AIIMS/ NEET-PG 2017 Ophthalmology MCQs 61-70

Q-61. Ciliary muscles are embryo-logically derived from
a) Neural ectoderm
b) Mesoderm
c) Surface ectoderm
d) Neural crest

Answer: Neural crest
Explanation:
Ciliary epithelium- Neural ectoderm
Ciliary muscles- Neural crest

Q-62. Which of the following is the most common complication after lens extraction in persistent hyperplastic primary vitreous?
a) Retinal detachment
b) Vitreous hemorrhage
c) Orbital cellulites
d) Keratitis

Answer: Retinal detachment
Explanation:
Retinal detachment (Most common) and vitreous hemorrhage are common complication after lens extraction in persistent hyperplastic primary vitreous.
Persistent hyperplastic primary vitreous (PHPV) is a congenital anomaly in which the hyaloid vasculature persists beyond fetal life.

Q-63. Which of the following protozoan affects the eye?
a) E. histolytica
b) E. coli
c) Giardia lamia
d) Toxoplasma

Answer: Toxoplasma
Explanation:
Congenital toxoplasmosis:
Convulsion
Chorio-retinitis
Intra-cranial calcification
Important points:
In active stage, the typical lesion is necrotic granulomatous retino-choroiditis involving the macular region.
Typical chorio-retinal lesion of acquired toxoplasmosis is similar to congenital toxoplasmosis.
Important point:
Protozoan Acanthamoeba causes keratitis.

Q-74. Which of the following not given as eye drops in corneal ulcer?
a) Fluorometholone
b) Olopatadine
c) Methylcellulose
d) Chloramphenicol

Answer: Fluorometholone
Explanation:
Fluorometholone is corticosteroid.
Corticosteroid is contra-indicated in corneal ulcer.
Important point:
Patient with severe ulcers may benefit from the use of corticosteroids as Adjuvantive therapy.

Q-65. The combination of fixed and dilated pupil with iris atrophy and secondary glaucoma following penetrating keratoplasty is known as
a) Benedikt’s syndrome
b) Posner-Schlossman syndrome
c) Urrets-Zavalia syndrome
d) Kaufman syndrome

Answer: Urrets-Zavalia syndrome
Explanation:
Urrets-Zavalia syndrome:
It is characterized by fixed and dilated pupil with iris atrophy and secondary glaucoma following penetrating keratoplasty for kerato-conus.
An acute increase in intraocular pressure and ischemia of the iris most probably play a major role

Q-66. Which of the following pairs of drugs is correctly matched with its mechanism of action?
a) Pilocarpine-Increased uveoscleral outflow
b) Latanoprost- Carbonic anhydrase inhibitor
c) Brimonidine- Decreased aqueous formation
d) Betaxolol-Increased trabecular outflow

Answer: Brimonidine- Decreased aqueous formation
Explanation:
Prostaglandins such as Latanoprost:
Increased out flow
Cholinomimetics such as pilocarpine:
Ciliary muscle contraction, opening of trabecular meshwork and increased outflow
Diuretics such as Acetazolamide:
Decreased aqueous secretion due to lack of HCO3-
Beta blockers:
Decreased aqueous secretion from the ciliary epithelium
Alpha2 selective agonist such as Brimonidine:
Decreased aqueous secretion

Q-67. Salt and pepper retinopathy is observed in all of the following except
a) Fundus flavimaculatus
b) Congenital rubella
c) Thioridazine toxicity
d) After healing of macular edema

Answer: After healing of macular edema
Explanation:
Salt and pepper retinopathy:
Area of hypo-pigmentation due to atrophic retinal changes (Salt) with pigmentary alterations from pigment migration (Pepper) in large portions of retina
Salt and pepper fundus:
Congenital syphilis and rubella
Drug toxicity: Thioridazine, chloroquine and deferoxamine
Stargardt’s disease or Fundus flavimaculatus
Refsum disease
Kearns Sayre Syndrome
Leber congenital amaurosis

Q-68. Calcification is seen in all of the following except
a) PHPV
b) Retinoblastoma
c) Choroidal osteoma
d) Optic nerve head drusen

Answer: PHPV
Explanation:
Calcification is seen in:
Retinoblastoma
Choroidal osteoma
Optic nerve head drusen
Important points:
In adults the most common intra-orbital calcifications occur at the tendinous insertion of the ocular muscles and the optic nerve head, also called ‘optic disc drusen’.
In children, calcifications occur in Retinoblastoma

Q-69. In a district hospital in India, an ophthalmologist is expected to perform which of the following surgeries most commonly
a) Trabeculectomy
b) Phaco-emulsification
c) Dacryocystectomy
d) Bilamellar tarsal rotation

Answer: Phaco-emulsification
Explanation:
In a district hospital in India, an ophthalmologist is expected to perform Phaco-emulsification (Cataract) surgeries most commonly.

Q-70. A 55 yr old diabetic patient present with unilateral transient obscuration for 2-3 days followed by sudden diminution of vision. Which of the following tests would you order?
a) Serum homo-cysteine level
b) Serum creatinine level
c) Serum ACE levels
d) Quantiferon gold TB test

Answer: Serum homo-cysteine level
Explanation:
Transient obscuration of vision followed by sudden diminution of vision→ Central retinal vascular pathology
Diabetes is risk factor for central retinal vascular occlusion.
Hyper-Homocystinemia has been found an independent risk factor for central retinal vascular occlusion.
The majority of hyperhomocystinemia is caused by low levels of folate and Vitamin B12.