UPSC-CMS 2019 — Ophthalmology

Q: All of the following are causes of acute red eye EXCEPT:

Acute macular oedema. ***Acute macular oedema*** - **Macular edema** primarily affects **central vision** and does not typically cause the visible **redness** associated with acute inflammation of the ocular surface or anterior segment. - It involves **fluid accumulation** in the **macula** (the central part of the retina), which is a posterior segment issue and does not present as a red eye. *Conjunctivitis* - **Inflammation** of the **conjunctiva** (the membrane lining the eyelid and sclera) commonly leads to **vasodilatation** and **redness** of the eye. - Often accompanied by **discharge**, **itching**, or a **gritty sensation**. *Acute glaucoma* - An acute rise in **intraocular pressure** (IOP) can cause significant eye **redness** due to **conjunctival injection** and **ciliary flush**. - Other symptoms include **severe eye pain**, **blurred vision**, and **halos around lights**. *Keratitis* - **Inflammation** of the **cornea** typically results in marked **redness**, often with a **ciliary flush** (perilimbal injection) due to perilimbal vascular engorgement. - Associated with **eye pain**, **photophobia**, and potential **vision loss**. [Practice more Ophthalmology PYQs on OnCourse]

Q: All are true about Vernal conjunctivitis EXCEPT:

Most signs are in lower lid. ***Most signs are in lower lid*** ✗ - This is **INCORRECT** and is the answer to this EXCEPT question. - **Vernal conjunctivitis (VKC)** primarily affects the **upper tarsal conjunctiva**, not the lower lid. - The characteristic **cobblestone papillae** develop on the **upper eyelid** due to friction from blinking, causing **papillary hypertrophy**. - While bulbar conjunctiva and limbus can be affected, the most severe signs are in the **upper lid**. *Type of allergic conjunctivitis* ✓ - **VKC** is correctly classified as a chronic, bilateral, severe form of **allergic conjunctivitis**. - It is typically a **Type I hypersensitivity reaction**, often associated with atopy. *Cobblestone appearance* ✓ - This refers to the characteristic **large, flattened giant papillae** that develop on the **upper tarsal conjunctiva** in VKC. - The appearance results from marked hypertrophy of these papillae, resembling cobblestones. *Itchy eyes with other allergic problems* ✓ - **Intense itching** is the cardinal symptom of VKC, often accompanied by **photophobia**, **tearing**, and stringy mucous discharge. - Patients frequently have a personal or family history of other **atopic conditions** like asthma, eczema, or allergic rhinitis. [Practice more Ophthalmology PYQs on OnCourse]

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All of the following are causes of acute red eye EXCEPT:

All are true about Vernal conjunctivitis EXCEPT:

UPSC-CMS 2019 - Ophthalmology UPSC-CMS Practice Questions and MCQs

Question 1: All of the following are causes of acute red eye EXCEPT:

A. Conjunctivitis
B. Acute glaucoma
C. Keratitis
D. Acute macular oedema (Correct Answer)

Explanation: ***Acute macular oedema*** - **Macular edema** primarily affects **central vision** and does not typically cause the visible **redness** associated with acute inflammation of the ocular surface or anterior segment. - It involves **fluid accumulation** in the **macula** (the central part of the retina), which is a posterior segment issue and does not present as a red eye. *Conjunctivitis* - **Inflammation** of the **conjunctiva** (the membrane lining the eyelid and sclera) commonly leads to **vasodilatation** and **redness** of the eye. - Often accompanied by **discharge**, **itching**, or a **gritty sensation**. *Acute glaucoma* - An acute rise in **intraocular pressure** (IOP) can cause significant eye **redness** due to **conjunctival injection** and **ciliary flush**. - Other symptoms include **severe eye pain**, **blurred vision**, and **halos around lights**. *Keratitis* - **Inflammation** of the **cornea** typically results in marked **redness**, often with a **ciliary flush** (perilimbal injection) due to perilimbal vascular engorgement. - Associated with **eye pain**, **photophobia**, and potential **vision loss**.

Question 2: All are true about Vernal conjunctivitis EXCEPT:

A. Type of allergic conjunctivitis
B. Cobblestone appearance
C. Itchy eyes with other allergic problems
D. Most signs are in lower lid (Correct Answer)

Explanation: ***Most signs are in lower lid*** ✗ - This is **INCORRECT** and is the answer to this EXCEPT question. - **Vernal conjunctivitis (VKC)** primarily affects the **upper tarsal conjunctiva**, not the lower lid. - The characteristic **cobblestone papillae** develop on the **upper eyelid** due to friction from blinking, causing **papillary hypertrophy**. - While bulbar conjunctiva and limbus can be affected, the most severe signs are in the **upper lid**. *Type of allergic conjunctivitis* ✓ - **VKC** is correctly classified as a chronic, bilateral, severe form of **allergic conjunctivitis**. - It is typically a **Type I hypersensitivity reaction**, often associated with atopy. *Cobblestone appearance* ✓ - This refers to the characteristic **large, flattened giant papillae** that develop on the **upper tarsal conjunctiva** in VKC. - The appearance results from marked hypertrophy of these papillae, resembling cobblestones. *Itchy eyes with other allergic problems* ✓ - **Intense itching** is the cardinal symptom of VKC, often accompanied by **photophobia**, **tearing**, and stringy mucous discharge. - Patients frequently have a personal or family history of other **atopic conditions** like asthma, eczema, or allergic rhinitis.