SOAL-SOAL TRY OUT UNSRI JANUARI 2009

1. A 60 years old woman came to policlinic with chief complain glare and
poor vision under bright light conditions. She also complain of increasing
difficulty reading the newspaper. After complete examination this patient
diagnosed with cataract. Which type of lens opacity is she most likely to
have ?
a. posterior subcapsular
b. nuclear
c. cortical
d. anterior polar
e. anterior subcapsular
Jawab : A (AAO 2008-2009 sect 11 hal 46-47)

2. This woman`s type of lens opacity can induce by some medicine. What
kind of medicine is that ?
1. Corticosteroids
2. Statins
3. Phenotiazines
4. Miotics
Jawab : E (AAO 2008-2009 sect 11 hal 52-53)

3. The ophthalmologist plan to do cataract surgery in this patient with

retrobulbar anesthesia. The complication that can happen cause by
retrobulbar anesthesia is
1. retrobulbar hemorrhage
2. brain stem anesthesia
3. globe penetration
4. cardiac arrhythmias
Jawab : E (AAO 2008-2009 sect 11 hal 100)
4. Before doing cataract surgery in this patient, the ophthalmologist do
preoperative preparation to reduce risk of endophthalmitis. Which of the
following preoperative measures has proven most effective in reducing the
risk of endophthalmitis ?
a. administering oral amoxicillin beginning 3 days before surgery
b. prescribing topical antibiotics for 2 weeks following surgery
c. decreasing the duration of cataract surgery
d. administering topical 5% povidon iodine solution at the time of surgery
e. injecting vancomycin into the infusion / irrigating solution
Jawab : D (AAO 2008-2009 sect 11 hal 190)

5.Besides endophthalmitis, what kind of other complication that can happen

to this women following cataract surgery ?
1. elevated intraocular pressure
2. corneal melting
3. cyclodialysis
4. toxic solutions
Jawab : E (AAO 2008-2009 sect 11 hal 163-178)

6. A 10 years old boy with a history of atopy presents with a seasonally

recurrent bilateral conjunctivitis and complains of blurred vision, itching in his
eyes and photophobia since 5 days ago. Giant papillae are seen in the upper
tarsus.
All the following could also be seen on the slit lamp except:
A. Pannus in the superior cornea
B. shield like shape epithelial ulcer with underlying stromal opacification in
central corne
C. Horner trantas dots in the limbus
D. Conjunctival scarring & can produce symblefaron formation
E. Neovascular
Answer: D Source: AAO 2008-2009 section 8, page 197

7. Laboratory finding from conjunctival inflammatory infiltrates in patient

number 6 are:
A. Eosinophils, lymphocytes, basophils, monocytes
B. Eosinophils, lymphocytes, plasma cells, monocytes
C. Eosinophils, lymphocytes, leucocytes, monocytes
D. Eosinophils, lymphocytes, basophils, leucocytes
E. Eosinophils, basophils, monocytes, neutrophil
Answer: B Source: AAO 2008 – 2009 section 8, page 197

8. Below are the management for patient number 6, except:

A.Topical antihistamine
B.Mast cell stabilizers
C.Antibiotics
D.Immunomodulator agent
E.Corticosteroid
Answer: C, Source: AAO 2008 – 2009 section 8, page 197

9. A 45 years old man presents with chief complain is vesicles on the skin and
eyelid margin in the left eye since 4 days ago. There are Swollen eyelid,
redness, foreign body sensation, blurred vision in left eye since 3 days ago.
From physical examination, there is a palpable preauricular lymph node. No
history of the same disease before.
Which of the following therapies would be most appropriate?
a.Vidarabine 3% ophthalmic ointment 5x/day for 10 days
b.Acyclovir 1% ophthalmic ointment 5x/day for 10 days
c.Trifluridine 3% ophthalmic solution 8x/day for 10 days
d.Acyclovir 400 mg 3x/day for 10 days
e.Acyclovir 800 mg 3x/day for 10 days
Answer: A Source: AAO 2008 – 2009 section 8, page 135-37
10. Below are complications that can be happen in disease number 9, except:
a. Epitheliopathy
b. Neurotrophic keratopathy
c. Ptosis
d. Metaherpetic ulcer

Answer: C Source: AAO 2008 – 2009 section 8, page 144-45

11. A man 70 years old come to eye clinic with main complain sudden visual
lost. Funduscopy examination macular edema, tortois retinal veins, intra
retinal hemorrahages in all of quadrant .what is the diagnosis of this patient :
A. BRVO
B. CRVO
C. BRAO
D. CRAO
E. Ablatio retina
Answer: Source: B AAO 2008 – 2009 section 12 p. 154-157

12. What is the suitable therapy of this patient :

A. Pan retinal photocoagulation
B. Focal laser photocoagulation
C. Grid laser photocoagulation
D. Laser photocoagulation
E. IVTA
Answer: Source: A (AAO 2008 – 2009 section 12 p. 157-158 )

13.A Lady 50 years old come to eye clinic with main complain small visual
field defect in her right eye. VA is 6/12. Fundus examination intra retinal
hemorrhage segmental and triangular shape which extended from artery
venous crossing, along the vascular arcade. What is the diagnose of this
patient
A. BRVO
B. BRAO
C. CRAO
D. BRAO
E. Ablatio retina
Answer: A Source: (AAO 2008 – 2009 section 12 p 150-152)

14. What is the suitable therapy of this man

A. Pan retinal photocoagulation
B. Focal laer photocoagulation
C. Grid laser photho coagulation
D. Laser photocoagulation
E. IVTA

Answer:C Source (AAO 2008 – 2009 section 12 p 152-154)

15. A man 40 years old come to eyeclinic with maincomplain non insulin
depending diabetes. Fundus examination CSME and neovascularitation and
vitreous hemorrhage what is the therapy of this patient
A. scatter photocoagulation
B. Focal laser photocoagulation
C. Blood sugar control
D. Laser photocoagulation
E. Buckle Sclera
Answer: A Source (AAO 2008 – 2009 section 12 p 124)

16. A woman, 28 years old, came to Mohammad Hoesin hospital with chief
complain she had blurred vision since 1 week ago, no redness or eye pain.
Ophthalmology examination found visual acuity in left eye 1/60 and right eye
6/6, anterior segment both eyes were quite. From funduscopy we found the
pale yellow or gray white raised lesion in the posterior pole and perivasculitis.
The diagnosis of this patient is :
a. Ocular histoplasmosis syndrome
b. Toxocariasis
c. Toxoplasma chorioretinitis
d. Birdshot chorioretinitis
e. Necrotizing herpetic retinitis
Answer C(AAO 2008-2009 Section 12 page 211-212)

17. The treatment for this patient :

a. Vitrectomy
b. Prednison and pirimethamin
c. Thiabendazole
d. Tetracycline
e. Acyclovir
Answer B(AAO 2008-2009 Section 12 page 212)

18. A 59 years old man with blood pressure of 180/95 mmHg has linear flame
shaped hemorrhages at the margin of the optic disc, blurring of the disc
margins, congestion of associated retinal veins, and secondary macular
exudates. The most probable differential diagnosis in this patient was :
a. BRVO
b. BRAO
c. CRVO
d. Retinal Arterial Macroaneurysms
e CRAO
Answer C(AAO 2008-2009 section 12 pg 154-155)

19. A man, 56 years old, suffered diabetic non-obese for 10 years, came to
hospital with chief complain blurred vision in both eyes. From funduscopy
 we found hard exudates, retinal edema. Diffuse intraretinal hemorrhages
and venous beading in 2 quadrants. Intraretinal microaneurysma in 1
quadrant. The diagnosis of this patient is :
a. mild NPDR (background diabetic retinopathy)
b. severe NPDR
c. moderate NPDR
d. PDR
e. very mild NPDR
Answer B (AAO 2008 – 2009 Section 12, pg 120)

20. A 68 years old man complained of sudden onset of decreased vision,

metamorphosia, paracentral scotomata in both of his eyes. There was
elevation of the RPE, subretinal lipid deposit, and PED. In order to
diagnosing whether there’s also choroidal neovascularization in this
patient, it’s best to us to perform
A. Indocyanine green angiography
B. Contrast Sensitivity test
C. Farnsworth Panel D-15 test
D. Fluorescent Angiography
E. Dark adaptation test
Answer D (AAO 2008 – 2009 Section 12, pg 73)

A 65 years old woman came to Eye clinic of RSMH with main complain
sudden blurred vision and metamorphopsia and paracentral scotoma
since 1 months ago. The examination found that: REVA 6/21 ph (-) and
LEVA 6/6, normal anterior segment and Posterior segmen found:
drussen , geographic atrophy and area of hyperpigmentasi and CNV
21. What the diagnosis of this patient?
1. Nonneovascular AMD
2. Nonexudative AMD
3. Dry AMD
 4. Neovascular AMD
Answer (D) AAO 2008 -2009:12:71

22. What kinds of the risk factor?

1. Light iris color
2. Female gender
3. Hyperopia
4. Cigarette smoking
Answer (E) AAO 2008 -2009 section12:71

23. What is the gold standar for diagnosing CNV

A. Indirect ophthalmoscop
B. Fluorescein angiography
C. OCT
D. Perimetry
E. Foto fundus
Answer (B) AAO 2008 -2009 section 12 p. 73

A 44 years old woman came to Eye clinic with main complain blurred
vision since 6 months ago. ROVA; 6/30 ph (-) , anterior segment got
acute iritis with hypopion systemic disease found: oral ulcer and genital
ulcer.

24. What should have be found at Posterior Segment involvement?

1. Occlusive retinal vasculitis

2. Drussen

3. Marked vitritis
4. Macular hole
Answer : (B) AAO 2008 -2009 section12:181
25. A 65 years old complains bitterly that she doubled vision ever since regaining
consciousness the day after the accident two months after a car accident. She
has a 30 ∆ esotropia in primary position at 6 m and moderate limited or abduction
on the left eye.
Treatment option at this time at this included all of the following except:
A. patch the affected eye
B. fit the a fresnel prism to her glasses
C. injection botulinum toxin to the ipsilateral medial rectus muscle
D. resect the lateral rectus muscle and recess the medial rectus
muscle of the affected eye
E. Spontaneous resolution may occur in more than half of patient
(Answer: C, AAO 2008-2009, page 107-108, section 6)

26. From the questions above, if botulinum toxin (botox) is injected into the
ipsilateral antagonist medial rectus of the patient in question no.1. What is the
most common complication that may arise?
A. ptosis
B. induced vertical deviation
C. globe perforation
D. paradoxical contracture
E. Permanent Diplopia
Answer A : AAO 2008-2009 page 196, section 6)

27. Sixth months after repair of a orbital floor blow out fracture in the right orbit,
the patient shown has vertical diplopia when he tries to read. He demonstrated
2∆ right hiperphoria in primary position but a 25∆ right hypertropia in down gaze.
Limitation of depression of the right eye after blow out fracture in down gaze.
The most suitable procedure for the patient is:
A. a Faden procedure
B. a right Harado Ito procedure
 C. recession of the contralateral inferior rectus with or without
an adjustable suture
D. recession of the ipsilateral inferior rectus with an adjustable
suture
E. recession of the ipsilateral inferior rectus without an
adjustable suture

Answer : C, AAO 2008-2009 ,page 140, section 6)

28. You are called into the clinic to see a four month old infant because the
parents think the child’s eyes have turned in since birth. The infant clearly has a
40∆ esotropia on your examination. Which of the following diagnosis is most
likely?
A. infantile esotropia
B. congenital sixth nerve palsy
C. duane’s syndrome
D. Bief episode of the overconvergence
E. Brown Syndrome
Answer : A , AAO 2008-2009 Section 6,page 97-98

29. A patient, 41 years old female, was complaining of headache and pain
around the eyes. The intraocular pressure was 39 mmHg. From the perimeter
examination, there was a decrease in field vision at the nasal region. The
anterior chamber angle needs to be determined. Which of the following are
not the structures of anterior chamber angle?
A. Scwalbe’s line
B. Schlemm’s canal
C. Endothel of the cornea
D. Scleral spur
E. Trabecular meshwork
Answer : C, AAO 2008-2009,Section 2, p.52
30. A boy, 9 years old, come to ophthalmology with chief complain lost of vision
gradually, painless at the left eye.in examination found displaying proptosis
with esotropia. Funduscopy examination found note swollen disc with
obscured disc margin.CT and MRI show fusiform enlargement of the optic
intracranial disease. Which of following diagnosis most likely?
a. Optic Nerve Glioma
b. Neurofibroma
c. Meningioma
d. Schwannoma
e. Lymphoma
Answer: A, AAO 2008 – 2009, Section 7, p 71

31. Management therapy of the up side can be considered by Radiation

therapy if :
1. Particularly with good vision on the involved side
2. Tumor growth rapidly
3. Radiographic evidence is characteristic the glioma is
confined to the orbit
4. Symptoms(particularly neurologic) progress

Answer D : AAO 2008 – 2009 section 7, p 73

32. Neurofibromatosis type 1 is associated with all of the following except:

a. Skin lesions known as adenoma sebaceum
b. Cafe-au-lait skin lesions
c. Plexiform neurofibromas in the eyelids
d. Optic nerve glioma
e. Congenital glaucoma
Answer : A, AAO 2008 – 2009 section 7, p 75
33.Fifty eight years old female was consulted from the internal medicine with
complain of watery eyes and has history of diabetes mellitus for ten years. The
break-up time test was normal and the schirmer test was 10 mm. The patient
was diagnosed with dried eye syndrome. Which one of the tear film layers had
the deficiency?
a. Mucin
b. Lipid
c. Aquous
d. Mucous
e. Mucin and Lipid

Answer : C, Source AAO Sec 2, 2008-2009, p 294-296

34.Based on the scenario above, what is the test to examine the quantity of tear
film?
1. Break-Up Time
2. Ferning test
3. Impresisitologi
4. Schirmer test
Answer : E AAO 2008-09 section 2 p. 294

35. Male, 70 years old came to policlinic with complain a 2 years history of a
painless, Progressive enlarged mass in central aspect of right upper eyelid.
This has resulted in distortion of the eyelid margin and loss of eyelashes.
Phisical examination pearly white on the mass and prominent vessels.
He have history of prolonged sun exposure, and history of cigarette smoking.
She never take any medicine before.
The most likely diagnosis is
A. Sebaceous gland carcinoma
B. Squamous cell carcinoma
C. Amelonotic melanoma
 D. Basal cell carcinoma
E. Dermal nevus
Answer D , AAO 2008-2009 Section 7, p 182

36.A woman 48 years old came to eye policlinic with main complain headache
and sometime seen like the rainbow since 3 month ago.The examination found
VOD 6/12PH(-) VOS 6/6.TIODS 25.8mmhg and TIOS 15,6mmhg.Radius
curvature cornea and diameter cornea is small USG: axial length 20mm , Coa
depth 20 mm.Visual field loss ,glaucomatous optic nerve damaged and
gonioscopy PAS are present. The possible diagnosis for this patient is

a. Primary open angle glaucoma

b. Primary congenital glaucoma
c. Primary angle closure glaucoma
d. Pigmentary glaucoma
e. Secondary angle closure glaucoma
Answer : C, AAO 2008-2009, Section 10, p 126-128

37.The same case,during an acute attack the IOP may be high to cause
glaucomatous optic nerve damage, ischemic nerve damaged, PAS can form
rapidly, atrophy of the iris, pupil may become permanently fixed and
dilated.Glaucomflecken is characteristic small anterior subcapsular
opacities.These finding helpful detection of previous episode:
a.Acute secondary angle closure glaucoma
b.Acute primary open angle glaucoma
c.Acute secondary glaucoma
d.Acute congenital glaucoma
e. Acute primary angle closure glaucoma.

Answer :E , AAO 2008-2009, Section 10, p129

38.If disorder disease occurs acute when IOP rises rapidly and manifest by
ocular pain headache blurred vision, rainbow colored halos around lights, nausea
and vomiting. Another sign found Iris bombe, middilated, sluggish and irregularly
shaped pupil, corneal epithel edema, congested episcleral and blood vessels
and amild amount of aquous flare and cells
The definitife treatment is :
a. Iridectomy, laser or surgical
b. Goniotomy
c. Trabeculoplasty
d. Gonioplasty and peripheral iridoplasty
e. Trabeculectomy
Answer A (AAO 2008-2009, section 10, hal: 129

39.An untreated the fellow eye had an acute angle closure attack has a 40%-
80% chance of developing an acute attack over the next…
a. 3-4 weeks
b. 3-4 month
c. 3-4 years
d. 5-10 month
e. 5-10 years
Answer : E (AAO 2008-2009, section 10, pg 130)

40.Characteristic finding primary congenital glaucoma include the classic triad of

presenting symptom in the new born. There are…
a. Epiphora , ambliopia, haab striae
b. Blefarospasme, epifora, ambliopia
c. Photophobia, blefarospasme, haab striae
d. Blefarospasme, epifora, blefarospasme
e. Epiphora, photophobia, blefarospasme.
Answer E AAO 2008-2009 section 10 page 157
41. A woman came to policlinic with chief complain photopsia and floaters in
the right eye since 2 days ago. After ananmnesis, she had scleral buckling
one 6 months ago with similar complain. After ophthalmology examination, we
found VA: VOD 1/~ PSB and VOS 6/6, IOP is 8 mmHg RE and 15.6 mmHg
LE. Funduscopy shows Breaks (+), retinal detachment in temporoinferior and
undulate with eye movement, demarcation line (+).

What`s the best surgery for retinal detachment are following ?

a. Primary vitrectomy
b. Scklera buckle
c. Vitrectomy and scklera buckle
d. Pneumatic retinopexy
e. Needle penetrating of the globe

Jawab: E
AAO section 12 2005-2006 Hal 268 & 335-336

42. According the question above, if the patient had the complain since 2 days
and didn`t have similar complain before, after funduscopy shows retinal
detachment caused by breaks in the superior two thirds of the fundus,
vitreoretinal traction (-).

What`s the best surgery for retinal detachment are following ?

a. Primary vitrectomy
b. Scklera buckle
c. Vitrectomy and scklera buckle
d. Pneumatic retinopexy
e. Needle penetrating of the globe

Jawab: D
AAO section 12 2005-2006 Hal 272

43. Female, 35 years old, weight 65kg had consulted from neurology
department with main complaint headache, nausea, vomiting and diplopia. In
ophthalmology examination visual acuity is normal, visual field show
enlarged blind spot and has papilledema in funduscopy. She has oral
contraceptive more than five years. Which of the following statements is
false?
a. An associated condition cerebral venous obstruction, arteriovenous
malformation, or systemic vasculitis.
b. MRI and lumbar puncture are preferred
 c. Chronic papilledema
d. Idiopathic Intracranial hypertension (IIH)
e. Acetazolmide (Diamox) required for medical therapy, shunting if
severe symptoms and signs unresponsive
Jawaban: C (AAO 2008-2009 Section 5, hal:118-119)

44.A women, 50 years old came to eye clinic with main complaint blurred on
awakening 1 month ago. In examination founded visual acuity OD 20/60, OS
1/60 and has atrophic optic disc and RAPD is present in OS, but edematous in
OD. What is the first step to appropriate manage this patient?
a. CT-Scan
b. Fluorescein angiography
c. Laboratory
d. Early therapy corticosteroid should begin immediately
e. Hyperbaric oxygen and optic nerve sheath decompression surgery
Jawaban: C (AAO 2008-2009, section 5, hal: 123-124)

45. A 25 year old woman was referred due to anisocoria. The patient had not
been aware of the problem. The right pupil was 3 mm and slightly oval in shape,
and left pupil was 5 mm and around. The right pupil reacted poorly to light but
promptly to near, whereas the left pupil reacted normally to both light and near.
Which of the following is the diagnosis?
a. Old Adie’s pupil, right eye
b. Acute Adie’s pupil, left eye
c. Argyll-robertson pupils
d. Physiologic anisocoria
e. Iris damage
Jawaban: A (AAO 2008-2009, section 5, hal: 262-266
46. A man has symptom head ache, nausea & vomiting. He has a gray out of
vision but visual acuity color vision is normal, pupillary response normal,
perimetry examination is normal/only an enlargement of the blind spot, papil
in fundus examination is hyperemic with dilatation of the existing disc surface
capillary net, telangiectasia of the surface & radial peripapillary vessels, &
often flame hemorrhages. Is the diagnosis for this patient?
a. acute papilledema
b. chronic papilledema
c. atrophy papil
d. hypoplasia papil
e. papilitis
Jawaban: A (AAO 2008-2009, section 5, hal:112)

47. A 45 year old presents with painful left horner syndrome of three days
duration. The most appropriate imaging would be
a. MRI/MRA, brain and neck
b. CT head
c. MRI, neck
d. Catheter angiography
e. MRI cavernous sinus
Jawaban: A (AAO 2008-2009, section 5, hal: 262-265

48. A women 23 years old came eye policlinic with chief complain blurred
vision. A patient diagnose have myopia -3 D treated with RGP that is flat K. If
the patient average K reading is 7,4 mm and lens base curve 7,35 mm. What
is the shape of the tear lens
a. plano
b. tear
c. concave
d. convex
e. Toric
Answer C ( AAO 2008-2009:13:181-182)

49. A women 16 years old came eye policlinic with chief complain blurred vision.
Visual acuity in LE 2/60 ph 6/30 and RE 6/9 ph 6/6 with correction OD S-10 C-
2.75 Axis 100→ 6/30 and OS S-0.75C-075 Axis 120 →6/6. Crowding test (+).
Management have been choosen :
a. Spectacles only
b. Contact Lens only
c. Spectacles and occlusion therapy
d. Contact Lens and occlusion therapy
e. None of the above
Answer B, AAO 2008-2009, section 3, page 173-180

50. A man 40 years old came to policlinic with a refraction disorder / astigmatism,
then he got the soft contact lenses for his eyes. What is the most common
adverse reaction to soft contact lenses ?
a. Giant papillary conjungtivitis (GPC)
b. Corneal neovascularization
c. Corneal hypoxia
d. Conjungtivitis
e. Keratitis
Answer: A ,AAO 2008-209, sec 3, pg 197-199

51. An 80-year-old white male presents with poor vision in his right eye with
sudden onset of pain and conjunctival hyperemia. The examination reveals
an IOP of 45 with a prominent cell and flare reaction without keratic
precipitates, a dense cataract, and an open anterior chamber angle. The most
likely diagnosis is
a. phacolytic glaucoma
b. phacoanaphylaxis
c. ICE syndrome
 d. Fuchs heterochromic iridocyclitis
e. Exfoliation syndrome
Answer: A, AAO 2008-2009, Section 10, p 108

52. A 45 years old men complain of difficulty near visual aquity tends to be
reduced more than distance visual aquity. VARE 1/60, VALE 4/60, tends to be
glare under bright lighting condition. Anterior segment examination was quiet
exactly appear granular opacities and a plaquelike opacity of the posterior
subcapsular cortex. Red reflex with the pupil dilated RLE (+), and funduscopy
examination RE detail unclear and LE was normal. Type of this cataract can
occured by:
a. Trauma
b. Exposure to ionizing radiation
c. Inflammation
d. The use of systemic or topical corticosteroid
e. All above correct
Answer : E, Source : AAO 2008- 2009, sect 11 p 46-48

53. A. 22 years old female came to policlinic and main complain photopobia and
decreased visual aquity visual visual aquity both eye Ophthalmological
examination found visual aquity RLE 6/20 PH( - ) , flare cell (+) , KPs (+) and
snowbank on the inferior pars plana .On Peripheral retinal had retinal venous
sheating and no cystoid macular edeme. This patient is often to pain of teeth and
dentist found dental carries. What diagnosis this patient ?
A. Anterior Uveitis
B. Intermediate Uveitis
C. Posterior Uveitis
D. Pan Uveitis
E. Pars Planitis

Answer : B AAO 2008-2009 Sect 9 page 166

54. A 51 years old lady present with a chronic, progressive, painful, idiopathic
ulceration in peripheral corneal and epithelium. The ulcer starts at periphery
of the cornea and spreads circumferentially and then centripetally, with
leading undermined edge of de-epithelized tissue.
This lady suffered from :
a. idiopathic peripheral ulcerative keratitis
b. Superior Limbus Keratitis
c. Ulcus mooren
d . Ulcus marginalis
e. Keratoconjungtivitis Sicca
Answer : C ( AAO 2008-2009 section 8 p. 232-233)

55. A 26 years old myopic man presents with a 5 day history of photopsia,
small scotomas, and blurred vision both eyes. He is recovering from a rescent
flu like illnness. Examination reveals best corrected visual acuity of 20/50 OD
and 20/ 40 OS. Slit lamp examination show mild flare and cell in both anterior
chambers and mild vitreous cell in both eyes. The fundus finding are similary
in both eyes with the multifocal choroiditis and chorioretinal scars in the nasal
retina. Which the following diagnoses is most likely in this patient ?
a. Presumed ocular histoplasmosis syndrome
b. Multifocal choroiditis
c. Birdshot retinochoroidopathy
d. Acute posterior multi focal placoid pigment epitheliopathy
e. Posterior uveitis
Answer :B AAO 2008-2009, sec 9, p 190-191

56. A 27 year old man presents with a history of floaters and blurred vision
OD. The patient was immigrated from India within the last year, is currently
good health, and denies any history of drug use. Two years ago, while in
India, he had a positive tuberkulin skin test and received 9 months of
 prophylactic INH, Rifampin, and Ethambutol therapy. Anterior segment is
normal. The right and left fundus is show retinal neovascularization , Vitreous
hemorrahage is noted in the inferior vitreous OD. No pars plana snowbanks
are noted in either eye.
Which of the following diagnoses is most likely in this patient ?
A. Eale’s disease
B. Sarcoidosis
C. Sickle cell retinopathy
F. Cat-scratch disease
G. Acute Retinal Necrosis
Answer : A AAO 2008-2009 section 9 p. 285-287

57. A father brought his 2 days old boy to an eye policlinic ,whose born with
some abnormality such as strabismus, blepharophitosis , epicantus, cataract,
glaucoma, coloboma of uvea, persistent fetal vasculature, dismorphogenesis
of retina, optic nerve hypoplasia. There was no family history of this
disease.What kind of drug involved in this case?
A. Cocaine
B. Heroine
C. Barbiturat
D. Alcohol
E. Tobacco
Answer : D AAO 2008-2009 section 5 p. 152

A man came to eye clinic at general hospital with main complaint is double vision
after eye injury. Eye examination found deficient elevation in adduction. When
he was in adduction, the palpebral fissure widens and a downshoot of the
involved eye is often seen.
58. A 48 year old man with myopia presents with complain of difficulty driving at
night and monocular diplopia. His best corrected visual aquity with a 2 D myopic
shift is 20/30. On slit lamp examination, he has minimal nuclear sclerosis. What
additional examination is helpful to evaluate his symptoms?
A. Red reflex
B. Corneal topography
C. Flourescen angiography
D. MRI scan.
E. CT scan
Answer: A, Source : AAO 2008-09 sect 11 p 43

59. A 50 years old female for cataract surgery, before operation she get local
anesthetic injection and after that found: orbital swelling, marked proptosis,
elevated intraocular pressure, reduced mobility of the globe, in ability to separate
the eye lids, and massive ecchymosis of the lids and conjunctiva. This condition
caused by:
A. Retrobulber hemorrhage.
B. Suprachoroidal hemorrhage.
C. Suprachoroidal effusion.
D. Expulsive suprachoroidal hemorrhage.
E. Delayed suprachoroidal hemorrhage.
Answer :A, Source:AAO 2008 -09 sect 11 p 169

60. A 60 years old man came to policlinic for control post extra capsular cataract
extraction with intraocular lens two months. His complain decreased visual aquity
since two weeks. Ocular examination found: intraretinal edema with cystoid
spaces. This condition caused by:
A. CME.
B. CSME.
C. Endopthalmitis.
D. Chronic uveitis.
 E. Retinal detachment.

Answer: A, Source:AAO 2008-09 sect 11 p 172

60. A 55 years old men came to policlinic with main complain of monocular
diplopia and glare. His visual aquity LRE 6/60 PH(-). On slit lamp examination, he
has wedge shaped opacities and histopathologically characterized by hydropic
swelling of the lens fibers. What type cataract this patient?
A. Nuclear cataract.
B. Cortical cataract.
C. Posterior subcapsularis cataract.
D. Anterior subcapsularis cataract.
E. Lamellar cataract.
Answer: B, Source: AAO 2008-09 sect 11 p 45-46

61. A 22 years old man came with hyperemia and decreased of visual acuity
of the both eyes. Ophthalmic examinations in the both eyes; Visual acuity:
right eye [ocular dextra (OD)] hand movement, left eye [ocular sinistra (OS)]
hand movement, corneal edema, Mutton fat (+), deep anterior chamber, flare
(+), Iris neovascularisation (+) and bombe, Seclusion (+), pupils 2-3 mm,
membrane (+) in front of the pupil, funduscopy undetectable. Intra Ocular
Pressure (IOP): hypotonic (palpation). Patients with history of irregular control
with ophthalmologist. USG on both of the eyes: vitreous haze, fibrin and
membrane. Despite medical treatment patients give: Intra Vitreal Injection
Triamcinolone acetonide (IVTA) 20-25 mg on the left eyes. 1 day after
operation improvement of visual acuity of the both eyes. Increased of Intra
Ocular Pressure (IOP) after IVTA can occur :
a. Short time after IVTA
b. Long time after IVTA
c. Short and long time after IVTA
d. Depend on the history of Primary Open Angle Glaucoma (POAG)
 e. All the answer are correct
Answer: C Source: AAO 2008-2009: Section 9, pg 121-141

62.The increase of IOP after IVTA for above condition caused by:
a) Migration of crystal Triamcinolone into anterior chamber block
trabecular meshwork
b) Increase of intravitreal cavity volume
c) Decrease of permeability caused by Corticosteroid
d) All the answer are correct
e) All the answer are incorrect
Answer D Source: AAO 2008-2009 Section 9, pg 121-141

63.On the case of intractable IOP increment after IVTA despite of anti glaucoma
agents medication could be managed by:
a. Filtering surgery
b. Vitrectomy and removals of Intravitreal Triamcinolone from the
vitreous cavity
c. Could not be managed by long term corticosteroid
d. Both of A and B
e. A, B, and C are correct
Answer D Source: AAO 2008-2009 Section 9, pg 121-141

64.Which of the following answer is the right reason for repeated intravitreal
triamcinolone:
A. Improvement of visual acuity after IVTA and then decreased
after several months after that
B. No improvement of cystoid macular edema (CME)
C. Increase of vitreous haze
D. Increase of neovascularization in the retina
E. Endophthalmitis
Answer A, Source: AAO 2008-2009 Section 9, pg 121-141

65.A 60 years old female came with hyperemic eyes since 6 months ago,
headache, nausea, seeing halo around the light. Ophthalmic
examinations; visual acuity: OD 0,25 , OS 0,30 , Kps (+), anterior chamber
Von Herrick grade 2, flare (+), iris atrophy (+), bombe (+), sinechia (+) with
pupillary block, reflex (-), diameter of the pupil 5-6 mm, nuclear opacity of
the lens, C/D 0,3-0,4. IOP: OD: 40.2 mm Hg OS: 30,4 mmHg.
Gonioscopy: OD: Peripheral Anterior Synechia (PAS) in 3 quadrants, OS:
PAS in 2 quadrants. Medication and laser iridectomy was failed to control
IOP for the both eyes. After trabeculectomy, OD: there was decrease of
IOP in the right eye. Pupil diameter became 3 mm. The diagnosis was
A. Secondary glaucoma caused by bilateral uveitis
B. Sub acute Primary closed angle glaucoma (PCAG)
C. Phacomorphic glaucoma
D. Posner-Schlosmann syndrome
E. Fuch Heterochromic Iritis
Answer B Source: AAO 2008-2009 Section 10, pg 126-134

66.A 37 years old man came with skin rash and bullae in all of the body.
Ophthalmic examinations in the both eyes: Visual acuity 0,90 [ocular
dextra-sinistra (ODS)], hyperemia of conjunctiva, palpebral margin edema,
clear cornea and mucous secretion. This medical history came after he
took tetracycline 3 days ago. The most important ocular management of
the patient:
A. Antibiotics + anti-inflammatory eye drops
B. Antibiotics + release of the conjunctival membrane
C. Antibiotics + artificial tear
D. Artificial tears + release of the conjunctival membrane
E. Anti-inflammatory eye drops + artificial tears
Answer D Source: AAO 2008-2009 Section 8, pg 216-219

67.The worst chronic complication for the above condition is:

A. Symblepharon
B. Dry Eyes
C. Keratopathy
D. Entropion
E. All the answer is right
Answer C,Source: AAO 2008-2009 Section 8, pg 216-219

68.A 51 years old man came with blind with history of ECCE 15 years ago
OS. OD hyperemic conjunctiva, round pupil 3 mm, reflex was decreased,
iris tremulans, very deep anterior chamber with flare, aphakia, IOP was
increased. There is no sign of intraocular surgery before in OD. Etiology of
increased IOP OD is
A. POAG
B. Secondary glaucoma caused by vitreous block OD
C. Sympatric ophthalmia
D. Lens induced glaucoma, before aphakia caused by illegal
medicine act
E. All answer is wrong
Answer B,Source: AAO 2008-2009 Section 10,pg 138

69.What kind of examination needed for question number 8?

A. Gonioscopy
B. Perimetry
C. Applanation tonometry
D. Ultrasonography (USG)
E. Non contact tonometry
Answer D,Source: AAO 2008-2009 Section 10 pg 138
 70.An 8-years-old girl sustained a left upper eyelid laceration after falling
from her bicycle. The laceration measures 13 mm and extends from above
the lid crease to the eyelid margin. Proper alignment is important to repair
the eyelid margin. All the following will prevent a notch of the eyelid margin
after a laceration repair except:
A. Reapproximating the tarsus
B. Everting sutures at the eyelid margin
C. Inverting sutures at the eyelid margin
D. Reapproximating the eyelid skin edges
E. Tight sutures
Answer C, Source: AAO 2008-2009 Section 7, pg 195-200

71. A 35-year-old patient come to the emergency room. He is struck over the left
eye. The radiography shows a fracture of the orbital floor.
Which one of the following bones orbita that contain of orbital floor?
a. Frontal, maxilla, palatine
b. Frontal, maxilla, orbital plate of zygomatic
c. Sphenoid, frontal, maxilla
d. Maxilla, palatine, orbital plate of zygomatic
e. Ethmoidal, maxilla, palatine
Answer D (AAO 2008-2009 P. 8, section 2)

72. A 65-year-old woman presents in your office with chief complaint disability in
opening the right eyelid. After examination, the diagnosis of this patient is ptosis.
Which of the following muscle is the most elevates the upper eye lid?
a. M. Levator palpebra
b. M. Rectus superior
c. M. Obliqus superior
d. M. Sfingter pupillae
e. M. Orbicularis Oculi
Answer A (AAO 2008-2009, section 2 P. 26 )

73.A 20 years old woman came with redness on her both eyes, she also suffer
fom rhinitis allergic and asthma. Which one is the most signified for this symptom:
a.Foreign body sensation
b.Itching
c.Sandy feeling
d.Deep pain
e.Lid pain

Answer : B (AAO 2008-2009 section 8 pg. 208)

74. Patiens came with red nodular mass, location surrounding the eye lashes,
she complains of tenderness and painful.The diagnosis is :
a. Internal hordeola
b.Styes
c.Chalazion
d.Periorbital celulitis
e.Meibomian glan dysfunction

Answer : B (AAO 2008-2009 section 8 pg. 168)

75.The management of the disease above is :

a.Culture
b.Topical antibiotic
c.Systemic antibiotic
d.Warm compress
e.All above is true

Answer : D (AAO 2008-2009 section 8 pg 168)

76.A 6 years old girl present with diffuse, erythematous & edema of the eye lids.
Lids are tenderness to touch and swollen, visual acuity and ocular motility are
normal. The most common organism can cause this problem is:
a.Streptococcus epidermidis
b.Staphylococcus aureus
c.Klebsiella sp.
d.Neiseria meningitidis
e.Pseudomonas aeruginosa

Answer : B (AAO 2008-2009 section 7 page 41-42)

77.A man, 35 years old present with serous discharge and red eye. Which of
the folowing statement aplies to him:
1.pattern of redness tends to be concentrated in the palpebra are rather than
near the cornea
2.palpable lymph node auricular
3.discharge swab revealed lymphosite dominant
4.folicular conjugtivitis

Answer :E (AAO 2008 -2009 section 8 pg 24-25)

78.A 65 years old lady who consumes many drugs for her diseases complained
burning, gritty sensation, reflex tearing and mild redness.
Which of these drugs can influence her symptoms?
1. systemic antihistamine
2. diuretic
3. antidepresant
4. non steroid inflamatory drug

Answer :B (AAO 2008 -2009 section 8, pg 81)

79. A Female model, 17 years old with cosmetic contact lens wear present with
redness, tearing , pain, photophobia and flourescein test positive at 3 and 9
o’clock in the cornea. The management were:
a. prescription of topical anesthesia
b. cyclopentolate 1% topical
c. anti inflamation eye drop 3 times daily
d. antibiotic ointment
e. antifungi eyedrop

Answer : D (AAO 2008 -2009 section 8 pg 406-407)

80.A 51 years old lady present with a chronic, progressive, painful, idiopathic
ulceration in peripheral corneal and epithelium. The ulcer starts at periphery
of the cornea and spreads circumferentially and then centripetally, with
leading undermined edge of de-epithelized tissue.
This lady suffered from :
a. idiopathic peripheral ulcerative keratitis
b. Superior Limbus Keratitis
c. Ulcus mooren
d . Ulcus marginalis
e. Keratoconjungtivitis Sicca

Answer : C ( AAO 2008 -2009 section 8 hal :232)

81.Which one following examination is not present in this disease:

a. Deficiency of Supressor T cell
b. Increased level of Ig A
c. Increased level of Ig G
d. Increased concentration of plasma cells and lymphocytes in the
conjungtiva adjacent to the ulcerated areas
 e. Tissue-fixed imunoglobulins and complements in the conjungtival
epithelium and peripheral cornea

Answer : C (AAO 2008 -2009 section 8 hal : 232)

82.Seorang wanita, 56 tahun mengalami ptosis kelopak mata kanan sebesar 4

mm dan 1 mm retraksi kelopak mata kiri atas. Dia mempunyai lid crease yang
tinggi dan fungsi levatornya baik pada kedua mata. Pilihan terapinya adalah :
a. Reseksi tarsoconjungtiva interna (Fasanella –Servat operation) pada
kelopak atas mata kanan
b. Resesi levator kelopak atas mata kiri
c. Levator aponeurosis advancement pada kelopak atas mata kanan
d. Pendekatan posterior, menggunakan mullerectomy standad pada kelopak
atas mata kanan
e. Suspensi otot frontalis pada kelopak atas mata kanan menggunakan
silikon agar dapat dinilai kembali paska operasi

Jawab : C (AAO 2008 -2009 section 7 hal 220-223)

83. Seorang pemuda berusia 18 tahun datang dengan riwayat kecelakaan lalu
lintas 1 jam sebelum ke Rawat Darurat. Dari pemeriksaan didapatkan laserasi
pada kornea mata kanan. Hasil pemeriksaan dibawah ini dapat memastikan
adanya perforasi bola mata yaitu
a. Bilik mata depan dangkal
b. Kemosis konjungtiva
c. Hipotoni
d . Seidel tes positif
e. Perdarahan subkonjungtiva
Answer : D (AAO 2008 -2009 section 8 hal 409)

84. A man 21 years old had blunt injury after accident motorcycle, according
ophthalmology examination, we found VA: 6/6 RE and 1/300 LE IOP 15.6
mmHg RE and 15.6 mmHg LE. Funduscopy shows : displacement of the
vitreous, Bruch`s membrane may tear along with the overlying RPE,
 subretinal hemorrhage. Ruptures of this part that extend through the central
macular area?

What`s diagnosed for this patient?

a. Vitreous hemorrhage
b. Commotio retinae
c. Choroidal rupture
d. Posttraumatic macular hole
e. Scleral rupture

Jawab: C AAO section 12 2008-2009 Hal 290-295

85. According the statement above, What`s measurement for him?

a. No immediate treatment
b. Amsler grid
c. Photodynamic therapy
d. Grid laser
e. Subfoveal surgery

Jawab: A AAO section 12 2008-2009 Hal 292

86. Dalam menangani laserasi full thickness kelopak mata atas akibat trauma
yang mengenai tepi kelopak mata , seorang oftamologis sebaiknya mengerti
struktur anatomi kelopak mata yang normal. Berdasarkan urutannya :
A. Kulit, preaponeurotic fat, septum, otot orbicularis, aponeurosis levator,
otot Muller’s, conjungtiva
B. Kulit, otot orbicularis, preaponeurotic fat, septum, otot Muller’s,
aponeurosis levator, conjungtiva
C. Kulit, preaponeurotic fat, otot orbicularis, septum, aponeurosis levator,
otot Muller’s, conjungtiva
D. Kulit, otot orbicularis, septum, preaponeurotic fat, aponeurosis levator,
otot Muller’s, conjungtiva
E. Kulit, otot orbicularis,preaponeurotic fat, septum, aponeurosis levator,
otot Muller’s, conjungtiva

Jawab : D (AAO 2008 -2009 section 7, hal 141)

87. A 22 years old man came with hyperemia and decreased of visual acuity of
the both eyes. Ophthalmic examinations in the both eyes; Visual acuity: right eye
[ocular dextra (OD)] hand movement, left eye [ocular sinistra (OS)] hand
movement, corneal edema, Mutton fat (+), deep anterior chamber, flare (+), Iris
neovascularisation (+) and bombe, Seclusion (+), pupils 2-3 mm, membrane (+)
in front of the pupil, funduscopy undetectable. Intra Ocular Pressure (IOP):
hypotonic (palpation). Patients with history of irregular control with
ophthalmologist. USG on both of the eyes: vitreous haze, fibrin and membrane.
Despite medical treatment patients give: Intra Vitreal Injection Triamcinolone
acetonide (IVTA) 20-25 mg on the left eyes. 1 day after operation improvement of
visual acuity of the both eyes. Increased of Intra Ocular Pressure (IOP) after IVTA
can occur :
A. Short time after IVTA
B. Long time after IVTA
C. Short and long time after IVTA
D. Depend on the history of Primary Open Angle Glaucoma
(POAG)
E. All the answer are correct

Answer : C, Source: AAO 2008-2009 Section 9, pg 121-141

88.The increase of IOP after IVTA for above condition caused by:
a. Migration of crystal Triamcinolone into anterior chamber block
trabecular meshwork
b. Increase of intravitreal cavity volume
c. Decrease of permeability caused by Corticosteroid
d. All the answer are correct
e. All the answer are incorrect

Answer : D, Source:AAO 2008-2009 Section 9,pg 121-141

89. A woman 56 years old came to policlinic with chief complain of the sudden
onset of decreased vision, metamorphopsia, and paracentral scotoma.
Clinically, there may be elevation of the RPE; subretinal or intraretinal lipid,
 fluid, or blood; pigment epithelial detachment; retinal epithelial tears; and
occasionally the gray-green CNV lession itself is seen, retinal angiomatous
proliferation lesion (+). After FFA we diagnosed classic CNV and then we do
PDT.

What`s it recently been approved for the treatment of... with PDT besides
AMD?
1. subfoveal CNV secondary to ocular histoplasmosis syndrome
2. central serous chorioretinopathy
3. subfoveal CNV secondary to pathologic myopia
4. ocular tumor

Jawab: E AAO section 12 2005-2006 Hal 63-66, 320-321

90.Which of the following answer is the right reason for repeated intravitreal
triamcinolone:
a. Improvement of visual acuity after IVTA and then decreased after
several months after that
b. No improvement of cystoid macular edema (CME)
c. Increase of vitreous haze
d. Increase of neovascularization in the retina
e. Endophthalmitis
Answer : A Source AAO 2008-2009 Section 9, chapter 6: pg 121-141

91.A 60 years old female came with hyperemic eyes since 6 months ago,
headache, nausea, seeing halo around the light. Ophthalmic examinations; visual
acuity: OD 0,25 , OS 0,30 , Kps (+), anterior chamber Von Herrick grade 2, flare
(+), iris atrophy (+), bombe (+), sinechia (+) with pupillary block, reflex (-),
diameter of the pupil 5-6 mm, nuclear opacity of the lens, C/D 0,3-0,4. IOP: OD:
40.2 mm Hg OS: 30,4 mmHg. Gonioscopy: OD: Peripheral Anterior Synechia
(PAS) in 3 quadrants, OS: PAS in 2 quadrants. Medication and laser iridectomy
was failed to control IOP for the both eyes. After trabeculectomy, OD: there was
decrease of IOP in the right eye. Pupil diameter became 3 mm. The diagnosis
was
 a. Secondary glaucoma caused by bilateral uveitis
b. Sub acute Primary closed angle glaucoma (PCAG)
c. Phacomorphic glaucoma
d. Posner-Schlosmann syndrome
e. Fuch Heterochromic Iritis

Answer: B, AAO 2008-2009 Section 10, pg 126-134

92.A 37 years old man came with skin rash and bullae in all of the body.
Ophthalmic examinations in the both eyes: Visual acuity 0,90 [ocular dextra-
sinistra (ODS)], hyperemia of conjunctiva, palpebral margin edema, clear cornea
and mucous secretion. This medical history came after he took tetracycline 3
days ago. The most important ocular management of the patient:
A. Antibiotics + anti-inflammatory eye drops
B. Antibiotics + release of the conjunctival membrane
C. Antibiotics + artificial tear
D. Artificial tears + release of the conjunctival membrane
E. Anti-inflammatory eye drops + artificial tears

Answer : D, AAO 2008-2009 Section 8, pg 216-219

93. he worst chronic complication for the above condition is:

A. Symblepharon
B. Dry Eyes
C. Keratopathy
D. Entropion
E. All the answer is right

Answer : C, AAO 2008-2009 Section 8, pg 216-219

94.A 51 years old man came with blind with history of ECCE 15 years ago OS.
OD hyperemic conjunctiva, round pupil 3 mm, reflex was decreased, iris
tremulans, very deep anterior chamber with flare, aphakia, IOP was increased.
There is no sign of intraocular surgery before in OD. Etiology of increased IOP
OD is
a. POAG
b. Secondary glaucoma caused by vitreous block OD
c. Sympatric ophthalmia
d. Lens induced glaucoma, before aphakia caused by illegal medicine
act
e. All answer is wrong

Answer : B, AAO 2008-2009 Section 10,pg 138

95.What kind of examination needed for question number 8?

a. Gonioscopy
b. Perimetry
c. Applanation tonometry
d. Ultrasonography (USG)
e. Non contact tonometry

Answer : D, AAO 2008-2009 Section 10, pg 138

96.An 8-years-old girl sustained a left upper eyelid laceration after falling from
her bicycle. The laceration measures 13 mm and extends from above the lid
crease to the eyelid margin. Proper alignment is important to repair the eyelid
margin. All the following will prevent a notch of the eyelid margin after a
laceration repair except:
a. Reapproximatilid marginng the tarsus
b. Everting sutures at the eye
c. Inverting sutures at the eyelid margin
 d. Reapproximating the eyelid skin edges
e. Tight sutures

Answer : C, AAO 2008-2009 Section 7, pg 195-200.

97.A 4-years-old boy was examined because of unilateral droopy eyelid since
birth. The visual acuity and ocular motility examinations were normal. The
eyelid measurements: Margin-reflex distance 0 mm, Levator function 3 mm,
and eyelid crease was absent. Bell’s phenomenon was positive. Which of the
following is the most appropriate surgical management?
a. Fasanella-Servat procedure
b. Levator aponeurosis advancement
c. Levator muscle resection
d. Levator suspension
e. Levator release

Answer : D, AAO 2008-2009 Section 7,pg 215-229

98.A squamous cell carcinoma of the lower eyelid was excised with controlled
margins. The eyelid defect was greater than 50%. Which of the following is
the most appropriate management?
a. Cutler-Beard procedure
b. Hughes procedure
c. Skin graft
d. Direct closure
e. Evisceration

Answer : B,AAO 2008-2009 Section 7,pg 195-200.

99.A 56-years-old man complains of an aching sensation around his left eye
that has lasted for 6 weeks. The discomfort increase on up gaze. One week
 ago he noted blurred vision in the left eye and a low-grade fever. His visual
acuity was OD: 1,00 and OS: 0,50. The patient has 3 mm of proptosis in the
left eye, mild erythema and tenderness around the left eyelid. Biomicroscopy
and fundus examination were normal. The most helpful diagnostic test for this
patient is:
a. Complete blood count
b. Skull films
c. CT scan of the orbits
d. Thyroid function tests
e. Exophthalmometer

Answer : C, AAO 2008-2009 Section 7,pg 39-46.

100.A 50-years-old woman was evaluated for painless bilateral proptosis. Her
eyes were normal until 1 year ago. The axial and coronal CT scans show bilateral
enlargement of the extraocular muscles. Which of the eyelid findings listed below
is most with this conditions:
a. Enteropion
b. Ectropion
c. Floppy eyelids
d. Eyelid retraction
e. Proptosis
Answer : D, AAO 2008-2009 Section 7, pg 230-232