Optometry and ophthalmology mcq part: 16

01. The 3rd cranial nerve supplies all muscles EXCEPT

1. A. inferior oblique
2. B. inferior rectus
3. C. superior oblique✓
4. D. superior rectus

02. The only extraocular muscle which does not arise from the apex of the orbit is:

1. A. Superior rectus
2. B. Superior oblique
3. C. Inferior oblique✓
4. D. Inferior rectus

03. Third cranial nerve innervates all of the following except

1. A. Superior oblique muscle✓
2. B. Levator palpebrae muscle
3. C. Inferior oblique muscle
4. D. Medial rectus muscle

04. All are causes of Uniocular diplopia except

1. A. Subluxated lens
2. B. paralytic squint✓
3. C. Incipient cataract
4. D. Keratoconus

05. Accommodative squint is correct by all except

1. A. Orthoptic exercises
2. B. Spectacles
3. C. Contact lens
4. D. Surgery✓

06. Which muscle inserts the farthest posterior to the limbus?

1. A) Medial rectus
2. B) Superior rectus
3. C) Inferior rectus
4. D) Superior oblique✓

Among rectus muscles, MR is closest (5.5) to limbus and SR farthest (7.9) from limbus.

07. In grades of binocular vision; grade 2 is:

1. a. Fusion ✓
2. b. Stereopsis
3. c. Simultaneous macular perception
4. d. Convergence

There are three grades of binocular vision as given by Worth's classification:

1. Grade I: Simultaneous macular perception
2. Grade II: fusion
3. Grade III: Stereopsis

08. In concomitant squint:

1. a. Primary deviation > Secondary deviation
2. b. Primary deviation < Secondary deviation
3. c. Primary deviation = Secondary deviation ✓
4. d. None of the above

concomitant or Nonparalytic strabismus is not due to paralysis of extraocular muscles.

Comitant (or concomitant) strabismusis a deviation that is the same magnitude

regardless of gaze position. Paralytic or Noncomitant (or incomitant) strabismus has a

magnitude that varies as the patient shifts his or her gaze up, down, or to the sides.

09. The only extraocular muscle which does not arise from the apex of the orbit is:

1. a. Superior rectus
2. b. Superior oblique
3. c. Inferior oblique ✓
4. d. Inferior rectus

10.The action of superior rectus is:

1. a. Elevation, intorsion, abduction
2. b. Elevation, intorsion, adduction ✓
3. c. Elevation, extorsion, adduction
4. d. Elevation, extorsion, abduction.

11. Nerve supply of LPS muscle

1. a. CN iii✓
2. b. CN iv
3. c. CN vi
4. d. CN vii

12. Secondary action of superior rectus muscle is

1. a. Intorsion✓
2. b. Extorsion
3. c. Adduction
4. d. Abduction

13. The tendons of all EOMs attach to _______.

1. a. Choroid
2. b. Sclera✓
3. c. Conjunctiva
4. d. Limbus

14. Following are features of paralytic squint except

1. A. Abnormal head posture
2. B. Amblyopia✓
3. C. Diplopia
4. D. Restricted eye movements

15. Crossed diplopia is associated with

1. A. Eso deviations
2. B. Exo deviations✓
3. C. Cyclo deviations
4. D. All

16. Third nerve palsy is associated with

1. A. Crossed diplopia✓
2. B. Uncrossed diplopia
3. C. Uniocular diplopia
4. D. Amblyopia

17. Action of right superior oblique muscle is?

1. A. dextrodepression
2. B. dextroelevation
3. C. levoelevation
4. D. levodepression✓

While looking towards left and down (levodepression) in LE depression as primary

action (muscle IR) and in RE depression as secondary action (muscle SO). Similarly

every direction can be calculated

• In Levo elevation, LE elevation by SR and RE elevation by IO
• In dextro depression RE depression by IR and LE depression by SO
• In dextro elevation, RE elevation by SR and LE elevation by IO

18. Oculomotor nerve palsy features include all, EXCEPT

1. a. facial weakness✓
2. b. divergent squint
3. c. dilated fixed pupil
4. d. absent accommodation

19. Which of the following extraocular muscle is supplied by the superior division of the oculomotor nerve?

1. A) Superior oblique
2. B) Inferior rectus
3. C) Medial rectus
4. D) Superior rectus✓

The superior division of CN III supplies the superior rectus and the levator. The inferior

division of CN III supplies the medial rectus, inferior rectus, and inferior oblique. The

superior oblique is supplied by CN IV. The lateral rectus is supplied by CN VI

20. Which muscle originates in the orbital apex above the annulus of Zinn?

1. A) Superior oblique✓
2. B) Superior rectus
3. C) Lateral rectus
4. D) Inferior oblique

21. Which extraocular muscle has the shortest tendon?

1. A) Medial rectus
2. B) Lateral rectus
3. C) Superior oblique
4. D) Inferior oblique✓

22. Superior oblique muscle is supplied by the

1. a. optic nerve
2. b. third cranial nerve
3. c. fourth cranial nerve✓
4. d. sixth cranial nerve

23. Vogt striae (Vogt lines) are seen in

1. A. Keratoconus✓
2. B. Keratoglobus
3. C. Corneal degeneration
4. D. Pterygium

Vogt's striae are vertical (rarely horizontal) fine, whitish lines in the deep/posterior

stroma and Descemet's membrane commonly found in patients with keratoconus

24. stocker's line on cornea is seen in cases of

1. A. Keratoconus
2. B. Keratoglobus
3. C. Corneal degeneration
4. D. Pterygium✓

vertical line at the head of pterygium is known as Stocker's line.

25. stocker's line is due to deposition of

1. A. Iron✓
2. B. Copper
3. C. Sodium
4. D. Calcium

Fleischer's ring in keratoconus, Hudson-Stähli's line in corneal scar, Ferry's line in

filtering bleb, and Stocker's line in pterygium, all these are due to iron deposition.

26. Mittendorf’s dot is located on

1. A. Cornea
2. B. Iris
3. C. Lens✓
4. D. Retina

A Mittendorf dot is a small, circular opacity on the posterior lens capsule, classically

nasal in location, which represents the anterior attachment of the hyaloid artery. The

hyaloid artery is present during gestation and typically regresses completely. Failure to

do so can lead to benign findings, such as a Mittendorf dot or a Bergmeister's papilla, or

pathologic changes as seen in persistent fetal vasculature syndrome.

Mittendorf dot may be seen in association with posterior polar cataract

27. Fischer-Khunt spot is located on

1. A. Cornea
2. B. Sclera✓
3. C. Iris
4. D. Lens

Senile scleral paque,area of hyalinised sclera anterior horizontal rectus muscle

insertion.Seen in old age

28. Anatomically optic disc is located on which side of macula

1. A. Nasal✓
2. B. Temporal
3. C. Central
4. D. Opposite

Nasal side of the retina corresponds to temporal field of vision. That's why in perimetry

blind spot is on temporal side

29. Macula lutea is also known as

1. A. Blind spot
2. B. Red spot
3. C. Yellow spot✓
4. D. Optic disc

30. Koplik’s spots are seen on

1. A. Conjunctiva✓
2. B. Cornea
3. C. Iris
4. D. Retina

Koplik’s spots on conjunctiva are seen in patients with measles infection.

31. Vossius ring is seen on

1. A. Cornea
2. B. Iris
3. C. Lens✓
4. D. Retina

Vossius ring occurs due to compression of the pigmented posterior iris epithelial cells

and/or pupillary ruff against the anterior lens capsule blunt injury to the eye. Rupture of

the cells causes deposition of a circular line of melanin pigment on the lens capsule

32. In which of the following condition, cattle truck appearance is seen:

1. A. Retinal neovascularization
2. B. BRVO
3. C. CRVO
4. D. CRAO✓

33. Cotton wool spots are seen in

1. A. Non-ischaemic CRVO
2. B. Diabetic retinopathy
3. C. Hypertensive retinopathy
4. D. All

34. Esophoria is a type of

1. A. Apparant squint
2. B. Latent squint✓
3. C. Manifest squint
4. D. Paralytic squint

35. Grade 2 binocular single vision stands for

1. A. Abnormal Retinal correspondence
2. B. Simultaneous macular perception (grade 1)
3. C. Steriopsis (grade 3)
4. D. Fusion✓

36.There are ______ cardinal positions of gaze

1. a. 9
2. b. 6✓
3. c. 4
4. d. 8

37. In Worth’s four dot test the patient has diplopia if he sees

1. a. only two red lights
2. b. only two green lights
3. c. green and red lights alternately
4. d. two red and three green lights✓

68. Hess screen is a record of

1. a. primary and secondary deviation✓
2. b. heterophoria
3. c. fusion
4. d. retinal correspondence

39. Exophoria is common in

1. a. myopia✓
2. b. hypermetropia
3. c. Presbyopia
4. d. Astigmatism

40. In paralytic squint

1. a. primary deviation > secondary deviation
2. b. primary deviation < secondary deviation✓
3. c. primary deviation = secondary deviation
4. d. none of the above

Primary and secondary deviation: The deviation of the squinting eye behind the occluder

when the nonsquinting eye is fixating is called primary deviation. The deviation of the

nonsquinting eye behind the occluder when the squinting eye is fixating is called

secondary deviation.

If both deviations are equal, the squint is comitant. The reason why the primary and

secondary deviations are equal is because of Hering's law, which means that the

movement of the 2 eyes is equal and symmetrical.

If the primary deviation is greater than the secondary, the squint is spastic and fibrotic

(incomitant). If this is due to contractures, a slight innervation will produce movement of

the affected eye and so the primary deviation is greater than the secondary deviation.

If the secondary deviation is greater than the primary, the squint is paralytic. This is

because increased innervation is required by the paretic muscle to move the eye into a

certain position and this same amount of innervation goes to the normal muscle in the

other eye, causing the secondary deviation to be greater than the primary deviation.