Previous year question on cataract based on neet pg, usmle, plab and fmge or mci screening exams

Which of the following statements about 'Stochastic effects' of radiation is TRUE?
A: Severity of effect is a function of dose
B: Probability of effect is a function of dose
C: It has a threshold
D: Erythema and cataract are common examples
Correct Ans:B
Explanation
Stochatic effects are bio effects that occur years after exposure to low doses of radiation (<
0.25). Stochatic effect of radiation is one in which the probability of an effect occurring
increases with radiation dose but the severity of the effect does not.
Ref: Rad Tech's Guide to Radiation Protection By Euclid Seeram, Page 47; Radiotherapy in
Practice - Brachytherapy By Peter Hoskin, Catherine Coyle, Page 45; Essential Physics for
Radiographers By John Ball, Adrian D. Moore, Page 326
Sample Previous Year Question on Cataract based on previous Year Questions
of NEET PG, USMLE,PLAB,FMGE (MCI Screening). Please visit
www.medicoapps.org for more such Quizzes
Use of Tamoxifen for breast cancer can cause all of the following adverse effects, EXCEPT:
A: Thromboembolism
B: Endometrial carcinoma
C: Carcinoma in contralateral breast
D: Cataract
Correct Ans:C
Explanation
Tamoxifen has shown a 45% reduction in the incidence of estrogen receptor positive breast
cancer, so it is approved as a primary prophylactic drug for breast cancer in high risk
women. Recurrence rate of cancer in ipsilateral and contralateral breast is reduced with
tamoxifen therapy.
Ref: Goodman and Gilman's The Pharmacological Basis of Therapeutics, 10th Edition, Pages
1440-1441;Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Page 279; The
New Harvard Guide to Women's Health By Karen J. Carlson, Page 100; KDT 6th Edition,
Page 304

The use of tamoxifen for breast cancer can cause all of the following adverse effects,
except:
A: The use of tamoxifen for breast cancer can cause all of the following adverse effects,
except:
B: Endometrial carcinoma
C: Carcinoma in contralateral breast
D: Cataract
Correct Ans:C
Explanation
Tamoxifen reduces the recurrence rate of breast cancer in ipsilateral as well as
contralateral breasts.
Adverse effects associated with the use of tamoxifen are:
 2-3 fold increased risk of thromboembolism
 2-3 fold increased risk of endometrial carcinoma
 Hot flushes, vomiting, vaginal discharge, menstrual irregularities
 Cataract, dermatitis, depression, mild leucopenia
A neonate is born at term with multiple problems. He is small for gestational age
and has cataract, hepatosplenomegaly and thrombocytopenia with purpura.
Further studies demonstrate patent ductus arteriosus, bone lucency, pneumonia,
and meningoencephalitis. The mother is a 17-year-old girl who had no prenatal
care and had a mild maculopapular rash in mid-pregnancy. Which of the
following is the most likely diagnosis?
A: Congenital cytomegalovirus infection
B: Congenital rubella
C: Congenital syphilis
D: Congenital toxoplasmosis

Correct Ans:B
Explanation
The rubella virus is one of the causes of devastating prenatal infection. In adults
and older children, the virus can cause asymptomatic infection or a relatively
mild febrile illness (German measles) with upper respiratory symptoms,
lymphadenopathy, maculopapular rash, and sometimes joint symptoms. The
effects on the fetus range from apparently asymptomatic infection to multiple
anomalies to death in utero.
Among the more common abnormalities are intrauterine growth retardation,
involvement of the senses and nervous system (meningoencephalitis, cataracts,
retinopathy, hearing loss), cardiac involvement (patent ductus arteriosus,
pulmonary arterial hypoplasia), hepatosplenomegaly, purpura (due to
thrombocytopenia),bluish red skin lesions (secondary to dermal erythropoiesis),
and pneumonia.
Apparently asymptomatic babies should be monitored for subsequent
development of hearing loss, mental retardation, endocrinopathies, and (rarely)
progressive encephalitis. Treatment is supportive, as no specific antiviral therapy
is available for this infection. The rubella vaccine should be given to women of
childbearing age who are not pregnant at the time.
Cytomegalovirus infections can cause asymptomatic to devastating disease in
newborns; look for periventricular calcifications and mothers with a flu-like
illness.
Congenital syphilis can cause devastating disease in newborns and can occur in
early forms (look for the rash of secondary syphilis) or late forms (look for bone
and teeth abnormalities).
Congenital toxoplasmosis can produce devastating infection in newborns; look
for a maternal history of cleaning cat litter boxes.

A 4 year old child develops an infection with Chlamydia trachomatis. How does
infection with this organism cause blindness?
A: Cataract formation
B: Hemorrhage into the anterior chamber
C: Hemorrhage into the posterior chamber
D: Scarring of the cornea
Correct Ans:D
Explanation
Chlamydia trachomatis (serotypes A, B, and C) causes a conjunctival and corneal
infection that is spread in developing countries by eye-seeking flies. The lesions
begin with formation of lymphoid follicles in the conjunctiva. With disease
progression, there is tissue necrosis, granulation tissue deposition, and scar
formation, leading to lacrimal duct obstruction and distortion of the eyelids.
With the loss of an adequate tear system, the cornea becomes vulnerable to
dehydration and opacification.
Also, the vigorous inflammatory response can directly involve the cornea, with
resulting opacity. In developed countries, chlamydial eye infections are often
transmitted venereally rather than by flies, and may cause conjunctivitis in the
newborn and in sexually active young adults.
Ref: Ray C.G., Ryan K.J. (2010). Chapter 39. Chlamydia. In C.G. Ray, K.J. Ryan
(Eds), Sherris Medical Microbiology, 5e
A 4 year old African child develops an infection with Chlamydia trachomatis.
How does infection with this organism cause blindness?
A: Cataract formation
B: Hemorrhage into the anterior chamber
C: Hemorrhage into the posterior chamber
D: Scarring of the cornea
Correct Ans:D
Explanation

Chlamydia trachomatis (serotypes A, B, and C) causes a conjunctival and
corneal infection that is spread in developing countries by eye-seeking flies. The
lesions begin with formation of lymphoid follicles in the conjunctiva. With
disease progression, there is tissue necrosis, granulation tissue deposition, and
scar formation, leading to lacrimal duct obstruction and distortion of the eyelids.
With the loss of an adequate tear system, the cornea becomes vulnerable to
dehydration and opacification. Also, the vigorous inflammatory response can
directly involve the cornea, with resulting opacity. In developed countries,
chlamydial eye infections are often transmitted venereally rather than by flies,
and may cause conjunctivitis in the newborn and in sexually active young adults.
Ref: Ray C.G., Ryan K.J. (2010). Chapter 39. Chlamydia. In C.G. Ray, K.J.
Ryan (Eds), Sherris Medical Microbiology, 5e.
All of the following are the targets for National Programme for Control of Blindness (NPCB),
EXCEPT:
A: Increase cataract surgery rate to 450 operations per lakh population
B: Intraocular lens implantation in more than 80 percent cataract surgery cases
C: 100% coverage of vitamin A prophylaxis doses from 9 months to 3 years of age
D: Development of 50 pediatric ophthalmic units
Correct Ans:C
Explanation
Targets for National Programme for Control of Blindness (NPCB):
 To increase the cataract surgery rate to 450 operations per lakh population
 Intraocular lens implantation in more than 80% cataract surgery cases by
2007
 Development of 50 pediatric ophthalmology units
 Facilities for early diagnosis and treatment of glaucoma and diabetic
retinopathy
 Setting up 20,000 Vision Centers in rural areas
 Development of 25 fully operational eye bank network
 Developing human resources and institutional capacity for eye care by
providing training to eye surgeons and other personnel at various levels,
supply of ophthalmic equipments and grant-in-aid to NGOs.
Ref: Park’s Textbook of Preventive and Social Medicine, 19th edition, Page 292.

Prevalence of cataract at one point of time can be determined by the following method:
A:
B: Longitudinal study
C: Cross-sectional study
D: Surveillance
Correct Ans:B
Explanation
Cross-sectional studies analyze data collected on a group of subjects at one time rather
than over a period of time. Subjects are selected and information is obtained in a short
period of time. Because they focus on a point in time, they are sometimes also
called prevalence studies. Surveys and polls are generally cross-sectional studies.
Ref: Dawson B., Trapp R.G. (2004). Chapter 2. Study Designs in Medical Research. In B.
Dawson, R.G. Trapp (Eds), Basic & Clinical Biostatistics, 4e.
All of the following statements are true about Congenital Rubella, EXCEPT:
A: It is diagnosed when the infant has IgM antibodies at birth
B: It is diagnosed when IgG antibodies persist from more than 6 months
C: Most common congenital defects are deafness, cardiac malformations and cataract
D: Infection after 16 weeks of gestation results in major congenital defects
Correct Ans:D
Explanation
The first trimester of pregnancy is the most disastrous time for the foetus as the organs are
developing. Infection in the second trimester may cause deafness but those infected after
week 16 suffer no major abnormalities.
Ref: Textbook of Obstetrics By Dutta, 6th Edition, Page 299; Park’s Textbook Of Preventive
And Social Medicine By K. Park, 18th Edition, Page 128

Which of the following is the most common cause of ocular morbidity in India?
A: Trachoma
B: Refractive error
C: Conjunctivitis
D: Cataract
Correct Ans:D
Explanation
Among the above given options, the most common cause of blindness in India is cataract
followed by refractive errors which is the second most common cause of blindness in India.
The existing definitions for blindness are based on visual acuity which is best-corrected
thus excluding uncorrected refractive errors as a cause of visual impairment or ocular
morbidity. Though conjunctivitis and cataract may cause blindness a long term
complication, cataract is the single best choice.
WHO has defined ocular morbidity (Low vision) as impairment of visual functioning even
after treatment of refractive errors, and has a visual acuity of less than 6/18 to light
perception. There is a high incidence of blindness in India due to the inadequate ophthalmic
personnel, underestimation of the available man power, malnutrition, lack of eye hygiene,
prevalence of infections and the use of home remedies and quack practice.
Ref: Park’s Textbook of Preventive and Social Medicine, 19th Edition, Pages 76 –
78;Postgraduate Ophthalmology By Zia Chaudhari, Pages 2 - 17; Khurana textbook of
Ophthalmology, 3rd Edition, Page 425 - 426, 499 - 501 ; Concise Textbook Of
Ophthalmology By Sharma, Pages 208 - 211.
Which of the following characteristics are TRUE or FALSE about osteopetrosis in a child?
1. Growth retardation
2. Mental retardation
3. Multiple fracture
4. Cataract
5. Hepatosplenomegaly
A: 1,3, 5 True & 2,4 False
B:
1,3,4, True & 2,5
False

C: 1.3,4, True & 5,2 False
D:
2,3 False & 1,4,5
True
Correct Ans:A
Explanation
It is an autosomal recessive disorder in which partly calcified cartilaginous intercellular
ground substance is not regularly reabsorbed and replaced by regular osteoid tissue &
bone. Clinical features are Multiple fractures, hepatosplenomegaly, growth retardation,
blindness, dental problems, macrocephaly, deafness, etc.
Ref: Ghai, 6th Edition, Page 600; Nelson, 18th Edition, Page 2882
All of the following are manifestations of congenital rubella, EXCEPT:
A: Deafness
B:
Catarac
t
C: Cardiac defects
D:
Hydrocephalu
s
Correct Ans:D
Explanation
Damage to the fetus is most likely when maternal infection occurs during the first 2 months
of pregnancy, although there is risk associated with infection up to 5 months.
The classic triad for congenital rubella syndrome (CRS) is sensorineural deafness, eye
abnormalities—especially retinopathy, cataract and microphthalmia, congenital heart
disease—especially patent ductus arteriosus.
Other manifestations of CRS may includes:
 Spleen, liver or bone marrow problems
 Mental retardation
 Small head size (microcephaly)
 Eye defects
 Low birth weight
 Thrombocytopenic purpura (presents as a characteristic blueberry muffin
rash)

 Hepatomegaly
 Micrognathia
A newborn vomits after each feeding of milk-based formula, and does not gain weight.
Biochemical testing reveals a severe deficiency of galactose-1-phosphate uridyltransferase,
consistent with homozygosity. If this condition goes untreated, what is the likely outcome
for this patient?
A: Benign disease except for cataract formation
B: Chronic emphysema appearing in early adulthood
C: Chronic renal failure appearing in adolescence
D: Death in infancy
Correct Ans:D
Explanation
Galactosemia occurs in two very different clinical forms. Deficiency of galactokinase
produces very mild disease with the only significant complication being cataract formation.
In contrast, homozygous deficiency of galactose-1-phosphate uridyltransferase produces
severe disease culminating in death in infancy. In addition to galactosemia and
galactosuria, these patients have impaired renal tubular resorption leading to
aminoaciduria, gastrointestinal symptoms, hepatosplenomegaly, cataracts, bleeding
diathesis, hypoglycemia, and mental retardation. Pathologically, the CNS showed neuronal
loss and gliosis and the liver shows fatty change progressing to cirrhosis.
Benign disease with cataract formation is characteristic of galactokinase deficiency.
Chronic emphysema is not associated with homozygous galactose-1-phosphate
uridyltransferase deficiency, but rather with alpha 1-antitrypsin deficiency.
Impaired tubular reabsorption (producing aminoaciduria) is seen within a few days or
weeks of feeding milk to an infant with severe galactosemia, as opposed tochronic renal
failure appearing in adolescence.
Ref: Bender D.A., Mayes P.A. (2011). Chapter 21. The Pentose Phosphate Pathway & Other
Pathways of Hexose Metabolism. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K.
Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.

Cataract in galactosemia is caused by accumulation of:
A: Sorbitol
B: Galactitol
C: Galactose
D: None of the above
Correct Ans:B
Explanation
Inability to metabolize galactose occurs in the galactosemia, which may be caused by
inherited defects of galactokinase, uridyl transferase, or 4-epimerase, though deficiency
of uridyl transferase is the best known. Galactose is a substrate for aldose reductase,
forming galactitol, which accumulates in the lens of the eye, causing cataract.
Ref: Harper 28th edition, chapter 21.
All of the following statements about Neurofibromatosis are true, except?
A:
Catarac
t
B: Scoliosis
C: Cutaneous neurofibromas
D: Autosomal Recessive Inheritance
Correct Ans:D
Explanation
Neurofibromatoses are a group of clinically and genetically different autosomal dominant
hereditary diseases that predispose to benign and malignant tumors of the nervous system.
It is of two types NF 1 and NF2. Cutaneous neurofibromas occur in NF1, and NF 2 is
associated with posterior subcapsular cataract.
Ref: Harrison’s Internal Medicine, 18th Edition, Chapter 379; Color Atlas of Genetics By
Eberhard Passarge, 3rd Edition, Page 338

All of the following statements about Neurofibromatosis are true, except?
A:
Catarac
t
B: Scoliosis
C: Cutaneous neurofibromas
D: Autosomal Recessive Inheritance
Correct Ans:D
Explanation
Neurofibromatoses are a group of clinically and genetically different autosomal dominant
hereditary diseases that predispose to benign and malignant tumors of the nervous system.
It is of two types NF 1 and NF2. Cutaneous neurofibromas occur in NF1, and NF 2 is
associated with posterior subcapsular cataract.
Ref: Harrison’s Internal Medicine, 18th Edition, Chapter 379; Color Atlas of Genetics By
Eberhard Passarge, 3rd Edition, Page 338
Which is the commonest cause of ocular morbidity globally?
A: Cataract
B: Refractive error
C: Ocular injury
D: Vitamin A deficiency
Correct Ans:B
Explanation
Uncorrected refractive error remains a major cause of vision loss throughout the world.
When included in the global statistics, uncorrected refractive error accounts for over 18%
of profound vision loss, with a much larger percentage of moderate and severe vision loss.
Ref: Pirbhai A, Kent S, Hodge W.G. (2011). Chapter 20. Causes and Prevention of Vision
Loss. In Riordan-Eva P, Cunningham E.T., Jr (Eds), Vaughan & Asbury's General
Ophthalmology, 18e.

Which of the following is the commonest cause of low vision in India?
A: Squint
B: Cataract
C: Glaucoma
D: Uncorrected refractive errors
Correct Ans:D
Explanation
Commonest cause of low vision and ocular morbidity in India is refractive errors.
The World Health Organization (WHO) defines low vision as best corrected distant visual
acuity in the better eye less than 20/60 (6/18, 0.33) but 20/400 (3/60, 0.05) or better
and blindness as best corrected distant visual acuity in the better eye of less than 20/400
(3/60, 0.05) or less or widest diameter of the visual field subtending an angle of less than
20 degrees.
Using this definition, it is estimated that 150 million people worldwide have low vision and
8 million are blind due to uncorrected refractive error, making it the most common cause of
visual impairment, worldwide.
Ref: Park’s Textbook of Preventive and Social Medicine, 19th Edition, Pages 261, 336-3 ;
Riordan-Eva P. (2013). Chapter 7. Disorders of the Eyes & Lids. In M.A. Papadakis, S.J.
McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013.
The most common cause of ocular morbidity in India is:
A: Cataract
B: Refractive error
C: Glaucoma
D: Trachoma
Correct Ans:B
Explanation
In the above question we need to first differentiate between ocular morbidity and ocular
mortality. Ocular morbidity refers to low vision whereas ocular mortality is related to

blindness. Therefore it is noted that refractive errors remain the most common cause of
ocular morbidity whereas cataract is the most common cause of ocular mortality.
Ref: Park’s Textbook of PSM 19th Edition, Page 336-337; PSM & Biostatistics: Self
Assessment & Review, By Deepak Mishra, Page 156; Pradeep sharma 1st Edition, Page 338,
339, 340
Which of the following refractive problems most closely resembles presbyopia?
A: Hyperopia
B:
Myopi
a
C: Astigmatism
D: Cataract
Correct Ans:A
Explanation
Presbyopia is the loss of accommodative power that occurs as a person ages. Because
accommodation cannot occur, the near point moves way from the eye and images must be
held at some distance from the eye to be clearly seen. This is similar to the situation in
hyperopia where the converging power is too weak for the axial length of the eye.
Hyperopes must accommodate to see distant objects clearly and thus have less
accommodation available for near vision. Thus hyperopes, like presbyopes, must hold
objects at a distance to see them clearly (hence the term “farsighted”).
Ref: Riordan-Eva P. (2011). Chapter 21. Optics & Refraction. In P. Riordan-Eva, E.T.
Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.
Which of the following disorders of eye is controlled using SAFE strategy?
A: Cataract
B: Trachoma
C: Glaucoma
D: Diabetic retinopathy

Correct Ans:B
Explanation
In 1997, WHO developed a strategy known as ‘SAFE’ to control trachoma worldwide.
S -- Surgery for trachomatous trichiasis
A -- Antibiotics (Azithromycin/tetracycline)
F -- Facial cleanliness
E -- Environmental change
Ref: Pg Ophthalmology: V. I and, Volume 2 By Zia Chaudhari, Pages 15-6.
Sarcoidosis is associated with:
A: Band keratopathy
B: Systemic amylodosis
C: Angioid streaks
D:
Cataracta
nigra
Correct Ans:A
Explanation
Among all the options given, band keratopathy is the correct option because band
keratopathy occurs due to hypercalcemia (calcium deposits on the cornea) and sarcoidosis
is associated with derangement of calcium metabolism.
Ref: Blueprints Medicine, By Vincent B. Young, William A. Kormos, Davoren A. Chick, Page
276; Fluorescein and Icg Angiography: Textbook and Atlas, By Gisbert Richard, Gisèle
Soubrane, Lawrence Yanuzzi, Page 178

A patient has a miotic pupil, IOP = 25, normal anterior chamber, hazy cornea and a shallow
anterior chamber in fellow eye. Diagnosis is:
A: Acute anterior uveitis
B: Acute angle closure glaucoma
C: Acute open angle glaucoma
D: Senile cataract
Correct Ans:A
Explanation
In this scenario patient present with signs of acute anterior uveitis, which is an
inflammation of iris and ciliary body.
Ref: Comprehensive Ophthalmology By A K Khurana, 4th Edition, Pages 141-44 ; Textbook
of Ophthalmology By Neema, 3rd Edition, Page 160
Late onset endophthalmitis after cataract surgery is most often caused by:
A: Staphylococcus Epidermidis
B: Pseudomonas
C: Streptococcus Pyogenes
D: Propionobacterium Acnes
Correct Ans:D
Explanation
Propionobacterium Acnes – most frequent isolate in chronic postoperative endophthalmitis followed by
S.epidermidis, aerobic streptococci and Actinomyces species. Most frequent reported organism is
Propionobacterium Acnes.
Ref: Clinical Eye Atlas - Page 700; Complications in Phacoemulsification: Avoidance,
Recognition, and Management – Page 304.

In which of the following uveitic conditions is it contraindicated to put in an intraocular lens
after cataract surgery?
A: Psoriatic arthritis
B: Reiter's syndrome
C: Fuch's heterochromic cyclitis
D: Juvenile rheumatopid arthritis
Correct Ans:D
Explanation
Currently, except uveitis associated with juvenile rheumatoid
arthritis, no other condition is considered a contraindication
for intraocular lens placement following cataract surgery.
Ref: Phacoemulsification Surgery By Vajpayee, Page
325; Comprehensive Ophthalmology By A K Khurana, 4th
Edition, Pages 141-5.
What should be treatment modality in a case of congenital cataract involving visual axis?
A: Wait and watch
B: Operated when the baby reaches an appropriate age
C: Mydriatic s are given
D:
Operate
immediately
Correct Ans:D
Explanation
If a lenticular opacity is in the visual axis, it is considered
visually significant and may lead to blindness. Immediate
surgery is indicated in such groups. If the cataract is small,
in the anterior portion of the lens, or in the periphery, no
visual loss may be present.

 Extracapsular cataract extraction with primary
posterior capsulectomy and anterior vitrectomy is
the procedure of choice (via limbal or pars plana
approach).
 Intracapsular cataract extraction in children is
contraindicated because of vitreous traction and
loss at the Wieger capsulohyaloid ligament.
Christmas tree cataract is seen in?
A: Diabetes
B: Atopic Dermatitis
C: Myotonic dystrophy
D: Rubella
Correct Ans:C
Explanation
Presenile cataract occurs in patients with atopic dermatitis (stellate opacities mostly
posterior), myotonic dystrophy (christmas tree cataract) and GPUT & GK enzyme
deficiency.
Reference:
A K Khurana, 5th Edition, Page 95
Sunflower cataract is associated with the inborn error of metabolism of which of the
following?
A: Iron
B: Nickel

C: Copper
D: Zinc
Correct Ans:C
Explanation
Sunflower cataract is associated with the inborn error of copper metabolism (Wilson’s
disease).
Ref: A K Khurana, 5th Edition, Page 91
Which is not a cause for Hamarlopia?
A: Polar cataract
B: Congenital deficiency of cones
C: Peripheral cortical cataract
D: Central corneal opacity
Correct Ans:C
Explanation
Peripheral cortical cataract causes Nyctalopia. Central vitreous opacity, Congenital
deficiency of cones and Central nuclear or polar cataracts can cause Hamarlopia (Day
blindness).
Ref: A K Khurana, 2nd Edition, Page 11.
A baby is brought to ophthalmology department with congenital cataract involving the
visual axis. What is the MOST appropriate management in this baby?
A: Immediate operation
B:
Wait &
watch
C: Mydriatics

D: Operate in adult
Correct Ans:A
Explanation
If the opacity is small enough so that it does not occlude the pupil, adequate visual acuity is
attained by focusing around the opacity.
If the pupillary opening is entirely occluded, however, normal sight does not develop, and
visual deprivation may lead to nystagmus and profound irreversible amblyopia.
Good visual results have been reported with both unilateral and bilateral cataracts treated
by early surgery and prompt correction of aphakia and amblyopia therapy.
Ref: Fredrick D.R. (2011). Chapter 17. Special Subjects of Pediatric Interest. In P. Riordan-
Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.
Polychromatic lusture is seen in:
A: Complicated cataract
B: Post radiation cataract
C: Diabetes mellitus
D: Congenital cataract
Correct Ans:A
Explanation
Poly chromatic luster or bread crumb appearance is seen in complicated cataract.
Ref: A.K KHURANA (2005), Chapter 5, “Disease of The Lens”, In the book, “Opthalmology”,
3rd Edition, Newdelhi, Page 194, 195
A two week old child presents with unilateral cataract. Which of the following represents
the best management advice:

A: The best age to operate him to get the best visual results is four years
B: The best age to operate him to get the best visual results is four weeks
C: The eye is already lost, only cosmetic correction is required
D:
The best age to operate him to get the best visual results is four
months
Correct Ans:B
Explanation
In the above case surgery must be done at the earliest. Since 4 weeks is the earliest answer
given here, it is correct. The treatment is essential to minimize visual loss.
Ref: A.K KHURANA (2005), Chapter 8, “Disease of The Lens”, In the book, “Opthalmology”,
3rd Edition, Newdelhi, Page 189
A child has got a congenital cataract in one eye involving the visual axis. When should the
child be operated ?
A: Immediately
B: At 2 months of age
C: At 1 year of age when the globe becomes normal sized
D:
After 4 years when entire ocular and orbital growth becomes
normal
Correct Ans:A
Explanation
Presence of dense cataract present at birth is an indication for urgent surgical management
to prevent amblyopia.
Ref: CURRENT Diagnosis and Treatment: Surgery, 13th Edition, Chapter 37; Comprehensive
Ophthalmology By AK Khurana, 4th Edition, Page 174.

Which one of the following conditions is associated with Soemmering’s ring?
A: After cataract
B:
Keratoconu
s
C: Wilson’s disease
D: Uveitis
Correct Ans:A
Explanation
After cataract is also known as secondary cataract. It is the opacity which persists or
develops after any form of planned or accidental extracapsular lens extraction.
It may present as thickened posterior capsule or a dense membranous after cataract
or Soemmering's ring which refers to a thick ring of after cataract formed behind the iris,
enclosed between the two layers of capsule or Elschnig's pearls in which the vacuolated
subcapsular epithelial cells are clustered like soap bubbles along the posterior capsule.
Which of the following is the optimal position for inserting an IOL during a cataract
surgery?
A:
Anterior
chamber
B: Posterior chamber
C: Iris clip
D: Any of the above
Correct Ans:B
Explanation
The lens should be placed in the capsular bag of the
posterior chamber. Intraocular lens implants can easily be
inserted behind the iris and in front of the posterior lens
capsule. This is safest and most secure place for intraocular
lens implants to rest within the eye.

Which of the following disease is associated with sunflower cataract?
A: a) Wilson’s disease
B:
b)
Trauma
C: c) Diabetes
D: Both ‘a’ and ‘b’
Correct Ans:C
Explanation
Sunflower cataract is associated with trauma and Wilson's disease. 3 types of cataract associated with
diabetes are snow flake cataract, senile cataract and secondary cataract.
A 76-year-old female presents with complaints of difficulty reading. Ophthalmologic
examination is remarkable for bilateral, white opacifications in her eyes, consistent with
cataract formation. In which of the following structures are the opacifications located?
A: Aqueous humor
B: Cornea
C: Lens
D: Optic nerve
Correct Ans:C
Explanation
Cataracts are lens opacifications. It is not known whether senile cataracts represent
disease or normal opacification with age. Cataracts may occur as a consequence of diabetes
mellitus, long-term steroids, or congenital infections. They are successfully treated at
present with lens extractions and implantation of prosthetic lenses.
Note:
Aqueous humor is continually replaced due to active secretion by the ciliary body. As such,
it does not undergo opacification; it is in constant flux.

Corneal opacification is generally a consequence of squamous metaplasia, in which the
transparent, non-keratinized, squamous cells are replaced by opaque, keratinized,
squamous cells. Squamous metaplasia is a reparative process, usually due to friction injury
to the cornea or vitamin A deficiency.
The optic nerve is not transparent, and it does not undergo opacification injury. It may,
however, atrophy due to ischemic, traumatic, infective, or metabolic insults.
Ref: Harper R.A., Shock J.P. (2011). Chapter 8. Lens. In P. Riordan-Eva, E.T. Cunningham,
Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.
Ocular examination of a man with a systemic disease shows ‘sunflower cataract’. It has
developed due to:
A: Diabetes mellitus
B: SLE
C: Chalcosis
D: Sarcoidosis
Correct Ans:C
Explanation
Chalcosis refers to the specific changes produced by the alloy of copper in the eye.
Clinical manifestations:
 Kayser-Fleischer ring: It is a golden brown ring which occurs due to
deposition of copper under peripheral parts of the Descemet’s membrane of
the cornea.
 Sunflower cataract: It is produced by deposition of copper under the
posterior capsule of the lens. It is brilliant golden green in colour and
arranged like the pearls of a sunflower.
 Retina: It may show deposition of golden plaques at the posterior pole
which reflect the light with a metallic sheen.
Ref: Comprehensive Ophthalmology by A K Khurana, 4th edition, Page 410.

A patient with cataract exhibits polychromatic lustre of reds, greens and blues. He is having
the following type of cataract:
B:
Diabetes
mellitus
C: Post-radiation cataract
Correct Ans:A
Explanation
Complicated cataract refers to opacification of the lens secondary to some other intraocular
disease. Typically the complicated cataract starts as posterior cortical cataract. Lens
changes appear typically in front of the posterior capsule. The opacity is irregular and
variable in density.
In the beam of slit lamp the opacities have an appearance like ‘bread crumb’. A very
characteristic sign is the appearance of iridescent coloured particles the so-
called‘polychromatic lustre’ of reds, greens, and blues. A diffuse yellow-haze is seen in the
adjoining cortex.
Ref: Ophthalmology by A K Khurana, 4th edition, Page 181-182.
Which of the following condition may give rise to sunflower cataract?
B: Injuries
C: Chalcosis
D: Infections
Correct Ans:C
Explanation
Chalcosis refers to the specific changes produced by the alloy of copper in the eye. Copper
ions from the alloy are dissociated electrolytically and deposited under the membranous
structures of the eye.
Clinical manifestations:
 Kayser-Fleischer ring: It is a golden brown ring which occurs due to
deposition of copper under peripheral parts of the Descemet’s membrane of

the cornea.
 Sunflower cataract: It is produced by deposition of copper under the
posterior capsule of the lens. It is brilliant golden green in colour and
arranged like the petals of a sunflower.
 In retina, it may show deposition of golden plaques at the posterior pole
which reflect the light with a metallic sheen.
Ref: Ophthalmology by A K Khurana, 4th Edition, Page 410
Which of the following statement is CORRECT about senile cataract?
A: Painful sudden vision loss
B: Painless sudden vision loss
C: Painful gradual vision loss
D: Painless gradual vision loss
Correct Ans:D
Explanation
Visual deterioration due to senile cataract is painless and gradually progressive in
nature. Patients with central opacities (e.g., cupuliform cataract) have early loss of vision.
These patients see better when pupil is dilated due to dim light in the evening(day
blindness). In patients with peripheral opacities (e.g., cuneiform cataract) visual loss is
delayed and the vision is improved in bright light when pupil is contracted.
As opacification progresses, vision steadily diminishes, until only perception of light and
accurate projection of rays remains in stage of mature cataract.
Ref: Ophthalmology by A K Khurana, 4th edition, Page 178-179.

Which of the following type of cataract gives a polychromatic lustre on slit lamp
examination of the eye?
B:
Diabetic
cataract
C: Post-radiation cataract
Correct Ans:A
Explanation
Slit lamp examination of the lens of the eye in a case of complicated cataract shows bread
crumbs like appearance and a characteristic rainbow display of colours which replaces the
normal achromatic sheen (polychromatic lustre).
Complicated cataract results from a disturbance of nutrition of the lens due to inflammatory
or degenerative disease of other parts of the eye, such as iridocyclitis, ciliary body tumors,
choroiditis, degenerative myopia, anterior segment ischemia, retinitis pigmentosa or retinal
detachment.
Ref: Parsons' Diseases of the Eye By Ramanjit Sihota & Radhika Tandon 21st edn page 262
Which of the following condition is associated with the development of sunflower cataract?
B: Injuries
C: Chalcosis
D: Infections
Correct Ans:C
Explanation
Sunflower cataract occur due to chalcosis. Chalcosis of the lens develop with the presence
of copper containing intra ocular foreign bodies or as a part of Wilson’s disease.
In this condition copper also gets deposited in basements membrane resulting in Kayser
Fleischer ring.
Retention of iron containing foreign bodies can cause cataract due to toxicity from ferrous
ions. Deposits within the lens epithelium, iris pigment epithelium and and retinal pigment
leads to siderosis. The ferrous ions cause a flower shaped cortical fiber opacity, brown
pigment deposition on the lens capsule and iris heterochromia.

Ref: Clinical Guide to Comprehensive Ophthalmology edited by David A. Lee, Eve J.
Higginbotham page 315.
Which is the commonest congenital cataract which presents as visual impairment?
A: Nuclear
B:
Zonula
r
C: Capsular
D: Coralliform
Correct Ans:B
Explanation
Lamellar or Zonular cataract refer to the developmental cataract in which the opacity
occupies a discrete zone in the lens. It is the most common type of congenital cataract
presenting with visual impairment. It is usually bilateral. Typically this cataract occurs in
a zone of fetal nucleus surrounding the embryonic nucleus.
Ref: Ophthalmology by A K Khurana, 4th edition, Page 172.
Find the wrong match:
A: Kayser Fleischer ring—Wilson's disease
B:
Sunflake cataract—
Haemochromatosis
C: Fleischer ring—Keratoconus
D: Bread crumb appearance —Injuries
Correct Ans:D
Explanation
Bread crumb appearance is seen in complicated cataract.
Typically the complicated cataract starts as posterior cortical cataract. The opacity is
irregular in outline and variable in density. In the beam of slit-lamp the opacities have an
appearance like ‘bread crumb’. A very characteristic sign is the appearance of iridescent

coloured particles the so called ‘polychromatic lustre’ of reds, greens, and blues. Slowly the
opacity spreads in the rest of the cortex, and finally the entire lens becomes opaque.
Ref: Comprehensive Ophthalmology by AK Khurana, 4th edition, Page 181-182.
Which of the following type of cataract is most commonly associated with ageing?
A: Nuclear cataract
B: Intumescent cataract
C: Morgagnian cataract
D: Posterior subcapsular cataract
Correct Ans:A
Explanation
Nuclear cataract is the most common and type and the one most commonly associated with
ageing. It consist of a central diffuse opacification and coloration that involve the lens
nucleus.
 Intumescent cataract is a form of cortical cataract where the nucleus is
white and the capsular bag is swollen because of fluid absorption.
 Morgagnian cataract is a hypermature cataract in which entire lens capsule
is wrinkled and total liquefaction of the cortex allows the nucleus to move
freely in the bag and sink inferiorly due to effects of gravity.
Ref: Cataract Surgery from Routine to Complex: A Practical Guide By George J. C. Jin, page
21.
Which of the following type of cataract is seen in a person 1-2years following exposure to
radiation?
A: Lamellar cataract
B: Christmas tree cataract
C: Posterior polar cataract
D: Posterior subcapsular cataract
Correct Ans:D

Explanation
Radiation usually causes posterior subcapsular cataract which has their onset 1-2 years
after completion of radiation therapy. A radiation dose of 15Gy is associated with a 50%
risk of cataract formation.
 Christmas tree cataract is a rare form of age related cataract. In this type,
the highly retractile multicolored needle shaped lenticular inclusions are
seen within the deep perinuclear cortex of the lens.
 Posterior polar cataract is a rare form of congenital cataract with a round,
discoid opacity located in the central posterior part of the lens adjacent to
and merging with the posterior capsule.
REF: Cataract Surgery from Routine to Complex: A Practical Guide By George J. C. Jin PAGE
21.
Which of the following is the most common type of congenital cataract?
A: Sutural cataract
B: Lamellar cataract
C: Coronary cataract
D: Embryonic nuclear cataract
Correct Ans:B
Explanation
Lamellar cataract is the most common type of congenital cataract. It occur in a zone of fetal
nucleus surrounding the embryonic nucleus. In this type, the main mass of the lens internal
and external to the zone of cataract is clear except for small linear opacities like spokes of
wheel seen towards the equator.
Coronary cataract is a common form of cataract occurring during puberty. It involves either
the adolescent nucleus or deeper layer of the cortex. The opacity have a regular radial
distribution in the peripheral of lens encircling the central axis.
Ref: Ophthalmology By A. K. Khurana page 188

Which type of senile cataract is notorious for glaucoma formation?
A: Incipient cataract
B: Hypermature morgagni
C: Intumescent cataract
D: Nuclear cataract
Correct Ans:C
Explanation
In intumescent cataract, the lens may take up fluid during cataractous change, increasing
markedly in size. It may then encroach upon the anterior chamber, producing both pupillary
block and angle crowding and resulting in acute angle closure. Treatment consists of lens
extraction once the intraocular pressure has been controlled medically.
Ref: Salmon J.F. (2011). Chapter 11. Glaucoma. In P. Riordan-Eva, E.T. Cunningham, Jr.
(Eds), Vaughan & Asbury's General Ophthalmology, 18e.
Which of the following type of cataract is associated with shallow anterior chamber ?
A: Mature cataract
B: Hypermature cataract
C: Intumescent cataract
D: Incipient cataract
Correct Ans:C
Explanation
In this, during cataract formation lens takes up fluid and markedly increase in size. It may
encroach on the anterior chamber making it shallow, and can also cause pupillary block,
angle crowding and acute angle closure.
Normal depth of anterior chamber is 2.5mm in the center.

Causes of shallow anterior chamber are:
 Primary narrow angle glaucoma
 Hypermetropia
 Postoperative shallow anterior chamber
 Malignant glaucoma
 Anterior perforations
 Anterior subluxation of lens
 Intumescent cataract
Ref: Ophthalmology By Khurana page 21. Salmon J.F. (2011). Chapter 11. Glaucoma. In P.
Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e.
All of the following are true about Morgagnian cataract, EXCEPT:
A: It is an immature cataract
B: Lens becomes a bag of milky fluid
C: Calcium deposits are seen on the lens capsule
D: Brown nucleus settles at the bottom
Correct Ans:A
Explanation
Morgagnian cataract is an hypermature cataract. In some patients, after maturity the whole
cortex liquefies and the lens is converted into a bag of milky fluid. The small brownish
nucleus settles at the bottom, altering its position with change in the position of the head.
Such cataract is called Morgagnian cataract. Calcium deposits may also be seen on the lens
capsule.
Ref: Comprehensive Ophthalmology by AK Khurana, 4th edition, Page 177.
A male patient with a history of hypermature cataract presents with a 2 day history of
ciliary congestion, photophobia, blurring of vision and on examination has a deep anterior
chamber in the right eye. The left eye is normal. The diagnosis is:
A: Phacomorphic glaucoma

B:
Phacolytic
glaucoma
C: Phototoxic glaucoma
D: Phacoanaphylactic uveitis
Correct Ans:D
Explanation
A hypermature cataract may leak lens proteins into anterior chamber. These proteins may
act as antigens and induce antigen antibody reaction leading to uveitis known
as phacoanaphylactic uveitis. Due to shrinkage of lens, anterior chamber becomes deep.
Clinical features include severe pain, loss of vision, marked congestion and signs of
granulomatous iridocyclitis associated with presence of lens matter in the anterior
chamber. Treatment consists of removal of causative lens matter, topical steroids and
cycloplegics.
Which among the following is the commonest type of congenital cataract?
A: Nuclear
B:
Zonula
r
C: Capsular
D: Coralliform
Correct Ans:B
Explanation
Lamellar or zonular cataract is the most common type of congenital cataract, accounting for
about 50% cases. Here, development of the lens is interfered at a later stage. Typically, this
cataract occurs in a zone of foetal nucleus surrounding the embryonic nucleus. The main
mass of the lens internal and external to the zone of cataract is clear, except for small
linear opacities like spokes of a wheel (riders) which may be seen towards the equator.
Ref: Ophthalmology by Khurana, 2005, Page 187.

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:
Retinoblastom
a
C: Endophtalmitis
D: Coats disease
Correct Ans:B
Explanation
Presence of leukocoria (white pupillary reflex) and calcification within the globe in a one
and a half year old child is almost diagnostic of retinoblastoma.
Ref:Comprehensive Ophthalmology By AK Khurana, 4th Edition, Pages 280-2
A chemistry student was brought to the emergency department after accidental spilling of
caustic soda in her eyes. Alkali injury causing global penetration can result in:
A: Symblepharon
B:
Optic
neuritis
C: Retinal detachment
D: Cataract
Correct Ans:A
Explanation
Symblepharon:
 This is a condition where adhesion of the lid to the globe takes place.
 Any cause which produces raw surfaces on two opposed areas of the
palpebral and bulbar conjunctiva will lead to adhesion if the areas are
allowed to remain in contact during the process of healing, and thus allows
cicatrization and fibrosis.
 Examples: Burns from heat or chemical injury, Stevens-Johnson syndrome,
ulcers, diphtheria, pemphigoid, operations etc.

Ref: Parsons' Diseases of the Eye By Ramanjit Sihota & Radhika Tandon, 21st edition, Page
450.
B: Pseudomonas
Correct Ans:D
Explanation
"Photo dynamic therapy” is used in the eye for the following disease:
A: Glaucoma
B:
Uveiti
s
C: Wet AMD (age related macular degeneration)
D: Cataract
Correct Ans:C
Explanation
Photodynamic therapy may prevent further deterioration of visual acuity in patients with
wet AMD. It induces apoptosis of endothelial cells and helps to reduce neovascularisation.

Ref: John S. Penn (2008), Chapter 23, “Novel Therapeutic Stratigies for Posterior Segment
Neovascularisation”, In the book, “Retinal and Choroidal Angiogenesis”, USA, Spiringer
Publications, Page 451 ; Clinical Ophthalmology By Kanski, 5th Edition, Page 417
Fundus fluorescein angiography done in a patient following cataract surgery shows a flower
petal pattern. What is he MOST likely suffering from?
A: Macular hole
B: Cystoid macular edema
C: Central serous retinopathy
D: None of the above
Correct Ans:B
Explanation
He is showing features of cystoid macular edema. Cystoid macular edema refers to a
condition in which there is fluid accumulation in honeycomb like spaces of the outer
plexiform and inner nuclear layers. Fluorescein angiography done shows leakage of
fluorescein dye from the perifoveal retinal capillaries and peripapillary region, and
accumulating in a flower-petal pattern around the fovea.
It most frequent occur following cataract surgery, especially if the surgery was complicated
or prolonged. It usually manifests at 4–12 weeks postoperatively.
Ref: Fletcher E.C., Chong N., Augsburger J.J., Corrêa Z.M. (2011). Chapter 10. Retina. In P.
Riordan-Eva, E.T. Cunningham, Jr. (Eds), Vaughan & Asbury's General Ophthalmology, 18e
A 60 year old male patient operated for cataract 6 months back now complains of floaters
and sudden loss of vision. The diagnosis is:
A: Vitreous hemorrhage
B:
Retinal
detachment
C: Central retinal artery occlusion
D: Cystoid macular edema

Correct Ans:B
Explanation
Floaters and sudden loss of vision are symptoms of retinal detachment. The incidence of
retinal detachment is higher in aphakic patients as compared to phakics.
Late postoperative complication of cataract surgery:
 Cystoid macular oedema
 Delayed chronic postoperative endophthalmitis
 Pseudophakic bullous keratopathy
 Retinal detachment
 Epithelial ingrowth
 Fibrous downgrowth
 After cataract
Ref: Comprehensive Ophthalmology by AK Khurana, 4th edition, Page 260-261.
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 Ans:A
Explanation
Sudden painless loss of vision with absence of fundal glow and a normal anterior chamber,
in absence of trauma (spontaneous) is consistent with a diagnosis of spontaneous vitreous
haemorrhage.
Ref:Comprehensive Ophthalmology By AK Khurana, 4th Edition, Page 246

B: Pseudomonas
Correct Ans:D
Explanation
A 27-yr male presents with a sudden, painless loss of vision. His ocular and systemic
history is unremarkable. The most likely diagnosis is:
A: Retinal detachment
B:
Eales’
disease
C: Glaucoma
D: Cataract
Correct Ans:B
Explanation
Eales’ disease:
 It is an idiopathic inflammation of the peripheral retinal veins.
 It is characterized by recurrent vitreous hemorrhage; so also referred to as
primary vitreous hemorrhage.
 It is a bilateral disease, typically affecting young adult males.
 The common presenting symptoms are sudden appearance of floaters
(black spots) in front of the eye or painless loss of vision due to vitreous
hemorrhage.

4 stages of clinical course:
 Stage of inflammation
 Stage of ischaemia
 Stage of retinal neovascularization
 Stage of sequelae
 Treatment: steroids, laser photocoagulation, vitreoretinal surgery.
Ref: Comprehensive Ophthalmology by A K Khurana, 4th edition, Page 254.
Babloo a 5 yrs old child presents with large cornea, lacrimation and photophobia; Diagnosis
is:
A: Megalocornea
B: Congenital glaucoma
C: Congenital cataract
D: Anterior uveitis
Correct Ans:B
Explanation
In this scenario signs and symptoms occur as a result of congenital glaucoma.
Ref: Comprehensive Ophthalmology A K Khurana 4th Edition, Pages 211-12 ; Textbook of
Ophthalmology By Neema, 3rd Edition, Page 190
Which among the following is the indication for using Fincham's test?
A: To diagnose congenital glaucoma
B: To diagnose acute congestive glaucoma
C: For differential diagnosis of acute congestive glaucoma from cataract
D: To diagnose congenital cataract
Correct Ans:C

Explanation
The coloured halos in glaucoma must be differentiated from those found in acute purulent
conjunctivitis and early cataractous changes. In conjunctivitis, the halos can be eliminated
by irrigating the discharge. The halos of glaucoma and immature cataract may be
differentiated by Fincham’s test in which a stenopaic slit is passed across the pupil. During
this test glaucomatous halo remains intact, while a halo due to cataract is broken up into
segments.
Blunt injury to the eye often causes all of the following, EXCEPT:
A: Angle recession
B: Anterior polar cataract
C: Berlin edema
D: Avulsion of optic nerve
Correct Ans:D
Explanation
Blunt injury to the eye causes:
NON UVEAL CHANGES
 Lid edema or hematoma
 Subconjunctival hemorrhage
 Cataract
 Berlin’s edema of retina
UVEAL CHANGES
 Iritis
 Anterior chamber angle recession
 Tear of root of iris
 Hyphema
 Mydriasis
 Tear of iris sphincter
 Cyclodialysis
 Choroidal hemorrhage
 Choroidal rupture
 Chorioretinitis sclopetaria
 Choroidal atrophy

Ref: Pocket Atlas of Ophthalmology edited by Torsten Schlote, PAGE 124.
Which of the following ocular complication can occur as a result of chronic systemic steroid
use?
A: Open angle glaucoma
B: Conjuctival & lid papillomatis
C: Uveitis
D: Cataract
Correct Ans:D
Explanation
Prolonged use of topical as well as systemic steroids produces a type of glaucoma very
similar to chronic simple glaucoma. The elevated intra ocular pressure (I.O.P) is reversible,
whereas the glaucomatous cupping and the field defects are irreversible.
Among the corticosteroids, dexamethasone and betamethasone both topical and systemic
are more potent in producing cataract and glaucoma than medrysone and prednisolone.
The longer the duration of steroid therapy the more will be the glaucomatous changes.
The I.O.P is reversible within 15 - 45 days after institution of antiglaucoma therapy and
subsequently without any drugs whatever may be the type and duration of steroids used.
But the glaucomatous cupping, field defects and cataract are persistent.
There is no connection between rise of I.O.P and the development of cataract.
In which of the following uveitic conditions is it contraindicated to put in an intraocular lens
after cataract surgery?
A: Psoriatic arthritis
B: Reiter's syndrome
C: Fuch's heterochromic cyclitis

D: Juvenile rheumatopid arthritis
Correct Ans:D
Explanation
Currently, except uveitis associated with juvenile rheumatoid
arthritis, no other condition is considered a contraindication
for intraocular lens placement following cataract surgery.
Ref: Phacoemulsification Surgery By Vajpayee, Page
325; Comprehensive Ophthalmology By A K Khurana, 4th
Edition, Pages 141-5.
Eye examination of a 48-year-old man showed a golden brown ring around the cornea. You
suspect a Kayser Fleisher ring, which is characteristically seen in which of the following
conditions?
A: Hemosiderosis
B: Wilson’s disease
C: Tyrosinemia
D: Hereditary cataract
Correct Ans:B
Explanation
Kayser Fleisher Ring is seen in Wilson’s disease. KF ring is a golden brown ring
which occur due to deposition of copper under the peripheral parts of the Descement’s
membrane of the cornea.
Wilson’s disease is a rare autosomal recessive disease of young adults characterized by
abnormal copper metabolism which inturn causes changes in the basal nuclei, liver
cirrhosis, and corneal pigmentation. Abnormal copper metabolism can result in deposition
of copper in the posterior capsule of the lens resulting in sunflower cataract.
Ref: Comprehensive Ophthalmology by A K Khurana, 4th edn, page 410

Which of the following will not cause pupillary white reflex?
A: Retinoblastoma
B:
Glaucom
a
C: Cataract
D: Retrolental fibroplasia
Correct Ans:B
Explanation
Glaucoma is not a cause of white pupillary reflex (cat’s eye reflex). The patient should be
evaluated immediately as an important differential diagnosis is retinoblastoma.
Ref: A.K KHURANA (2005), In the book, “Opthalmology”, 3rd Edition, Newdelhi, Page 23,
170, 269
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:
Retinoblastom
a
C: Endophtalmitis
D: Coats disease
Correct Ans:B
Explanation
Presence of leukocoria (white pupillary reflex) and calcification within the globe in a one
and a half year old child is almost diagnostic of retinoblastoma.
Ref:Comprehensive Ophthalmology By AK Khurana, 4th Edition, Pages 280-2

B: Pseudomonas
Correct Ans:D
Explanation
All of the following are given global prominence in the VISION 2020 goal, EXCEPT:
A: Onchocerciasis
B:
Catarac
t
C: Glaucoma
D: Refractive errors
Correct Ans:C
Explanation
Vision 2020: The Right to Sight
Objective: It is a global initiative to eliminate avoidable blindness by the year 2020.
Global target diseases include: Cataract, childhood blindness, trachoma, refractive errors &
low vision & onchocerciasis.
Ref: A K Khurana, 5th Edition, Page 205

Which is the most common cause of blindness in India?
A: Refractory errors
B: Cataract
C: Glaucoma
D: Trachoma
Correct Ans:B
Explanation
According to the NPCB survey 2001- 2002, cataract is the most common cause of blindness
(62.6%) in India.
Refractive errors account for the second most common (19.7%) case.
Glaucoma is the third most common cause (5.8%).
In developed countries 50% of all blindness is due to age related macular degeneration,
while another 10-20% each is because of glaucoma, diabetic retinopathy and cataract.
In developing countries, frequent causes are cataract, infectious diseases, xerophthalmia,
injuries, glaucoma and onchocerciasis.
Ref: Comprehensive Ophthalmology By AK Khurana, 4th Edition, Page 445
Which of the following is the MOST important factor in the prevention of the
endophthalmitis due to cataract surgery?
A: Preoperative preparation with povidone iodine
B:
One week antibiotic therapy prior to
surgery
C: Trimming of eyelashes
D: Use of intravitreal antibiotics
Correct Ans:A
Explanation

Clinical studies have proven that use of 5% povidone iodine cream to clean conjunctiva and
eyelids before cataract surgery has significant benefits in reducing the rate of
endophthalmitis. Therefore it should be applied to eyes before surgery to reduce the
incidence of endophthalmitis.
Studies have shown some efficacy of intracameral antibiotics in prevention of postoperative
endophthalmitis. The addition of gentamicin and vancomycin to the irrigating fluid during
phacoemulsification may result in significant reduction in the microbial contamination of
anterior chamber aspirates.
Ref: Modern Ophthalmology: The Highlights By Benjamin F. Boyd, page 273-4.
A 2 weeks old newborn is brought to the clinic with
complaints of vomiting and diarrhea. On examination she
appears to be jaundiced, shows hepatomegaly and bilateral
cataract.
Assertion: Child is showing features of Galactosemia which is an autosomal recessive disorder.
Reason: There is a deficiency of the enzyme Galactose 1 phosphate uridyl transferase which result in
accumulation of galactose 1 phosphate.
A: Both Assertion and Reason are true, and Reason is the correct explanation for Assertion
B:
Both Assertion and Reason are true, and Reason is not the
correct explanation for Assertion
C: Assertion is true, but Reason is false
D: Assertion is false, but Reason is true
Correct Ans:A
Explanation
Neonate in the question is showing features of galactosemia caused by deficiency of the
enzyme galactose 1 phosphate uridyl transferase. Deficiency of this enzyme result in
accumulation of galactose 1 phosphate. Neonates usually presents with vomiting, diarrhea,
failure to thrive and prolongation of physiologic jaundice. Examination shows evidence of
cataract and hepatomegaly.
Ref: Essentials of Paediatrics by OP Ghai, 6th Edition, Page 613.

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Previous year question on cataract based on neet pg, usmle, plab and fmge or mci screening exams