OPHTHALMOLOGY PRACTICE EXAM
QUESTIONS AND DETAILED
SOLUTIONS 2026
▶ Evaluating the Visual Field. Answer: Using the patients four quadrants,
hold up a number with your fingers - 1, 2 or 5 - 40 cm from the patient
(about 40cm from the examiner as well. The patient should correctly
identify the number of fingers presented in each quadrant for each eye, if
not note that quadrant. FTF C (Full to Finger Count). If the patient has a
visual field defect, the finding should be followed up with an appropriate
referral - possible imaging.
▶ Cornea. Answer: Transparent structure located in the anterior eye which
is responsible for refracting (bending light). Clear structure which overlies
the iris. Expected finding - clear - the entire iris should be visible beneath
the cornea.
▶ Blink Reflex. Answer: The cornea is composed of unmyelinated nerve
endings which are very sensitive to light and touch. Blink reflex will result in
a direct and consensual response (both eyes close). Assessing by brushing
a cotton swab in the periphery of the patient's cornea checks the autonomic
innervation of the eye. The ophthalmic branch of the trigeminal nerve CN V.
Assess the efferent (motor) function of the orbicularis muscle (eyelid)
innervated by the facial nerve CN VII.
▶ Ocular Health Exam: Anterior Portion of the Eye. Answer: Slit Lamp &
Gross Observation
▶ Ocular Health Exam: Posterior Portion of the Eye. Answer: Slit Lamp
with Specialized Lenses, Binocular Indirect Ophthalmoscope, Direct
Opthalmoscope
▶ Expected Findings for the Lips/Lashes (Anterior Structures). Answer: -
Symmetric Rt Eye vs. Lt Eye
-Smooth, uniform skin
, -Clean without debris
-Complete lid closure with no exposure of the globe
▶ Ptosis. Answer: Drooping upper eye lid - possible causes Horner
syndrome, myasthenia gravis, superior eyelid or oribatl malignancy,
congenital myogenic ptosis, cranial nerve III palsy. If it is acute onset ptosis
with diplopia (double vision) - STAT REFERRAL.
▶ Ectropion. Answer: Outward turning eyelid margin resulting in severe
dry eye - mostly caused by aging - or less commonly CN VII palsy,
cicatricial, mechanical
▶ Entropion. Answer: Inward turning eyelid margin resulting in chronic
irritation of ocular surface due to lashes rubbing on globe - mostly caused
by aging - less commonly cicatricial (rare autoimmune sub-epithelial
blistering disease) or mechanical.
▶ Hordeolum. Answer: Acute infection of gland within eyelid typically
caused by staphylococcus infection (tender and erythematous). Treat with
warm compresses and consider oral antibiotics - Common infection of the
eyelid and periorbital soft tissues - appropriate treatment of hordeolum will
prevent chalazion development.
▶ Chalazion. Answer: Chronic infection of the Meibomain gland (oil glands
in the eyelid). Not tender or erythematous. Treat with incision and curettage
or steroid injection.
▶ Periorbital Cellulitis. Answer: "Preseptal" cellulitis, infection of the eye lid
(anterior to the orbital septum) which typically results from local spread of
an adjacent sinusitis. Eyelid erythema and edema without proptosis or
restriction of extraocular muscles. Treat with oral antiobiotics - common
infection.
▶ Orbital Cellulitis. Answer: Infection involving the eyelid which involves
structures posterior to the orbital septum commonly associated paranasal
sinus infection or dental infection - acute eyelid erythema and edema and
may include proptosis of the eye, restriction of extraocular muscles
resulting in pain on eye movement, reduced vision, and possible pupil
involvement. - EMERGENT ADMITTANCE TO HOSPITAL - broad
spectrum antibiotics and Neuro consult.
QUESTIONS AND DETAILED
SOLUTIONS 2026
▶ Evaluating the Visual Field. Answer: Using the patients four quadrants,
hold up a number with your fingers - 1, 2 or 5 - 40 cm from the patient
(about 40cm from the examiner as well. The patient should correctly
identify the number of fingers presented in each quadrant for each eye, if
not note that quadrant. FTF C (Full to Finger Count). If the patient has a
visual field defect, the finding should be followed up with an appropriate
referral - possible imaging.
▶ Cornea. Answer: Transparent structure located in the anterior eye which
is responsible for refracting (bending light). Clear structure which overlies
the iris. Expected finding - clear - the entire iris should be visible beneath
the cornea.
▶ Blink Reflex. Answer: The cornea is composed of unmyelinated nerve
endings which are very sensitive to light and touch. Blink reflex will result in
a direct and consensual response (both eyes close). Assessing by brushing
a cotton swab in the periphery of the patient's cornea checks the autonomic
innervation of the eye. The ophthalmic branch of the trigeminal nerve CN V.
Assess the efferent (motor) function of the orbicularis muscle (eyelid)
innervated by the facial nerve CN VII.
▶ Ocular Health Exam: Anterior Portion of the Eye. Answer: Slit Lamp &
Gross Observation
▶ Ocular Health Exam: Posterior Portion of the Eye. Answer: Slit Lamp
with Specialized Lenses, Binocular Indirect Ophthalmoscope, Direct
Opthalmoscope
▶ Expected Findings for the Lips/Lashes (Anterior Structures). Answer: -
Symmetric Rt Eye vs. Lt Eye
-Smooth, uniform skin
, -Clean without debris
-Complete lid closure with no exposure of the globe
▶ Ptosis. Answer: Drooping upper eye lid - possible causes Horner
syndrome, myasthenia gravis, superior eyelid or oribatl malignancy,
congenital myogenic ptosis, cranial nerve III palsy. If it is acute onset ptosis
with diplopia (double vision) - STAT REFERRAL.
▶ Ectropion. Answer: Outward turning eyelid margin resulting in severe
dry eye - mostly caused by aging - or less commonly CN VII palsy,
cicatricial, mechanical
▶ Entropion. Answer: Inward turning eyelid margin resulting in chronic
irritation of ocular surface due to lashes rubbing on globe - mostly caused
by aging - less commonly cicatricial (rare autoimmune sub-epithelial
blistering disease) or mechanical.
▶ Hordeolum. Answer: Acute infection of gland within eyelid typically
caused by staphylococcus infection (tender and erythematous). Treat with
warm compresses and consider oral antibiotics - Common infection of the
eyelid and periorbital soft tissues - appropriate treatment of hordeolum will
prevent chalazion development.
▶ Chalazion. Answer: Chronic infection of the Meibomain gland (oil glands
in the eyelid). Not tender or erythematous. Treat with incision and curettage
or steroid injection.
▶ Periorbital Cellulitis. Answer: "Preseptal" cellulitis, infection of the eye lid
(anterior to the orbital septum) which typically results from local spread of
an adjacent sinusitis. Eyelid erythema and edema without proptosis or
restriction of extraocular muscles. Treat with oral antiobiotics - common
infection.
▶ Orbital Cellulitis. Answer: Infection involving the eyelid which involves
structures posterior to the orbital septum commonly associated paranasal
sinus infection or dental infection - acute eyelid erythema and edema and
may include proptosis of the eye, restriction of extraocular muscles
resulting in pain on eye movement, reduced vision, and possible pupil
involvement. - EMERGENT ADMITTANCE TO HOSPITAL - broad
spectrum antibiotics and Neuro consult.
