NEET-PG 2021 - Ophthalmology PYQs Practice Questions

Q: A patient presented with dryness in the eye with a gritty sensation along with corneal softening. What is the most probable cause?

Vitamin A deficiency. Vitamin A deficiency - **Dry eyes** with a **gritty sensation (xerophthalmia)** and **corneal softening (keratomalacia)** are classic signs of severe vitamin A deficiency [1], [2]. - This condition can lead to blindness if not treated promptly, as vitamin A is crucial for the health of the **cornea** and **retina** [1], [2]. *Follicular conjunctivitis* - Characterized by the presence of **lymphoid follicles** on the conjunctiva, often due to viral infections like **adenovirus** or **chlamydia**. - While it can cause dryness, it does not typically lead to **corneal softening** or the severe vision-threatening complications seen with vitamin A deficiency. *Viral Keratitis* - Involves inflammation of the **cornea** due to a viral infection, commonly by **herpes simplex virus**. - Symptoms include pain, redness, blurred vision, and sensitivity to light, but **generalized dryness** and **corneal softening** as the primary presentation are less characteristic. *Riboflavin Deficiency* - Also known as **ariboflavinosis**, this deficiency can cause ocular symptoms like **photophobia**, **corneal vascularization**, and **conjunctivitis**. - However, it typically does not present with **severe dry eyes** or **corneal softening (keratomalacia)** as seen in vitamin A deficiency. [Practice more Ophthalmology PYQs on OnCourse]

Q: What is the SI unit of illuminance (brightness of light on a surface)?

Lux. ***Lux*** - **Lux** is the SI unit specifically designated for **illuminance**, which measures the **luminous flux** incident on a surface per unit area. - It quantifies the perceived **brightness** of light on a surface, taking into account the human eye's sensitivity to different wavelengths. *Luminance* - **Luminance** is a measure of the **intensity of light emitted or reflected from a surface** in a given direction, expressed in candelas per square meter (cd/m²). - It describes the brightness of a surface as perceived by the eye, but unlike illuminance, it is **independent of the incident light**. *Candela* - The **candela** is the SI base unit of **luminous intensity**, measuring the **power emitted by a light source in a particular direction**. - It doesn't describe the **brightness on a surface** but rather the output of the light source itself. *Lumen* - The **lumen** is the SI unit of **luminous flux**, representing the total amount of **visible light emitted by a source per unit time**. - While related to brightness, it describes the **total light output** of a source, not the illuminance on a specific surface. [Practice more Ophthalmology PYQs on OnCourse]

Q: A patient with contact lens use for the past 2 years presents with the ocular findings shown in the image below. What is the most probable diagnosis?

Giant Papillary conjunctivitis. ***Giant Papillary conjunctivitis*** - The image shows **large, elevated papillae** on the **tarsal conjunctiva**, which are characteristic findings of giant papillary conjunctivitis. - This condition is common among **contact lens wearers**, caused by chronic mechanical irritation and an allergic response to lens material or deposits. *Trachoma* - Trachoma is a **chronic infectious disease** caused by *Chlamydia trachomatis*, leading to scarring of the conjunctiva. - It typically presents with **follicles** in the early stages, followed by **scarring** and **pannus formation**, not the large papillae seen here. *Ocular Surface Squamous Neoplasia (OSSN)* - OSSN refers to a spectrum of conditions from **dysplasia to squamous cell carcinoma** affecting the conjunctiva or cornea. - It usually presents as a **gelatinous, fleshy, or leukoplakic lesion**, often at the limbus, which is distinct from the diffuse papillae shown. *Vernal Keratoconjunctivitis* - Vernal keratoconjunctivitis (VKC) is a **severe form of allergic conjunctivitis** but primarily affects children and young adults with a history of atopy. - While it can cause large papillae (cobblestone papillae), it is not specifically associated with contact lens wear and usually has other systemic allergic manifestations. [Practice more Ophthalmology PYQs on OnCourse]

Q: A 15-year-old girl with myopic astigmatism does not want to wear glasses. What is the best alternative for her?

Contact lenses (Toric). ***Contact lenses (Toric)*** - **Toric contact lenses** are specifically designed to correct **astigmatism**, along with myopia or hyperopia, by having different refractive powers in different meridians. - They offer a non-surgical alternative to glasses, addressing the patient's desire not to wear spectacles, and are generally safe and effective for teenagers. *LASIK* - **LASIK (Laser-Assisted In Situ Keratomileusis)** is a surgical procedure to correct refractive errors, but it is not typically recommended for individuals under **18-21 years of age** due to continued eye growth and refractive changes. - The patient's age of 15 makes her an unsuitable candidate for LASIK at this time. *Spherical Specs* - **Spherical spectacles** are designed to correct myopia or hyperopia but cannot adequately correct **astigmatism**, which is a significant component of this patient's refractive error. - The patient also explicitly states she does not want to wear glasses, making this option undesirable. *FEMTO Lasik* - **FEMTO LASIK** is an advanced form of LASIK that uses a femtosecond laser to create the corneal flap, offering higher precision and safety. - However, similar to traditional LASIK, it is a **refractive surgical procedure** and typically not performed on patients younger than **18 years old** due to ongoing eye development. [Practice more Ophthalmology PYQs on OnCourse]

Q: A child presenting with a whitish pupillary reflex (leukocoria) was treated with enucleation. Histopathology of the specimen showed Flexner-Wintersteiner rosettes. What is the most likely diagnosis?

Retinoblastoma. ***Retinoblastoma*** - The presence of **leukocoria** (whitish pupillary reflex) in a child is the most common presenting sign of **retinoblastoma** [2]. - **Flexner-Wintersteiner rosettes** are characteristic histological features of retinoblastoma, confirming the diagnosis [1]. *Astrocytoma* - Astrocytomas are **brain tumors** that typically do not cause leukocoria or originate in the retina [3]. - Their histology involves glial cells and would not show Flexner-Wintersteiner rosettes [3]. *Medulloblastoma* - Medulloblastomas are **malignant brain tumors** of the cerebellum, presenting with symptoms like ataxia and hydrocephalus [4]. - They are not associated with leukocoria or retinal involvement. *Rhabdomyosarcoma* - Rhabdomyosarcoma is a **malignant tumor of skeletal muscle**, most commonly found in the head and neck, genitourinary tract, or extremities. - While it can occur in the orbit, its histology is distinct and involves rhabdomyoblasts, not rosettes, and it's less likely to present purely as leukocoria. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Eye, pp. 1341-1342. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 737-738. [3] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 725-726. [4] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1314-1315. [Practice more Ophthalmology PYQs on OnCourse]

Question 1

A patient presented with dryness in the eye with a gritty sensation along with corneal softening. What is the most probable cause?

Accepted Answer

Vitamin A deficiency

Answer

Follicular conjunctivitis

Answer

Viral Keratitis

Answer

Riboflavin Deficiency

Question 2

What is the SI unit of illuminance (brightness of light on a surface)?

Accepted Answer

Lux

Answer

Luminance

Answer

Candela

Answer

Lumen

Question 3

A patient with contact lens use for the past 2 years presents with the ocular findings shown in the image below. What is the most probable diagnosis?

Accepted Answer

Giant Papillary conjunctivitis

Answer

Trachoma

Answer

Ocular Surface Squamous Neoplasia (OSSN)

Answer

Vernal Keratoconjunctivitis

Question 4

A 15-year-old girl with myopic astigmatism does not want to wear glasses. What is the best alternative for her?

Accepted Answer

Contact lenses (Toric)

Answer

LASIK

Answer

Spherical Specs

Answer

FEMTO Lasik

Question 5

A child presenting with a whitish pupillary reflex (leukocoria) was treated with enucleation. Histopathology of the specimen showed Flexner-Wintersteiner rosettes. What is the most likely diagnosis?

Accepted Answer

Retinoblastoma

Answer

Astrocytoma

Answer

Medulloblastoma

Answer

Rhabdomyosarcoma

Question 6

A one-month-old baby presents with excessive tearing (watering) and an increased corneal size. What is the most likely diagnosis?

Accepted Answer

Buphthalmos

Answer

Galactosemia

Answer

Cataract

Answer

Hurler syndrome

Question 7

An elderly woman presented with gradual painless diminution of vision. The fundus picture is shown below. What is the most likely diagnosis?

Accepted Answer

Central Retinal Vein Occlusion (CRVO)

Answer

Central Retinal Artery Occlusion (CRAO)

Answer

Hypertensive Retinopathy

Answer

Diabetic Retinopathy

Question 8

What is the most likely complication of the condition shown in the image below?

Accepted Answer

Exposure Keratitis

Answer

Difficulty in eye movement

Answer

Cataract

Answer

Glaucoma

NEET-PG 2021 — Ophthalmology