TESTS “STEP-2”

Visual functions and the main objective research methods

1. A patient 60 years of age complains of central vision decrease and peripheral vision limitation.
Computer tomography reveals hypophyseal adenoma. What reason causes vision limitation?
A *Bitemporal heteronymic hemianopsia
B Binasal heteronymic hemianopsia
C Right-side homonymic hemianopsia
D Left-side homonymic hemianopsia
E Central scotoma

2. Eye fundus description: optic disk is round, pale pink, with clear-cut outlines. It localizes on
the same level with retina (isn’t elevated). Arteriovenous ratio is 2:3. Yellow spot region has
shape of horizontal oval of red color. How should you interpret such picture of eye fundus?
A *Normal eye fundus
B Hypertonic angiopathy
C Diabetic angiopathy
D Optic neuritis
E Optic nerve atrophy

Refraction
3. A patient 22 years old has visual acuity 0,15 that can be improved with a few glasses. What
glass shows degree of his myopia?
A *sph -1,5
B sph -2,0
C sph -2,5
D sph -3,0
E sph -3,5

Eyelids diseases
5. A patient 36 years old visited a general doctor due to complains of headache, body
temperature elevation up to 38 degree of Celsius, pain in his right eye region. The upper eyelid
of his right eye is edematous, hyperemic. The edema spreads on superciliary and temporal
region. There is tenderness of the eyelid, yellowish abscess head above a hair follicle. The
patient treated himself with tea lotions, penicillin ointment, and dry sterile bandage on the sick
eye. Put diagnosis, please.
A *Hordeolum
B Chalazion
C Neoplasm
D Blepharitis
E Conjunctivitis

6. A woman 34 years old visited a general doctor due to presence of a tumor in the upper eyelid
of her right eye. According to anamnesis the tumor was figured out to be small at first but later
enlarge up to size a bean. Results of examination: there is round tumor of the right upper eyelid
that is not soldered with the skin and without any signs of inflammation. Grayish-yellow focus
with a slight conjunctival hyperemia around is visible in the eyelid cartilage. What is your
diagnosis?
A *Chalazion
B Abscess
C Neoplasm
D Hordeolum
E Dermatitis

7. A patient came to a doctor due to the upper eyelid swelling that had increasing for a month.
Objectively: there is neoplasm in the middle third of the eyelid. Its size is about a bean, distance
from the free eyelid edge is 6-8 mm. Skin above the neoplasm is mobile, not changed; there is
hyperemia of conjunctiva. Put diagnosis, please.
A *Chalazion of the upper eyelid
B Abscess of the upper eyelid
C Neoplasm of the upper eyelid
D Hordeolum of the upper eyelid
E Parasitic invasion of the upper eyelid

8. A patient 19 years of age complains of sharp pain and redness of her upper eyelid. She has
being ill for 2 days. Objectively: body temperature is 38,2 degree of Celsius. There is hyperemia
and edema of the upper eyelid more prominent in the central part, sharp tenderness and
fluctuation in the same region. The eyelid edge is unchanged. What is the most likely
preliminary diagnosis?
A. *Abscess of the upper eyelid
B. Blepharitis
C. Chalazion of the upper eyelid
D. Dacryoadenitis
E. Orbital cellulitis

9. A patient 45 years of age complains of discomfort during reading, redness of her eyelid edges,
white foamy discharge in angles of her eyes. Objectively: there is hyperemia and thickening of
free eyelids edges, widening of excretory ducts of the eyelid cartilage glands. What is the
diagnosis?
A *Meibomian blepharitis
B Adenoviral conjunctivitis
C Gonorrheal conjunctivitis
D Chronic conjunctivitis
E Acute dacryoadenitis

10. Patient complains of thickening and redness of eyelids edge, white foamy discharge in angles
of eye gap. During massage of eyelids the sebaceous white secret is allocated. During the last
year such signs disturbed the patient for several times. What is your diagnosis?
A *Meibomian blepharitis
B Simple blepharitis
C Hordeolum
D Bacterial conjunctivitis
E Viral conjunctivitis

11. A patient complains of foreign body sensations under the upper eyelids. Examination: there
is hyperemia of eyelids edge, sebaceous white secret is discharged while intermarginal space
pressing. Conjunctiva is not changed, optical structures are transparent, retina is normal. What
kind of local treatment is preferable in the patient?
A *Massage of eyelids edges
B Greasing of edge of eyelids with Vaselinum
C Greasing of edge of eyelids by ointment with corticosteroids

2
D Dry heat locally, UHF
E Locally drops with antibiotics, antiseptics

12. A patient, 28 years of age, complaints of foreign body sensation in his eyes, dryness in eyes,
lacrimation, especially in the evening. At examination: hyperemia and edema of eyelids edges,
there are some flakes between eyelashes, conjunctiva is not changed, optical structures are
transparent. Visual acuity is 1,0. What does the patient have?
A *Blepharitis
B Spring catarrh
C Hordeolum
D Chalasion
E Keratitis

13. A patient 42 years old complains of itch, foreign body sensation under his eyelids, frequent
blinking, fast fatigability of his eyes. Objectively: there are hyperemia and thickening of free
eyelids edges, grayish-white flakes around roots of eyelashes. After elimination of the flakes
bright-red skin is visible. What is the diagnosis?
A *Scaly blepharitis
B Adenoviral conjunctivitis
C Gonorrheal conjunctivitis
D Chronic canaliculitis
E Meibomian blepharitis

14. Redness and thickening of eyelids, flakes close to eyelashes roots, itch in eyes are observed
in 12-years-old child. What disease should you think about?
A *Scaly blepharitis
B Acute meibomiitis
C Hordeolum
D Allergic dermatitis
E Acute conjunctivitis

15. A patient was directed to a doctor with complains of heaviness and burning sensation in his
eyelids. There is hyperemia of eyelids edges, edges are thick, whitish flakes are visible close to
roots of eyelashes. What is your diagnosis?
A *Simple blepharitis
B Acute conjunctivitis
C Chronic conjunctivitis
D Meibomiitis
E Cellulitis of eyelid

16. The child, 12 years old, complains of itch, burning and foreign body sensation in his eyelids,
and presence of crusts around his eyelashes. Edges of eyelids are red, thick, covered with crusts.
After elimination of the crusts the surface under them bleeds. What is your diagnosis?
A *Ulcerative blepharitis
B Simple blepharitis
C Hordeolum
D Bacterial conjunctivitis
E Viral conjunctivitis

17. An elderly patient complains of constant itch in his eyes, eyelids edema and redness, light
lacrimation, lost of eyelashes, purulent crusts near eyelashes roots. What is your diagnosis?
A *Ulcerative blepharitis

3
B Scaled blepharitis
C Simple blepharitis
D Angular blepharitis
E Demodectic blepharitis

18. A patient suffers from severe hyperemia and edema of eyelids edges, purulent crusts between
eyelashes. After the crusts have been excised surface under them bleeds. Any discharges from
the conjunctival cavity are absent. The patient has such problems for a long time. Optical
structures are transparent, retina is normal. Visual acuity is 1,0. What is your diagnosis?
A *Ulcerative blepharitis
B Scaly blepharitis
C Chronic dacryocystitis
D Hordeolum
E Contagious molluscum

19. A patient suffers from trichiasis with hyperemia, thickness of eyelids edge, presence of
purulent crusts between eyelid and ulcers under the crusts. What is reason of the trichiasis?
A *Ulcerative blepharitis
B Eyelid eczema
C Eyelid dermatitis
D Scaled blepharitis
E Eyelid cellulitis

Conjunctiva diseases
20. A patient complains of sand sensation in his left eye, mucous-purulent discharges, "glued
eyes" especially in the morning. Objectively: mucous-purulent discharges and conjunctival
injection are visible in conjunctival cavity. Visual acuity and other structures of eyes are not
changed. Put diagnosis, please.
A *Acute purulent conjunctivitis
B Adenoviral conjunctivitis
C Superficial foreign bodies of conjunctiva
D Allergic conjunctivitis
E Chronic dacryocystitis

21. A patient 19 years of age complains of “sand” sensation, redness of his right eye,
impossibility to open the eye in the morning. Objectively: there is hyperemia of conjunctiva,
purulent discharges in the inner angle of the eye. Cornea is transparent. What is the diagnosis?
A *Acute conjunctivitis
B Chronic conjunctivitis
C Hordeolum
D Blepharitis
E Keratits

22. A 32-year-old patient complains of redness, burning, and foreign body sensation in his right
eye. Start of the disease was acute. On examination: visual acuity of the both eyes is 1,0. In the
right eye there are conjunctival hyperemia and swelling, superficial injection. There are purulent
discharges in conjunctival sac. Cornea is transparent. Color and pattern of the iris are unchanged,
pupil is mobile. What diagnosis is the most likely?
A. *Acute conjunctivitis
B. Acute iridocyclitis
C. Acute glaucoma attack

4
D. Corneal foreign body
E. Acute dacryocystitis

23. A 20-years old patient has red eye, lacrimation, foreign body sensation, purulent discharges
from his eyes. At eye examination redness of conjunctiva is revealed. Cornea is transparent,
pupil diameter is 3,0 mm, lens and vitreous are transparent. What is the diagnosis?
А. *Acute bacterial conjunctivitis
B Gonorrhoeal conjunctivitis
C Adenoviral keratoconjunctivitis
D Allergic conjunctivitis
E Acute iritis

24. A patient 45 years old complains of mucous-purulent discharges from his right eye,
mulligrubs, redness of the eye, sensation of “sand” during 2 days, accumulation of mucous-
purulent discharges, conjunctival redness especially in folds of conjunctiva. Other eye structures
are unchanged. What is the most probably pathology in the patient?
A *Acute purulent conjunctivitis
B Iridocyclitis
C Keratits
D Dacryocystitis
E Blepharitis

25. A 10 grade pupil visited a doctor due to right eye is “glued” in the morning, redness of the
eye, sensation of burning and itch, presence of yellow discharges in the eye angle and on
eyelashes. Objectively: visual acuity of his right eye is 1,0; right eye gap is narrowed; there is
hyperemia and swelling of eyelids, expressed conjunctival injection, yellow discharges in
conjunctival cavity. Cornea is transparent; the anterior chamber and iris are unchanged, pupil is
round, its photoreaction is active. Deeper structures and eye fundus are normal. What is the
patient’s disease?
A *Conjunctivitis
B Blepharitis
C Keratits
D Iridocyclitis
E Chalazion

26. A patient 25 years of age after respiratory tract infection has red eye, mucopurulent
discharges, itch, foreign body sensation. The diagnosis of conjunctivitis was made. Which test
can help you in diagnosis?
А. *Smear for bacterial culture
B Biomicroscopy
C Transillumination
D Gonioscopy
E Ophthalmoscopy

27. A child who had been born a day before was noticed to have edema and redness of eyelids.
Objectively: there are expressed edema and hyperemia of eyelids, sanguinolent discharges when
trying to uncover the eyelids. Eyeball and eyelids conjunctiva is hyperemic, edematous. What is
the diagnosis?
A *Conjunctivitis
B Iridocyclitis
C Dacryocystitis
D Blepharitis

5
E Keratits

28. A child who was born 5 days before has hyperemia and edema of eyelids skin,
blepharospasm, sanguinolent discharges from his eyes, and hyperemia of all the parts of
conjunctiva. The child’s mother has gonorrhea in anamnesis, she was not treated. What are
measures of this disease prevention in newborns?
A *Preventive check-ups and treatment of gonorrhea in pregnant
B Penicillin instillations just after birth
C Preventive check-ups of pregnant by venereologist
D Sanitary and educational work among the population
E Research of smears in all pregnant women before childbirth

29. Examination of a newborn revealed edema of eyelids. During palpation eyelids were firm,
the palpebral fissure was not completely opened. There was conjunctival hyperemia and redness
of palpebral edge, chemosis, discharges from a conjunctival sac like “meat slopes”. The cornea
was not changed. What is your diagnosis?
A *Gonococcal conjunctivitis
B Diphtheritic conjunctivitis
C Epidemic conjunctivitis
D Tubercular-allergic conjunctivitis
E Acute purulent conjunctivitis

30. A child 10 years old complains of body temperature elevation up to 38,8 degree of Celsius,
redness of his eyes. Results of examination: there are redness and hyperemia of eyelids, grey
films tightly soldered with conjunctiva. When trying to eliminate the films conjunctiva is
bleeding. What is the diagnosis?
A *Diphtheritic conjunctivitis
B Abscess of eyelids
C Keratitis
D Hordeolum
E Blepharitis

31. A patient complains of headache, high body temperature (39 degree of C), and edema of
eyelids. Eyelids are firm. There is muddy liquid with plates in conjunctival cavity, grey
membranes on the conjunctiva. During excision of the membranes conjunctival surface are
bleeding. What is your diagnosis?
A *Diphtheritic conjunctivitis
B Gonococcal conjunctivitis
C Epidemic conjunctivitis
D Tubercular-allergic conjunctivitis
E Acute purulent conjunctivitis

32. A patient K., 40 years old, complains of “glued” eyelids, mucous-purulent discharges, and
foreign body sensation in his eyes. Objectively: in both his eyes there is drooping of the upper
eyelid, superficial corneal vascularization and infiltration of grey color. There are expressed
hyperemia and infiltration of eyelids and folds conjunctiva, follicles of different size with opaque
contents in the upper conjunctival intermediate fold. What is your diagnosis?
A *Trachoma
B Diphtheritic conjunctivitis
C Spring allergic conjunctivitis
D Drug conjunctivitis
E Angular conjunctivitis

6
33. A patient P. 18 years of age complains of itch, heaviness, redness of his eyelids that have
being observed for some years at the end of February. Objectively: eyelids are edematic, with
thickened edges, there are separate proliferations in conjunctiva of the upper eyelid divided with
deep furrows from each other that looks like “paving stones”. What is the diagnosis?
A *Spring allergic conjunctivitis
B Blepharitis
C Iridocyclitis
D Abscess of eyelids
E Keratitis

34. A child of 10 years old has blepharospasm, photophobia, lacrimation. The symptoms get
worse at spring and summer. The child has being ill for some years. Objectively: there is edema
and hyperemia of eyelids conjunctiva in both eyes. Conjunctival surface is papillose due to
presence of proliferations of different size and shape, that look like “paving stones”. Threadlike
viscous discharges are visible in conjunctival cavity. What is your diagnosis?
A *Spring allergic conjunctivitis
B Trachoma
C Diphtheritic conjunctivitis
D Drug conjunctivitis
E Angular conjunctivitis

35. A boy 13 years of age notices itch, photophobia, lacrimation in both eyes at spring and
summer. Objectively: eyelids conjunctiva has milky-white shade, are covered with pale pink
papillary proliferations that look like “paving stones”. What is your diagnosis?
A *Spring allergic conjunctivitis
B Acute pneumococcal conjunctivitis
C Diphtheritic conjunctivitis
D Adenoviral conjunctivitis
E Gonorrheal conjunctivitis

36. A 55-year-old patient complains of severe itch, burning sensation and pain in his eyes,
redness of skin in the outer corners of the palpebral gap. Objectively: skin near the outer corners
of the palpebral gaps is macerated, eczematous, there are single moist cracks. Palpebral
conjunctiva is hyperemic. There are minor filiform mucous discharges. What is the most likely
diagnosis?
A. *Chronic conjunctivitis
B. Acute conjunctivitis
C. Sty
D. Blepharitis
E. Atopic eyelid dermatitis

Lacrimal organs diseases

37. A patient is a boy 2-months of age. During the last month parents are noticing him to have
accumulation of dry scales and purulent discharges after sleeping in his right eye. Conjunctiva of
eyelids is slightly hyperemic. What is your diagnosis?
A *Neonatal dacryocystitis
B Chronic conjunctivitis
C Acute bacterial conjunctivitis
D Angular conjunctivitis of Morax-Aksenfeld
E Gonorrheal conjunctivitis of newborns

7
38. A woman with a child 2 months of age visited a general doctor due to purulent discharges
from the child’s right eye that had been noticed a week after birth. At examination: there is
protrusion near the inner angle of the right eye. When pressing at this region purulent discharges
from lacrimal points are seen. Put the diagnosis, please.
A *Neonatal dacryocystitis
B Conjunctivitis
C Hordeolum
D Chalazion
E Dacryoadenitis

39. Mother of a child 3 months of age notices redness and purulent discharges in his eye. At
examination there is hyperemia of conjunctiva in both eyes. When pressing in the left lacrimal
sac projection purulent discharges from lacrimal points are seen. What treatment does he need?
A *Nasolacrimal duct probing
B Dacryocystorhinostomy
C Drops with antibiotics
D Disinfectants drops
E Lacrimal sac massage

Orbit diseases
40. A patient 52 years old was directed by otolaryngologist to ophthalmologic department after
purulent pansinusitis treatment. There is general weakness, increasing of body temperature up to
38,5 degree of Celsius, periorbital ecchymosis, edema of eyelids, conjunctival chemosis,
exophthalmos. Mobility of right eye is limited. Reposition of the eye is difficult. What is the
diagnosis?
А. *Orbital cellulites
B Acute blepharoconjunctivitis
C Retrobulbar tumor
D Retrobulbar haematoma
E. Orbital pseudotumor

41. A patient 36 years old came to a general doctor with complains of sharp headache, high
temperature (38 degree of Celsius), pain in her right eye. According to anamnesis the woman is
known to suffer from chronic sinusitis. At examination: eye gap is narrowed, eyelids are
swelling, hyperemic. Edematous conjunctiva is strangulated between eyelids (chemosis). There
is expressed protrusion of the eye, limitation of its movement, visual acuity is low. Put the
diagnosis.
A *Phlegmon of the right orbit
B Orbital neoplasm
C Hordeolum
D Retrobulbar hematoma
E Hemophthalmus

42. A patient has problems with nasal breathing, purulent discharges from his nose. Two days
ago pain in his right orbit and the eyeball protrusion appeared. Objectively: visual acuity in both
eyes is normal. There is hyperemia and swelling of eyelids, pain during the right eyeball
movement and limitation of movements, moderate exophthalmos. Transparent structures of the
eye and eye fundus are normal. Put the diagnosis.
A *Incipient abscess of right orbit
B Echinococcus of right orbit

8
C Tumor of right orbit
D Retrobulbar hematoma of right orbit
E Venous thrombosis of right orbit

43. A patient 42 years of age visited a general doctor due to his left eye protrusion, diplopia, and
vision deterioration. According to anamnesis the exophthalmos appeared 4 months ago and
increased rapidly. At examination there is widening of eye gap, extensive protrusion and outward
deviation of the left eye, limitation of the eye movement to nose. Any signs of inflammation are
absent. Put the diagnosis.
A *Orbital tumor
B Orbital phlegmona
C Periostitis
D Retrobulbar hematoma
E Allergic eyelids edema

Keratitis
44. A patient 22 years old, contact lenses user, complains of pain, lacrimation, photophobia,
vision deterioration. Objectively: there is pericorneal injection, infiltration of grey color in the
center of cornea. Deeper structures are unchanged. What is the diagnosis?
A *Keratitis
B Conjunctivitis
C Iridocyclitis
D Corneal leucoma
E Blepharitis

45. A patient visited a general doctor due to pain in his right eye, lacrimation, photophobia,
inability to open the eye, vision deterioration. Objectively: eyelids are edematous, the eye gap is
closed. There is pericorneal injection, corneal infiltration of grey color. Put the diagnosis.
A *Keratitis
B Conjunctivitis
C Orbital phlegmona
D Corneal ulcer
E Hordeolum

46. A 70-years old patient complains of pain, lacrimation, decreased vision in his right eye. 3
days ago the eye was damaged with the branch of tree. The eye is red. Photophobia, sensation of
dry is present. Corneal opacity with unclear contour, progressive edge and epithelial defect can
be observed. Corneal sensitivity is normal. There is hypopion. The patient suffers of chronic
dacriocyctitis. What is the diagnosis?
А. *Corneal ulcer
B Acute conjunctivitis
C Viral conjunctivitis
D Acute iritis
E Penetrating eye injury

47. A patient complains of lacrimation, photophobia, and severe pain in her left eye. 3 days ago
she got sand in the eye suddenly. The patient has suffering of left-side dacryocystitis for 2 years.
Visual acuity of the left eye is 0,01, not correctable. Objectively: there is blepharospasm,
lacrimation, mixed injection, defect of central part of corneal stroma with two different edges:
undermined and sloping, hypopion. The deeper structures are invisible due to pathological

9
process in cornea. Intraocular pressure is normal. What pathology the most probably causes such
clinical symptoms?
A *Purulent creeping corneal ulcer
B Traumatic corneal erosion
C Corneal foreign body
D Corneal leukoma
E Acute iridocyclitis

48. Patient complains of pain, lacrimation, photophobia in his eye at illumination. There is
blepharospasm, mixed injection, dendritic corneal opacity with blurred edges. Corneal sensitivity
is low. Visual acuity of the sick eye is 0,7, not correctable. What drugs should we use for
treatment?
A *Viralstatic
B Antibiotics
C Vitamins
D Antihistamines
E Sulphanilamides

49. A patient 40 years old 6 months ago was treated in hospital due to herpetic keratitis. He was
discharged from the hospital with stable remission. Visual functions were saved. What measures
of keratitis relapse prevention are necessary in this case?
A *Treatment by an immunologist (immunotherapy)
B Treatment by an ophthalmologist (repeated course of anti-inflammatory treatment, taking into
account the diseases specificity)
C Treatment of infectious disease
D Examination and treatment by an otolaryngologist
E Remediation of infection foci in the body

50. A patient suffers from chronic conjunctivitis. 2 days ago pain, lacrimation, photophobia of
his right eye occurred. Objectively: there is mixed injection, corneal infiltration close to limb that
is stained after fluorescein instilling. What is the diagnosis?
A *Marginal keratitis
B Creeping corneal ulcer
C Corneal mycosis
D Penetrating corneal injury
E Keratoconus

51. A patient complains of vision deterioration in his left eye. Objectively: the eye gap is well-
opened, the eye is not irritated. There is bluish-white corneal opacity 4x5 mm of size in the
central part. Iris pattern is unchanged. Pupil is round. Deeper structures are unchanged. Put the
diagnosis, please.
A *Corneal leukoma
B Keratitis
C Corneal erosion
D A precipitate
E. Pannus

Uveitis
52. A patient, 27 years old, complains of pain in his right eye, especially at night, vision
deterioration, photophobia, lacrimation. The patient is known to catch flu a week ago.

10
Objectively: eye gap is narrowed, pupil is narrow, iris is changed in color, contents of the
anterior chamber is opalescent. There is cyclic pain. What diagnosis is the most probably?
A. *Iiridocyclitis
B. Iritis
C. Keratitis
D. Conjunctivitis
E. Dacryoadenitis

53. A 40-year-old female has a history of rheumatism. She complains of acute pain in her left
eye, especially at night, vision impairment, photophobia, lacrimation. The patient cannot
determine any reasons of the disease. Objectively: slight pericorneal injection, flattening of iris
relief, iris discoloration. What is the most likely diagnosis?
A. *Iridocyclitis
B. Iritis
C. Keratitis
D. Choroiditis
E. Acute glaucoma attack

54. A patient 25 years of age complains of visual acuity deterioration, pain and irritation of his
right eye. He has being ill for 24 hours. There is injection of the eye, pupil of irregular shape,
narrow, precipitates on the posterior corneal surface. Anterior chamber angle is open. Intraocular
pressure is 18 mm. Hg. What is the preliminary diagnosis?
A *Acute iridocyclitis
B Acute attack of primary glaucoma
C Secondary inflammatory glaucoma
D Acute conjunctivitis
E Acute keratitis

55. A patient complains of lacrimation, photophobia, decrease of visual acuity and night pain in
his eye. There is blepharospasm, mixed injection, cilliary pain, anterior chamber opacity,
changes of iris color. Visual acuity of the sick eye is 0,2, not correctable. What method of
treatment is necessary for using as an acute management?
A *Instillation of mydriatics
B Instillation of myotics
C Surgical treatment
D Laser treatment
E UHF treatment

Cataract
56. A 65-year-old patient complains of gradual worsening of his left eye vision for 10 months.
On physical examination: visual acuity of the left eye is 0,01, not correctable. The eye is not
irritated, pupil is grayish, reflex from the eyeground is absent. Intraocular pressure is 18 mm/Hg.
What is the most probable preliminary diagnosis?
A. *Senile cataract
B. Open-angle glaucoma
C. Disorder of blood circulation in retina vessels
D. Leukoma of the cornea
E. Exfoliation of the retina

57. A 65-years-old patient complains of significant vision deterioration in both eyes that was
developing gradually. Visual acuity of his right eye is 0,08, not correctable. Visual acuity of his

11
left eye is 0,03, not correctable. In both eyes: cornea has normal properties; anterior chamber is
of average depth; biomicroscopy reveals inhomogeneous lens opacity; reflex from eyefundus is
absent. What is your diagnosis?
A *Immature senile cataract
B Hypermature cataract
C Secondary cataract
D. Congenital cataract
E Vitreous body opacity

58. A patient 67 years of age complains of gradually deterioration of vision has being observed
for 3 years without any reason. At examination: visual acuity is light perception with correct
projection of light; cornea is transparent; anterior chamber angle is open, lens is evenly opaque
in all its layers; shadow of iris is absent. Fundoscopia is impossible. What is your preliminary
diagnosis?
A *Mature senile cataract
B Immature senile cataract
C Initial senile cataract
D Traumatic cataract
E Primary close-angle glaucoma

59. A patient 70 years of age has visual acuity of his right eye equal to light perception with
correct light projection; visual acuity of his left eye 0,05, not correctable. At examination of the
right eye: lens is totally opaque, shadow of iris and reflex from eyefundus are absent; IOP
(intraocular pressure) is 20 mm. Hg. In the left eye: anterior chamber is shallow, lens is grey,
enlarged, with great amount of transparent and semitransparent fibers in its anterior layers.
Reflex from eyefundus is very dim, IOP is 20 mm. Hg. Put diagnosis, please.
A *Mature senile cataract of the right eye
B Leucoma
C Glaucoma
D Vitreous body opacity
E Secondary cataracta

60. A patient complains of impaired far vision in his right eye. Previously the eye often turned
red and hurt. Objectively: the eyes are not irritated, cornea is transparent, anterior chambers are
of average depth, their liquid is transparent. Iris of the right eye has normal color, its pattern is
unchanged. The pupil is of irregular shape, scalloped. Biomicroscopy of the crystalline lens
reveals the areas of opacity and vacuoles. Put a diagnosis:
A. *Complicated cataract of the right eye
B. Senile cataract of the right eye
C. Diabetic cataract of the right eye
D. Tetanic cataract of the right eye
E. Radiation cataract of the right eye

Glaucoma
61. A patient who has entered to a hospital in emergency basis complains of acute pain in her
eyes, headache mainly in the forehead, blurred vision, halos around lights, nausea, vomiting. At
examination increased intraocular pressure was revealed. What is the diagnosis?
A *Acute glaucoma attack
B Acute iridocyclitis
C Keratitis
D Chronic iridocyclitis

12
E Cataract

62. Patient has headache, severe eye pain, nausea, blurred vision, and halos around lights. Such
symptoms happened twice, but were resolved spontaneously. But now all the symptoms and
permanent vision loss occur within 14 days. OS – redness, corneal edema, shallow anterior
chamber, pupil diameter is 4,0 mm. Intraocular pressure +++. What is the diagnosis?
А. *Subacute angle closured glaucoma
B Acute iritis
C Keratitis
D Iridocyclitis
E Cyclitis

63. A patient 59 years of age complains of pain in his left eye and left side of head, significant
deterioration of vision in the eye, nausea and vomiting. Objectively: visual acuity of right eye is
1,0, of left eye is 0,03, not correctable. Intraocular pressure in the right eye is 21 mm Hg, in the
left eye is 65 mm Hg. There is congestive injection of sclera in the left eye. Cornea is edematous
and thickened. Anterior chamber is shallow, its moisture is transparent. The pupil is wide, its
reaction to light is absent. Eyefundus is invisible. What is the most probably diagnosis?
A. *Acute glaucoma attack
B. Acute iridocyclitis
C. Intraocular tumor of the II stage
D. Endophthalmitis
E. Panophthalmitis

64. A 72 year old female has been treated for urolithiasis at urological department. After atropine
injection she got acute pain in her left eye and abrupt vision impairment. Objectively: visual
acuity of the left eye is 0,01, the eye is dense but painless on palpation, cornea is opaque, there is
cyanotic induration of eyeball vessels. What is the most probable diagnosis?
A. *Acute attack of primary glaucoma
B. Acute iridocyclitis
C. Secondary glaucoma
D. Acute keratitis
E. Cornel degeneration

65. A 60 y.o. man complains of severe pain in his right eye, photophobia, lacrimation, reduction
of vision, ache in the same half of his head. Pain occurred 2 days ago. On examination: Vis OD
= 0,03, there is congested injection of the eye, significant cornea edema, anterior chamber is
shallow, pupil is wide, iris is atrophic, there is optic nerve excavation, intraocular pressure is 38
mm Hg. Vis OS = 0,8, not correctable. The eye isn’t irritated. Intraocular pressure is 22 mm Hg.
What is the most probable diagnosis?
A. *Acute glaucoma attack
B. Uveitis
C. Keratitis
D. Optic neuritis
E. Maculodystrophy

66. A patient complains of significant vision deterioration, redness of his right eye, severe
headache, nausea and stomach ache have being observed for a day. Stress had preceded the
disease. Objectively: visual acuity of the right eye is 0,02, not correctable. There is narrow eye
gap, moderate lacrimation, photophobia, congestive injection, moderate corneal edema and
roughness, loss of shine. Anterior chamber is shallow, iris is smooth, pupil is wide, reflex from

13
eyefundus is dull pink, eyefundus is invisible due to corneal transparency decrease. At palpation
intraocular pressure is T+3. What is the most probably diagnosis?
A *Acute glaucoma attack
B Keratitis
C Acute conjunctivitis
D Neuralgia of the first trigeminal nerve branch
E Acute abdomen

67. A female patient came to surgical department of a municipal hospital. She was operated due
to acute cholecystitis the day before. She complains of acute pain in the right part of her head,
vision depression, iridescent circles near a source of light. The doctor performed examination of
the patient and found out her right eyeball to be irritated, at lateral illumination the cornea was
translucent, the anterior chamber was shallow, and pupil was wide with no reaction to light.
Palpation through the closed eyelids revealed the right eye to be firmer than the left one. What
condition had been developed at the patient?
A *Acute attack of glaucoma
B Iridocyclitis
C Acute conjunctivitis
D Keratitis

68. A patient is being observed due to angle closed glaucoma of his right eye. Acute glaucoma
attack of the right eye developed in evening. Give an urgent care.
A *Pilocarpine, acetazolamide, lytic mix
B Antibiotics – generally and drops
C Atropine drops
D Sulfatsil sodium 30% drops
E Dexamethasone drops

69. A patient K., 52 years of age, complains of mist in his left eye every morning, halos around
lights that disappear by themselves. Also periodical feeling of fullness in the eye and minor pain
in the left temple vanishing without any treatment were noticed by the patient. At examination
visual acuity of the left eye is 1,0, intraocular pressure is 29 mm Hg. Anterior segment of the eye
and transparent structures are not changed, visual fields are normal. There is enlargement of
optic disc excavation. What is the diagnosis?
A *Glaucoma
B Optic neuritis
C Retinal detachment
D Optic nerve atrophy
E Keratitis

70. A patient 49 year old has been diagnosed open angle glaucoma for the first time. Prescribe
drops:
A. *Pilocarpine hydrochloride 1%
B. Atropine sulfate 1%
C. Dexamethasone 1%
D. Sodium sulfatsil 30%
E. Taurine

71. A patient A. visited a gastroenterologist due to duodenal ulcer with complains of epigastric
pain. There is remark “Glaucoma” on patient’s card. What kind of medicine must not be
prescribed to the patient?
A *Atropine sulfate

14
B Bismuth remedies
C Amoxicillin
D Metronidazole
E Omeprazole

Eye trauma and burns

72. A metallurgist complains of cutting pain and a lacrimation in his right eye. Unpleasant
sensations appeared after unloading of coke coal. Objectively: ОD - lacrimation, there is
irritation of eye, conjunctival injection. In conjunctival fold is black round formation 0,5х0,5
mm.is visible. Cornea is normal. What is your diagnosis?
A *Foreign body of conjunctiva
B Acute conjunctivitis
C Acute scleritis
D Conjunctival tumor
E Keratoconjunctivitis

73. A patient 50 years old who works as a turner, complains of photophobia, lacrimation,
mulligrubs in his right eye. The patient is known to work on a lathe without shield. At
examination: there is mixed injection (irritation) of the eye, a dark-brown object 0,5 mm of
diameter with precise outlines in cornea close to limb. Other structures of eye are unchanged. Put
a diagnosis.
A *Corneal foreign body
B Corneal infiltration
C Corneal phlyctena
D Corneal tumor
E Pterygium

74. The 23-years old patient had trauma of his left eye during the work with stone. 30 minute
later the foreign body was removed from the eye. What kind of medication should you use to
prevent complications?
А. *0,3% gentamycini sulfatis
B 1% pilocarpini hydrochloridi
C 1% atropini sulfatis
D 40% glucose
E 3% kalium iodide

75. A patient complains of photophobia, foreign body sensation, lacrimation. There was eye
trauma in anamnesis. At examination: there is pronounced conjunctival injection, corneal edema.
What is your diagnosis?
A *Corneal scratch
B Corneal foreign body
C Chronic conjunctivitis
D Corneal burn
E Keratitis

76. A 10 year old boy complains of pain in his left eye and severe photophobia after he had
injured the eye with a pencil. Results of the eye examination: blepharospasm, mixed (ciliary and
conjunctival) injection of eye, cornea is transparent, other structures of eyeball are unchanged.
Visus is 0,9. Right eye is normal, Visus is 1,0. What additional method would you choose first of
all?
A. *Staining test with 1%fluorescein

15
B. X-ray examination of orbit
C. Tonometria
D. Gonioscopia
E. Cornea sensation-test

77. A patient 32 years of age complains pain, photophobia, lacrimation, deterioration of vision in
his left eye. A day ago during working with a hammer a splinter of metal had ricocheted and
injured the eye. Objectively: vis OD = 1,0, the eye is healthy. Vis OS = 0,05, not correctable.
There is photophobia, lacrimation, blepharospasm, mixed injection of the eyeball. A valvular
corneal wound is present in 3 mm from limb. Anterior chamber is shallow, cornea is edematous,
pupil is narrow, deeper structures are difficult visible. What is the diagnosis?
A *Penetrating corneal injure of the left eye
B The left eye contusion
C Penetrating corneal injure of the right eye
D Nonpenetrating corneal injure of the left eye
E Keratitis

78. A patient visited a doctor due to vision deterioration of his right eye. The patient is known to
have got trauma of the eye with a metal piece at a workshop. Objectively: the cornea has not
been injured, anterior chamber is deep. There is linear wound and hemorrhage in conjunctiva and
sclera, hypotension. What is your diagnosis?
A *Penetrating scleral injure
B Contusion
C Penetrating corneal injure
D Penetrating corneo-scleral injure
E Foreign body of conjunctiva

79. A worker visited a factory doctor due to a penetration injury of his right eye with a metal
fragment. A half of the fragment is inside anterior chamber, the other one is outside. The doctor
removed the splinter, put a binocular bandage, injected antitetanus serum and immediately
directed the patient to an eye hospital. What mistake did the doctor during first aid?
A. *Removed the metal fragment
B. Put a binocular bandage
C. Injected antitetanus serum
D. Did not drop midriatics
E. Did not directed the patient to X-ray of the orbit

80. A patient affirms to have got trauma of his eye with metal shavings during work with metal.
The doctor can not found out a corneal wound, however shape of pupil is changed and anterior
chamber is shallow. There is hypotony of the eye at palpation. What is the most informative
method of an intraocular foreign body detection in this situation?
A *Radiography with Comberg-Baltin prostesis
B Examination with lateral illumination
C Ophthalmoscopy
D Examining in transmitted light
E Gonioscopy

81. A patient was put diagnosis: penetrating corneal wound of the right eye. At examination in
focal illumination: intraocular pressure is low, there is corneal edema, wound in paracentral zone
of cornea, the anterior chamber is 2 mm. of depth. What examination is necessary to be done?
A *Radiography with Comberg-Baltin prosresis
B Survey radiography in two projections

16
C Radiography according to Vogt
D Rheography of the eye
E Echography of the eye

82. A patient had ocular trauma with a metal fragment. At examination: there is corneal erosion
1 mm of size, defect of iris. Intraocular foreign body is suspected to be present but X-ray
examination did not reveal it. What kind of examination does the patient need?
А. *X-ray examination according to Voght
B X-ray examination according to Comberg- Baltin
C Ultrasound examination
D Computer tomography
E Magnetic resonance imaging

83. A baby has decreased vision on his right eye. This happened after he had got eye trauma with
the branch of tree. OD - redness, corneal erosion 2x3 mm, hyphema. Intraocular pressure is
normal. What is the diagnosis?
А. *Contusion
B Penetrating corneal injury
C Penetrating scleral injury
D Keratitis
E Iridocyclitis

84. After contusion of his right eye a patient complains of sudden loss of vision with remaining
light perception. Objectively: the eye is not irritated. Cornea is transparent. Pupil reacts to light.
The pupil area is black. Fundus reflex is absent. What is the most likely cause of vision loss?
A. *Hemophthalmus
B. Retinal detachment
C. Traumatic cataract
D. Acute occlusion of retinal vessels
E. Optic nerve avulsion

85. At ocular examination a foreign metallic body was found in the retina of the left patient’s
eye. The eye is not irritated. Iris is darker than one of the right eye. There are dark brown
deposits on the corneal endothelium. There are grains of pigment under the lens capsule, retinal
pigmented lesions. What is the diagnosis?
А. *Syderosis of the eye
B Chalcosis of the eye
C Chronic iridocyclitis
D Traumatic cataract
E Traumatic chorioiditis

86. A patient G., 26 years old, 5 days ago got trauma of his right eye (penetration corneal injury)
but visited a doctor only 2 days after the trauma. He complains of severe pain in his right eye,
photophobia, lacrimation, vision deterioration. At examination: liquid of the anterior chamber is
translucent (clouding of the anterior chamber moisture), pupil is narrow. There is ciliary
tenderness, mixed injection. Put a diagnosis.
A *Posttraumatic iridocyclitis of the right eye
B Keratitis
C Penetrating injury
D Subatrophy of the eyeball
E Glaucoma

17
87. A patient complains of mulligrubs, redness, vision deterioration of his left eye, pain that is
being increased during the eye palpation. At examination mixed injection of the eyeball and
precipitations on the posterior corneal surface are revealed. Iris is green (on the right eye iris is
grey). There are a few posterior adhesions between the iris and lens. Reflex from eyefundus is
dull pink. Eyefundus is without any pathological changes. Vis OS = 0,4, not correctable,
intraocular pressure (IOP) is 19 mm of Hg. Three months ago the patient got penetrating injury
of his right eye and was done a primary microsurgical treatment due to penetration corneal
trauma. Objectively: the right eye is hypotonic (IOP=13 mm Hg), VisOD = 0, there is mixed
injection of the eyeball, a corneoscleral scar that is soldered with iris. The deeper structures of
eye are not visible through the scar. What is the most probably diagnosis?
A *Sympathetic inflammation of the left eye
B Acute conjunctivitis of the left eye
C Episcleritis of the left eye
D Keratitis of the left eye
E Corneal erosion of the left eye

88. A worker had observed for electric welding for an hour. In the evening severe mulligrubs in
his eyes, photophobia, lacrimation and blepharospasm occurred. Objectively: there is expressed
edema and redness of eyelids, lacrimation, blepharospasm, moderate injection of eyeball vessels.
Open part of cornea in both eyes is slightly edematous. The deeper structures of eye are not
changed. Put the diagnosis.
A *Electric ophthalmia on both eyes
B The burn of conjunctiva and cornea in both eyes with infrared rays
C Thermal burn of conjunctiva and cornea in both eyes
D Acute keratitis of both eyes
E Keratopathy of both eyes

89. A nurse 30 years of age works in physiotherapy with electrical equipment that emits
radiation of the all electromagnetic spectrum parts. The nurse does not use individual protection
means. She complains of pain and sensation of “sand” in her eyes, impossibility of looking on
bright light. Objectively: there is hyperemia and edema of eyeballs conjunctiva. What
professional disease is possible to occur in this situation?
A *Keratoconjunctivitis
B Cataract
C Photoallergy
D Blepharospasm
E Progressive myopia

90. A patient K., 35 years of age, complains of severe pain in his right eye, photophobia, vision
deterioration have occurred after welding. At examination: eye gap is narrow; there is moderate
pericorneal injection; cornea is edematous. What does the patient need?
A *Anesthetic instillations
B Dexamethasone instillations
C Dry heat.
D Sulfatsil sodium 20% drops
E Taurine solution

Eyes and a general pathology

91. A 15 year old adolescent was taken to the hospital with complaints of poor night vision.
Objectively: there is increased darkness adaptation time, Bitot’s spots on conjunctiva. The

18
patient’s skin is dry, covered with scales; there are signs of folliculitis on his face. What is the
cause of the disease?
A. *Retinole deficit
B. Thiamine deficit
C. Biotin deficit
D. Folic acid deficit
E. Napthtochynones deficit

92. A patient 50 years of age complains of loss of vision in her right eye had happened suddenly.
Visual acuity of the eye is 0,04, not correctable. Anterior segments and deeper structures of the
eye are without any pathology. On eyefundus optic nerve disc and retina is pale, there are Gvist’s
and Salus’s-II symptoms, symptom of “cherrystone”. What is the most probably cause of such
condition?
A *Hypertonic disease
B Cardiopsychoneurosis
C Iron-deficiency anemia
D Phlebeurysm
E Myelogenous leukemia

93. A patient complains of vision decrease in both eyes have been present since his childhood.
Visual acuity in both eyes is 0,1, not correctable. The anterior segment of eye and transparent
structures are unchanged. Optic nerve disc has precise outlines, of grey color, its vessels are
narrow. Put the diagnosis.
A *Optic nerve atrophy
B Glaucoma
C Congestive optic disc
D Myopia
E Retinal detachment

Sudden vision loss

94. A 57 year old patient abruptly lost vision of one eye. Examination revealed his visual acuity
to be 0,02 excentrically, there are hemorrhages of eyefundus of different shape and sizes
(“crushed tomato” symptom). Optic nerve disk is hyperemic. There is general vascular pathology
in anamnesis. Direct-acting anticoagulants were administered. What is the most probable
diagnosis?
A. *Central retinal vein thrombosis
B. Hypertensive angiopathy
C. Hypertensive angioneuropathy
D. Central retinal artery embolism
E. Diabetic retinopathy

19