NEET-PG 2013 Practice Questions

Q: Maximum correction of myopia can be done by?

LASIK. ***LASIK*** - **LASIK (Laser-Assisted In Situ Keratomileusis)** allows for significant correction of high myopia by reshaping the cornea with an excimer laser. - It involves creating a **corneal flap** and then ablating tissue underneath, offering precise and stable vision correction for a wide range of refractive errors. - Among the given corneal refractive procedures, LASIK can correct myopia up to **-10 to -12 D**. *Radial keratotomy* - **Radial keratotomy (RK)** involves making radial incisions in the cornea to flatten it, primarily used for low to moderate myopia (up to -3 to -4 D). - It has a higher risk of **unpredictable outcomes**, induced astigmatism, and glare compared to modern laser procedures. *Photorefractive keratectomy* - **Photorefractive keratectomy (PRK)** involves direct ablation of the corneal surface without creating a flap, which is suitable for moderate myopia (up to -8 to -10 D). - While effective, PRK typically has a **longer recovery period** and more post-operative pain than LASIK. *Orthokeratology* - **Orthokeratology (Ortho-K)** uses specially designed rigid contact lenses worn overnight to temporarily reshape the cornea and correct myopia. - The effect is **temporary**, requiring continuous lens wear to maintain vision correction, and is generally limited to low to moderate myopia (up to -4 to -6 D).

Q: Which Goldmann type is considered the standard in perimetry?

Goldmann type III (commonly used stimulus size). ***Goldmann type III (commonly used stimulus size)*** - This stimulus size is the **international standard** for kinetic perimetry and ensures comparability of visual field charts worldwide. - It provides a balance between **sensitivity** and minimizing the effects of **pupil size** and other ocular factors. *Goldmann type I (small stimulus size)* - While very small, this stimulus type is **not the standard** for general perimetry. - It is sometimes used for detecting **subtle defects** or for patients with very good visual acuity, but its small size can make it harder to detect. *Goldmann type II (medium-small stimulus size)* - This stimulus size is **smaller than the standard** and is not universally adopted for perimetry. - It offers slightly more sensitivity than the standard but can be more affected by **refractive errors** or media opacities. *Goldmann type IV (large stimulus size)* - This stimulus is **much larger than the standard** and is typically used for detecting **gross defects** or in patients with severely impaired vision. - Its large size makes it **less sensitive** to smaller visual field abnormalities.

Q: Which of the following conditions is NOT diagnosed by fluorescein angiography?

Hypertensive retinopathy. ***Hypertensive retinopathy*** - This condition is primarily diagnosed by **clinical fundoscopic examination**, not fluorescein angiography - Diagnosis is based on characteristic clinical findings: **arteriovenous nicking, copper/silver wire arterioles, cotton-wool spots, flame-shaped hemorrhages, and papilledema** in severe cases - **Fluorescein angiography** is rarely needed and only used in research settings or to assess severe complications; it is **not a standard diagnostic tool** for hypertensive retinopathy *Diabetic retinopathy* - **Fluorescein angiography** is extensively used for diagnosing and staging diabetic retinopathy - It helps identify **microaneurysms, capillary non-perfusion areas, macular edema, and neovascularization** - Essential for detecting **proliferative diabetic retinopathy** and planning laser photocoagulation *Central serous retinopathy* - **Fluorescein angiography** shows characteristic **"smokestack" or "inkblot" pattern** of leakage at the RPE level - Demonstrates one or more **leakage points** with progressive pooling of dye in the subretinal space - While **OCT** is now preferred for initial diagnosis, FA remains valuable for identifying leakage sites and guiding treatment *Choroidal neovascularization* - **Fluorescein angiography** is the gold standard for diagnosing **choroidal neovascularization (CNV)** - Shows **early hyperfluorescence with progressive leakage** from abnormal vessels - Critical for determining the **type (classic vs occult), location, and extent** of CNV for treatment planning

Q: During retinoscopy of a 30-year-old male, which cycloplegic is used routinely?

Cyclopentolate 1% drop. ***Cyclopentolate 1% drop*** - When cycloplegia is required for retinoscopy, **cyclopentolate 1%** is the preferred agent in adults due to its **rapid onset** (30-60 minutes) and **intermediate duration** (6-24 hours). - It provides adequate **cycloplegia** (paralysis of accommodation) to reveal the full refractive error without the prolonged effects of atropine. - **Clinical note:** In routine practice, most adults aged 30 years undergo retinoscopy **without cycloplegia** as accommodation is usually not a significant factor. Cycloplegia in adults is reserved for specific indications like suspected latent hyperopia, accommodative spasm, or unreliable subjective refraction. *Homatropine 2% drop* - Homatropine has a **slower onset** (1 hour) and **longer duration** (1-3 days) compared to cyclopentolate, making it less practical for routine diagnostic use. - It is typically used for therapeutic purposes such as in **anterior uveitis** to provide cycloplegia and mydriasis. *Atropine 1% ointment* - Atropine is the **strongest** and **longest-acting** cycloplegic with effects lasting **7-14 days**, which is excessively long for diagnostic retinoscopy. - It is primarily used in **young children** (especially under 5 years) for accurate refraction and in therapeutic settings for **cycloplegic refraction in amblyopia** treatment. *None of the options* - While it's true that **routine retinoscopy in a healthy 30-year-old adult** typically does NOT require cycloplegia, this question asks which cycloplegic would be used **when indicated**. - Among the available cycloplegic options, **cyclopentolate** remains the appropriate choice for adults when cycloplegia is deemed necessary.

Q: In specular microscopy endothelial density is measured by?

Fixed frame analysis. ***Fixed frame analysis*** - This is the **standard method** used in specular microscopy to measure corneal endothelial cell density. - It involves analyzing a specific, fixed area of the **endothelial mosaic** and counting the number of cells within that defined frame. - The cell count from this fixed area is then **extrapolated** to calculate the overall endothelial cell density (cells/mm²). - This technique provides **quantitative assessment** of endothelial health, which is crucial for evaluating corneal function and pre-operative assessment for intraocular surgeries. *Optical doubling* - This is not a standard method for measuring endothelial density in specular microscopy. - Optical doubling relates to **refractive phenomena** or optical measurement techniques used in other contexts, not for endothelial cell counting. *Optical focusing* - While **essential for image acquisition**, optical focusing is merely a preliminary step to obtain a clear, sharp image of the endothelium. - It does not measure or count cells; it only ensures proper visualization before analysis. - The actual measurement requires subsequent **cell counting methods** like fixed frame analysis. *None of the options* - Incorrect because **fixed frame analysis** is indeed the recognized and widely used method for measuring endothelial density in specular microscopy.

Q: Retinitis pigmentosa is characterized by ?

Loss of peripheral vision. ***Loss of peripheral vision*** - Retinitis pigmentosa is a group of genetic disorders that cause **progressive degeneration of photoreceptor cells**, primarily rods, which are concentrated in the periphery of the retina. - This degeneration leads to a gradual **loss of peripheral vision**, often beginning with **night blindness** and progressing to tunnel vision. *Loss of central vision* - Loss of central vision is characteristic of conditions affecting the **macula**, such as **age-related macular degeneration** or certain forms of **macular dystrophy**. - While later stages of retinitis pigmentosa can affect central vision, the initial and primary characteristic is loss of peripheral vision. *Tubular vision* - **Tubular vision** is an advanced stage of peripheral vision loss, where the visual field shrinks to a narrow central area, resembling looking through a tube. - While it can be a consequence of retinitis pigmentosa, it is a description of the **extent of visual field constriction** rather than the primary characteristic of the disease itself. *Visual field constriction* - **Visual field constriction** is a general term for any reduction in the extent of the visual field. - While retinitis pigmentosa certainly causes visual field constriction, the term "loss of peripheral vision" is more specific to the initial and dominant pattern of vision loss in this condition.

Q: Which of the following statements about the c-wave in electroretinogram (ERG) is most accurate?

The 'c' wave is a slow positive wave.. ***The 'c' wave is a slow positive wave.*** - The **c-wave** in an ERG is generated by the **retinal pigment epithelium (RPE)** and is characterized by its **slow, positive deflection**. - It reflects the **hyperpolarization** of the RPE cells in response to light stimulation. *The 'c' wave is a negative wave.* - This statement is incorrect because the **c-wave** is consistently observed as a **positive deflection** in the ERG tracing. - A negative wave like the **a-wave** is generated by photoreceptor hyperpolarization, which is a different component. *The 'b' wave arises primarily from photoreceptors.* - The **b-wave** primarily arises from the **Müller cells** and **bipolar cells**, not directly from photoreceptors. - Photoreceptor activity is primarily reflected in the **a-wave**. *The 'a' wave is a positive wave.* - The **a-wave** is a **negative deflection** in the ERG, representing the **hyperpolarization of photoreceptors** in response to light. - It is the earliest component of the ERG waveform.

Q: Arcuate field defect akin to glaucoma is seen in?

Optic nerve lesion. ***Optic nerve lesion*** - An **arcuate field defect** is a specific pattern of visual field loss that follows the course of nerve fibers in the retina and is characteristic of **optic nerve damage**, similar to what is seen in glaucoma. - This type of defect is due to damage to the **bundle of retinal nerve fibers** that arch above or below the macula, often causing a scotoma (blind spot) that respects the horizontal meridian. - Common causes include **anterior ischemic optic neuropathy (AION)**, **optic neuritis**, and other optic nerve pathologies that affect the nerve fiber layer. *Pituitary adenoma* - A pituitary adenoma typically causes a **bitemporal hemianopsia** due to compression of the optic chiasm. - This visual field defect involves the lateral halves of both visual fields, which is different from an arcuate defect. *Posterior cerebral artery infarct* - An infarct in the posterior cerebral artery typically leads to a **homonymous hemianopsia** (loss of half of the visual field on the same side in both eyes) or a quadrantanopsia. - This type of defect results from damage to the **visual cortex** or optic radiations, not the optic nerve itself in a glaucoma-like pattern. *None of the options* - This is incorrect because **optic nerve lesion** is a valid and correct answer. - Optic nerve pathologies are well-established causes of arcuate field defects similar to those seen in glaucoma.

Q: Binocular single vision is tested by?

Synoptophore. ***Synoptophore*** - The **synoptophore** is an ophthalmic instrument used to diagnose and treat various binocular vision anomalies, including **strabismus** and suppression. - It allows for the precise measurement and assessment of the eyes' ability to **fuse images** from both eyes into a single perception, which is the essence of **binocular single vision**. *Amsler grid* - The **Amsler grid** is primarily used to detect central visual field defects, such as those caused by **macular degeneration** or other retinal pathologies. - It does not directly assess the brain's ability to fuse images from both eyes into a single vision. *Cardboard test* - The "cardboard test" is not a standard ophthalmic test for binocular single vision. - It may refer to various informal or rudimentary tests, but it lacks the precision and standardization required for accurate assessment of binocular functions. *Maddox rod* - The **Maddox rod** is used to detect and measure **heterophoria** (latent strabismus) or **heterotropia** (manifest strabismus). - It dissociates the images seen by each eye, preventing fusion and revealing the deviation of the eyes, rather than directly testing the ability to achieve binocular single vision.

Q: From which surface is the Purkinje IV image formed?

Posterior surface of lens. ***Posterior surface of lens*** - The **Purkinje IV image** is formed by reflection from the **posterior surface of the lens**, which is the most curved surface in the eye. - Due to the higher curvature and refractive index difference, this surface acts as a concave mirror, producing an **inverted, virtual image**. *Anterior surface of cornea* - The **Purkinje I image** is formed from the **anterior surface of the cornea**, which is the primary reflective surface of the eye. - This image is **bright, erect, and virtual**, serving as a basic reference for eye position. *Posterior surface of cornea* - The **Purkinje II image** originates from the **posterior surface of the cornea**, a much less curved and reflective surface than the anterior. - This image is typically **fainter** and less frequently used in clinical assessments due to its reduced visibility. *Anterior surface of lens* - The **Purkinje III image** is generated by reflection from the **anterior surface of the lens**. - This image is **inverted and virtual**, and its movement relative to Purkinje I can indicate lens accommodation changes.

Question 1

Maximum correction of myopia can be done by?

Accepted Answer

LASIK

Answer

Radial keratotomy

Answer

Photorefractive keratectomy

Answer

Orthokeratology

Question 2

Which Goldmann type is considered the standard in perimetry?

Accepted Answer

Goldmann type III (commonly used stimulus size)

Answer

Goldmann type I (small stimulus size)

Answer

Goldmann type II (medium-small stimulus size)

Answer

Goldmann type IV (large stimulus size)

Question 3

Which of the following conditions is NOT diagnosed by fluorescein angiography?

Accepted Answer

Hypertensive retinopathy

Answer

Diabetes retinopathy

Answer

Central serous retinopathy

Answer

Choroidal neovascularization

Question 4

During retinoscopy of a 30-year-old male, which cycloplegic is used routinely?

Accepted Answer

Cyclopentolate 1% drop

Answer

Homatropine 2% drop

Answer

Atropine 1% ointment

Answer

None of the options

Question 5

In specular microscopy endothelial density is measured by?

Accepted Answer

Fixed frame analysis

Answer

None of the options

Answer

Optical doubling

Answer

Optical focusing

Question 6

Retinitis pigmentosa is characterized by ?

Accepted Answer

Loss of peripheral vision

Answer

Loss of central vision

Answer

Visual field constriction

Answer

Tubular vision

Question 7

Which of the following statements about the c-wave in electroretinogram (ERG) is most accurate?

Accepted Answer

The 'c' wave is a slow positive wave.

Answer

The 'c' wave is a negative wave.

Answer

The 'b' wave arises primarily from photoreceptors.

Answer

The 'a' wave is a positive wave.

Question 8

Arcuate field defect akin to glaucoma is seen in?

Accepted Answer

Optic nerve lesion

Answer

Pituitary adenoma

Answer

Posterior cerebral artery infarct

Answer

None of the options

Question 9

Binocular single vision is tested by?

Accepted Answer

Synoptophore

Answer

Amsler grid

Answer

Cardboard test

Answer

Maddox rod

Question 10

From which surface is the Purkinje IV image formed?

Accepted Answer

Posterior surface of lens

Answer

Anterior surface of cornea

Answer

Posterior surface of cornea

Answer

Anterior surface of lens

NEET-PG 2013

Ophthalmology