Q-41. A patient developed proptosis and diplopia of 2 months duration following injury. On examination there is chemosis conjunctival redness, and external ocular nerve palsy. Investigation of choice is
a) MRI
b) CECT
c) MR angiography
d) Intra arterial digital subtraction angiography
Answer: Intra arterial digital subtraction angiography
Explanation:
See above explanation
Q-42. Oculomotor nerve palsy causes all except
a) Miosis
b) Ptosis
c) Outward eye deviation
d) Diplopia
Answer: Miosis
Explanation:
Oculomotor nerve palsy:
Ptosis
Lateral squint
Dilatation of pupil
Loss of accommodation
Slight proptosis
Q-43. Most radio-sensitive layer in retina
a) Retinal vascular epithelium
b) Ganglion cell layer
c) Rods and cones
d) Bipolar cells
Answer: Retinal vascular epithelium
Explanation:
All retinal cells are relatively radio-resistant, and the non-replicating neural cells are highly radio-resistant.
The relative radio-sensitivity of the retinal vascular cells seems to be related to the conformation of their nuclear chromatin.
Most radio-resistant cells in retina: Retinal pigment epithelium
Most radio-sensitive cells in retina: Retinal vascular epithelium > Rods
Q-44. Percentage of endothelial loss in Descemet’s stripping automated endothelial keratoplasty
a) 5%
b) 10-20%
c) 30-40%
d) 50-60%
Answer: 30-40%
Explanation:
Descemet’s stripping automated endothelial keratoplasty (DSAEK):
DSAEK is a partial thickness cornea transplant procedure that involves selective removal of the patient’s Descemet membrane and endothelium, followed by transplantation of donor corneal endothelium in addition to donor corneal stroma.
The procedure is used to treat corneal edema in the setting of endothelial dystrophies (such as Fuchs corneal dystrophy and posterior polymorphous corneal dystrophy), pseudophakic bullous keratopathy, irido-corneal endothelial (ICE) syndrome, and endothelial failure in the setting of prior intraocular surgery or of a previous PK graft.
A major disadvantage of DSAEK:
24-59 % endothelial cell loss
Q-45. A pt present with sudden B/L loss of vision with loss of light perception. The loss is more on right side. Papillary reflex, opto-kinetic nystagmus is present. Pt cannot touch his fingers on closing his right eye. What is diagnosis?
a) Optic neuritis
b) Anterior ischemic optic neuropathy
c) CMV retinitis
d) Functional vision loss
Answer: Functional vision loss
Explanation:
Sudden visual loss rules out CMV retinitis.
Presence of pupillary reflex-> Unimpaired lower visual pathways (Thus rule out optic neuritis and anterior ischemic optic neuropathy)
Negative finger test-> Functional vision loss
Functional Visual Loss is a decrease in visual acuity and/or visual field not caused by any organic lesion. It is therefore also called non-organic visual loss.
The decrease in visual acuity may involve one or both eyes and may vary from mild blurriness to complete blindness.
Functional Visual Loss is commonly associated with concurrent diagnoses of depression, anxiety, panic attacks, and fibromyalgia.
Q-46. Most radio-resistant cells in retina
a) Retinal pigment epithelium
b) Ganglion cell layer
c) Rods and cones
d) Bipolar cells
Answer: Retinal pigment epithelium (?)
Explanation:
All retinal cells are relatively radio-resistant, and the non-replicating neural cells are highly radio-resistant.
The relative radio-sensitivity of the retinal vascular cells seems to be related to the conformation of their nuclear chromatin.
Most radio-resistant cells in retina: Retinal pigment epithelium
Most radio-sensitive cells in retina: Retinal vascular epithelium > Rods
Q-47. In Herpes Zoster Keratitis all occurs except
a) Pseudo-dendritic keratitis
b) Anterior endothelial keratitis/uveitis
c) Sclero-keratitis
d) Endothelitis
Answer: Sclero-keratitis
Explanation:
Herpes Zoster Keratitis:
Pseudo-dendritic
Kerato-uveitis and Endothelitis
Anterior endothelial keratitis
Punctate epithelial keratitis
Disciform keratitis
Episcleritis and scleritis
Iridocyclitis
Important point:
Sclero-keratitis is the least common type of ocular involvement in Herpes Zoster Keratitis.
Q-48. Corneal dystrophies are usually
a) Primarily unilateral
b) Primarily bilateral
c) Primarily unilateral without systemic disease
d) Primarily bilateral with systemic disease
Answer: Primarily bilateral
Explanation:
Corneal dystrophies:
Inherited disorder and restricted to the cornea
Non inflammatory
Not associated with systemic diseases
Bilateral and manifested occasionally at birth but more usually first or second decade
Q-49. Weakness of both adduction and abduction is seen in
a) Duane’s retraction syndrome type 1
b) Duane’s retraction syndrome type 2
c) Duane’s retraction syndrome Type 3
d) All
Answer: Duane’s retraction syndrome Type 3
Explanation:
Duane’s retraction syndrome is a rare, congenital disorder of eye movement.
Duane’s retraction syndrome type 1: Most common type
Abduction is limited, but adduction is normal or nearly so.
Duane’s retraction syndrome type 2:
Adduction of the affected eye is limited, whereas abduction of the eye is normal or only slightly limited.
Duane’s retraction syndrome type 3:
Adduction and abduction of the affected eye is limited.
Q-50. Area of fundus seen with direct ophthalmoscope is
a) 1 DD
b) 2 DD
c) 3 DD
d) 4 DD
Answer: 2 DD
Explanation:
Direct ophthalmoscope:
Most common practised method for routine fundus examination
Image is erect, virtual and 15 times magnified in emmetropes (More in myopes and less in hypermetropes)
Area of field: 2 Disc Dioptres