A. Diabetic Retinopathy
B. Optic Atrophy
C. Acute Glaucoma
D. Optic Disc Drusen
Explanation:- The optic cup of the above fundus image is quite large. The cupping usually we get from chronic simple glaucoma( POAG). you can see here C.D ratio is somewhere between 0.7 to 0.8. Also, we can see a very thin neuroretinal rim(NRR). This confirms the diagnosis of Acute Glaucoma.
2. A 45-year-old Aids patient was started on antiretroviral therapy following which he develops a decrease in visual acuity. Fundus appearance was done. All are used for the management of the patient except?
B. CMV Hyper immunoglobulin
C. Valganciclovir
D. Foscarnet
Explanation:- The CMV Hyper immunoglobulin is used for Prophylaxis, not management. Once we started antiretroviral therapy, CMV hyper immunoglobulin is not given.
3. A case of Non-insulin-dependent Diabetes Miletus(NIDDM) with a history of diabetes for one year should have an Ophthalmic examination:-
A. As early as feasible
B. After 5 years
C. After 10 years
D. Only after visual symptoms develop
Explanation:- The type-I- IDDM is a Juvenile onset and Diabetic Retinopathy(DR) takes a longer period(Start screening within 5 years) to occur whereas the type-II-NIDDM is a Maturity onset and if we diagnose 1 year back, then the patient will be left with DR. So Examination should be done as early as feasible.
4. A 30-year-old man, under investigation for abdominal cramps and passing blood rectally, presents an acutely painful, red, and photophobic eye. What is the most likely sign on ocular examination?
A. Conjunctival Purulent Discharge
B. White Corneal Stromal infiltrate
C. Mydriasis of the affected eye
D. Hypopyon
Explanation:- This condition is related to inflammatory bowel disease(IBD). So the best answer to this question is Hypopyon. This is the uveitic hypopyon associated with arthritis.
5. The Pupils shown below are miotic and irregular in shape. Light test and accommodation test were done which are shown n the image. All are causes of these pupils except
B. Multiple Sclerosis
C. Pinealoma
D. Iridocyclitis
Explanation:- Among the three pictures, the first one is normal. The second picture shows that the right eye has absence of light reflex( both direct as well as an indirect reflex). The third picture shows a normal accommodation reflex. This is the case of Argyll Robertson Pupil(ARP). ARP involves accommodation reflex, not the light reflex, and involves lesion of Pretectal Nucleus. Here All three except Diabetes Mellitus involve the case of this type of pupil.
6. In a young patient complaining of flashes of bright light, " a veil falling in front of the eye," with painless loss of vision, the most likely clinical diagnosis is?
A. Retinal detachment
B. Eale's disease
C. Vitreous hemorrhage
D. Macular hole
Explanation:- The complaint of the patient shows Photopsia, veil(Curtain effect) with sudden painless vision. These indicate the most likely clinical diagnosis is Retinal detachment.
7. Which of the following statements regarding the condition depicted in this image is true?
B. It most commonly occurs in the fall and winter
C. Occurs in the palpebral, limbal, and mixed forms
D. Generally it is not self-limiting in children and needs aggressive therapy to cause remission.
Explanation:- This is the condition of VKC which occurs in humid and hot climates. the cobblestone appearance indicates vernal kerato-conjunctivitis(VKC). So here only option(c) is correct.
8. All of the following symptoms/signs are commonly observed in a patient with acute angle closer glaucoma Except:
A. Blurred Vision
B. Bradycardia
C. Ciliary Flush
D. Pain in the Occiput
Explanation:- This is the case of acute red-eye and ophthalmic emergencies. This patient presents sudden painful loss of vision. Sudden closure of angle of anterior chamber raises the intraocular pressure( IOP ). This is more common in females and also presents nausea and vomiting, and colored halos.
9. A 72-years- old male presented with vision loss. On fundus examination, he has features of optic atrophy. visual field shows, nerve fiber loss involving both the areas of the blind spot and the macular area. he was diagnosed with a case of toxic optic neuropathy. Scotoma in his field is-
A. Peripheral Scotoma
B. Centrocecal scotoma
C. Central Scotoma
D. Bjerrum Scotoma
Explanation:- The involvement of the macular area along with the blind spot indicates Centrocecal scotoma. We all know Toxic neuropathy is found mostly unilateral and painful diminution of vision but Bilateral toxic neuropathy is painless and Injection Vit-B12- 1000 units is given intramuscularly weekly for 10 times( For 10 Weeks).
10. A 32-year-old Woman Comes to the office distraught because "the colors looked washed out!". She has had this vision impairment since yesterday. She also complains of pain on eye movements. her vital signs are stable, and she is afrible. Examination revealed decreased visual acuity, sluggish afferent pupillary response to light, and changes in color perception. Fundoscopy reveals a swollen disc. What is the most likely diagnosis?
A. Orbital Cellulities
B. Optic neuritis
C. Acute Anterior Uveitis(AAU)
D. Open Angle Glaucoma
Explanation:- The defect in vision, pain in ocular movement, Sluggish pupillary response to light(RAPD), defect in color perception, and swollen disc are indicating Optic neuritis. we can also assure from the hint of the question that Swollen disc indicates an optic nerve defect. So the answer will be (b) Optic Neuritis. The Superior Rectus(SR) and Medial Rectus(MR) are adherents to the optic nerve sheath. Out of the three types of Optic neuritis, it is the case of Papilitis.
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