Ophthalmology





1) Which statement about corneal abrasions is 6) Patients with type II diabetes should be
incorrect? initially seen by an ophthalmologist for a
a) Abrasions are accompanied by dilated fundus exam:
photophobia a) Within 5 years of diagnosis
b) Abrasions are painful b) Within a year of diagnosis
c) The eye is often red c) At 10 years
d) Fluorescein will delineate the abraded d) When vision changes
area e) At the time of diagnosis
e) Abrasions often cause scarring

7) Which of the following is false concerning

2) A patient complains of sudden onset herpes zoster ophthalmicus:
flickering lights and a persistent loss of part a) It is more common in elderly and
of the visual field but no pain. This patient immunocompromised patients
likely has: b) Vesicles on the tip of the nose suggest
a) Posterior cerebral artery occlusion involvement of first branch of the fifth
b) Retinal detachment cranial nerve
c) Migraine c) Corneal sensation may be reduced on
d) Optic neuritis testing
d) Early treatment with an antiretroviral
such as Acyclovir is of limited benefit
3) The most common cause of an ISOLATED e) Referral to ophthalmology should be
third cranial nerve palsy with pupil made if ocular involvement is suspected
involvement is:
a) Vascular hypertension
b) Multiple sclerosis 8) Which of the following concerning a
c) Diabetes mellitus chalazion is false?
d) An aneurysm a) Systemic antibiotics are a useful initial
e) A neoplasm treatment
b) It is a chronic granulomatous
inflammation of the meibomian gland
4) A patient with acute angle closure glaucoma c) Hot compresses are of value as initial
can present with all of the following treatment
EXCEPT: d) A recurrent lid mass should be biopsied
a) A fixed, dilated pupil e) Initial treatment with topical antibiotics
b) Nausea and vomiting may be beneficial
c) Complaint of haloes around objects
d) Ocular hypotension
e) A steamy cornea on ocular exam 9) If multiple vertical epithelial lesions are seen
on slit lamp exam, one should suspect:
a) Herpes zoster ophthalmicus
5) Signs of diabetic retinopathy include all of b) Herpes simplex keratitis
the following EXCEPT: c) Foreign body behind the upper lid
a) Dot and blot hemmorhages d) A chalazion
b) Hard exudates e) Dye eye syndrome
c) Venous beading
d) Macroaneurysms
e) Macular Edema
10) Which is not a major risk factor for open 12) A 55-year-old male patient presents to the
angle glaucoma? ER with sudden painless loss of vision in his
a) Black race right eye. The patient’s medical history
b) Family history of glaucoma consists of Rheumatoid Arthritis currently
c) Intraocular hypertension >21 mm Hg well controlled on Plaquenil and poorly
d) Hyperthyroidism controlled Hypertension. The patient says
e) Age that he had sudden loss of vision in his right
eye 5 days ago and that the vision has not
recovered since. On ocular examination,
11) A 57-year-old female patient presents with a you discover a normal anterior segment
6-day history of new onset headache that is while fundoscopy reveals widespread
moderate-severe in nature. She says that hemorrhages and areas of infarction
the headache is unilateral and she has also throughout the retina. What is the most likely
experienced a blurring of her vision during diagnosis?
this time. Upon further questioning she also a) The patient has likely developed uveitis
complains of some pain in her jaw when secondary to his diagnosis of
eating. On examination, you find a pale optic Rheumatoid Arthritis
nerve in her left eye. What is the next step in b) Bulls-eye maculopathy caused by
this patient’s management? Plaquenil
a) Reassure the patient that she is c) Retinal Detachment
experience migraine headaches and d) Central Retinal Vein Occlusion
advise her to follow-up after 2 weeks
with a headache diary
b) Order bloodwork for ESR and CRP and 13) An 84-year-old female patient presents with
treat with oral Prednisone if these are a 2-year history of gradually worsening
elevated vision. She continues to see 20/40 in both
c) Treat the patient through surgical eyes. On examination, you see a normal
excision of her temporal artery anterior segment and normal lenses.
d) Obtain a temporal artery biopsy and start Fundoscopy reveals mild drusen in both
the patient on oral prednisone therapy maculae with no hemorrhages visible. What
is the most appropriate next step in the
management of this patient’s condition.
a) Treat with anti-VEGF agents such as
Avastin or Lucentis
b) Place the patient on a regimen of ocular
vitamins such as Vitalux
c) Laser Photocoagulation
d) Photodynamic therapy with Visudyne
14) A 55-year-old man presents with a 18) The causes of efferent pupil defects
complaint of seeing floaters in his vision include… (choose the correct answer)
over the last 1.5 years. There has been a a) Damage to the medial geniculate
gradual increase in the number of these nucleus
floaters but there has not been any sudden b) Damage to the optic nerve
change in his vision. He does not complain c) Adie's syndrome
of seeing any flashes of light and has not d) Damage to the lateral geniculate nucleus
noticed any shadows or curtains over his
vision. There is no photophobia and no
ocular pain. Examination reveals mild 19) A 59-year-old male presents to his family
cataracts in both eyes and his retina appear physician with a 6-month history of
normal and healthy. What is the most likely progressive ptosis and diplopia. On
cause for this patient’s symptoms? examination, the left eye is normal, but the
a) Peripheral Retinal Detachment not right eye exhibits a significant ptosis,
visible with slit lamp examination limitation of all extraocular movements, a
b) Central Retinal Artery Occlusion small pupil not reactive to light, and loss of
c) Posterior Vitreous Detachment corneal sensation. What is the most likely
d) Cataract diagnosis?
a) Graves ophthalmopathy
b) Myasthenia gravis
15) Which lesion would produce a homonymous c) Multiple sclerosis
hemianopia? d) Intercavernous internal carotid artery
a) To the optic tract aneruysm
b) To the optic nerve
c) At the chiasm 20) A 2-year-old girl presents with a white
d) At the retina pupillary reflex (leukocoria) which the child’s
mother noticed in some recent family
photos. What is the least likely diagnosis?
16) In Horner's syndrome a) Retinopathy of prematurity
(choose correct answer) b) Retinoblastoma
a) 1.0% hydroxyamphetamine will dilate a c) Congenital glaucoma
postganglionic lesion d) Cataract
b) 1.0% phenylephrine will dilate a
preganglionic lesion
c) The miosis is most apparent in low light
levels
d) The ptosis only affects the upper lid

17) In afferent pupil defects (choose correct

answer)
a) The pupil is fixed and dilated
b) The pupil responds to light shone into
the second, normal eye
c) Both pupils constrict when light passes
from the normal to the abnormal eye
d) The damage could be to the oculomotor
nerve
ANSWERS

1. E 5. D 9. C 13. B 17. B
2. B 6. E 10. D 14. C 18. C
3. D 7. D 11. D 15. A 19. D
4. D 8. A 12. D 16. C 20. C