Ophthalmology Image-based Questions for NEET PG Preparation

Q1. A 70-year-old male patient comes to your clinic with complaints of glare and diminution of vision for 3 months. On examination, you notice the following appearance:

Choose the correct statement regarding the correct diagnosis.

1.  The Iris shadow test becomes positive only when the whole cortex is involved.
2. Patients see better in dark surroundings.
3. Characterized by saucer-shaped opacities in the center of the posterior cortex.
4. Vision loss occurs at a late stage.

Ans. 4) Vision loss occurs at a late stage.

Q2. An 80-year-old female patient came with complaints of gradual progressive diminution of vision for 2 years in both her eyes. She reports that over the last year, she noticed an improvement in her ability to read without glasses. The following finding is seen on slit lamp examination over the right eye and the left eye has similar opacity.​

Choose the most appropriate course of management for this patient.

1. ​Advise lifestyle modification and review after 3 months
2. Recommend corticosteroids eye drops and reassess in 6 months.
3. Plan for Phacoemulsification.
4. Prescribe her rigid gas-permeable contact lenses.

Ans. 3) Plan for phacoemulsification.

Q3. An elderly male diabetic patient came with loss of vision in the left eye associated with pain in the left eye. On examination, the left eye appears red, and visual acuity- Perception of light and IOP is raised in the same eye. The patient gives a history of blurring and diminution of vision for the past 1 year. The slit lamp examination is given below.

Choose the correct diagnosis and appropriate pathophysiology for this patient.

1.  Phacomorphic glaucoma - Secondary open-angle glaucoma
2. Phacomorphic glaucoma - Secondary closed-angle glaucoma
3. Phacolytic glaucoma - Secondary open-angle glaucoma
4. Phacolytic glaucoma - Secondary closed-angle glaucoma

Ans. 3) Phacolytic glaucoma - Secondary open-angle glaucoma

Q4. The doctor noticed leukocoria in a 3-month-old baby during a routine examination and the eye appeared as shown below.

Choose the least appropriate statement regarding the most likely diagnosis

1. ​Most common type of congenital cataract
2. Commonly inherited as autosomal dominant trait
3. Usually zone of fetal nucleus is involved
4. Associated with vitamin-D deficiency

​Ans. 1) Most common type of congenital cataract

Q5. An infant with leukocoria presents with recurrent gastrointestinal infections and developmental regression. Bilateral eye examination revealed the following​

Choose the most appropriate next step in evaluation.

1. Serum estimation of glucose, calcium, and phosphorous levels
2. Estimation of antibody titers for infections
3. Urine chromatography for amino acids
4. Urine assay for the presence of reducing substances

Ans. 4) Urine assay for the presence of reducing substances

Q6. A newborn presented with the following findings.

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There is a positive maternal history for fever during the first trimester of pregnancy. Which among the following is least likely to be seen in this newborn?

1. ​Patent ductus arteriosus
2. Limb hypoplasia
3. Microphthalmia
4. Sensorineural hearing loss

​Ans. 2) Limb hypoplasia

Q7. A 30-year-old contact lens wearer presents with very severe eye pain, blurred vision, and discomfort in his right eye. O/E, the following corneal finding is noted. Based on the image and the clinical presentation, which of the following is the most likely diagnosis?

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1. ​Herpes Simplex Keratitis
2. Fungal Keratitis
3. Acanthamoeba Keratitis
4. Bacterial Keratitis

Ans. 3) Acanthamoeba Keratitis

Q8. A 45 y/o patient presents with worsening vision, mild pain, and redness 6 months after Penetrating Keratoplasty. Examination reveals the following. Which feature is most indicative of endothelial rejection?

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1. ​Increased Flare and Cells
2. Kayes dots
3. Khodadoust Line
4. Epithelial Rejection Line

Ans. 3) Khodadoust Line

Q9. A 45 y/o male presents with progressively worsening vision in his left eye over the past year. O/E, the following findings were observed, which caused significant blurring of his vision.

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Which of the following corneal opacities is most likely causing the greatest reduction in his vision?

1. ​Nebular corneal opacity
2. Macular corneal opacity
3. Leucomatous corneal opacity
4. Adherent leucoma

Ans. 1) Nebular corneal opacity

Q10. A 35-year-old patient presents with a 1-week history of worsening eye pain and redness. On examination, a constricted pupil, a hazy anterior chamber, and deposits on the back of the cornea as shown below. Based on these findings, which of the following is the most likely diagnosis?

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1. Herpes Simplex Keratitis
2. Conjunctivitis
3. Anterior Uveitis
4. Acute Angle Closure Glaucoma

Ans. 3) Anterior Uveitis

Q12. A 45-year-old woman has had progressive blurring of vision in both eyes for the past several months. She also reports difficulty seeing in dim light and noticing floaters. A fundoscopic examination is shown below. Which of the following conditions is most likely responsible for her symptoms?

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1. ​Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE)
2. Serpiginous Geographical Choroidopathy
3. Birdshot Retinochoroidopathy
4. Central Chorioretinitis

Ans. 3) Birdshot Retinochoroidopathy

Q13. A 30-year-old patient with HIV presents with vision loss and floaters. On examination, the patient has a CD4+ count of 40 cells/mm³. Fundoscopy reveals areas of necrosis with the following appearance. What is the most likely diagnosis?

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1. ​Acute Retinal Necrosis
2. Herpes Simplex Virus (HSV) Retinitis
3. Progressive Outer Retinal Necrosis
4. Herpes Zoster Ophthalmicus

Ans. 3) Progressive Outer Retinal Necrosis

Q14. A 32-year-old immunocompetent woman living with cats presents with decreased vision in her left eye. On examination, she has mild anterior uveitis with vitritis and the fundoscopy image is shown below. Which of the following is the most likely causative organism?

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1. ​Cytomegalovirus (CMV)
2. Candida albicans
3. Toxoplasma gondii
4. Histoplasma capsulatum

Ans. 3) Toxoplasma gondii

Q15. A 28-year-old woman diagnosed with Vogt–Koyanagi–Harada (VKH) disease, Fundus examination shows the following finding. What does it indicate?

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1. ​Prodromal phase
2. Uveitic phase
3. Convalescent phase
4. Recurrent phase

Ans. 3) Convalescent phase

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