OPHTHO PRACTICE QUESTIONS well
answered to pass rated A+
A 59-year-old male complains of "flashing lights behind my eye" followed by sudden loss of
vision, stating that it was "like a curtain across my eye." He denies trauma. He takes Glucophage
for his diabetes mellitus and atenolol for his hypertension. He has no other complaints. On
funduscopic exam, the retina appears to be out of focus. Which of the following is the most
likely diagnosis?
A.Central retinal vein occlusion
B.Retinal artery occlusion
C.Retinal detachment
D. Hyphema - correct answer ✔✔C.Retinal detachment
A 32 year-old carpenter complains of right eye irritation all day after driving a metal stake into
the ground with his hammer. He states that "something flew into my eye." Visual acuity is
20/20. Pupils are equal, round, reactive to light and accommodation. Extraocular movements
are intact. There is minimal right corneal injection. No foreign body is noted with lid eversion.
Fluorescein stain reveals a tiny pinpoint uptake in the area of the corneal injection. Which of the
following is the most appropriate diagnostic test at this stage?
A MRI
B. X-ray orbits
C Applanation tonometry
D Fluorescein angiography - correct answer ✔✔B. X-ray orbits
Orbital x-rays or CT scan will be most helpful in identifying an intraocular metallic foreign body.
A 64 year-old woman complains of headache and left eye pain for about a day. She says it
started yesterday as a dull ache and now is throbbing. She also complains of nausea and
,vomiting, which she attributes to the popcorn she ate at the movie theater yesterday afternoon.
On exam, the left pupil is mid-dilated and nonreactive. The cornea is hazy. A ciliary flush is
noted. Which of the following is the most likely diagnosis?
A. Migraine headache
B. Temporal arteritis
C. Acute glaucoma
D. Retinal artery occlusion - correct answer ✔✔C. Acute glaucoma
Acute glaucoma often presents with abdominal complaints that may delay diagnosis. Findings of
ciliary flush, mid-dilated and nonreactive pupil, and hazy cornea in a patient with severe eye
pain are consistent with acute angle closure glaucoma.
Which of the following is the most common cause of adult blindness in the USA?
A. Hypertension
B. Diabetes mellitus
C. Macular degeneration
D. Retinal artery occlusion - correct answer ✔✔B. Diabetes mellitus
Diabetes is the leading cause of blindness in the US, and is usually due to diabetic retinopathy.
Up to 15% of type 1 diabetics and up to 7% of type 2 diabetics become legally blind.
An 18 year-old college student took her goggles off in the chemistry lab while she was washing
her glassware from an experiment she had just completed. She thinks the beaker had contained
sodium hydroxide, and it splashed into her right eye. She rinsed her eye out for about five
minutes in the lab. Which of the following is the most appropriate first step?
A. Check visual acuity
B. Flush the eye with two liters saline
C. Check for corneal damage with fluorescein
, D. Instill a topical anesthetic to facilitate examination - correct answer ✔✔B. Flush the eye with
two liters saline
A 12 year-old presents with complaint of both eyes "watering." He also complains of sinus
congestion and sneezing for two weeks. On exam vital signs are T-38°C, P-80/minute, and RR-
20/minute. The eyes reveal mild conjunctival injection bilaterally, clear watery discharge, and no
matting. Pupils are equal, round, and reactive to light and accommodation. The extraocular
movements are intact. The funduscopic exam shows normal disc and vessels. The TMs are
normal and the canals are clear. The nasal mucosa is boggy, with clear rhinorrhea. Which of the
following is the most helpful pharmacologic agent?
A Artificial tears
B Tobramycin drops
C Erythromycin ointment
D Naphazoline (Naphcon-A) drops - correct answer ✔✔D Naphazoline (Naphcon-A) drops
Naphazoline is a topical antihistamine that relieves symptoms of allergic conjunctivitis.
A 72-year-old male presents with progressive bilateral loss of central vision. This has made
driving difficult, and often finds himself needing a bright light to look at objects. He reports that
his peripheral vision is intact. When looking at a specific region at line grid, he reports a dark
"spot" in the center, with bent lines. Dilated ophthalmic examination is shown here. What is the
most likely diagnosis?
A. Atrophic macular degeneration
B. Cataracts
C. Retinal vein occlusion
D. Open angle-closure glaucoma - correct answer ✔✔A. Atrophic macular degeneration
Which of the following is a staphylococcal infection characterized by a localized red swollen and
acutely tender abscess of the upper or lower eyelid?
A. Hordeolum
answered to pass rated A+
A 59-year-old male complains of "flashing lights behind my eye" followed by sudden loss of
vision, stating that it was "like a curtain across my eye." He denies trauma. He takes Glucophage
for his diabetes mellitus and atenolol for his hypertension. He has no other complaints. On
funduscopic exam, the retina appears to be out of focus. Which of the following is the most
likely diagnosis?
A.Central retinal vein occlusion
B.Retinal artery occlusion
C.Retinal detachment
D. Hyphema - correct answer ✔✔C.Retinal detachment
A 32 year-old carpenter complains of right eye irritation all day after driving a metal stake into
the ground with his hammer. He states that "something flew into my eye." Visual acuity is
20/20. Pupils are equal, round, reactive to light and accommodation. Extraocular movements
are intact. There is minimal right corneal injection. No foreign body is noted with lid eversion.
Fluorescein stain reveals a tiny pinpoint uptake in the area of the corneal injection. Which of the
following is the most appropriate diagnostic test at this stage?
A MRI
B. X-ray orbits
C Applanation tonometry
D Fluorescein angiography - correct answer ✔✔B. X-ray orbits
Orbital x-rays or CT scan will be most helpful in identifying an intraocular metallic foreign body.
A 64 year-old woman complains of headache and left eye pain for about a day. She says it
started yesterday as a dull ache and now is throbbing. She also complains of nausea and
,vomiting, which she attributes to the popcorn she ate at the movie theater yesterday afternoon.
On exam, the left pupil is mid-dilated and nonreactive. The cornea is hazy. A ciliary flush is
noted. Which of the following is the most likely diagnosis?
A. Migraine headache
B. Temporal arteritis
C. Acute glaucoma
D. Retinal artery occlusion - correct answer ✔✔C. Acute glaucoma
Acute glaucoma often presents with abdominal complaints that may delay diagnosis. Findings of
ciliary flush, mid-dilated and nonreactive pupil, and hazy cornea in a patient with severe eye
pain are consistent with acute angle closure glaucoma.
Which of the following is the most common cause of adult blindness in the USA?
A. Hypertension
B. Diabetes mellitus
C. Macular degeneration
D. Retinal artery occlusion - correct answer ✔✔B. Diabetes mellitus
Diabetes is the leading cause of blindness in the US, and is usually due to diabetic retinopathy.
Up to 15% of type 1 diabetics and up to 7% of type 2 diabetics become legally blind.
An 18 year-old college student took her goggles off in the chemistry lab while she was washing
her glassware from an experiment she had just completed. She thinks the beaker had contained
sodium hydroxide, and it splashed into her right eye. She rinsed her eye out for about five
minutes in the lab. Which of the following is the most appropriate first step?
A. Check visual acuity
B. Flush the eye with two liters saline
C. Check for corneal damage with fluorescein
, D. Instill a topical anesthetic to facilitate examination - correct answer ✔✔B. Flush the eye with
two liters saline
A 12 year-old presents with complaint of both eyes "watering." He also complains of sinus
congestion and sneezing for two weeks. On exam vital signs are T-38°C, P-80/minute, and RR-
20/minute. The eyes reveal mild conjunctival injection bilaterally, clear watery discharge, and no
matting. Pupils are equal, round, and reactive to light and accommodation. The extraocular
movements are intact. The funduscopic exam shows normal disc and vessels. The TMs are
normal and the canals are clear. The nasal mucosa is boggy, with clear rhinorrhea. Which of the
following is the most helpful pharmacologic agent?
A Artificial tears
B Tobramycin drops
C Erythromycin ointment
D Naphazoline (Naphcon-A) drops - correct answer ✔✔D Naphazoline (Naphcon-A) drops
Naphazoline is a topical antihistamine that relieves symptoms of allergic conjunctivitis.
A 72-year-old male presents with progressive bilateral loss of central vision. This has made
driving difficult, and often finds himself needing a bright light to look at objects. He reports that
his peripheral vision is intact. When looking at a specific region at line grid, he reports a dark
"spot" in the center, with bent lines. Dilated ophthalmic examination is shown here. What is the
most likely diagnosis?
A. Atrophic macular degeneration
B. Cataracts
C. Retinal vein occlusion
D. Open angle-closure glaucoma - correct answer ✔✔A. Atrophic macular degeneration
Which of the following is a staphylococcal infection characterized by a localized red swollen and
acutely tender abscess of the upper or lower eyelid?
A. Hordeolum
