1. Which one of the following ocular or systemic conditions is NOT associated with Ectopia Lentis ?
A. Homocystinuria
B. Tauma
C. Microcornea
D. Weill-Marchesani
E. Ehlers-Danlos
ANSWER: C
2. A 1-month-old infant presents with bilateral nuclear cataracts . What is the most
common identifiable cause for the cataracts?
A. Hereditary autosomal dominant
B. Persistent hyperplastic primary vitreous (PHPV)
C. Galactosemia
D. Intrauterine infection
E. local dysgenesis
ANSWER: A
3. A 3-year-old child is referred by his pediatrician with a 7-day history of fever of unknown etiology and
bilateral conjunctival infection. Other findings include a polymorphous rash, erythema and edema of the
palms and soles, periungual desquamation, cervical lymphadenopathy, infected pharynx and tongue,
and
fissuring of the lips. Ophthalmic evaluation reveals a mild bilateral anterior uveitis.
Which one of the following studies is most appropriate?
A. Electrocardiogram
B. Two-dimensional echocardiography
C. Chest radiograph
D. HLA-B27
E. ANA
ANSWER: B
4. A 3-year-old child is referred by his pediatrician with a 7-day history of fever of unknown etiology and
bilateral conjunctival infection. Other findings include a polymorphous rash, erythema and edema of the
palms and soles, periungual desquamation, cervical lymphadenopathy, infected pharynx and tongue,
and
fissuring of the lips. Ophthalmic evaluation reveals a mild bilateral anterior uveitis.
Which one of the following is the treatment of choice for this condition?
A. Systemic corticosteroid therapy
B. Parenteral penicillin
C. Isoniazid
D. Aspirin
E. Paracetamol
ANSWER: D
5. A 4-year-old girl presents for evaluation of poor vision. Ophthalmologic examination reveals
translucent irides, hypopigmentation of the fundi, and foveal hypoplasia. Each one of the following
may be an associated finding EXCEPT:
A. bleeding diathesis
B. recurrent sinopulmonary infections
C. oculodigital massage
D. sensory nystagmus
E. neutropenia
ANSWER: C
6. 27. An infant presents for evaluation of poor vision. Which one of the following signs is LEAST
worrisome?
A. Eye-popping reflex
B. Gazing at bright lights
C. Eye rubbing
D. Paradoxic pupillary response to light
E. Eye pressing, or gouging
ANSWER: A
7. An infant born prematurely at 27 weeks of gestation weighing 950 g has been admitted to the
neonatal ICU. When should this infant have his initial retinal examination to screen for retinopathy
of prematurity (ROP)?
A. Immediately
B. 1 to 2 weeks after birth
C. 4 to 6 weeks after birth
D. 8 to 10 weeks after birth
E. 10 to 12 weeks after birth
ANSWER: C
8. Which one of the following statements regarding juvenile onset diabetes mellitus (JODM) is
FALSE?
A. Background diabetic retinopathy rarely occurs under the age of 20 years.
B. Retinopathy rarely occurs less than 3 years after onset of diabetes mellitus.
C. The prevalence of retinopathy in patients with JODM for more than 15 years approaches 90%.
D. Teenage diabetics should be examined for the presence of retinopathy within 5 years of
diagnosis.
E. Nonproliferative changes seen in the pediatric population include microaneurysms, cotton-wool
spots, hard exudates, retinal hemorrhages
ANSWER: A
9. A 2-year-old child presents with unilateral periorbital inflammation. Which one of the following
is the LEAST likely cause?
A. Dermoid cyst
B. Rhabdomyosarcoma
C. Orbital cellulitis
D. Toxoplasmosis
E. Infantile cortical hyperostosis
ANSWER: D
10. An infant presents with a hyphema with no history of trauma. Which one of the following is the
LEAST likely cause?
A. JXG
B. Herpes simplex uveitis
C. Lymphoma
D. Retinoblastoma
E. Coats' disease
ANSWER: C
11. A 2-year-old boy presents with periorbital ecchymosis. The differential diagnosis includes all of
the following EXCEPT:
A. Neuroblastoma
B. Leukemia
C. Lymphangioma
D. Dermoid cyst
E. Lymphangioma
ANSWER: D
12. What do ghost cells represent?
A. Hemosiderin-laden macrophages
B. Denatured lens proteins
C. Spherical red blood cells
D. Inflammatory cells
E. Calcium-lipid complex
ANSWER: C
13. Which one of the following conditions is NOT associated with HLA-B27—linked acute iritis?
A) Behçet's disease
B) Psoriatic arthritis
C) Crohn's disease
D) Reiter's syndrome
E) Ankylosing spondylitis
ANSWER: A
14. Which form of uveitis is most common in ocular sarcoidosis?
A. Panuveitis
B. Intermediate uveitis
C. Anterior uveitis
D. Choroiditis
E. Vitritis
ANSWER: C
15. Which one of the following regarding acute retinal necrosis is NOT true?
A. Severe arteritis is common.
B. Herpes zoster virus has been implicated as etiologic agent.
C. Posterior pole is involved initially with centrifugal spread.
D. Retinal detachments occur frequently.
E. Patients present with vitritis , confluent peripheral necrotizing retinitis
ANSWER: C
16. Complications of pars planitis include all of the following EXCEPT:
A. calcific band keratopathy
B. choroidal neovascularization
C. vitreous hemorrhage
D. tractional retinal detachment
E. peripheral retinal neovascularization
ANSWER: B
17. IV or intravitreal antiviral induction therapy for cytomegalovirus retinitis is given for:
A. 2 days
B. 10 days
C. 7 days
D. 14 days
E. 5 days
ANSWER: D
18. Which one of the following is NOT a risk factor for POAG?
A. Topical corticosteroid response
B. African American heritage
C. Positive family history
D. Diabetes mellitus
E. Old age
ANSWER: A
19. Which drug used during general anesthesia is associated with an increase in intraocular
pressure (IOP)?
A. Halothane
B. Ketamine
C. Valium
D. Phenobarbital
E. Barbiturates
ANSWER: B
20. What is the best initial therapy for malignant glaucoma?
A. Pilocarpine 2%
B. Laser iridotomy
C. Mydriatic-cycloplegic therapy
D. Lens removal
E. Timolol eye drop 0.5%
ANSWER: C
21. Which one of the following types of glaucoma is LEAST likely to respond to medical therapy
alone?
A. Phacolytic glaucoma
B. Pigmentary glaucoma
C. Lens particle glaucoma
D. Pseudoexfoliation
E. POAG
ANSWER: A
22. The eye condition LEAST likely to be associated with aqueous misdirection syndrome is:
A. angle closure glaucoma
B. uveitis
C. myopia
D. nanophthalmos
E. hyperope
ANSWER: C
23. Use of 5-FU following filtration surgery has been associated with all of the following EXCEPT:
A. conjunctival wound leaks
B. suprachoroidal hemorrhage
C. hypotony maculopathy
D. retinal detachment
E. corneal epithelial defects
ANSWER: D
24. Apraclonidine (Iopidine), an alpha2-adrenergic agonist, has all of the following side effects
EXCEPT:
A. systemic hypotension
B. superior lid retraction
C. dry mouth
D. blanching of conjunctival vessels
E. systemic hypertension
ANSWER: A
25. Which one of the following associations between a microorganism and a useful medium for
growth is CORRECT?
A. Moraxella—blood agar in 5% to 10% carbon dioxide
B. Fungi—Sabouraud's dextrose agar with cycloheximide
C. Mycobacterium tuberculosis—Loeffler's medium
D. Haemophilus—blood agar
E. saprophytic fungi— chocolate agar
ANSWER: A
26. Which one of the following medications is most commonly used to treat cases of filamentous
fungal keratitis caused by Fusarium spp?
A. Flucytosine
B. Natamycin
C. Amphotericin B
D. Miconazole
E. Ofloxacin
ANSWER: B
27. All of the following are appropriate therapy for primary HSV epithelial keratitis EXCEPT:
A. trifluridine 1% ophthalmic solution every 2 hours while awake
B. acyclovir 800 mg five times daily
C. débridement of corneal lesions
D. valacyclovir 500 mg twice a day
E. famciclovir 500 mg twice daily
ANSWER: B
28. A 2-year-old boy presents with poor vision in both eyes, mental retardation, a thin upper lip,
and low-set ears. The patient's mother is currently being treated with disulfiram for her substance
abuse problem. Findings of your examination might include all of the following EXCEPT:
A. Peters' anomaly
B. tortuous retinal vessels
C. optic nerve hypoplasia
D. sclerocornea
E. microphthalmia
ANSWER: D
29. Which one of the following concerning congenital hereditary stromal dystrophy is FALSE?
A. Autosomal dominant inheritance
B. Pain, tearing, photophobia
C. Central anterior stromal flaky, feathery opacity
D. Cornea of normal thickness
E. presenting at birth
ANSWER: B
30. You obtain a cornea for an elective penetrating keratoplasty and you notice that the color of
the storage medium is yellow-orange instead of the usual pink. What does this indicate?
A. Decrease in antibiotic levels
B. Loss of epithelium
C. A cornea over 3 days old
D. Possible microbial contamination
E. Loss of endothelium
ANSWER: D
31. Of the following, what is currently the MOST common indication for penetrating keratoplasty
in adults?
A. Fuchs' dystrophy
B. Aphakic bullous keratopathy
C. Pseudophakic bullous keratopathy
D. Herpes simplex keratitis
E. Reis-Buckler's dystrophy
ANSWER: C
32. Superficial phototherapeutic keratectomy is indicated in treating symptoms in the following
conditions EXCEPT:
A. Reis-Buckler's dystrophy
B. granular dystrophy
C. epithelial basement membrane dystrophy
D. Fleck dystrophy
E. Cogan microcystic dystrophy
ANSWER: D
33. Of the following, which is the MOST frequent indication for penetrating keratoplasty in
children?
A. Sclerocornea
B. Interstitial keratitis
C. Peters' anomaly
D. Bacterial keratitis
E. Herpetic keratits
ANSWER: C
34. Postoperative complications in pediatric penetrating keratoplasty include all of the following
EXCEPT:
A. glaucoma
B. amblyopia
C. slow or delayed healing
D. graft rejection
E. self-induced trauma is a frequent problem
ANSWER: C
35. Approximately what percentage of corneal grafts performed for HSV keratitis remains clear
greater than 1 year postoperatively?
A. 90%
B. 65%
C. 50%
D. 40%
E. 35%
ANSWER: B
36. Overall, the risk of an endothelial graft rejection episode is:
A. 1%
B. 5%
C. 20%
D. 40%
E. 50%
ANSWER: C
37. Most rigid gas permeable contact lens wearers should discontinue use of their lenses at least
how many days before a refractive surgery evaluation?
A. 7 days
B. 21 days
C. 3 days
D. 60 days
E. 30 days
ANSWER: B
38. Concerning radial keratotomy, after what number of incisions does the dioptric effect per
incision decrease significantly?
A. 4 incisions
B. 8 incisions
C. 16 incisions
D. 2 incisions
E. 32 incisions
ANSWER: B
39. Concerning astigmatic keratotomy for naturally occurring astigmatism, arcuate incisions
greater than how many degrees are relatively contraindicated?
A. 60°
B. 90°
C. 120°
D. 130°
E. 150°
ANSWER: B
40. Which one of the following regarding exudative retinal detachments is FALSE?
A. May occur with choroidal hemangiomas
B. May occur with choroidal melanomas
C. Should be treated with scleral buckle and vitrectomy with internal drainage of the subretinal fluid
D. Are characterized by shifting subretinal fluid
E. It can be quite bullous
ANSWER: C
41. A patient has synchysis scintillans. Which historical feature is most probable?
A. Previous blunt trauma with hyphema
B. Dense arcus senilis
C. Carotid atherosclerosis with a history of amaurosis
D. Cushingoid appearance from long-term steroid use
E. Systemic hypercalcemia
ANSWER: A
42. An intraocular bubble of which one of the following gases would last the longest?
A. Air
B. Perfluoropropane (C3F8)
C. Sulfur hexafluoride (SF6)
D. Perfluoroethane (C2F6)
E. Selicon oil
ANSWER: B
43. The surface tension of silicone oil against the retina is:
A. greater than C3F8 against the retina
B. greater than air against retina
C. less than SF6 against retina
D. equal to water against the retina
E. more than SF6 against the retina
ANSWER: C
44. Macular complications of retinitis pigmentosa include all of the following EXCEPT:
A. macular atrophy
B. epiretinal membrane
C. CME
D. subretinal scarring
E. Pigment disturbances which may be perivascular in the midperiphery
ANSWER: D
45. What percentage of patients that have sensitivity to penicillin will have cross-reactivity to
cephalosporins?
A. 10%
B. 20%
C. 30%
D. 40%
E. 50%
ANSWER: A
46. Natamycin may be effective in the treatment of all of the following infectious agents EXCEPT:
A. Aspergillus
B. Candida albicans
C. Fusarium
D. Mucor
E. Cephalosporium
ANSWER: D
47. Agents reported to be effective in the treatment of Acanthamoeba include all of the following
EXCEPT:
A. neomycin
B. polyhexamethylene biguanide
C. propamidine
D. trifluridine
E. natamycin
ASNSWER: D
48. Which of the following characteristics is undesirable in the design of a viscoelastic?
A. Iso-osmotic
B. Hydrophilic
C. Inert
D. Clear
E. nonpyogenic
ANSWER: B
49. How long does it take for a photoreceptor to renew its outer segment?
A. 1 hour
B. 1 day
C. 10 days
D. 1 month
E. 100 days
ANSWER: C
50. You suspect Leber's hereditary optic neuropathy. What would be the best test to confirm your
suspicion?
A. MRI scan of brain
B. Lumbar puncture
C. Serum electrophoresis
D. DNA analysis
E. Chest X-Ray
ANSWER: D
51. Myasthenia patients are at higher risk for all of the following EXCEPT:
A. thymoma
B. Graves' disease
C. systemic lupus erythematosus
D. multiple sclerosis
E. rheumatoid arthritis
ANSWER: D
52. Postoperative cystoid macular edema is
A. More common after ECCE than after ICCE.
B. Always associated with visually symptomatic patients.
C. Almost always a result of the IOL.
D. Almost always treated surgically.
E. Almost always a result of increased perifoveolar capillary permeability
ANSWER: E
53. Which of the following statements is TRUE about the management of cataract associated with ocular
trauma?
A. After blunt or penetrating trauma in children, fibrin can be deposited on the anterior lens capsule,
which mimics the appearance of cataract.
B. Cataracts associated with large corneal lacerations should be removed through the laceration to avoid
making an additional corneoscleral wound.
C. If a cataract does not develop in the injured eye within 10 days of the trauma, the patient is unlikely
to develop a cataract later.
D. Phacoemulsification through a small limbal incision is the best approach to the removal of any
cataract associated with acute trauma.
E. The benefits of inserting an IOL at the time of surgery outweigh the risks when removing a cataract
during the repair of a paracentral corneal laceration
ANSWER: A
54. A 76-year-old man complains of difficulty driving because of reduced vision. His best-corrected visual
acuity is 20/70 OD and 20/40 OS. Goldmann visual fields are constricted, more in the OD than the OS. A
moderate nuclear cataract is present OD, and a mild one is seen OS. His IOP is 23 mm Hg OD and 18 mm
Hg OS. He uses timolol 1/2% bid OD and dorzolamide tid OD. His cup-to-disc ratio is 0.8 OD and 0.6 OS.
The fundus is otherwise normal. Which of the following statements is TRUE?
A. Cataract surgery should not be considered because of the risk of loss of fixation postoperatively.
B. Cataract surgery combined with glaucoma filtering surgery is the only approach that should be
considered for this patient.
C. Medical glaucoma treatment should be maximized before considering cataract surgery.
D. The visual field constriction in this case is probably caused by glaucoma.
E. The use of latanoprost after cataract surgery may increase the risk of postoperative CME
ANSWER: E
55. Which of the following statements about anticoagulation therapy and cat¬aract surgery is FALSE?
A. It is more important to maintain constant anticoagulation therapy in a patient after mechanical heart
valve implant than when atrial fibrillation is present.
B. The risk of hemorrhage in an anticoagulated patient is not reduced by administering peribulbar rather
than retrobulbar anesthetic injection.
C. The use of clear corneal cataract surgery with topical anesthetic minimizes the risk of hemorrhage in a
patient who requires anticoagulation therapy.
D. General anesthesia is the preferred technique for cataract surgery in most patients on anticoagulation
therapy.
E. Small-incision cataract surgery with peribulbar or retrobulbar anesthetic injection can be safely
performed with only a small risk of hemorrhage
ANSWER: D
56. All of these diagnostic tests are useful in evaluation of a patient with a re¬tained magnetic
intraocular foreign body EXCEPT:
A. Indirect ophthalmoscopy
B. Computed tomography
C. Electrophysiology
D. Magnetic resonance imaging
E. Echography
ANSWER: D
57. Which vitreoretinal abnormality is most likely to lead to retinal detachment?
A. Lattice with atrophic holes
B. Operculated holes
C. Acute horseshoe retinal tear
D. Meridional complex
E. Acute posterior vitreous detachment
ANSWER: C
58. Which of the following is LEAST likely to be present in an eye with a purely tractional retinal
detachment?
A. Concave surface
B. Sickle cell retinopathy
C. Smooth retinal surface
D. Extension of detachment to the midperiphery
E. Tobacco dust
ANSWER: E
59. Which of the following is most characteristic of exudative retinal detachment?
A. Shifting fluid
B. Tobacco dust
C. Fixed folds
D. Equatorial traction folds
E. Demarcation lines
ANSWER: A
60. Most eyes with the ocular ischemic syndrome have an ipsilateral carotid artery stenosis of at least
A. 25%
B. 50%
C. 70%
D. 90%
E. 100%
ANSWER: D
61. What percent of eyes with acute central retinal artery obstruction have visible emboli in the affected
fundus?
A. 10%
B. 20%
C. 50%
D. 75%
E. 100%
ANSWER: B
62. Causes of central artery obstruction include all of the following EXCEPT:
A. Hemorrhage under an atherosclerotic plaque
B. Dissecting aneurysm
C. Emboli
D. Thrombi
E. Vascular rupture
ANSWER: E
63. Features of the ocular ischemic syndrome include all of the following EXCEPT:
A. Ocular pain
B. Prolonged recovery following exposure to bright light
C. Decreased vision
D. 5-year mortality of 40%
E. Stroke as the leading cause of death
ANSWER: E
64. As defined by the Diabetic Retinopathy Study, all of the following features are significant in
determining the presence of high-risk proliferative diabetic retinopathy EXCEPT:
A. The presence of new vessels
B. Location of new vessels on or near the optic disc
C. The presence of vitreous hemorrhage
D. Localized tractional retinal detachment
E. Moderate to severe NVE
ANSWER: D
65. Most eyes with the ocular ischemic syndrome have an ipsilateral carotid artery stenosis of at least
A. 25%
B. 50%
C. 70%
D. 90%
E. 100%
ANSWER: D
66. Which of the following features is NOT characteristic of Coats disease?
A. Predominance of males
B. Unilaterality
C. Exudative response
D. Retinal neovascularization
E. Idiopathic
ANSWER: D
67. Congenital stationary night blindness (with a normal fundus) is generally characterized by
A. Absent off-responses in the retina
B. A “negative-type” electroretinogram
C. Delayed regeneration of rhodopsin
D. Mizuo-Nakamura phenomenon
E. A tritan (blue-yellow) color defect
ANSWER: B
68. The most critical and constant finding in retinitis pigmentosa is
A. Dense bone speckle pigmentation in the retinal periphery
B. An abnormality in the rhodopsin gene
C. Acquired red-green color deficiency
D. A significantly reduced electroretinogram
E. Small tubular visual fields
ANSWER: D
69. An individual who is born without red-sensitive cone pigment function (protanopia) is likely to
A. Have poor visual acuity
B. Confuse blue and yellow
C. Perceive the long-wavelength portion of the spectrum as being darker than normal
D. Manifest photophobia
E. Be hypersensitive to green
ANSWER: C
70. Primary dysfunction of the cone system (achromatopsia, rod monochromatism) is characterized by
all of the following EXCEPT:
A. Decrease in visual acuity
B. Photophobia
C. Absent color discrimination
D. Poor night vision
E. Nystagmus
ANSWER: D
71. A 52-year-old man with a complaint of poor vision for approximately 20 years is seen. Fundus
examination reveals well-delineated, atrophic macular areas with some yellowish marginal material. No
other family members are available for examination, but he states that his maternal grandfather, his
mother, and his maternal uncle also had poor vision, with onset in the mid-30s. Work-up reveals a visual
acuity of 20/200 in each eye, central scotoma with full peripheral visual fields, a few errors with the
Farnsworth Panel D-15, an electro-oculogram ratio of 1.30, and a normal photopic and scotopic
electroretinogram. The most likely diagnosis is
A. Central areolar choroidal dystrophy
B. Old disciform macular degeneration
C. Best disease
D. Retinitis pigmentosa
E. Stargardt’s disease
ANSWER: C
72. Retinal racemose haemangioma is a feature of:
A. von Hippel Lindau syndrome
B. Wyburn Mason syndrome
C. Sturge-Weber syndrome
D. incontinentia pigmentii
E. Louis-Bar syndrome
ANSWER: B
73. All of the following are associated with ectopia lentis EXCEPT:
A. Refsum syndrome
B. Stickler's syndrome
C. Hyperlysinaemia
D. Crouzon syndrome
E. Aniridia
ANSWER: A
74. A patient presents with a salt-and-pepper pigmentary retinopathy. Which medication in his history
may be significant:
A. gentamicin
B. quinine
C. rifampicin
D. amiodarone
E. ethambutol
ANSWER: B
75. Which genus of organism is most commonly isolated in bleb-associated endophthalmitis:
A. Propionibacterium
B. Streptococcus
C. Neisseria
D. Staphylococcus
E. Enterococcus
ANSWER: B
76. A young baby with hypotonia and development delay is referred to ophthalmology where
microphakia, posterior lenticonus and cataract are diagnosed. The intra-ocular pressure is 29mmHg
bilaterally with Perkins tonometry.
What abnormality would be MOST likely on urinalysis?
A. aminoaciduria
B. leucocytes
C. red blood cells
D. reducing substances
E. glucose
ANSWER: A
77. The organism with the poorest prognosis in post-traumatic endophthalmitis is:
A. Streptococcus pneumoniae
B. Bacillus cereus
C. Aspergillus
D. Staphylococcus aureus
E. Acanthamoeba
ANSWER: B
78. Retinal metastases are most commonly from a primary:
A. breast tumor
B. lung tumor
C. prostate tumor
D. gastrointestinal tumor
E. cutaneous melanoma
ANSWER: E
79. Which of the following is NOT considered a potential side-effect of the hyperosmotic agents?
A. mental confusion
B. congestive heart failure
C. subdural hemorrhage
D. bronchoconstriction
E. headache
ANSWER: D
80. Which of the following medications is most clearly associated with drug-induced myasthenia?
A. warfarin
B. diltiazem
C. ranitidine
D. penicillamine
E. methotrexate
ANSWER: D
81. A patient has posterior polymorphous corneal dystrophy. There is a history of hearing loss.
What is the most likely systemic diagnosis?
A. Cystinosis
B. Gaucher disease
C. Lowe syndrome
D. Alport syndrome
E. Alagille syndrome
ANSWER: D
82. In which condition is the underlying pathology stained with Masson trichrome?
A. Schnyder dystrophy
B. lattice dystrophy
C. Scheie syndrome
D. macular dystrophy
E. granular dystrophy
ANSWER: E
83. Retinoblastoma is caused by a defect on chromosome:
A. 8
B. 13
C. 5
D. 21
E. 17
ANSWER: B
84. A patient has pigmentary retinopathy, anosmia and ataxia. Which dietary component has most likely
caused this clinical picture?
A. beta-lipoprotein
B. copper
C. zinc
D. phytanic acid
E. B12
ANSWER: D
85. Which is FALSE regarding accommodative esotropia:
A. by definition patients have a high AC/A ratio
B. less than half of patients are amblyopic
C. usually intermittent at onset before becoming constant
D. patients rarely develop diplopia
E. acquired
ANSWER: A
86. A 43-year-old female smoker on tamoxifen develops gradual onset unilateral proptosis. What is the
most likely cause?
A. orbital varices
B. metastatic carcinoma
C. thyroid eye disease
D. cavernous haemangioma
E. myasthenia gravis
ANSWER: C
87. A 14-year-old girl is struggling to read homework and complains of poor central vision. Her acuities
are 6/24 bilaterally. The first year ophthalmology trainee reports no abnormalities on dilated fundus
examination.
What is the most likely diagnosis?
A. Stargardt's disease
B. central serous chorioretinopathy
C. enhanced S-cone syndrome
D. Sjogren-Larsson syndrome
E. Best's disease
ANSWER: A
88. Crouzon's syndrome is associated with all of the following ophthalmic findings EXCEPT:
A. telecanthus but not hypertelorism
B. exotropia
C. nystagmus
D. optic atrophy
E. parrot beak nose
ANSWER: A
89. A 23-year-old man who underwent LASIK surgery 6-months ago for myopia suffers blunt ocular
trauma with a football. On examination, there is a dislocated right corneal flap with rolled edges.
What is the most appropriate treatment?
A. sutures to the corneal flap
B. amniotic membrane graft
C. penetrating keratoplasty
D. conservative with antibiotic drops and close follow-up
E. reposition of the flap and bandage contact lens
ANSWER: E
90. The synoptophore can be used to assess all of the following EXCEPT:
A. abnormal retinal correspondence
B. vertical and torsional misalignments simultaneously
C. the degree of stereopsis
D. sensory fusion
E. suppression
ANSWER: C
91. A man of no fixed abode is admitted to hospital with confusion and peripheral neuropathy. 2 days
later he complains of painless bilateral reduced vision, though fundoscopy is normal.
What is the most likely diagnosis?
A. Friedrich ataxia
B. nutritional optic neuropathy
C. non-organic visual loss
D. demyelinating disease
E. Wolframm syndrome
ANSWER: B
92. A 33-year-old woman was treated 1 week previously with trimethoprim for a urinary tract infection.
She presents with acute blistering of her skin. On examination, the mucosa of her mouth and throat are
inflamed and there is severe bilateral conjunctivititis.
What is the most likely diagnosis?
A. mucus membrane pemphigoid
B. toxic epidermal necrolysis
C. linear IgA disease
D. Stevens-Johnson syndrome
E. epidermolysis bullosa
ANSWER: D
93. Which of the following complications is most likely after central retinal artery occlusion?
A. new vessel at disc
B. rubeosis iridis
C. corneal oedema
D. new vessel in the retina
E. cataract
ANSWER: B
94. A 72-year-old Caucasian lady presents with a highly pigmented lesion on the lid margin. What is the
most appropriate management?
A. observation
B. cryotherapy
C. excision with a clear margin
D. reassure and discharge
E. anti-fungul skin cream and observe
ANSWER: C
95. The most common cause of anterior uveitis in the adult population is:
A. idiopathic iridocyclitis
B. herpes simplex keratouveitis
C. herpes zoster keratouveitis
D. syphilitic uveitis
E. HLA-B27 iridocyclitis
ANSWER: A
96. Which medication can cause acute angle-closure glaucoma?
A. vigabatrin
B. topiramate
C. chlorpromazine
D. sodium valproate
E. acetylsalicylic acid
ANSWER: B
97. What is the most common location for a retinal tear?
A. 3 and 9 o'clock
B. 6 and 12 o'clock
C. 10 o'clock to 2 o'clock
D. 4 o'clock to 8 o'clock
E. 5 and 8 o'clock
ANSWER: C
98. The differential diagnosis of childhood leucocoria includes all EXCEPT:
A. retinopathy of prematurity
B. homocystinuria
C. Coats' disease
D. persistent hyperplastic primary vitreous
E. retinoblastoma
ANSWER: B
99. Which clinical feature might be expected in a young child with bilaterally poor vision and the CT scan
shows absence of the septum pellucidum ?
A. pheochromocytoma
B. ash-leaf macules
C. mental retardation and lacunar peripheral retinopathy
D. precocious puberty
E. panhypopituitarism
ANSWER: E
100. Congenital lid colobomas are most characteristic of which systemic syndrome?
A. Pierre Robin syndrome
B. Hallermann-Streiff syndrome
C. Stickler syndrome
D. Goldenhar syndrome
E. Marfan syndrome
ANSWER: D
