QIAIUNCC/EYE-TEST-3 huggingface dataset:
Question: Not true about Fuch's corneal dystrophy ?
Options:
A. Posterior dystrophy
B. Endothelial dystrophy
C. Unilateral condition
D. Occurs in old age

Rationale: Ans. is 'c' i.e., Unilateral condition Corneal dystrophies are bilateral. Fuch's epithelial endothelial dystrophy Fuchs dystrophy is frequently seen as a slowly progressive bilateral condition affecting females more than males, usually between fifth and seventh decade of life. Primary open angle glaucoma is its common association. Clinical features can be divided into following four stages :? Stage of cornea guttata. It is characterised by the presence of Hassal-Henle type of excrescenses in the central pa of cornea. A gradual increase of central guttae with peripheral spread and confluence gives rise to the so called 'beaten-metal ' appearance. The stage is asymptomatic. Oedematous stage or stage of endothelial decompensation is characteirsed by the occurrence of early stromal oedema and epithelial dystrophy. Patients complains of blurring vision. Stage of bullous keratopathy. This stage follows long-standing stromal oedema and is characterised by marked epithelial oedema with formation of bullae, which when rupture cause pain, discomfo and irritation with associated decreased visual acuity. Stage of scarring. In this stage epithelial bullae are replaced by scar tissue and cornea becomes opaque and vascularized. The condition may sometiems be complicated by occurrence of secondary infection or glaucoma.

Answer: OPTION C IS CORRECT.
Question: Rigor mois stas in: UP 08
Options:
A. Eyelids
B. Hea
C. Voluntary muscle
D. Limbs

Rationale: Ans. Hea

Answer: OPTION B IS CORRECT.
Question: Progressive multifocal leukoencephalopathy spares
Options:
A. White matter of cerebrum
B. White matter of parietal lobe
C. White matter of periventricular area
D. Spinal cord and optic nerve

Rationale: Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease which results from the reactivation of John Cunningham virus (JC virus) infecting oligodendrocytes(which provide suppo and insulation to axons in CNS) The term Leukoencephalopathy refers to all of the brain white matter diseases Toxic leukoencephalopathy or toxicspongiform leukoencephalopathy is a rare condition that is characterized by progressive damage (-pathy) to white matter (-leuko-) in the brain (-encephalo-), paicularly myelin, due to causes such as exposure to drug abuse, environmental toxins, or chemotherapeutic drugs

Answer: OPTION D IS CORRECT.
Question: Which of the following drug is deposited in the retina?
Options:
A. Isoninazid
B. Chloroquine
C. Rifampicin
D. Pyrizinamide

Rationale: Prolonged use of high doses (as needed for rheumatoid ahritis, DLE, etc.) may cause loss of vision due to retinal damage. Corneal deposits may also occur and affect vision, but are reversible on discontinuation. ESSENTIALS OF PHARMACOLOGY page no. 823

Answer: OPTION B IS CORRECT.
Question: Stellwagg's sign of graves disease is
Options:
A. Difficulty in eversion of upper lid
B. Infrequent blinking
C. Fullness of eyelids
D. Lid lag

Rationale: Lid lag - Von graefe's sign.
Fullness of eyelids - Enroth's sign.

Answer: OPTION B IS CORRECT.
Question: The most characteristic visual field change in primary open-angle glaucoma is:
Options:
A. Nerve fibre bundle defect
B. Enlargement of blind spot
C. Generalised constriction of field
D. Sector-shaped defects

Rationale: Ans. Nerve fibre bundle defect

Answer: OPTION A IS CORRECT.
Question: Which of the following is not true regarding fungal corneal ulcer: March 2009
Options:
A. Convex hypopyon
B. Commonly perforates
C. Hyphate margins
D. Satellite lesions are seen

Rationale: Ans. B: Commonly perforates Causative fungi: Filamentry fungi - include- Aspergillus, fusarium, cephalosphorium, curvuluria, penicillium. Yeast - Candida, Cryptococcus Mode of infection: Injury by vegetative materials (Common sufferers are field workers specially in harvesting season) Injury by animal tail Secondary fungal ulcer - is commonly found in immunosuppresed hosts. Patients who are suffering from dry eye, herpetic Keratitis, bullous keratopathy and Post-operative case of keratoplasty Fungi do not infect the cornea easily - they require trauma, immunological compromised state & tissue devitalization. Fungal corneal infections tend to spread deep into the corneal stroma, where the organisms are inaccessible to the usual diagnosis and therapeutic measure. Fungi even may penetrate an intact Descement's membrane into the anterior chamber. Clinical features: Pain Watering - reflex hyperlacrimation Photophobia - Stimulation of nerve ending Redness - Congestion of circum-corneal vessels, Dry eye, grayish white with elevated rolled out margins Feathery figure like extension surround the stroma under intact epithelium, Yellow line demarcation (sterile immune ring) known as Wessley's ring due to deposition of immune complex and inflammatory cell around the ulcer. Multiple small satellite lesions may present around the ulcer Hypopion - Big, thick, immobile, not sterile may be present Perforation - rarely Corneal vascularisation are conspicuously absent. Diagnosis: - Wet KOH - Direct smear immediately fixed with methyl alcohol. - Giemsa stain - Show ghosting of fungal wall and yeast budding is may be noted. - Gomori methanamine Silver technique - Delineate the hyphae as sharp black structure against a pale green background. - Gram stain - fungus can be seen directly - Periodic acid schiff (PAS) - Calco fluor white

Answer: OPTION B IS CORRECT.
Question: According to Vision 2020, the recommendations for secondary care services including cataract surgery is:
Options:
A. 1 service center for 5000 population
B. 1 service center for 50,000 population
C. 1 service center for 5,00,000 population
D. 1 service center for 50,00,000 population

Rationale: Ans. c. 1 service center for 5,00,000 population (Ref: Khurana 5/e p484 4/454)According to Vision 2020, the recommendations for secondary care sendees including cataract surgery is 1 service center for 5,00,000 population."There is need to develop 2000 service centres at secondary level. Each with 2 Ophthalmologist and 8 paramedics (Hospital based MLOP), and one eye care manager covering a population of 5 lacs.""Vision 2020': The Right to Sight'Vision 2020': The Right to Sight, is a global initiative launched by WHO in 1999 in a broad coalition with a 'Task Force of International Non-Governmental Organizations (NGOs)' to combat the gigantic problem of blindness in the world.Objective of Vision 2020:To eliminate avoidable blindness by the year 2020 and to reduce the global burden of blindnessQGovernment of India has adopted 'Vision 2020: Right to Sight' under National Programme for Control of Blindness.Infrastructure Pyramid Based on WHO RecommendationsPrimary level Vision Centres:There is need to develop 20,000 vision centresQEach with one Ophthalmic Assistant or equivalent (Community based MLOP)Covering population of 50,000QService Centres:There is need to develop 2000 service centres at secondary levelQEach with 2 Ophthalmologist and 8 paramedics (Hospital based MLOP), and one eye care managerCovering a population of 5 lacsQTraining Centres:There is need to develop 200 Training Centres' for the training of OphthalmologistQCovering population of 50 lacsQCentre of Excellence (COE):There is need to develop 20 COE with well developed all subspecialties of OphthalmologyQ.Covering a population of 5 croreQBasic Strategies Linder Vision 2020:Disease prevention and controlTraining of personnelStrengthening the existing eye care infrastructureUse of appropriate and affordable technologyMobilization of resourcesGlobal Vision 2020 (5 diseasesQ)Indian Vision 2020 (7 diseasesQ)* Cataract* Refractive errors and low vision* Childhood blindness* Trachoma* Onchocerciasis* Cataract* Refractive errors and low vision* Childhood blindness* Trachoma (Focal)* Glaucoma* Diabetic retinopathy* Corneal blindness

Answer: OPTION C IS CORRECT.
Question: Progressive pterygium causes:
Options:
A. Myopia
B. Hypermetropia
C. Astigmatism
D. Cataract

Rationale: Ans: c (Astigmatism) Ref: AK Khurana, 4th ed, p. 81Corneal astigmatism may occur in pterygium due to fibrosis in regressive stage.Pterygium:* Wing shaped fold of conjunctiva encroaching cornea from either side within the palpebral fissure* Degeneration & hyperplastic condition of conjunctiva* May be unilateral or bilateral, usually starts nasally (triangular fold of conjunctiva)* Symptoms-usually asymptomatic- Visual disturbance due to corneal astigmatism]- Diplopia* Psuedopterygium- Due to chemical bums* Treatment-Surgical excisionRecurrent recalcitrant pterygium - Surgical excision + lamellar keratectomy+lamellar keratoplasty

Answer: OPTION C IS CORRECT.
Question: Orbital apex syndrome constitutes all except-
Options:
A. Ptosis
B. CSF rhinorrhea
C. Ophthalmoplegia
D. Pain over distribution of optic nerve

Rationale: *Superior orbital fissure syndrome consists of deep orbital pain, frontal headache and progressive paralysis of CN 6, 3 and 4 and in that order. *Orbital apex syndrome is superior orbital fissure syndrome along with the involvement of optic nerve and maxillary division of trigeminal nerve. *Both these syndromes can occur as a complication of sinusitis. Ref: Dhingra 5th/e p.213

Answer: OPTION B IS CORRECT.
Question: Refractive Index of cornea is about
Options:
A. 1.3
B. 1.33
C. 1.37
D. 1.42

Rationale: Refractive index of the cornea (1.37), Refractive index of the aqueous humour (1.33), Refractive index of the crystalline lens (1.42), and Refractive index of the vitreous humour (1.33) Ref:Khurana 4e pg: 26

Answer: OPTION C IS CORRECT.
Question: Axenfeld anomaly is seen in glaucoma associated with
Options:
A. Aniridia
B. Phakomatosis
C. Iridocorneal dysgenesis
D. Ectopia lentis

Rationale: a) Microdontia; b.Slit pupil and iris atrophy; c.Corectopia with iris atrophy; d,e.Posterior embryotoxon; f.Broad peripheral anterior synechiae. Axenfeld anomaly is seen in glaucoma associated with iridocorneal dysgenesis. It is a posterior embryotoxon characterised by prominent Schwalbe's ring. Ref: Comprehensive Ophthalmology, A. K. Khurana, 4th edition, p214.

Answer: OPTION C IS CORRECT.
Question: True about Reye's syndrome -
Options:
A. Microvesicular fatty infiltration
B. Hepatic encephalopathy
C. Brain edema
D. All

Rationale: Ans. is All

Answer: OPTION D IS CORRECT.
Question: Which type of senile cataract is notorious for glaucoma formation?
Options:
A. Incipient cataract
B. Hypermature morgagni
C. Intumescent cataract
D. Nuclear cataract

Rationale: In intumescent cataract, the lens may take up fluid during cataractous change, increasing markedly in size. It may then encroach upon the anterior chamber, producing both pupillary block and angle crowding and resulting in acute angle closure. Treatment consists of lens extraction once the intraocular pressure has been controlled medically. Ref: Salmon J.F. (2011). Chapter 11. Glaucoma. In P. Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.

Answer: OPTION C IS CORRECT.
Question: Smallest diameter of the eyeball is:
Options:
A. Veical
B. Horizontal
C. Anteroposterior
D. More than 24 mm

Rationale: Ans. Veical

Answer: OPTION A IS CORRECT.
Question: Topical glucocorticoids in eyes causes:
Options:
A. Glaucoma
B. Optic atrophy
C. Retinal detachment
D. Corneal ulcer

Rationale: Ans: A (Glaucoma) Ref: Parson's Diseases of the Eye Pg:358: Basok Diseases of the Eye 5th edition, pg no 50Explanation:STEROIDSSystemic and topical steroids - causes. Posterior subcapsular cataractTopical steroids - causes, Open angle glaucomaThere is no safe dosageWho is Steroid responder?After 6 weeks of topical steroids, if the IOP>30mmHg - high responders22-30mmHg - moderate respondersNo change - non respondersStrong steroids (dexamethasone. betamethasone, prednisolone] - more potent in increasing the IOPFluoromethalone - lesser propensity to increase IOPDifluprednate - strong steroid but least potent to increase IOPOther Local Side Effects:Increased risk of super infectionDelayed wound healingCorneal meltingIndications of steroids in eye:Sterile ocular inflammationDisciform keratitisEpiscleritisScleritisUveitisOptic neuritisAllergic problemsPhlyctenVernal catarrahAllergic blepharoconjunctivitisPost operativeFollowing cataract surgeryKeratoplastyVitrectomyTrabeculectomy

Answer: OPTION A IS CORRECT.
Question: Which of the following drug is not used in treatment of iridocyclitis:
Options:
A. Atropine eye ointment
B. Pilocarpine eye drops
C. Timolol eye drops
D. Steroid eye drops

Answer: OPTION C IS CORRECT.
Question: Most common cause of retinal detachment is?
Options:
A. Myopia
B. Hypermetropia
C. Tractional
D. Exudates

Rationale: Ans. (a) MyopiaRef: Khurana 4/e, p 275, Kanski 7/e, Chapter 16, Parson's 21/e, p 326

Answer: OPTION A IS CORRECT.
Question: Abduction of eyeballs is by the action of
Options:
A. Lateral rectus, superior oblique and the inferior oblique
B. Medial rectus, superior rectus and the inferior rectus
C. superior oblique and the superior rectus
D. Inferior oblique and the inferior rectus

Answer: OPTION A IS CORRECT.
Question: Eale's disease
Options:
A. Recurrent anterior uveitis
B. Recurrent vitreous haemorrhage
C. Recurrent macular haemorrhage
D. Recurrent subconjuctival haemorrhage

Rationale: It is an idiopathic inflammation of the peripheral retinal veins, characterised by recurrent vitreous hemorrhage. Etiology not exactly known, but consider to be a hypersensitivity reaction to tubercular protiens. Bilateral disease, typically affecting young adult males. Ref : khurana 6 th edition , page no. 265 Eales disease (ED) is an idiopathic, inflammatory retinal venous occlusive disease characterized by 3 stages: vasculitis, occlusion and retinal neovascularization, leading to recurrent vitreous hemorrhages and vision loss. Ref AK khurana 6/e p240

Answer: OPTION B IS CORRECT.
Question: A 48 year old diabetic with orbital cellulitis presented with a corneal ulcer. An aqueous tap showed branched hyphae. Diagnosis is -
Options:
A. Herpetic ulcer
B. Mycotic Ulcer
C. Bacterial Ulcer
D. Anterior staphyloma

Rationale: Ans. is 'b' i.e., Mycotic Ulcer Mycotic (fungal) corneal ulcero The incidence of corneal ulceration due to fungi has increased significantly due to long-term unwarranted use of antibiotic and steroid. The most common mode of infection is injury by vegetative material such as crop leaf, horn, wooden stick. The causative fungus are Aspergillus fumigatus (most common), Candida albicans and fusarium.Clinical featureso Symptoms are similar to bacterial comeal ulcers but in general they are less marked than the equal size bacterialulcer.On the other hand signs are very prominent, i.e. signs are more prominent than symptoms, o Following signs can be seen: -i) Greyish-white dry looking ulcer with the elevated rolled out feathery & hyphate margins.ii) Feathery finger like extension into surrounding stroma under intact epithelium.iii) A sterile immune ring (yellow line) of Wesseley.iv) Multiple small satellite lesions.v) Non-sterile (infected) hypopyon (Pseudohypopyon-Hence penetrated the endothelium)vi) Perforation is rare and comeal vascularization is conspicuously absent.Diagnosiso Examination of wet KOH will show:-i) Flamentous fungi (branched septate hyphae ):- Aspergillus fumigatus, Fusarium.ii) Non-filamentous (yeast like fungi): - Candida.Treatment of fungal corneal ulcero Treatment of comeal fungal ulcer involves:- 1) Specific (definitive) treatment, and 2) Adjunctive (concurrent) treatment.1) Definitive treatment: - It includes antifungal drugs: -A) Topical antifungals -i) For filamentous fungi (Aspergillus,fusarium):- Natamycin (5%) eye drops (drug of choice), Miconazole ointment, Amphotericin B drops.ii) For yeast (Candida): - Amphotericin B (Drug of choice), nystatin, flucytocine.B) Systemic antifungals: - May be required in severe cases. Fluconazole or ketoconazole may be used.2) Adjunctive/Concurrent therapy: - This follows the same principles as in any other infectious comeal diseases.# Cycloplegic (1% atropine ointment or drop is the DOC) should be used to: - i) Reduce pain from ciliary spasm; ii) Prevent posterior synaechiae; iii) Reduce uveal inflammation.# Topical steroids enhance fungal replication and comeal invasion and are contraindicated during early therapy of a fungal comeal ulcer.

Answer: OPTION B IS CORRECT.
Question: Fundoscopy of a patient shows chalky white optic disc with well defined margins. Retinal vessels and surrounding retina appears normal. Which of the following is the most likely diagnosis:
Options:
A. Primary Optic Atrophy
B. Post-neuritic secondary optic atrophy
C. Glaucomatous optic atrophy
D. Consecutive optic atrophy

Rationale: A i.e. Primary Optic Atrophy

Answer: OPTION A IS CORRECT.
Question: The critical angle of cornea-air interface is:
Options:
A. 36o
B. 46o
C. 56o
D. 66o

Rationale: Cornea air interface is 46 degree.

Answer: OPTION B IS CORRECT.
Question: Biondi Ring Tangles (B) are found in:
Options:
A. Choroidal plexus cells
B. Golgi type II cells
C. Basket cells
D. Piamatter

Rationale: A i.e. Choroid plexus Coiconuclear fibers pass through the genu of internal capsule.Biondi ring tangles are inclusion bodiesfound in choroidal plexus epitheliumCrossed occulomotor (111,9 nerve palsy i.e. IlIrd nerve plasy with crossed (contralateral) hemiplegia (Weber's syndrome)or with crossed (C/L) ataxiaQ (Claude syndrome) is found in occlusive syndromes of Posterior cerebral aery (P1 segment).

Answer: OPTION A IS CORRECT.
Question: In retinal detachment:
Options:
A. Effusion of fluid into the suprachoroidal space
B. Retinoschisis
C. Separation of sensory retina from pigment epithelium
D. None of the above

Rationale: Ans. Separation of sensory retina from pigment epithelium

Answer: OPTION C IS CORRECT.
Question: In one and half syndrome w hich movement is classically spared?
Options:
A. Limitation of horizontal eye movement to abduction in one eye
B. No horizontal movement of the other eye
C. Presence of nystagmus when the eye on the opposite side of the lesion is abducted
D. Convergence

Rationale: (D) Convergence# ONE AND A HALF SYNDROME is a rare ophthalmoparetic syndrome characterized by Ma conjugate horizontal gaze palsy in one direction and an internuclear ophthalmoplegia in the other".> Most common manifestation of this unusual syndrome is limitation of horizontal eye movement to abduction (moving away from the midline) of one eye (e.g. right eye in the diagram on the right) with no horizontal movement of the other eye (e.g. left eye in the diagram on the right).> Nystagmus is also present when the eye on the opposite side of the lesion is abducted. Convergence is classically spared as Cranial Nerve III (oculomotor nerve) and its nucleus is spared bilaterally.

Answer: OPTION D IS CORRECT.
Question: A 15-year-old boy presented with one day history of bleedig gums, subconjunctival bleed and purpuric rash. Investigations revealed the following results:Hb-6.4 gm/dL; TLC-26,500/mm3 Platelet 35,000 mm3; prothrombin time-20 sec with a control of 13 sec; partial thromboplastin time-50sec; and Fibrinogen 10ing/dL. Peripheral smear was suggestive off acute myeloblastic leukemia. Which of the following is the most likely -
Options:
A. Myeloblastic leukemia without maturation
B. Myeloblastic leukemia with maturation
C. Promyelocytic leukemia
D. Myelomonocytic leukemia

Rationale: The child presents with acute onset of bleeding, along with the following laboratory anamolies.


Thrombocytopenia    (iii) Increased partial thromboplastin time.
Increased prothrombin time    (iv) Decreased Fibrinogen


These hematological abnormalities indicate Disseminated intravascular coagulation
The peripheral blood smear of the patient is suggestive of acute myeloblastic leukemia (mentioned in the question)
The AML most likely to occur in this setting is promyelocytic leukemia as it is the most common myeloid leukemia associated with DIC.
Promyelocytic (AML-M3) leukemic promyelocytes liberate tissue thromboplastin leading to disseminated intravascular coagulation.

Answer: OPTION C IS CORRECT.
Question: Open angle glaucoma causes –
Options:
A. Sudden loss of vision
B. Difficulty in dark adaptation
C. Amaurosis fugax
D. Uniocular diplopia

Rationale: Some patients experience difficulty in dark adaptation.

Answer: OPTION B IS CORRECT.
Question: Which of the following prevalence rates indicates xerophthalmia problem in the community: September 2011
Options:
A. Nightblindness more than 1%
B. Corneal xerosis more than 1%
C. Bitot spot's more than 1%
D. Conjunctival xerosis more than 0.5%

Rationale: Ans. A: Nightblindness more than 1% Criteria for determining the "Xerophthalmia problem" in a community includes prevalence o f night blindness of more than 1.0% Prevalence criteria for determining the xerophthalmia problem Nightblindness: More than 1% Bitot's spots: More than 0.5% Corneal xerosis/corneal ulceration/ keratomalacia: More than 0.01% Corneal ulcer: More than 0.05% Serum retinol (less than 10 mcg/ dB: More than 5%

Answer: OPTION A IS CORRECT.
Question: A patient came to eye OPD with h/o dactylitis, anemia and growth retardation. In fundus there is sea fan neovascularization and salmon patches. What is the probable diagnosis
Options:
A. Syphillis
B. Sickle cell anemia
C. Toxoplasma
D. Histoplasmosis

Rationale: The presentation is typical of sickle cell retinopathy Sickle cell Retinopathy SS genotype causes more severe systemic disease than SC and S-Thal genotypes, while the SC and S-Thal genotypes present with a greater incidence of ocular manifestations, including proliferative sickle cell retinopathy. The underlying systemic and ocular manifestations of SCD (Sickle Cell Disease) are a result of vaso-occlusive ischemia due to the blocking of blood vessels by sickle-shaped erythrocytes. Figure 1. Salmon-patch Figure 2. Sea fan formation with neovascularization.

Answer: OPTION B IS CORRECT.
Question: Pigmentary glaucoma- findings seen is -
Options:
A. Fevy line
B. Flesscher's line
C. Hadson hauti line
D. Krukenberg's spindles

Rationale: Deposition of pigment granules in posterior surface of cornea is called krukenbergs spindle it is seen in pigment dispersion syndrome Ref:Comprehensive ophthalmology -6th edition chapter -10 page no :250

Answer: OPTION D IS CORRECT.
Question: Not a complication of orbital cellulitis
Options:
A. Exposure keratopathy
B. Optic neuritis
C. Subperiosteal abscess
D. Retinal detachment

Rationale: Retinal detachment is not a complication of orbital cellulitis Orbital Cellulitis Inflammation of orbital septum Complications Exposure keratopathy Compression of optic nerve Central retinal aery occlusion Orbital Abscess Intracranial spread of infections Septicemia

Answer: OPTION D IS CORRECT.
Question: Congenital glaucoma presents as:
Options:
A. Microphthalmos
B. Photophobia
C. Leucocoria (white reflex)
D. Pain

Rationale: Ans. Photophobia

Answer: OPTION B IS CORRECT.
Question: Ine foreign body in the eye ?
Options:
A. Nickel
B. Copper
C. Iron
D. Silver

Rationale: Ans. is 'd' i.e., Silver Local reaction of the ocular tissues to a foreign body varies with chemical nature of the foreign body. Glass, plastic and porcelain are ine. Stone may occasionally give rise to chemical changes, depending on its composition. Of the metals :- La Gold, silver, platinum and titanium are ine. u Lead, usually occuring as shot-gun pellets, becomes coated with the carbonate and excites little reaction. 1:1 Aluminium frequently becomes powdered and excites a local reaction; so does zinc; which may excites suppuration a reaction often associated with nickel and constantly with mercury. u Iron and copper, the two most common material found, undergo electrolytic dissociation and are widely deposited throughout the eye causing impoant degenerative changes.

Answer: OPTION D IS CORRECT.
Question: In Waardenburg's syndrome, following are seen except:
Options:
A. Widening of the eyebrow
B. Sho palpebral fissure
C. Interstital keratitis
D. Heterochromia iridis

Rationale: Ans. Interstital keratitis

Answer: OPTION C IS CORRECT.