Past MRCOphth/MRCS questions: 20
1. In fractures of the orbit:
a. pure blow out fractures of the floor are commonest
b. trauma to the infraorbital nerve causes anaesthesia to 
    the lips and gum
c. enophthalmos on initial examination indicates a large 
    fracture fo the floor
d. early surgical intervention is indicated in the presence 
    of diplopia and infraorbital anaesthesia
e. marked orbital and lid swelling is common following 
    repair of blow-out fractures

2. In papilloedema:

a. axonal distension occurs as the first sign
b. it takes 24-48 hours for early papilloedema to occur 
    and one week for it to develop fully
c. is usually asymmetric and greater on the side of a 
    supratentorial lesion
d. a fully developed papilloedema fully resolves in four 
    weeks with adequate treatment
e. it can be associated with sudden visual loss after 
    sudden decrease in systolic perfusion pressure

3. Regarding blow out fractures:

a. forced duction test is useful in differentiating tissue 
    prolapse from muscle shortening
b. the inferior oblique is more prone to nerve paresis than 
    the inferior rectus
c. surgery should only be performed after documentation 
    that there is no further worsening of ocular motility
d. mydriasis is more likely to be seen in medial wall 
    fractures than floor fractures
e. enophthalmos due to muscle fibrosis and shortening is 
    difficult to correct

4. Retinoblastoma:

a. is caused by a genetic abnormality on chromosome 
b. is inherited with a visible chromosomal defect in most 
c. is inherited in an autosomal dominant fashion
d. is associated with esterase D deficiency in most case
e. is due to somatic mutation in most cases

5. Retinoblastoma tends to present with:

a. leukocoria
b. squint
c. microphthalmia
d. cataract
e. a painful red eye

6. Risk factors for metastatic retinoblastoma are:

a. a short optic nerve stump at enucleation ie. less 
    than 5 mm
b. a large tumour size
c. optic nerve invasion of any degree
d. choroidal invasion of any degree
e. anterior segment involvement

7. Coat's disease:

a. tends to occur in females
b. usually presents before the age of four years
c. is usually bilateral
d. is inherited as an autosomal dominant fashion
e. is indistinguishable from retinoblastoma on 

8. Birdshot choroidopathy:

a. tends to be unilateral
b. is associated with HLA A-29 antigen
c. is associated with cystoid macular oedema
d. can be treated with steroids
e. rarely occurs after the age of 50

9. Acute multifocal placoid pigment epitheliopathy:

a. usually has a good visual prognosis
b. usually occurs in elderly individuals over the age of 50
c. may be unilateral or bilateral
d. can be associated with cerebral vasculitis
e. can cause a serious retinal detachment

10. Sympathetic ophthalmia:

a. is best prevented by early enucleation of the 
    traumatized eye
b. should be treated by enucleation of the exciting eye
c. usually develops between 2 weeks and 3 months in 
    most cases
d. causes multiple pinpoint hyperfluorescence spots in 
e. can be prevented by prophylactic steroids
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