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ICO/FICO Past Papers
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ICO/FICO Past Papers
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Full question bank
All 83 free ICO/FICO Past Papers 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
Uveoscleral outflow accounts for what percentage of aqueous outflow?
- A2%
- B5%
- C5–10%
- D10–50%
- E75–90%
Show answer and explanationHide answer
Answer: D — 10–50%
Uveoscleral outflow is pressure-independent. Normally contributes 10–50% of aqueous drainage.
- 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 explanationHide answer
Answer: C — 0.28 μL/min/mmHg
Normal range ≈ 0.22–0.28 μL/min/mmHg
- 3
Main reflex tear secretor?
- AGland of Wolfring
- BGland of Krause
- CLacrimal gland
- DMeibomian gland
Show answer and explanationHide answer
Answer: C — Lacrimal gland
Lacrimal gland → reflex tears; Krause + Wolfring → basal tears.
- 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 explanationHide answer
Answer: A — Stromal wound healing → Type I collagen
Stromal wound healing → Type III collagen; Corneal stroma → Type I collagen.
- 5
Normal aqueous humor production?
- A2 μL/min
- B4 μL/min
- C6 μL/min
- D8 μL/min
Show answer and explanationHide answer
Answer: A — 2 μL/min
Produced by non-pigmented ciliary epithelium.
- 6
Electrolytes present at half plasma concentration in aqueous humor?
- ANa+, K+
- BCa²⁺, PO₄²⁻
- CCl⁻, HCO₃⁻
- DCu²⁺, Zn²⁺
Show answer and explanationHide answer
Answer: B — Ca²⁺, PO₄²⁻
- 7
Most common primary orbital malignancy of childhood arises from:
- AMuscle
- BHistiocytes
- CMesenchyme
- DCapillary endothelial cells
Show answer and explanationHide answer
Answer: C — Mesenchyme
Rhabdomyosarcoma = most common primary orbital malignancy in children. Origin = undifferentiated mesenchymal cells.
- 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 explanationHide answer
Answer: D — Bowman membrane is a true basement membrane
Bowman layer is not a true basement membrane; it is condensed anterior stromal collagen.
- 9
Thickest layer of tear film?
- AMarginal strip
- BLipid layer
- CAqueous layer
- DGlycoprotein layer
Show answer and explanationHide answer
Answer: C — Aqueous layer
Lipid ≈ 0.5 μm; Aqueous ≈ 7 μm; Mucin ≈ 0.1 μm.
- 10
NOT a feature of basal cell carcinoma?
- APearly elevated margins
- BSpread to regional lymph nodes
- CUlceration
- DTelangiectasia
Show answer and explanationHide answer
Answer: B — Spread to regional lymph nodes
BCC is the most common eyelid malignancy and rarely metastasizes.
- 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 explanationHide answer
Answer: C — Lash loss, central ulceration, rapid growth
- 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 explanationHide answer
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
Physiologic diplopia occurs:
- AOn horopter
- BWithin Panum area
- CIn front of Panum area
- DNone
Show answer and explanationHide answer
Answer: C — In front of Panum area
Occurs in front of and behind Panum's area.
- 14
Rhabdomyosarcoma type with worst prognosis?
- ABotryoid
- BPleomorphic
- CAlveolar
- DEmbryonal
Show answer and explanationHide answer
Answer: C — Alveolar
Worst → Alveolar; Most common → Embryonal.
- 15
Protein accumulation causing brunescence cataract?
- AHigh molecular weight crystallin
- BAlpha crystallin
- CGamma crystallin
- DWater-insoluble protein
Show answer and explanationHide answer
Answer: D — Water-insoluble protein
- 16
Largest crystallin in human lens?
- Aβ-crystallin
- Bα-crystallin
- Cγ-crystallin
- DTaxon-specific crystallin
Show answer and explanationHide answer
Answer: B — α-crystallin
- 17
NOT protective against oxidation in lens?
- AGlutathione peroxidase
- BVitamin A
- CSuperoxide dismutase
- DCatalase
Show answer and explanationHide answer
Answer: B — Vitamin A
Glutathione, Catalase, Superoxide dismutase, Vitamins C & E.
- 18
Protective mechanism against lens oxidation?
- AGlutathione
- BVitamin A
- CAldose reductase
- DVitamin B12
Show answer and explanationHide answer
Answer: A — Glutathione
- 19
Best stain for sebaceous gland carcinoma?
- AGiemsa
- BH&E
- COil Red O
- DMethenamine silver
Show answer and explanationHide answer
Answer: C — Oil Red O
Oil Red O stains lipids.
- 20
Pagetoid spread is most associated with:
- AMelanoma
- BSCC
- CSebaceous gland carcinoma
- DMerkel cell tumor
Show answer and explanationHide answer
Answer: C — Sebaceous gland carcinoma
- 21
Melanoma with best prognosis?
- AIris
- BCiliary body
- CAnterior choroid
- DPosterior choroid
Show answer and explanationHide answer
Answer: A — Iris
Iris melanoma is often diagnosed early and can be excised completely.
- 22
Elderly woman with unilateral chronic blepharitis, thickened upper lid, lymphadenopathy?
- ABCC
- BKeratoacanthoma
- CMolluscum contagiosum
- DSebaceous gland carcinoma
Show answer and explanationHide answer
Answer: D — Sebaceous gland carcinoma
"Chronic unilateral blepharitis in elderly = sebaceous gland carcinoma until proven otherwise."
- 23
RPE characteristic NOT correct?
- ABasal Na-K pump maintains ion gradient
- BBlood-retinal barrier
- CRetinal adhesion
- DVitamin A isomerization
Show answer and explanationHide answer
Answer: A — Basal Na-K pump maintains ion gradient
Na-K ATPase is located on the apical surface.
- 24
RPE function NOT correct?
- ARetinal adhesion
- BVisual pigment regeneration
- CNutrient transport
- DPhagocytosis of photoreceptor inner segments
Show answer and explanationHide answer
Answer: D — Phagocytosis of photoreceptor inner segments
RPE phagocytoses outer segment tips.
- 25
Rods are how much more sensitive than cones?
- AEqual
- B10×
- C1000×
- D10,000×
Show answer and explanationHide answer
Answer: C — 1000×
- 26
Found in inner plexiform layer?
- AAxons of ganglion cells
- BAxons of amacrine cells
- CSynapses of photoreceptors
- DMüller cell footplates
Show answer and explanationHide answer
Answer: B — Axons of amacrine cells
IPL Contains: Ganglion dendrites, Bipolar axons, Amacrine processes.
- 27
Ocular gland statements true?
- A1 and 2
- B1 and 3
- C2 and 4
- D3 and 4
Show answer and explanationHide answer
Answer: B — 1 and 3
Accessory glands → basal tears; Main lacrimal gland → reflex tears; Meibomian glands are not associated with eyelashes.
- 28
Keratoconjunctivitis sicca staining occurs where?
- ASuperior third
- BMiddle third (interpalpebral)
- CInferior third
- DDiffuse
Show answer and explanationHide answer
Answer: B — Middle third (interpalpebral)
- 29
Corneal layer staining most with PAS?
- AEndothelium
- BBowman layer
- CWing cells
- DDescemet membrane
Show answer and explanationHide answer
Answer: D — Descemet membrane
PAS highlights basement membranes.
- 30
Tear layer containing IgA?
- AMucin layer
- BLipid layer
- CAqueous layer
- DGlycoprotein layer
Show answer and explanationHide answer
Answer: C — Aqueous layer
- 31
Contributes to aqueous layer of tear film?
- AWolfring glands
- BZeis glands
- CGoblet cells
- DMeibomian glands
Show answer and explanationHide answer
Answer: A — Wolfring glands
- 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 explanationHide answer
Answer: A — Corneal wound healing → Type III collagen
- 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 explanationHide answer
Answer: B — Abnormal from birth with seizures and mental retardation
Patients are usually normal at birth and develop symptoms later.
- 34
NOT a true basement membrane?
- ADescemet membrane
- BBruch membrane
- CLens capsule
- DBowman membrane
Show answer and explanationHide answer
Answer: D — Bowman membrane
- 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 explanationHide answer
Answer: C — Lens fibers in nucleus continue to divide throughout life
Division occurs in equatorial lens epithelium. Central lens fibers do not divide.
- 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 explanationHide answer
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
Cardinal signs of inflammation include all EXCEPT:
- ARedness
- BIrreversible architectural disruption
- CPain
- DLoss of function
- EWarmth
Show answer and explanationHide answer
Answer: B — Irreversible architectural disruption
Key Point — Five cardinal signs:; Rubor = Redness; Calor = Warmth; Dolor = Pain; Tumor = Swelling; Functio laesa = Loss of function
- 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 explanationHide answer
Answer: E — Antibiotic treatment must be prolonged because of resistance
Blindness results from cicatrization and scarring. Serotypes A, B, Ba, C cause trachoma.
- 39
Which disease is NOT caused by Chlamydia trachomatis?
- ALigneous conjunctivitis
- BAdult inclusion conjunctivitis
- CLymphogranuloma venereum
- DTrachoma
Show answer and explanationHide answer
Answer: A — Ligneous conjunctivitis
Trachoma → Serotypes A–C; Adult inclusion conjunctivitis → D–K; LGV → L1–L3
- 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 explanationHide answer
Answer: A — Moraxella — Blood agar in 5–10% CO₂
M. tuberculosis → Lowenstein–Jensen medium; Haemophilus → Chocolate agar; Ocular fungi → Sabouraud agar WITHOUT cycloheximide
- 41
Organism NOT usually a commensal of lids and lashes?
- AMoraxella catarrhalis
- BHaemophilus influenzae
- CPropionibacterium acnes
- DStaphylococcus epidermidis
Show answer and explanationHide answer
Answer: B — Haemophilus influenzae
Key Point — Normal lid flora:; Staphylococcus epidermidis; Corynebacterium; Moraxella catarrhalis; Streptococcus viridans
- 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 explanationHide answer
Answer: C — Topical antibiotic for 3 days + povidone-iodine at surgery
Antibiotic pretreatment + povidone iodine gives maximal reduction.
- 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 explanationHide answer
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
Most likely extraocular focus in endogenous bacterial endophthalmitis?
- ALiver abscess
- BEndocarditis
- COrbital cellulitis
- DMeningitis
- ESeptic arthritis
Show answer and explanationHide answer
Answer: A — Liver abscess
Key Point — Most common sources:; Liver abscess; Endocarditis
- 45
Species most frequently implicated in adult preseptal cellulitis?
- AStaphylococcus species
- BStreptococcus species
- CHaemophilus species
- DPseudomonas species
- EBacillus species
Show answer and explanationHide answer
Answer: A — Staphylococcus species
Staphylococcus aureus is most common; Streptococcus is second.
- 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 explanationHide answer
Answer: A — Toxic follicular conjunctivitis
May take weeks, months, or years.
- 47
Classic clinical sign of staphylococcal blepharoconjunctivitis?
- AInferior follicular conjunctivitis
- BScurf
- CLimbal papillae
- DCollarettes
- ESleeving of lashes
Show answer and explanationHide answer
Answer: D — Collarettes
Collarettes → Staphylococcus; Scurf → Seborrhea; Sleeves → Demodex
- 48
Most common cause of acute painful enlargement of lacrimal gland?
- ASarcoidosis
- BSjögren syndrome
- CBacterial dacryoadenitis
- DLeprosy
- EHerpes zoster
Show answer and explanationHide answer
Answer: C — Bacterial dacryoadenitis
Usually ascending staphylococcal infection. Viral dacryoadenitis is often painless.
- 49
Chronic asymptomatic dacryocystitis is most commonly caused by?
- AStaphylococcus aureus
- BStreptococcus pneumoniae
- CStaphylococcus epidermidis
- DHaemophilus influenzae
- EPseudomonas aeruginosa
Show answer and explanationHide answer
Answer: B — Streptococcus pneumoniae
Silent dacryocystitis classically caused by pneumococcus.
- 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 explanationHide answer
Answer: C — 2–5 days postop, Staphylococcus most common
Most common organism: Staphylococcus epidermidis. Usually from patient's lid flora.
- 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 explanationHide answer
Answer: A — Large frequently branching dendrite
Key Point — HZO pseudodendrites:; Smaller; Less branching; No terminal bulbs; Blunt ends
- 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 explanationHide answer
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
Most abundant antibody in tear film?
- AIgE
- BIgM
- CIgA
- DIgG
Show answer and explanationHide answer
Answer: C — IgA
Secretory IgA is the dominant immunoglobulin in tears.
- 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 explanationHide answer
Answer: A — 1,2,3
Key Point — Surface immunoglobulins: IgM, IgD, IgG function as antigen receptors on B lymphocytes.
- 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 explanationHide answer
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
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 explanationHide answer
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
Factors increasing corneal penetration EXCEPT:
- AHigher drug concentration
- BHigher vehicle viscosity
- CHigher pH of the drug
- DHigher lipid solubility
- EBenzalkonium chloride
Show answer and explanationHide answer
Answer: C — Higher pH of the drug
Extreme pH causes reflex tearing and dilution. BAK disrupts corneal epithelium and increases penetration.
- 58
NSAIDs block formation of all EXCEPT:
- AThromboxane
- BLeukotrienes
- CProstaglandins
- DProstacyclin
Show answer and explanationHide answer
Answer: B — Leukotrienes
NSAIDs block COX. Leukotrienes are produced through LOX pathway.
- 59
Aminoglycoside most commonly causing topical hypersensitivity?
- AGentamicin
- BTobramycin
- CKanamycin
- DAmikacin
- ENeomycin
Show answer and explanationHide answer
Answer: E — Neomycin
Most frequent topical allergic reactions among aminoglycosides. Hypersensitivity occurs in ~6–8%.
- 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 explanationHide answer
Answer: B — Empiric use in neutropenia is recommended for prophylaxis
CDC recommends avoiding routine empiric vancomycin due to resistance concerns.
- 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 explanationHide answer
Answer: C — Increase thromboxane production
NSAIDs decrease prostaglandins, prostacyclin, and thromboxane.
- 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 explanationHide answer
Answer: D — Increased hydrophilicity of the drug
Increased lipid solubility improves corneal penetration.
- 63
Higher uptake as ointment rather than drops EXCEPT:
- ATetracycline
- BChloramphenicol
- CFluorometholone
- DPenicillin
Show answer and explanationHide answer
Answer: D — Penicillin
Penicillin penetrates ocular tissues poorly.
- 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 explanationHide answer
Answer: A — Proliferative vitreoretinopathy after vitrectomy
MMC is primarily used on external ocular surfaces.
- 65
Natamycin may be effective against all EXCEPT:
- AAspergillus
- BCandida albicans
- CFusarium
- DMucor
Show answer and explanationHide answer
Answer: D — Mucor
Mucor responds better to Amphotericin B.
- 66
Amphotericin B alone may be effective against all EXCEPT:
- AAspergillus
- BCandida
- CCryptococcus
- DMucor
Show answer and explanationHide answer
Answer: D — Mucor
Mucor generally requires Amphotericin B plus surgical debridement.
- 67
Effective agents for Acanthamoeba EXCEPT:
- ANeomycin
- BPolyhexamethylene biguanide (PHMB)
- CPropamidine
- DTrifluridine
Show answer and explanationHide answer
Answer: D — Trifluridine
Trifluridine is antiviral. PHMB + diamidines are classic therapy.
- 68
Side effects of systemic corticosteroids include all EXCEPT:
- AAseptic necrosis of hip
- BHypoglycemia
- CHypertension
- DGastric ulceration
Show answer and explanationHide answer
Answer: B — Hypoglycemia
Steroids cause hyperglycemia, not hypoglycemia.
- 69
Side effects of prostaglandin analogues EXCEPT:
- AConjunctival hyperemia
- BCystoid macular edema
- CDecrease in iris pigmentation
- DHypertrichosis
Show answer and explanationHide answer
Answer: C — Decrease in iris pigmentation
Prostaglandin analogues increase iris pigmentation.
- 70
Best topical beta-blocker for mild bronchoconstrictive disease?
- ATimolol
- BBetaxolol
- CMetipranolol
- DLevobunolol
Show answer and explanationHide answer
Answer: B — Betaxolol
Betaxolol is β1-selective. Preferred in mild pulmonary disease.
- 71
Least suitable IOP-lowering drug in mild bronchoconstrictive disease?
- ATimolol
- BBetaxolol
- CLatanoprost
- DBrimonidine
Show answer and explanationHide answer
Answer: A — Timolol
Non-selective β-blockers can cause bronchospasm.
- 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 explanationHide answer
Answer: D — Metabolic acidosis is greater with oral than IV acetazolamide
Metabolic acidosis is greater with IV acetazolamide.
- 73
Dipivefrin is converted to epinephrine in:
- ATears
- BConjunctiva
- CCornea
- DAqueous humor
- EIris stroma
Show answer and explanationHide answer
Answer: C — Cornea
Corneal esterases cleave dipivefrin to epinephrine.
- 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 explanationHide answer
Answer: C — Pilocarpine
Epinephrine/dipivefrin: risk of CME in aphakia.; Timolol: bronchospasm.; Acetazolamide: caution in depression.; Pilocarpine becomes safest option.
- 75
Embryonic Fissure Closure?
- ADay 17
- BDay 23
- CDay 27
- DDay 33
Show answer and explanationHide answer
Answer: D — Day 33
Embryonic (optic) fissure closure occurs around day 33 of gestation. Failure → coloboma.
- 76
Bony Boundaries of Nasolacrimal Sac?
- ALacrimal, ethmoid
- BMaxillary, ethmoid
- CNasal, lacrimal
- DLacrimal, maxillary
Show answer and explanationHide answer
Answer: D — Lacrimal, maxillary
The nasolacrimal sac sits in the lacrimal fossa, formed by the lacrimal bone and the maxillary bone (frontal process of maxilla).
- 77
Epithelium of Nasolacrimal Duct System?
- AStratified squamous epithelium
- BPseudostratified columnar epithelium
- CCuboidal epithelium
- DStratified columnar epithelium with goblet cell overlay
Show answer and explanationHide answer
Answer: B — Pseudostratified columnar epithelium
Nasolacrimal drainage system is lined by pseudostratified columnar epithelium (respiratory-type).
- 78
Nasolacrimal Duct Opening?
- AAbove the inferior turbinate
- BThrough the valve of Rosenmüller
- CThrough an ostium partially covered by a mucosal fold (Valve of Hasner)
- DInto the superior meatus
Show answer and explanationHide answer
Answer: C — Through an ostium partially covered by a mucosal fold (Valve of Hasner)
NLD opens into the inferior meatus under the inferior turbinate, partially covered by the valve of Hasner. Valve of Rosenmüller is at the common canaliculus–sac junction.
- 79
Bones Forming the Orbital Floor?
- AMaxillary
- BLacrimal
- CZygomatic
- DPalatine
Show answer and explanationHide answer
Answer: B — Lacrimal
Orbital floor = maxilla (orbital plate), zygomatic bone, palatine bone. Lacrimal bone forms part of the medial orbital wall.
- 80
Muscle Originating Above the Annulus of Zinn?
- ASuperior oblique
- BSuperior rectus
- CLateral rectus
- DInferior oblique
Show answer and explanationHide answer
Answer: A — Superior oblique
Superior oblique originates from the sphenoid bone superomedial to the optic canal, above the annulus of Zinn. All other EOMs arise from the annulus except inferior oblique (orbital floor).
- 81
Myelinated Nerve Fibers?
- AMyelination begins at the lateral geniculate body and progresses anteriorly.
- BMyelination begins at the lamina cribrosa and extends posteriorly.
- CAbnormal myelination is due to a defect in the lamina cribrosa.
- DMyelination is completed after birth.
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Answer: B — Myelination begins at the lamina cribrosa and extends posteriorly.
Normal optic nerve myelination proceeds from the lateral geniculate body anteriorly toward the globe and stops at the lamina cribrosa. In myelinated nerve fibers, myelination extends past the lamina cribrosa through a defect/sieve in the lamina cribrosa.
- 82
Ankyloblepharon?
- ASixth week
- BThird month
- CFifth month
- DEighth month
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Answer: C — Fifth month
Eyelids form and fuse by the 8th–9th week and reopen around the 5th–6th month. Ankyloblepharon (failure of complete separation of eyelid margins) is a fifth-month anomaly.
- 83
Lateral Orbital Tubercle of Whitnall?
- ACheck ligament of the lateral rectus
- BSuspensory ligament of the eyeball (Lockwood's ligament)
- CLateral canthal tendon
- DAponeurosis of the levator muscle
- EWhitnall's ligament
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Answer: E — Whitnall's ligament
Whitnall's (superior transverse) ligament is a fascial condensation of the levator aponeurosis; it does not insert into the lateral orbital tubercle. The tubercle gives attachment to the lateral check ligament, Lockwood's ligament laterally, lateral canthal tendon, and levator aponeurosis.
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