DIPLOPIA IN SUPERIOR OBLIQUE PALSY
In paralysis of the superior oblique muscle (trochlear nerve palsy), maximum diplopia is experienced when the patient looks down.
This is especially important when the patient tries to climb downstairs and when trying to read a book.
The patient tries to compensate by tucking the chin towards the chest.
- Which of the following is a topical NSAID for ophthalmic use?
A. Ibuprofen
B. Diflunisal
C. Nepafenac
D. Oxaprozin
Correct answer : C. Nepafenac
Nepafenac is a topically administered NSAID sold as 0.1% eye drops. It is used for the treatment of pain and inflammation in patients undergoing cataract surgery. Nepafenac is a prodrug of amfenac which has COX-1 and COX-2 inhibitor activity. Treatment is started 1 day prior to cataract surgery and is continued 2 weeks postoperatively. Side effects include foreign body sensation and decreased visual acuity.
- Arden index is used for interpretation of?
A. Visual evoked response
B. Electrooculogram
C. Electroretinogram
D. Visual field charting
Correct answer : B. Electrooculogram
Arden index is used for interpretation of an electrooculogram.
- All of the following are involved in endophthalmitis except?
A. Retina
B. Vitreous
C. Sclera
D. Uvea
Correct answer : C. Sclera
Endophthalmitis does not involve the scleral coat of the eye. Sclera in involved only in panophthalmitis.
- Organism most commonly implicated in Late onset endophthalmitis after cataract surgery is?
A. Pseudomonas aeruginosa
B. Staphylococcus epidermidis
C. Candida albicans
D. Propionibacterium acnes
Correct answer : D. Propionibacterium acnes
Propionibacterium acnes is a gram positive, non spore forming bacillus which is most commonly implicated in Late onset endophthalmitis after cataract surgery.
- An 18 year old boy comes to the eye casuality with history of injury with a tennis ball. On examination there is no perforation but there is hyphaema. The most likely source of the blood is
A. Iris vessels
B. Circulus iridis major
C. Circulus iridis minor
D. Short posterior ciliary vessels
Correct answer : B. Circulus iridis major
- In Von Hippel Lindau Syndrome, the retinal vascular tumours are often associated with intracranial hemangioblastoma. Which one of the following regions is associated with such vascular abnormalities in this syndrome?
A. Optic radiation
B. Optic tract
C. Cerebellum
D. Pulvinar
Correct answer : C. Cerebellum
- The mother of a one and a half year old child gives history of a white reflex from one eye for the past 1 month. On computed tomography scan of the orbit there is calcification seen within the globe. The most likely diagnosis is:
A. Congenital cataract
B. Retinoblastoma
C. Endophtalmitis
D. Coats disease
Correct answer : B. Retinoblastoma
1 1/2 year old child with white reflex and calcification in the eye is diagnostic of retinoblastoma.
- Enlarged corneal nerves may be seen in all of the following except:
A. Keratoconus
B. Herpes simplex keratitis
C. Leprosy
D. Neurofibromatosis
Correct answer : B. Herpes simplex keratitis
Best Test Series for NEET PG
25. Contact lens wear is proven to have deleterious effects on the comeal physiology. Which of the following statements is incorrect in connection with contact lens wear?
A. The level of glucose availability in the corneal epithelium is reduced
B. There is a reduction in hemidesmosome density
C. There is increased production of CO2 in the epithelium
D. There is a reduction in glucose utilization by corneal epithelium
Correct answer : A. The level of glucose availability in the corneal epithelium is reduced
Contact lens wear decreases gas exchange across the anterior surface of cornea resulting in hypoxia and hypercapnia. In the hypoxic state there is decrease in glucose utilisation. But there is no decrease in glucose availability as it occurs through the aqueous humour on the posterior surface of cornea. Also, there is decreased epithelial cell adhesion due to decrease in hemidesmosome density.
- Which of the following statement is true regarding Acanthamoeba keratitis?
A. For the isolation of the causative agent, corneal scraping should be cultured on a nutrient agar plate
B. The causative agent, Acanthamoeba is a helminth whose normal habitat is soil
C. Keratitis due to Acanthamoeba is not seen in the immunocompromised host
D. Acanthamoeba does not depend upon a human host for the completion of its life-cycle
Correct answer : D. Acanthamoeba does not depend upon a human host for the completion of its life-cycle
- A 25 year old male gives history of sudden painless loss of vision in one eye for the past 2 weeks. There is no history of trauma. On examination the anterior segment is normal but there is no fundal glow. Which one of the following is the most likely cause?
A. Vitreous haemorrhage
B. Optic atrophy
C. Developmental cataract
D. Acute attack of angle closure glaucoma
Correct answer : A. Vitreous haemorrhage
Among the options given, only vitreous haemorrhage causes sudden painless loss of vision.
- A 30 year old man has 6/5 vision each eye, unaided. His cycloplegic retinoscopy is +1.0 D sph. at 1 metre distance. His complaints are blurring of newsprint at 30 cm, that clears up in about two minutes. The most probable diagnosis is:
A. Hypermetropia
B. Presbyopia
C. Accommodative inertia
D. Cycloplegia
Correct answer : C. Accommodative inertia
His distant vision is normal. He has blurring of newsprint at 30cm distance for 2 minutes. This is due to accommodative inertia. His accommodation system takes some time to focus on near objects. (Normally it should take only 1 second).
- Horner’s syndrome is characterized by all of the following except:
A. Miosis
B. Enopthalmos
C. Ptosis
D. Cycloplegia
Correct answer : D. Cycloplegia
Components of horner’s syndrome –
Ptosis
Miosis
Anhidrosis
Enophthalmos
Loss of ciliospinal reflex
- The most common second malignancy in survivors of retinoblastoma is:
A. Thyroid cancer
B. Nasopharyngeal carcinoma
C. Optic glioma
D. Osteosarcoma
Correct answer : D. Osteosarcoma
Osteosarcoma and retinoblastoma both can arise in those with RB gene mutation.