NORTH CAROLINA OPTOMETRY BOARDS
EXAM Questions With 100% Correct
Solved Detailed
Answers latest update 2025
What are the symptoms of canaliculitis? --- correct answer ---Chronic
unilateral red eye, epiphora, discharge in the nasal part of the eye
What is the most common pathogenic cause of canaliculitis? ---
correct answer ---Actinomyces
What is treatment for canaliculitis? --- correct answer ---Warm
compress, antibiotics (1st gen cephalosporin) sometimes surgery to
remove concretions or foreign bodies
What is dacryocystitis? --- correct answer ---inflammation of the
lacrimal sac
Which organisms are typically the cause of dacryocystitis? --- correct
answer ---Streptococcus, Haemophilus influenza, pseudomonas
aeruginosa
,What is the cause of chronic dacryocystitis? --- correct answer ---
Chronic obstruction due to systemic disease, repeated infection,
dacryoliths, and chronic inflammatory debris of the nasolacrimal
system. Some common systemic diseases include Wegener's
granulomatosis, sarcoidosis, and systemic lupus erythematosus
What is the cause of acquired dacryocystitis? --- correct answer ---
Repeated trauma, surgeries, medications, neoplasms, nasolacrimal
obstruction
Congenital forms of daceyocystitis are caused by the obstruction of? --
- correct answer ---Membranous obstruction of the valve of Hasner in
the distal nasolacrimal duct
What are the symptoms of acute dacryocystitis? --- correct answer ---
Symptoms may occur over several hours to several days and is
characterized by pain, erythema, and edema over the medial canthus
and the area overlying the lacrimal sac at the inferomedial portion of
the orbit. The redness can extend to involve the bridge of the nose.
Purulent material can sometimes be expressed from the puncta and
tearing may be present.
,What are the symptoms of chronic dacryocystitis? --- correct answer -
--Excessive tearing and discharge are the most common symptom.
Changes in visual acuity may be present due to tear film production.
Erythema involving the entire orbit ad pain with extraocular
movement are not typically associated with dacrycystitis and should
prompt the health care provider to search for alternative diagnoses.
How is dacryocysititis diagnosed? --- correct answer ---A Crigler, or
tear duct massage can be performed to express material for culture
and gram stain.
In patients who appear acutely toxic or those who present with visual
changes, imaging and bloodwork should be considered.
In chronic cases , serological testing can be performed if systemic
conditions are suspected. Imaging is not typically needed for diagnosis
unless suspicion arises on history and physical (for example patient
complains of hemolacria)
CT scans can be performed in cases of trauma.
Dacryocystography or plain film dacryosystogram (DCG) can be
performed when anatomic abnormalities are suspected.
Nasal endoscopy is useful to rule out hypertrophy of the inferior
turbinate, septal deviation and inferior meatal narrowing.
The fluorescein dye disappearance test (DDT) is another option
available to evaluate for adequate lacrimal outflow. The persistence of
dye coupled with asymmetric clearance of the dye from the tear
, meniscus after five minutes, indicates an obstruction. However this
does not distinguish between an upper (punctal, canalicular, or sac)
and lower (nasolacrimal duct) obstruction.
How is acute dacryocystitis treated? --- correct answer ---Treatment
of acute dacryocystitis includes conservative measures such as warm
compresses and attempts of Crigler massage.
For uncomplicated cases consideration of oral antibiotics should be
given. Coverage should always be aimed at gram-positive organisms,
particularly antistaphylococcal agents.
In complicated cases or patients who appear toxic, intravenously
antibiotics should be administered. Empiric antibiotics should include
gram positive and gram negative coverage.
Lacrimal probing in discouraged in the acute phase.
For recurrent infections, referral to ophthalmology for surgical
evaluation is advised.
What is the treatment for chronic dacryocystitis? --- correct answer --
-Chronic dacryocystitis is almost always managed surgically with high
success rates. Probing is accepted as first-line management in chronic
cases and can be done in the outpatient setting. Inevitable, patients
will likely need to progress to further surgical options to treat the
condition. Balloon dacryoplasty, nasolacrimal intubation, and
nasolacrimal stenting have all been attempted with variable first-time
EXAM Questions With 100% Correct
Solved Detailed
Answers latest update 2025
What are the symptoms of canaliculitis? --- correct answer ---Chronic
unilateral red eye, epiphora, discharge in the nasal part of the eye
What is the most common pathogenic cause of canaliculitis? ---
correct answer ---Actinomyces
What is treatment for canaliculitis? --- correct answer ---Warm
compress, antibiotics (1st gen cephalosporin) sometimes surgery to
remove concretions or foreign bodies
What is dacryocystitis? --- correct answer ---inflammation of the
lacrimal sac
Which organisms are typically the cause of dacryocystitis? --- correct
answer ---Streptococcus, Haemophilus influenza, pseudomonas
aeruginosa
,What is the cause of chronic dacryocystitis? --- correct answer ---
Chronic obstruction due to systemic disease, repeated infection,
dacryoliths, and chronic inflammatory debris of the nasolacrimal
system. Some common systemic diseases include Wegener's
granulomatosis, sarcoidosis, and systemic lupus erythematosus
What is the cause of acquired dacryocystitis? --- correct answer ---
Repeated trauma, surgeries, medications, neoplasms, nasolacrimal
obstruction
Congenital forms of daceyocystitis are caused by the obstruction of? --
- correct answer ---Membranous obstruction of the valve of Hasner in
the distal nasolacrimal duct
What are the symptoms of acute dacryocystitis? --- correct answer ---
Symptoms may occur over several hours to several days and is
characterized by pain, erythema, and edema over the medial canthus
and the area overlying the lacrimal sac at the inferomedial portion of
the orbit. The redness can extend to involve the bridge of the nose.
Purulent material can sometimes be expressed from the puncta and
tearing may be present.
,What are the symptoms of chronic dacryocystitis? --- correct answer -
--Excessive tearing and discharge are the most common symptom.
Changes in visual acuity may be present due to tear film production.
Erythema involving the entire orbit ad pain with extraocular
movement are not typically associated with dacrycystitis and should
prompt the health care provider to search for alternative diagnoses.
How is dacryocysititis diagnosed? --- correct answer ---A Crigler, or
tear duct massage can be performed to express material for culture
and gram stain.
In patients who appear acutely toxic or those who present with visual
changes, imaging and bloodwork should be considered.
In chronic cases , serological testing can be performed if systemic
conditions are suspected. Imaging is not typically needed for diagnosis
unless suspicion arises on history and physical (for example patient
complains of hemolacria)
CT scans can be performed in cases of trauma.
Dacryocystography or plain film dacryosystogram (DCG) can be
performed when anatomic abnormalities are suspected.
Nasal endoscopy is useful to rule out hypertrophy of the inferior
turbinate, septal deviation and inferior meatal narrowing.
The fluorescein dye disappearance test (DDT) is another option
available to evaluate for adequate lacrimal outflow. The persistence of
dye coupled with asymmetric clearance of the dye from the tear
, meniscus after five minutes, indicates an obstruction. However this
does not distinguish between an upper (punctal, canalicular, or sac)
and lower (nasolacrimal duct) obstruction.
How is acute dacryocystitis treated? --- correct answer ---Treatment
of acute dacryocystitis includes conservative measures such as warm
compresses and attempts of Crigler massage.
For uncomplicated cases consideration of oral antibiotics should be
given. Coverage should always be aimed at gram-positive organisms,
particularly antistaphylococcal agents.
In complicated cases or patients who appear toxic, intravenously
antibiotics should be administered. Empiric antibiotics should include
gram positive and gram negative coverage.
Lacrimal probing in discouraged in the acute phase.
For recurrent infections, referral to ophthalmology for surgical
evaluation is advised.
What is the treatment for chronic dacryocystitis? --- correct answer --
-Chronic dacryocystitis is almost always managed surgically with high
success rates. Probing is accepted as first-line management in chronic
cases and can be done in the outpatient setting. Inevitable, patients
will likely need to progress to further surgical options to treat the
condition. Balloon dacryoplasty, nasolacrimal intubation, and
nasolacrimal stenting have all been attempted with variable first-time
