeppe. *Zeiss* - The **Zeiss lens** (4-mirror lens) is used for **indirect gonioscopy** and allows a rapid 360-degree view of the angle. - It is commonly used with a **slit lamp** and requires minimal or no coupling fluid due to its small contact surface. [Practice more Ophthalmology PYQs on OnCourse]

Q: Identify the correct sequence of staining in dry eyes? 1. Fluorescein stain 2. Lissamine green 3. Rose Bengal stain

iii, ii, i. ***iii, ii, i*** - The correct order for staining in dry eyes is **Rose Bengal, Lissamine Green, and then Fluorescein**. This sequence minimizes the discomfort and potential interference between the dyes. - **Rose Bengal** and **Lissamine Green** stain devitalized or damaged epithelial cells and mucus, while **Fluorescein** stains areas where the epithelium is absent, indicating corneal or conjunctival abrasions or erosions. *i, iii, ii* - This sequence is incorrect because applying fluorescein first could mask the interpretation of epithelial damage by Lissamine Green or Rose Bengal, as it highlights epithelial defects rather than devitalized cells. - The dyes should be applied in an order that optimizes the visualization of different aspects of ocular surface health. *i, ii, iii* - Applying **Fluorescein** first is generally not recommended as it can spread over the ocular surface and potentially interfere with the specific staining patterns of other vital dyes like Lissamine Green or Rose Bengal. - This order does not follow the standard clinical practice for efficient and accurate dry eye assessment. *ii, iii, i* - While Lissamine Green can be used before Fluorescein, placing Rose Bengal after Lissamine Green but still before Fluorescein is not the optimal sequence. - The standard practice aims to assess different layers or types of damage sequentially for a comprehensive evaluation. [Practice more Ophthalmology PYQs on OnCourse]

Q: What is the earliest change in glaucoma on perimetry?

Isopter contraction + baring of blind spot. ***Isopter contraction + baring of blind spot*** - Early glaucomatous damage often manifests as an **isopter contraction**, meaning the **visual field narrows** for a given stimulus intensity. - **Baring of the blind spot** occurs when the isopter for a small target contracts inwards, leaving the physiological blind spot exposed to targets that would normally be seen. *Complete field loss* - This is indicative of **very advanced glaucoma**, representing extensive damage to the optic nerve. - It would be preceded by numerous earlier, more subtle visual field defects. *Tunnel vision defect* - **Tunnel vision** is a severe form of visual field constriction, characteristic of **advanced glaucoma** where only the central field of vision remains. - It is not the earliest change as it implies significant peripheral field loss has already occurred. *Complete vision loss* - **Complete vision loss** in an eye signifies end-stage disease, far beyond the earliest changes seen in glaucoma. - It means there is no light perception, indicating total destruction of the optic nerve fibers. [Practice more Ophthalmology PYQs on OnCourse]

Question 1

The given image shows blanching of vascularity after the phenylephrine use. What is the likely diagnosis?

Accepted Answer

Nodular episcleritis

Answer

Nodular scleritis

Answer

Conjunctivitis

Answer

Anterior uveitis

Question 2

Which of the following lens is used in direct gonioscopy?

Accepted Answer

Koeppe

Answer

Goldmann

Answer

Richardson

Answer

Zeiss

Question 3

Identify the correct sequence of staining in dry eyes?

1. Fluorescein stain
2. Lissamine green
3. Rose Bengal stain

Accepted Answer

iii, ii, i

Answer

i, iii, ii

Answer

i, ii, iii

Answer

ii, iii, i

Question 4

What is the earliest change in glaucoma on perimetry?

Accepted Answer

Isopter contraction + baring of blind spot

Answer

Complete field loss

Answer

Tunnel vision defect

Answer

Complete vision loss

INI-CET 2023 — Ophthalmology