250+ High Frequency Multiple Choice Questions (MCQs) in Optometry and Ophthalmology

Multiple Choice Questions (MCQs) in Optometry and Ophthalmology

Well,  if you are a recent graduate of optometry (and or vision science), PCL ophthalmic science or ophthalmology; and if you are thinking of upgrading your career, then you are at the right place. Please go through each question and practice similar questions more. Hence this page is dedicated to career-oriented optometrists, ophthalmic assistants and ophthalmologists who want to refresh their knowledge in core theories of ophthalmology and optometry.

Who will be benefited by reading this MCQs in Optometry and Ophthalmology?

It will benefit those who-

a)            are appearing in licensing examination of pertinent council (health professional council,  optometry council or medical council)

b)           are appearing in the entrance examination for Master of Optometry

c)            are fighting for an optometry job, ophthalmic assistant job or ophthalmology job and have to appear in a competitive written examinations (for example: eye hospitals, Nepal Army, Nepal police, Lok Sewa Ayog, etc)

d)           All types examinations in the field of eye care that encompasses MCQs

e)            Viva voce examinations of Ophthalmic Assistants, Optometrists and Ophthalmologists

My advice: first go through the questions serially from question number one and try to answer them by writing the correct answer (that you think) in a separate paper. And after finishing, you can compare your answers with the ones given at the end of this page. You have to go to the specific textbook to look for the explanation so that you will be able to answer similar questions in the given contexts.

Rabindra Adhikary
These MCQs are prepared by Rabindra Adhikary

1.            Excimer laser is used in

a)            LASIK

b)           LASEK

c)            PRK

d)           All

2.            IOL Master uses the principle of

a)            Ultrasound

b)           Coherence Interferometry

c)            Linear Polarization

d)           Fraunhofer Diffraction

3.            Power of Prism mostly depends upon

a)            Media in which it is kept

b)           Angle

c)            Thickness

d)           All

4.            The correct one about Stenopic slit is

a)            Used to assess the site for optical PI in corneal opacity

b)           Works on the principle of Prism

c)            The rays of light are limited on the meridian perpendicular to the axis of slit

d)           All

5.            World Sight Day is celebrated on:

a)            2nd Thursday of October each year

b)           2nd Thursday of October alternate year

c)            2nd Wednesday of October each year

d)           2nd Wednesday of October alternate year

6.            Human Crystalline lens develops from

a)            Neuro-ectoderm

b)           Surface ectoderm

c)            Mesenchyme

d)           Mesoderm

7.            The latest version of disease classification system developed by WHO is

a)            ICD-8

b)           ICD-9

c)            ICD-10

d)           ICD-11

8.            The longest part of optic nerve is

a)            Intra-ocular

b)           Intra-orbital

c)            Intra-cranial

d)           Intra-canalicular

9.            Which of the following is true about cortical blindness except

a)            Pupillary Light Reflex is intact

b)           Funduscopy reveals normal finding

c)            VEP can be used as the accurate diagnostic test

d)           Afferent pathway not affected

10.       Onset of presbyopia depends upon all except

a)            Refractive error

b)           Pupil size

c)            Ciliary tone

d)           AC Depth

11.       The co-efficient of correlation lies between

a)            0 to 1

b)           -1 to 0

c)            +1 to -1

d)           +0.5 to -0.5

12.       In axial myopia

a)            Posterior staphyloma is associated

b)            Rays of light focused beyond retina

c)            No risk of progressive retinal degeneration

d)           Yielding of the elastic membrane of the sclera

13.       ERG b-wave amplitude is reduced in

a)            Oguchi’s Disease

b)           Punctata Albicans

c)            Diabetic

d)           Optic Atrophy

14.       Gender (male/female) is which entity?

a)            Nominal

b)           Ordinal

c)            Cardinal

d)           Interval

15.       IOL power is increased if

a)            Corneal curvature increases and axial length is increases

b)           Corneal curvature increases and axial length decreases

c)            Corneal curvature decreases and axial length decreases

d)           Corneal curvature decreases and axial length increases

16.       Contrast sensitivity peaks at

a)            2 cycles/degree

b)           3 cycles/degree

c)            3.5 cycles/degree

d)           4 cycles/degree

17.       Which of the following is a parametric test?

a)            Chi-square test

b)           The Kruskal Wallis test

c)            Wilcoxon Signed Rank test

d)           t-test

18.       Prism produces……………image

a)            Erect

b)           Laterally inverted

c)            Virtual

d)           Shifted towards its base

19.       The change in stimuli perception from scotopic vision condition to photopic vision condition is best explained by

a)            Purkinje Shift

b)           Photochromatic interval

c)            Visual adaptation

d)           Biphasic threshold

20.       A case of Retinitis Pigmentosa might be best benefitted by

a)            Field expanding channel lenses

b)           Corning Photochromatic Filters

c)            Telemicroscope

d)           CCTV

21.       Blue end of visible light causes

a)            Photoophthalmia

b)           Maculopathy

c)            Corneal burns

d)           Xanthelasma

22.       The prism used in the slit lamp to make the inverted image erect is

a)            Internal doubling prism

b)           Porro Abbe prism

c)            Integrated Fresnel Prism

d)           Reflective polyhedral prism

23.       Choose the wrong about the range of wavelength

a)            UVC 220-280 nm

b)           UVB 280-315

c)            UVA 315-400 nm

d)           IR A 780-3000 nm

24.       Public health does not deal with………..care

a)            Promotive

b)           Rehabilitative

c)            Curative

d)           Preventive

25.       One is regarded as Basement’s membrane

a)            Bowman’s layer

b)           Stroma

c)            Descement’s membrane

d)           Retinal pigment epithelium

26.       The contact lens seems loose and rides high while blinking on slit lamp examination. With the diameter constant, altering which of the following parameters do we obtain an optimal fit?

a)            Lens thickness increase

b)           BOZR decrease

c)            Peripheral optic zone decrease

d)           Oxygen permeability increase

27.       The image formed by reflection of light

a)            Dioptric

b)           Catoptric

c)            Rectilinear

d)           Both b and c

28.       Of the four Purkinje-Sanson’s  image, which one is inverted?

a)            P1

b)           P2

c)            P3

d)           P4

29.       In orbital trauma the bone most likely to be damaged is

a)            Lateral Zygomatic

b)           Orbital floor of maxillary

c)            Nasal

d)           Ethmoid

30.       Diplopia is permitted in

a)            If retinal disparity is not within Panum’s Fusional area

b)           ARC

c)            Eccentric fixation

d)           All

31.       ……assist a low vision patient

a)            Anomaloscope

b)           Typoscope

c)            Periscope

d)           Orthoscope

32.       Lea Grating chart is a………acuity

a)            Recognition

b)           Forced Preferential looking

c)            Resolution

d)           OKN

33.       Full form of RAAB is

a)            Rapid Assessment of Avoidable Blindness

b)           Re Assessment of Avoidable Blindness

c)            Random Assessment of Avoidable Blindness

d)           Revised Assessment of Avoidable Blindness


34.       False about Hess Charting

a)            Performed at 135 cm

b)           Red-green goggles are better than red-green glasses

c)            Follows Herring’s and Sherrington’s law

d)           25 test points

35.       The luminous efficiency of human eye is maximum at

a)            500nm

b)           550 nm

c)            650 nm

d)           700 nm

36.       One is incorrect about children’s vision test

a)            CSM is recorded for children 1 year or above

b)           Cardiff acuity test consists of vanishing optotypes

c)            At birth a child has 3/60 VA

d)           Teller Acuity is modified form of preferential looking

37.       Which of the following is not included under occupational care of optometry

a)            Workplace survey

b)           Vision screening

c)            Steps in implementation of program

d)           Epidemiological survey

38.       Father of Modern optometry is

a)            Theodore Grosvenor

b)           Charles Prentice

c)            Irvin Borish

d)           Gunter K von Noorden

39.       Spasmus Nutans is not characterized by

a)            Jerky nystagmus

b)           Torticolis

c)            Fades away as child grows

d)           Thiamine and Iron deficiency

40.       The angle between the line of direction from fovea to the anomalously fixated point in retina is

a)            Objective angle

b)           Subjective angle

c)            Angle of anomaly

d)           Angle kappa

41.       In JCC, the axis of Jackson cylinder is held ……to the axis of correcting cylinder while refining the cylindrical axis   

a)            45 degree

b)           90 degree

c)            135 degree

d)           Both a & c

42.       A patient complains that the reading materials appear distorted when looking through a hand magnifier. Which of the following do you think is responsible for this complaint?

a)            The patient maybe holding the reading material farther than the focal length of the magnifying lens

b)           The magnifying lens might be held at an incorrect angle to the reading material

c)            The magnifying lens maybe of poor quality

d)           All

43.       The new born baby does not have………color perception

a)            Red

b)           Green

c)            Blue

d)           All

44.       The industrial safety standards advise which materials to be used?

a)            CR-39

b)           Ophthalmic Flint

c)            Polycarbonate

d)           PMMA

45.       In dendritic keratitis, …………ointment acyclovir is applied

a)            3%, 3 times

b)           5%, 5 times

c)            3%, 5 times

d)           5%, 3 times

46.       Light

a)            Is a wave

b)           Is an energy

c)            Propagates transversely

d)           All

47.       Which of the following property of image is not possible when formed by convex lens?

a)            Real, inverted

b)           Real, upright

c)            Virtual, inverted

d)           Virtual, upright

48.       Prevalence of cataract in a city is based estimated by…….study

a)            Cohort

b)           Cross-sectional

c)            Longitudinal

d)           Case-control

49.       For a sportswear, prescription glass should pass

a)            ANSI z87.1

b)           0.25 ounce drop ball test

c)            ASTM F803

d)           All

50.       Neutral density filters allow

a)            Long wavelength

b)           Short wavelength

c)            Broad spectrum

d)           Narrow spectrum

51.       In PDR, there should be

a)            Cotton wool spot

b)           IRMA

c)            Rubeosis

d)           Neovascularization

52.       In 24-2 program of Humphrey field analyzer, total points tested are

a)            54

b)           72

c)            76

d)           48

53.       Unit of Dk/t is

a)            Cm2 ml O2/sec.ml mmHg

b)           Cm ml O2 / sec. ml mmHg

c)            Cm ml O2 sec / ml mmHg

d)           Cm ml O2 mmHg / sec ml

54.       Which sampling is appropriate for a homogenous population?

a)            Systematic

b)           Simple random

c)            Purposive

d)           Stratified

55.       Koeppe’s nodule is found in

a)            Choroid

b)           Ciliary body

c)            Iris

d)           Eyelids

56.       In OCT the high reflectivity is obtained from……….layer

a)            Outer plexiform

b)           Inner Nuclear

c)            Nerve fiber layer

d)           Internal limiting membrane

57.       Most common stabilization technique for soft toric

a)            Double truncation with peripheral slab off

b)            Prism ballasting with superior shifting of optical center

c)            Single truncation with dynamic stabilization

d)           Double slab off with periballast

58.       Which is not altitude based scanning of cornea?

a)            ORBSCAN

b)           Pantacam

c)            Oculyzer

d)           Videokeratographer

59.       An object is placed 45 cm ahead of a diverging lens of focal length 15 cm. Which is correct?

a)            Image distance=11.24, M=4

b)           Image distance=-11.25, M=0.25

c)            Image distance=22.5, M=2

d)           Image distance=-22.5, M=0.5

60.       Which parameter of light remains constant when a light enters another medium from the first of any?

a)            Wavelength

b)           Velocity

c)            Frequency

d)           Color

61.       B Scan means

a)            Frequency scan

b)           Brightness scan

c)            Axial scan

d)           Mode scan

62.       The second most common cause of blindness in the world

a)            Diabetic retinopathy

b)           Glaucoma

c)            Onchocerciasis

d)           Age related macular degenerations

63.       Most reliable method of Gonioscopy includes…..lens

a)            Koeppe

b)           Barkan

c)            Goldman

d)           4 mirror

64.       The add required for a 40 year old with working distance <30cm

a)            +0.75 D

b)           +1 D

c)            +1.25 D

d)           +1.5 D

65.       Contrast sensitivity is fully developed at

a)            3 months

b)           6 months

c)            9 months

d)           12 months

66.       A patient comes with the splashing of detergent in the eyes. After thorough wash, you see punctuate keratopathy with NO epithelial defect. Which treatment protocol would you like to follow?

a)            Topical antibiotic with analgesia

b)           Topical antibiotic, steroid with analgesia

c)            Topical potassium citrate with analgesia

d)           Topical potassium ascorbate with lubricants

67.       Which one does have hereditary correlation

a)            Green color defect

b)           Blue Defect

c)            Red defect

d)           All

68.       1M letter subtends 5 degree angle at the nodal point of eye when the object of regard is kept at

a)            40 cm

b)           1m

c)            5m

d)           25 cm

69.       …………is not a low vision aid

a)            Text scanner

b)           Plus plano cylinder

c)            Concave mirror

d)           Channel lenses

70.       The illuminance of the room while using computer should be

a)            50 lux

b)           100-200 lux

c)            300-500 lux

d)           500-700 lux

71.       A person wears +4 D spherical spectacles but his glasses are pantoscopically tilted by 10 degrees. Which is false?

a)            The optical center should have been shifted lower by 5 mm

b)           The tilt will develop a plus cylinder whose axis will be at 180 degrees

c)            The effective spherical power will be less than +4 D

d)           None

72.       The first field defect in POAG

a)            Isolated nasal scotima

b)           Bjerrum’s scotoma

c)            Arcuate Scotoma

d)           Ring Scotoma

73.       The action of superior oblique is best explained by

a)            Abduction, elevation, extorsion

b)           Adduction, elevation, intorsion

c)            Abduction, depression, intorsion

d)           Abduction, depression, extorsion

74.       The cycloplegic effect of tropicamide would last

a)            30-45 min

b)           45- 90 min

c)            2-4 hours

d)           6 hours

75.       Disc edema is observed in all except

a)            Papillitis

b)           CRVO

c)            BRVO

d)           Neovascular Glaucoma

76.       Metamorphopsia is demonstrated best in……char  of Amsler Grid

a)            Chart 2

b)           Chart 5

c)            Chart 6

d)           Both b and c

77.       In Amsler chart 1, each square will constitute ……degree of visual field

a)            0.5

b)           1

c)            2

d)           10

78.       In divergence excess type of exodeviation, one among all is false

a)            High AC/A ratio

b)           Normal near point of convergence

c)            Normal near point of accommodation

d)           Near exo= 25 prism, far exo= 10

79.       What percentage of cyclepentolate is recommended in the cycleplegic refraction of a young child more than 3 years old?

a)            0.25%

b)           0.5%

c)            1%

d)           2%

80.       A 53 year old male has been wearing add +1.75Ds. He has no distance error. He complains of slight difficulty reading small prints. What changes would he have to make if he wanted to see clearly with the same diopters?

a)            Use a progressives of same prescription in a hard design

b)           Use the lenses to fit into separate frame so that segment height is slightly elevated

c)            Move the glasses away from the corneal apex thereby increasing the vertex distance

d)           Use the low powered hand magnifier when needed

81.       The disadvantage of monovision fitting of contact lens in presbyopia instead of bifocal contact lens is

a)            Loss of stereopsis

b)           Dizziness and headache until adaptation

c)            Relative loss of contrast

d)           Reduced field of view

82.       All are signs of anterior uveitis except

a)            Reduced VA

b)           Miosis

c)            Circum-ciliary injection

d)           Papillae

83.       The test of Psychophysical test does not include

a)            Visual Acuity

b)           Color Vision

c)            Contrast sensitivity

d)           VEP

84.       Third Nerve Palsy is best demonstrated by

a)            Ptosis, diplopia and esodeviation

b)           Ptosis, mydriasis and exodeviation

c)            Ptosis, miosis and exodeviation

d)           Diplopia, exodeviation and miosis

85.       All are used for binocular vision test except

a)            WFD test

b)           Anaglyph

c)            Maddox rod

d)           Duochrome test

86.       Bilateral superior oblique muscle palsy is elucidated by all except

a)            V pattern

b)           Bielshowsky head tilt test positive

c)            Spontaneous torsional diplopia

d)           Associated history of trauma

87.       In thyroid ophthalmopathy there is NOT

a)            Proptosis

b)           Ptosis

c)            Thickening of orbital tissues

d)           Restriction in eye movement

88.       DRS type II is characterized by all except

a)            Marcus jaw winking

b)           Crocodile tears

c)            Retraction of the eyeball as the eye moves inward

d)           Poor abduction, good adduction

89.       Which color vision is hereditary in nature

a)            Red

b)           Green

c)            Blue

d)           All

90.       Nepal government signed the global initiative vision 2020 the right to sight in

a)            1998

b)           1999

c)            2000

d)           2001

91.       Optotypes of ETDRS contrast charts have

a)            Gradual progression of 5/4 ratio

b)           0.1 log unit larger than the ones in the preceding line

c)            Charts can only be used either 2m or 4m

d)           Non-sheriff consistent number of letters

92.       In GAT, 4D of corneal astigmatism bring about the change in IOP error by

a)            1 mmofHg

b)           2 mm of Hg

c)            3 mm of HG

d)           4 mm of Hg

93.       World optometry day is observed in

a)            22 March

b)           23 March

c)            24 March

d)           25 March

94.       Glaucoma has the essential feature of

a)            Raised intra-ocular pressure

b)           Associated family history

c)            Visual field defect

d)           Tunnel vision

95.       Which of the following telescopes has the largest exit pupil

a)            7x50

b)           8x35

c)            10x20

d)           10x40

96.       In Bruckner test, the affected eye

a)            shines with dull, red reflex

b)           shines with bright, red reflex

c)            shines with dim, yellow reflex

d)           shines with bright, yellow reflex

97.       In which condition B Scan is suggested even if the media is clear?

a)            Absolute glaucoma with NPL vision

b)           Retrobulbar neuritis

c)            Retinal detachment

d)           Macular hole

98.       Piezo-electric crystals are used in

a)            Biometric probe

b)           Pneumatic Tonometer

c)            B scan transducer

d)           Ultrasonic pachymeter

99.       The removal of ocular structures with the sclera and extraocular muscle remaining in situ is

a)            Enucleation

b)           Exenteration

c)            Evisceration

d)           Orbitotomy

100.  With regard to pin-hole, one is FALSE

a)            The vision through the pinhole is usually worse in patient with macular disease

b)           It may allow presbyopic patients to read comfortably without optical correction

c)            Failure of the vision to improve to 6/6 with pinhole indicates the presence of macular disease

d)           Too small a pinhole can affect vision through interference

101.  Spot of stationary light fades away due to the retinal bleaching is described by

a)            Broca-Sulzer Effect

b)           Troxler effect

c)            Bruckner Belzowsky effect

d)           None

102.  Saccadic motion to the left involves…..as agonist

a)            Left medial rectus

b)           Right lateral rectus

c)            Left lateral rectus

d)           Both lateral recti

103.  Age related changes in the eye encompass all except

a)            Syneresis

b)           Dermatochalasis

c)            Xanthelasma

d)           Mesopia at higher level of ambient luminance

104.  The exact anatomic location of intra-ocular lens to be implanted is

a)            Zonular fossa

b)           Capsular bag

c)            Intracapsular bag

d)           Vitreous cavity

105.  The prismatic effect when a +5Ds lens is decentered by 10mm is……prism diopter

a)            50

b)           0.5

c)            5

d)           2

106.  Specular microscopy visualizes mosaic pattern of

a)            Epithelium

b)           Endothelium

c)            Bowman’s layer

d)           Descemet’s membrane

107.  The donated cornea is cryopreserved in M-K medium at…..degree Celsius

a)            Less than 0

b)           2-8

c)            10-25

d)           28-37

108.  Hypopyon is the

a)            Blood in the AC

b)           Foreign body in the AC

c)            Pus in the AC

d)           Flares in the AC

109.  In case of Anisometropia,

a)            Of more than 1D in hyperopic patients can usually be controlled through accommodation of the more hypermetropic eye

b)           Is a common cause of amblyopia in patients with uncorrected low myopia

c)            Of recent onset may be caused by development of posterior subcapsular cataract

d)           May result from unilateral central serous retinopathy

110.  Patient with significant peripheral visual field loss may not be relieved from

a)            Prism with base towards the area of visual field loss

b)           Mirror mounted on glasses

c)            Galilean telescope

d)           Concave lens

111.  All are tests of Eikonometry except

a)            Turville Test

b)           Brecher’s Procedure

c)            Horizontal Miles Procedures

d)           Forced duction test

112.  Hiedelberg’s Retinal tomography uses

a)            Lasers

b)           Infrared

c)            Neons

d)           Halogens

113.  A patient has -3..00/-3.00 x 180 spectacle Rx. A trial toric of -3.3/-3.00 x 170 is selected to observe right hand side rotation with respect to the patient by 10 degrees. The final power of the prescriptions, provided all other things are constant, is:

a)            -3.00/-3.00 x 10

b)           -3.00/-2.5 x 10

c)            -3.00/-3.00 x 160

d)           -3.00/-2.5 x 180

114.  The materials used in making prosthetic eye

a)            Plasters of Paris

b)           Hydroxy-appetites

c)            Alginates

d)           Borro-sillicates

115.  A 5ml vial of an ophthalmic drug contains……drops of medicines

a)            50-60

b)           80-90

c)            110-120

d)           140-150

116.  The pH value of human healthy tear is

a)            6.5

b)           6.8

c)            7.1

d)           7.4

117.  Which of the following drug has been recently postulated to be effective for the reversal of crystalline aggregation and cataract formation?

a)            Cholecalciferol

b)           Lanosterol

c)            Inositol

d)           Fludrocortisol

118.  The first antibiotic that was discovered by humankind acted against which of the following bacterial mechanism

a)            Protein Synthesis

b)           DNA Synthesis

c)            Cell wall synthesis

d)           Folic Acid synthesis

119. First order neuron is defined by

a)            Horizontal cells

b)           Retinal Bipolar Cells

c)            Retinal Ganglion Cells

d)           Amacrine cells

120. Pie in the sky defect in the visual field is seen when a lesion affects

a)            Medullary optic lamina of optic radiation

b)           Visuopsychic peristriate area 18

c)            Mayer's Loop

d)           Dorsolateral aspect of optic tract

121. A man has central corneal thickness of 542 μm in the right eye with IOP 22 mmHg. Keeping all other parameters constant, what would be the predicted IOP if his right eye would have measured 522 μm in pachymetry?

a)            20 mmHg

b)           21 mmHg

c)            23mmHg

d)           24 mmHg

122. The geometrical shape of a normative adult cornea can best be described as

a)            Prolate Ellipsoid

b)           Oblate Ellipsoid

c)            Prolate Spheroid

d)           Oblate Spheroid

123. Due to an acquired retinal disease a person's visual condition was so worse that he is diagnosed to fall under low vision criteria. He undergoes a sequential psychological process in the order as:

a)            Denial, anger, depression, bargaining, acceptance

b)           Denial, bargaining, anger, depression, acceptance

c)            Denial, bargaining, anger, acceptance, finding meaning

d)           Denial, anger, bargaining, depression, acceptance

124. Which are the FOUR original guiding principles for optometry profession stated by Beauchamp and Childress ?

a)            Beneficence, justice, respect of autonomy, non-maleficience

b)           Beneficence, justice, respect of autonomy, confidentiality

c)            Beneficence, justice, non-maleficience, collegiality

d)           Beneficience, justice, respect of autonomy, protecting the vulnerable

125. A monochromatic light comes from a source kept at 50 cm from a convex lens of 10 diopters. The approximate optical path distance between object and image if this phenomenon occurs in air:

a) 40 cm

b) 60 cm

c)80 cm

d) 100 cm

126. The critical cut-off value of corneal thickness to determine whether to go for a refractive LASIK surgery is

a) 470

b) 500

c) 530

d) 550

127. Of all below, one falls under low order aberrations

a) Spherical aberration

b) Secondary astigmatism

c) Coma

d) Piston

128. The correctional mechanism against the lag of target to position on fovea is called

a) Vestibular reflex

b) Version

c) Saccade

d) Pursuit

129. All of the following represent a form of adaptation to neurogenic palsy of extra-ocular muscles. Odd one out:

a) Amblyopia

b) Supression

c) Torticollis

d) Abnormal Retinal Correspondence

130. Which of the following is not responsible for reduced corneal sensation?

a) Neurotrophic keratitis

b) Fungal corneal ulcer

c) Penetrating Keratoplasty

d) Hansen's Disease


131. Mechanical obstruction in ocular motility cannot be diagnosed by

a) Forced duction test

b) Hess charting

c) Force generation test

d) Positional tonometry

132. Bacteria that cannot break into the intact cornea

a) Corneybacteerium diptheriae

b) Neisseria gonorrhoeae

c) Streptococcus hemolyticus

d)Nesseria mengitidis

133. The classical triad of Horner's syndrome is

a) Mydriasis, ptosis and anhidrosis

b) Miosis, proptosis and anhidrosis

c) Miosis, ptosis and anhidrosis

d) Anisocorea, proptosis and anhidrosis

134. Mettendorf's dots are found in

a) iris

b) lens

c) lens capsule

d) vitreous

135. The viewing of anterior chamber structures is possible if the rays of light coming from the angle strikes the line normal to cornea at

a) 420

b) 460

c) 500

d) 540

136. Which one of the following would you prioritize as ocular emergency?

a) Corneal Abrasion

b) Hyphema

c) Macular Edema

d) orbital cellulitis

137. Cotton wool spots as seen in diabetic retinopathy lies in which layer of retina?

a) Internal Limiting Membrane

b) Nerve fiber layer

c) Outer Plexiform Layer

d) Pigment Epithelial layer

138. The clinical presentation of CRVO is most often seen in ……..retina

a) Infero-nasal

b) Infero-temporal

c) supero-nasal

d) supero-temporal

139. Dilation of pupil while going in the dark demonstrate the integrity of

a) Afferent Pathway

b)Efferent Pathway

c) Sympathetic Pathway

d) Parasympathetic Pathway

140. One is false about Ishihara Pseudo-isochromatic plates

a) It consists of 4 types of diagnostic plates: vanishing, transformation, hidden-digit, and qualitatively diagnostic.

b) The only systematic difference between the figure and background dots is in color: the figure is composed of dots of one or more colors, and the background is composed of dots of different color or colors.

c) The failure to read even the diagnostic plate is a sign of non-physiologic visual loss

d) Minimum distance BCVA required in order for the reliable results is 6/18

141. In a before-and-after study design, the effect that brings about the error in outcome variable when the measurement time after the treatment is significantly delayed is called

a) Regression effect

b) Hawthorne effect

c) Maturation effect

d) Reactive effect

142. Which of the following drug acts by inhibiting protein synthesis of micro-organism?

a) Ciprofloxacin

b) Chloramphenicol

c) Natamycin

d) Acyclovir

143. Odd one out about an ideal artificial tear substitute

a) should lower the surface tension of the tear film

b) should be preservative-free if intended for use by patients who require frequent instillation

c) pH does not account much as long as it is isotonic at 300 m Osm/L

d) should aid in the formation of a hydrophilic layer that is compatible with adsorbed mucin and enhance tear volume

144. One with the lowest index of refraction is

a) Ophthalmic Flint

b) Ophthalmic Crown

c) Polycarbonate

d) Columbia Resin


145. A +3.50 Ds hypermetrope has a near point that is 50cm from her cornea when she is not wearing her spectacles. With her spectacles (vertex distance 15mm) on, how far from her cornea is her near point now located?

a) Infinity

b) 67.7 cm

c) 33.3 cm

d) None

146. What is the spectacle magnification of a spectacle lens of back vertex power -5.00Ds refractive index 1.523 and center thickness 4.0mm) made with a front surface power if +5.00Ds and placed 13 mm from the cornea?

a) 0.95

b) 0.07

c) 2.35

d) 1.03


147. One is false about the normal distribution curve

a) standard normal variate implies how many standard deviation away is the given point from the mean

b) mean, median and mode all lie on a single plane which divides the curve into mirror halves

c) Within one standard deviation interval, there is 68.26% of sample population

d) The maximum probability of a sample being selected on a random picking is at three standard deviation away from mean


148. one is not a RGP complication

a) Residual refractive error

b) Dimple veling

c) Lens flexure

d) Ptosis


149. Principle of wavefront aberration finds the clinical utility in

a) refractive and cataract surgeries

b) understanding to minimize coma and secondary astigmatism

c) correcting the piston

d) designing wavefront-guided progressive lenses to counter high order aberrations


150. which method of lamellar corneal transplant is most common in Nepal?

a)  SALK




151. Which of the following part of the eye is not transparent?

a)            Cornea

b)           Conjunctiva

c)            Lens

d)           Iris


152. The portion that connects eye to the brain is

a)            Retina

b)           Choroid

c)            Optic Nerve

d)           Sclera


153. The resolving power of the eye is called

a)  vision

b) visual acuity

c) eye capacity

d) color vision


154. When presenting visual acuity of a patient is 6/18, we call it

a) mild visual impairment

b) moderate visual impairment

c) low vision

d) severe visual impairment


155. The person is said to be blind when visual acuity is……in the better seeing eye

a) less than 6/60

b) less than 3/60

c) less than 1/60

d) not perceiving the light


156. the chart used to assess the visual acuity is

a) Ishihara Chart

b) Near Acuity chart

c) Snellen’s chart

d) Pelli-Robson chart


157. Most common ocular disease that causes blindness in Nepal is

a) High power

b) glaucoma

c) cataract

d) trauma


158. The treatment option for low vision is

a) refractive error correction

b) surgery

c) rehabilitation

d) medicines


159. The cause of deafblind condition is mostly

a) due to trauma

b) congenital

c) viewing eclipse

d) ear infection & sinusitis


160. Leukocorea is

a) childhood condition which can be seen through torch light

b) white pupil in one or both eye

c) a condition that warrants referral to eye hospital soon as possible

d) all of above

161. All of the following are the important Zernike's coefficients affecting visual quality except

a) coma

b) spherical aberration

c) Oblique Astigmatism

d) Trefoil

162. one is false

a) Compared with shapes derived from Zernike polynomial analysis, the shapes derived from Fourier analysis are more detailed, theoretically allowing for the measurement and treatment of more highly aberrant corneas.

b) Myopia, hyperopia, and regular astigmatism are all lower-order (second-order) aberrations

that can be expressed as wavefront aberrations

c) Myopia produces negative defocus while hyperopia produces positive defocus.

d) Regular (cylindrical) astigmatism produces a wavefront aberration that has orthogonal and oblique components


163. The underlying main cause of night myopia is

a) induced accommodation

b) spherical aberration

c) Increased depth of field

d) decreased contrast sensitivity


164. Nine diopters of myopia is to be corrected for the optical zone diameter of 3 mm.  The excimer laser photoablation depth should be

a) 9 micron

b) 27 micron

c) 81 micron

d) none


165. Which one of the following causes of irregular astigmatism is self-reversible?

a) Keratoconus

b) Toric IOL rotation

c) corneal warpage due to RGP

d) Pellucid marginal degeneration


166. The hallmark sign of proliferative diabetic retinopathy is

a) Rubeosis Irides

b) Cotton wool spots

c) Neovascularization

d) Micro-aneurysm


167. Advanced diabetic eye disease is a vision threatening condition most probably due to

a) Macular Edema

b) Cataract

c) Retinal Detachment

d) retinal arterial abnormalities


168. The relative shift in refractive error is a commonly observed clinical phenomenon in


b) Rubella

c) Hypertension

d) Diabetes mellitus


169. Vitamin A deficiency dry eye is termed as

a) Keratoconjunctivitis Sicca (KCS)

b) Xerosis

c) Xerophthalmia

d) Sjogren Syndrome


170. The role of vitamin A in eye is

a) Synthesis of photoreceptor proteins

b) Maintain the transparency of ocular media

c) Facilitate in the focusing mechanism of lens

d) Act as effective anti-oxidant agent


171. One of the following is strictly a corneal sign of Vitamin A deficiency

 a) Keratinization

b) Xerosis

c) Keratomalacia

d) Nyctalopia


172. The most commonly affected extra-ocular muscle in thyroid eye disease is

a) Lateral Rectus

b) Inferior Rectus

c) Medial Rectus

d) Inferior Oblique

Answer b) Inferior Rectus


173. In thyroid eye disease, all of the following can be ocular signs EXCEPT

a) Lid lag on lower gaze

b) Lid retraction

c) staring or bulging eyes

d) convergence excess


174. A 37 year old lady underwent ocular examination and there was clear signs of anterior granulomatous uveits. Which of the following disease would you presume if this uveitis has a systemic association? 

a) Hashimoto's disease or thyroiditis

b) Diabetes Mellitus

c) Leprosy or Hansen's disease  

d) Xeophthalmia



175. Which of the following bacterial species can readily and vigorously invade intact cornea?

a) Neisseria gonorrhoeae

b) Corynebacterium diptheriae

c) Corynebacterium xerosis

d) Neisseria meningitidis


176. Which of the following correctly describes the retinal signs of hypertensive eye disease?

a) Focal arteriolar narrowing, venous outpouchings, copper wiring

b) Arteriovenous nipping, tomato-splashed appearance, edema

c) arteriosclerosis, flame-shaped hemorrhage, optic disc swelling

d) Genaralized arteriolar narrowing, hard exudates, Hollenhorst plaques


177. All of the infections can be vertically transmitted to a newborn child EXCEPT?

a) Toxoplasmosis

b) Rubella

c) Syphillis

d) Gonorrhea


178. Feature of congenital rubella syndrome

a) cataract

b) Aniridia

c) Big eyes

d) Exotropia


179. Treatment option for diabetic eye disease

a) Medical therapy

b) surgical therapy

c) laser therapy

d) All of the above


180. HIV/AIDS most commonly affects the human eye in

a) cornea

b) lens

c) retina

d) optic nerve


181. One of the following is a binocular eye movement

a)            Extortion

b)           Depression

c)            Dextroversion

d)           Abduction


182. The primary function of superior oblique muscle is

a)            Intortion

b)           Depression

c)            Elevation

d)           Abduction


183. Sixth cranial nerve supplies which extra-ocular muscle?

a)            Levator palpebral superioris

b)           Lateral Rectus

c)            Superior Oblique

d)           Inferior Oblique


184. Magnitude of tropia can be found by

a)            Cover test

b)           Alternate cover test

c)            Prism Cover test

d)           Cover Uncover test


185. Which one is monocular phenomenon?

a)            Eccentric Fixation

b)           Anomalous correspondence

c)            Suppression

d)           Stereopsis


186. In Hirschberg corneal reflection test, each 1 mm of decentration of the corneal reflection roughly corresponds to……..of deviation of visual axis


b)           15°

c)            30°

d)           45°


187. Krimsky test needs

e)            Trial Frame

f)             Prism

g)            Maddox rod

h)           Synoptophore


188. The unit of measurement of convergence is

a)            Arc meter

b)           Meter diopter

c)            Meter angle

d)           Radian diopter


189. Suppression is a sensory adaptation to avoid

a)            Asthenopia

b)           Aniseikonia

c)            binocular rivalry

d)           diplopia


190. The four prism diopter base out test is a clinical test for

a)            simultaneous macular perception

b)           Small suppression scotoma

c)            Anomalous retinal correspondence

d)           Functional Amblyopia


191. Stereopsis is tested by

a)            stereogram

b)           haploscope

c)            Ishihara Chart

d)           Wesson Card


192. Stimulus to accommodation is

a)            diplopia

b)           ghost image

c)            blur

d)           nearness


193. Accommodative facility can be clinically measured by

a)            prism flippers

b)           Jackson cross cylinder

c)            Minus lens

d)           Lens flippers


194. Age related physiological decrease in accommodation leads to

a)            presbyopia

b)           plus power

c)            Accommodative excess

d)           Pseudomyopia


195. Gross test of convergence can be done by

a)            torch and pencil

b)           pencil and scale

c)            Occluder and target

d)           torch and occluder


196. The keratometry reading of a myopic eye of 5 Diopters is 43 Diopters and 41 Diopters horizontally and vertically respectively. What is the expected average k-reading after refractive surgery in general?
              a) 38
              b) 40
              c) 41
              d) 45

197. The typical irregular against-the-rule astigmatism in which the topographic steepening nasally and temporally connects inferiorly is seen in

             a) Keratoconus

            b) Post-pk

            c) PMD

            d) Keratoglobus


198. One thing is true about the Maddox wing:

a.            Certain time should be given to the patient to allow the binocular dissociation

b.            This can be employed to measure the deviation both for near and distance

c.             It cannot measure the latent cyclo-deviations

d.            Works well even if the patient has anomalous retinal correspondence


199. Fluorophotometry is an useful measure of

a)            the pattern of sodium fluorescein in RGP fitting

b)           the expulsion of post-lens tear volume in Silicone hydrogels

c)            tear exchange in hydrogel soft lenses

d)           movement of debris and metabolites in pre-corneal tear film


200. According to Holden and Mertz criteria, hydrogel lens with the critical oxygen transmissibility of 87.0 ± 3.3 x 1-9 (cm x ml O2) /(sec X ml x mmHG) may create the edema of……..on overnight wear

a)                   4%

b)                  8%

c)                   9.9%

d)                  12.1%

201.  In a typical commercial PAL, a progressive corridor is given by

        a)     length from the distance circle to the near circle

        b)    length from the prism reference point to near add circle

        c)     length from the fitting cross to near add circle

        d)    length from fitting cross to the point with 85% of near add


 202. A point in the horizontal line 3.0mm away from the umbilics of a progressive lens has a 6 diopters of astigmatism. What is its rate of change in the spherical add power per mm?

a)            0.5

b)           1

c)            1.8

d)           2

203. A bifocal has following parameters: segment depth: 4.5mm, segment drop 1.5mm, segment width 6.5mm segment inset 2mm. What is your expected segment height for this bifocal lens?

a)            2mm

b)           4mm

c)            6mm

d)           8mm


204. In the brown tinting of an ophthalmic lens, which element is most likely to be used?

a)            Uranium

b)           Sulphur

c)            Nickel

d)           Cerium


205. In subtractive color system, the three primary colors are

a)            Red, green, yellow

b)           Cyan, Magenta, yellow

c)            Red, green, blue

d)           Cyan, magenta, green


206. One is false about bifocals

a)            In flat-top bifocals the segment optical center is generally 5 mm below the top

b)           Blended bifocals and fused bifocals terms can be used interchangeably.

c)            Ribbon-segments are available only in glass

d)           If the major reference point falls farther than 2 mm outward from the geometrical center, the total inset will be out.


207. Geneva lens measure works closely on the principle of

a)            Lens guage regression formula

b)           Vector law of Radiuscope

c)            spherometer and lensometer

d)           Sagittal depth formula


208. A CR-39 prism shifts an object by 8 degrees. The apical angle of this prism should approximate to:

a)            2 degrees

b)           4 degrees

c)            12 degrees

d)           16 degrees


209. Find out the correct tube length of a Galiliean telescope whose objective and eyepiece are of forty and twenty diopters respectively.

a)            2cm

b)           2.5cm

c)            6.5 cm

d)           7.5 cm


210. The ophthalmic lenses did have inbuilt UV protective properties, which contact lenses did not. Later to incorporate these properties in contact lens a chemical additive was added, the name of which is

a)            Chromatin

b)           Chromosphere

c)            Chromophore

d)           Chromium 


211. The ghost images seen in high power spectacles are the product of

a)            Internal reflection

b)           Spherical aberration

c)            Prismatic effect

d)           Jack-in-the-box phenomenon


212. A patient is advised to have a variable vertex distances for reading, intermediate and distance viewing. Which feature of frame would you think suite her?

a)            Comfort cable

b)           Skull temple

c)            Library temple

d)           Clip-on frame


213.Corneal epithelium consists 3 layers of cells. Exclude the one which does not fall in those layers:

a)            Goblet cells

b)           Superficial cells

c)            Wing cells

d)           Basal cells


214. These lenses incorporate a reading or near segment located eccentrically. These lens move on the cornea in such a way that the wearer views distance and near through the appropriate segment at the appropriate time. To be effective, the contact lens must translate upwards on the cornea when eyes look down to view near objects. As the design is rotationally asymmetric, lens must remain correctly at all times. All points make a case for

a)            Concentric design contact lenses

b)           Diffractive design contact lenses

c)            Aspheric design contact lenses

d)           Alternating vision contact lenses


215. One of the following is true

a)            Lens flexure will induce a plus cylinder whose axis is aligned with flattest corneal meridian

b)           Lens flexure will induce a minus cylinder whose axis is aligned with flattest corneal meridian

c)            Lens flexure will induce a plus cylinder whose axis is aligned with steepest corneal meridian

d)           Lens flexure will induce a minus cylinder whose axis is aligned with steepest corneal meridian


216. Nepal Eye Bank was established in

a)            1981

b)           1994

c)            1999

            d)           2001

217. Endothelial decompensation occurs if endothelial cell density is below

a)            2000/mm sq

b)           1000 mm sq

c)            500 /mm sq

d)           250/ mm sq

218. coefficient of variation in specular microscopy measures which of the following endothelial attributes:

a.            Polymegathism

b.            Blebs

c.             Pleomorphism

d.            Guttata

219. Hospital Cornea Retrieval Program from Nepal Eye Bank was started in

a)            2008

b)           2011

c)            2013

d)           2015


220. Enormous corneal sensitivity is due to the thousands of nerves entering into the cornea. The number of nociceptors approximate to

a)            5500 /mm sq

b)           7000 /mm sq

c)            10,000 /mm sq

d)           15, 000/ mmsq


221. Which one is not a contraindication for donor tissue for a cornea transplant?

a)            Hepatitis B and C

b)           HIV

c)            Lung Cancer

d)           Syphilis


222. One of the following seems the most feasible age criteria to be a cornea donor (death at:)

a)            Birth-100 years

b)           2 years - 80 years

c)            5 years - 70 years

            d)           10 years - 50 years

223. Prior to tissue retrieval the technician should wash the anterior ocular surface by sterile phosphate buffered saline followed by 3 minutes rinsing of povidone iodine solution whose percentage should be

a)            2%

b)           5%

c)            10%

            d)           12%

224. The corneal tissue would not be worth for optical transplantation if the endothelial count is below

a)            2000 / sq mm

b)           1500 sq mm

c)            1000 sq mm

d)           2500 sq mm

225. The first surgeon who performed the penetrating keratoplasty in Nepal is

a)            Dr. Dev Narayan Shah

b)           Dr. Madan Prasad Upadhyaya

c)            Dr. ND Joshi

d)           Dr. PC Karmacharya


226. McCarey-Kaufman medium is a tissue storage media where we can store the corneal tissue for up to:

a)            3-4 days

b)           7-8 days

c)            14-15 days

            d)           29-30 days

227. Optisol cornea storage media is enriched with

a)            Mucopolysaccharides and gentamicin

b)           Chondroitin sulfate and dextran

c)            Glucose and benzalkonium chloride

d)           Sucrose and streptomicin


228. Hypothermic storage modality of donated tissue the chamber temperature is maintained at

a)            Below 0 degree Celsius

b)           2 to 8 degree Celsius

c)            1 to 15 degree Celsius

            d)           -10 degree Celsius

229. DSAEK, a type of corneal lamellar graft, stands for

a)            Descement Stripping Automated Epithelial Keratoplasty

b)           Descement Stripping Automated Endothelial Keratoplasty

c)            Directly Stimulated Alloplastic Endothelial Keratoplasty

            d)           Direct Stromal Automated Epi Keratoplasty

230. If a cornea retrieved from a crematorium disqualifies for optical transplant in that the polymegathism is 80% of total endothelial. We can do all of the following to this tissue except

a)            use for tectonic graft

b)           use for therapeutic purpose

c)            use for research and training

            d)           discard it in a safe place

231.  When the whole eye ball is enucleated, we can also preserve the severed sclera in 90% ethanol after processing. The preservation period  during which it is accepted for surgical procedures

a)            15 days

b)           30 days

c)            6 months

d)           2 years


232. The poor candidate for eye donation

a)            Old age

b)           Bilateral cataract surgery

c)            Suspected social behavior

d)           All


233. The first human corneal graft was done in 1886 by

a.            Edward Konrad

b.            Von Hippel

c.             Ludwig Rehn

d.            Ebers Papyrus

234. Event of graft rejection can occur in the recipient in

a)            6 months

b)           1 years

c)            2 years

d)           Throughout life


235. Which disease warrants an excellent prognosis in penetrating keratoplasty?

a)            Keratocounus

b)           Inactive herpetic scars

c)            Keratoglobus

d)           Severe dry eyes

236. Hospital Cornea Retrieval Program (HCRP) in Nepal, an initiative to collect cornea from the general hospitals where death toll is high, was started in:
 a) 2013
 b) 1991
 c) 1994
 d) 1999

237. One among the following is false about the Krimsky test

a)            Prism base is kept opposite to the direction of deviation

b)           It is used when patient has manifest deviation and fairly poor vision in one eye

c)            Estimated amount of prism is kept in the front of fixating eye

d)           Patient fixates at light kept at 6m distance


238. Which portion of the visible spectrum of light is particularly harmful to the retina?

a)     390-400 nm

b)    440-450 nm

c)     550-560 nm

d)    700 – 710 nm

239. which of the following materials would you least prefer to recommend for a typical sportswear?

a)     Polycarbonate

b)    NXT

c)     CR-39

d)    Trivex

240. Which sunwear filter does not taint the perception of natural colors?

a)     Amber Filters

b)    Photochromatic filter

c)     Green-range tints

d)    Neutral density filters

241. Normal indoor office environment should have a luminance of

a)     100-200 Lux

b)    300-500 Lux

c)     600- 750 Lux

d)    800-1000 Lux

242. In Age Related Eye Disease Study Phase 2 (AREDS2), which two of the following ingredients were replaced in place of beta-carotene used in AREDS1?

a)     Vitamin C and E

b)    Zinc and Copper

c)     Lutean and Zeaxanthin

d)    Flavinoids and Omega-3 fatty acids

243. False one is

a)     The average latency of initiation of saccades is more than that of pursuits.

b)    If a target trajectory is predictable then latencies for both saccades and pursuit can be minimized

c)     Pursuit eye movements have the capacity to follow targets at speeds of up to 40 degrees/second (or faster if the trajectory is predictable)

d)     saccadic eye movements have the capacity for speeds up to 100 degrees/second




1 d

2 b

3 b

4 d

5 a

6 b

7 d

8 b

9 c

10 d

11 c

12 a

13 c

14 a

15 c

16 d

17  d

18 a

19 b

20 b

21 b

22 b

23 d

24 c

25 a

26 b

27 b

28 d

29 b

30 a

31 b

32 c

33 a

34 a

35 b

36 a

37 d

38 c

39 d

40 a

41 d

42 d

43 d

44 c

45 c

46 d

47 c

48 b

49 d

50 c

51 d

52 a

53 b

54 b

55 c

56 c

57 b

58 d

59 b

60 c

61 b

62 c

63 d

64 c

65 c

66 a

67 d

68 b

69 b

70 c

71 d

72 a

73 c

74 d

75 d

76 d

77 b

78 d

79 c

80 c

81 b

82 d

83 d

83 d

85 d

86 b

87 b

88 d

89 d

90 b

91 c

92 a

93 b

94 c

95 a

96 d

97 c

98 c

99 c

100 c

101 b

102 c

103 c

104 b

105 c

106 b

107 b

108 c

109 b

110 c

111 d

112 a

113 d

114 c

115 b

116 d

117 b


119 b

120 c

121 b

122 a

123 d

124 a

125 c

126 a

127 d

128 c

129 c

130 b

131 b

132 c

133 c

134 c

135 a

136 d

137 b

138 d

139 c

140 d

141 c

142 b

1143 c

144 d

145 d

146 a

147 d

148 a

149 c

150 b

151 d

152 c

153 b

154 a

155 c

156 c

157 c

158 c

159 b

160 d

161 c

162 b

163 b

164 b

165 c

166 c

167 c

168 d

169 c

170 a

171 c

172 b

173 d

174 c

175 a

176 c

177 d

178 a

179 d

180 c


182 a

183 b

184 c

185 a

186 a

187 b

188 c

189 d

190 b

191 a

192 c

193 d

194 a

195 b

196 a

197 c

198 a

199 b

200 a

201 d

202 b

203 d

204 c

205 b

206 b

207 d

208 d

209 b

210 c

211 a

212 c

213 a

214 d

215 a

216 b

217 c

218 c

219 c

220 b

221 c

222 b

223 b

224 a

225 c

226 a

227 b

228 b

229 b

230 d

231 d

232 d

233 b

234 d

235 a

236 a

237 d

238 b

239 c

240 d

241 b

242 c











 If you want to see the Past Questions of 2021 Medical Education Commission of M. Optom, click Here.

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