Eye quiz page – The Emergency Medicine Manual

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Eyes

This is a 10 question quiz about eyes.

The questions are randomly drawn from a bank of 52 questions so will be different each time you take it.

1 / 10

1. The feature most specific for iritis at 8 hours since onset is

a) Hypopyon

b) Episcleral vascular injection

c) Consensual photophobia

d) Increased intraocular pressure

In iritis there is early episcleral injection from associated keratitis, however this may be difficult to differentiate from conjunctivitis (but most prominent around the limbus). There is photophobia, and consensual photophobia is a key finding (i.e. pain in the symptomatic eye when the unaffected eye is exposed to light). Visual acuity may be mild to moderately decreased and the pupil may be small, normal, or irregular. There is a muddy appearance of the iris and cell and flare in the anterior chamber. The intraocular pressure is initially < 15 mmHg but may be increased later due to synechiae. A hypopyon may develop, but usually only after 2-3 days of symptoms.

In iritis there is early episcleral injection from associated keratitis, however this may be difficult to differentiate from conjunctivitis (but most prominent around the limbus). There is photophobia, and consensual photophobia is a key finding (i.e. pain in the symptomatic eye when the unaffected eye is exposed to light). Visual acuity may be mild to moderately decreased and the pupil may be small, normal, or irregular. There is a muddy appearance of the iris and cell and flare in the anterior chamber. The intraocular pressure is initially < 15 mmHg but may be increased later due to synechiae. A hypopyon may develop, but usually only after 2-3 days of symptoms.

2 / 10

2. Visual acuity is expressed as the distance from which the test was performed and the number on the chart for the lowest line the patient can correctly read

a) All the letters except one

b) More than half the letters

c) More than 2/3 of the letters

d) All the letters

Visual acuity is expressed as the distance from which the test was performed and the number on the chart for the lowest line the patient can correctly read most of the letters.

Visual acuity is expressed as the distance from which the test was performed and the number on the chart for the lowest line the patient can correctly read most of the letters.

3 / 10

3. Which one of the following causes of sudden visual loss usually causes ocular pain?

a) Posterior vitreous detachment

b) Central retinal artery occlusion

c) Retinal detachment

d) Optic neuritis

Optic neuritis is the only one of these conditions that usually causes ocular pain, particularly on movement.

Optic neuritis is the only one of these conditions that usually causes ocular pain, particularly on movement.

4 / 10

4. A 25-year-old man complains of persistent blurring to his left eye one day after sustaining a blow to the area in an altercation.
VAR is 6/6, VAL 6/60, correcting to 6/6 with pin hole. Pupils are equal, round, and reactive.
Fundoscopy is normal at -12 diopters. Slit lamp examination is unremarkable.
Which one of the following is the most likely cause?

a) Retinal detachment

b) Hyphema

c) Macular oedema

d) Lens dislocation

5 / 10

5. Risk factors for acute angle closure glaucoma include all of the following except

a) South east Asian ethnicity

b) Male sex

c) Increasing age

d) Increased lens thickness

Risk factors for acute angle closure glaucoma include

increasing age

shallow anterior chamber

increased lens thickness

family history of glaucoma

South east Asian / Inuit ethnicity

female sex (3 times more frequently affected than males)

Risk factors for acute angle closure glaucoma include

increasing age

shallow anterior chamber

increased lens thickness

family history of glaucoma

South east Asian / Inuit ethnicity

female sex (3 times more frequently affected than males)

6 / 10

6. Visual acuity results using a Snellen chart are usually reported as what a person can accurately see at the following distances (in m)

a) 5,6,9,12,18,24,36,60

b) 5,6,7.5,9,12,18.24.36.60

c) 5,6,7.5.12,18,24,36,60

d) 6,7.5,9,12,15,18,21,36,60

Visual acuity results are usually reported as what a person can accurately see at 5,6,7.5,9,12,18.24.36.60 m.

Visual acuity results are usually reported as what a person can accurately see at 5,6,7.5,9,12,18.24.36.60 m.

7 / 10

7. A 20 year woman presents with rapid loss of vision in one eye.
Examination reveals pain on movement of the eye ball, normal fundi and normal pupillary reactions.
Visual field testing reveals a large central scotoma.
Which ONE of the following is the most likely diagnosis?

a) Tobacco toxicity

b) Glaucoma

c) Optic neuritis

d) Methanol toxicity

8 / 10

8. The layers of the eye normally seen in an optical section from superficial to deep are

1. Layer 1 - bright zone (most superficial)

2. Layer 4 - grey wider granular area

3. Layer 5 - bright inner zone (deepest)

4. Layer 3 - bright thin line

5. Layer 2 - dark grey line

The layers of the eye normally seen in an optical section from superficial to deep are:

Bright zone is the surface of the tears

Dark gray line is the epithelium

Bright thin line is Bowman's membrane

Grey wider granular area is the stroma

Bright inner zone is the endothelium

The layers of the eye normally seen in an optical section from superficial to deep are:

Bright zone is the surface of the tears

Dark gray line is the epithelium

Bright thin line is Bowman's membrane

Grey wider granular area is the stroma

Bright inner zone is the endothelium

9 / 10

9. In children, visual acuity can usually be tested the same was as adults from about

a) 5-6 years of age

b) 2-3 years of age

c) 7-8 years of age

d) 3-4 years of age

Visual acuity can usually be tested the same way as in adults from about 5-6years of age.

Visual acuity can usually be tested the same way as in adults from about 5-6years of age.

10 / 10

10. A 67 year-old woman notes a sudden painless loss of vision to her left eye beginning 20 minutes prior to presentation.
By the time she is examined, her symptoms have resolved. Past medical history is notable for hypertension and angina.
Visual acuity, visual fields, and fundoscopy are all normal.
The most likely likely diagnosis is

a) Temporal arteritis

b) Amaurosis fugax

c) Central retinal artery occlusion

d) Central retinal vein occlusion

Your score is
The average score is 53%
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