Rafi Ophthalmology- Questions &
Answers
A 32-year-old patient comes into your clinic saying that she noticed a difference in her pupil
sizes this morning when she was putting on her makeup. On examination, you confirm
anisocoria, with the right pupil being bigger than the normal left pupil. There is more than
0.5mm difference in pupil sizes.
The most likely cause of this presentation is?
There is no pathology
Sympathetic ganglionic pathology (Horner's syndrome)
Cranial nerve III (occulomotor nerve) palsy
Cranial nerve II (optic nerve) neuralgia" Correct Ans-Cranial nerve III (occulomotor nerve)
palsy
"
Joan O'Connell, a 28-year-old female, presents to A&E with a 2-month history of headache. She
reports that her headache is at its worse in the morning and that it wakes her up around 05:00
AM; she is usually nauseated at this time and has vomited once. Additionally, sneezing or
coughing precipitates her headache. She has also felt unusually tired over the last 2 months. She
is overweight, with a BMI of 31. Fundoscopy shows no papilloedema, but retinal venous
pulsations are absent. Her temperature is 37 oC and her inflammatory markers are normal.
Which of the following is the most appropriate next step?
,Advise weight loss
Brain MRI
Lumbar puncture
Prescribe propranolol
Empirical antibiotics Correct Ans-Brain MRI
Which of the following is least likely to cause a relative afferent pupillary defect (RAPD)?
Cataract
Advanced glaucoma
Total retinal detachment
Anterior ischaemic optic neuropathy
Optic neuritis Correct Ans-Cataract
A 40-year-old woman presents to her GP due to changes in her vision. She says that the vision in
her right eye has become progressively more cloudy over the past two weeks. She also describes
some pain in the right eye. On examination, she has a reduction in colour vision in her right eye.
Her visual acuity is normal. The light reflex in her right eye is slow, and she has a relative
afferent pupillary defect (RAPD).
What is the MOST likely cause of her problem?
,Optic neuritis
Giant cell arteritis
Dry macular degeneration
Central retinal artery occlusion
Wet macular degeneration Correct Ans-Optic neurtitis
A patient presents with diplopia. When asked to look straight ahead, his left eye is stuck looking
inferolaterally, the pupil is dilated and there is ipsilateral ptosis.
What is the most likely cause of this presentation?
Oculomotor nerve (CNIII) palsy
Horner's syndrome
Trochlear nerve (CNIV) palsy
Abducens nerve (CNVI) palsy" Correct Ans-Oculomotor nerve (CNIII) Palsy
"
A 50-year-old woman has a left corneal abrasion. When the left cornea is touched with cotton,
neither eye blinks. When the right cornea is touched with cotton, both eyes blink.
Selected the cranial nerve most likely to be affected.
CN II
, CN X
CN III
CN IV
CN VII
CN IX
CN I
CN V
CN VIII
CN VI Correct Ans-CN V
The colour of fluorescein staining in corneal ulcer is
Yellow
Blue
Green
Royal Blue" Correct Ans-Green
"
Which of the following organisms can penetrate intact corneal epithelium
Strep pyogenes
Staph aureus
Answers
A 32-year-old patient comes into your clinic saying that she noticed a difference in her pupil
sizes this morning when she was putting on her makeup. On examination, you confirm
anisocoria, with the right pupil being bigger than the normal left pupil. There is more than
0.5mm difference in pupil sizes.
The most likely cause of this presentation is?
There is no pathology
Sympathetic ganglionic pathology (Horner's syndrome)
Cranial nerve III (occulomotor nerve) palsy
Cranial nerve II (optic nerve) neuralgia" Correct Ans-Cranial nerve III (occulomotor nerve)
palsy
"
Joan O'Connell, a 28-year-old female, presents to A&E with a 2-month history of headache. She
reports that her headache is at its worse in the morning and that it wakes her up around 05:00
AM; she is usually nauseated at this time and has vomited once. Additionally, sneezing or
coughing precipitates her headache. She has also felt unusually tired over the last 2 months. She
is overweight, with a BMI of 31. Fundoscopy shows no papilloedema, but retinal venous
pulsations are absent. Her temperature is 37 oC and her inflammatory markers are normal.
Which of the following is the most appropriate next step?
,Advise weight loss
Brain MRI
Lumbar puncture
Prescribe propranolol
Empirical antibiotics Correct Ans-Brain MRI
Which of the following is least likely to cause a relative afferent pupillary defect (RAPD)?
Cataract
Advanced glaucoma
Total retinal detachment
Anterior ischaemic optic neuropathy
Optic neuritis Correct Ans-Cataract
A 40-year-old woman presents to her GP due to changes in her vision. She says that the vision in
her right eye has become progressively more cloudy over the past two weeks. She also describes
some pain in the right eye. On examination, she has a reduction in colour vision in her right eye.
Her visual acuity is normal. The light reflex in her right eye is slow, and she has a relative
afferent pupillary defect (RAPD).
What is the MOST likely cause of her problem?
,Optic neuritis
Giant cell arteritis
Dry macular degeneration
Central retinal artery occlusion
Wet macular degeneration Correct Ans-Optic neurtitis
A patient presents with diplopia. When asked to look straight ahead, his left eye is stuck looking
inferolaterally, the pupil is dilated and there is ipsilateral ptosis.
What is the most likely cause of this presentation?
Oculomotor nerve (CNIII) palsy
Horner's syndrome
Trochlear nerve (CNIV) palsy
Abducens nerve (CNVI) palsy" Correct Ans-Oculomotor nerve (CNIII) Palsy
"
A 50-year-old woman has a left corneal abrasion. When the left cornea is touched with cotton,
neither eye blinks. When the right cornea is touched with cotton, both eyes blink.
Selected the cranial nerve most likely to be affected.
CN II
, CN X
CN III
CN IV
CN VII
CN IX
CN I
CN V
CN VIII
CN VI Correct Ans-CN V
The colour of fluorescein staining in corneal ulcer is
Yellow
Blue
Green
Royal Blue" Correct Ans-Green
"
Which of the following organisms can penetrate intact corneal epithelium
Strep pyogenes
Staph aureus
