QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: An Ophthalmologist Diagnosed as A 'simple myopia with regular astigmatism'. Which of following glasses to be prescribed?
Options:
A. +2D spherical, 90deg cylindrical
B. -2D spherical -90deg cylindrical
C. Both cylindrical -2D
D. Both spherical -2D

Rationale: (B) -2D spherical -90deg cylindricalHere, the options provided in the answers are a bit confusing.The correct answer should be a cylindrical only, mentioning its axis, since the diagnosis is a simple myopic astigmatism - where power at one axis will be plane or nill and another corresponding axis to have a power.When eye-wear prescriptions are written, they can be classified into different areas depending on the power or refractive error.There are seven categories to which prescriptions can fall:1. Simple Hyperopia, the Rx will be (+) sphere2. Simple Myopia, the Rx will be (-) sphere3. Simple Myopic Astigmatism, the Rx will be piano (-)4. Simple Hyperopic Astigmatism, the Rx will be (+)5. Compound Hyperopic Astigmatism, major meridian power will be (+)(+) on both 90 and 180 degree axis.6. Compound Myopic Astigmatism, major meridian power will be (-)(-) on both 90 and 180 degree axis.7. Mixed Astigmatism, major meridian powers will be opposites (-)(+)(+)(-) on both 90 and 180 degree axis.Curvature ametropia has a special importance because it is the cause of another very troublesome error of refraction called astigmatism.In most eyes the areas of the refractive surfaces uncovered by the pupil and used in vision are very nearly spherical.When the cornea has its direction of greatest and least curvature at right angles to one another, the condition is called regular astigmatism.In the commonest form when the vertical meridian is the more curved, the condition is generally called regular astigmatism

Answer: OPTION B IS CORRECT.
Question: Commonest congenital tumour of conjunctiva is:
Options:
A. Epibulbar dermoid
B. Benign melenoma
C. Papilloma
D. Capillary haemangioma

Rationale: Ans. Epibulbar dermoid

Answer: OPTION A IS CORRECT.
Question: A man injured his eye in an accident. After two weeks his other developed minor signs of anterior uveitis. Histologic sections of the traumatized eye shows Dalen-Fuchs nodules. Diagnosis is
Options:
A. Sympathetic ophthalmia
B. Anterior uveitis
C. Eye injury
D. Glaucoma

Rationale: Sympathetic ophthalmia is an inflammation in the second eye after the other has been damaged by penetrating injury. The uninjured or "sympathizing" eye develops minor signs of anterior uveitis after a period ranging from 2 weeks to many years. As a result of ciliary body inflammation, floating spots and loss of the power of accommodation are among the earliest symptoms. The disease may progress to severe iridocyclitis with pain and photophobia. The retina usually remains uninvolved except for perivascular cuffing of the retinal vessels with inflammatory cells. There may be choroidal lesions, representing the macroscopic manifestation of Dalen-Fuchs nodules. Ref: Chan T.Y., Hodge W.G. (2011). Chapter 16. Immunologic Diseases of the Eye. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.

Answer: OPTION A IS CORRECT.
Question: Following anatomic factors predispose to glaucoma, EXCEPT:
Options:
A. Flat cornea
B. Increased length of eyeball
C. Shallow anterior chamber
D. Big size of ciliary body

Rationale: Anatomic risk factors for the development of acute angle closure glaucoma are small eyes with shallow anterior chamber, sho axial length, small corneal diameter, shallow limbal chamber depth and thick, relatively anteriorly positioned lens. Risk factors for primary open angle glaucoma: Age Race Family history Diabetes mellitus Thin central cornea Systemic hypeension REF: Pearls of Glaucoma Management edited by JoAnn A. Giaconi, page 415.

Answer: OPTION B IS CORRECT.
Question: A 24 year old male was brought to emergency depament with complaints of nausea and vomiting, sweating, secretions from the eyes,anxiety,yawning, . What shall be the probable diagnosis ?
Options:
A. Organophosphate toxicity
B. Cannabis toxicity
C. Opioid withdrawal
D. Lead toxicity

Rationale: OPIOID WITHDRAWAL =After withdrawal of the drug for > 12 hours and lasts about a week. =Clinical feature Yawning is the most common feature. =Grading MINOR: Dilated pupils, piloerection, yawning, rhinorrhoea, myalgia, cramps, lacrimation, anorexia. MODERATE: Restlessness, insomnia, hypeension, tachycardia, tachypnoea, diaphoresis. MAJOR: Vomiting, diarrhoea, hyperactive bowel sounds, hypotension. =Death is caused by cardiac arrest following an arrhythmia and ventricular fibrillation. = Rx- Methadone (25 to 50 mg )twice daily helps recovery.

Answer: OPTION C IS CORRECT.
Question: Recommendations for gonococcal eye prophylaxis includes all except
Options:
A. 0.5 % Erythromycin ophthalmic ointment
B. 1 % silver nitrate ophthalmic ointment
C. 1 % tetracycline ophthalmic ointment
D. Single-dose ceftriaxone 100mg / kg

Rationale: Single-dose ceftriaxone 100mg / kg i.m or i.v is given for treatment of conjunctivitis in neonate born to mother with untreated gonorrhea.

Answer: OPTION D IS CORRECT.
Question: Keratometry is useful in measuring
Options:
A. Corneal curvature
B. Corneal thickness
C. Corneal diameter
D. Depth of anterior chamber

Rationale: A i.e. Corneal curvature Keratometry or opthalmometry is objective method of estimating the corneal astigmatism by measuring curvature of cornea Q. Its readings are not of much value in routine refraction for prescribing glasses but are of utmost value for prescribing, contact lens and for calculating the power of intraocular lens to be implanted. Examination Done by Corneal thickness Patchymeter Corneal endothelium (the normal cell density is r.:., 3000-4000 cells/mm 2) Specular microscope Corneal curvature Keratometer Q Corneal sheen (shining or polish) Placido's disc examination (there is loss of sharpness of the outline of image of circles) Corneal surface Placido's disc, window reflex, slit lamp biomicroscopy Corneal staining Fluorescein stain: corneal ulcer is stained brilliant green. Alcian blue: stains excess mucus selectively Bengal rose 1% (with Xylocaine 2%): stain diseased & devitalized cells red

Answer: OPTION A IS CORRECT.
Question: Eye of a newborn is
Options:
A. Emmetrophic
B. Hypermetrophic
C. Myopic
D. Astigmatic

Rationale: Eye at bih Anteroposterior diameter - 16.5 mm (adult size is attained by 7-8 years). Corneal diameter- 10 mm. (Adult size - 11.7 mm- attained by 2 years). Anterior chamber - shallow and angle is narrow. Lens - spherical at bih. An infantile nucleus is present. Retina - Fully differentiated except for macula which differentiates by 4-6 months after bih. Myelination of optic nerve fibres has reached the lamina cribrosa. Newborn - usually hypermetropic by +2 to +3 D. Orbit - more divergent (50deg) as compared to adult (45deg). Lacrimal gland - underdeveloped and tears are not secreted. Postnatal period Macula - fully developed by 4-6 months. Fusional reflexes, stereopsis, and accommodation - well developed by 4-6 months. Cornea attains normal adult diameter by 2 years of age. Lens grows throughout life. Reference : Khurana Ophthalmology: 4th Edition Page 11.

Answer: OPTION B IS CORRECT.
Question: Central Retinal aery occlusion is known to be associated with -
Options:
A. Panophthalmitis
B. Diabetic Retinopathy
C. CMV retinitis
D. Orbital mucormycosis

Rationale: RETINAL AERY OCCLUSION Etiology Occlusive disorders of retinal vessels are more common in patients suffering from hypeension and other cardiovascular diseases. Common causes of retinal aery occlusion are:  Atherosclerosis-related thrombosis at the level of lamina cribrosa is the most common cause (75%) of CRAO.  Emboli from the carotid aery and those of cardiac origin account for about 20% cases of CRAO.  Retinal aeritis with obliteration (associated with giant cell aeritis) and periaeritis (associated with polyaeritis nodosa, systemic lupus erythema-tosus, Wegner's granulomatosis and scleroderma) are other causes of CRAO.  Angiospasm is a rare cause of retinal aery occlusion. It is commonly associated with amaurosis.  Raised intraocular pressure may occasionally beassociated with obstruction of retinal aeries for example due to tight encirclage in retinal detachment surgery.  Thrombophilic disorders such as inherited defects of anticoagulants may occasionally be associated with CRAO in young individuals. Clinical features Clinically retinal aery occlusion may present as central retinal aery occlusion or branch aery occlusion. It is more common in males than females. It is usually unilateral but rarely may be bilateral (1 to 2% cases). 1. Central retinal aery occlusion (CRAO).It occurs due to obstruction at the level of lamina cribrosa. Symptoms. Patient complains of sudden painless loss of vision. Signs. Direct pupillary light reflex is absent. On ophthalmoscopic examination retinal aeries are markedly narrowed but retinal veins look almost normal. Retina becomes milky white due to oedema. Central pa of the macular area shows cherry-red spot due to vascular choroid shining through the thin retina of this region. In eyes with a cilioretinal aery, pa of the macular will remain normal . Blood column within the retinal veins is segmented (cattle-trucking). After a few weeks the oedema subsides,and atrophic changes occur which include grossly attenuated thread-like aeries and consecutive optic atrophy . Ref:comprehensive ophthalmology-AK Khurana -4/E pageno:255.

Answer: OPTION D IS CORRECT.
Question: Which of the following is wrong regarding ophthalmic artery -
Options:
A. Present in dura along with optic nerve
B. Supplies anterior ethmoidal sinus
C. Artery to retina is end artery
D. Leaves orbit through inferior orbital fissure

Rationale: Ans. is 'd' i.e., Leaves orbit through inferior orbital fissure OPHTHALMIC ARTERYOrigino The ophthalmic artery is a branch of the cerebral part of the internal carotid artery, given off medial to the anterior clinoid process close to the optic canal.Course and relationsThe artery enters the orbit through the optic canal, lying inferolateral to the optic nerve. Both the artery and nerve lie in a common dural sheath.In the orbit, the artery pierces the dura mater, ascends over the lateral side of the optic nerve, and crosses above the nerve from lateral to medial side along with the nasociliary nerve. It then runs forwards along the medial wall of the orbit between the superior oblique and the medial rectus muscles, and parallel to the nasociliary' nerve.It terminates near the medial angle of the eye by dividing into the supratrochlear and dorsal nasal branches.Brancheso Ophthalmic artery' gives following branches :Central artery of retina. Lacrimal artery :-It gives following branches :Lateral palpebral branch.ZygomaticotemporalZygomaticofacialRecurrent meningealMeningealCiliaryAnterior ethmoidalPosterior ethmoidalMedial palpebralSupratrochlearSupraorbitalDorsal nasalo Ophthalmic artery is the first and most important branch. It is an end artery'.

Answer: OPTION D IS CORRECT.
Question: Bull's eye lesion seen with -
Options:
A. Chloroquine
B. Dapsone
C. Rifampicin
D. Ethambutol

Rationale: Ans. is 'a' i.e. Chloroquine Salt and Pepper fundusCongenital rubella, Congenital syphilis, Congenital leber amaurosis, Mayous Batten disease, Thioridazine toxicity.Crumbled chees and ketchup appearance (sauce and cheese appearance)Pizza pie appearance Brush fire appearanceCMV retinitisSatellite lesionHead light in the fog appearanceToxoplasmosisHemorrhagic retinal necrosisHSV, toxoplasmosis, Bechet's retinitis, CRVO or branch vein occlusionMost common ocular infection in AIDS Most common cause of chorioretinitis in AIDSCMVBull's eye retinopathy (macuiopathy)Chloroquine, Phenothiazine, Bardet-Biedle syndrome, Batten disease, inverse retinitis pigmentosa, Stargardt disease, Dystrophies,Chronic macular holeRoth spotsSnowball opacities in vitreousBacterial endocarditis, Puerperal septicemia Pars planitis, Candidiasis, Sarcoidosis, Lyme disease

Answer: OPTION A IS CORRECT.
Question: A 42-year-old man with known valvular heart disease develops a fever for 1 week. He appears unwell; findings include a pansystolic murmur at the apex that radiates to the axilla and a soft S1 sound. He has petechiae on his conjunctival sac, linear hemorrhages under a few fingernails, and painful, tender, and erythematous nodules on some of the distal fingertips. Which of the following is the most responsible mechanism for these physical findings?
Options:
A. direct bacterial invasion
B. immune response
C. vascular phenomena
D. valvular damage

Rationale: Common findings in infective endocarditis include petechiae, Roth's spots, Osler's nodes, Janeway lesions, splinter hemorrhages, stroke, and infarction of viscera, or extremities.Many of the complications are thought to be embolic but may include vasculitis. Autopsy studies reveal that many systemic emboli go unrecognized. Brain, lung, coronary arteries, spleen, extremities, gut, and eyes are common locations for emboli.

Answer: OPTION C IS CORRECT.
Question: Tomato ketchup retina is seen in -
Options:
A. Cental retinal artery occlusion
B. Central retinal vein occlusion
C. Coats disease
D. Side cell retinopathy

Rationale: Ans. is 'b' i.e. Central retinal vein occlusion o Tomato ketchup or splash tomato fundus is seen in central retinal vein occlusion.

Answer: OPTION B IS CORRECT.
Question: ICG angiography is primarily indicated in
Options:
A. Minimal classical CNV
B. Occult CNV
C. Angioid streaks with CNV
D. Polypoidal choroidal vasculopathy

Rationale: We recommend ICG with some enthusiasm for identifying feeder vessels in age-related macular degeneration, choroidal neovascular membranes, chronic central serous retinopathy, multiple evanescent white dot syndrome, vasculitis, acute multifocal placoid pigment epitheliopathy, Vogt-Koyanagi-Harada syndrome Ref ganong's review of medical physiology 25e 643

Answer: OPTION B IS CORRECT.
Question: A 70 year old patient presents with dizziness and headache followed by left sided hemiparesis with right eye dilatation and ptosis. Most probable blood vessel damaged is:-
Options:
A. Middle cerebral aery
B. Anterior communicating aery
C. Posterior cerebral aery
D. Basilar aery

Rationale: Ipsilateral 3 CN palsy present along with ptosis & C/L Hemiparesis s/o Weber syndrome Cause: Lesion in Midbrain due to occlusion of P1 PCA Hemiplegia can occur due to occlusion in: MCA P1 PCA Basilar aery ant spinal aery

Answer: OPTION C IS CORRECT.
Question: A 40 year old male patient complains of diminished vision during night and dryness of eyes. Patient gives history of recurrent bacterial infections. The plasma level of retinol binding protein in this patient will be:
Options:
A. Decreased
B. Increased
C. Unchanged
D. Fluctuating

Rationale: Night blindness (nyctalopia) is one of the earliest symptoms of vitamin A deficiency. Severe deficiency of vitamin A leads to xerophthalmia. The plasma level of retinol binding protein is decreased in vitamin A deficiency.
Satyanarayana- Biochemistry, 3rd edition, pg-123

Answer: OPTION A IS CORRECT.
Question: All are known to produce parenchymatous conjunctival xerosis except:
Options:
A. Vitamin A deficiency
B. Diphtheric membranous conjunctivitis
C. Trachoma
D. Stevens-Johnson syndrome

Rationale: Ans. Vitamin A deficiency

Answer: OPTION A IS CORRECT.
Question: Left homonymous hemianopia is seen in which right sided lesion?
Options:
A. Optic tract
B. Optic nerve
C. Optic chiasma
D. Occipital lobe (visual coex)

Rationale: Contralateral homonymous hemianopia occurs in retrochiasmal lesions which includes lesions of optic tract, lateral geniculate nucleus,optic radiations. Lesions of the visual pathways at the level of: 1. Optic nerve; 2. Proximal pa of optic nerve; 3. Central chiasma; 4. Lateral chiasma (both sides); 5. Optic tract; 6. Geniculate body; 7. Pa of optic radiations in temporal lobe; 8. Pa of optic radiations in parietal lobe; 9. Optic radiations; 10. Visual coex sparing the macula; 11. visual coex, only macula

Answer: OPTION A IS CORRECT.
Question: Argon Laser trabeculoplasty is done in –
Options:
A. Open angle glaucoma
B. Secondary glaucoma
C. Angle recession glaucoma
D. Angle closure glaucoma

Rationale: Argon or diode laser trabeculoplasty is indicated in POAG when TOP is uncontrolled by medical therapy or when patient is non-compliant to medical therapy.

Answer: OPTION A IS CORRECT.
Question: Mannitol is used in the management of:-
Options:
A. Congestive cardiac failure
B. Acute congestive glaucoma
C. Acute renal failure
D. Pulmonary edema

Rationale: Option A: Treated by Lasix (Furosemide), morphine, O2, Positioning (LMNOP) Option C: Managed by Hemodialysis

Answer: OPTION B IS CORRECT.
Question: Aerial supply of hippocampus?
Options:
A. Medial striate aery from middle cerebral aery
B. Lateral striate aery from middle cerebral aery
C. Anterior choroidal aery
D. Anterior cerebral aery

Rationale: Internal carotid aery gives anterior choroidal aery, which branches & form anterior hippocampal aery. Posterior cerebral aery gives branches to middle & posterior hippocampal aery. Internal capsule & basal ganglia is supplied by the lenticulostriate branches of middle cerebral aery. Ischemia to hippocampus causes anterograde amnesia

Answer: OPTION C IS CORRECT.
Question: A 30 year old female wears contact lens for 2 months continuously. The symptoms she experiences therafter could be due to all except-
Options:
A. Giant Papillary conjunctivitis
B. Microbial keratits
C. Increased sensitivity
D. Open angle glaucoma

Rationale: Ans. is 'd' i.e., Open angle glaucoma * Complications of contact lens wearing are : -1) Intolerance: - Some people find wearing contact lenses intolerable.2) Corneal complications : - Corneal abrasion, Corneal edema, Corneal vascularization, Microbial keratitis (Pseudomonas, acanthamoeba), Sterile corneal infiltrate.3) Giant papillary conjunctivitis4) Hypoxia : - Cornea is deprived of oxygen from the tear film by the presence of the contact lens. The cornea becomes edematous and new vessels may develop in the limbal area.5) Sensitivity: - This may develop in response to the preservative (thiomersal) in the cleaning and soaking solution. This results in allergic conjunctivitis.

Answer: OPTION D IS CORRECT.
Question: Glaukomflecken is a feature of:
Options:
A. Acute narrow-angle glaucoma
B. Pseudoexfoliative glaucoma
C. Juvenile glaucoma
D. Phacolytic glaucoma

Rationale: Ans. Acute narrow-angle glaucoma

Answer: OPTION A IS CORRECT.
Question: All of the following are true about Albinism except:
Options:
A. Congenital disorder characterized by depigmented skin, hair and eyes
B. It is caused by mutation in Tyrosinase enzyme
C. Melanocytes are normal in number
D. Autosomal dominant

Rationale: Albinism is a autosomal recessive condition and histopathology shows normal number of melanocytes, but with decreased melanin production.

Answer: OPTION D IS CORRECT.
Question: What is the nerve supply of cornea -
Options:
A. Maxillary division of trigeminal nerve
B. Facial Nerve
C. Auriculotemporal nerve
D. Ophthalmic division of Cranial nerve V

Rationale: Ans. is 'd' i.e., Ophthalmic division of Cranial nerve V Innervation of cornea:o The cornea is one of the most sensitive tissues of the body, as it is densely innervated with sensory nerve fibres via the ophthalmic division of the trigeminal nerve by way of70-80 long ciliary nerves and short ciliary nerves. Research suggests the density of pain receptors in the cornea is 300-600 times greater than skin and 20-40 times greater than dental pulp, making any injury to the structure excruciatingly painfulo The ciliary nerves run under the endothelium and exit the eye through holes in the sclera apart from the optic nerve (which transmits only optic signals).o The nerves enter the cornea via three levels; scleral, episcleral and conjunctival. Most of the bundles give rise by subdivision to a network in the stroma, from which fibres supply the different regions. The three networks are, midstromal, subepithelial/sub-basal, and epithelial. The receptive fields of each nerve ending are very large, and may overlap.

Answer: OPTION D IS CORRECT.
Question: A 60-year-old alcoholic who sustained blunt trauma to his head due to assault is brought to the ER. HE opens his eyes to pain and speaks incomprehensible words when his sternum is pressed. He withdraws his hand to pain. His Glasgow Coma Score is-
Options:
A. 6
B. 8
C. 10
D. 12

Rationale: Ans. is 'b' i.e., 8 E-To pain +V- incomprehensible words + M- Withdraws to pain 2+2+4 A) Eye opening B) Verbal response C) Motor response Spontaneous 4 Oriented 5 Obeys commands 6 To Voice 3 Confused 4 Localises pain 5 To pain 2 Inappropriate words 3 Withdraws (pain) 4 None 1 Incomprehensible words 2 Flexion (pain) 3 None 1 Extension (pain) None 2 1 o A score of 7 or less is classed as coma o A score of 9 or more excludes coma

Answer: OPTION B IS CORRECT.
Question: Which one of the following drugs is contraindicated in treatment of dendritic corneal ulcer
Options:
A. Atropine
B. Cefazolin
C. Acyclovir
D. Dexamethasone

Rationale: Ans.(d) DexamethasoneRef: A.K. Khurana 6th ed. /108-109* Dendritic ulcer is an irregular linear branching ulcer with knobbed ends and reduced corneal sensations seen in epithelial keratitis* It is caused by herpes simplex infection.* Steroids cause progression of dendritic ulcer, into geographical ulcer so, they are contraindicated.* The treatment is done with 3% acyclovir ointment and mechanical debridement. Other antibiotics may be required if there is a secondary infection.

Answer: OPTION D IS CORRECT.
Question: Keratometry is done to assess: March 2012
Options:
A. Corneal sensation
B. Corneal endothelium
C. Corneal thickness
D. Curvature of cornea

Rationale: Ans: D i.e. Curvature of cornea Instruments & their uses Corneal sensitivity may be tested by touching it in various places with a wisp of cotton wool twisted to a fine point & comparing the effect with that on the other, normal cornea The corneal endothelium can be examined cursorily by the specular examination technique on the slit lamp. Corneal thickness can be measured by an optical pachymeter on a slit lamp or an ultrasonic pachymeter A keratometer (ophthalmometer) measures the curvature of the anterior surface of the cornea at 2 points about 1.25 mm on either side of its centre.

Answer: OPTION D IS CORRECT.
Question: Ganglion associated with accommodation of eye for near vision is ?
Options:
A. Geniculate
B. Ciliary
C. Otic
D. Sphenopalatine

Answer: OPTION B IS CORRECT.
Question: All are features of epidemic dropsy, except -
Options:
A. Glaucoma
B. Diarrhoea
C. Convulsion
D. Hea failure

Rationale: The symptoms of epidemic dropsy are sudden non inflammatory bilateral swelling of legs,often associated with diarrhoea,dyspnoea cardiac failure and death.sometimes patients may develop glaucomaREF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-608.

Answer: OPTION C IS CORRECT.
Question: In which of the following conditions Berlin's edema is
Options:
A. Open angle glaucoma
B. After cataract surgery
C. After concussional trauma
D. Diabetic retinopathy

Rationale: C i.e. After concussion trauma Blunt trauma to eye may produce Berlin's edema or commotio retinae Q which is a cloudy swelling characterized by a grey appaerance, most frequently in the temporal region. It may also manifest as cherry red spot in the foveal region.

Answer: OPTION C IS CORRECT.
Question: Objective assessment of the refractive state of the eye is termed –
Options:
A. Retinoscopy
B. Gonioscopy
C. Ophthalmoscopy
D. Keratoscopy

Rationale: Objective refraction methods are retinoscopy, refractometry and keratometry.

Answer: OPTION A IS CORRECT.