Satellite nodules are typically associated with which of the following conditions?
Recurrent anterior uveitis with increased intraocular tension is seen in which of the following conditions?
Which of the following conditions is least likely to be associated with neovascular glaucoma?
Laser iridotomy is done in?
What type of deposit is commonly associated with age-related macular degeneration?
What does extraretinal fibrovascular proliferation at the ridge indicate?
In which condition is the swinging light test positive?
Most common malignant tumour of eyelid is ?
Bilateral ptosis is seen in all except which of the following?
Which of the following statements about corneal dystrophy is true?
NEET-PG 2012 - Ophthalmology NEET-PG Practice Questions and MCQs
Question 51: Satellite nodules are typically associated with which of the following conditions?
- A. Tuberculosis
- B. Sarcoidosis
- C. Viral ulcer
- D. Fungal corneal ulcer (Correct Answer)
Explanation: ***Fungal corneal ulcer*** - **Satellite lesions** (small, isolated infiltrates surrounding a larger central ulcer) are a characteristic feature of **fungal keratitis**, indicating the spread of fungal hyphae. - Unlike bacterial ulcers, fungal ulcers often have a feathery, indistinct margin and can be slow-growing. *Tuberculosis* - Ocular tuberculosis can present with granulomatous inflammation, often involving the uvea or retina, but **satellite nodules** around a corneal ulcer are not typical. - Corneal involvement in tuberculosis is rare and usually manifests as interstitial keratitis or phlyctenular keratitis. *Sarcoidosis* - Ocular sarcoidosis commonly causes **uveitis**, conjunctival nodules, or retinal vasculitis. - While it can cause corneal deposits or band keratopathy, it does not typically present with satellite lesions around a primary corneal ulcer. *Viral ulcer* - Viral corneal ulcers, particularly those caused by **herpes simplex virus**, often present as **dendritic ulcers** or geographic ulcers. - Although epithelial lesions can spread, the distinct **satellite infiltrates** in the stroma seen in fungal infections are not characteristic of viral keratitis.
Question 52: Recurrent anterior uveitis with increased intraocular tension is seen in which of the following conditions?
- A. Posner-Schlossman syndrome (Correct Answer)
- B. Foster-Kennedy syndrome
- C. Vogt-Koyanagi-Harada syndrome
- D. Fuchs heterochromic iridocyclitis
Explanation: ***Posner-Schlossman syndrome*** - Characterized by **recurrent, unilateral, non-granulomatous anterior uveitis** associated with markedly **elevated intraocular pressure (IOP)**. - The condition is also known as **glaucomatocyclitic crisis**, highlighting the episodic inflammation and glaucoma. - Key features include **acute attacks** lasting hours to weeks with **dramatic IOP elevation** (often >40 mmHg). *Foster-Kennedy syndrome* - This syndrome is defined by ipsilateral **optic atrophy**, contralateral **papilledema**, and often **anosmia**, typically due to a frontal lobe tumor. - It does not involve anterior uveitis or primary elevated intraocular tension. - This is a neuro-ophthalmologic syndrome, not an inflammatory ocular condition. *Vogt-Koyanagi-Harada syndrome* - An autoimmune disorder affecting pigmented tissues, leading to **bilateral granulomatous panuveitis**, often with hearing loss, vitiligo, poliosis, and neurological symptoms. - While it involves uveitis, it is typically **bilateral and panuveitis**, not recurrent unilateral anterior uveitis. - IOP may be elevated but not the defining feature with dramatic episodic rises. *Fuchs heterochromic iridocyclitis* - A chronic, **unilateral, low-grade anterior uveitis** with characteristic iris heterochromia. - May have mild IOP elevation but **not recurrent episodic attacks** with marked pressure spikes. - Inflammation is typically **quiet and chronic** rather than acute and recurrent.
Question 53: Which of the following conditions is least likely to be associated with neovascular glaucoma?
- A. Diabetes
- B. Open angle glaucoma (Correct Answer)
- C. CRVO
- D. Eale's disease
Explanation: ***Open angle glaucoma*** ✓ - **Open-angle glaucoma** is a primary **neurodegenerative disease** of the optic nerve, characterized by progressive loss of **retinal ganglion cells** and their axons, leading to characteristic **optic neuropathy** and visual field defects. - It does **NOT** directly cause **neovascularization** or increased VEGF production, which are the underlying mechanisms for **neovascular glaucoma**. - This is the **least likely** association among the given options. *Diabetes* - **Diabetic retinopathy** is a **major cause** of **neovascularization** due to retinal ischemia and increased production of **vascular endothelial growth factor (VEGF)**, which can lead to **neovascular glaucoma**. - **Neovascularization** on the iris (rubeosis iridis) and angle can block aqueous outflow, causing a severe, rapidly progressing form of secondary glaucoma. *CRVO (Central Retinal Vein Occlusion)* - **CRVO** leads to significant retinal ischemia and subsequent release of **VEGF**, which prompts the growth of new, fragile blood vessels. - These new vessels (neovascularization) can grow in the iris and angle, obstructing aqueous humor outflow and causing **neovascular glaucoma**. - **Ischemic CRVO** is one of the **most common causes** of neovascular glaucoma. *Eale's disease* - **Eale's disease** is an **idiopathic occlusive vasculitis** primarily affecting the **peripheral retinal veins**, leading to **retinal ischemia**. - This ischemia stimulates **neovascularization** and the production of **VEGF**, increasing the risk of **neovascular glaucoma** due to the formation of new blood vessels in the anterior chamber.
Question 54: Laser iridotomy is done in?
- A. Pigmentary glaucoma
- B. None of the options
- C. Angle closure glaucoma (Correct Answer)
- D. Open angle glaucoma
Explanation: ***Angle closure glaucoma*** - **Laser iridotomy** creates a small hole in the iris, allowing aqueous humor to flow directly from the posterior to the anterior chamber, thus relieving pupillary block and opening the angle. - This procedure is the definitive treatment to prevent further **angle closure attacks** and is also used prophylactically in eyes at risk. *Open angle glaucoma* - This condition involves an **open angle** but impaired outflow of aqueous humor through the **trabecular meshwork**. - Laser iridotomy is not indicated as it does not address the primary outflow obstruction in the trabecular meshwork. *Pigmentary glaucoma* - This is a type of **open-angle glaucoma** caused by pigment dispersion that clogs the trabecular meshwork, leading to increased intraocular pressure. - While pigment can be released from the iris, the primary issue is the **trabecular meshwork obstruction**, which is not directly resolved by iridotomy. *None of the options* - This option is incorrect because **angle closure glaucoma** is a clear indication for laser iridotomy.
Question 55: What type of deposit is commonly associated with age-related macular degeneration?
- A. Iron
- B. Drusen (Correct Answer)
- C. Lipochrome
- D. Hemosiderine
Explanation: ***Drusen*** - **Drusen** are yellow deposits of extracellular material that accumulate beneath the **retinal pigment epithelium (RPE)**. - Their presence is a hallmark sign of **age-related macular degeneration (AMD)** and can lead to vision loss by disrupting retinal function. *Iron* - While iron can accumulate in ocular tissues in conditions like **siderosis bulbi** (due to retained intraocular foreign bodies), it is not a characteristic deposit of macular degeneration. - Ocular iron deposition typically causes different pathologies, such as retinal dysfunction or glaucoma, rather than AMD. *Lipochrome* - **Lipochrome** refers to a class of pigments, including **lipofuscin**, which can accumulate in cells as a byproduct of cellular metabolism and aging. - Although lipofuscin buildup occurs in the RPE with age, **drusen** are the specific, organized extracellular deposits pathognomonic for macular degeneration. *Hemosiderine* - **Hemosiderin** is an iron-storage complex formed from the breakdown of hemoglobin, found in situations of hemorrhage or chronic bleeding. - It is not a typical deposit found in macular degeneration; its presence in the retina usually indicates a history of retinal hemorrhage.
Question 56: What does extraretinal fibrovascular proliferation at the ridge indicate?
- A. Normal retina
- B. Stage II Retinopathy of Prematurity
- C. Stage III Retinopathy of Prematurity (Correct Answer)
- D. Stage I Retinopathy of Prematurity
Explanation: ***Stage III Retinopathy of Prematurity*** - Extraretinal fibrovascular proliferation at the ridge is the defining characteristic of **Stage III Retinopathy of Prematurity (ROP)**. - This stage signifies significant **neovascularization** extending into the vitreous, increasing the risk of **retinal detachment**. *Normal retina* - A normal retina does not exhibit **fibrovascular proliferation** or a distinct ridge, as its vascularization is fully developed and confined to the retinal plane. - Absence of any abnormal vascular growth or demarcation line indicates a healthy, mature retinal structure. *Stage II Retinopathy of Prematurity* - Stage II ROP is characterized by a **ridge** that is elevated and appears three-dimensional, but it **lacks extraretinal fibrovascular proliferation**. - This stage represents progression from Stage I, where the demarcation line becomes a prominent ridge, but without new vessel formation outside the retina. *Stage I Retinopathy of Prematurity* - Stage I ROP is characterized by a thin, flat **demarcation line** distinguishing vascularized from avascular retina, without any significant elevation or fibrovascular proliferation. - This initial stage indicates an arrested phase of retinal vascular development, but without the more severe signs of neovascularization.
Question 57: In which condition is the swinging light test positive?
- A. Conjunctivitis
- B. Glaucoma
- C. Keratoconus
- D. Optic neuritis (Correct Answer)
Explanation: ***Optic neuritis*** - The swinging light test (also known as the **Marcus Gunn pupil** or relative afferent pupillary defect, RAPD) is positive when there is a significant **asymmetry in the afferent visual pathway** between the two eyes. - In optic neuritis, the **optic nerve** is inflamed and demyelinated, impairing the transmission of light signals to the brain, which leads to a paradoxical pupillary dilation when the light is swung from the unaffected to the affected eye. *Conjunctivitis* - This is an **inflammation of the conjunctiva**, the membrane lining the eyelid and sclera, which primarily affects the ocular surface. - It does not involve the optic nerve or afferent pupillary pathways, so the swinging light test would be **negative**. *Glaucoma* - Glaucoma is a condition characterized by **progressive optic nerve damage**, often associated with elevated intraocular pressure, leading to peripheral vision loss. - While it causes optic neuropathy, a positive swinging light test is typically seen only in **severe, asymmetric cases** and is not its primary diagnostic feature. *Keratoconus* - This is a non-inflammatory eye condition in which the normally round dome-shaped cornea **thins and bulges outward into a cone-like shape**. - It affects the **cornea's shape and vision quality**, but not the optic nerve or the afferent pupillary reflex pathway, thus the swinging light test would be negative.
Question 58: Most common malignant tumour of eyelid is ?
- A. Basal cell carcinoma (Correct Answer)
- B. Malignant melanoma
- C. Squamous cell carcinoma
- D. Sebaceous gland carcinoma
Explanation: ***Basal cell carcinoma*** - **Basal cell carcinoma (BCC)** accounts for approximately 85-95% of all eyelid malignancies, making it the most common type. - It often presents as a **pearly nodule** with telangiectatic vessels, frequently affecting the lower eyelid. *Squamous cell carcinoma* - **Squamous cell carcinoma (SCC)** is the second most common eyelid malignancy, but it is significantly less frequent (5-10%) than BCC. - SCC has a **higher metastatic potential** compared to BCC. *Malignant melanoma* - **Malignant melanoma** is a rare but highly aggressive eyelid tumor, accounting for less than 1% of all eyelid malignancies. - It is characterized by its **pigmented appearance** and rapid growth pattern. *Sebaceous gland carcinoma* - **Sebaceous gland carcinoma** is a relatively uncommon, but aggressive, tumor of the eyelid, comprising about 1-5% of cases. - It often mimics benign lesions like a **chalazion** or chronic blepharitis, leading to delayed diagnosis.
Question 59: Bilateral ptosis is seen in all except which of the following?
- A. Trauma
- B. Hyperthyroidism (Graves' disease) (Correct Answer)
- C. Congenital
- D. Myotonic dystrophy
Explanation: ***Hyperthyroidism (Graves' disease)*** - **Hyperthyroidism** causes eyelid retraction, leading to a **stare** or **lid lag**, rather than **ptosis**. - **Graves' ophthalmopathy** can cause proptosis (bulging eyes) and conjunctival injection, but does not typically manifest as ptosis. *Congenital* - **Congenital ptosis** is often present at birth due to improper development of the **levator palpebrae superioris muscle**. - It can be **bilateral** and is usually isolated, without other systemic symptoms. *Trauma* - **Traumatic ptosis** can occur if the **levator muscle**, **aponeurosis**, or **third cranial nerve** is damaged. - This can be **bilateral** depending on the nature and extent of the head trauma. *Myotonic dystrophy* - **Myotonic dystrophy** is a **hereditary muscle disorder** characterized by progressive muscle weakness. - **Bilateral ptosis** is a very common early sign of **myotonic dystrophy**, often accompanied by **facial weakness** and **myotonia**.
Question 60: Which of the following statements about corneal dystrophy is true?
- A. It involves neovascularization.
- B. It is caused by inflammation.
- C. It is usually unilateral.
- D. It is typically bilateral. (Correct Answer)
Explanation: ***It is typically bilateral.*** - **Corneal dystrophies** are inherited genetic disorders that usually affect both eyes symmetrically. - This bilateral presentation is a key characteristic distinguishing them from other corneal conditions. *It is caused by inflammation.* - **Corneal dystrophies** are primarily genetic and degenerative, not inflammatory. - While inflammation can cause corneal damage (e.g., keratitis), it is not the underlying cause of dystrophy. *It involves neovascularization.* - **Neovascularization** (growth of new blood vessels) is typically a response to chronic inflammation, hypoxia, or infection in the cornea. - It is generally not a feature of primary corneal dystrophies, which are characterized by abnormal deposits or structural changes within the corneal layers. *It is usually unilateral.* - As inherited genetic conditions, **corneal dystrophies** almost always affect both eyes. - Unilateral involvement would suggest a different etiology, such as trauma, infection, or a localized acquired condition.