1. The following are true about isolated fourth (trochlear nerve)

    a. head trauma is the most common cause in children

    b. aneurysm is a common cause in adult

    c. the head is usually tilted away from the palsied side

    d. congenital form tends to have a large vertical fusional range

    e. vertical prism is useful in correcting the torsional diplopia


2. The following signs are useful in distinguishing between the
    congenital and acquired form of Horner's syndrome:

    a. absent light reflex of the affected eye

    b. lighter iris colour of the affected eye

    c. decreased facial sweating of the affected side

    d. dilatation of the affected pupil with 10% cocaine

    e. dilatation of the affected pupil in response to 1% adrenaline


3. Palinopsia occurs in:

    a. use of hallucinogens

    b. parietal lobe lesion

    c. occipital lobe lesion

    d. frontal lobe lesion

    e. migraine


4. In spasmus nutans:

    a. the age of onset is usually between 4 and 18 months of age

    b. the nystagmus is classically horizontal

    c. the condition does not requires further investigation

    d. the eye movement is symmetrical

    e. spontaneous resolution commonly occurs


5. Downbeat nystagmus occurs in:

    a. lithium toxicity

    b. alcohol intake

    c. Arnold-Chiari's syndrome

    d. middle ear diseases

    e. spinocerebellar degeneration


6. Bitemporal hemianopia may be seen in:

    a. tilted disc

    b. bilateral ischaemic optic neuropathy

    c. dermatochalasia

    d. sectorial retinitis pigmentosa

    e. retinoschisis


7. Vertical gaze is impaired in the following conditions:

    a. internuclear ophthalmoplegia

    b. walled-eye syndrome

    c. juvenile Gaucher disease

    d. progressive supranuclear palsy

    e. Sylvian aqueduct syndrome


8. The following findings make benign intracranial hypertension

    a. bilateral sixth nerve palsy

    b. morning headache and nausea

    c. increased protein in the cerebrospinal fluid

    d. enlarged ventricle on brain scan

    e. hard exudate in the macula


9. Optic nerve hypoplasia is associated with:

    a. maternal diabetes mellitus

    b. maternal alcoholism

    c. hypopituitarism

    d. maternal use of phenytoin

    e. maternal folate deficiency


10. In a patient with bilateral centrocecal scotoma, the following
      tests are useful in diagnosis:

    a. full blood count

    b. serum folate level

    c. liver function tests

    d. serum copper level

    e. ESR


11. In non-arteritic ischaemic optic neuropathy:

    a. optic disc oedema is common

    b. embolism is the cause in the majority of cases

    c. visual loss is usually more severe than arteritic ischaemic optic

    d. a small cup-to-disc ratio is a risk factor

    e. optic nerve fenestration is useful in improving final visual outcome


12. In contrast to surgical third nerve palsy, medical third nerve

    a. does not affect pupillary response to light

    b. does not affect accommodation

    c. does not cause upper lid elevation on attempted downgaze

    d. does not cause complete ptosis

    e. causes a decreased in intraocular pressure


13. In optic neuritis:

    a. there is usually progression over the first three weeks from onset

    b. pain on ocular movement is usually worse on adduction

    c. the central scotoma may worsen with raised in body temperature

    d. systemic steroid has been shown to affect the final visual outcome

    e. a swollen disc make the diagnosis unlikely


14. In myasthenia gravis:

    a. the horizontal recti are more commonly affected than the vertical

    b. there is a delayed tendon reflex

    c. the pupillary response to light is not affected

    d. steroid may worsen the muscular problems

    e. neonates born to mother with the disease may be affected due to
        the anticholinesterase receptor antibodies closing the placenta


15. The following are true:

    a. opticokinetic drum can be used to differentiate a lesion in the parietal
        lobe from that of a occipital lobe.

    b. cerebral dyschromatopsia is associated with bilateral superior
        homonymous hemianopia.

    c. postfixation visual loss in bitemporal hemianopia

    d. afferent pupillary defect and homonymous hemianopia in lesion of
        the optic tract

    e. sensory inattention is associated with left inferior homonymous
        quadrinopia in a right handed person


16. In Parinaud's syndrome:

    a. the lesion is in the dorsal mid-brain

    b. light-near dissociation is a feature

    c. accommodative spasm occurs on attempted upgaze

    d. convergence-retraction nystagmus occurs with vertical saccades

    e. demyelination is a known cause


17. The following are true:

    a. Uhtoff's symptom refers to a decrease in vision with an increase in
        body temperature

    b. prosopagnosia occurs with a bilateral medial occipitotemporal lesion

    c. in Riddoch phenomenon, the patient can perceive objects in motion
        but not stationary objects.

    d. skew deviation occurs in lesion of the supraneuclear vertical gaze

    e. Anton's syndrome is associated with denial of blindness


18. In Benedikt's syndrome:

    a. third nerve palsy is present

    b. there is a contralateral weakness

    c. there is a contralateral tremor

    d. there is contralateral sensory loss

    e. the facial nerve is involved.


19. In Leber's optic neuropathy:

    a. DNA analysis is useful

    b. the offsprings of an affected man have a 50% chance of
        acquiring the disease

    c. in the acute phase a macular star is typically seen

    d. the optic disc is hyperaemic with telangiectatic capillaries

    e. fluorescein angiography in the acute phase shows leakage in
        the optic disc


20. In thyroid eye disease:

    a. the medial and inferior recti are the most commonly affected
        extraocular muscles.

    b. smoker is more likely to be affected than non-smoker

    c. optic nerve fenestration is useful in patients with optic nerve

    d. upgaze is most commonly affected in patients with ocular
        motility problems

    e. the thyroid function test always shows hyperthyroidism


21. In Argyll-Robertson's pupils:

    a. the condition occurs in acquired but not congenital syphilis

    b. the pupils dilate poorly with atropine

    c. the irregularity of the pupils are caused by iritis

    d. the pupils dilate with topical cocaine

    e. the lesion is in the rostral area of the Edinger-Westphal nucleus.


22. In Adie's (tonic) pupil:

    a. the pupil may not respond to light or accommodation in the acute

    b. Guillain-Barré syndrome is a known cause

    c. the pupil constricts with 2.5% mecholyl solution

    d. there is usually a permanent loss of accommodation

    e. the condition may be confused with Argyll-Robertson's pupil.


23. In a dilated pupil:

    a. a light-near dissociation is seen with third nerve palsy

    b. failure of constriction to 1% pilocarpine is seen in third nerve palsy

    c. failure of constriction to 1% pilocarpine occurs with mydriasis
        induced by atropine

    d. problem with accommodation is a useful sign in distinguishing
        mydriasis induced by atropine from that caused by third nerve

    e. consensual light reflex of the normal eye is absent in third nerve


24. The following are true:

    a. Cogan's rule: a patient with homonymous hemianopia but otherwise
        neurologically intact is caused by a lesion in the occipital lobe

    b. Wernicke's hemianopic pupillary response: occurs in optic tract field

    c. Gertman's syndrome: lesion in the non-dominant parietal lobe

    d. Marcus Gunn's pupil: diagnostic of optic neuritis

    e. Foster-Kennedy's syndrome: lesion in the optic tract


25. The following are true about visual field defects:

    a. macular sparing is commoner with an anterior rather than a
        posterior lesion of the calcarine cortex

    b. horizontal sectoranopia is a feature of lateral geniculate body

    c. an unilateral field loss rules out a lesion in the post-chiasmal region

    d. a homonymous hemianopia with temporal sparing is seen in lesion
        of the posterior calcarine cortex

    e. altitudinal defect is a feature of glaucoma


26. In a left optic tract lesion:

    a. a right afferent pupillary defect may be present

    b. the visual field shows congruous homonymous hemianopia

    c. the left optic disc may show temporal pallor

    d. the right optic disc may show nasal pallor

    e. the lesion may result from a pituitary adenoma


27. Optic nerve gliomas:

    a. usually occur in the third decade of life

    b. proptosis is the most common presentation

    c. are usually bilateral

    d. cause death through cerebral invasion

    e. require early surgical excision


28. Tuberous sclerosis has the following features:

    a. mental retardation

    b. ashleaf lesion best seen with Wood's light

    c. mulberry tumours which contain calcification

    d. presence of café au lait patches

    e. over 90% of the cases have a positive family history


29. In visual evoked potential (VEP):

    a. the latency is prolonged in recovered optic neuritis

    b. the amplitude is normal in recovered optic neuritis

    c. it is essentially a test of the macula

    d. the result is abnormal in patients with ocular albinism

    e. it can be used to detect malingering


30. In  type 1 neurofibromatosis, the following signs may be seen:

    a. pulsatile proptosis

    b. bilateral acoustic neuroma

    c. Lisch's nodules

    d. cerebral meningioma

    e. cavernous haemangioma of the retina


Click here for more MCQs