Ophthalmology Oral Questions by Dr. Abdel Baset.docx

Ophthalmology Oral Questions by Dr. Abdel Baset

1. 1- What’s the normal external appearance of the eye?
a- The eye lid is in normal position; the upper and lower lashes are attached to the
corresponding lids.
b- Normal eyes have parallel lenses without deviation(no squint).
c- Normal corneal luster.
d- Normal position of brows.

2- How can a patient with hypermature cataract see without surgery?
A degeneration of zonules leads to falling of the lens backwards which leads to light being able
to enter the eye, and the patient being able to see.
3- Where does light converge in the following visual acuity tests: Light perception (LP) & Hand
movement (HM)?
In light perception, light converges behind the doctor.
In hand movement, light converges behind the patient.
4- What are the mechanisms of binocular diplopia post cataract extraction?
1- In cases where the implanted IOL has a power different than the power of the second eye.
2- In cases where an IOL is implanted in the operated eye and the second eye is aphakic.
3- In cases of IOL subluxation in the operated eye leading to the formation of two images.
5- Does monocular diplopia occurs in a patient with a hypermature subluxed lens?
No. In subluxed hypermature cataract, there are two refractive media, the lens and cornea. The
lens is completely opaque and does not refract light. Only the cornea refracts light. Therefore,
no diplopia.
6- Explain the presence of bilateral shallow Anterior Chamber (A.C) in a patient with cataracts and
normal lens thickness?
The patient has bilateral hypermetropia.
7- Explain the presence of bilateral deep A.C in a patient with cataracts and normal lens thickness?
The patient has bilateral myopia.

8- Common drugs that cause cataract include?
a- Pilocarpine: cause anterior capsular & subcapsular cataracts.
b- Cortisone: causes posterior capsular cataract
9- What is the mechanism of cataract formation in cases trauma with a foreign body?
In cases of penetrating trauma, the aqueous leaks and cataract forms within hours.

10-What’s the normal iris pattern?
The Iris is an anterior circular muscular part of the eye and has a Ciliary and papillary border. The
ciliary part has serrated ruffle and regular crypts, while the papillary border has contraction
furrows and collarette with radial lines.
(WRONG: Iris covers the lens anteriorly and is attached to the ciliary body posteriorly)
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2. 11- What is the importance Diabetes Mellitus (D.M) and hypertension (HTN) is history taking when
considering cataract extraction?
a- Must control both D.M and HTN before cataract extraction.
b- There may be other additional causes of progressive painless diminution of vision such as
diabetic retinopathy in a patient with diabetes.

12- What is the importance of a patient's complaint is history taking?
a- discover the main complaint (Diminution of vision or other complaints)
b- discover whether the condition is progressive and its incidence.
c- discover whether the condition is painful or painless.
d- Discover the affected eye.
e- discover duration of complaint.

13- How can pterygium affect vision?
a- By compressing the cornea leading to irregular astigmatism.
b- In advanced pterygium it covers the pupil.
14- How can you differentiate between active & passive pterygii?
Active pterygii have a white line of corneal infiltration(cap) on its head.
15- What’s the most important measure to do before removing the pterygium?
A pterygium should be made it stationary (stop its progression) by prescribing corticosteroids
and decongestants.
16- How can you differentiate between pseudophakic & phakic person?
By counting the number of Purkinje images. A phakic person has 3 Purkinje images and a
pseudophakic has 2 Purkinje images.
17- What are the causes of lens induced glaucoma?
a- Hypermature cataract leads to denatured protein leading to exiting of lens fibres and being
engulfed by macrophage and then closure of angle of filtration. (Phacolytic glaucoma - 2ry.
open angle).
b- Lens swelling leads to contact between Iris & lens which leads to collection of aqueous
behind the iris resulting in iris bulging and closure of angle of filtration (Phacomorphic
glaucoma).
c- Spherophakia (rounded lens) leads to Irido-lenticular touch.
d- Micro-spherophakia (small rounded lens) leading to touch of the periphery of the lens by the
iris and closure of the angle).
e- Anterior lens dislocation.
f- Posterior lens dislocation causing bulging of vitreous.
g- Traumatic rupture of lens leading to exiting of lens material which leads to peripheral
anterior synechia and closure of the angle.
h- In pseudo-exfoliation by the rubbing movement of amyloid like material by iris movement
leading to distribution & accumulation of the material in periphery and leading to closure of the
angle.
i- Pigmentary glaucoma by rubbing of iris to the lens leading to dispersion of pigmented cells of
the iris leading to 2ry. open angle glaucoma.
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