OPHTHA – EXIT EXAM RECALLS RATIO GO KATE GO!

1. A patient came to you with VA of 20/67 but improved to 8. What is the mechanism of action of Tropicamide?
20/20 with pinhole. The blurring of vision is probably a. Muscarinic receptor antagonist
secondary to: b. Alpha receptor agonist - Clonidine
a. Error of refraction c. Beta receptor agonist
b. Age-related macular degeneration d. Beta receptor antagonist - Timolol
c. Retinal detachment
d. Optic atrophy 9. What is the preferred and most commonly used surgical
procedure for cataract?
2. A 54-year-old patient comes to you with severe a. Phacoemulsification
headache radiating to the right side, and repetitive b. Laser iridotomy
vomiting. Gross exam shows eye redness, hazy cornea, c. Trabeculectomy
with fixed and mid-dilated pupils on the right eye. On d. Keratoplasty
digital palpation, the right eye is hard. What emergency
treatment would you provide? 10. Which of the following are the true ocular emergencies?
a. Tobramycin every 15 minutes for 6 doses while a. Perforating and blunt trauma to the eye
at ER then 4xday b. Orbital and Maxillary fractures
b. Prednisolone Acetate every 1 hour while awake c. Chemical burn and central retinal artery
c. Acetazolamide 250 mg/tab 2 tabs stat then 1 occlusion
tab every 6 hours d. Endophthalmitis and orbital cellulitis
d. Tranexamic Acid 500 mg/tab 1 tab every 8
hours 11. What is the clinical manifestation of pre-septal cellulitis?
a. Significant eyelid swelling
3. What eye pathology is most likely to be seen in b. Chronic decrease in vision
immunocompromised patients? c. Painful proptosis
a. CMV retinitis d. Restricted ocular movement
b. Allergic conjunctivitis
c. Retinal detachment 12. A 7-year old was brought to the ER for proptosis of the
d. Glaucoma left eye associated with lid swelling, hyperemia,
chemosis, limitation of EOMs, and diplopia. What is the
4. The focal point of an uncorrected hyperope is located most likely diagnosis?
a. In front of the retina - Myopia a. Preseptal cellulitis
b. On the retina b. External hordeolum
c. Behind the retina c. Orbital cellulitis
d. In front and behind the retina d. Blepharitis

5. A condition that starts at around 40-years-old, 13. A patient with a history of asthma consulted because of
characterized by weakening of the accommodation of itchy and red eye. What is the most likely diagnosis?
the crystalline lens resulting in difficulty in reading fine a. Fungal keratitis – infection of cornea
print. b. Vernal conjunctivitis – allergic reaction
a. Hypermetropia c. Herpes simplex keratitis
b. Myopia - Nearsightedness d. Viral conjunctivitis – adenovirus, pink eya
c. Presbyopia
d. Astigmatism – Distorted vision 14. Which of the following is a non-vision threatening cause
of red eye?
6. Which of the following has the highest diopteric power a. Iritis
in the eye? b. Pinguecula – abnormal growth of tissue on the
a. Cornea conjunctiva
b. Aqueous humor c. Scleritis
c. Lens d. Hyphema
d. Vitreous humor
15. Which of the following is a vision-threatening red eye
7. Which of the following may be used to measure visual disorder?
acuity for patients who are unable to read or for a. Corneal infection
pediatric patients? b. Subconjunctival hemorrhage
a. Picture chart c. Meibomian cyst
b. ETDRS chart d. Adenoviral conjunctivitis
c. Snellen chart 16. The most common cause of acute conjunctivitis is
d. LogMar chart a. Allergic

CATON | OPHTHA
 b. Bacterial b. Convergence
c. Fungal c. Accommodation
d. Viral – “Pink Eye” d. Diplopia

17. A 17-year-old patient was accidentally hit with a 25. The aqueous humor is produced by which structure of
baseball on the right eye. The patient complains of the eye:
diplopia and on PE there is limitation in upgaze of the a. Cornea
affected eye. What is the most likely diagnosis? b. Iris
a. Blow-out fracture c. Lens
b. Subdural hematoma d. Ciliary Body
c. Acute conjunctivitis
d. Hordeolum 26. How many bones comprise the orbit? (Q1)
a. 4
18. Among the fibrous layers of the eye, which of the b. 5
following is opaque, composed of fibrous tissue, made c. 6
up of different types of collagen, and is almost acellular? d. 7
a. Sclera
b. Cornea 27. The floor of the orbit consist of which bones? (Q1)
c. Uvea a. Zygomatic, sphenoid
d. Retina b. Zygomatic, maxilla, palatine
c. Palatine, ethmoid, sphenoid
19. The thickest layer of the cornea is the d. Lacrimal, maxilla
a. Epithelium
b. Bowman's membrane 28. What is the most common fracture that occurs in the
c. Stroma orbit?
d. Endothelium a. Blow-out fracture
b. Linear frontal fracture
20. Which bone does not contribute to the orbit? c. Comminuted maxillary fracture
a. Lacrimal bone d. Naso-ethmoid fracture
b. Ethmoid bone
c. Nasal bone 29. True of orbital cellulitis: (Q2)
d. Zygomatic bone a. It is commonly caused by undiagnosed orbital
malignancies.
21. What is the most common orbital primary malignancy in b. It is an infection of the soft tissues of the orbit
children? posterior to the orbital septum.
a. Retinoblastoma c. It presents with eyelid swelling, eye pain, and
b. Rhabdomyosarcoma full movement of the extraocular muscles.
c. Lymphoma d. Staphylococcus epidermidis is the most
d. Cavernous hemangioma common type of bacteria to cause this
condition.
22. Presentation of bilateral optic disc swelling in the
presence of 20/20 visual acuity on both eye is most likely 30. Which of the following confrontational visual field
due to finding makes a clinician suspect a pituitary tumor? (Q1)
a. Bilateral optic neuritis a. Left superior hemianopia
b. Increased intracranial pressure b. Bitemporal hemianopia
c. Congenital disc anomaly c. “Pie on the floor”
d. Diabetic papillopathy d. Right altitudinal defect

23. The following structures pass through the superior 31. Which of the following test findings requires an urgent
orbital fissure EXCEPT: >> CN III, IV, V, VI referral to neurosurgery service on a post-traumatic
a. Optic nerve – !Optic Foramen coma patient? (Q1)
b. Nasociliary nerve – branch of V1 a. Lateral gaze deficit on doll’s head maneuver
c. Abducens nerve - VI b. Blown pupil
d. Oculomotor nerve - III c. Non-reactive pupil
d. Normal fundus findings
24. The accommodation reflex is a response of the eye
characterized by the following EXCEPT:
a. Miosis

CATON | OPHTHA
32. A 20-year-old male was involved in a vehicular accident 39. The orbital apex is the site of origin of these extraocular
sustaining injuries on his body. He was referred to muscles EXCEPT:
ophthalmology because of drooping of the right eyelid. a. Superior rectus
On examination, you noted miosis on the right eye as b. Inferior rectus
well. This is most likely to be: c. Superior oblique
a. Horner’s syndrome d. Inferior oblique – Originate at the orbital floor
b. Foster syndrome - Unilateral visual loss with a just lateral to the nasolacrimal groove
compressive optic atrophy in one eye and
contralateral papilledema 40. The uveal tract is composed of:
c. Raccoon sign - unilateral or bilateral a. Iris, ciliary body, and choroid
progressive proptosis, periorbital ecchymosis, b. Pars plana, retina, and choroid
and edema c. Ora serrata, ciliary processes and choroid
d. Battle Sign - mastoid ecchymosis (behind ear) d. Scleral spur, pars plana, and choroid

33. The following findings are characteristic of a cranial

nerve III palsy EXCEPT: (Q2)
a. Elevation deficit
b. Depression deficit
c. Ptosis
d. Miotic pupil - !Mydriatic (enlarged pupil)

34. What are the consistent findings of an optic

neuropathy? (Q1)
a. Motility deficits
b. Blurred vision and rapid
c. Blurred vision and color vision deficits
d. Blurred vision, RAPD, and color vision deficits

35. Which of the following symptoms is NOT due to vitreo-

retina disorders?
a. Floaters
b. Curtain-like blurring of vision
c. Scintillating scotoma - Migraine
d. Photopsias

36. What is the strongest point of attachment of the

vitreous is:
a. Optic disc
b. Fovea
c. Retinal vessels
d. Ora serrata

37. The external distance of the ora serrata from the limbus
is:
a. 2-3 mm
b. 4-5 mm
c. 6-7 mm
d. 8-9 mm

38. What is the yellowish pigment found at the macula?

a. Melanin - black
b. Hemoglobin - red
c. Xanthophyll
d. None of the above

CATON | OPHTHA
OPHTHA – QUIZZES RATIO GO KATE GO!

QUIZ 1
9. A patient consulted at the emergency room for blurring
1. How many bones comprise the orbit? (Q1) of vision. However, equipment for refraction is not
a. 4 available at the ER. What test will you do to check if
b. 5 blurring of vision may be due to refraction?
c. 6 a. Pinhole test
d. 7 b. Pupillary reflex test
c. Convergence test
2. The floor of the orbit consist of which bones? (Q1) d. Color vision test
a. Zygomatic, sphenoid
b. Zygomatic, maxilla, palatine 10. A patient entered the out-patient clinic complaining of
c. Palatine, ethmoid, sphenoid blurring of vision. Enumerate 6 important information
d. Lacrimal, maxilla you need to ask the patient in order to evaluate the
patient thoroughly
3. What makes up the largest volume of the eye?
a. Anterior aqueous humor o Onset (sudden or gradual)
b. Anterior chamber angle o Which eye is involved (unilateral or bilateral)
c. Posterior chamber o Which part of the visual field is involved,
d. Vitreous o Duration (if continuous or intermittent)
o If blurring is more prominent in the nighttime or
4. The sensory innervation of the cornea comes from: daytime
a. Cranial nerve V1 o Any factors that aggravate or reduce the blurring of
b. Cranial nerve V2 vision
c. Cranial nerve V3
d. Cranial nerve VII 11. What comprises the 6-point eye exam? Enumerate the
6 steps.
5. Which of the following is FALSE about the human o Visual Acuity
crystalline lens? o Gross Eye Examination
a. Localized behind the iris and pupil o EOMs
b. Vascularized structure o Tonometry
c. Held in place by zonular fibers o Fundoscopy
d. Contributes 20 diopters of focusing power o Slit Lamp Examination

6. Which of the following confrontational visual field

finding makes a clinician suspect a pituitary tumor?
a. Left superior hemianopia
b. Bitemporal hemianopia
c. “Pie on the floor”
d. Right altitudinal defect

7. Which of the following test findings requires an urgent

referral to neurosurgery service on a post-traumatic
coma patient?
a. Lateral gaze deficit on doll’s head maneuver
b. Blown pupil
c. Non-reactive pupil
d. Normal fundus findings

8. What are the consistent findings of an optic

neuropathy?
a. Motility deficits
b. Blurred vision and rapid
c. Blurred vision and color vision deficits
d. Blurred vision, RAPD, and color vision deficits

CATON | OPHTHA
QUIZ 2 6. A 65-year-old diabetic and hypertensive complained of
sudden blurring of vision on the right eye. On
1. What is the most common fracture that occurs in the fundoscopy, a cherry red spot was noted. What is the
orbit? most likely diagnosis?
a. Blow-out fracture a. Proliferative diabetic retinopathy
b. Linear frontal fracture b. Hypertensive retinopathy
c. Comminuted maxillary fracture c. Branch retinal vein occlusion
d. Naso-ethmoid fracture d. Central retinal artery occlusion

2. True of orbital cellulitis: 7. 35-year old male fell while riding a motorbike. He
a. It is commonly caused by undiagnosed orbital developed periorbital hematoma on both eyes. What
malignancies. important diagnostic examination will you request?
b. It is an infection of the soft tissues of the orbit a. Fluorescein angiogram
posterior to the orbital septum. b. Optical coherence tomography
c. It presents with eyelid swelling, eye pain, and c. CBC with platelet count
full movement of the extraocular muscles. d. Skull X-ray
d. Staphylococcus epidermidis is the most
common type of bacteria to cause this 8. A patient with red eye of the right consulted at the ER.
condition. On examination, subconjunctival hemorrhage was
noted with no other significant findings. The least
3. A 20-year-old male was involved in a vehicular accident important information to review in the history-taking is:
sustaining injuries on his body. He was referred to a. History of rubbing eyes/Valsalva
ophthalmology because of drooping of the right eyelid. b. History of easy-bruising
On examination, you noted miosis on the right eye as c. History of diabetes
well. This is most likely to be: d. History of hypertension
a. Horner’s syndrome
b. Foster syndrome - Unilateral visual loss with a 9. A 21-year-old female came in the emergency room
compressive optic atrophy in one eye and because of pain and swelling of the whole right upper
contralateral papilledema lid. On palpation, you note a lump near the lid margin
c. Raccoon sign - unilateral or bilateral with pointing. Extraocular muscle movement is
progressive proptosis, periorbital ecchymosis, complete. Your initial management would include the
and edema following EXCEPT: *
d. Battle Sign - mastoid ecchymosis (behind ear) a. Warm compress
b. Topical antibiotics
4. A patient rushed to the emergency room because Liquid c. Oral antibiotics
Soza was accidentally splashed on her eyes. Initial d. Incision and curettage
management is:
a. Topical lubricants 10. A 2-year-old patient entered the emergency room for
b. High dose Vitamin C proptosis of the right eye. On gross examination, there
c. Copious irrigation is leukocoria and fundoscopy show a yellowish-white
d. Keratoplasty retinal mass. The most likely diagnosis is:
a. Rhabdomyosarcoma
5. At the emergency room, a patient came in due to eye b. Orbital cellulitis
pain associated with headache, nausea, and vomiting. c. Retinoblastoma
On examination, the eye is red, the cornea is hazy, and d. Dacryocystitis
feels hard on palpation. The most likely diagnosis is:
a. Acute Angle Closure Glaucoma
b. Acute conjunctivitis
c. Bacterial keratitis
d. Chalazion

CATON | OPHTHA
QUIZ 3 7. A 12-year old patient came in the ER because he was
accidentally poked with a finger on the right eye. On
1. The following findings are characteristic of cranial examination, visual acuity was 20/30 improved to
nerve III palsy EXCEPT: 20/20 on pinhole. No penetrating injury was noted.
a. Elevation deficit However, fluorescein dye uptake was noted on the
b. Depression deficit cornea. Your next step in management is:
c. Dilated pupil a. Advise warm compress 3x a day
d. Miotic pupil b. Prescribe topical antibiotics 4x a day
c. Request for ocular ultrasound
2. The following are differentials for acute red eye, d. Do emergency corneal repair
EXCEPT?
a. Corneal abrasion 8. A 55-year-old male consulted at the OPD for
b. Conjunctivitis progressive painless blurring of vision of both eyes. On
c. Scleritis history, you found out that he recently started
d. Optic neuritis treatment for pulmonary TB. At the top of your
differential diagnoses is:
3. A patient came in the at OPD for red eye with a. Ethambutol toxicity optic neuropathy
associated photophobia. On examination, there was b.
ciliary injection around the limbus, clear cornea, and c.
small poorly reactive pupil. The most likely impression d.
is:
a. Acute iritis 9. Differential for leukocoria in children include the
following EXCEPT:
4. A 65-year-old male went to emergency room for a. Congenital glaucoma
sudden transient blurring of vision of the right eye. Eye b. Congenital cataract
examination was essentially normal. What is your next c. Retinoblastoma
step in the management? d. Congenital aniridia
a. Examine for other neurologic signs
b. Do ocular massage 10. A 48-year-old farmer consulted the OPD for eye
c. Request for ocular ultrasound redness on the left eye. On examination, there was
d. Refer to an ophthalmologist note of fleshy mass at the nasal area of the conjunctiva
and cornea. Your next step in the management is:
5. A 70-year-old female consulted for progressive a. Advise warm compress 3xday
painless blurring of vision of both eyes but more b. Prescribe topical antibiotics 4xday
prominent on the right. On examination, she has c. Request for fluorescein angiogram
uninflamed eyes, clear cornea, and opaque lens on d. Advise excision
both eyes. The most likely diagnosis is:
a. Central Retinal Vein Occlusion
b. Amaurosis fugax
c. Retinal detachment
d. Mature cataract

6. When the image of distant objects focuses in front of

the retina in the unaccommodated eye, the eyes is
diagnosed to have:
a. Myopia
b. Hypermetropia – Behind the retina
c. Emmetropia – focused on the retina
d. Presbyopia – gradual loss to focus

CATON | OPHTHA