NEET-PG 2019 - Ophthalmology PYQs Practice Questions

Q: Esotropia is most commonly associated with:

Hyperopia. ***Hyperopia*** - **Hyperopia** (farsightedness) requires greater accommodative effort to focus on distant and near objects, which is coupled with **convergence**. This excessive convergence can lead to **esotropia** (inward turning of the eye). - Accommodative esotropia is a common type of strabismus directly linked to uncorrected hyperopia. *Presbyopia* - **Presbyopia** is an age-related loss of the eye's ability to focus on nearby objects due to stiffening of the lens, typically occurring after age 40. - It affects accommodation but does not primarily cause esotropia; rather, it makes near work difficult, and patients may prefer to hold objects further away to see them. *Astigmatism* - **Astigmatism** is a refractive error where the eye does not focus light evenly onto the retina due to an irregularly shaped cornea or lens, leading to blurred or distorted vision at all distances. - While it can cause visual discomfort and eye strain, it is not directly associated with the development of esotropia. *Myopia* - **Myopia** (nearsightedness) is a refractive error where distant objects appear blurry because light focuses in front of the retina. - High myopia can sometimes be associated with **exotropia** (outward turning of the eye) due to divergence excess, rather than esotropia. [Practice more Ophthalmology PYQs on OnCourse]

Q: Esotropia is commonly seen in which type of refractive error?

Hypermetropia. ***Hypermetropia*** - **Esotropia**, or convergent strabismus, is commonly associated with **uncorrected hypermetropia**, especially in children. - The constant effort to **accommodate** to see clearly for hypermetropic individuals can lead to excessive convergence, causing the eye to turn inward. *Myopia* - Myopia, or **nearsightedness**, rarely causes esotropia. - In some cases, high myopia can be associated with **exotropia** (divergent strabismus) due to reduced accommodative effort. *Astigmatism* - **Astigmatism** causes blurry vision at all distances due to an irregularly shaped cornea or lens, but it is not directly linked to specific forms of strabismus like esotropia or exotropia. - While it can contribute to **amblyopia** if severe and uncorrected, it does not typically cause the eyes to turn inward. *Presbyopia* - **Presbyopia** is an age-related loss of the eye's ability to focus on nearby objects due to stiffening of the lens. - It affects accommodation but does not cause strabismus such as esotropia; it typically begins around age 40. [Practice more Ophthalmology PYQs on OnCourse]

Q: Which chemotherapy agents are commonly used for the treatment of retinoblastoma?

vincristine, carboplatin and etoposide. ***Vincristine, carboplatin and etoposide*** - This combination is a well-established and commonly used **chemotherapy regimen** for the systemic treatment of retinoblastoma, particularly when there is significant intraocular disease or extraocular extension. - **Vincristine** targets microtubules, **carboplatin** is an alkylating agent, and **etoposide** is a topoisomerase inhibitor, working together to achieve a synergistic antineoplastic effect. *Vinblastine, etoposide and bleomycin* - While etoposide is used, **vinblastine** is not a primary agent for retinoblastoma, and **bleomycin** is more commonly associated with germ cell tumors or lymphomas, not retinoblastoma. - This combination lacks the broad spectrum of activity and specific targeting for retinoblastoma that is present in the standard regimen. *Vinblastine, vincristine and etoposide* - Although vincristine and etoposide are used, **vinblastine** is not typically included in the first-line systemic chemotherapy for retinoblastoma. - The absence of a platinum agent like carboplatin would make this regimen less effective for retinoblastoma, which often requires a strong alkylating agent. *Vinblastine, vincristine and cisplatin* - While vincristine is appropriate, **vinblastine** is not a standard component, and **cisplatin** is an alkylating agent but **carboplatin** is generally preferred in retinoblastoma due to its similar efficacy and a more favorable toxicity profile, especially regarding nephrotoxicity. - The use of cisplatin can lead to more significant **renal toxicity** and potentially ototoxicity compared to carboplatin, which is often avoided in a pediatric population when alternatives exist. [Practice more Ophthalmology PYQs on OnCourse]

Q: A patient presented with a history of diplopia and restricted eye movements. What is the most likely diagnosis based on the clinical and CT images?

Blowout fracture. ***Blowout fracture*** - The CT image shows a **fracture of the orbital floor**, with associated **herniation of orbital contents** (fat and inferior rectus muscle) into the maxillary sinus. - This type of fracture commonly causes **diplopia** (due to muscle entrapment) and **restricted eye movements**. *Le Fort fracture* - Le Fort fractures involve the **midface and maxilla** as a whole, typically causing widespread facial instability. - They are classified into three types (I, II, III), none of which are exclusively characterized by an isolated orbital floor fracture with muscle entrapment. *Maxillary fracture* - While an orbital floor fracture involves the maxilla, a "maxillary fracture" is a broad term and does not specifically describe the characteristic features of **orbital content prolapse** and their resulting symptoms. - Isolated maxillary fractures might not cause diplopia or restricted eye movements unless they directly involve the orbit. *Zygomatic fracture* - A zygomatic fracture (either isolated or as part of a zygomaticomaxillary complex fracture) primarily affects the **cheekbone**. - While it can involve the orbital rim, it typically presents with **facial asymmetry**, **numbness** in the infraorbital nerve distribution, and sometimes **trismus**, rather than isolated muscle entrapment causing diplopia, as seen in the image. [Practice more Ophthalmology PYQs on OnCourse]

Question 1

Esotropia is most commonly associated with:

Accepted Answer

Hyperopia

Answer

Presbyopia

Answer

Astigmatism

Answer

Myopia

Question 2

What conditions can be diagnosed using the cover-uncover test?

Accepted Answer

Eye alignment disorders including strabismus and heterophoria

Answer

Convergent strabismus (Esotropia)

Answer

Latent misalignment (Heterophoria)

Answer

Strabismus (Squint)

Question 3

Esotropia is commonly seen in which type of refractive error?

Accepted Answer

Hypermetropia

Answer

Myopia

Answer

Astigmatism

Answer

Presbyopia

Question 4

Which chemotherapy agents are commonly used for the treatment of retinoblastoma?

Accepted Answer

vincristine, carboplatin and etoposide

Answer

vinblastine, etoposide and bleomycin

Answer

vinblastine, vincristine and etoposide

Answer

vinblastine, vincristine and cisplatin

Question 5

A patient presented with a history of diplopia and restricted eye movements. What is the most likely diagnosis based on the clinical and CT images?

Accepted Answer

Blowout fracture

Answer

Le Fort fracture

Answer

Maxillary fracture

Answer

Zygomatic fracture

Question 6

Which is the most common ocular finding in myasthenia gravis?

Accepted Answer

Ptosis

Answer

Lagophthalmos

Answer

Proptosis

Answer

Enophthalmos

Question 7

Which of the following statements about conjunctival lesions is NOT true?

Accepted Answer

Surgery is treatment of choice

Answer

Arise from any part of conjunctiva

Answer

Can cause Astigmatism

Answer

UV exposure is risk factor

Question 8

The most common cause of proptosis in adults:-

Accepted Answer

Thyroid eye disease

Answer

Preseptal cellulitis

Answer

Capillary hemangioma

Answer

Orbital cellulitis

Question 9

A patient presents to the emergency department after sustaining blunt trauma to the left eye. Clinical examination reveals enophthalmos, diplopia on upward gaze, and periorbital ecchymosis. The CT scan image is shown below. What is your diagnosis?

Accepted Answer

Orbital blow out fracture

Answer

Oculomotor nerve paralysis

Answer

Retrobulbar hemorrhage

Answer

Orbital roof fracture

Question 10

Identify the instrument? (NEET Pattern 2019)

Accepted Answer

Maddox rod

Answer

Maddox wing

Answer

Red green glasses

Answer

Bagolini's striated glasses

NEET-PG 2019 — Ophthalmology