QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: Ophthalmic examination of a patient shows 'Herbe pits' on cornea which is characteristic of the following infection:
Options:
A. Trachoma
B. Psoriasis
C. Spring catarrh
D. Fungal keratitis

Rationale: In established trachoma (caused by caused by C trachomatis serovars A, B, Ba, or C), there may also be superior epithelial keratitis, subepithelial keratitis, pannus, or superior limbal follicles, and ultimately the pathognomonic cicatricial remains of these follicles, known as Herbe's pits--small depressions covered by epithelium at the limbocorneal junction. Ref: Nijm L.M., Garcia-Ferrer F.J., Schwab I.R., Augsburger J.J., Correa Z.M. (2011). Chapter 5. Conjunctiva & Tears. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.

Answer: OPTION A IS CORRECT.
Question: 18 month old child presents with both eyes adducted. What is the first thing for diagnosis?
Options:
A. Examination under anaesthesia
B. Refractive error examination
C. Forced duction testing
D. Fundus examination

Rationale: Given the age of the child in question, any test has to be performed under anesthesia(EUA), since the child will not cooperate for any examination. During EUA: Refractive error examination is done to rule out hypermetropia as a cause of B/L adduction. Force duction test is used for diagnosis of Restrictive strabismus (eg Duane's retraction syndrome).

Answer: OPTION A IS CORRECT.
Question: A pediatrician calls an ophthalmologist to examine baby if:
Options:
A. Baby born at 28 weeks gestation
B. Baby has respiratory distress
C. Birth weight of the baby is 2.3 kg
D. Jaundice

Rationale: a. Baby born at 28 weeks gestation(Ref: Nelson's 20/e p 3050, Ghai 8/e p 666)Indications of Screening for Retinopathy of prematurity (ROP):Birth weight <1,500g or gestational age < 32 wk &Selected neonates with a birth weight between 1,500 and 2,000g or gestational age of >32 wk with an unstable clinical course, including those requiring cardiorespiratory support.

Answer: OPTION A IS CORRECT.
Question: Which muscle is intoer of eye
Options:
A. Inferior oblique
B. Inferior rectus
C. Superior rectus
D. Medial rectus

Rationale: Actions of extraocular muscles : Muscle Primary Secondary Teiary action action action LR Abduction -- -- SR Elevation Intorsion Adduction IR Depression Extorsion Adduction SO Intorsion Depression Abduction IO Extorsion Elevation Abduction Ref;A.K.Khurana ; 6th edition; Page no:339

Answer: OPTION C IS CORRECT.
Question: Satellite lesion is seen in which corneal ulcer?
Options:
A. Trachoma
B. Fungal
C. Angular
D. Herpes

Rationale: ANSWER: (B) FungalREF: Khurana 4th ed p. 100Fungal corneal ulceration* Dry* Delicate feathery extensions* Satellite lesions* Sterile immune ring* Big hypopyon* Perforation* Central vascularization

Answer: OPTION B IS CORRECT.
Question: true about TRIAD congenital rubella syndrome
Options:
A. PDA, cataract and deafness is seen
B. Hepatosplenomegaly, mental retardation, deafness
C. Chorioretinitis, multiorgan failure, pneumonitis
D. None of these

Rationale: Answer: A. PDA, cataract and deafness is seenCongenital rubella syndrome (CRS) can occur in a developing fetus of a pregnant woman who has contracted rubella, usually in the first trimester. If infection occurs 0-28 days before conception, the infant has a 43% risk of being affected.Infection in 2nd trimester - may be deafness only.>6 wks - no major abnormalitiesDiagnosis: Isolation of virus in cell cultures of throat samples, urine or other secretions.Detection of IgM in single serum sample sholy after bih.Persistance of Rubella IgG antibodies serum beyond 1 year or rising antibody titer anytime during infancy in an unvaccinated child

Answer: OPTION A IS CORRECT.
Question: Revised strategy for NPCB includes all except –
Options:
A. Fixed facility surgery
B. IOL implantation for cataract
C. Mobile surgical camps
D. Uniform distribution

Rationale: The National Programme for Control of Mildness (NPCB) was launched in the year 1976 as a 100 per cent centrally sponsored programme and incorporates the earlier trachoma control programme
Based on survey conducted during 1998-99 & 1999-2000, following measures were included under revised strategy.
Revised strategies -

a) To make NPCB more comprehensive by strengthening services for other causes of blindness like corneal blindness (requiring transplantation of donated eyes), refractive errors in school going children, improving follow-up services of cataract operated persons and treating other causes of blindness like glaucoma; To shift from the eye camp approach to afixed facility surgical approach and from conventional surgery to IOL implantation for better quality of post operative vision in operated patients;
b) To expand the World Bank project activities like construction of dedicated ere operation theatres, eye wards at district level, training of eye surgeons in modern cataract surgery and other eye surgeries and supply of ophthalmic equipments etc. to the whole country;
c) To strengthen participation of Voluntary Organizations in the programme and to earmark geographic areas to NGOs and Government Hospitals to avoid duplication of effort and improve the performance of Government Units like Medical Colleges, District Hospitals, Sub Divisional Hospitals, community Health Centers, Primary Health Centers etc.
d) To enhance the coverage of eye care services in tribal and other under-served areas through identification of bilateral blind patients, preparation of village-wise blind register and giving preference to bilateral blind patients for cataract surgery.

Answer: OPTION C IS CORRECT.
Question: Drug among the following causing cataract is
Options:
A. Amikacin
B. Dexamethasone
C. Chloramphenicol
D. Penicillin

Rationale: Drugs causing cataract:i. Coicosteroidsii. Phenothiazines and other antipsychoticsiii. Topical mioticsiv. Amiodaronev. StatinsRef. Aravind FAQs in Ophthalmology(first edition) Pg-310

Answer: OPTION B IS CORRECT.
Question: On mutation, which of the following may give rise to hereditary glaucoma?
Options:
A. Optineurin
B. Ephrins
C. RBA8
D. Huntingtin

Rationale: Ans. is 'a' i.e. optineurin The Journal - "Investigative Ophthalmology Visual Science, 2003 September; 44 (9): 388-4" in the article - "Different optineurin mutation pattern in primary open angle glaucoma" by Leung YF et al writes "The optineurin gene (OPTN) is the second gene besides MYOC in which mutation have been identified to be associated with POA G."The following journals also support the answer:Journal: Science 295, 1077- 1079 (2002)Article: Adult-onset primary open angle glaucoma caused by mutation in optineurin by Rezaic. T et al.Journal: Science 275, 668 - 670 (1997).Article identification of a gene that causes primary open angle glaucoma "by Stone et al.

Answer: OPTION A IS CORRECT.
Question: Keratometer measures September 2010 September 2012, March 2013 (e)
Options:
A. Thickness of cornea
B. Radius of cornea
C. Curvature of cornea
D. Depth of posterior chamber

Rationale: Ans. C: Curvature of cornea A keratometer, also known as a ophthalmometer, is a diagnostic instrument for measuring the curvature of the anterior surface of the cornea, paicularly for assessing the extent and axis of astigmatism. A keratometer uses the relationship between object size (0), image size (I), the distance between the reflective surface and the object (d), and the radius of the reflective surface (R). If three of these variables are known (or fixed), the fouh can be calculated using the formula R = 2dI/0

Answer: OPTION C IS CORRECT.
Question: A 43-year-old man is admitted to the emergency department with a fracture of the base of his skull. A thorough physical examination reveals that a number of structures have been injured, possibly including the right greater petrosal nerve. Which of the following conditions needs to be identified during physical examination to confirm the diagnosis of greater petrosal nerve injury?
Options:
A. Partial dryness of the mouth due to lack of salivary secretions from the submandibular and sublingual glands
B. Partial dryness of the mouth due to lack of salivary secretions from the parotid gland
C. Dryness of the right cornea due to lack of lacrimal secretion
D. Loss of taste sensation from the right anterior two thirds of the tongue

Rationale: The greater petrosal nerve carries parasympathetic fibers that are involved in the innervation of the lacrimal gland, as well as the mucosal glands of the nose, palate, and pharynx. As a result, an injury to the right greater petrosal nerve would be expected to result in decreased lacrimal secretions for the right eye. The sublingual and submandibular glands receive their parasympathetic fibers from the facial nerve via the chorda tympani and the lingual nerve. They would be unaffected by this lesion. The parotid gland receives its parasympathetic secretory innervation from the glossopharyngeal nerve via the lesser petrosal and auriculotemporal nerves and would be unaffected. Taste to the anterior tongue is provided by the facial nerve via the chorda tympani, and general sensation to the anterior tongue is provided by the mandibular division of the trigeminal nerve via the lingual nerve.

Answer: OPTION C IS CORRECT.
Question: Because of circle of least diffusion, the distant vision is comparatively good in:
Options:
A. Simple myopic astigmatism
B. Compound myopic astigmatism
C. Mixed astigmatism
D. Compound hypermetropic astigmatism

Rationale: Ans. Mixed astigmatism

Answer: OPTION C IS CORRECT.
Question: Which of the following is not seen in the given clinical condition:
Options:
A. Glaucoma
B. Seizures
C. Port wine stain
D. Parkinsonian signs

Rationale: Ans. D. Parkinsonian signsGiven image is Sturge weber syndrome.Following characteristic present in Sturge weber syndrome:* Stain-Port wine stain* Total cerebral atrophy* UMN paralysis* Recurrent seizures* Glaucoma* Epilepsy

Answer: OPTION D IS CORRECT.
Question: Pathognomic clinical feature of measles are -
Options:
A. Erythematous macular rash
B. Kolpik spots
C. Brushfield spots
D. Bitots spots

Rationale: Ans. is 'b' i.e., Kolpik spots * Koplik's spots are pathognomonic of measles and consist of bluish white dots ~1 mm in diameter surrounded by erythema. The lesions appear first on the buccal mucosa opposite the lower molars but rapidly increase in number to involve the entire buccal mucosa. They fade with the onset of rash.

Answer: OPTION B IS CORRECT.
Question: Which of the following disorders of eye is controlled using SAFE strategy?
Options:
A. Cataract
B. Trachoma
C. Glaucoma
D. Diabetic retinopathy

Rationale: In 1997, WHO developed a strategy known as 'SAFE' to control trachoma worldwide. S -- Surgery for trachomatous trichiasis A -- Antibiotics (Azithromycin/tetracycline) F -- Facial cleanliness E -- Environmental change Ref: Pg Ophthalmology: V. I and, Volume 2 By Zia Chaudhari, Pages 15-6.

Answer: OPTION B IS CORRECT.
Question: Relative afferent pupillary defect is characteristically seen In damage to -
Options:
A. Optic nerve
B. Optic tract
C. Lateral geniculate body
D. Occulomotor nerve

Rationale: For testing relative afferent pupillary defect (RAPD), a strong, steady light is used. The light is shined into one eye, and then quickly switched to the other. This is repeated back and foh, until one of four conclusions is reached (listed below). Since light in one pupil causes both pupils to constrict, quickly switching from one eye to the other will give a "relative" indication of the functioning of each eye and optic nerve. If both eyes are equally dysfunctional, no "relative" defect would be found.

Answer: OPTION A IS CORRECT.
Question: True about cuboid bone :
Options:
A. It develops by membranous ossification
B. Proximally aiculate with lunate bone
C. Flexor retinaculum is attached
D. Aiculates with Calcaneum

Rationale: D i.e. Aiculates with Calcaneum

Answer: OPTION D IS CORRECT.
Question: C - wave in electroretinography is due to
Options:
A. Rods & cones
B. Muller cells
C. Bipolar cells
D. Retinal pigment epithelium

Rationale: A wave - Rods & cones.
B wave - muller cells & Bipolar cells.
C wave - RPE.

Answer: OPTION D IS CORRECT.
Question: What is the instrument used for?
Options:
A. Assessment of eye size
B. Stool assessment tool
C. Assess the volume of testicles
D. Growth assessment tool

Rationale: The above image represents Orchidometer.
It helps to assess the volume of testicules.
Testicular size > 4cc in volume is the 1st sign of puberty in males.

Answer: OPTION C IS CORRECT.
Question: Goblet cells are seen in -
Options:
A. Cornea
B. Conjunctiva
C. Retina
D. Vitreous

Rationale: Ans. is 'b' i.e. Conjunctiva o Epithelial lining of Conjunctiva is stratified non-keratinized epithelium which varies from region to region. The important cells of conjunctiva are : -i) Goblet cells: - Occur throughout the conjunctiva, especially the plica semilunaris singly or in association with epithelial crypts. Goblets cells are most dense nasally and least dens in upper temporal fornix. Goblet cells are absent in palpebral mucocutaneous junction and the limbus.ii) Melanocytes: - Are found in the conjunctiva at limbus, fornix, camucle and at the site of entery of anterior ciliary vessels.iii) Langerhans cells: - In all parts of conjunctiva.

Answer: OPTION B IS CORRECT.
Question: A 45 year old diabetic patient has immunosuppressed with uncontrolled diabetes mellitus. The lesions are locally destructive and have eroded into the eye, palate, and central nervous system, often from an initial site in the sinuses. The organism can be difficult to culture. The appropriate treatment is:
Options:
A. Is intravenous amphotericin only
B. Surgical debridement only
C. Watchful observation
D. Intravenous amphotericin but surgical debridement should also be strongly considered

Rationale: Intravenous amphotericin but surgical debridement should also be strongly considered

Answer: OPTION D IS CORRECT.
Question: Corneal complications of contact lens use ?
Options:
A. Acanthamoeba keratitis
B. Corneal infiltrate
C. Corneal vascularization
D. All of the above

Rationale: Ans. is 'd' i.e., All of the above Advantages of contact lens Contact lens has several advantages over spectacles :- Retain binocularity in Anisometropia owing to less magnification of size of retinal image. Irregular astigmatism can be corrected. No peripheral distoration as it moves with eye and there is normal field of vision. Not subjected to moistening. Several varieties of contact lens can aid in treatment of dry eye. Hard contact lens may stimulate reflex tearing and also prevent evaporation of tear . Cosmatically superior. Tinted contact lenses relieve photophobia in albinism. Disadvantages of contact lens Complications of contact lens wearing are : ? Intolerance : - Some people find wearing contact lenses intolerable. Corneal complications : - Corneal abrasion, Corneal edema, Corneal vascularization, Microbial keratitis (Pseudomonas, acanthamoeba), Sterile corneal infiltrate. Giant papillary conjunctivitis. 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 timbal area. 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: Not a feature of Congenital rubella syndrome is
Options:
A. Congenital Cataract
B. Microphthalmia
C. Salt and pepper retinitis
D. Anterior Uveitis

Rationale: Anterior Uveitis is Not a feature of Congenital rubella syndrome.

Answer: OPTION D IS CORRECT.
Question: A 45 year man is diagnosed with diabetes at his present visit for the first time. When should he visit an ophthalmologist-
Options:
A. On his 50th bihday
B. When dimness of vision stas
C. Before his 50th bihday
D. Immediately at time of diagnosis

Rationale: Ans is option 4 - immediately Patients with type 2 DM should have an initial dilated and comprehensive eye examination soon after diagnosis. Due ti risk of diabetic retinopathy at tume of diabetes diagnosis. According to American diabetic association guidelines for screening of diabetic retinopathy.

Answer: OPTION D IS CORRECT.
Question: A male 45 years old complains of weakness. He is obese and a type 2 diabetic and hypertensive. General examination reveals hepatomegaly. Icterus is visible on sclera and pale coloration of skin present.Which of the following liver diseases can be seen in this patient?
Options:
A. Alcoholic hepatitis
B. Nonalcoholic fatty liver disease (NAFLD)
C. Alcoholic fatty liver disease (AFLD)
D. All of the above

Rationale: For a variety of reasons, lipid—mainly as triacylglycerol—can accumulate in the liver. Extensive accumulation is regarded as a pathologic condition. Nonalcoholic fatty liver disease (NAFLD) is the most  common liver disorder worldwide. 
NAFLD is considered by many to be the hepatic manifestation of the ‘metabolic syndrome, as it is strongly associated with obesity, dyslipidaemia, type 2 diabetes and hypertension. 
Alcoholic fatty liver disease (AFLD) usually presents with elevated transaminases in the absence of hepatomegaly.
Reference: HARPERS ILLUSTRATED BIOCHEMISTRY30th ed Page no 260,261:  Davidson Medicine 23rd edition page no 882

Answer: OPTION B IS CORRECT.
Question: Duret haemorrhage is/are seen in
Options:
A. Conjunctiva
B. Middle ear
C. Encardium of hea
D. Brain

Rationale: Duret Hemorrhage In case of increased ICP downward herniation of brainstem occur, which cause stretching of perforators of basilar aery and may result in bleed (Duret hemorrhage) Duret hemorrhage is a small area of bleeding in ventral and paramedian pa of upper brainstem (midbrain and pons). It usually indicates a fatal outcome, however survival has been repoed Diagnosis is made on CT or MRI Ref: Robbins 9th edition Pgno :1255

Answer: OPTION D IS CORRECT.
Question: Vitreous hemorrhage is caused commonly by: March 2013 (f)
Options:
A. Retinal aery occlusion
B. Retinal vein occlusion
C. Retinitis pigmentosa
D. Retinoblastoma

Rationale: Ans. B i.e. Retinal vein occlusion

Answer: OPTION B IS CORRECT.
Question: Macular sparing is seen in lesion of -
Options:
A. Visual cortex
B. Optical tract
C. Optical chiasma
D. Optic nerve

Rationale: Ans. is 'a' i.e., Visual cortex Lesions of visual cortexo Features depend on the site of visual cortex involvement:i) Anterior part occipital cortex : - Congruous homonymous hemianopia with macular sparing. The lesion occurs due to occlusion of posterior cerebral artery.ii) Tip of occipital cortex : - Congruous homonymous macular defect, i.e., homonymous hemianopia only in the central vision (due to involvement of macula). The lesion occurs due to head injury or gun shot injuries. Pupillary light reflex is normal.

Answer: OPTION A IS CORRECT.
Question: A 62 years old poorly controlled diabetic presents with sudden painless loss of vision. No history of floaters. He also complaints of visual field defect which is progressively worsening over past few months. History of similar complaints present in the other eye and vitrectomy was done. What is next step in management?
Options:
A. Pan- retinal photocoagulation
B. Pars plana vitrectomy
C. Scleral buckling
D. Pneumatic retinopexy

Rationale: Refer: Kanski s Clinical Ophthalmology: A Systematic Approach 8th edition pg 602
TRACTIONAL RETINAL DETACHMENT

Due to retina being mechanically pulled away from its bed by the contraction of fibrous tissue in the vitreous (vitreoretinal tractional bands).
Clinical features
	
presence of vitreoretinal bands
Retinal breaks are usually absent and configuration of the detached area is concave.
The highest elevation of the retina occurs at sites of vitreoretinal traction.
Retinal mobility is severely reduced and shifting fluid is absent.


Treatment - It is difficult and requires pars plana vitrectomy to cut the vitreoretinal tractional bands and internal tamponade.

Answer: OPTION B IS CORRECT.
Question: Polychromatic lustre is seen in
Options:
A. Post radiation cataract
B. Diabetic cataract
C. Congenital cataract
D. Complicated cataract

Rationale: COMPLICATED CATARACT It refers to opacification of the lens secondary to some other intraocular disease. Etiology: 1. Inflammatory conditions. These include uveal inflammations (like iridocyclitis, parsplanitis, choroiditis), hypopyon corneal ulcer and endophthalmitis. 2. Degenerative conditions such as retinitis pigmentosa and other pigmentary retinal dystrophies and myopic chorioretinal degeneration. 3. Retinal detachment. 4. Glaucoma (primary or secondary). 5. Intraocular tumours such as retinoblastoma or melanoma may give rise to complicated cataract in late stages. Clinical features: Typically the complicated cataract stas as posterior coical cataract. Lens changes appear typically in front of the posterior capsule. The opacity is irregular in outline and variable in density. In the beam of slit- lamp the opacities have an appearance like 'bread- crumb'. A very characteristic sign is the appearance of iridescent coloured paicles the so-called 'polychromatic lustre' of reds, greens and blues. A diffuse yellow-haze is seen in the adjoining coex. Slowly the opacity spreads in the rest of the coex, and finally the entire lens becomes opaque, giving chalky white appearance. Deposition of calcium is common in the later stages. Ref:- A K KHURANA; pg num:-181,182

Answer: OPTION D IS CORRECT.
Question: Congenital Rubella Syndrome has all of the following EXCEPT:
Options:
A. Sensorineural deafness
B. Cataract
C. Cardiac Defects
D. Hydrocephalus

Rationale: Ans. (d) HydrocephalusRef.: OP Ghai 8th ed./272The classic Triad for Congenital Rubella Syndrome is:* Sensorineural deafness (58% of patients)* Eye abnormalities--especially retinopathy, cataract and microphthalmia (43% of patients)* Congenital heart disease--especially patent ductus arteriosus (50% of patients)* "Salt-and-pepper" retinopathy is the most common ocular manifestation of congenital rubella.Other Manifestations of CRS may Include:* Spleen, liver or bone marrow problems* Mental retardation* Microcephaly* Eye defects* Low birth weight* Thrombocytopenic purpura (presents as a characteristic blueberry muffin rash)* Hepatomegaly* Micrognathia

Answer: OPTION D IS CORRECT.
Question: An old man presented with complaints of frequent giddiness. Examination showed instability in Romberg test with eyes closed. Which of the following condition may give rise to this finding in this patient?
Options:
A. Veebrobasilar insufficiency
B. Vestibulotoxic drugs
C. Acoustic neuroma
D. Syphilis

Rationale: Romberg test: In peripheral vestibular lesions, the patient sways to the side of lesion. In central vestibular disorder, patient shows instability. Central vestibular disorders are, Veebrobasilar insufficiency Posterior inferior cerebellar aery syndrome (Wallenberg's syndrome) Basilar migraine Cerebellar disease Multiple sclerosis Tumors of brain stem and floor of IVth ventricle Temporal lobe epilepsy

Answer: OPTION A IS CORRECT.
Question: Topical steroid is contraindicated in which ocular condition -
Options:
A. Anterior uveitis
B. Posterior uveitis
C. Fungal Corneal ulcer
D. Moorens ulcer

Rationale: Ans. is 'c' i.e., Fungal Corneal ulcer * Topical steroids enhance fungal replication and corneal invasion and are contraindicated during early therapy of a fungal corneal ulcer.

Answer: OPTION C IS CORRECT.
Question: A child age 5 years, presents with loss of vision and mild proptosis of left eye . On examination direct is absent but consensual is present in left eye. He is having:
Options:
A. Optic nerve glioma
B. Optic sheath meningioma
C. Retinoblastoma
D. Optic disc angioma

Rationale: A i.e. Optic nerve glioma

Answer: OPTION A IS CORRECT.
Question: Pseudoproptosis caused by
Options:
A. Buphthalmos
B. Meningioma of optic nerve
C. Orbital cellulitis
D. Dermoid cyst

Rationale: Answer- A. Buphthalmoscauses are:Buphthalmos (congenital glaucoma),High myopia,Upper lid retraction,Paralysis of the extrinsic muscles,Stimulation of muller muscle by cocaine,Shallow orbit as in craniofacial dysostosis

Answer: OPTION A IS CORRECT.