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Free Ophthal MCQs High Yield MCQs

High-yield MCQ bank across all ophthalmology subspecialties for rapid revision.

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All 142 free Ophthal MCQs High Yield MCQs, with answers and explanations

The quiz above serves a random 10 of these each time you retake it. Every question in the set is listed below — read the stem, commit to an option, then open the answer to check your reasoning against the explanation.

  1. 1

    Uveoscleral outflow accounts for what percentage of aqueous outflow?

    • A2%
    • B5%
    • C5–10%
    • D10–50%
    • E75–90%
    Show answer and explanation

    Answer: D — 10–50%

    Uveoscleral outflow is pressure-independent. Normally contributes 10–50% of aqueous drainage.

  2. 2

    Mean normal outflow facility is:

    • A0.05 μL/min/mmHg
    • B0.15 μL/min/mmHg
    • C0.28 μL/min/mmHg
    • D0.48 μL/min/mmHg
    • E1.0 μL/min/mmHg
    Show answer and explanation

    Answer: C — 0.28 μL/min/mmHg

    Normal range ≈ 0.22–0.28 μL/min/mmHg

  3. 3

    Main reflex tear secretor?

    • AGland of Wolfring
    • BGland of Krause
    • CLacrimal gland
    • DMeibomian gland
    Show answer and explanation

    Answer: C — Lacrimal gland

    Lacrimal gland → reflex tears; Krause + Wolfring → basal tears.

  4. 4

    Which association is FALSE?

    • AStromal wound healing → Type I collagen
    • BDescemet membrane → Type IV collagen
    • CVitreous → Type II collagen
    • DLens capsule → Type IV collagen
    Show answer and explanation

    Answer: A — Stromal wound healing → Type I collagen

    Stromal wound healing → Type III collagen; Corneal stroma → Type I collagen.

  5. 5

    Normal aqueous humor production?

    • A2 μL/min
    • B4 μL/min
    • C6 μL/min
    • D8 μL/min
    Show answer and explanation

    Answer: A — 2 μL/min

    Produced by non-pigmented ciliary epithelium.

  6. 6

    Electrolytes present at half plasma concentration in aqueous humor?

    • ANa+, K+
    • BCa²⁺, PO₄²⁻
    • CCl⁻, HCO₃⁻
    • DCu²⁺, Zn²⁺
    Show answer and explanation

    Answer: B — Ca²⁺, PO₄²⁻

  7. 7

    Most common primary orbital malignancy of childhood arises from:

    • AMuscle
    • BHistiocytes
    • CMesenchyme
    • DCapillary endothelial cells
    Show answer and explanation

    Answer: C — Mesenchyme

    Rhabdomyosarcoma = most common primary orbital malignancy in children. Origin = undifferentiated mesenchymal cells.

  8. 8

    Which statement concerning cornea is FALSE?

    • AEpithelial oxygen comes from tears
    • BEndothelium pumps water into aqueous
    • CDescemet has fetal and adult layers
    • DBowman membrane is a true basement membrane
    Show answer and explanation

    Answer: D — Bowman membrane is a true basement membrane

    Bowman layer is not a true basement membrane; it is condensed anterior stromal collagen.

  9. 9

    Thickest layer of tear film?

    • AMarginal strip
    • BLipid layer
    • CAqueous layer
    • DGlycoprotein layer
    Show answer and explanation

    Answer: C — Aqueous layer

    Lipid ≈ 0.5 μm; Aqueous ≈ 7 μm; Mucin ≈ 0.1 μm.

  10. 10

    NOT a feature of basal cell carcinoma?

    • APearly elevated margins
    • BSpread to regional lymph nodes
    • CUlceration
    • DTelangiectasia
    Show answer and explanation

    Answer: B — Spread to regional lymph nodes

    BCC is the most common eyelid malignancy and rarely metastasizes.

  11. 11

    Features suggesting malignant eyelid lesion?

    • ATenderness, erythema, pigmentation
    • BRaised pearly margin, pruritus
    • CLash loss, central ulceration, rapid growth
    • DHyperkeratosis with dark pigmentation
    Show answer and explanation

    Answer: C — Lash loss, central ulceration, rapid growth

  12. 12

    Correct gland-secretory type match?

    • AMoll-apocrine, Lacrimal-eccrine, Meibomian-apocrine
    • BKrause-holocrine, Zeis-apocrine, Goblet-holocrine
    • CWolfring-eccrine, Moll-apocrine, Goblet-holocrine
    • DLacrimal-eccrine, Meibomian-holocrine, Zeis-apocrine
    Show answer and explanation

    Answer: C — Wolfring-eccrine, Moll-apocrine, Goblet-holocrine

    High-Yield Table: | Gland | Secretion Type | | Lacrimal | Eccrine | | Krause | Eccrine | | Wolfring | Eccrine | | Meibomian | Holocrine | | Zeis | Holocrine | | Moll | Apocrine | | Goblet | Holocrine |

  13. 13

    Physiologic diplopia occurs:

    • AOn horopter
    • BWithin Panum area
    • CIn front of Panum area
    • DNone
    Show answer and explanation

    Answer: C — In front of Panum area

    Occurs in front of and behind Panum's area.

  14. 14

    Rhabdomyosarcoma type with worst prognosis?

    • ABotryoid
    • BPleomorphic
    • CAlveolar
    • DEmbryonal
    Show answer and explanation

    Answer: C — Alveolar

    Worst → Alveolar; Most common → Embryonal.

  15. 15

    Protein accumulation causing brunescence cataract?

    • AHigh molecular weight crystallin
    • BAlpha crystallin
    • CGamma crystallin
    • DWater-insoluble protein
    Show answer and explanation

    Answer: D — Water-insoluble protein

  16. 16

    Largest crystallin in human lens?

    • Aβ-crystallin
    • Bα-crystallin
    • Cγ-crystallin
    • DTaxon-specific crystallin
    Show answer and explanation

    Answer: B — α-crystallin

  17. 17

    NOT protective against oxidation in lens?

    • AGlutathione peroxidase
    • BVitamin A
    • CSuperoxide dismutase
    • DCatalase
    Show answer and explanation

    Answer: B — Vitamin A

    Glutathione, Catalase, Superoxide dismutase, Vitamins C & E.

  18. 18

    Protective mechanism against lens oxidation?

    • AGlutathione
    • BVitamin A
    • CAldose reductase
    • DVitamin B12
    Show answer and explanation

    Answer: A — Glutathione

  19. 19

    Best stain for sebaceous gland carcinoma?

    • AGiemsa
    • BH&E
    • COil Red O
    • DMethenamine silver
    Show answer and explanation

    Answer: C — Oil Red O

    Oil Red O stains lipids.

  20. 20

    Pagetoid spread is most associated with:

    • AMelanoma
    • BSCC
    • CSebaceous gland carcinoma
    • DMerkel cell tumor
    Show answer and explanation

    Answer: C — Sebaceous gland carcinoma

  21. 21

    Melanoma with best prognosis?

    • AIris
    • BCiliary body
    • CAnterior choroid
    • DPosterior choroid
    Show answer and explanation

    Answer: A — Iris

    Iris melanoma is often diagnosed early and can be excised completely.

  22. 22

    Elderly woman with unilateral chronic blepharitis, thickened upper lid, lymphadenopathy?

    • ABCC
    • BKeratoacanthoma
    • CMolluscum contagiosum
    • DSebaceous gland carcinoma
    Show answer and explanation

    Answer: D — Sebaceous gland carcinoma

    "Chronic unilateral blepharitis in elderly = sebaceous gland carcinoma until proven otherwise."

  23. 23

    RPE characteristic NOT correct?

    • ABasal Na-K pump maintains ion gradient
    • BBlood-retinal barrier
    • CRetinal adhesion
    • DVitamin A isomerization
    Show answer and explanation

    Answer: A — Basal Na-K pump maintains ion gradient

    Na-K ATPase is located on the apical surface.

  24. 24

    RPE function NOT correct?

    • ARetinal adhesion
    • BVisual pigment regeneration
    • CNutrient transport
    • DPhagocytosis of photoreceptor inner segments
    Show answer and explanation

    Answer: D — Phagocytosis of photoreceptor inner segments

    RPE phagocytoses outer segment tips.

  25. 25

    Rods are how much more sensitive than cones?

    • AEqual
    • B10×
    • C1000×
    • D10,000×
    Show answer and explanation

    Answer: C — 1000×

  26. 26

    Found in inner plexiform layer?

    • AAxons of ganglion cells
    • BAxons of amacrine cells
    • CSynapses of photoreceptors
    • DMüller cell footplates
    Show answer and explanation

    Answer: B — Axons of amacrine cells

    IPL Contains: Ganglion dendrites, Bipolar axons, Amacrine processes.

  27. 27

    Ocular gland statements true?

    • A1 and 2
    • B1 and 3
    • C2 and 4
    • D3 and 4
    Show answer and explanation

    Answer: B — 1 and 3

    Accessory glands → basal tears; Main lacrimal gland → reflex tears; Meibomian glands are not associated with eyelashes.

  28. 28

    Keratoconjunctivitis sicca staining occurs where?

    • ASuperior third
    • BMiddle third (interpalpebral)
    • CInferior third
    • DDiffuse
    Show answer and explanation

    Answer: B — Middle third (interpalpebral)

  29. 29

    Corneal layer staining most with PAS?

    • AEndothelium
    • BBowman layer
    • CWing cells
    • DDescemet membrane
    Show answer and explanation

    Answer: D — Descemet membrane

    PAS highlights basement membranes.

  30. 30

    Tear layer containing IgA?

    • AMucin layer
    • BLipid layer
    • CAqueous layer
    • DGlycoprotein layer
    Show answer and explanation

    Answer: C — Aqueous layer

  31. 31

    Contributes to aqueous layer of tear film?

    • AWolfring glands
    • BZeis glands
    • CGoblet cells
    • DMeibomian glands
    Show answer and explanation

    Answer: A — Wolfring glands

  32. 32

    Correct corneal collagen association?

    • ACorneal wound healing → Type III collagen
    • BDescemet membrane → Type I collagen
    • CBowman layer → Type IV collagen
    • DStroma → Type II collagen
    Show answer and explanation

    Answer: A — Corneal wound healing → Type III collagen

  33. 33

    False statement about homocystinuria?

    • AOsteoporosis and renal dysfunction occur
    • BAbnormal from birth with seizures and mental retardation
    • CEctopia lentis occurs in >30%
    • DLow methionine, high cysteine diet beneficial
    Show answer and explanation

    Answer: B — Abnormal from birth with seizures and mental retardation

    Patients are usually normal at birth and develop symptoms later.

  34. 34

    NOT a true basement membrane?

    • ADescemet membrane
    • BBruch membrane
    • CLens capsule
    • DBowman membrane
    Show answer and explanation

    Answer: D — Bowman membrane

  35. 35

    False statement regarding lens structure?

    • AY suture represents lens fiber ends
    • BLens nuclei concentrated near equator
    • CLens fibers in nucleus continue to divide throughout life
    • DAnterior Y suture is upright
    Show answer and explanation

    Answer: C — Lens fibers in nucleus continue to divide throughout life

    Division occurs in equatorial lens epithelium. Central lens fibers do not divide.

  36. 36

    True statements concerning neonatal conjunctivitis include all EXCEPT:

    • ADefinitive diagnosis can be made by identifying intracytoplasmic inclusion bodies on Giemsa stain
    • BHerpes simplex is not an important cause in infants under 4 weeks of age
    • CChlamydia is a common cause of ophthalmia neonatorum
    • DGonococcal infection can rapidly involve the cornea
    • ESystemic treatment is often required
    Show answer and explanation

    Answer: B — Herpes simplex is not an important cause in infants under 4 weeks of age

    HSV is an important cause of neonatal conjunctivitis. Chlamydia is the most common infectious cause.

  37. 37

    Cardinal signs of inflammation include all EXCEPT:

    • ARedness
    • BIrreversible architectural disruption
    • CPain
    • DLoss of function
    • EWarmth
    Show answer and explanation

    Answer: B — Irreversible architectural disruption

    Key Point — Five cardinal signs:; Rubor = Redness; Calor = Warmth; Dolor = Pain; Tumor = Swelling; Functio laesa = Loss of function

  38. 38

    Which statement about trachoma is FALSE?

    • ASerotypes A–C are responsible
    • BBlindness is due to hypersensitivity response to Chlamydia
    • CStages I & II have follicles without scarring
    • DWHO grading includes follicles, scarring, trichiasis, corneal opacity
    • EAntibiotic treatment must be prolonged because of resistance
    Show answer and explanation

    Answer: E — Antibiotic treatment must be prolonged because of resistance

    Blindness results from cicatrization and scarring. Serotypes A, B, Ba, C cause trachoma.

  39. 39

    Which disease is NOT caused by Chlamydia trachomatis?

    • ALigneous conjunctivitis
    • BAdult inclusion conjunctivitis
    • CLymphogranuloma venereum
    • DTrachoma
    Show answer and explanation

    Answer: A — Ligneous conjunctivitis

    Trachoma → Serotypes A–C; Adult inclusion conjunctivitis → D–K; LGV → L1–L3

  40. 40

    Association between microorganism and culture medium that is CORRECT?

    • AMoraxella — Blood agar in 5–10% CO₂
    • BFungi — Sabouraud agar with cycloheximide
    • CMycobacterium tuberculosis — Loeffler medium
    • DHaemophilus — Blood agar
    Show answer and explanation

    Answer: A — Moraxella — Blood agar in 5–10% CO₂

    M. tuberculosis → Lowenstein–Jensen medium; Haemophilus → Chocolate agar; Ocular fungi → Sabouraud agar WITHOUT cycloheximide

  41. 41

    Organism NOT usually a commensal of lids and lashes?

    • AMoraxella catarrhalis
    • BHaemophilus influenzae
    • CPropionibacterium acnes
    • DStaphylococcus epidermidis
    Show answer and explanation

    Answer: B — Haemophilus influenzae

    Key Point — Normal lid flora:; Staphylococcus epidermidis; Corynebacterium; Moraxella catarrhalis; Streptococcus viridans

  42. 42

    Most effective preoperative regimen to reduce conjunctival bacterial counts?

    • ATopical antibiotic for 3 days
    • BPovidone-iodine for 3 days
    • CTopical antibiotic for 3 days + povidone-iodine at surgery
    • DPovidone-iodine at surgery only
    • EPovidone-iodine then saline flush
    Show answer and explanation

    Answer: C — Topical antibiotic for 3 days + povidone-iodine at surgery

    Antibiotic pretreatment + povidone iodine gives maximal reduction.

  43. 43

    Vaccination for varicella zoster virus — all true EXCEPT:

    • ASingle dose adequate in children 1–12 years
    • BTwo doses for patients >12 years
    • CReduces incidence of shingles in adults with prior childhood varicella
    • DContraindicated during pregnancy
    • EAvoid salicylates for 6 weeks after vaccination
    Show answer and explanation

    Answer: C — Reduces incidence of shingles in adults with prior childhood varicella

    Varivax prevents primary varicella. It is not intended to prevent shingles after prior infection.

  44. 44

    Most likely extraocular focus in endogenous bacterial endophthalmitis?

    • ALiver abscess
    • BEndocarditis
    • COrbital cellulitis
    • DMeningitis
    • ESeptic arthritis
    Show answer and explanation

    Answer: A — Liver abscess

    Key Point — Most common sources:; Liver abscess; Endocarditis

  45. 45

    Species most frequently implicated in adult preseptal cellulitis?

    • AStaphylococcus species
    • BStreptococcus species
    • CHaemophilus species
    • DPseudomonas species
    • EBacillus species
    Show answer and explanation

    Answer: A — Staphylococcus species

    Staphylococcus aureus is most common; Streptococcus is second.

  46. 46

    Which hypersensitivity conjunctivitis takes the longest to develop?

    • AToxic follicular conjunctivitis
    • BToxic papillary conjunctivitis
    • CContact dermatitis with conjunctivitis
    • DAnaphylactoid reaction
    • ENo pattern exists
    Show answer and explanation

    Answer: A — Toxic follicular conjunctivitis

    May take weeks, months, or years.

  47. 47

    Classic clinical sign of staphylococcal blepharoconjunctivitis?

    • AInferior follicular conjunctivitis
    • BScurf
    • CLimbal papillae
    • DCollarettes
    • ESleeving of lashes
    Show answer and explanation

    Answer: D — Collarettes

    Collarettes → Staphylococcus; Scurf → Seborrhea; Sleeves → Demodex

  48. 48

    Most common cause of acute painful enlargement of lacrimal gland?

    • ASarcoidosis
    • BSjögren syndrome
    • CBacterial dacryoadenitis
    • DLeprosy
    • EHerpes zoster
    Show answer and explanation

    Answer: C — Bacterial dacryoadenitis

    Usually ascending staphylococcal infection. Viral dacryoadenitis is often painless.

  49. 49

    Chronic asymptomatic dacryocystitis is most commonly caused by?

    • AStaphylococcus aureus
    • BStreptococcus pneumoniae
    • CStaphylococcus epidermidis
    • DHaemophilus influenzae
    • EPseudomonas aeruginosa
    Show answer and explanation

    Answer: B — Streptococcus pneumoniae

    Silent dacryocystitis classically caused by pneumococcus.

  50. 50

    Which statement about postoperative endophthalmitis is TRUE?

    • A7–10 days postop, Streptococcus most common
    • B2–5 days postop, Streptococcus most common
    • C2–5 days postop, Staphylococcus most common
    • D7–10 days postop, Staphylococcus most common
    • EOrganisms originate from surgeon flora
    Show answer and explanation

    Answer: C — 2–5 days postop, Staphylococcus most common

    Most common organism: Staphylococcus epidermidis. Usually from patient's lid flora.

  51. 51

    Features favoring herpes zoster ophthalmicus dendrites EXCEPT:

    • ALarge frequently branching dendrite
    • BPlaque of epithelial cells
    • CNo terminal bulb
    • DCoarse blunt-ended dendrites
    • EDull fluorescein staining
    Show answer and explanation

    Answer: A — Large frequently branching dendrite

    Key Point — HZO pseudodendrites:; Smaller; Less branching; No terminal bulbs; Blunt ends

  52. 52

    Class I MHC:

    • APresent on almost all nucleated cells
    • BHLA-DR, DP, DQ
    • CWorks with CD4 T cells
    • DProcesses endocytosed antigens
    Show answer and explanation

    Answer: A — Present on almost all nucleated cells

    Class I: HLA-A, B, C; CD8 T cells; present on almost all nucleated cells.; Class II: HLA-DR, DP, DQ; CD4 T cells.

  53. 53

    Most abundant antibody in tear film?

    • AIgE
    • BIgM
    • CIgA
    • DIgG
    Show answer and explanation

    Answer: C — IgA

    Secretory IgA is the dominant immunoglobulin in tears.

  54. 54

    Immunoglobulin classes important in antigen reception on lymphocyte surfaces during primary immune responses?

    • A1,2,3
    • B1 and 3
    • C2 and 4
    • D4 only
    • E1,2,3,4
    Show answer and explanation

    Answer: A — 1,2,3

    Key Point — Surface immunoglobulins: IgM, IgD, IgG function as antigen receptors on B lymphocytes.

  55. 55

    Which statement about prostaglandins is FALSE?

    • ACOX pathway produces prostaglandins, prostacyclin, and thromboxane
    • BIn general, prostaglandins cause mydriasis
    • CCorticosteroids inhibit both COX and LOX pathways
    • DLow-dose prostaglandins decrease IOP; high doses may increase IOP
    • EProstacyclin is a vasodilator; thromboxane is a vasoconstrictor
    Show answer and explanation

    Answer: B — In general, prostaglandins cause mydriasis

    Topical PGE and PGF cause miosis, not mydriasis. Steroids inhibit phospholipase A2 → block both COX and LOX pathways.

  56. 56

    All methods increase ocular absorption of topical medications EXCEPT:

    • AAdding a second eye drop immediately after the first
    • BWaiting 5–10 min between medications
    • CNasolacrimal occlusion
    • DClosing eyes after administration
    • EPrior topical anesthetic
    Show answer and explanation

    Answer: A — Adding a second eye drop immediately after the first

    Second drop may wash out the first. One drop (~50 µL) exceeds conjunctival sac capacity (~10 µL).

  57. 57

    Factors increasing corneal penetration EXCEPT:

    • AHigher drug concentration
    • BHigher vehicle viscosity
    • CHigher pH of the drug
    • DHigher lipid solubility
    • EBenzalkonium chloride
    Show answer and explanation

    Answer: C — Higher pH of the drug

    Extreme pH causes reflex tearing and dilution. BAK disrupts corneal epithelium and increases penetration.

  58. 58

    NSAIDs block formation of all EXCEPT:

    • AThromboxane
    • BLeukotrienes
    • CProstaglandins
    • DProstacyclin
    Show answer and explanation

    Answer: B — Leukotrienes

    NSAIDs block COX. Leukotrienes are produced through LOX pathway.

  59. 59

    Aminoglycoside most commonly causing topical hypersensitivity?

    • AGentamicin
    • BTobramycin
    • CKanamycin
    • DAmikacin
    • ENeomycin
    Show answer and explanation

    Answer: E — Neomycin

    Most frequent topical allergic reactions among aminoglycosides. Hypersensitivity occurs in ~6–8%.

  60. 60

    Which statement about vancomycin is FALSE?

    • AInhibits cell wall synthesis
    • BEmpiric use in neutropenia is recommended for prophylaxis
    • CDrug of choice in filtering bleb-related endophthalmitis
    • DUseful in pseudomembranous colitis
    • ENephrotoxicity increased with aminoglycosides
    Show answer and explanation

    Answer: B — Empiric use in neutropenia is recommended for prophylaxis

    CDC recommends avoiding routine empiric vancomycin due to resistance concerns.

  61. 61

    All statements are true of diclofenac-class drugs EXCEPT:

    • ACan cause corneal melt/perforation
    • BUsed for postoperative inflammation
    • CIncrease thromboxane production
    • DDecrease prostaglandin synthesis
    Show answer and explanation

    Answer: C — Increase thromboxane production

    NSAIDs decrease prostaglandins, prostacyclin, and thromboxane.

  62. 62

    Ways to increase ocular absorption EXCEPT:

    • APrior topical anesthetic
    • BNasolacrimal occlusion
    • CEye closure after drop instillation
    • DIncreased hydrophilicity of the drug
    Show answer and explanation

    Answer: D — Increased hydrophilicity of the drug

    Increased lipid solubility improves corneal penetration.

  63. 63

    Higher uptake as ointment rather than drops EXCEPT:

    • ATetracycline
    • BChloramphenicol
    • CFluorometholone
    • DPenicillin
    Show answer and explanation

    Answer: D — Penicillin

    Penicillin penetrates ocular tissues poorly.

  64. 64

    Mitomycin-C has been used in all EXCEPT:

    • AProliferative vitreoretinopathy after vitrectomy
    • BConjunctival fibrosis after trabeculectomy
    • CPterygium recurrence
    • DStromal haze after PRK
    Show answer and explanation

    Answer: A — Proliferative vitreoretinopathy after vitrectomy

    MMC is primarily used on external ocular surfaces.

  65. 65

    Natamycin may be effective against all EXCEPT:

    • AAspergillus
    • BCandida albicans
    • CFusarium
    • DMucor
    Show answer and explanation

    Answer: D — Mucor

    Mucor responds better to Amphotericin B.

  66. 66

    Amphotericin B alone may be effective against all EXCEPT:

    • AAspergillus
    • BCandida
    • CCryptococcus
    • DMucor
    Show answer and explanation

    Answer: D — Mucor

    Mucor generally requires Amphotericin B plus surgical debridement.

  67. 67

    Effective agents for Acanthamoeba EXCEPT:

    • ANeomycin
    • BPolyhexamethylene biguanide (PHMB)
    • CPropamidine
    • DTrifluridine
    Show answer and explanation

    Answer: D — Trifluridine

    Trifluridine is antiviral. PHMB + diamidines are classic therapy.

  68. 68

    Side effects of systemic corticosteroids include all EXCEPT:

    • AAseptic necrosis of hip
    • BHypoglycemia
    • CHypertension
    • DGastric ulceration
    Show answer and explanation

    Answer: B — Hypoglycemia

    Steroids cause hyperglycemia, not hypoglycemia.

  69. 69

    Side effects of prostaglandin analogues EXCEPT:

    • AConjunctival hyperemia
    • BCystoid macular edema
    • CDecrease in iris pigmentation
    • DHypertrichosis
    Show answer and explanation

    Answer: C — Decrease in iris pigmentation

    Prostaglandin analogues increase iris pigmentation.

  70. 70

    Best topical beta-blocker for mild bronchoconstrictive disease?

    • ATimolol
    • BBetaxolol
    • CMetipranolol
    • DLevobunolol
    Show answer and explanation

    Answer: B — Betaxolol

    Betaxolol is β1-selective. Preferred in mild pulmonary disease.

  71. 71

    Least suitable IOP-lowering drug in mild bronchoconstrictive disease?

    • ATimolol
    • BBetaxolol
    • CLatanoprost
    • DBrimonidine
    Show answer and explanation

    Answer: A — Timolol

    Non-selective β-blockers can cause bronchospasm.

  72. 72

    Which statement about carbonic anhydrase inhibitors is FALSE?

    • A>90% inhibition required before significant reduction in aqueous production
    • BReduced urinary citrate/magnesium predisposes to kidney stones
    • CCan cause acute transient myopia
    • DMetabolic acidosis is greater with oral than IV acetazolamide
    Show answer and explanation

    Answer: D — Metabolic acidosis is greater with oral than IV acetazolamide

    Metabolic acidosis is greater with IV acetazolamide.

  73. 73

    Dipivefrin is converted to epinephrine in:

    • ATears
    • BConjunctiva
    • CCornea
    • DAqueous humor
    • EIris stroma
    Show answer and explanation

    Answer: C — Cornea

    Corneal esterases cleave dipivefrin to epinephrine.

  74. 74

    Best single medication for POAG in an aphakic patient with chronic bronchitis, labile hypertension and depression on MAO inhibitors?

    • AEpinephrine
    • BDipivefrin
    • CPilocarpine
    • DTimolol
    • EAcetazolamide
    Show answer and explanation

    Answer: C — Pilocarpine

    Epinephrine/dipivefrin: risk of CME in aphakia.; Timolol: bronchospasm.; Acetazolamide: caution in depression.; Pilocarpine becomes safest option.

  75. 75

    Central Retinal Artery Occlusion (CRAO)?

    • AHyperbaric oxygen
    • BAnterior chamber tap
    • CAcetazolamide + topical β-blockers
    • DAnticoagulation with Coumadin
    Show answer and explanation

    Answer: D — Anticoagulation with Coumadin

    CRAO treatments historically attempted: ocular massage, anterior chamber paracentesis, IOP lowering, hyperbaric oxygen, carbogen, intra-arterial tPA. Warfarin has no role in acute CRAO.

  76. 76

    Uveal Effusion Syndrome?

    • AOccurs in eyes with abnormally short axial length
    • BPrevented by Flieringa ring
    • CTreated by vitrectomy
    • DAssociated with hypertension and atherosclerosis
    Show answer and explanation

    Answer: A — Occurs in eyes with abnormally short axial length

    Uveal effusion syndrome: nanophthalmos, thick sclera, impaired vortex vein drainage, recurrent choroidal effusions. Association: short eye + thick sclera.

  77. 77

    Fastest Expanding Intraocular Gas?

    • AAir
    • B100% C3F8
    • C100% SF6
    • D14% C3F8
    Show answer and explanation

    Answer: C — 100% SF6

    | Gas | Expansion | | Air | None | | SF6 | Fastest | | C3F8 | Longest duration |

  78. 78

    Silicone Oil Surface Tension?

    • AGreater than C3F8
    • BGreater than air
    • CLess than SF6
    • DEqual to water
    Show answer and explanation

    Answer: C — Less than SF6

    All gases have higher surface tension than silicone oil. Gas tamponade > Silicone oil tamponade.

  79. 79

    Coats Disease?

    • AUsually unilateral
    • BIncreased risk of rhegmatogenous RD
    • CMale predominance
    • DMay require laser photocoagulation
    Show answer and explanation

    Answer: B — Increased risk of rhegmatogenous RD

    Classic Coats Disease: Young boys, unilateral, retinal telangiectasia, massive lipid exudation, exudative RD. ❌ Not rhegmatogenous RD.

  80. 80

    Persistent Fetal Vasculature (PFV/PHPV)?

    • AInitially associated with clear lens or mild opacity that later becomes dense cataract
    • BOften bilateral
    • CAssociated with low birth weight
    • DAssociated with buphthalmos
    Show answer and explanation

    Answer: A — Initially associated with clear lens or mild opacity that later becomes dense cataract

    PFV: Failure of hyaloid regression, microphthalmos, leukocoria, usually unilateral.; ROP: Prematurity, low birth weight.; PFV is NOT associated with low birth weight.

  81. 81

    Presumed Ocular Histoplasmosis Syndrome (POHS)?

    • AMild vitritis
    • BChoroidal neovascularization
    • CSmall punched-out chorioretinal scars
    • DPeripapillary atrophy
    Show answer and explanation

    Answer: A — Mild vitritis

    Punched-out scars, peripapillary atrophy, CNVM.

  82. 82

    Young Patient with CRVO?

    • AHypercoagulable condition
    • BInfection
    • CGiant cell arteritis
    • DThromboembolic disease
    Show answer and explanation

    Answer: A — Hypercoagulable condition

    Young CRVO (<50 years): hypercoagulable workup (APS, Protein C/S deficiency, Factor V Leiden).

  83. 83

    Branch Retinal Artery Occlusion (BRAO)?

    • AESR/CRP/Platelets
    • BLower IOP
    • CEmergent embolic workup
    • DOcular massage
    Show answer and explanation

    Answer: C — Emergent embolic workup

    BRAO = Stroke equivalent. Workup: carotid Doppler, echocardiography, brain imaging.

  84. 84

    Ocular Ischemic Syndrome (OIS)?

    • ACarotid occlusive disease
    • BPDR
    • CRVO
    • DRadiation retinopathy
    Show answer and explanation

    Answer: A — Carotid occlusive disease

    Mid-peripheral hemorrhages, iris neovascularization, ocular pain, delayed choroidal filling, low retinal arterial pressure.

  85. 85

    Multiple Cotton-Wool Spots?

    • ALiver transplantation
    • BEpisodes of weakness and numbness
    • CHigh-risk sexual behavior
    • DPolyuria, polydipsia, polyphagia
    Show answer and explanation

    Answer: B — Episodes of weakness and numbness

    Interferon retinopathy. Associated with liver transplant, hepatitis treatment, diabetes, HIV. Not multiple sclerosis.

  86. 86

    Imaging Question: Most Specific Noninvasive Test for RPE Cell Death?

    • AFAF
    • BFluorescein angiography
    • CFundus photography
    • DOCTA
    Show answer and explanation

    Answer: A — FAF

    Lipofuscin in RPE fluoresces. Dead RPE → loss of autofluorescence → dark lesions on FAF. FAF best for geographic atrophy, Stargardt disease, pattern dystrophies.

  87. 87

    Electrophysiology Question: Direct Measure of Retinal Ganglion Cell Function?

    • APERG
    • BEOG
    • CmfERG
    • DVEP
    Show answer and explanation

    Answer: A — PERG

    | Test | Measures | | PERG | Ganglion cells | | EOG | RPE function | | mfERG | Macular function | | VEP | Visual pathway |

  88. 88

    Posterior Vitreous Detachment (PVD)?

    • AMore common after intracapsular cataract surgery
    • B<20% symptomatic PVD have retinal tears
    • C>50% symptomatic PVD + vitreous hemorrhage have tear
    • DPVD starts at optic disc and spreads temporally
    Show answer and explanation

    Answer: D — PVD starts at optic disc and spreads temporally

    OCT shows PVD typically begins in perifoveal macula, NOT optic disc.

  89. 89

    Lattice Degeneration?

    • APrevalence 5–10% of population
    • B>75% RRD eyes have lattice
    • CBilateral in >75%
    • DLess common in myopes
    Show answer and explanation

    Answer: A — Prevalence 5–10% of population

    Population prevalence 5–10%; bilateral 30–50%; present in 20–30% of RRD.

  90. 90

    Main Site of Resistance to Aqueous Outflow?

    • AUveal trabecular meshwork
    • BCorneoscleral trabecular meshwork
    • CJuxtacanalicular trabecular meshwork
    • DSchlemm's canal
    Show answer and explanation

    Answer: C — Juxtacanalicular trabecular meshwork

    Trabecular meshwork layers: uveal meshwork, corneoscleral meshwork, juxtacanalicular meshwork (cribriform layer) ← greatest resistance. Most common glaucoma board question.

  91. 91

    Glaucoma Laser Trial (GLT)?

    • ABetter visual field score with laser first
    • BLower IOP with laser first
    • CMost laser-treated eyes did not require medication
    • DLaser trabeculoplasty ≈ timolol efficacy
    Show answer and explanation

    Answer: C — Most laser-treated eyes did not require medication

    After 2 years: ~56% still required medications. ALT comparable to timolol.

  92. 92

    Infantile Glaucoma Progression?

    • AIncreasing axial length
    • BAmblyopia
    • CIncreasing horizontal diameter
    • DIncreasing myopia
    Show answer and explanation

    Answer: B — Amblyopia

    Increasing axial length, buphthalmos, increased corneal diameter, increasing myopia.

  93. 93

    Late Bleb-Associated Endophthalmitis?

    • AStaph epidermidis
    • BStreptococcus pneumoniae
    • CPseudomonas
    • DPropionibacterium acnes
    Show answer and explanation

    Answer: B — Streptococcus pneumoniae

    Late bleb infection → Streptococcus species or H. influenzae. Early postop cataract endophthalmitis → Staph epidermidis.

  94. 94

    Superior Visual Field Defect?

    • AGlaucoma
    • BLens rim artifact
    • CHigh false-positive rate
    • DPtosis
    Show answer and explanation

    Answer: C — High false-positive rate

    High false-positive VF: "trigger-happy" patient, artificially better sensitivity, white scotomas.

  95. 95

    Most Urgent Post-Trabeculectomy Problem?

    • AChoroidal hemorrhage
    • BChoroidal effusion
    • CShallow AC with lens-cornea touch
    • DShallow AC with iris-cornea touch
    Show answer and explanation

    Answer: C — Shallow AC with lens-cornea touch

    Lens-cornea touch causes corneal decompensation and cataract progression. Needs immediate intervention.

  96. 96

    Elevated IOP After Heavy PRP?

    • ACycloplegic
    • BLaser iridotomy
    • CLaser iridoplasty
    • DTrabeculectomy
    Show answer and explanation

    Answer: A — Cycloplegic

    PRP → ciliary body edema → forward rotation of ciliary body → angle closure.

  97. 97

    Earlier Detection of Glaucoma?

    • ASuprathreshold testing
    • BOCT
    • CCSLO
    • DFrequency-doubling technology (FDT)
    Show answer and explanation

    Answer: D — Frequency-doubling technology (FDT)

    FDT targets magnocellular ganglion cells and can detect early glaucomatous damage.

  98. 98

    Infantile Glaucoma with Corneal Clouding?

    • ATrabeculectomy
    • BTrabeculotomy
    • CCyclophotocoagulation
    • DGoniotomy
    Show answer and explanation

    Answer: B — Trabeculotomy

    | Cornea | Surgery | | Clear | Goniotomy | | Cloudy | Trabeculotomy |

  99. 99

    Apraclonidine (Iopidine)?

    • AAlpha-1 agonist
    • BMay cause transient lid retraction
    • CCommonly causes hypotension
    • DCauses CME in aphakia
    Show answer and explanation

    Answer: B — May cause transient lid retraction

    Apraclonidine: alpha-2 agonist, conjunctival blanching, lid retraction, allergic blepharoconjunctivitis.

  100. 100

    Pilocarpine in Young Myope?

    • ASmall pupil
    • BIncreased myopia
    • CRetinal detachment
    • DIncreased hyperopia
    Show answer and explanation

    Answer: B — Increased myopia

    Pilocarpine: accommodative spasm, lens thickening, forward lens movement, increased myopia.

  101. 101

    Goldmann Applanation Tonometry?

    • A3.06 mm
    • B3.16 mm
    • C3.10 mm
    • D3.01 mm
    Show answer and explanation

    Answer: A — 3.06 mm

    At 3.06 mm, corneal rigidity and tear-film surface tension cancel each other.

  102. 102

    Medication Causing Most Dermatitis?

    • ALatanoprost
    • BBrimonidine
    • CDorzolamide
    • DApraclonidine
    Show answer and explanation

    Answer: D — Apraclonidine

    Apraclonidine: allergic dermatitis ≈ 40%, limits chronic use.

  103. 103

    Herpetic Keratitis and Glaucoma Therapy?

    • ALatanoprost
    • BTimolol
    • CBrimonidine
    • DMethazolamide
    Show answer and explanation

    Answer: A — Latanoprost

    Prostaglandin analogs may reactivate HSV keratitis, uveitis, CME. Avoid in these settings.

  104. 104

    Visual Field Artifact and Pupil Size?

    • A1.5 mm
    • B2.5 mm
    • C3.5 mm
    • D4.5 mm
    Show answer and explanation

    Answer: B — 2.5 mm

    Pupil <2.5 mm → generalized depression artifact on Humphrey VF.

  105. 105

    Substance That Lowers IOP?

    • AAlcohol
    • BLSD
    • CCaffeine
    • DKetamine
    Show answer and explanation

    Answer: A — Alcohol

    ↓ IOP: Alcohol, Cannabis, Heroin; ↑ IOP: Ketamine, LSD

  106. 106

    Image Question: Gray-White Lens Deposits?

    • AAcute angle-closure glaucoma
    • BChronic angle closure glaucoma
    • CUveitic glaucoma
    • DPseudoexfoliation glaucoma
    Show answer and explanation

    Answer: A — Acute angle-closure glaucoma

    Glaukomflecken = anterior subcapsular lens epithelial necrosis caused by a previous acute angle-closure attack.

  107. 107

    Diffusely Distributed Keratic Precipitates?

    • AFuchs heterochromic iridocyclitis
    • BSarcoidosis
    • CVogt–Koyanagi–Harada syndrome
    • DSyphilis
    Show answer and explanation

    Answer: C — Vogt–Koyanagi–Harada syndrome

    Diffuse KPs → Fuchs, Sarcoidosis, Syphilis, Keratouveitis. VKH usually has inferior KPs.

  108. 108

    HLA-B27 Associated Disease?

    • ABehçet disease
    • BPsoriatic arthritis
    • CCrohn disease
    • DReactive arthritis
    Show answer and explanation

    Answer: A — Behçet disease

    Behçet → HLA-B5 (Bw51), not HLA-B27.

  109. 109

    Band Keratopathy in JIA?

    • ACalcium carbonate at Descemet membrane
    • BCalcium hydroxyapatite at Descemet membrane
    • CCalcium carbonate at Bowman membrane
    • DCalcium hydroxyapatite at Bowman membrane
    Show answer and explanation

    Answer: D — Calcium hydroxyapatite at Bowman membrane

    Band keratopathy = calcium hydroxyapatite deposition in Bowman layer.

  110. 110

    HLA-B27 Counseling?

    • AAlmost 10% will develop AAU
    • B8% of population is HLA-B27 positive, but only 0.012% develop AAU
    • CTwo-thirds of HLA-B27 positives develop AAU
    • DHLA-B27 is not associated with AAU
    Show answer and explanation

    Answer: B — 8% of population is HLA-B27 positive, but only 0.012% develop AAU

    Only about 1 in 667 HLA-B27 positive individuals develop AAU.

  111. 111

    HLA-DR4 Association?

    • AAcute anterior uveitis
    • BBehçet disease
    • CBirdshot chorioretinopathy
    • DSympathetic ophthalmia
    Show answer and explanation

    Answer: D — Sympathetic ophthalmia

    HLA-DR4 ↔ Sympathetic ophthalmia and VKH.

  112. 112

    JIA Chronic Anterior Uveitis?

    • ABand keratopathy
    • BFibrinous AC reaction
    • CHypopyon
    • DVitritis
    Show answer and explanation

    Answer: A — Band keratopathy

    JIA uveitis is chronic, silent, destructive → band keratopathy, cataract, posterior synechiae.

  113. 113

    SUN Classification of Recurrent Uveitis?

    • ARecurrence <3 months after stopping treatment
    • BRecurrence >3 months after treatment discontinued
    • CRecurrence irrespective of treatment status
    • DResolves in <3 months
    Show answer and explanation

    Answer: B — Recurrence >3 months after treatment discontinued

    Acute: <3 months; Chronic: relapse <3 months after stopping therapy; Recurrent: relapse after >3 months of inactivity off treatment

  114. 114

    Intermediate Uveitis with Multiple Sclerosis?

    • ASC adalimumab
    • BIV infliximab
    • CIV methylprednisolone
    • DSC etanercept
    Show answer and explanation

    Answer: C — IV methylprednisolone

    Anti-TNF agents may worsen demyelinating disease.

  115. 115

    Drug Causing Human Anti-Chimeric Antibodies?

    • AAbatacept
    • BInfliximab
    • CInterferon alfa-2a/2b
    • DTacrolimus
    Show answer and explanation

    Answer: B — Infliximab

  116. 116

    HLA-B27 Uveitis with Ankylosing Spondylitis?

    • AUrinalysis
    • BPathergy test
    • CAqueous tap PCR
    • DChest X-ray and cardiac echogram
    Show answer and explanation

    Answer: D — Chest X-ray and cardiac echogram

    AS may be associated with pulmonary apical fibrosis and aortic regurgitation.

  117. 117

    Scleritis and BRAO?

    • AANA
    • BLumbar puncture
    • CUrinalysis
    • DTemporal artery biopsy
    Show answer and explanation

    Answer: C — Urinalysis

    Scleritis with tracheomalacia suggests relapsing polychondritis or systemic vasculitis. Urinalysis assesses renal involvement.

  118. 118

    Ocular vs Generalized Myasthenia?

    • AMore commonly associated with Graves' disease
    • BMore responsive to anticholinesterase drugs
    • CMore responsive to steroids
    • DCompletely localized to ocular or bulbar involvement
    Show answer and explanation

    Answer: D — Completely localized to ocular or bulbar involvement

    Ocular myasthenia is restricted to extraocular, levator, and orbicularis oculi muscles (± bulbar). It is less responsive to anticholinesterases than generalized disease and is not specifically linked to Graves' disease.

  119. 119

    Drug-Induced Myasthenia?

    • AWarfarin
    • BD-penicillamine
    • CDiltiazem
    • DRanitidine
    Show answer and explanation

    Answer: B — D-penicillamine

    D-penicillamine is the classic drug causing an autoimmune myasthenic syndrome. Other reported agents include aminoglycosides, macrolides, fluoroquinolones, statins, and beta-blockers.

  120. 120

    Migraine with Homonymous Hemianopia?

    • ACerebral MRI
    • BDiscontinue oral contraceptives
    • CSumatriptan (Imitrex)
    • DTangent screen
    Show answer and explanation

    Answer: A — Cerebral MRI

    A new, persistent homonymous hemianopia in a migraine patient requires neuroimaging to rule out a posterior visual pathway lesion (stroke, mass, AVM). Aura is transient; persistent deficit is not typical aura.

  121. 121

    Indications for Treating Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)?

    • A1, 2, 3
    • B1 and 3
    • C2 and 4
    • D4 only
    • E1, 2, 3, 4
    Show answer and explanation

    Answer: C — 2 and 4

    Treatment of IIH is indicated for debilitating headache and any visual field loss/threat to vision. Asymptomatic papilledema alone may be observed; obesity is a risk factor managed but is not itself an indication for acute IIH therapy.

  122. 122

    Permanent Visual Loss in Cavernous Sinus-Dural Fistula?

    • ANeovascular glaucoma
    • BCorneal exposure
    • COpen-angle glaucoma
    • DChoroidal effusions
    • EStrabismus
    Show answer and explanation

    Answer: C — Open-angle glaucoma

    Carotid-cavernous/dural fistulas can cause elevated episcleral venous pressure → impaired aqueous outflow → secondary open-angle glaucoma. This is the leading cause of permanent vision loss.

  123. 123

    Antidote for Edrophonium Overdose?

    • AAtropine
    • BDantrolene
    • CEpinephrine
    • DVerapamil
    Show answer and explanation

    Answer: A — Atropine

    Edrophonium is a short-acting acetylcholinesterase inhibitor. Overdose causes cholinergic excess (bradycardia, bronchospasm, sweating, salivation). Atropine blocks muscarinic effects and is the antidote.

  124. 124

    Feature NOT Seen in Adie's Pupil?

    • AVermiform movement of iris border
    • BHypersensitivity to parasympathomimetic drugs
    • CLight-near dissociation
    • DAnisocoria greater in the dark
    Show answer and explanation

    Answer: D — Anisocoria greater in the dark

    Adie's tonic pupil is larger than the fellow eye and shows light-near dissociation, segmental iris sphincter palsy (vermiform movements), and denervation supersensitivity to dilute pilocarpine. The anisocoria is typically greater in bright light (the Adie's pupil dilates poorly and constricts poorly).

  125. 125

    Bilateral Optic Neuritis with Poor Recovery?

    • AMultiple sclerosis
    • BNeuromyelitis optica (NMO)
    • CGiant cell arteritis
    • DFingolimod adverse effect
    Show answer and explanation

    Answer: B — Neuromyelitis optica (NMO)

    Bilateral, severe optic neuritis with poor visual recovery is classic for NMO (AQP4-IgG) rather than MS. MS-related optic neuritis is usually unilateral and has better recovery.

  126. 126

    Post-Traumatic Headache, Ptosis, and Amaurosis Fugax?

    • ACT brain and orbits
    • BBilateral carotid Doppler study
    • COrbital ultrasound
    • DCT angiography (CTA) of the neck
    Show answer and explanation

    Answer: D — CT angiography (CTA) of the neck

    The triad of post-traumatic headache, partial Horner syndrome (mild ipsilateral ptosis + miosis), and transient monocular vision loss is highly suggestive of carotid artery dissection. CTA/MRA of the neck is the investigation of choice.

  127. 127

    Canthal Tendon Avulsion After Periorbital Trauma?

    • APulling the eyelid and palpating the insertions of the tendon
    • BObserving the contour of the eyelids and the position of the puncta
    • CReviewing the medical history and the mechanism of the trauma
    • DProbing and irrigating the lacrimal outflow
    Show answer and explanation

    Answer: A — Pulling the eyelid and palpating the insertions of the tendon

    Physical examination with gentle traction on the eyelid and palpation over the normal insertion sites is the best bedside test for canthal tendon avulsion. Laxity or absence of a firm stop suggests avulsion.

  128. 128

    Ptosis with Lid Lag in Downgaze?

    • ACongenital ptosis
    • BSuperior orbital mass
    • COcular myasthenia
    • DDehiscence of the aponeurosis
    Show answer and explanation

    Answer: A — Congenital ptosis

    Congenital ptosis is characterized by decreased levator function and lid lag in downgaze (the ptotic lid remains higher or fails to descend normally). Aponeurotic ptosis typically worsens in downgaze.

  129. 129

    Ptosis with Dysphagia and Respiratory Symptoms?

    • AExternal levator resection
    • BElectromyography and edrophonium (Tensilon) testing
    • CInternal ptosis repair
    • DAnti-acetylcholine receptor antibody testing
    Show answer and explanation

    Answer: B — Electromyography and edrophonium (Tensilon) testing

    Fluctuating ptosis with systemic bulbar/respiratory symptoms suggests myasthenia gravis. EMG with repetitive nerve stimulation and edrophonium/Tensilon test are key diagnostic steps. Surgery is contraindicated before diagnosis.

  130. 130

    Imaging After Blunt Orbital Trauma?

    • ACT scan with contrast
    • BMRI
    • CCT scan without contrast
    • DMRI with contrast
    Show answer and explanation

    Answer: C — CT scan without contrast

    Non-contrast CT is the first-line imaging for orbital trauma because it best demonstrates bony fractures, orbital wall displacement, and intraorbital hemorrhage. MRI is reserved for soft-tissue/optic nerve evaluation.

  131. 131

    Dermolipoma Excision and Dry Eye?

    • ALacrimal gland ductules
    • BMeibomian glands
    • CGlands of Zeis
    • DGlands of Wolfring
    Show answer and explanation

    Answer: A — Lacrimal gland ductules

    Dermolipomas arise in the superotemporal fornix, close to the palpebral lobe of the lacrimal gland and its ductules. Over-aggressive excision can damage ductules → severe aqueous deficiency dry eye.

  132. 132

    New-Onset Thyroid Eye Disease?

    • AEyelid retraction repair
    • BOrbital decompression
    • CThyroid lab testing
    • DStrabismus surgery
    Show answer and explanation

    Answer: C — Thyroid lab testing

    New-onset thyroid-associated orbitopathy requires biochemical confirmation (TSH, free T4, T3, TSH receptor antibodies) and assessment of disease activity before any surgical intervention.

  133. 133

    Upper Lid Blepharoplasty Landmark?

    • AOrbital septum
    • BMüller muscle
    • CLevator aponeurosis
    • DConjunctiva
    Show answer and explanation

    Answer: B — Müller muscle

    The peripheral arterial arcade runs along the anterior surface of Müller muscle. Encountering it during upper lid surgery indicates the dissection plane is at or just anterior to Müller muscle.

  134. 134

    SOOF Equivalent?

    • AOrbital fat
    • BSubcutaneous fat
    • CRetro-orbicularis oculi fat (ROOF)
    • DTemporal fat pad
    Show answer and explanation

    Answer: C — Retro-orbicularis oculi fat (ROOF)

    SOOF is the inferior (midface) counterpart of ROOF in the upper eyelid/forehead region. Both lie deep to the orbicularis oculi muscle.

  135. 135

    Acute Painful Proptosis in a Child?

    • ACavernous hemangioma
    • BSinusitis with orbital abscess
    • CTraumatic retrobulbar hemorrhage
    • DOrbital lymphangioma
    Show answer and explanation

    Answer: A — Cavernous hemangioma

    Cavernous hemangioma is a slow-growing, painless, adult-onset benign tumor. It does not present with acute painful proptosis. The other options are classic causes of acute pediatric orbital presentation.

  136. 136

    Acute Ecchymosis with Cystic Orbital Lesion?

    • ARhabdomyosarcoma
    • BCapillary hemangioma
    • COrbital abscess
    • DLymphangioma
    Show answer and explanation

    Answer: D — Lymphangioma

    Orbital lymphangioma (lymphatic malformation) is characterized by cystic spaces that undergo spontaneous hemorrhage, producing acute proptosis and ecchymosis. Fluid-fluid levels on MRI are typical.

  137. 137

    Most Common Primary Orbital Malignancy in Children?

    • ANeuroblastoma
    • BRhabdomyosarcoma
    • CEwing sarcoma
    • DNone of the above
    Show answer and explanation

    Answer: B — Rhabdomyosarcoma

    Rhabdomyosarcoma is the most common primary malignant orbital tumor in children, usually arising from undifferentiated mesenchymal cells. It presents with rapid-onset proptosis.

  138. 138

    Painless Lacrimal Gland Swelling in Older Adult?

    • APrimary lacrimal gland lymphoma
    • BPleomorphic adenoma
    • CAdenoid cystic carcinoma
    • DMalignant pleomorphic adenoma
    Show answer and explanation

    Answer: A — Primary lacrimal gland lymphoma

    Painless lacrimal gland enlargement in older adults with molding of bone on CT strongly suggests lymphoma. Pleomorphic adenoma typically shows smooth bony remodeling, while carcinomas are more destructive.

  139. 139

    Enophthalmos Without Trauma?

    • ACavernous hemangioma
    • BMetastatic breast carcinoma in a woman
    • COrbital cellulitis
    • DAll of the above
    Show answer and explanation

    Answer: B — Metastatic breast carcinoma in a woman

    Scirrhous metastatic breast carcinoma can cause enophthalmos due to orbital fibrosis and contraction. Cavernous hemangioma and cellulitis typically cause proptosis, not enophthalmos.

  140. 140

    Most Common Cause of Bilateral Adult Exophthalmos?

    • ACavernous hemangioma
    • BPseudotumor
    • CThyroid-related orbitopathy
    • DMetastatic disease
    Show answer and explanation

    Answer: C — Thyroid-related orbitopathy

    Thyroid eye disease is the most common cause of bilateral proptosis in adults, especially women. It is also the leading cause of unilateral or asymmetric exophthalmos.

  141. 141

    Most Common Cause of Unilateral Childhood Exophthalmos?

    • ACapillary hemangioma
    • BThyroid-related orbitopathy
    • COrbital hemorrhage
    • DOrbital cellulitis
    Show answer and explanation

    Answer: D — Orbital cellulitis

    Orbital cellulitis, often secondary to paranasal sinusitis, is the most common cause of unilateral proptosis in children and requires urgent treatment to prevent vision loss and intracranial spread.

  142. 142

    Predisposing Conditions for Mucormycosis?

    • ADiabetes
    • BRenal disease
    • CDehydration
    • DAll of the above
    Show answer and explanation

    Answer: D — All of the above

    Mucormycosis is an aggressive fungal infection seen in immunocompromised and metabolically deranged patients. Risk factors include uncontrolled diabetes (especially diabetic ketoacidosis), renal disease, dehydration, immunosuppression, and iron overload.

These 142 questions are a free sample. The full Ophthal MCQs High Yield bundle carries 1000+ questions with the same depth of explanation — see what is included .