Q-71. A patient presents with an upper eyelid swelling. Diagnosis of chalazion is made. Histopathology would reveal
a) Suppurative granulomatous inflammation
b) Lipo-granulomatous inflammation
c) Xantho-granulomatous inflammation
d) Foreign body granulomatous inflammation
Answer: Lipo-granulomatous inflammation
Explanation:
Chalazion is also called a tarsal or meibomian cyst.
It is a chronic non-infective granulomatous inflammation (Lipo-granulomatous inflammation) of meibomian gland.
Q-72. An infant weighing less than 1000 gm is more likely to develop which of the following complications?
a) Cataract
b) Retinopathy of prematurity
c) Retinal detachment
d) Glaucoma
Answer: Retinopathy of prematurity
Explanation:
Retinopathy of prematurity (Earlier known as retro-lental fibrosis):
It is bilateral proliferative retinopathy occurring in premature infants with low birth weight (Primary causative factors) who often have been exposed to high concentration of oxygen.
Retinopathy of prematurity is usually confined to those with a birth weight of less than 1.5 kg and/ or a gestational age of 32 weeks.
Stages of Retinopathy of prematurity:
Stage-I: Demarcation line
Stage-II: Demarcation ridge
Stage-III: Extra-retinal fibro-vascular proliferation
Stage-IV-a: Sub-total retinal detachment not involving macula
Stage-IV-b: Sub-total retinal detachment involving macula
Stage-V: Total retinal detachment (Funnel shaped detachment)
Zones of involving Retinopathy of prematurity:
Zones-I: Circle with optic disc as centre and twice the disc-macula distance as the radius
Zones-II: Circle with optic disc as centre and disc-nasal ora serrata as the radius excluding zone-I
Zones-III: Temporal arc of retina beyond Zone-II
Plus disease:
Presence of tortuous dilated vessels at posterior pole at any stage of retinopathy of prematurity
Important point:
Retinal examinations in preterm infants should be performed by an ophthalmologist who has sufficient knowledge and experience to identify accurately the location and sequential retinal changes of ROP.
Photocoagulation or Cryotherapy may check progression of the disease if applied in the early stage.
Q-73. Most common intraocular metastasis in females is from which of the following primary tumor?
a) Breast
b) Ovary
c) Cervix
d) Endometrium
Answer: Breast
Explanation:
Most common primary tumor causing intra-ocular metastasis:
Women: Breast cancer
Men: Lung cancer
Q-74. Ocriplasmin is the newer drug used in which of the following
a) Retinal break
b) Vitreo-macular adhesion
d) Sub-macular bleed
c) Diabetic macular bleed
Answer: Vitreo-macular adhesion
Explanation:
Ocriplasmin Intravitreal Injection is a proteolytic enzyme indicated for the treatment of symptomatic vitreo-macular adhesion.
Q-75. The risk of rhegmatogenous retinal detachment is increased in all of the following except?
a) Hyperopia
b) Pseudo-phakia
c) Lattice degeneration
d) Trauma
Answer: Hyperopia
Explanation:
Rhegmatogenous or primary retinal detachment:
Usually associated with a retinal break through which sub-retinal fluid seep and separate the sensory retina from pigmentary epithelium.
Predisposing factors:
Age
Sex- More common in males
Myopia
Aphakia
Retinal degeneration
Senile posterior vitreous detachment
Trauma
Q-76. The most common presentation of retinoblastoma is
a) Leukocoria and Pseudo-hypopyon
b) Leukocoria and Hyphema
c) Leukocoria and Strabismus
d) Leukocoria and Heterochromia iridis
Answer: Leukocoria and Strabismus
Explanation:
Retinoblastoma is caused by retinoblastoma gene (RB), which is a mutation in the long arm of chromosome 13.
Leukocoria (white pupillary reflex or cat’s eye reflex) is the most common presenting sign of retinoblastoma.
Strabismus, which occurs as a result of visual loss, is the second most common mode of presentation.
Q-77. Which of the following is false regarding acute conjunctivitis?
a) Pupil is not affected
b) Vision is not affected
c) Topical antibiotic is the treatment of choice
d) Cornea is infiltrated
Answer: Cornea is infiltrated
Explanation:
Acute conjunctivitis:
Acute conjunctivitis can be caused by numerous bacteria, virus or allergens.
Symptoms are hyperemia, lacrimation, irritation, and discharge.
Treatment is with topical antibiotics, augmented by systemic antibiotics in more serious cases.
Q-78. About degenerative myopia which of the following is true?
a) Myopic degeneration can lead to retinal detachment
b) It is more common in men than women
c) Less than – 6D
d) Optic disc swelling is seen
Answer: Myopic degeneration can lead to retinal detachment
Explanation:
Pathological/ degenerative/ progressive myopia:
Myopia > -5 D
Eye ball length > 26 mm
Progressive choroidal degeneration
Complications of Pathological/ degenerative/ progressive myopia:
Retinal detachment
Complicated cataract
Vitreous hemorrhage
Choroidal hemorrhage
Strabismus fixus convergence
Q-79. In which of the following optic atrophy is not seen
a) Polypoidal choroidal vasculopathy
b) Methanol poisoning
c) Retinitis pigmentosa
d) Central retinal artery occlusion
Answer: Polypoidal choroidal vasculopathy
Explanation:
Optic nerve is caused by damage to nerve fibres at any point from ganglion cells of retina to lateral geniculate body.
Causes of optic atrophy:
Retinal causes:
Central retinal artery occlusion
Retinitis pigmentosa
Toxic: Quinine and Methyl alcohol
Optic nerve:
Ischemic optic neuropathy
Optic and retro-optic neuropathy
Chronic glaucoma
Papillo-edema, Optic nerve glioma or Meningioma
Toxic: Alcohol
Pernicious anemia
Optic tract:
Pituitary adenoma
Q-80. Regarding indirect ophthalmoscopy, all are true except
a) Can be used in hazy medium
b) The image is real and erect
c) Convex lens is used
d) Magnification is 4-5 times
Answer: The image is real and erect
Explanation:
Indirect Ophthalmology:
Essential for the assessment and management of retinal detachment and other peripheral retinal lesions
Convex lens is used.
Image: Real, inverted and magnified (4-5 times)