LAST MINUTE REVISION
QUESTIONS AND
ANSWERS
-Quickest revision typed and illustrated notes for various entrance
exams , college and university exams
By Dr. MSA
, CONTENTS
UNIT NAME Page No.
1. ANATOMY, PHYSIOLOGY & REFRACTION 3
2. CONJUNCTIVA 18
3. CORNEA & SCLERA 39
4. UVEAL TRACT 61
5. LENS 75
6. GLAUCOMA 92
7. RETINA, VITREOUS & INTRAOCULAR TUMOURS 113
8. EYELIDS 133
9. LACRIMAL APPARATUS & ORBIT 152
10. NEURO-OPHTHALMOLOGY & OCULAR MOTILITY 168
11. OCULAR INJURIES, SYSTEMIC & COMMUNITY 192
OPHTHALMOLOGY
@arsalaan6646 @ars6646
, Anatomy, Physiology and Refraction
Q. Write a short note on presbyopia.
Ans. - Presbyopia (eye sight of old age) is not an error of refraction but a
condition of physiological insufficiency of accommodation leading to a
progressive fall in near vision.
- In an emmetropic eye far point is infinity (∞) and near point varies
with age (being about 7 cm at the age of 10 years, 25 cm at the
age of 40 years and 33 cm at the age of 45 years).
- After the age of 40 years, near point of accommodation recedes
beyond the normal reading or working range. This condition of failing
near vision due to age-related decrease in the amplitude of
accommodation is called presbyopia.
Causes :
1. Age-related changes in the lens which include:
• Decrease in the elasticity of lens capsule, and
• Progressive increase in size and hardness (sclerosis) of lens
2. Age-related decline in ciliary muscle power.
Causes of premature presbyopia are:
1. Uncorrected hypermetropia.
2. Premature sclerosis of the crystalline lens.
3. General debility causing presenile weakness of ciliary muscle.
4. Chronic simple glaucoma.
, Symptoms
1. Difficulty in near vision. Difficulty in reading small prints.
2. Asthenopic symptoms due to fatigue of the ciliary muscle.
3. Intermittent diplopia, occurring due to disturbed relationship
between accommodation and convergence.
TREATMENT
1. Optical treatment : The treatment of presbyopia is the prescription
of appropriate convex glasses for near work. Rough guide for providing
presbyopic glasses in an emmetrope can be made from the age of the
patient.
• 45 years : +1 to +1.25D
• 50 years : +1.5 to +1.75D
• 55 years : +2 to +2.25D
• 60 years : +2.5 to +3D
Basic principles for presbyopic correction are:
• Always find out refractive error for distance and first correct it.
• Find out the presbyopic correction needed in each eye separately
and add it to the distant correction.
• Near point should be fixed by taking due consideration for profession
of the patient.
• The weakest convex lens with which an individual can see clearly at
the near point should be prescribed, since overcorrection will also
result in asthenopic symptoms. Presbyopic spectacles may be
unifocal, bifocal or varifocal, i.e. progressive.
2. Surgical treatment of presbyopia is also being considered.
QUESTIONS AND
ANSWERS
-Quickest revision typed and illustrated notes for various entrance
exams , college and university exams
By Dr. MSA
, CONTENTS
UNIT NAME Page No.
1. ANATOMY, PHYSIOLOGY & REFRACTION 3
2. CONJUNCTIVA 18
3. CORNEA & SCLERA 39
4. UVEAL TRACT 61
5. LENS 75
6. GLAUCOMA 92
7. RETINA, VITREOUS & INTRAOCULAR TUMOURS 113
8. EYELIDS 133
9. LACRIMAL APPARATUS & ORBIT 152
10. NEURO-OPHTHALMOLOGY & OCULAR MOTILITY 168
11. OCULAR INJURIES, SYSTEMIC & COMMUNITY 192
OPHTHALMOLOGY
@arsalaan6646 @ars6646
, Anatomy, Physiology and Refraction
Q. Write a short note on presbyopia.
Ans. - Presbyopia (eye sight of old age) is not an error of refraction but a
condition of physiological insufficiency of accommodation leading to a
progressive fall in near vision.
- In an emmetropic eye far point is infinity (∞) and near point varies
with age (being about 7 cm at the age of 10 years, 25 cm at the
age of 40 years and 33 cm at the age of 45 years).
- After the age of 40 years, near point of accommodation recedes
beyond the normal reading or working range. This condition of failing
near vision due to age-related decrease in the amplitude of
accommodation is called presbyopia.
Causes :
1. Age-related changes in the lens which include:
• Decrease in the elasticity of lens capsule, and
• Progressive increase in size and hardness (sclerosis) of lens
2. Age-related decline in ciliary muscle power.
Causes of premature presbyopia are:
1. Uncorrected hypermetropia.
2. Premature sclerosis of the crystalline lens.
3. General debility causing presenile weakness of ciliary muscle.
4. Chronic simple glaucoma.
, Symptoms
1. Difficulty in near vision. Difficulty in reading small prints.
2. Asthenopic symptoms due to fatigue of the ciliary muscle.
3. Intermittent diplopia, occurring due to disturbed relationship
between accommodation and convergence.
TREATMENT
1. Optical treatment : The treatment of presbyopia is the prescription
of appropriate convex glasses for near work. Rough guide for providing
presbyopic glasses in an emmetrope can be made from the age of the
patient.
• 45 years : +1 to +1.25D
• 50 years : +1.5 to +1.75D
• 55 years : +2 to +2.25D
• 60 years : +2.5 to +3D
Basic principles for presbyopic correction are:
• Always find out refractive error for distance and first correct it.
• Find out the presbyopic correction needed in each eye separately
and add it to the distant correction.
• Near point should be fixed by taking due consideration for profession
of the patient.
• The weakest convex lens with which an individual can see clearly at
the near point should be prescribed, since overcorrection will also
result in asthenopic symptoms. Presbyopic spectacles may be
unifocal, bifocal or varifocal, i.e. progressive.
2. Surgical treatment of presbyopia is also being considered.
