Page 1 of 24
OPHTHO PRACTICE QUESTIONS AND WELL VERIFIED
ANSWERS LATEST UPDATE
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
, Page 2 of 24
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
, Page 3 of 24
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
OPHTHO PRACTICE QUESTIONS AND WELL VERIFIED
ANSWERS LATEST UPDATE
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
, Page 2 of 24
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
, Page 3 of 24
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
