Lens and cataract
1. The following are true about cataract:
a. it is the most common cause of blindness in the world

b. nuclear sclerosis reduces the distant vision more than

c. posterior subcapsular cataract is more likely to cause
    problem with distant vision than near

d. more females than males have cataract surgery

e. outdoor workers are more likely to develop cataract
    than indoor workers

2. True association include:

a. Wilson's disease - sun-flower cataract

b. myotonic dystrophy - Christmas tree cataract

c. amiodarone - anterior capsular cataract

d. Alport's syndrome - posterior lenticonus

e. Down's syndrome - cerulean (blue-dot) cataract

3. The following are true about microspherophakia:

a. it is associated with myopia

b. it can cause pupillary block glaucoma which should be
    treated with mydriatic

c. it is associated with short stature and stiff joints

d. anterior dislocation is a known complication

e. it can be an autosomal recessive disorder.

4. The following metabolic disorders are associated with

a. hyperlysinemia

b. hypercalcemia

c. hypocalcemia

d. hypoglycaemia

e. uraemia


5. Drug-induced cataract include:

a. phenothiazine

b. echothiopate

c. aspirin

d. lovastatin

e. systemic beta-blockers

6. True statements about the ocular effects of congenital rubella

a. eye defect typically occurs with infection during the
    first trimester of pregnancy

b. lamellar cataract is the most common type of cataract
    seen in congenital rubella

c. viral particles usually remain in the lens particle long
    after birth

d. myopia is common

e. congenital rubella causes progressive chorioretinitis.

7. The following are true about blunt trauma on the lens:

a. Vossius ring is caused by the imprint of the pupillary
    pigment on the lens

b. Vossius ring causes decreased vision in the majority
     of patients

c. Vossius ring is a permanent sign

d. contusion cataract is usually rosette-shaped

e. contusion cataract typically involves the anterior cortex

8. In congenital cataract:

a. patients with severe bilateral cataract should have the
    cataracts removed before three months of age

b. intraocular lens should be used

c. the posterior capsule is usually left intact

d. post-operative visual acuity is usually better in patients
    with unilateral cataract than bilateral cataract

e. visual prognosis is poor in patients who develop

9. With regard to the materials used in intraocular lens:

a. PMMA is the most common material used in making
    foldable lens

b. PMMA transmits a broader spectrum of light than
    natural lens

c. silicone is associated with increased capsular fibrosis

d. silicone lens tends to be thinner than PMMA for the
    same dioptre power

e. hydrogel lens has a lower tensile strength than PMMA

10. Regarding eye drops used in cataract surgery:

a. flurbiprofen is used to dilate pupil

b. flurbiprofen prevents post-operative inflammation

c. phenylephrine stimulates the alpha receptors

d. phenylephrine should be avoided in patients on
    monoamine oxidase inhibitors

e. cyclopentolate acts on the constrictor muscle of the iris

11. Homocystinuria:

a. is an autosomal recessive condition

b. causes inferonasal subluxation of the lens

c. is associated with raised serum methionine

d. is associated with mental retardation

e. causes osteoporosis

12. The histological features of the following are true:

a. Elschnig pearls - proliferation of lens epithelium
    onto the posterior capsule

b. posterior subcapsular cataract - bladder cells

c. cortical cataract - morgagnian globules

d. glaucoflecken - Wedl cells

e. Soemmerring ring - sequestration of proliferating  lens
    fibres in the equatorial region of the capsule

13. In a 6 month old baby with bilateral cataract, urine test is
       useful in:

a. homocystinuria

b. galactosemia

c. Lowe's syndrome

d. abetalipoproteinemia

e. cystinosis

14. In galactosemia:

a. the condition is autosomal dominant

b. the most common form is caused by
    galatose-a-phosphate uridyl transferase deficiency

c. mental retardation is a feature in untreated cases

d. the cataracts usually assume oil droplet appearance

e. early cataracts are reversible with dietary restriction

15. Factors that can increase intravitreal pressure during
      phacoemulsification include:

a. excessive peribulbar anaesthesia

b. patient taking deep breadth

c. pressure from the speculum

d. choroidal haemorrhage

e. a high bottle height

16. With regard to viscoelastics:

a. they are cleared in an unmetabolised state by filtration
    through the trabecular meshwork

b. sodium hyaluronate has a higher pseudoplastic
    behaviour than chondroitin sulphate

c. they are toxic to the endothelium if not removed at the
    end of the surgery

d. methylcellulose is cheaper than sodium hyaluronate

e. Viscoat is made up sodium hyaluronate and chondroitin

17. Pseudoexfoliation syndrome:

a. is commonly seen in glass blowers

b. is most commonly in the fifth decade of life

c. causes mid-periphery transillumination

d. causes iridonosis

e. is associated with poor pupillary dilatation

18. The advantages of capsulorrhexis over capsulotomy

a. easier delivery of the nucleus during extracapsular
    cataract operation

b. holds the nucleus in the capsular bag during

c. better centration of the intraocular lens

d. less likelihood of capsular contraction

e. less likelihood of  anterior capsular tear extending into
    the posterior capsule

19. Cataract extraction in an eye that had previous par plana
      vitrectomy is associated with an increased risk of :

a. zonular dehiscence

b. suprachoroidal haemorrhage

c. posterior capsule rupture

d. globe collapse

e. cystoid macular oedema

20. True statements about the aspiration systems used in
       phacoemulsification include:

a. diaphragm pump produces the slowest build up of

b. peristaltic pump allows linear control of vacuum

c. Venturi pump is associated with the highest risk of
     inadvertent engagement of unwanted tissue

d. Venturi pump gives the most rapid rise in vacuum

e. high aspiration is needed during the early stage of


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