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1. Gorlin's syndrome:
a. Is an inherited ondition !. Is asso iated "ith m#ltiple !asal ell ar inoma . In reases the in iden e of atara t d. Is asso iated "ith li$er ar inoma e. In reases the ris% of retinal deta hment
&. 'osterior polymorpho#s dystrophy : a. Is present at !irth !. Ca#ses ore topia . Is inherited in an a#tosomal re essi$e fashion d. Ca#ses !lindness in o$er ()* of s#fferers e. Can !e treated "ith lamellar orneal +rafts
,. Crystalline deposits in the on-#n ti$a may !e fo#nd in: a. .myloidosis !. Cystinosis . Gold treatment d. Conta t lens "ear
e. /raemia
0. The histolo+y of ptery+i#m in l#des: a. My1oid de+eneration !. 2pithelial in l#sion !odies . 're an ero#s han+es d. 34#amo#s metaplasia of the epithlei#m e. 2lastoti de+eneration
5. The follo"in+ may !e fo#nd in on-#n ti$a in %erato on-#n ti$itis si a a. 6ysplasia of the epitheli#m !. 7eratinisation . 2osinophils d. 8#mero#s +o!let ells e. 9ympho yti infiltrates
:. Mer%el ell ar inoma: a. Is most ommon in the !#l!ar on-#n ti$a !. Is asso iated "ith +ood pro+nosis . Is an .'/6 ell t#mo#r
;. <istolo+i al han+es in lens ind# ed #$eitis in l#de: a. Ghost ells !. Giant ell rea tion . .myloid in the ornea d. =as #litis e. 8on> aseatin+ +ran#loma
?. @eroderma pi+mentosa is asso iated "ith: a. Intrao# lar t#mo#rs !. Meta!oli disorders . 'hotosensiti$ity d. .#tosomal re essi$e inheritan e e. 34#amo#s ell ar inoma
(. 'atholo+i al han+es in thyroid ophthalmopathy in l#des: a. 9ympho yti infiltrates !. Giant ell rea tion
1). In histolo+i al stains: a. Chlamydia in l#sion !odies stain "ith Giemsa !. Osmi#m tetro1ide is the stain #sed in ele tron mi ros opy . F#n+i stain "ith F#el+in's stain d. 2osin stains the n# lei !l#e e. <aemato1ylin stains the n# lei pin%
11. 3ympatheti ophthalmitis a. Is hara terised !y 6ellen>F# hs' nod#le !. 're$ented !y remo$al of the e1 itin+ eye "ithin : "ee%s of in-#ry . 'i+ment laden ma ropha+es are dia+nosti d. Is asso iated "ith poliosis and $itili+o e. Is a ommon a#se of $is#al loss in tra#mati eye in-#ry
1&. .!normal material "hi h may !e present in the $itreo#s in l#de: a. 21foliation !. 9ipof#s in . <aemosiderin d. .myloidosis e. Cal i#m
1,. In +iant ell arteritis: a. <istolo+i al dia+nosis is !ased on fra+mentation of the internal intimal !. C>rea ti$e protein is al"ays raised . Giant ell is needed for dia+nosis d. .nterior ere!ral artery is often in$ol$ed e. .naemia is a feat#re
10. The follo"in+ onditions are pre>mali+nant: a. On o ytoma of the ar#n le !. . tini %eratosis . Ao"en's disease d. 34#amo#s papilloma e. 3yrin+oma
15. <ypo1i dama+e in dia!eti mellit#s is s#++ested !y: a. 8er$e fi!re layers haemorrha+e !. Iris neo$as #larisation . .nterior #$eitis d. =as #lar loop e. 6e reased hard e1#date
1:. The follo"in+ !iopsy report may !e fo#nd "ith rhe#matoid arthritis: a. 'osterior s leritis !. 9oss of +o!let ells in the on-#n ti$a . 2pis leral ne roti tiss#e d. Giant ell rea tion e. =as #litis
1;. The follo"in+ report is asso iated "ith in reased mortality in an en# leated eye "ith retino!lastoma: a. In$ol$ement of the opti ner$e !. 'resen e of al ifi ation "ithin the t#mo#rs . 8e rosis "ithin the t#mo#rs d. 21ophyti retino!lastoma e. 'resen e of retinal deta hment
1?. 6ia!eti mi roan+iopathy in l#de: a. 2ndothelial $as #lar proliferation !. 'roliferation of peri ytes asso iated "ith mi roane#rysms . 6eposition of al i#m in the intima d. Thi %enin+ of the !asement mem!rane e. 8e rosis of the endotheli#m
1(. Opti ner$e +lioma: a. Is asso iated "ith ne#rofi!romatosis type I !. In reased in iden e after ,) years old . Ma-ority is of pilo yti astro ytoma d. Rarely infiltrate the perine#ral tiss#e e. Mortality of 0)*
&). M#tton fat %erati pre ipitates are seen in: a. /$eal eff#sion syndrome !. T#!er #losis . F# h's hetero hromia y litis d. 3ar oidosis e. F#n+al infe tion
&1. .l!inism: a. <air !#l! for tyrosine positi$ity test is #sef#l only "hen the hild is 5 years old !. Is asso iated "ith platelets a!normality espe ially "ith aspirin . Complete de #ssation is in$aria!le in all al!inism d. Is asso iated "ith throm!osis #nder +eneral anaesthesia e. Ca#ses ma #lar hypoplasia
&&. Infanitle +la# oma is asso iated "ith: a. .niridia !. 3t#r+e>Be!er syndrome . .l!inism d. .1ial iris stromal a!normality e. =on <ippel>9inda#'s syndrome
&,. The follo"in+ are tr#e a!o#t nysta+m#s: a. 3ee>sa" nysta+m#s is asso iated "ith homonymo#s hemianopia !. 6o"n>!eat nysta+m#s is asso iated "ith lesion in the foramen ma+n#m
. Manifest latent nysta+m#s o #r in #nilateral on+enital atara t d. GaCe>e$o%ed nysta+m#s is spe ifi for ere!ellar lesion e. Con$er+en e retra tion nysta+m#s is asso iated "ith mid>!rain t#mo#rs
&0. Melano ytoma: a. Contains pl#mp !la % nae$#s ells !. Metastasises to the !rain . Is ommoner in temperate than tropi al o#ntries d. 6oes not a#se opti ner$e ompression e. Is asso iated "ith renal t#mo#r
&5. Retino!lastoma: a. Is inherited in 5)* of ases !. Is a#sed !y deletion of 11410 . Rosettes s#++est +ood pro+nosis d. There is an in reased in iden e of osteosar oma e. Ca#ses death in :)* of s#fferers in the /7
&:. Corneal dystrophy may ontain the follo"in+ s#!stan es: a. M# opolysa harides
&;. 9a rimal +land t#mo#r of the adeno yti type: a. <as a pea% in iden e of aro#nd :) years !. <as "ell>defined aps#le . 3pread thro#+h perine#ral tiss#e d. Metastasise to the !rain early e. Ca#ses mortality in o$er ()* of ases in the /7
&?. 6isso iated $erti al de$iation: a. <yperde$iation on a!d# tion and add# tion !. Ae+an at & to , years old . 'oor !ino #lar sin+le $ision d. Inferior re ession is the treatment of hoi e e. <i+hest in iden e "ith on+enital esotropia
a. Ca#ses limited a!d# tion and add# tion !. Bidenin+ of the palpe!ral fiss#re on a!d# tion . 3i1th ner$e palsy is an asso iated pro!lem d. Ca#ses head tilt more ommonly than other types e. Is asso iated "ith si1 ranial ner$e n# le#s aplasia
,). Retinos hisis: a. 3ho#ld !e treated "ith laser to pre$ent pro+ression !. Ca#ses a!sol#te s otoma . Is asso iated "ith "ater mar% d. Is !ilateral in the ma-ority of ases e. 6oes not a#se retinal deta hment
,1. Medi ations for +la# oma: a. Aeta>!lo %er is ontraindi ated in primary heart !lo % !. Aeta>!lo %er is ontraindi ated in those on nifedipine . . etaColamide is ontraindi ated in aller+y to s#lphonamide d. . etaColamide needs potassi#m s#pplement e. 9atanoprost is ontraindi ated in patient "ith #$eitis
,&. 6endriti #l ers may !e treated !y: a. .r+on laser !. Iodination . Topi al a y lo$ir d. 3ystemi a y lo$ir e. Tarsorrhaphy
,,. In horoidaemia: a. 'i+mentary han+es o #rs in arriers !. Carriers may ha$e a!normal 2OG . The mode of inheritan e is a#tosomal dominant d. .r+inine free diet is !enefi ial e. Central $ision is lost early
,0. 6eafness is asso iated "ith: a. Co %ayne's syndrome !. .lstrom's syndrome . .lport's syndrome d. /sher's syndrome e. .!etalipoproteinaemia
,5. 'rominent orneal ner$es are seen in : a. 2 todermal dysplasia !. I hythyosis . Refs#m's syndrome d. Ma #lar dystrophy e. . anthoamoe!a %eratitis
,:. The follo"in+ are re o+nised asso iation: a. .!etalipoproteinaemia and a antho ytosis !. Refs#m's disease is asso iated "ith ere!ellar ata1ia . 3pino ere!ellar ata1ia in Friedri h's ata1ia d. <omo ystin#ria and re #rrent deep $ein throm!osis e. 'a+et's disease and deafness
,;. 7erato on#s is asso iated "ith: a. 6o"n's syndrome !. 2hlers>6anlos' syndrome . Marfan's syndrome d. /sher's syndrome e. .topi %erato on-#n ti$itis
,?. In a 4#ired syphilis: a. Interstitial %eratitis is a re o+nised feat#re !. The infe tion is most infe tio#s in the se ondary sta+e . Ca#ses se ondary #$eitis d. Treatment is "ith pro aine peni illin e. May present "ith a rash "hi h is hi+hly infe tio#s
,(. Red# ed !lin% refle1 o #rs in: a. .l ohol into1i ation !. 'ar%insonism . 'ro+ressi$e s#pran# lear palsy d. Myasthenia +ra$is e. <ypothyroidism
y litis:
a. :)* of patients de$elop +la# oma !. 3ho" a +ood response "hen treated "ith steroids . 9ens implantation follo"in+ atara t s#r+ery is ontraindi ated d. <yphaema d#rin+ atara t s#r+ery is d#e to iris neo$as #lariCation
01. Retinal dialysis: a. Is asso iated "ith posterior $itreo#s deta hment !. Is asso iated "ith myopia . <as a mo!ile posterior flap d. Can !e treated !y ryotherapyD en ir lement and a lo al s leral !# %le e. Is ommonest in the s#perior temporal 4#adrant
0&. O #lar !o!!in+: a. Is asso iated "ith pontine haemorrha+es !. Is only seen in omatose patients . Is asso iated "ith loss of doll's head mo$ement d. Is asso iated "ith +lio!lastoma e. O #rs in !ilateral ere!ral infar tion
0,. The follo"in+ tests may !e #sef#l in the assessment of a patient "ith sar oidosis: a. Chest @>ray !. .C2
00. In <olmes>.die p#pil: a. There is a!sent or retarded p#pil rea tions to li+ht and near !. Most ases are !ilateral . Commoner in male than female d. Ca#ses red# ed or a!sent a ommodation e. Constri ts "ith &.5* metha holine
05. . fi1ed dilated p#pil "hi h does not rea t to dire t or onsens#al li+ht stim#l#s o#ld !e a#sed !y: a. Opti ner$e a$#lsion !. 6#e to !l#nt tra#ma . Or!ital ape1 syndrome "ith third ner$e palsy d. Topi al appli ation of atropine e. 3iderosis !#l!i
0:. 9e!er's opti ne#ropathy: a. Typi ally presents in the fo#rth de ade of life
!. Males do not transmit the disease . /s#ally affe t the males more than the females d. Is inherited in a#tosomal @>lin% fashion e. The opti dis is pale early in the disease
0;. In a #te .M''2: a. Ailateral in the ma-ority of ases !. <ypofl#ores en e in early sta+e of fl#ores ein an+io+raphy . 3pontaneo#s re o$ery is ommon d. ?)* of patients ha$e e1#dati$e $as #litis e. .nterior #$eitis is a prominent feat#re
0?. In entral sero#s retinopathy: a. .!normalities re orded on the .msler's hart are #n ommon !. Often sho"s fo al lea%a+e on fl#ores ein f#nd#s photo+raphy . . ma #lar hole is a ommon end res#lt d. The ima+e per ei$ed !y the patient on the affe ted side in #nilateral ases is !i++er than on the normal side e. . dense entral s otoma is the most ommon presentation
a. Ca#sed !y opper in the Ao"man's mem!rane !. <as !ro"n>+reenD +rey or oran+e olo#r . 6e reases "ith 6>peni llamine treatment d. Can o #r "ith opper intrao #lar forei+n !ody e. 3tarts at , and ( O' lo %
5). Corneal +rafts ha$e: a. <ost epitheli#m !. <ost endotheli#m . <ost %erato ytes d. <ost !asement and des emet's mem!rane e. <ost ner$es
51. =ernal %erato on-#n ti$itis: a. Is #s#ally #nilateral !. 2osinophil is ommon in the papillae . Can !e of lim!al type alone d. Is ommoner in ad#lt than hildren e. Ca#ses orneal melt
5&.The follo"in+ onditions are inherited in an a#tosomal re essi$e patterns: a. 'rotanopia !. Con+enital retinos hisis . 3t#r+e>Be!er's syndrome d. 8e#rofi!romatosis type II e. Al#e one a hromatopsia
5,. Coat's disease: a. <as e4#al se1 in iden e !. Ca#sed !y peripheral neo$as #lariCation . Is inherited in an a#tosomal dominant pattern d. Ca#ses rhe+mato+eno#s deta hment e. Can !e treated "ith laser
50. Bith re+ard to laser: a. @anthophll a!sor! +reen li+ht !. 6iode laser penetrate $itreo#s haemorrha+e . .r+on !l#e>+reen is ommonly #sed for +rid laser d. E.G laser prod# es red olo#r e. Ophthalmi laser is lassified as type I laser
55. Roth's spots ontain: a. 'ositi$e staphylo o #s !a teria !. '#r#lent e1#dates . =as #lar o l#sion d. 9ympho!lasts e. 2osinophils
5:. Area%s in des emet's mem!rane o #r in: a. 7erato on#s !. F# h's dystrophy . . #te +la# oma d. 9atti e dystrophy e. Con+enital +la# oma
5;. . #te +la# oma is s#++ested !y: a. 3phin ter paralysis !. Catara t . 2 topia #$ea d. 'osterior s#! aps#lar atara t e. Re #rrent orneal erosion
5?. In !lo">o#t fra t#re: a. . step on the or!ital rim is palpa!le !. .dd# tion pro!lem o #r . 3#r+i al emphysema is a re o+nised feat#re d. Immediate treatment is important e. 6e reased sensation at the tip of the nose is ommon
5(. 'ersistent hyperplasti primary $itreo#s: a. Ca#sed elon+ated iliary m#s les !. .n+le los#re +la# oma is a re o+nised feat#re . Opti dis a!normality is seen d. Ca#ses mi rophthalmi eye e. =is#al pro+nosis is +ood if treated early
:). 'ars planitis: a. Is fre4#ently asso iated "ith retinal deta hment !. Ca#ses $itreo#s haemorrha+e . <as poor $is#al pro+nosis d. Ca#ses y liti mem!rane e. <as a pea% in iden e at the fifth de ade
rareD a#tosomal dominant and m#ltisystem disorder hara terised !y m#ltiple !asal ell ar inomaD -a" ystsD s%eletal anomaliesD e topi al ifi ation of the fal1 ere!ri and pittin+ of the hand and feet o #lar feat#res also in l#de hypertelorismD lateral displa ement of the medial anthi and prominent s#praor!ital rid+es
&.
a.T
!.T
.F
d.F
e.F
a !ilateral dominantly inherited dystrophy $esi #lar polymorpho#s deposits "ith lear halos in 6es emet's mem!rane #s#ally asymptomati D rarely endotheli#m de ompensation re4#irin+ penetratin+ orneal +raft the a!normal endotheli#m may e1tend into the tra!e #lar mesh"or% and iris +la# oma an o #r as a res#lt of tra!e #lar mesh"or% in$ol$ement iris in$ol$ement an lead to ore topia and e topia sim#latin+ irido orneal endothelial syndrome e1 ept that the later is #nilateral
,.
a.T
!.T
.T
d.F
e.T
myloidosis as in m#ltiple myeloma ystinosis treatment "ith +old #ri a id from #raemia
0.
a.T
!.F
.F
d.F
e.T
'tery+i#m:
fi!ro$as #lar o$er+ro"th of the !#l!ar on-#n ti$a the stroma sho"s !asophili de+eneration (elastoti ) of olla+en the epitheli#m is often thin !#t may sho" hyperplasia or dysplasia it is not re+arded as pre an ero#s
5.
a.T
!.T
.F
d.T
e.T
a (dry eyes):
a#ses dysplasia of the epitheli#m "hi h may e$ent#ally !e ome %eratinise the +o!let ells may in rease d#e to hroni irritation from dry eyes in 3-o+ren's syndromeD there is lympho yti infiltration of the la rimal and a essory +lands
:.
a.F
!.F
.T
d.F
e.F
an a++ressi$e primary t#mo#r of the s%inD arisin+ from papillary dermis #s#ally presents as a firm non>tender solitary s%in nod#le on the fa e and ne % early metastasis thro#+h the lymphati hannels
;.
a.F
!.T
.F
d.F
e.T
ha oanalphyla ti endophthalmitis
> se$ere +ran#lomato#s inflammation "hen the lens protein is e1posed > Conal +ran#lomato#s rea tion s#rro#ndin+ the e1posed lens material. The inflammation in l#de ne#trophilsD epihtelioid ellsD ma ropha+es and +iant ells pha oto1i #$eitis
> non+ran#lomato#s inflammation "hen the lens protein is e1posed. > non>spe ifi inflammation "ith lympho ytesD ma ropha+es and o asional +iant ells pha olyti +la# oma
> ma ropha+es laden "ith eosinophili lens materials are seen in the anterior ham!er and the tra!e #lar mesh"or%
a.F
!.F
.T
d.T
e.T
@eroderma pi+mentosa:
inheritan e is a#tosomal re essi$e mar%ed sensiti$e of s%in to s#nli+ht mali+nant s%in t#mo#rs in l#din+ s4#amo#s ell t#mo#rD !asal ell ar inoma and fi!rosa orma main defe t is d#e to the ina!ility of the ells to repair dama+ed 68. follo"in+ #ltra$iolet e1pos#re
(.
a.T
!.F
.T
d.T
e.T
there is enlar+ement and inflammation of or!ital tiss#e espe ially the e1trao #lar m#s les histolo+i ally there is interstitial oedema and inflammatory ell infiltration (mainly lympho ytesD plasma ells and sometimes mast ells) the ondition tend to in$ol$e the nontendino#s part of e1trao #lar m#s le the endomysial fi!ro!lasts prod# es m# opolysa haride espe ially hyal#roni a id the m#s les are initially inflammed and at later sta+e #nder+oes fi!rosis and sho"s fatty infiltrate
1).
a.T
!.T
.T
d.F
e.F
<istolo+i al stainin+:
Giemsa stain an demonstrate in l#sion !ody s# h as hlamydia osmi#m tetro1ide is #sed to fi1 and stain myelin for ele tron mi ros opy yeast and f#n+i an !e stained "ith F#el+in's stainD '.3D 9#1ol !l#e fast and Gomori methenamine sil$er eosin stains the ytoplasm pin% "hereas haemato1ylin stains the n# lei !l#e
11.
a.T
!.F
.F
d.T
e.F
3ympatheti ophthalmitis
a #n ommon !ilateral +ran#lomato#s pan#$eitis "hi h o #rs after penetratin+ o #lar in-#ry or intrao #lar s#r+ery the inflammation #s#ally !e+ins 0 to ? "ee%s after the in-#ry 6ellen>F# h's nod#les are seen at the le$el of Ar# h's mem!rane and represent a++re+ates of epitheloid ellsD it is not dia+nosti as the nod#les also o #r in =7< syndrome may ha$e systemi manifestation identi al to =o+t>7oyana+i><arada syndrome "ith ere!rospinal fl#id pleo ytosisD minin+ism#sD alope iaD $itili+o and poliosis pre$ention is only #sef#l if the in-#red eye "ere remo$ed "ithin the first & "ee%s after in-#ry
1&.
a.T
!.F
.T
d.T
e.T
haemosiderin from $itreo#s haemorrha+e amyloidosis in familial amyloidosis al i#m in asteroid hyalosis
1,.
a.T
! .T
.F
d.F
e.T
disease of the elderly s#ddenD painless and profo#nd $is#al loss female more s#s epti!le than male head a heD lo" +rade fe$erD anore1iaD "ei+ht lossD tenderness #pon !r#shin+ hair and -a" la#di ation 23R and C>rea ti$e proteins are al"ays raised !#t not dia+nosti of the ondition dia+nosis is !ase on !iopsy "hi h re$eal fra+mentation of the internal elasti lamina and +iant ell infiltration of the t#ni a media of the artery. <o"e$erD +iant ells are not essential for dia+nosis.
10.
a.F
!.T
.T
d.F
e.T
a tini %eratosis is the res#lt of metaplasia d#e to #ltra$iolet li+ht Ao"en's disease On o ytoma of the ar#n le res#lts from metaplasia of the a essory +land and is not tho#+ht to !e pre>mali+nant 34#amo#s papilloma is !eni+n hyperplasia of the s%in 3yrin+oma is !eni+n t#mo#r of the s"eat +lands
15.
a.T
!.T
.T
d.T
e.F
otton>"ool spots e1tensi$e IRM. $as #lar !eadin+ e1tensi$e retinal haemorrha+es iris neo$as #lariCation
1:.
a.T
! .F
.T
d.F
e.T
posterior s leritis epis leral ne roti tiss#e $as #litis The dry eye in rhe#matoid arthritis is a#sed !y a4#eo#s defi ien y and not +o!let ell dysf#n tion
1;.
a.T
!.F
.F
d.F
e.F
ell differentiation Cal ifi ation and ne rosis are ommon in retino!lastoma.
1?.
a.F
!.F
.F
d.T
e.F
mi ro$as #lar o!str# tion and non>perf#sion of apilaries retinal apillary mi roane#rysms a!sent mem!rane thi %enin+ loss of peri ytes intraretinal mi ro$as #lar a!normality
1(.
a.T
!.F
.T
d.T
e.F
asso iated "ith type I ne#rofi!romatosis most ommon type is pilo yti (hair>li%e) astro ytoma the a+e of onset is #s#ally !efore the a+e of 1) lo">+rade and rarely infiltrate the perine#ral tiss#e rea ti$e menin+eal hyperplasia +ood lon+>term s#r$i$al
&)
a.F
!.T
.F
d.T
e.T
M#tton fat %erati pre ipitates: > o #rs in hroni +ran#lomato#s #$eitis and seen in
t#!er #losis f#n+al leprosy syphilis sar oidosis -#$enile 1antho+ran#loma histio ytosis @ sympatheti ophthalmia =o+t>7oyana+i><arada syndrome to1oplasmosis
&1.
a.F
!.T
.F
d.F
e.T
.l!inism:
an !e of o #lo #taneo#s or o #lar types o #lo #taneo#s types an !e di$ided into tyrosinase>positi$e and tyrosinase>ne+ati$e types. <air !#l! test is #sef#l to differentiate the t"o "ithin the first three years of life is asso iated "ith a!normal platelet a++re+ation in <ermans%y>'#dla% syndrome poor $ision is #s#ally d#e to ma #lar hypoplasia
&&.
a.T
!.T
.F
d.T
e.F
aniridia 3t#r+e>Be!er's syndrome anterior ham!er an+le lea$a+e syndrome s# h as 'eter's anomaly or .1enfeld's syndrome
&,.
a.F
!T
.T
d.F
e.T
8ysta+m#s:
see>sa" nysta+m#s is seen "ith !itemporal hemianopia do"n>!eat nysta+m#s o #rs "ith lesion in the er$i o>med#llary -#n tion at the foramen ma+n#m manifest latent nysta+m#s is a type of horiContal -er% nysta+m#s "hi h in reases in amplit#de "hen one eye is o$ered. It o #rs in stra!ism#sD am!lyopia or #nio #lar patholo+y s# h as atara t +aCe>e$o%ed potential is not spe ifi for ere!ellar lesionD it o #rs "hen the eyes are #na!le to maintain an e entri +aCe position thro#+h "ea%ness of m#s le tone in the a+onist m#s le on$er+en e retra tion nysta+m#s o #rs "ith mid>!rain t#mo#rs s# h as pinealoma
&0.
a.T
!.F
.F
d.F
e.F
Melano ytoma:
most ommonly fo#nd in opti ner$e head histolo+i ally sho"s pl#mp polyhedral ells e4#ally se1 in iden e ommoner in !la % pop#lation #s#ally asymptomati !#t may sho" enlar+ement of !lind spots 5)* ha$e asso iated horoidal nae$#s rarely the t#mo#r sho"s ne rosisD $as #lar o!str# tion and opti ner$e ompression
&5.
a.F
!.F
.T
d.T
e.F
Retino!lastoma:
most ases are d#e to ne" +ene m#tation only 1)* is inherited a#sed !y deletion of 1,410 rosettese s#++ests ell differentiation and therefore !etter pro+nosisF ho"e$er other fa tors s# h as siCe and opti ner$e in$ol$ement may !e more important has in reased ris% of osteosar om (the on o+ene of "hi h is also lo ated on hromosome 1,) pro+nosis is +enerally +ood at aro#nd ()*
&:.
a.T
!. T
.T
d.F
e.F
Corneal dystrophy: > inherited and !ilateral onditions > the follo"in+ a!normal s#!stan e are do #mented:
yaline de+eneration (+ran#lar dystrophy) amyloid (latti e dystrophy) lipid (fle % dystrophy) holesterol ( entral rystalline dystrophy)
&;.
a.T
!.F
.T
d.T
e.T
.deno ysti
the most ommon mali+nant t#mo#r of the la rimal +land has no "ell>defined aps#le in$ade perine#ral tiss#e a#sin+ pain and metastasise early to the !rain 5 histolo+i patterns: ri!riform (3"iss heese and of lo"er +rade)D solid (!asaloid)D s lerosin+D omedo ar inomato#s and t#!#lar (d# tal) treatment is "ith or!ital e1enternation and remo$al of in$ol$ed !one the pro+nosis is $ery poor
&?.
a.F
!.T
.T
d.F
e.T
refers to the phenomenon in "hi h the eye ele$ates "hen the amo#nt of li+ht enterin+ it is red# ed #s#ally !e+ins !et"een & to , years of a+e asso iated "ith infantile esotropia the !ino #lar $ision is #s#ally poor
&(.
a.T
!.T
.F
d.F
e.T
6#ane type .:
Type .: limited a!d# tion and less mar%ed add# tion limitation Type A: limited a!d# tion and normal add# tion Type C: limitation of add# tion e1 eeds the limitation of a!d# tion "idenin+ of the palpe!ral fiss#re on a!d# tion +lo!e retra tion and palpe!ral narro"in+ on add# tion fa e t#rns to the affe ted side is ommon a#sed !y inner$ation of the lateral re t#s !y a !ran h of third ner$e in pla e of a!sent si1th ner$e si1th ner$e n# le#s aplasia has !een do #mented
,).
a.F
!.T
.F
d.T
e.F
Retinos hisis:
presents in 5* of the pop#lation and is a#sed !y the splittin+ of the ne#rosensory retinal in the o#ter ple1iform layer often !ilateral arises from oales en e of peripheral ystoid de+eneration asso iated "ith hypermetropia
asymptomati !#t an a#se a!sol#te s otoma ( f "ith retinal deta hment "hi h a#ses relati$e s otoma) does not a#se "ater mar% "hi h is a feat#re of retinal deta hment and is d#e to transformation of es aped retinal pi+ment epithelial ells renal !rea%s on the internal layer is ommon !#t if asso iated "ith !rea%s in the o#ter layerD there is a ris% of retinal deta hment
,1.
a.F
!.F
.T
d.T
e.T
!eta>!lo %er a#ses slo"in+ of heart rate !#t is not ontra>indi ated in primary heart !lo % ( prolon+ed 'R inter$al) !eta>!lo %er sho#ld !e a$oided in patients ta%in+ entrally a tin+ al i#m hannel !lo %er s# h as $erapamil. 8ifedipine a ts peripherally a etaColide ontains str# t#re similar to s#lphonamide and sho#ld !e a$oided in those "ho is aller+i to it a etaColamide a#ses di#resis and loss of potassi#mD s#pplement may !e needed latanoprost is ontraindi ated in patients "ith intrao #lar inflammation
,&.
a.F
!.T
.T
d.T
e.F
,,.
a.T
!.F
.F
d.F
e.F
Choroidaemia:
@>lin%ed re essi$e disorder hara terised !y pro+ressi$e de+eneration of the horio apillaris and R'2 typi ally affe ts male onset is in the first de ade "ith ni+ht !lindness entral $ision is affe ted late 2RG sho"s red# ed a and ! "a$es female arriers may sho"s peripheral pi+mentary han+es
,0.
a.T
!.T
.T
d.T
e.F
Co %ayne's syndrome: premat#re a+ein+D d"arfismD !ird li%e fa ies and retinal de+eneration .ltroem's syndrome: retinitis pi+mentosaD deafnessD o!esity and dia!etes mellit#s .lport's syndrome: haemat#riaD sensorine#ral deafnessD anterioir lenti on#s /sher's syndrome: ne#rosensory deafnessD retinitis pi+mentosa
,5.
a.T
!.T
.T
d.F
e.T
i hthyosis Refs#m's disease F# hs' orneal dystrophy ne#rofi!romatosis leprosy tra#ma on+enital +la# oma failed orneal +raft %erato on-# nti$itis si a ad$an ed a+e a anthoamoe!a %eratitis
,:.
a.T
!.T
.T
d.F
e.T
a!etalipoproteinaemia "ith a antho ytosis Refs#m's disease "ith ere!ellar ata1ia Friedri h'a ata1ia "ith spino ere!ellar de+eneration 'a+et's disease and deafness <omo ystin#ria a#ses re #rrent aterial throm!osis
,;.
a.T
!.T
.T
d.F
e.T
onne ti$e tiss#e disorders s# h as 2hlers>6anlos's syndrome and Marfan's syndrome atopi eye onditions s# h as atopi %erato on-#n ti$itis 6o"n's syndrome
,?.
a.F
!.F
.T
d.T
e.F
. 4#ired syphilis:
a#ses painless #l er in the primary sta+e "hi h is hi+hly infe tio#s in the se ondary sta+eD the patient may de$elop a rash "hi h is non>infe tio#s #$eitis an o #r in the se ondary sta+e treatment is "ith peni illin Interstitial %eratitis is a feat#re of on+enital syphilis
,(.
a.T
!.T
.T
d.F
e.F
'ar%inson's disease pro+ressi$e s#pran# lear palsy al ohol into1i ation ne#rotrophi %eratitis onta t lens "ear
0).
a.F
!.F
.F
d.T
e.T
<etero hromi
y litis:
hroni #$eitis asso iated "ith atara t and +la# oma +la# oma de$elops in &)* of patients iris atrophy a#ses transill#mination .msler's si+n o #rs d#rin+ atara t e1tra tion and is d#e to "ispy iris $essels "hi h e1tends from the iris to the tra!e #lar mesh"or% and do not a#se anterior syne hiae is resistant to steroid treatment
01
a. F
!.F
.F
d.T
e.F
Retinal dialysis:
a#sed !y f#ll hi %ness separation of the retina at the ora serrata tra#mati dialysis is most often fo#nd in the s#peronasal 4#adrant idiopathi dialysis is most often in the inferotemporal 4#adrant an !e losed "ith ryotherapy to the !ase of the dialysis follo"ed !y lo al s leral !# %le
0&.
a.T
!.F
.T
d.T
e.F
O #lar !o!!in+:
on-#+ate in$ol#ntary re #rrent do"n"ard mo$ement of the eyes rapid do"n"ard mo$ement "ith a slo"er ret#rn to the ne#tral position a!sent horiContal mo$ements o #rs in patients "ith a #te pontine lesion "ho are either omatose or lo %ed>in state an o #r "ith t#mo#r in the pontine
0,.
a.T
!.T
.T
d.T
e.T
hest @>ray typi ally sho"s !ilateral hilar lymphadenopathyD there may also !e interstitial infiltrate .C2 on entration is in reased on-#n ti$al !iopsy may sho" non> aseatin+ +ran#loma ser#m al i#m may !e raised in sar oidosis +alli#m s an sho"s in rease in parts of !ody affe ted !y sar oidosis
00.
a.T
!.F
.F
d.T
e.T
<olme>.die's p#pil:
there is li+ht>near disso iation ho"e$er there may !e delayed or a!sent p#pil rea tion to !oth the ondition is #s#ally #nilateral "omen are affe ted more often than men d#e to paralysis of the iliary m#s leD the a ommodation is impaired dener$ation hypersensiti$ity is demonstrated !y onstri tion to &.5* metha holine and ).1* pilo arpine
05.
a.F
!.T
.T
d.T
e.T
> o #r "hen the iris of the affe ted eye is paralysed and this o #r in
0:.
a.F
!.T
.T
d.F
e.F
a mito hondrial inherited disease !ilateral loss of entral $ision "hi h is se$ere and painless typi ally in the se ond de ade of life lassi early pi t#re sho"s a triad of ir #mpapillary telan+ie tati mi roan+iopathyD pse#doedema of the dis and a!sent fl#ores ein stainin+
0;.
a.T
!.T
.T
d.F
e.F
.M''2:
typi ally affe ts healthy yo#n+ ad#lts "ho presents "ith s#dden onset entral or para entral $is#al loss after a fl# li%e illness s atteredD pat hy reamy lesions at the le$el of the retinal pi+ment epitheli#m layers the lesions fade after one to t"o "ee%s lea$in+ !ehind +ran#lar pi+mentary han+es fl#ores ein an+io+raphy sho"s early !lo %a+e of horoidal ir #lation !y these lesions !#t in the late phase the lesions sho" late stainin+
other findin+s: #$eitisD sero#s retinal deta hmentD ere!ral $as #litisD ere!rospinal fl#id pleo ytosisD heada heD hearin+ loss and tinnit#s spontaneo#s resol#tion is ommon and systemi steroid has not !een sho"n to !e #sef#l
0?.
a.F
!.T
.F
d.F
e.F
the patient #s#ally presents "ith distorted $ision "itho#t si+nifi ant entral $is#al loss .msler's hart testin+ #s#ally sho"s distortion of lines or s otoma the ima+e appears smaller than the #naffe ted eye
0(.
a.T
!.T
.T
d.T
e.F
o #rs in Bilson's disease and intrao #lar opper forei+n !ody the rin+ is a#sed !y opper deposited in 6es emet's mem!rane "hi h may !e oran+eD !ro"nD +reen> !ro"n or +rey in olo#r it !e+ins s#periorly then inferiorly and finally ir #mferentially re+resses "ith 6>peni illamine treatment
5).
a.T
!.F
.T
d.F
e.T
In orneal +raft:
the epithli#mD %erato ytesD ner$es and epitheli#m "ill e$ent#ally !e repla ed !y the host tiss#e the endotheli#m does not re+enerate and therefore "ill remains that of donor. the des emet's mem!rane is prod# ed !y the endotheli#m and "ill therefore remains that of donor
51.
a.F
!.T
.T
d.F
e.F
affe ts mainly yo#n+ people an aller+i inflammatory ondition hara terised !y +iant papillae in the tarsal on-#n ti$a the lim!al type is fo#nd ommonly in !la % "ith typi al <orner>Trantas' dots "hi h are +iant papillae ontainin+ eosinophils a#ses %eratitis and orneal #l er / s arrin+ treatment is a$oidan e of aller+ensD mast ell sta!ilisers and short o#rse of steroid in a #te phase
5&.
a.F
!.F
.F
d.F
e.T
@>lin%ed in protanopia (red>+reen olo#r !lindness) and -#$enile retinos hisis a#tosomal dominant in ne#rofi!romatosis a#tosomal re essi$e in !l#e one a hromatopsia non>inherited in 3t#r+e>Be!er's syndrome
5,.
a.F
!.F
.F
d.F
e.T
Coat's disease:
non>hereditaryD #nilateral on+enital disorder hara terised !y a!normal telan+ie tati and ane#rysmal retinal $essels in the peripheral retina male o#tn#m!er female !y , to 1 presents "ith le#%o oria and stra!ism#s. /ntreated an lead to e1#dati$e retinal deta hmentD +la# oma and pthisi al eye laser is #sef#l in destroyin+ the a!normal !lood $essels
50.
a.F
!.T
.F
d.F
e.F
9aser:
+reen li+ht is not a!sor!ed !y 1anthophyll and therefore it is theoreti ally more ad$anta+eo#s to #se +reen laser in the ma #lar area diode laser penetrate $itreo#s haemorrha+e "ell and is therefore ideal in $itreo#s haemorrha+e E.G laser is olo#rless and therefore re4#ire neodymi#m to +i$e it red olo#r for tar+etin+ #sed in ophthalmi pra ti e is lassified as type I= laser
55.
a.T
!.T
.F
d.T
e.F
Roth's spots:
many a#ses in l#din+ s#!a #te !a terial endo arditisD le#%aemiaD anaemia et
ontain "hite areas in the entre of retinal haemorrha+e the "hite areas may ontain imm#no omple1D lympho!lasts or p#r#lent e1#dates in s#!a #te !a terial endo arditisD the "hite entres may ontain or+anismsD altho#+h the ma-ority are sterile and onsists mainly of "hite !lood ells and fi!rin throm!#s at the site of e1tra$asation of !lood
5:.
a.T
!.F
.F
d.F
e.T
5;.
a.T
!.T
.F
d.F
e.F
iris atrophy sphin ter paralysis d#e to is haemia pi+ment dispersion +la#%omfle %en "hi h is "hite opa ities on the anterior s#rfa e of the lens a#sed !y ne rosis of the anterior lens aps#le
5?.
a.T
!.T
.T
d.F
e.F
the or!ital rim may !e fra t#re or inta t. In the former a step an !e felt o #r only "hen the air sin#ses ha$e de$elop s#r+i al emphysema is a feat#re altho#+h typi ally a#se pro!lem "ith #p+aCeD the horiContal re ti ha$e onne ti$e tiss#e that e1tends to the or!ital floor and therefore horiContal mo$ement may !e impaired to some e1tent the infraor!ital ner$e is in$ol$ed !#t the ner$e does not s#pply the tip of the nose "hi h is !y naso iliary ner$e 5(. a.T !.T .T d.T e.T
a#sed !y a!normal re+ression of primiti$e hyaloid $as #lar system typi ally there is a fi!ro$as #lar stal% e1tendin+ from opti dis and form a retrolental mem!rane the mem!rane e1tend to the iliary pro ess and if ontra t an lead to elon+ation of the iliary pro esses a#ses shallo" anterior ham!er and a #te +la# oma in #ntreated ases the pro+nosis is +ood if treated early espe ially if the retina "ere normal :). a.F !.T .F d.T e.F
'ars planitis:
ommonly affe t yo#n+ ad#lt and hildren presents "ith folater or de reased $is#al a #ity d#e to ystoid ma #lar oedema ?)* !ilateral lini al e1amination sho"s inflammatory ells and sno"!all opa ity in $itreo#s main ompli ations are atara t and ystoid ma #lar oedema. <o"e$erD the $is#al pro+nosis is #s#ally +ood
rare ompli ation in l#de !and %eratopathyD +la# omaD $itreo#s or+anisationD tra tional retinal deta hment and $itreo#s haemorrha+e. treatment is indi ated only "ith de reased $is#al a #ity from CMO and se$ere inflammation treatment in l#de: perio #lar steroidD ryotherapy to $itreo#s !aseD par plana $itre tomy and #se of imm#nos#ppresi$e a+ents.
,. Tr#e statements a!o#t an%ylosin+ spondylitis in l#de: a. <9.>A&; is fo#nd in ()* of s#fferers !. #$eitis is fo#nd in 15 to &)* of s#fferers . the ondition is ommoner in female d. female s#fferers ha$e a more se$ere o#rse than male e. the radiolo+i al han+es an o #r in the spine !efore symptoms
0. In s leritis: a. s leromala ia perforans are more ommonly asso iated "ith systemi diseases than posterior s leritis !. pain is not a prominent feat#re . retinal deta hment is a %no"n ompli ation d. systemi steroid is indi ated in all s leritis e. +la# oma is a %no"n ompli ation
5. The follo"in+ parasites an a#se o #lar pro!lems: a. Tri hinella spiralis !. 3 histosoma haemolyti a . .s aris l#m!ri oides d. 9oa loa
e. 9eishmania dono$ani
:. In #$eal melanoma: a. the ondition is more ommon in Ca# asian than other ra es !. the in iden e is hi+her in female than males . the opti ner$e is ommonly infiltrated !y the t#mo#r d. epithelioid ell type has poorer pro+nosis than other ell type e. a!dominal CT s annin+ is more sensiti$e than !lood test in dete tin+ hepati metastasis
;. Con ernin+ Marfan's syndrome: a. the ondition is inherited in a#tosomal dominant manner !. it is a#sed !y defe t in the formation of type I olla+en . the lens typi ally sho"s #pper nasal s#!l#1ation d. the patients ha$e a hi+her in iden e of hypermetropi refra ti$e error e. the s#fferers tend to !e mentally s#!normal
?. The follo"in+ are tr#e a!o#t measles: a. it is an R8. $ir#s !. a#ses 7opli%'s spots on the on-#n ti$a . a #te atarrhal on-#n ti$itis is a %no"n feat#res
d. a#ses !lindin+ %eratitis in the presen e of $itamin . defi ien y e. a#ses s#!a #te s lerosin+ panen ephalitis
(. Cy losporin .: a. is a f#n+al meta!olite !. has poor tiss#e penetration "hen applied topi ally . is the dr#+ of hoi e in Aeh et's disease d. a#ses hepatoto1i ity as the main side effe ts e. hirs#tism and +in+i$al hyperplasia are %no"n side effe ts
1). 'hly ten#lar on-#n ti$itis: a. the most ommon a#se is t#!er #losis !. the lesions are typi ally fo#nd near the lim!#s . sho#ld not !e treated "ith steroid d. predominantly affe ts hildren e. is a type I= hypersensiti$ity rea tion
11. The follo"in+ are tr#e a!o#t thiamine defi ien y: a. e1ternal ophthalmople+ia is a typi al feat#re !. fail#re of the p#pils to respond to li+ht
ar inoma
d. post>mortem re$eals peri$as #lar haemorrha+es in the re+ion of the fo#rth $entri le and a4#ed# t e. the ondition responds to hi+h dose $itamin A1&
1,. Feat#res of 9a"ren e>Moon>Aiedle's syndrome in l#de: a. hypo+onadism !. o!esity . polyda tyly d. mental retardation e. pi+mentary retinopathy
!. is ommoner in elderly people . a#ses aseatin+ +ran#loma d. prod# es !ilateral hilar lymphadenopathies in the a!sen e of p#lmonary symptoms e. a#ses lympho ytosis
15. Bith re+ard to si %le ell disease: a. &5* of the !la % pop#lation ha$e si %le ell disease !. the most se$ere form of si %le ell retinopathy is asso iated "ith 33 disease . opti dis is the first site of neo$as #lariCation in patient "ith se$ere retinal is hamia d. salmon pat hes are the res#lt of is haemia e. horoidal is haemia is the main a#se of $is#al loss
1:. .lport's syndrome is asso iated "ith: a. ne#ro>sensory deafness from !irth !. posterior lenti on#s . retinal deta hment d. peripheral retinal fle % e. haemorrha+e nephritis
1?. The follo"in+ are tr#e a!o#t entral retinal artery o l#sion: a. it is a ommon a#se of r#!eosis iridis !. an a#se neo$as #larisation of the retina . is a re o+niCed ompli ation of atrial fi!rillation d. fl#ores en e an+io+raphy typi ally sho"s delayed hyperfl#ores en e of the horoidal ir #lation e. a#ses opti atrophy "ithin the first "ee%
1(. In a ommodati$e esotropia: a. there is an in reased in iden e of hypermetropia !. the patients typi ally presents after the a+e of 1? months . !ifo al +lasses are ommonly pres ri!ed for these patients in the /nited 7in+dom d. the !ino #lar f#sion is #s#ally poor e. inferior o!li4#e o$era tion is a ommon feat#re
&). Bith re+ard to the #se of phopholine iodide in the treatment of esotropia: a. it an !e #sed to orre t hypermetropi a ommodati$e esotropia !. it is #sed in patients "ith esotropia d#e to hi+h .C/. ratio
. it an a#se iris ysts the in iden e of "hi h an !e red# ed "ith on #rrent treatment "ith phenylephrine d. it a#ses retinal deta hments e. it sho#ld !e stopped in patients a!o#t to #nder+o stra!ism#s s#r+ery
a. am!lyopia is #n ommon !. the ma-ority of patients ha$e asso iated ne#rolo+i al defi it . a hi+h refra ti$e error is ommon d. disso iated $erti al de$iation is fo#nd in ;5* of ases e. mono #lar opti o%ineti asymmetry is a feat#re
on+enital nysta+m#s:
a. there is in$erse opti o%ineti nysta+m#s !. the nysta+m#s is "orse "ith on$er+en e . the nysta+m#s is "orse "hen one eye is o$ered d. os illopsia is a ommon omplaint e. parado1i al p#pillary onstri tion to dar%ness
a. there is do"nshootin+ of the ipsilateral eye on add# tion !. there is asso iated s#perior re t#s o$era tion in the ontralateral eye
. may resol$e spontaneo#sly d. an !e treated !y inferior re t#s re ession in the ontralateral eye e. an !e treated !y inferior o!li4#e re ession in the ipsilateral eye
&0. /nilateral intern# lear ophthalmople+ia is asso iated "ith: a. red# ed add# tion on the affe ted side !. red# ed on$er+en e . nysta+m#s on a!d# tion in the affe ted side d. diplopia an o #r e. there is a!normal opti o%ineti nysta+m#s
&5. The follo"in+ are feat#res of a!errant third ner$e re+eneration: a. red# ed a!d# tion of the ipsilateral eye !. p#pillary onstri tion on a!d# tion . y lotorsion on ele$ation d. ele$ation of the ontralateral lid on lateral +aCe e. ele$ation of the lid on ipsilateral add# tion
&:. The follo"in+ are tr#e a!o#t <olme>.die's p#pil: a. the dia+nosis an !e onfirmed "ith edrophoni#m
!. females are more ommonly affe ted than males . a#ses pro!lem "ith readin+ that an !e orre ted "ith pl#s lenses d. onstri tion of p#pil an o #r e. partial relati$e afferent p#pillary defe t is seen in 5)* of ases
&;. .n+ioid strea%s o #r in: a. 3t#r+e>Be!er's syndrome !. 3i %le ell disease 33 . pse#doe1foliation syndrome d. septo>opti dysplasia e. 2hlers>6anlos syndrome
&?. The follo"in+ are tr#e a!o#t latanaprost: a. it is a prosta+landin inhi!itors !. it red# es the intrao #lar press#re !y in reasin+ the #$eal s leral o#tflo" . it has a +reater effe t than !eta !lo %ers in red# in+ the intrao #lar press#re d. hypertri hosis is a %no"n side effe ts e. it is ontra>indi ated in patients "ith orneal +raft re-e tion
a. it is ommoner in females than males !. it is a feat#res of Chandler's syndrome . the press#re an !e ontrolled "ith ar+on laser tra!e #loplasty d. there is se torial iris transill#mination e. the intrao #lar press#re may rise sharply follo"in+ e1er ise
,). In !eni+n intra ranial hypertension: a. there is a restri tion of #p+aCe !. normal $entri les is fo#nd in 5)* of ases . !rain s an is important in yo#n+ "oman to e1 l#de sa++ital sin#s throm!osis d. opti ner$e fenetration sho#ld !e performed early !efore the $ision is affe ted e. $entri #lar>peritoneal sh#nt is indi ated in the ma-ority of patients
,1. The follo"in+ medi ations may interfere "ith onta t lens "ear: a. rifampi in !. ontra epti$e pill . oral peni illin d. erythromy in e. di+o1in
,&. Go#t:
a. is a#sed !y p#rine meta!olism disorder !. a#ses s leritis . a#ses tophi in the e1trao #lar m#s le tendon d. is dire tly related to al ohol ons#mption e. #ri rystals may !e fo#nd in the deep stroma
,,. The follo"in+ are tr#e a!o#t iron deposition in the ornea: a. Fleis her's rin+ is fo#nd at the ape1 of %erato on#s !. <#dson>3tahli line is fo#nd in re #rrent erosion syndrome . 3to %er's line is asso iated "ith ptery+i#m d. Ferry's line is fo#nd at the front of a tra!e #le tomy !le! e. iron deposition o #rs in radial %eratotomy
a. Ceno+rafts refers to transplant !et"een different spe ies !. iso+rafts refers to transplant !et"een the same spe ies . lamellar %eratoplasty is #sef#l in patient "ith F# h's dystrophy d. pre$io#s !lood transf#sion in reases the in iden e of re-e tion e. !ro%en orneal s#t#re an eli it re-e tion
a. #nilateral epi!#l!ar dermoids !. presen e of prea#ri #lar s%in ta+ . presen e of synda tyly d. in reased in iden e of an+le los#re +la# oma e. loss of pi+ments on eyelashes
,:. Red>+reen olo#r defe t is fo#nd in: a. opti ne#ritis !. 3tar+ardt's disease . to!a o am!lyopia d. ma #lar de+eneration e. primary open an+le +la# oma
,;. The follo"in+ lini al feat#res are s#++esti$e of a a$erno#s sin#s lesion in a patient "ith #nilateral third ner$e palsy:
a. dilatation of the p#pil !. impaired ipsilateral orneal refle1 . onstri tion of p#pil d. fail#re of the eye to a!d# t e. hearin+ loss
,?. Feat#res of arotid> a$erno#s fist#la in l#de: a. dilated s#perior ophthalmi $ein on CT s an !. !lood in the 3 hlemmn's anal . proptosis of ontralateral eye s#++ests !ilateral arotid> a$erno#s fist#la d. d#ral fist#la is the ommonest type seen follo"in+ head in-#ry e. tra#mati fist#la rarely lose spontaneo#sly
a. Fa!ry's disease !. Refs#m's disease . 8orries's disease d. horoideremia e. rod mono hromatism
0). In mesodermal dys+enesis: a. .1enfeld's syndrome has posterior em!ryoto1on and iris hypoplasia !. .1enfeld's syndrome is inherited as an a#tosomal re essi$e disorder . Rie+er's anomaly is asso iated "ith dental and fa ial hypoplasia d. 'eter's anomaly is asso iated "ith !ilateral orneal opa ities e. 'eter's anomaly is asso iated "ith +la# oma in 5)* of ases
01. In latti e de+eneration: a. ?* of the pop#lation ha$e the ondition !. photo oa+#lation is re ommended for e1tensi$e ases . holes sho#ld !e treated d. it has a hi+her in iden e amon+st hi+h myopes e. &5* of retinal deta hment is d#e to latti e de+eneration
0&. The indi ation for s#!retinal fl#id draina+e in l#de: a. immo!iliCed retina !. !#llo#s lesion "here tear annot !e identified . hypotony d. s#perior retinal deta hment e. presen e of !lood in the $itreo#s
0,. The follo"in+ are tr#e a!o#t intra$itreal in-e tion: a. it an a#se se ondary retinal tear !. it an a#se atara t . C,F? has a lon+er half life than 3F: d. 3F: is more e1pansile than C,F? e. 3F: a#ses less in rease in the intrao #lar press#re than C,F?
a. !ro" s#spension is the treatment of hoi e in se$ere on+enital ptosis !. Fasa$ella>3er$ant is the treatment of hoi e in patients "itho#t le$ator f#n tion . posterior approa h is the re ommended pro ed#re in patient "ith pre$io#s ptosis s#r+ery d. ma1imal rese tion is re ommended in patients "ith mito hondrial myopathy e. Aell's phenomenon and orneal sensation sho#ld !e aref#lly assessed !efore s#r+ery
05. Fo#rth ner$e palsy an !e treated "ith: a. ipsilateral s#perior re ession !. ipsilateral inferior o!li4#e re ession . ontralateral inferior re t#s rese tion d. ipsilateral s#perior o!li4#e t# %in+ e. ipsilateral inferior re t#s re ession
a. it o #rs in a!o#t 5* of hyphema !. it is related to the se$erity of the hyphaema . it is ommoner in de ompensated ornea d. it is a#sed !y red !lood ells mi+ratin+ into the stroma e. spontaneo#s learin+ of the hyphema typi ally !e+ins entrally
a. 3taphylo o #s a#re#s is the most ommon patho+en !. presents "ithin 0? ho#rs of s#r+ery in the ma-ority of ases . topi al and systemi anti!ioti are #s#ally ade4#ate to ontrol the infe tion d. steroid is ontraindi ated e. it is often diffi #lt to differentiate !a terial from my oti a#ses
a. dar% olo#r iris responds poorly to ar+on laser iridotomy !. more ener+y is needed for ar+on laser than E.G laser for a +i$en siCe iridotomy . steroid pre>treatment is effe ti$e in de reasin+ the intrao #lar press#re d. presen e of red refle1 d#rin+ the pro ed#re indi ate the iridotomy is patent e. si+nifi ant atara t de$elops in 5)* of ases follo"in+ treatment
a. a history of on-#n ti$itis !. history of hepatitis . . less than 1) years old d. endothelial ell o#nt of less than &))) per s4#are mm e. senile dementia
5). In ar+on laser tra!e #loplasty: a. the s# ess rate is proportional to the ener+y #sed !. the res#lts are !etter in the elderly than the yo#n+ . the intrao #lar press#re is red# ed d#e to de reased a4#eo#s prod# tion d. typi ally prod# e a drop in the intrao #lar press#re of !et"een 1) and 15 mm<+ e. it is #sed as an ad-#n ti$e treatment to ma1imal medi al therapy
51. In refra ti$e s#r+eryF a. radial %eratotomy may !e #sed in myopes of 1)6 or more !. radial %eratotomy is a "ell>esta!lished safe te hni4#es "ith predi ta!le res#lt . post>operati$e asti+matism may !e red# ed !y remo$in+ the s#t#re alon+ the a1is of the lar+est pl#s ylinders d. post>operati$e asti+matism may !e red# ed !y remo$in+ s#t#res in the flatter a1is e. %eratomile#sis in$ol$es #sin+ a donor ornea
5&. The follo"in+ te hni4#es are #sef#l in red# in+ post>operati$e asti+matism: a. pha oem#lsifi ation rather than e1tra aps#lar te hni4#e !. the #se of folda!le lens . a lim!al in ision rather than a orneal in ision d. s#perior orneal approa h rather than temporal approa h e. di$ide and on4#er te hni4#e d#rin+ pha oem#lsifi ation rather than pha o> hop
5,. The follo"in+ are tr#e a!o#t anterior aps#le remo$al in atara t s#r+ery:
a. aps#lorrhe1is prod# es a stron+er ed+e than an>opener aps#lotomy !. aps#lorrhe1is re4#ires less $is oelasti than an>opener aps#lotomy . displa ement of the intrao #lar lens is less ommon "ith aps#lorrhe1is than an> opener aps#lotomy d. hydrodisse tion of the lens is not re4#ired "ith aps#lorrhe1is e. aps#lorrhe1is is an easier te hni4#e to master than an>opener aps#lotomy
50. Inferior o!li4#e re ession: a. need aref#l prism meas#rement !. is performed in ipsilateral fo#rth ner$e palsy to remo$e y lotorsion . is performed in =>pattern esotropia d. is performed in ontralateral s#perior re t#s palsy e. is easier to perform than inferior o!li4#e mye tomy
a. s#r+ery an speed #p re o$ery !. !ot#lin#m to1in in-e tion into the ipsilateral medial re t#s speeds #p re o$ery . rese tion/re ession is in appropriate d. no more than t"o m#s les sho#ld !e operated
5:. The follo"in+ are tr#e a!o#t ystoid ma #lar oedema: a. it a#ses $is#al impairment in 1)* of #n ompli ated e1tra aps#lar atara t operation !. the in iden e of ystoid ma #lar oedema is hi+her in intra aps#lar atara t e1tra tion than e1tra aps#lar atara t operation . the ris% of ystoid ma #lar oedema is in reased in patients "ho ha$e post>operati$e orneal oedema d. $itreo#s prolapsed is a %no"n pre ipitatin+ fa tor for ystoid ma #lar oedema e. malpositioned of intrao #lar lens is a re o+niCed fa tor for ystoid ma #lar oedema
5;. The follo"in+ are tr#e a!o#t the lassifi ation of retinopathy of premat#rity: a. 3ta+e 1: normal retina !. 3ta+e &: presen e of demar ation lines that protr#de into the $itreo#s . 3ta+e ,: presen e of fi!ro$as #lar proliferation in the peripheral retina d. 3ta+e 0: total retinal deta hment e. 3ta+e 5: proliferati$e $itreo#s retinopathy
5?. The follo"in+ are tr#e a!o#t pse#doe1foliation syndrome: a. the a+e "hen +la# oma de$elops is older than primary open an+le +la# oma !. the intrao #lar press#re al"ays responds !etter to medi al treatment than primary
open an+le +la# oma . asymmetri al +la# oma is more ommon than primary open an+le +la# oma d. there is an in reased pi+ment deposition in the tra!e #lar mesh"or% e. tra!e #le tomy is less s# essf#l in ontrollin+ the press#re than in primary open an+le +la# oma.
a. the main patholo+y is o l#si$e mi roan+iopathy !. the lo"est dose of radiation re4#ired to a#se radiation retinopathy is 11 Gy . the photore eptors are more sensiti$e to radiation than the retinal $as #lar ells d. patients on hemotherapy are more $#lnera!le to radiation retinopathy e. hyper!ari o1y+en is #sef#l in pre$entin+ the pro+ression of radiation retinopathy
:). The follo"in+ are tr#e a!o#t lo al anaesthesia: a. peri!#l!ar anaesthesia re4#ires a lon+er time than retro!#l!ar anaesthesia to a hie$e a%inesia !. li+no aine re4#ires a shorter time than mar aine to a hie$e anaesthesia . li+no aine has a lon+er d#ration of a tion than mar aine d. topi al ametho aine is inade4#ate for iris anaesthesia e. retro!#l!ar haemorrha+e in reases the ris% of e1p#lsi$e haemorrha+e .ns"ers to Test T"o
1.
a.T
!.F
.T
d.T
e.T
Many dr#+s ha$e !een impli ated in opti ne#ropathyD the follo"in+ are the !etter %no"n:
anti>t#!er #lo#s: etham!#tol and isoniaCid hlorampheni ol di+italis oral hypo+ly aemi a+ents: hlopropamide and tol!#tamide hloro4#ine dis#lfir#m 6>peni illamine
&.
a.T
!.T
.F
d.T
e.F
<ypotony:
o #rs "hen the intrao #lar press#re is s#ffi ient lo" to ompromise the o #lar f#n tion #s#ally !elo" : mm<+ may !e a#sed !y de reased a4#eo#s prod# tion or e1 essi$e a4#eo#s draina+e an res#lts in:
> orneal oedema > atara t formation > #$eal eff#sion > ma #lar oedema > dis oedema > horoidal folds
,.
a.T
!.T
.F
d.F
e.T
.n%ylosin+ spondylitis:
inflammatory disorders of spinal -oints ()* ha$e the <9.>A&; halotype systemi feat#res in l#de peripheral arthritisD #$eitisD aorti $al$e in ompeten e and hroni inflammatory !o"el disease the ondition is ommoner and more se$ere in males than females in the spineD the inflammation !e+ins at the site "here li+aments are atta hed to $erte!ral !one (the entheses)D ho"e$erD si+ns may o #r !efore the patients omplain of any symptoms.
0.
a.T
!.F
.T
d.F e.T
3 leritis:
many $arieties and some ha$e a hi+her in iden e of systemi asso iation than other. In de reasin+ order: ne rotiCin+ s leritis "itho#t inflammation ie. s leromala ia perforans (o$er G()*)D nod#lar and ne rotiCin+ s leritis (5)*)D diff#se s leritis (,)*) and posterior s leritis (1)*) se$ere pain is ommon sero#s retinal deta hment is a %no"n ompli ation espe ially "ith posterior s leritis in mild to moderate s leritisD oral non>steroidal anti>inflammatory a+ents s# h as di oflena are #sef#l in s#ppressin+ the inflammation +la# oma o #rs in 5* of ases and is related to: steroid #seD in reased epis leral $eno#s press#re and rarely an+le los#re +la# oma d#e to horoidal eff#sion
5.
a.T
!.F
.F
d.T
e.F
O #lar parasites:
Tri hinella spiralis a#ses tri hinosis "hi h is an infestation of striated m#s le !y the lar$a. They are a 4#ired thro#+h eatin+ #nder oo%ed por%. The or!it and the #pper lid an !e ome infested leadin+ to inflammation and pain on eye mo$ement. 9oa loa is a 4#ired thro#+h !ites from Man+o flies . The patients presents "ith pr#riti s#! #taneo#s s"ellin+. O #lar manifestation in l#de mi+ration of "orms #nder the on-#n ti$aD in the anterior ham!er and the $itreo#s 9eishmania dono$ani an a#se either #taneo#s or / and $is eral leishmaniasis. It is transmitted !y the !ite of sandfly. In #taneo#s formD the eyelids may !e ome in$ol$ed and #ntreated an lead to interstitial %eratitis.
:.
a.T
!.F
.F
d.T
e.F
/$eal melanoma:
o #r mainly in the "hite pop#lation the in iden e sho"s little differen e !et"een the se1es #nli%e retino!lastoma the opti ner$es are seldom infiltrated epithelioid ell type is asso iated "ith poor pro+nosis !lood test is more sensiti$e than CT s annin+ in re$ealin+ hepati metastasis
;.
a.T
!.F
.F
e.F
e.F
Marfan's syndrome:
a#tosomal dominant ondition a#sed !y in orre t e1pression of a +ene prod# t for ,5)%6 +ly oprotein %no"n as fi!rillin "hi h is responsi!le for the e1tra ell#lar mi rofi!rol net"or%. Type I olla+en a!normality is seen in osteo+enesis imperfe ta ?)* ha$e lens s#!l#1ation "hi h is typi ally displa ed #p and o#t lenti #lar myopia "ith normal a1ial len+th is a feat#re #nli%e homo ystin#riaD the patient is mentally normal
?.
a.T
!.T
.T
d.T
e.T
Measles:
is a paramy1o$ir#s ontainin+ R8. a#ses 7opli%'s spots on the on-#n ti$a and ar#n le a#ses a #te atarrhal on-#n ti$itis a#ses p#n tate %eratitis "hi h is self>limitin+ in de$eloped o#ntries !#t in the presen e of maln#trition espe ially $itamin . defi ien yD !lindin+ %eratitis an o #r s#!a #te s lerosin+ panen ephalitis tends to o #r in hildren "ho a 4#ire measles !efore one year of a+e. It is hara teriCed !y pro+ressi$e ne#rolo+i al defi it "ith dementiaD myo lon#s and fo al si+ns a#sin+ death.
(.
a.T
!.T
.T
d.F
e.T
Cy losporin .:
is the prod# t of the f#n+#s Tolypo ladi#m inflat#m inhi!its T ell a ti$ation !y stoppin+ the e1pression of re eptors on T lympho ytes that re o+niCe the 6R anti+en fo#nd on anti+en presentin+ ells has poor tiss#e penetration "hen applied topi ally
is the dr#+ of hoi e in patients "ith Aeh et's disease a#ses nephroto1i ity as the main side effe t "hi h is dose>dependent
other side effe ts in l#de: hypertensionD hypertri hosisD +astrointestinal #psetD +in+i$al hyperplasiaD anaemia and raised 23R
1).
a.F
!.T
.F
d.T
e.T
'hly ten#lar on-#n ti$itis: is a type I= imm#ne response to some sensitiCed anti+en typi ally !a teria anti+en t#!er #losis is a %no"n a#se !#t it is more often asso iated "ith 3taphlo o #s a#re#s often o #rs near the lim!#s ommoner in hildren topi al steroid is the treatment of hoi e
11.
a. T
!.F
.T
d.T
e.F
ommon in hroni al oholi s and in those "ith lon+>standin+ diseases of the #pper +astrointestinal tra t s# h as pepti #l er or +astri ar inoma a#ses Berni %e's en epholopathy "ith memory impairmentD ata1iaD peripheral ne#ropathy. O #lar si+ns in l#de e1ternal ophthalmople+ia and nysta+m#s there is hara teristi peri$as #lar haemorrha+es in the re+ion of the fo#rth $entri le and a4#ed# t and also in the mamillary !odies treatment of hoi e is "ith intra$eno#s thiamine ($itamin A1)
1&.
a.T
!.T
.T
d.T
e.T
Tentorial herniation:
o #rs "hen a mass lesion ma%es one ere!ral hemisphere too lar+e for its ompartment and a#se the infero>medial part of the ere!ral hemisphere to !e p#shed thro#+h the tentorial hiat#s ( "hi h separates the ere!r#m from the ere!ell#m) the in reased press#re a#ses $omitin+ deterioration of ons io#sness o #rs d#e to dist#r!an e of the reti #lar formation ompression on the third ner$e res#lts in dilated p#pilD o #lar palsy and ptosis res#lts in onin+ "ith the "hole !rainstem !ein+ p#shed do"n"ard. This interfere "ith the $ital f#n tions of respiration ( ontrolled !y med#lla o!lon+ata)
1,.
a.T
!.T
.T
d.T
e.T
mental retardation o!esity hypo+enitalism polyda tyly spasti paraple+ia retinitis pi+mentosa
10.
a.F
!.F
.F
d.T
e.F
3ar oidosis:
a systemi disorder of #n%no"n ori+in tends to affe t people in their &)s and ,)s prod# es non> aseatin+ +ran#loma !ilateral hilar lymphadenopathies are ommon e$en in the a!sen e of hest symptoms a#ses red# ed n#m!er of ir #latin+ lympho ytes
15.
a.F
!.F
.F
d.F
e.F
si %le ell trait o #rs in ?* of the pop#lation altho#+h 33 disease has the most se$ere systemi manifestationD retinopathy is most se$ere "ith 3C and 3>thal diseases neo$as #lariCation typi ally o #rs in the peripheral retina salmon pat hes are the res#lt of pre>retinal or internal linin+ mem!rane haemorrha+es the main a#se of $is#al loss is $itreo#s haemorrha+e and rhe+mato+eno#s retinal deta hment.
1:.
a.T
!.F
.F
d.T
e.T
.lport's syndrome:
a disease "ith ne#rosensory hearin+ loss and haemorrha+i nephritis only 15* ha$e o #lar a!normalities and this in l#de anterior lenti on#s and peripheral
retinal fle % inheritan e may !e dominant (most ommon)D @>lin%ed and re essi$e
1;.
a.T
!.T
.T
d.T
e.F
Corneal deposits:
the m# opolysa haradosis is a +ro#p of stora+e disease a#sed !y an error of ar!ohydrate meta!olism. Corneal deposits are seen in all types e1 ept in 3anfilippo's (type III) and the ma-ority of <#nter's (type II) syndrome myeloma an lead to amyloidosis of ornea
ystinosis is an a#tosomal re essi$e ondition hara teriCed !y "idespread ystine rystal deposits in l#din+ the ornea
1?.
a.F
!.T
.T
d.F
e.F
Central retinal artery o l#sion: r#!eosis iridis o #rs in a!o#t 1)* of patients rarely retinal neo$as #lariCation is seen atrial fi!rillation is a a#se of em!ol#s "hi h may lead to retinal artery o l#sion delayed hyperfl#ores en e of horoidal ir #lation is a feat#re of ophthalmi artery o l#sion opti atrophy o #rs d#e to loss of +an+lion ell layers and these may ta%e months to de$elop
1(.
a.T
!.T
.F
d.F
e.F
. ommodati$e esotropia:
there is o$er on$er+en e asso iated "ith a ommodation most patients ha$e a hypermetropia of H&.)) dioptres or more a+e of presentation is !et"een 1? months and 0 years !ino #lar f#sion is #s#ally +ood #nli%e infantile esotropiaD inferior o!li4#e o$era tion is not a feat#re
&).
a.T
!.T
.T
d.T
e.T
'hospholine iodide:
is an a etyl holinesterase inhi!itor "hi h is #sed as a mioti a+ent an help patient "ith hypermetropi a ommodati$e esotropia and patient "ith a hi+h .C/. ratio a#ses ontra tion of iliary m#s le and iris sphin ter res#ltin+ in an in reased a ommodation for a +i$en a ommodati$e effort and therefore less on$er+en e side effe ts in l#de: iris ysts (red# ed "ith on #rrent treatment "ith phenylephrineD atara tD retinal deta hment and an+le los#re +la# oma in ad#lts. has systemi effe t and an prolon+ the a tion of s# inyl holine. ThereforeD patients sho#ld not ha$e s# inyl holine or ha$e to stop the drops at least si1 "ee%s prior to s#r+ery
&1.
a.T
!.F
.F
d.T
e.T
Infantile esotropia:
the patients typi ally present in the first si1 months of life there is a lar+e an+le esotropia asso iated feat#res in l#de: inferior o!li4#e o$era tion (;)*)D 6=6 (;5*) and latent nysta+m#s (5)*) a mild to moderate hypermetropia is ommon (H&.)) to H,.)) dioptres) mono #lar asymmetri al O78 is seen "ith poor response "hen the dr#m is rotated from the nasal to temporal dire tion
&&.
a.T
!.F
.T
d.F
e.T
Con+enital nysta+m#s:
may !e sensory d#e to a!normality in$ol$in+ the afferent $ision or motor the nysta+m#s is "orse "hen one eye is o$ered the nysta+m#s is red# ed on on$er+en e and this may res#lt in nysta+m#s !lo %a+e syndrome "ith esotropia a!o#t &/, of the patients ha$e parado1i al in$ersion of the opti o%ineti response (the dire tion of the 4#i % re o$ery phase is the same as that of the dr#m rotation instead of in the opposite dire tion) os illopsia is not a feat#re parado1i al p#pillary onstri tion may o #r "ith the p#pil initially onstri t "hen the room li+ht is dimmed
&,.
a.T
!.T
.T
d.F
e.T
Aro"n's syndrome:
a#sed !y a ta#t s#perior o!li4#e tendon sli+ht do"nshootin+ on add# tion is ommon and "idenin+ of the palpe!ral fiss#re on
add# tion the ondition may resol$e spontaneo#sly and therefore s#r+ery is not #s#ally indi ated
s#r+ery in l#de s#perior o!li4#e tenotomy "ith sili one e1pander or s#perior o!li4#e tenotomy "ith ipsilateral inferior o!li4#e re ession to pre$ent post>operati$e inferior o!li4#e o$era tion
&0.
a.T
!.F
.F
d.T
e.T
res#lts from a lesion in the medial lon+it#dinal fas i #l#s !et"een the si1th ner$e and third ner$e n# lei a#ses fail#re of the ipsilateral medial re t#s to add# t on horiContal +aCe there is nysta+m#s of the ontralateral a!d# tin+ eye ( a#sed !y e1 essi$e inner$ation to the normal lateral re t#s in a ordan e "ith <erin+'s la") diplopia is a feat#re
&5.
a.F
!.F
.F
d.F
e.T
feat#res of on+enital third ner$e palsies and those a#sed !y t#mo#rsD ane#rysms and tra#ma !#t not those d#e to is haemi ophthalmople+ia %no"n feat#res in l#de: ele$ation of the #pper lid on attempted add# tion or depression of the eyeD retra tion of the +lo!e on attempted depression or ele$ation of the eye
&;.
a.F
!.T
.F
d.F
e.T
'a+et's disease
&?.
a.F
!.T
.T
d.T
e.T
9atanaprost:
is a prosta+landin analo+#e more potent than !eta>!lo %er in red# in+ the intrao #lar press#re "or%s !y in reasin+ the #$eal s leral o#tflo" side effe ts in l#de: on-#n ti$al in-e tionD in reased iris pi+mentationD hypertri hosis and o #lar inflammation
&(.
a.F
!.F
.T
d.F
e.T
raised press#re is !elie$ed to !e d#e to !lo %a+e of the tra!e #lar mesh"or% !y the pi+ments there is radial iris transill#mination hi+h intrao #lar press#re follo"in+ e1er ise is a feat#re
,).
a.F
!.F
.T
d.F
e.F
the eye mo$ement is #s#ally normal !#t there may !e si1th ner$e palsy the CT s an sho#ld !e normal in yo#n+ "omen on ontra epti$e pillD !rain s an is important to e1 l#de sa++ital sin#s throm!osis "hi h may presents "ith similar pi t#res opti ner$e fenestration is indi ated if there "ere e$iden e of opti ner$e dysf#n tion the ondition an !e treated "ith di#reti and repeated l#m!ar p#n t#re. =entri #lar> peritoneal is rarely re4#ired.
,1.
a.T
!.T
.F
d.F
e.F
ontra epti$e pill may a#se poor tear se retion and interfere "ith onta t lens "ear rifampi in a#ses dis oloration of se retion in l#din+ the tear "hi h may stain the onta t lens
,&.
a.T
!.T
.T
d.F
e.F
Go#t:
is the res#lt of p#rine meta!olism may !e asso iated "ith e1 ess al ohol ons#mption !#t not a dire t lin% a#ses on-#n ti$itis and s leritis if the #ri on-#n ti$a or s lera rystals "ere to !e ome deposited in the
may a#se #ri a id rystals deposition in the ornea typi ally in the interpalpe!ral fiss#re !#t the rystals are typi ally s#!epithelial
,,.
a.F
!.F
.T
d.T
e.T
Fleis her's rin+ o #rs at the !ase of %erato on#s <#dson>3tahli's line is a normal a+ein+ han+e 3to %er's line is fo#nd in front of a ptery+i#m Ferry's line is fo#nd in front of a !le! iron deposition is ommonly seen near in isions of radial %eratotomy
,0.
a.T
!.F
.F
d.F
e.T
Corneal +rafts:
Ceno+rafts refer to transplant !et"een t"o different spe ies iso+rafts refer to transplant !et"een t"o identi al t"ins lamellar %eratoplasty is not s#ita!le for F# h's dystrophy "here the endotheli#m is non> f#n tionin+
!lood transf#sion does not appear to affe t +raft s#r$i$al. In some transplant li%e renalD pre$io#s transf#sion a t#ally has a positi$e effe t !ro%en s#t#re an eli it neo$as #lariCation leadin+ to in reased re-e tion
,5.
a.T
!.T
.F
d.F
e.F
Goldenhar's syndrome:
is a type of hemifa ial mi rosomia sporadi o #rren e fa ial asymmetry "ith mandi!#lar hypoplasia prea#ri #lar appenda+esD malformation of the earD hearin+ loss a#sed !y e1ternal ear lesions o #lar feat#res: epi!#l!ar dermoidsD lim!al dermoidsD eyelid olo!omas and s#! #taneo#s dermoids of the lids
,:.
a.T
!.F
.T
d.F
e.T
Colo#r defe t:
ma #lar pro!lems #s#ally a#se loss of !l#e/yello" olo#r dis rimination opti ner$e defe ts tend to res#lt in red / +reen olo#r defe t
,;.
a.F
!.T
.T
d.T
e.F
in$ol$ement of other ner$es in the a$erno#s sin#s s# h as fo#rth ner$eD si1th ner$eD fifth ner$e ( a#sin+ red# ed orneal refle1 and de reased fa ial sensation)D and sympatheti ner$e (p#pil onstri tion).
,?.
a.T
!.T
.F
d.F
e.T
dilated s#perior ophthalmi $ein an !e seen on CT s an d#e to on+estion !lood in the 3 hlemmn's anal o #rs d#e to raised epis leral press#re as the t"o a$erno#s sin#ses are inter onne tedD #nilateral fist#la an a#se ontralateral proptosis there are t"o types of fist#la: the hi+h flo" in "hi h there is dire t onne tion !et"een the internal arotid artery and the a$erno#s sin#s this is seen in the tra#mati ases. The lo" flo" is the d#ral fist#la "hi h res#lts from a onne tion !et"een the menin+eal !ran hes of the internal arotid or e1ternal arotid artery and the a$erno#s fist#la. The lo" flo" is typi ally seen in post>menopa#sal "omen "ith history of atheros lerosis or hypertension hi+h flo" fist#la rarely lose spontaneo#sly "hereas the lo" flo" loses spontaneo#sly in a!o#t 5)* of ases
,(.
a.T
!.F
.T
d.T
e.F
@>lin%ed ondition:
Fa!ry's disease is an @>lin%ed re essi$e disorder a#sed !y the defi ien y of the enCyme +ala tosidase Refs#m's disease is an re essi$e ondition in "hi h there is a defe t in the fatty a id meta!olism and res#lt in in reased le$els of phytani a id 8orrie's disease is an @>lin%ed re essi$e disorder "ith o #lar dys+enesis "ith pro+ressi$e a#ditory and mental impairment. Choroideremia is an @>lin%ed re essi$e disorder "ith !ilateral pro+ressi$e de+eneration of the horio apillaris.
Rod mono hromatism (a hromatopsia is an a#tosomal re essi$e disorder "ith red# ed $isionD nysta+m#sD photopho!ia
0).
a.F
!.F
.F
d.T
e.T
Mesodermal dys+enesis:
.1enfeld's syndrome is asso iated "ith posterior em!ryoto1on and iris strands e1tendin+ onto the ornea. Iris hypoplasia is a feat#re of Rei+er's anomaly .1enfeld's syndrome is an a#tosomal dominant disorder Rie+er's anomaly is asso iated "ith posterior em!ryoto1onD prominent iris pro esses and iris stroma atrophy. Rie+er's syndrome is Rie+er anomaly pl#s s%eletalD fa ialD ranial and dental anomalies peter's anomaly onsists of !ilateral entral orneal opa ity d#e to defe ts in the posterior stroma. 5)* of ases ha$e +la# oma
01.
a.T
!.F
.F
d.T
e.T
9atti e de+eneration:
fo#nd in ?* of the pop#lation a#ses &5* of the retinal deta hment has a hi+her in iden e amon+st the hi+h myopes retinal deta hment #s#ally o #rs d#e to tear at the periphery of the de+eneration rather than d#e to the hole "ithin the latti e e1tensi$e ases are !etter treated "ith ryotherapy
0&.
a.T
!.T
.F
d.F
e.T
!#llo#s deta hment ma%in+ hole or tear identifi ation diffi #lt immo!iliCed retina raised intrao #lar press#re inferior retinal deta hment
0,.
a.T
!.T
.T
d.F
e.F
an a#se retinal tear and atara t C,F? has a lon+er half life than 3F: and also more e1pansile. C,F? typi ally e1pands to 0 times its $ol#me "here as 3F: only & to , times and therefore C,F? also a#ses more si+nifi ant in rease in intrao #lar press#re than 3F:
00.
a.T
!.F
.F
d.F
e.T
In ptosis s#r+ery:
!ro" s#spension allo"s the frontalis to perform #pper lids ele$ation and is therefore re ommended in se$ere on+enital ptosis Fasa$ella>3er$ant is reser$ed for mild ptosis pre$io#s ptosis res#lts in distortion of the normal lid anatomy ma%in+ posterior approa h #ns#ita!le in mito hondrial myopathy poor Aell's phenomenon is often a feat#re and ma1imal
rese tion an res#lt in orneal e1pos#re assessment of Aell's phenomenon and orneal sensation are essential prior to s#r+ery to a$oid e1pos#re %eratitis
05.
a.F
!.T
.F
d.T
e.F
stren+thenin+ of the ipsilateral s#perior o!li4#e s# h as t# %in+ "ea%enin+ of ipsilateral inferior o!li4#e (mye tomy or re ession) "ea%enin+ of the ontralateral inferior re t#s (re ession)
0:.
a.T
!.T
.T
d.F
e.F
seen in 5* of hyphaema a#sed !y passa+e of erythro yte !rea%do"n prod# t into the stroma it is ommoner in: re #rrent hyphaemaD lar+e hyphaemaD presen e of endothelial dysf#n tion and ele$ated intrao #lar press#re learin+ of the stainin+ typi ally !e+ins peripherally and mo$e entrally. This may ta%e months or years
0;.
a.F
!.F
.F
d.F
e.F
3taphylo o #s epidermidis is the most ommon patho+en a ordin+ to the 2ndophthalmitis =itre tomy 3t#dyD the ma-ority of patients present at : days after operation the 3t#dy also sho"s systemi anti!ioti is of no $al#e and treatment sho#ld in l#de intra$itreal anti!ioti s the role of steroid is ontro$ersial !#t not ontraindi ated my oti a#ses tend to ta%e lon+er to de$elop
0?.
a.F
!.T
.F
d.F
e.F
9aser iridotomy:
dar% olo#r iris a!sor!s ar+on laser "ell and therefore respond !etter than li+ht olo#r iris less ener+y is #s#ally re4#ired for E.G than ar+on laser raised intrao #lar press#re may !e red# ed "ith anti>+la# oma treatment s# h as iodipine patient iridotomy is indi ated "hen pi+ment is seen flo"in+ o#t of the hole atara t may o #r !#t is #s#ally lo aliCed and of no $is#al si+nifi ant.
0(.
a.F
!.F
.F
d.T
e.F
history of hepatitis A or <I= are ontraindi ated lo" endothelial ell o#nt ontri!#te to early orneal de ompensation
5).
a.F
!.T
.F
d.F
e.T
hi+h po"er an lead to si+nifi ant inflammation and anterior syne hiae is !etter in those o$er 5) years of a+e red# ed press#re is d#e to alternation of the a4#eo#s o#tflo" prod# es a drop of press#re of !et"een 5 to 1) mm<+ is #sed "hen the patient is not responsi$e to ma1imal medi al therapy for +la# oma
51.
a.F
!.F
.T
d.F
e.F
Refra ti$e s#r+ery: radial %eratomy is s#ita!le only for myopes "ith less than ?6 of myopia. 9on+ term sta!ility is a pro!lem in !et"een 15 to ,)* of patients "ith hypermetropi shift and there are ompli ations asso iated "ith the pro ed#res in l#din+ loss of !est orre ted $is#al a #ityD +lareD di#rnal fl# t#ation of $is#al a #ity and et . remo$al of s#t#re alon+ the a1is of the lar+est pl#s ylinder is #sef#l in red# in+ asti+matism %eratomile#sis in$ol$es remo$al of the anterior part of the orneal tiss#e "hi h is then ar$ed on its posterior stromal s#rfa e to alter its radi#s of #r$at#re !efore repla in+ it.
5&.
a.T
!.T
.T
d.F
e.F
Red# tion of post>operati$e asti+matism: red# ed !y small in ision red# ed !y in ision far from the entre of the ornea and therefore lim!al !etter than orneal approa h and temporal orneal approa h !etter than s#perior approa h (the
5,.
a.T
!.F
.T
d.F
e.F
.nterior aps#le remo$al: aps#lorrhe1is is a more diffi #lt te hni4#e to master than aps#lotomy !#t prod# es a stron+er ed+e and a#ses less displa ement of the lens d#e to more e4#al distri!#tion of for e sho#ld the aps#le #nder+oes fi!rosis
50.
a.F
!.F
.T
d.T
e.F
Inferior o!li4#e re ession: a "ea%enin+ pro ed#re is performed in the follo"in+ sit#ation: primary inferior o!li4#e o$era tion as in =>pattern esotropia or se ondary inferior o$era tion as in ipsilateral s#perior o!li4#e palsy or ontralateral s#perior re t#s palsy is more diffi #lt to perform than mye tomy as the m#s le needs to !e reatta hed posteriorly
55.
a.F
!.F
.F
d.T
e.T
/nre o$ered si1th ner$e palsy: !ot#lin#m to1in in-e tion red# es the pro!lem of medial re t#s ontra t#re !#t does not speed #p re o$ery
rese tion/re ession of the affe ted eye an mo$e the eye into the primary position and red# es diplopia in this position operation on more than t"o m#s les is asso iated "ith anterior se+ment is haemia Faden's pro ed#re on the ontralateral medial re t#s prod# es pro+ressi$e "ea%enin+ on add# tion "hi h mat hes the poor a!d# tion of the affe ted eye
5:.
a.F
!.T
.F
d.T
e.T
Cystoid ma #lar oedema: $is#ally insi+nifi ant CMO o #rs in a!o#t 15* of patients #nder+oin+ e1tra aps#lar atara t e1tra t as demonstrated !y fl#ores ein an+io+raphy. =is#ally si+nifi ant CMO only o #rs in a!o#t 1* of these patients the ris% of CMO is hi+her in intra aps#lar atara t e1tra tion than e1tra aps#lar e1tra tion other ris% fa tors in l#de: prolapsed $itreo#sD malpositioned of the intrao #lar lens and post>operati$e endophthalmitis.
5;.
a.F
!.T
.T
d.F
e.F
The lassifi ation of retinopathy of premat#rity is as follo": 3ta+e 1: presen e of demar ation line 3ta+e &: presen e of demar ation line that protr#des into the $itreo#s 3ta+e ,: presen e of peripheral retina fi!ro$as #lar proliferation 3ta+e 0: s#!total retinal deta hment 3ta+e 5: total retinal deta hment
5?.
a.F
!.F
.T
d.T
e.F
'se#doe1foliation syndrome: ompare "ith primary open an+le +la# omaD the intrao #lar press#re is more diffi #lt to ontrol "ith medi ation and there is +reater in iden e of asymmetry of +la# oma. Other"iseD the a+e ran+e is identi al and the s# ess rate of tra!e #le tomy is not different there is presen e of pi+ments in the tra!e #lar mesh"or% alled the 3ampaolesi's line
5(.
a.T
!.T
.F
d.T
e.F
Radiation therapy:
the patholo+y appears similar to dia!eti retinopathy "ith o l#si$e mi roan+iopathy se ondary to loss of endothelial ell and apillary los#re the lo"est report dose is 11 Gy the photore eptors are more resistant than the $as #lar ells the dama+e of "hi h is the main a#se of radiation therapy patients "ho are on hemotherapyD hypertensi$e and dia!eti are more $#lnera!le to radiation therapy hyper!ari o1y+en is of #npro$en !enefit
:).
a.T
!.T
.F
d.T
e.T
9o al anaesthesia:
peri!#l!ar anaesthesia relies on diff#sion of the anaestheti a+ents into the m#s le one to a hie$e anaesthesia "hereas "ith retro!#l!ar anaesthesiaD the anaestheti a+ents are in-e ted dire tly into the m#s le one
li+no aine "or%s faster than mar aine !#t the d#ration of a tion is shorter topi al ametho aine an a hie$e ade4#ate anaesthesia of ornea and on-#n ti$a !#t no the iris retro!#l!ar haemorrha+e in reases the or!ital press#re and therefore the ris% of e1p#lsi$e haemorrha+e
M#ltiple Choi e I#estions on Medi al Retina ( li % the n#m!er for the ans"ers)
a. it is an a#tosomal re essi$e disorder !. it has a f#ndal appearan e similar to patients "ith retinopathy of premat#rity
horiodopathy):
a. myopia is an asso iation !. more male than female are affe ted
. $itritis is ommon
0. The follo"in+ are tr#e a!o#t I'C= (idiopathi polypoidal horiodal $as #lopathy): a. it is seen e1 l#si$ely in patients of .fri an ori+in. !. it a#ses re #rrent $itreo#s haemorrha+e
d. the ondition is hara teriCed !y dilated horoidal is !est seen "ith indo yanine +reen an+io+raphy
5. 3ti %ler's syndrome: a. is an a#tosomal dominant ondition !. is asso iated "ith retinal deta hment in &)* of the patients
:. The differen es !et"een .R8 (a #te retinal ne rosis) and 'OR8 (pro+ressi$e o#ter retinal ne rosis) in l#de: a. .R8 is asso iated "ith herpes simple1 $ir#s !#t not 'OR8 !. .R8 has a "orse $is#al pro+nosis than 'OR8
;. Tr#e statements a!o#t $i+a!atrin in l#de: a. it is the first line of treatment in patient "ith petit mal !. it is a G.A. transaminase inhi!itors
?. O+# hi's disease: a. is an a#tosomal dominant ondition !. is hara teriCed !y stationary ni+ht !lindness
(. Retinal rystals are seen in the #se of: a. tamo1ifen !. hydro1y hloro4#ine
. antha1anthin
d. desferrio1amine
1). In retinopathy a#sed !y sha%en !a!y syndrome: a. the patient is #s#ally !et"een the a+e of , and 5 years of a+e !. the retinopathy may resem!le entral retinal $ein o l#sion
11. The follo"in+ si+ns fa$o#r the dia+nosis of entral retinal artery o l#sion rather than ophthalmi artery o l#sion:
a. the presen e of herry red spot !. the presen e of relati$e afferent p#pillary defe t
1&. The follo"in+ onditions an +i$e rise to the lini al appearan e of ystoid ma #lar oedema !#t "itho#t fl#ores ein an+io+raphi e$iden e of late fl#ores ein lea%a+e: a. epiretinal mem!rane !. Ir$ine>Gass syndrome
d. ni otini a id ma #lopathy
e. Goldman>Fa$re syndrome
1,. The follo"in+ retinal findin+s are asso iated "ith rhe+mato+eno#s retinal deta hment: a. pa$in+ stone de+eneration !. ysti retinal t#ft
e. meridonal folds
10. Feat#res of a #te ma #lar ne#roretinopathy in l#de: a. para entral s otoma !. mild $itritis
a. retinal an+ioma is seen in 5)* of the patients !. an+ioma of the dis may mimi horoidal neo$as #lariCation.
e1#dation
1:. Tr#e statements a!o#t 3tar+ardt's disease in l#de: a. the ma-ority of the ases are inherited in an a#tosomal dominant pattern !. the ondition is symptomati in the first or se ond de ade of life
1;. In By!#rn>Mason's syndrome: a. is an @>lin%ed inheritan e !. the f#ndal appearan e is a#sed !y arterio$eno#s omm#ni ation
a. ele troretino+ram is dia+nosti of 3tar+ardt's disease !. amplit#de of ele troretino+ram is red# ed in arriers of horoideremia
. ele tro>o #lo+ram li+ht pea% to dar% tro#+h ratio is normal in ad#lt onset fo$eoma #lar dystrophy
&). The follo"in+ m# opolysa haridosis are asso iated "ith pi+mentary retinopathy:
. 3 heie's syndrome
d. Moratea#1>9amy's syndrome
e. 3ly's syndrome
&1. The follo"in+ onditions are asso iated "ith an opti ally empty $itreo#s and peripheral pi+mentary han+es:
d. Fa$re>Goldmann's syndrome
e. 7earn>3ayre's syndrome
&&. The follo"in+ statements are tr#e a!o#t Kansen's disease and Ba+ner's disease: a. !oth onditions ha$e a#tosomal dominant inheritan e !. !oth onditions are asso iated "ith in reased retinal deta hment rate
a. more ommon in "omen than men !. more ommon in the temporal ar ade than the nasal ar ade
. retinal artery o
l#sion
e. pro+ressi$e enlar+ement and therefore early treatment "ith treatment "ith laser photo oa+#lation is re ommended
&0. In ar inoma asso iated retinopathy (C.R): a. the ondition is a paraneoplasti syndrome !. olo#r $ision and ni+ht !lindness are typi al presentation
&5. 6eafness and pi+mentary retinopathy are seen in the follo"in+ onditions: a. /sher's syndrome
!. on+enital r#!ella
. on+enital syphilis
d. <#nter's syndrome
e. Refs#m's syndrome
&:. 8orrie's disease has the follo"in+ feat#res: a. mental retardation !. histolo+y of the retina re$eals rosette formation
. @>lin%ed inheritan e
d. deafness
&;. In @>lin%ed retinos hisis: a.the splittin+ of the retina o #rs at the le$el of inner ple1iform layer !. ele trophysiolo+y re$eals ne+ati$e 2RG
e. myopia is ommon
&?. In 2T6R3 (2arly Treatment 6ia!eti Retinopathy 3t#dy) si+nifi ant ma #lar oedema is defined as: a. hard e1#dates "ithin 5))#m of the fo$ea !. retinal thi %enin+ "ithin 5))#m of the fo$ea
d. retinal thi %enin+ +reater than one dis area in siCe and "ithin one dis diameter of the entre of the fo$ea
&(. The follo"in+ are tr#e re+ardin+ the re ommendations of the Aran h Retinal =ein O l#sion 3t#dy for patient "ith !ran h retinal $ein o l#sion: a. fl#ores ein an+io+raphy sho#ld !e performed "ithin fo#r "ee%s of the onset of !ran h retinal $ein o l#sion
!. presen e of more than 5 dis diameter of is haemia sho#ld !e treated "ith pan>photo oa+#lation . ma #lar oedema sho#ld !e treated "ithin & months of the onset of !ran h retinal $ein o l#sion
,). The follo"in+ are the findin+s from the 6ia!etes Control and Compli ations Trial: a. ti+ht +ly aemia ontrol red# es the pro+ression of dia!eti retinopathy in !oth ins#lin and non>ins#lin dependent dia!eti !. the need for ma #lar laser treatment is de reased in "ell> ontrolled +ro#p
1.
a.F !.T
.T
d.T
e.T
F2=R is normally an a#tosomal dominantly inherited disease !#t @>lin%ed inheritan e has !een des ri!ed. altho#+h !oth eyes are affe tedD the de+ree of in$ol$ement
may !e $ery asymmetri al. the f#nd#s appearan es may !e onf#sed "ith retinopathy of premat#rity (RO') it is hara teriCed !y peripheral areas of a$as #larity in the peripheral retinaD almost indistin+#isha!le from RO'. The la % of history of premat#re !irthD lo" !irth "ei+htD or o1y+en therapy differentiates this ondition from retinopathy of premat#rity. dra++in+ of the retina temporally "ith $essel strai+htenin+D s#!retinal e1#dationD i atriCation and retinal deta hment are all feat#res of this ondition. Compli ations in l#de neo$as #larisation in the peripheral retina. treatment "ith ryotherapy to neo$as #lar areasD and s leral !# %lin+ and $itre tomy pro ed#res for tra tional deta hments ha$e all !een #sed in the treatment.
relentless pro+ression is #n ommon. =is#al impairment tends to o #r early and it is rare to lose $ision after the a+e of ,) #nless the patient de$elops tra tional retinal deta hment.
&.
a.T
!.F
.F
d.F
e.F
an idiopathi onditions "hi h may !e pre ipitated !y p#n tate inner horoiodapthy ('IC)D m#ltifo al horoiditis (MIC) or m#ltiple e$asnes ent "hite dot syndrome (M2B63) it is hara teriCed !y a rapid loss of $is#al field "hi h
han+es
initial presentation is "ith photopsia and in reased !lind spot in the presen e of normal $is#al a #ity. 9aterD the $is#al field is de reased "ith de reased $is#al a #ity. fl#ores ein an+io+raphy is not helpf#l as it is normal or mi+ht only sho" the pre ipitation ondition initially. In ele trophysiolo+yD the ele tro>o #lo+ram (2OG) li+ht rise is often red# ed and the 2RG is #s#ally $ery a!normal. there is no effe ti$e treatment. In some patientsD the $ision ret#rns spontaneo#sly.
,.
a.T
!.F
.F
d.F
e.F
horiodopathy ('IC)
patients presents "ith !l#rred $isionD para entral s otoma and photopsia.
the a #te lesions are small yello" lesions "ith sli+htly f#CCy !orders. there are no ells or other si+ns of inflammation in the $itreo#s or anterior ham!er. the lesions +rad#ally e$ol$e into "ell defined s ars and
$iral prodrome is not asso iated "ith 'IC the $is#al pro+nosis of eyes "ith that do not de$elop s#!fo$eal C8= is $ery +ood.
0.
a.F
!.T
.T
d.T
e.T
Idiopathi polypoidal horoidal $as #lopathy (I'C=) is also %no"n as posterior #$eal !leedin+ syndrome and m#ltiple re #rrent serosan+#ineo#s R2' deta hment syndrome. altho#+h ori+inally des ri!ed in !la % hypertensi$e females in middle a+e. It is no" !een re o+niCed in other ra es. the hara teristi lesion appears to !e an inner horoidal $as #lar net"or% of $essels endin+ in an ane#rysmal !#l+e or o#t"ard pro-e tion. re #rrent and m#ltiple R2' deta hments "ith or "itho#t the asso iated s#!retinal !leedin+ (posterior #$eal !leedin+ syndrome) may then o #r. the a!sen e of dr#senD retinal $as #lar disease and intrao #lar inflammation is hara teristi of the ondition. =itreo#s haemorrha+e may also o #r.
the lesions "ere ori+inally des ri!ed to !e peripapillary in lo ationD !#t p#re ma #lar lesions ha$e also !een reported.
it has a !etter pro+nosis than other a#ses of haemorrha+i deta hments of the retina. 6ire t laser therapy to the
lesion appears to arry a !etter pro+nosis in I'C= ompared to laser therapy of C8= in .M6 patients.
5.
a.T
!.F
.T
d.T
e.T
a#tosomal disorders
o #lar feat#res in l#de myopiaD atara tsD stra!ism#sD and opti ally>empty $itreo#s $itreo#s tra tion and latti e de+eneration m#ltiple retinal !rea%s o #rs in more than ;5* of the patients. systemi manifestation in l#de ma1illary and mandi!#lar hypoplasiaD left palateD a!normal #$#laD ne#rosensory hearin+ loss and s%eletal a!normalities "ith -oint hypere1tensi!ilityD and marfanoid ha!it#s :. a.F !.F .F d.T e.T
6ifferen e !et"een .R8 and 'OR8: !oth onditions are asso iated "ith herpes $ir#s hiefly herpes simple1 and Coster !oth onditions an lead to retinal deta hment .R8 is seen !oth in healthy and imm#no ompromised patients "hereas 'OR8 is seen e1 l#si$ely in .I63 or imm#no ompromised patients $itritis is often se$ere in .R8 !#t is #s#ally minimal or a!sent in 'OR8
.R8 responds to intra$eno#s a y lo$ir !#t 'OR8 responds poorly and 'OR8 patients
;.
a.F
!.T
.F
d.T
e.F
=i+a!atrin:
indi ated only "hen all other appropriate antiepilepti dr#+ om!inations ha$e pro$ed ineffe ti$e or poorly tolerated is an G.A. transaminase inhi!itor indi ated as first line therapy only in infantile spasm a!o#t 1/, of epilepsy patients #sin+ it ha$e hara teristi $is#al field defe ts "hi h an $ary from asymptomati to se$ere and disa!lin+ the defe t is not re$ersi!le e$en "ith essation of the therapy the a#se of the $is#al field loss is #n%no"n
?.
a.F
!.T
.F
d.T
e.F
O+# hi disease:
is a form of on+enital stationary ni+ht !lindness is hara teriCed !y a +olden/+rey>"hite dis oloration of the retina +i$in+ a metalli sheen to the !a % of the eye. This disappeared "hen the f#nd#s "as $ie"ed after some time in the dar% and has !e ome %no"n as the MiC#o>8a%am#ra phenomenon. $is#al a #ityD olo#r $ision and $is#al fields are #s#ally normal in O+# hi disease. t"o +enes in$ol$ed in O+# hi disease ha$e !een identified
and in l#de: arrestinD a +ene lo ated in the re+ion of the distal arm of hromosome &4D and rhodopsin %inase. The arrestin m#tations are more ommon in Kapanese O+# hi diseaseD and rhodopsin %inase in 2#ropean O+# hi disease.
patients are asymptomati in li+htD !#t are ni+ht !lind. dar% adaptation sho"s e1tremely retarded rod f#n tion.
(.
a.T
!.F
.T
d.F e.F
dr#+>ind# ed: tamo1ifen antha1anthin tal metho1yfl#rane meta!oli disorders ysintonosis primary o1alosis type 1 others Aietti retinal dystrophy
3-or+ren>9arsson syndrome
1).
a.F
!.T
.T
d.F
e.F
typi ally o #rs in hildren less than , years of a+e and res#lts from $iolent sha%in+ there is no e1ternal eye in-#ry !#t the posterior se+ment sho"s retinal haemorrha+es (!oth intra and s#!retinal) and $itreo#s haemorrha+e s%#ll fra t#re is #n ommon !#t CT s an re$eals s#!ara hnoid or intra ere!ral haemorrha+es $omitin+D lethar+y and fo al ne#rolo+i findin+s are ommon the $is#al pro+nosis is poor d#e to ma #lar s arrin+D $itreo#s haemorrha+e and retinal deta hment
11.
a.F
!.F
.F
d.T
e.T
!oth +i$e herry>red spot in the a #te phase !oth a#ses relati$e afferent p#pillary defe t in ophthalmi artery o l#sionD the a and ! "a$es on the 2RG are a!normal d#e to ins#lt to the o#ter and inner retina in ophthalmi artery o l#sionD !oth the horoidal and retinal ir #lation are delayed
in ophthalmi artery o l#sionD the R2' is dist#r!ed res#ltin+ in pi+mentary han+es at a later date
1&.
a.F
!.F
.T
d.T
e.T
some ases of retinitis pi+mentosa @>lin%ed -#$enile retinos hisis Goldman>Fa$re syndrome
ni otini a id ma #lopathy
1,.
a.F
!.T
.F
d.F
e.T
posterior $itreo#s deta hment latti e de+eneration ysti retinal t#ft meridonal folds "hite "itho#t press#re
10.
a.T
!.F
.T
d.F
e.F
an #n ommon ondition "hi h a#ses para entral s otoma in yo#n+ ad#lt f#ndos opy re$eals dar% lesion in the ma #la "hi h is typi ally trian+#lar in shape other"ise the f#nd#s is normal the lesion is onfined to the ma #la and therefore the 2RG is normal the $is#al loss is mild and spontaneo#s re o$ery is ommon
15.
a.T
!.T
.T
d.T
e.T
$on <ippel>9inda#'s syndrome: is an a#tosomal dominant ondition "ith $aria!le penetran e 5)* of the patients has an+iomatosis retinae "hi h may !e fo#nd in the opti dis or the periphery those in the opti dis or -#1tapapillary may mimi horoidal neo$as #lariCation
the an+ioma enlar+es slo"ly leadin+ to $is#al loss mainly thro#+h e1#dati$e ma #lopathy and also $itreo#s haemorrha+eD tra tional retinal deta hment or epiretinal mem!rane 1:. a.F !.T .T d.F e.F
3tar+ardt's disease:
is #s#ally inherited in an a#tosomal re essi$e inheritan e it is re+arded as a type of f#nd#s fla$ima #lat#s lipof#s in s#!stan e is fo#nd "ithin the R2' ells "hi h +i$e rise to dar% horoid d#rin+ fl#ores ein an+io+raphy olo#r $ision defe t alon+ the red>+reen a1is is ommon in late sta+e the ma #la an ass#me !#ll's eye ma #lopathy
most patients !e ome symptomati "ithin the first or se ond de ade of life
1;.
a.F
!.T
.F
d.F
e.T
By!#rn>Mason's syndrome:
hara teriCed !y arterio$eno#s omm#ni ations of the retina and !rain !e+innin+ in adoles en e the arterio$eno#s omm#ni ations of the retina +i$es rise to ra emose ane#rysm of the retina #nli%e $on <ippel 9inda# syndromeD e1#dati$e ma #lopathy is #n ommon instead the $is#al loss is d#e to the loss of apillary !ed or o$erlyin+ of the $essels o$er the ma #la tram>line al ifi ation seen in s%#ll @>ray is hara teristi of 3t#r+e>Be!er's syndrome $is#al field defe t is seen in one>third of the patient d#e to the $as #lar a!normalities 1?. a.F !.F .T d.T e.T
2le trophysiolo+y:
2OG is #sef#l in dete tin+ Aest's disease !#t is normal in ad#lt onset fo$eoma #lar dystrophy ele troretino+ram is a!normal in arrier of @>lin%ed retinitis pi+mentosa and is dia+nosti in 9e!er's on+enital ama#rosis in 3tar+ardt's diseaseD the 2RG is $aria!le and is therefore not #sef#l for dia+nosis arrier of horoideremia has normal 2RG despite han+es in the peripheral retina 1(. a.F !.T .T d.T e.T
it is an a#tosomal re essi$e disorders is hara teriCed !y rystalline deposits in all layers of the retinaD ornea and also in the lympho ytes the rystals are made #p of holesterol and lipid R2' and horoidal atrophy are ommon feat#res patients present "ith ni+ht !lindness and pro+ressi$e $is#al loss 2RG and 2OG are a!normal &). a.T !.T .T d.F e.F
M# opolysa haridosis asso iated "ith pi+mentary retinopathy in l#de: Type I>< (<#rler) Type I>3 (3 heie) Type II (<#nter) Type III (3anfilippo's) Type I= (Mor4#io's)
Type =I (Marotea#1>9amy's syndrome) and type =II (3ly's syndrome) are not asso iated "ith pi+mentary retinopathy
&1.
a.T
!.T
.F
d.T
e.F
Opti ally empty $itreo#s (d#e to $itreo#s li4#efa tion) and peripheral retinal pi+mentary han+es o #r in:
&&.
a.T
!.F
.T
d.T
e.T
!oth onditions are a#tosomal dominant hi+h myopiaD atara t and +la# oma are ommon in !oth onditions the 2RG are a!normal in !oth onditions the 2OG are normal in !oth onditions the main distin+#ishin+ feat#re is the in reased ris% of retinal deta hment in Kansen's disease "hi h is not seen in Ba+ner's disease &,. a.T !.T .T d.T e.F
Ma roane#rysms:
are more ommon in "omen than men fo#nd mainly alon+ the temporal ar ade a#ses retinal artery o l#sionD retinal haemorrha+es and $itreo#s haemorrha+es
symptomati only if it !leeds or a#ses e1#dati$e ma #lopathyD spontaneo#s los#re is ommon d#e to throm!osis IR=.8 syndrome is made #p of Idiopathi Retinal =as #litisD .ne#rysms and 8e#roretinitis. It is hara teriCed !y !ilateral m#ltiple !ilateral ma roane#rysms &0. a.T !.T .F d.T e.F
is a paraneoplasti syndrome olo#r $ision defe tD ni+ht !lindness and rapid $is#al loss are typi al presentation the ondition may present !efore the dia+nosis of the primary t#mo#r "hi h is typi ally oat ell ar inoma of the l#n+ a#toanti!odies are ommonly seen in the !lood !oth rod and one 2RG are a!normal
Con+enital syphilis Con+enital r#!ella /sher's syndrome Co %aryne's syndrome .lstroms syndrome 9e!er's ama#rosis .lport's syndrome <#nter's syndrome (M' II)
&:.
a.T
!.T
.T
d.T
e.T
8orrie's disease:
a rare @>lin%ed disorders !ilateral !lindness "ith a!normal retina de$elopment rosette formation is ommon in retina histolo+y 1/, has hearin+ a!normality retrolental masses are ommon "hi h may !e mista%en for retino!lastoma
&;.
a.F
!.T
.F
d.T
e.F
splittin+ of the retina o #rs at the ner$e fi!re layer ele trophysiolo+y re$eals ne+ati$e 2RG "ith normal a "a$e !#t red# ed ! "a$e the main a#se of $is#al loss is entral ma #lar a!normalities other a#ses of $is#al loss in l#de retinal deta hment and $itreo#s haemorrha+e hypermetropia is an asso iation 68. analysis is #sef#l in dete tin+ the arrierD the a!normal +ene is lo ated at @9R31+ene on the short arm of the @> hromosome &?. a.F !.T .F d.T e.F
retinal thi %enin+ "ithin 5)) mi rons of the entre of the fo$ea hard e1#date "ithin 5)) mi rons of the entre of the fo$ea "ith ad-a ent retinal thi %enin+ one dis area of retinal thi %enin+D any part of "hi h is "ithin 1 dis diameter of the entre of the fo$ea
&(.
a.F
!.F
.F
d.F
e.F
no treatment for ma #lar oedema for at least , months fl#ores ein an+io+raphy is not #sef#l at the time of presentation d#e to retinal haemorrha+esD it is only #sef#l "hen the haemorrha+es lear laser treatment is #sef#l in patients "ith $ision of :/1& or less and "itho#t e$iden e of ma #lar is haemia on fl#ores ein an+io+raphy altho#+h se torial panphoto oa+#lation is #sef#l in red# in+ the ris% of $itreo#s haemorrha+e in those patients "ho ha$e more than 5 dis diameter of is haemiaD the re ommendation is for the 'R' to !e performed only in the presen e of neo$as #lariCation and not !ased on is haemia of more than 5 dis diameter as the ma-ority of the eyes do not de$elop neo$as #lariCation ,). a.F !.T .T d.T e.F
Findin+s of the 6ia!etes Control and Compli ations Trial are: intensi$e ins#lin treatment res#lted in a statisti ally si+nifi ant red# tion in in iden e and pro+ression of 6R and the need for ma #lar laser panphoto oa+#lation or 'R'
these only apply to ins#lin dependent dia!eti initial "orsenin+ d#rin+ the first year "as noted in some eyesD !#t after , years there "as a !enefi ial effe t on pro+ression of 6R se$ere hypo+ly aemia "as more ommon in the ti+ht ontrol +ro#p
. ? year>old +irl "as referred "ith a history of sore eyes "hen "at hin+ T= and readin+ the !la %!oard. <er parents omplained that her eye appeared to "onder o#t at times. The $is#al a #ity "as :/: in !oth eyes. .lternate o$er test re$ealed e1ophoria "ith slo" re o$ery "ith the an+le of de$iation meas#rin+ ,5 prism dioptre at distan e and 1) prism dioptre at near. Follo"in+ a pat h testD she meas#red ,5 prism dioptre at distan e and 15 dioptre at near. (I#estions 1 > ,)
a. the patient has intermittent e1otropia of the di$er+en e e1 ess type !. !ino #lar sin+le $ision may !e s#ppressed for distant fi1ation !#t normal "ith near fi1ation
d. mioti
e. !ase>in prisms
,. Operation "as arried o#t "ith !ilateral lateral re t#s re ession. One day post>operati$eD the patient meas#red 1) prism dioptres of onse #ti$e esotropia. The follo"in+ are tr#e: a. pat hin+ of the +ood eye sho#ld !e arried o#t !. pres ri!e prism to maintain !ino #lar f#sion
d. o$er orre tion of e1otropia is desira!le and the patient sho#ld !e reass#red
. : year>old +ird "as referred ha$in+ mo$ed into yo#r area. 3he "as pre$io#sly #nder the are of another hospital and had s4#int operation for a on$er+ent s4#int "hi h "as present sin e infan y. <er $is#al a #ity "as :/( in the ri+ht eye and :/: in the left. Co$er test re$ealed a small ri+ht e1otropia of 5 prism dioptres. The o$ered eye sho"ed ele$ation and nysta+m#s "as o!ser$ed "hen either eye "as o$ered.The nysta+m#s "as a!sent "hen !oth eyes "ere #n o$ered. (I#estions 0 > :) 0. The follo"in+ are tr#e:
a. the esotropia prior to the s#r+ery "as li%ely to !e more than ,) prism dioptres !. the patient is li%ely to ha$e hi+h hypermetropia in the ri+ht eye
a. it is termed manifest latent nysta+m#s !. the fast phase is to"ard the side of the #n o$ered eye
. 5 year>old hild is referred the orthopti !e a#se of stra!ism#s. The findin+s in l#de an esotropia of &) prism dioptre in the primary position "ith limited a!d# tion of the ri+ht eye. On add# tionD there is narro"in+ of the lid fiss#re and #pshootin+ ot he ri+ht. The
a. the hild is li%ely to !e male than female !. the patient is li%ely to ha$e a ri+ht fa e t#rn
. the narro"in+ of the lid is a#sed !y a!errant re+eneration of the third ner$e
?. The follo"in+ may !e asso iated "ith this ondition: a. Mar #s G#nn Ka" "in%in+ !. ro odile tears
. +la# oma
d. atara t
e. mi rophthalmos
d. rese tion of the m#s les may "orsen narro"in+ of the lid
. &0 year>old man "as referred to the eye as#alty !e a#se of intermittent $erti al diplopia. .lternatin+ o$er test re$ealed a $erti al phoria and "hen loo%in+ at a "hite dot thro#+h Maddo1 rods thro#+h !oth eyes he des ri!ed the lines as follo":
(I#estions 1) > 1,) 1). The follo"in+ are tr#e if the patient had a fo#rth ner$e palsy:
a. the patient has a ri+ht fo#rth ner$e palsy !. "hen the $erti al diplopia is presentD the left eye may !e hyperde$iated
. "ith the first step of the three step testsD the ri+ht eye "ill sho" hyperphoria
d. "ith the se ond step of the three step testD the left eye "ill sho" hyperphoria in left +aCe
e. "ith the third step of the three step testD the ri+ht eye "ill
11. The follo"in+ feat#res fa$o#rs a on+enital to an a 4#ired fo#rth ner$e palsy: a. a!sen e of y lotorsion
!. an a!normal head post#re onsists mainly of hin depression . positi$e Aiel ho"s%y head tilt test to either side
e. lar+e = pattern
1,. 3#r+i al treatment in this patient may in l#de: a. ri+ht inferior o!li4#e re ession !. ri+ht s#per re t#s re ession
. :0 year>old man omplains of horiContal diplopia "hi h is "orse on ri+ht +aCe. (I#estions 10 > 1;) 10. The follo"in+ are tr#e if he had a si1th ner$e palsy:
a. a ri+ht esotropia "hi h is "orse for distan e than near !. a fa e t#rn to the left
d. = pattern on #p+aCe
15. The follo"in+ m#s le se4#elae may o #r if he had a si1th ner$e palsy: a. ontra tion of the ri+ht lateral re t#s !. ontra tion of the ri+ht medial re t#s
1:. The follo"in+ additional si+ns and the lo ation of the lesion are tr#e:
a. !ilateral s"ollen dis > posterior fossa t#mo#r !. ri+ht miosis and ptosis > a$erno#s sin#s lesion
d. ri+ht fa ial ner$e palsy and anal+esia and loss of taste to anterior t"o third of the ton+#e > dorsal pon
1;. Treatment of this patient may in l#de: a. in-e tion of !ot#lin#m to1in into the ri+ht medial re t#s !. !ase o#t Fresnel prism o$er the ri+ht eye
d. re ession of the left medial re t#s and rese tion of the ri+ht lateral re t#s
e. re ession of the ri+ht medial re t#s and rese tion of the left lateral re t#s
a. it may res#lt from operation for on+enital esotropia !. the an+le of de$iation is typi ally !et"een 15 and &) prism dioptres
1(. 3pasm#s n#tans: a. #s#ally !e+ins at , years of a+e !. is asso iated "ith head noddin+
a. #s#ally !e+ins aro#nd the a+e of & years !. may !e a#sed !y a hi+h .C/. ratio
d. diplopia is rare
e. am!lyopia is #n ommon.
MCIs on /$eitis 1. The mat hin+ of the follo"in+ diseases and their <9. asso iation are tr#e:
<9.>.11
<9.>A5
<9.>AB5
e. =o+t>7oyana+i><arada
<9.>A&&
a. ytome+alo$ir#s retinitis
!. serpi+iono#s horoidpathy
a. a history of $is eral lar$a mi+rans is al"ays present !. e1amination of the patient's stool is #sef#l in dia+nosin+ the disease
. !ilateral o #lar in$ol$ement sho#ld ma%e one do#!t the a #ra y of the dia+nosis
a. the #$eitis is #s#ally +ran#lomato#s !. the eyes are typi ally "hite
5. The follo"in+ are tr#e "ith re+ard to atara t in -#$enile hroni arthritis:
a. atara t sho#ld not !e performed !efore the patients is ? year>old !. operation sho#ld !e performed only "hen the anterior ham!er is free of flare
a. it is rarely seen in patients "ith a C6 0H o#nts of more than 5) ells/#l !. it a#ses f#ll thi %ness retinal ne rosis
a. +an i lo$irD fos anet and idofo$ir are all $irostati !. +an i lo$ir a#ses !one marro" s#ppression
e. re #rrent CM= retinitis is rare in patients on a maintenan e dose of +an i lo$irD fos anet or idofo$ir
a. it red# es the re #rrent rate of CM= retinitis !. it is #sef#l in maintainin+ a hi+h le$el of C6 0H o#nts
a. !rain a!s ess o #rs in 0)* of ases !. the retinitis is more se$ere than imm#no ompetent patients
1). . pre+nant "oman de$elops to1oplasmosis in her first trimester of pre+nan y. The follo"in+ are tr#e:
a. there is a 0)* han e of the fet#s a 4#irin+ the infe tion !. s#!se4#ent offsprin+s are at ris% of infe tions
a. it is asso iated "ith m#ltiple s lerosis in 5* of ases !. sheathin+ of the $ein is a#sed !y peri$as #lar #ffin+ of lympho ytes
d. $itreo#s !alls are omposed of epitheloid ells and m#ltin# leated +iant ells
1&. . &) year>old man omplains of de reased ri+ht $ision. Fo#r "ee%s earlierD he had #nder+one an e1tensi$e !o"el operation for Crohn's disease and had re ei$ed hyperalimentationa dn intra$eno#s anti!ioti s sin e the operation. On f#ndal e1aminationD a fl#ffy "hite horoidal lession is seen near the ma #la. There is minimal $itritis. The follo"in+ are tr#e a!o#t the or+anisms most li%ely to !e responsi!le for this ondition:
a. #lt#re of the !lood is #s#ally positi$e !. altho#+h ommonly seen in the respiratory tra tD it rarely a#ses pne#monia
a. there is loss of retinal pi+ment epitheli#m and the horoid !. the lesion typi ally !e+ins near the opti dis
d. fl#ores ein an+io+raphy in the a #te phase re$eals early hyperfl#ores en e of the lesions
e. systemi
10. Tr#e statements a!o#t .'M''2 (a #te posterior m#ltifo al pla oid pi+ment epitheliopathy)
a. females are more ommonly affe ted than males !. re #rren e does not o #r
. in the later phase of the fl#ores ein an+io+raphyD the lesions appears hyperfl#ores ent
. rifampi in
d. di+o1in
e. alpha> hymotrypsin
a. there is raised intrao #lar press#re !. the #nderlyin+ a#se is rhe+mato+eno#s retinal
deta hment
y litis:
a. 7oeppe's nod#les are seen !. a!normal $essels are seen !rid+in+ the an+le of the tra!e #lar mesh"or%
a. is painless
d. is a self>limitin+ ondition
ystitis
&). . &5 year>old man from the Middle 2ast omplains of !l#rred ri+ht $ision. On e1aminationD he "as fo#nd to ha$e a small hypopyon in the ri+ht anterior ham!er. 'osterior se+ment of the ri+ht eye re$eals sheathin+ of the !lood $essels "ith retinal haemorrha+es. <e +a$e a past history of painf#l lesions in his mo#th and his +enitals. The follo"in+ are tr#e a!o#t this ondition:
a. histopatholo+y of the painf#l lesion re$eals patho+nomoni feat#re !. p#n t#rin+ the s%in "ith an hypodermi needle may !e #sef#l in dia+nosis
. the posterior se+ment patholo+y is a#sed !y inflammation of the retina and horoid
d. oral steroid alone is #s#ally effe ti$e in pre$entin+ relapse of the o #lar inflammation
Gla# oma 1. The follo"in+ $is#al field defe ts are typi ally seen in primary open an+le +la# oma:
. entral s otoma
&. 2arly si+ns of +la# omato#s dama+e in l#de: a. splinter haemorrha+e of the opti dis !. +la# ofle %en
e. peripapillary atrophy
. tan+ent s reen
d. O top#s
e. <#mphrey
. Thorpe
d. Jeiss
e. Aar%an
a. the pi+ments is a#sed !y the release of melanin from the anterior s#rfa e of the iris !. the in iden e of affe ted male to female is 5:1
d. hetero hromia an o #r
d. hypotony
e. ne#rofi!romatosis
a. laser iridotomy is ineffe ti$e a+ainst phar omorphi +la# oma !. pha olyti +la# oma is hara teriCed !y !lo %a+e of the tra!e #lar mesh"or% !y protein laden mar opha+es
. pha olyti +la# oma typi ally o #rs follo"in+ atara t e1tra tion
atara t
?. In a patient "ith an+le re ession +la# omaD +onios opy may re$eal:
a. separation of the iliary !ody from its atta hment to the s leral sp#r !. in reased $isi!ility of the s leral sp#r
d. mar%ed $ariation in the iliary !ody "idth in different 4#adrant of the same eye
a. the in iden e is 1:1&D5)) !irths !. the orneal diameter is #s#ally +reater than ? mm
a. pilo arpine is the treatment of hoi e in patient "ho an not ta%e !eta !lo %ers !. +irls "ith pa# iarti #lar -#$enile rhe#matoid arthritis are
. simple tra!e #le tomy is asso iated "ith hi+h fail#re rate
d. irido y litis is often asso iated "ith lo" rather than hi+h intrao #lar press#re
a. a false>ne+ati$e response: fail#re to respond to a s#prathreshold stim#l#s at a lo ation that the patient "o#ld !e e1pe ted to see !. fi1ation loss: o #rs "hen the patient responds to a tar+et sho"n at his !lind spot
e. short term $ariation refers to han+e in sensiti$ity "hen the same area is retested.
1,. The follo"in+ +la# oma are asso iated "ith !ilateral primary a!normalities of the orneal endotheli#m:
. Co+an>Reese syndrome
a. 1)* of patients do not sho" therape#ti response !. therape#ti response is red# ed in patients on systemi !eta>!lo %ers #se
. the additi$e effe t on +la# oma is in reased if it is om!ined "ith topi al adrenaline than "ith topi al a etaColamide
d. !eta1olol is more effe ti$e than timolol in lo"erin+ intrao #lar press#re
15. The ris% of de$elopin+ steroid>ind# ed +la# oma is in reased in the follo"in+ onditions:
d. dia!etes mellit#s
a. 8d:E.G laser re4#ires fe"er appli ation ompared "ith ar+on laser !. !leedin+ is less ommon "ith ar+on than 8d:E.G laser
. late los#re of the iridotomies is ommoner "ith ar+on than 8d:E.G laser
a. it sho#ld !e a$oided in patients aller+i to s#lphonamides !. it is asso iated "ith meta!oli a idosis
en ephalopathy
1?. The follo"in+ are tr#e a!o#t a4#eo#s draina+e de$i es:
a. all ontain a sili one t#!e atta hed to a syntheti plate !. orneal de ompensation is a %no"n ompli ation
a. they are applied to the s leral flap d#rin+ tra!e #le tomy !. they in rease the in iden e of post>operati$e endophthalmitis
e. mitomy in C is asso iated "ith a hi+her in iden e of "o#nd lea% than 5>fl#oro#ra il
d. prod# es miosis
Gla# oma 1. The follo"in+ $is#al field defe ts are typi ally seen in primary open an+le +la# oma:
. entral s otoma
&. 2arly si+ns of +la# omato#s dama+e in l#de: a. splinter haemorrha+e of the opti dis !. +la# ofle %en
e. peripapillary atrophy
. tan+ent s reen
d. O top#s
e. <#mphrey
. Thorpe
d. Jeiss
e. Aar%an
a. the pi+ments is a#sed !y the release of melanin from the anterior s#rfa e of the iris !. the in iden e of affe ted male to female is 5:1
d. hetero hromia an o #r
d. hypotony
e. ne#rofi!romatosis
a. laser iridotomy is ineffe ti$e a+ainst phar omorphi +la# oma !. pha olyti +la# oma is hara teriCed !y !lo %a+e of the tra!e #lar mesh"or% !y protein laden mar opha+es
. pha olyti +la# oma typi ally o #rs follo"in+ atara t e1tra tion
?. In a patient "ith an+le re ession +la# omaD +onios opy may re$eal:
a. separation of the iliary !ody from its atta hment to the s leral sp#r !. in reased $isi!ility of the s leral sp#r
d. mar%ed $ariation in the iliary !ody "idth in different 4#adrant of the same eye
a. the in iden e is 1:1&D5)) !irths !. the orneal diameter is #s#ally +reater than ? mm
a. pilo arpine is the treatment of hoi e in patient "ho an not ta%e !eta !lo %ers !. +irls "ith pa# iarti #lar -#$enile rhe#matoid arthritis are more li%ely to de$elop +la# oma than their male o#nterpart
. simple tra!e #le tomy is asso iated "ith hi+h fail#re rate
d. irido y litis is often asso iated "ith lo" rather than hi+h intrao #lar press#re
a. a false>ne+ati$e response: fail#re to respond to a s#prathreshold stim#l#s at a lo ation that the patient "o#ld !e e1pe ted to see !. fi1ation loss: o #rs "hen the patient responds to a tar+et sho"n at his !lind spot
e. short term $ariation refers to han+e in sensiti$ity "hen the same area is retested.
1,. The follo"in+ +la# oma are asso iated "ith !ilateral primary a!normalities of the orneal endotheli#m:
. Co+an>Reese syndrome
a. 1)* of patients do not sho" therape#ti response !. therape#ti response is red# ed in patients on systemi !eta>!lo %ers #se
. the additi$e effe t on +la# oma is in reased if it is om!ined "ith topi al adrenaline than "ith topi al a etaColamide
d. !eta1olol is more effe ti$e than timolol in lo"erin+ intrao #lar press#re
15. The ris% of de$elopin+ steroid>ind# ed +la# oma is in reased in the follo"in+ onditions:
d. dia!etes mellit#s
a. 8d:E.G laser re4#ires fe"er appli ation ompared "ith ar+on laser !. !leedin+ is less ommon "ith ar+on than 8d:E.G laser
. late los#re of the iridotomies is ommoner "ith ar+on than 8d:E.G laser
a. it sho#ld !e a$oided in patients aller+i to s#lphonamides !. it is asso iated "ith meta!oli a idosis
1?. The follo"in+ are tr#e a!o#t a4#eo#s draina+e de$i es:
a. all ontain a sili one t#!e atta hed to a syntheti plate !. orneal de ompensation is a %no"n ompli ation
a. they are applied to the s leral flap d#rin+ tra!e #le tomy
e. mitomy in C is asso iated "ith a hi+her in iden e of "o#nd lea% than 5>fl#oro#ra il
d. prod# es miosis
1. The follo"in+ are tr#e a!o#t atara t: a. it is the most ommon a#se of !lindness in the "orld !. n# lear s lerosis red# es the distant $ision more than near
. posterior s#! aps#lar atara t is more li%ely to a#se pro!lem "ith distant $ision than near
e. o#tdoor "or%ers are more li%ely to de$elop atara t than indoor "or%ers
a. Bilson's disease > s#n>flo"er atara t !. myotoni dystrophy > Christmas tree atara t
a. it is asso iated "ith myopia !. it an a#se p#pillary !lo % +la# oma "hi h sho#ld !e treated "ith mydriati
. hypo al emia
d. hypo+ly aemia
e. #raemia
a. phenothiaCine !. e hothiopate
. aspirin
d. lo$astatin
a. eye defe t typi ally o #rs "ith infe tion d#rin+ the first trimester of pre+nan y !. lamellar atara t is the most ommon type of atara t seen in on+enital r#!ella
. $iral parti les #s#ally remain in the lens parti le lon+ after !irth
d. myopia is ommon
a. =ossi#s rin+ is a#sed !y the imprint of the p#pillary pi+ment on the lens !. =ossi#s rin+ a#ses de reased $ision in the ma-ority of patients
?. In on+enital atara t:
atara ts remo$ed !efore three months of a+e !. intrao #lar lens sho#ld !e #sed
d. post>operati$e $is#al a #ity is #s#ally !etter in patients "ith #nilateral atara t than !ilateral atara t
a. 'MM. is the most ommon material #sed in ma%in+ folda!le lens !. 'MM. transmits a !roader spe tr#m of li+ht than nat#ral lens
d. sili one lens tends to !e thinner than 'MM. for the same dioptre po"er
e. a#ses osteoporosis
a. 2ls hni+ pearls > proliferation of lens epitheli#m onto the posterior aps#le !. posterior s#! aps#lar atara t > !ladder ells
e. 3oemmerrin+ rin+ > se4#estration of proliferatin+ lens fi!res in the e4#atorial re+ion of the aps#le
1,. In a : month old !a!y "ith !ilateral atara tD #rine test is #sef#l in:
. 9o"e's syndrome
d. a!etalipoproteinemia
e. ystinosis
a. the ondition is a#tosomal dominant !. the most ommon form is a#sed !y +alatose>a>phosphate #ridyl transferase defi ien y
15. Fa tors that an in rease intra$itreal press#re d#rin+ pha oem#lsifi ation in l#de:
d. horoidal haemorrha+e
a. they are leared in an #nmeta!olised state !y filtration thro#+h the tra!e #lar mesh"or% !. sodi#m hyal#ronate has a hi+her pse#doplasti !eha$io#r than hondroitin s#lphate
. they are to1i to the endotheli#m if not remo$ed at the end of the s#r+ery
a. is ommonly seen in +lass !lo"ers !. is most ommonly in the fifth de ade of life
d. a#ses iridonosis
a. easier deli$ery of the n# le#s d#rin+ e1tra aps#lar atara t operation !. holds the n# le#s in the aps#lar !a+ d#rin+ pha oem#lsifi ation
e. less li%elihood of anterior aps#lar tear e1tendin+ into the posterior aps#le
1(. Catara t e1tra tion in an eye that had pre$io#s par plana $itre tomy is asso iated "ith an in reased ris% of :
d. +lo!e ollapse
&). Tr#e statements a!o#t the aspiration systems #sed in pha oem#lsifi ation in l#de:
a. diaphra+m p#mp prod# es the slo"est !#ild #p of $a ##m !. peristalti p#mp allo"s linear ontrol of $a ##m
. =ent#ri p#mp is asso iated "ith the hi+hest ris% of inad$ertent en+a+ement of #n"anted tiss#e
e. hi+h aspiration is needed d#rin+ the early sta+e of pha oem#lsifi ation