Quiz Review

1.Which of the following describes the visual phenomenon
of ‘monocular diplopia’ as it relates to cataracts?
A. Double vision is resolved by using a pinhole during the examination.
B. The double vision disappears immediately when either eye is closed.
C. Double vision only occurs when looking at objects in the peripheral field.
D. The double vision persists in one eye even when the unaffected eye is covered.

Right answer: D
Cataracts cause light to scatter within a single eye, leading to double vision that remains even if the other eye is closed, unlike neurological diplopia.
B:This describes binocular or neurological diplopia, which occurs when the eyes are misaligned rather than due to a lens opacity.
C:Cataract-induced diplopia is typically central and related to how light passes through the clouded lens, not its position in the visual field.

2.In the context of age-related cataracts, what is the primary mechanism of ‘nuclear sclerosis’?
A. The central nucleus hardens and compresses as new cortical fibers form concentrically.
B .Rapid enlargement of lens cells causes fluid-filled vacuoles to form in the cortex.
C. The crystalline lens loses its attachment to the zonular fibers.
D. The lens capsule becomes thinner and more prone to spontaneous rupture.

Right answer : A
As the lens ages, it increases in mass and the formation of new layers pushes inward, leading to the hardening of the center.
B:This describes a metabolic or secondary pathology rather than the standard age-related hardening of the nucleus.
C:Loss of attachment refers to lens subluxation or dislocation, not the process of opacification and hardening.

3.A patient’s slit-lamp examination reveals wedge-shaped
or ‘spoke-like’ opacities. Which type of cataract does this
specifically indicate?
A.Cortical Cataract
B. Nuclear Cataract
C. Subcapsular Cataract
D. Polar Cataract

Right answer : A

A.Cortical cataracts develop in the outer layers and typically present as peripheral wedge-shaped or spoke-like opacities.
B:Nuclear cataracts involve a central hardening and yellowing/browning rather than peripheral wedge shapes.
C:These form at the back of the lens near the capsule and are usually associated with systemic factors like steroids or diabetes.
D:Polar cataracts are described as small dots or opacities located at the anterior or posterior poles.

4.Which of the following medications is identified as a potential cause of drug-induced cataracts besides systemic corticosteroids?
A. Amiodarone
B. Penicillin
C. Metformin
D. Lisinopril

Right answer :A
Other medicine -phenothiazines

5.During phacoemulsification, what is the primary role of
the ultrasound probe?
A.To suture the 3 mm incision after the lens is inserted.
B.To break the cloudy lens into small fragments for aspiration.
C.To cauterize blood vessels in the anterior chamber to prevent haemorrhage.
D.To measure the exact dimensions required for the artificial lens.

Right Answer :B
Emulsification involves using ultrasound energy to fragment the lens so it can be easily sucked out
through a small incision.
A-Modern phacoemulsification often uses self sealing incisions.
C-anterior chamber is typically quiet and bloodless in standard cataract case

6.Which finding during a physical examination is
considered a sign of a severe, dense cataract?

A.A clear red reflex upon ophthalmoscopy.
B.A briskly reactive pupil with no RAPD.
C.A whitish appearance of the pupil.
D.An abnormally deep anterior chamber.

Right answer :C
In mature or dense cases, the lens becomes so opaque that the pupil appears white to the naked eye.
A:A cataract typically causes an abnormally dim or absent red reflex, not a clear one.
B:This indicates a healthy pupillary response and retinal function, which can be found in both clear eyes and eyes with cataracts.

7.What metabolic error is specifically linked to the
development of congenital cataracts?
A.Diabetes Mellitus
B.Phenylketonuria
C.Galactosaemia
D.Hypercalcemia

Right answer :C
Galactosaemia is a metabolic disorder explicitly listed in the source material as a cause of congenital cataracts.
A:Diabetes is primarily listed as a cause of acquired (senile or secondary) cataracts in adults, not specifically congenital metabolic errors.

8.Which complication is described as an ophthalmic emergency presenting with a red, painful eye and vision loss after surgery?
A.Posterior Capsular Rupture
B.Myopic Shift
C.Infective Endophthalmitis
D.Iris Shadow Absence

Right answer :C
This is a rare but devastating infection within the eye that requires immediate medical attention.
A:This is an intraoperative complication (damage to the ‘bag’) rather than a post-operative infective presentation.
B:A myopic shift is a refractive change occurring during the development of a cataract, not an acute surgical emergency.
D:An absent iris shadow is a clinical sign of a mature cataract, not a post-surgical complication