Proptosis (1390/1700)

A 7yo boy presents with proptosis and periorbital edema. What is the immediate action that needs to be taken?
a. IV morphine and immediate ophthalmoscopy
b. IV morphine
c. Observation only

Acute Red Eye (807/1700)

A 52yo man has a painful, red, photophobic right eye with slightly blurred vision and watering
for 3days. He has had no such episodes in the past. On slit lamp examination there are cells and
flare in the ant chamber and pupil is sluggish to react. What is the single most appropriate
clinical dx?
a. Acute close-angle glaucoma
b. Acute conjunctivitis
c. Acute dacrocystitis
d. Acute iritis
e. Corneal foreign body

Ophthalmic anesthesia (1665/1700)

An elderly lady with COPD has chronic SOB. She is listed for cataract extraction. What is the anaesthetic of choice?
a. Facial nerve block
b. Bupivacaine infiltration of the peri-orbital skin
c. IV midazolam
d. Peribulbar acupuncture
e. Peribulbar lignocaine infiltration
f. Topical xylocaine
g. IV alfentanil
h. Epidural anesthesia
i. General anesthesia
j. Retrobulbar xylocaine Inj

Visual Impairment (1553/1700)

A 50yo man with a known hx of stroke is unable to get out of his house because he can’t find where the door is. He refuses help from his wife and says he is not blind. What is the single most likely defect?
a. Paracentral scotoma
b. Tunnel vision
c. Total blindness
d. Central scotoma
e. Cortical blindness

Upright gaze diplopia (938/1700)

A 33yo female complains of diplopia on upright gaze. Exam: ptosis can be seen. There are no
other complains or any significant PMH. What is the most appropriate inv for him?
a. Ophthalmoscopy
b. Visual field test
c. TFT
d. CT
e. Checking red reflex

Blurred vision and intermittent clumsiness (537/1700)

A woman presented with blurred vision and intermittent clumsiness for 3m. Reflexes are brisk inher arm and optic disc is pale. What is the single most appropriate test to confirm dx?

a. CSF analysis
b. CT
c. MRI
d. EEG
e. EMG

Occular manifestations of rheumatological disease (841/1700)

A 36yo lady comes with hx of early morning stiffness of her small joints and with red and painful eye. What is the single most appropriate option?

a. Iris
b. Ciliary body
c. Cornea
d. Conjunctivitis
e. Sclera
f. Lichen planus

Headache and loss of vision (487/1700)

A 62yo lady presents with right sided headache and loss of vision. What is the single most inv?
a. ESR
b. BUE
c. CT head
d. XR orbit
e. IOP

Double vision (473/1700)

A 62yo male comes to the GP complaining of double vision while climbing downstairs. Which of
the following nerve is most likely involved?
a. Abducens nerve
b. Trochlear nerve
c. Oculomotor nerve
d. Optic nerve
e. Trigeminal nerve

Mild cupping & scotoma (460/1700)

A 55yo man presents with mild headache. He has changed his spectacles thrice in 1 yr. there is
mild cupping present in the disc and sickle shaped scotoma present in both eyes. What is the
single most appropriate tx?

a. Pan retinal photo coagulation
b. Pilocarpine eye drops
c. Corticosteroids
d. Scleral buckling
e. Analgesics alone

Sudden loss of vision (443/1700)

A 38yo female presents with sudden loss of vision but fundoscopy is normal. She a similar
episode about 1 year ago which resolved completely within 3m. Exam: mild weakness of right
upper limb and exaggerated reflexes. What is the single most appropriate tx?

a. Pan retinal photo coagulation
b. Pilocarpine eye drops
c. Corticosteroids
d. Peripheral iridectomy
e. Surgical extraction of lens

Conjunctivitis Treatment (429/1700)

A pt presents with a painful, sticky red eye with a congested conjunctiva. What is the most
suitable tx?
a. Antibiotic PO
b. Antihistamine PO
c. Antibiotic drops
d. Steroid drops
e. IBS

Myopic develops sudden vision loss (419/1700)

A 54yo myopic develops flashes of light and then sudden loss of vision. That is the single most
appropriate tx?

a. Pan retinal photocoagulation
b. Peripheral iridectomy
c. Scleral buckling
d. Spectacles
e. Surgical extraction of lens

Loss of vision (398/1700)

A pt comes with sudden loss of vision. On fundoscopy the optic disc is normal. What is the
underlying pathology?

a. Iritis
b. Glaucoma
c. Vitreous chamber
d. Retinal detachment

Loss of vision (397/1700)

An old woman having decreased vision can’t see properly at night. She has changed her glasses
quite a few times but to no effect. She has normal pupil and cornea. What is the most likely dx?

a. Cataract
b. Glaucoma
c. Retinal detachment
d. Iritis
e. GCA

Loss of vision (378/1700)

A 32yo woman had progressive decrease in vision over 3yrs. She is now dx as almost blind. What
would be the mechanism?
a. Cataract
b. Glaucoma
c. Retinopathy
d. Uveitis
e. Keratitis

Flame shaped hemorrhages (372/1700)

A HTN male loses vision in his left eye. The eye shows hand movement and a light shined in the eye is seen as a faint light. Fundus exam: flame shaped hemorrhages. The right eye is normal. What is the cause of this pts unilateral blindness?

a. HTN retinopathy
b. CRA thrombosis
c. CRV thrombosis
d. Background retinopathy
e. Retinal detachment

Decreasing vision (335/1700)

A 48yo woman who has been taking medications for asthma for a long time has now presented
with decreasing vision. What is the most probable cause for her decrease in vision?

a. Inhaled salbutamol
b. Inhaled steroids
c. Aminophylline
d. Beta-blockers
e. Oral steroids

Eye deviates outwards with diplopia (332/1700)

A man presents with outward deviation of his right eye and diplopia. Which nerve is affected?
a. Left trochlear
b. Left oculomotor
c. Right trochlear
d. Right abducens
e. Right oculomotor

Diabetic retinopathy (167/1700)

A 45yo T1DM had an annual check up. Ophthalmoscopy showed dot and blot hemorrhage +
hard exudate and multiple cotton wool spots. What is the next step in management?

a. Reassurance and annual screening only
b. Urgent referral to ophthalmologist
c. Laser therapy
d. Non-urgent referral to ophthalmologist
e. Nothing can be done