Retinal disorders -EYE

Question 1

An 80-year-old man presents with a gradual decline in central vision. Fundoscopy shows drusen deposits. What is the most likely diagnosis?

Answer 1

Dry age-related macular degeneration (AMD).

Question 2

A 60-year-old man with chronic hypertension presents with arteriovenous nicking and copper wiring on fundoscopy. What is the most likely diagnosis?

Answer 2

HTN retinopathy

Question 2

What is the immediate management for retinal artery occlusion?

Answer 2

Ocular massage and hyperbaric oxygen therapy

Question 2

What is a serious complication of proliferative diabetic retinopathy?

Answer 2

Tractional retinal detachment.
+ vitreous hemorrhage

Question 2

What fundoscopic finding is characteristic of branch retinal vein occlusion?

Answer 2

Retinal hemorrhages localized to a specific quadrant.

Question 2

What is the primary cause of proliferative diabetic retinopathy?

Answer 2

Retinal hypoxia leading to VEGF-mediated neovascularization.

Question 3

What is the primary pathological process underlying dry AMD?

Answer 3

Accumulation of drusen (extracellular material) between the retina and choroid.

Question 4

What is the first-line treatment for wet AMD?

Answer 4

Anti-VEGF therapy (e.g., bevacizumab, ranibizumab)

Question 5

A patient with AMD experiences sudden vision loss. Fundoscopy reveals subretinal hemorrhage and neovascularization. What type of AMD is this?

Answer 5

Wet AMD

Question 5

A 55-year-old diabetic presents with microaneurysms, hard exudates, and cotton-wool spots on fundoscopy. What is the diagnosis?

Answer 5

Nonproliferative diabetic retinopathy.

Question 5

What early symptom is characteristic of AMD?

Answer 5

Metamorphopsia (distortion of straight lines).

Question 5

A patient presents with sudden, painless monocular vision loss. Fundoscopy reveals a pale retina with a cherry-red spot at the fovea. What is the most likely diagnosis?

Answer 5

Central retinal artery occlusion.

Question 5

What is the best method for screening diabetic retinopathy in patients with long-standing diabetes?

Answer 5

Fundoscopic examination.

Question 6

Which of the following is NOT a feature of nonproliferative diabetic retinopathy?
A) Microaneurysms
B) Cotton-wool spots
C) Retinal neovascularization
D) Hard exudates

Answer 6

C) Retinal neovascularization (seen in proliferative diabetic retinopathy).

Question 6

What is the hallmark finding of severe hypertensive retinopathy?

Answer 6

Macular star (caused by lipid exudates from damaged vessels).
hard exudates

Question 6

Cotton-wool spots in hypertensive retinopathy are caused by what underlying pathology?

Answer 6

Retinal nerve fiber layer infarctions.

Question 7

What immediate intervention is required for a patient with papilledema due to hypertensive retinopathy?

Answer 7

Urgent blood pressure lowering

Question 7

A 70-year-old patient with uncontrolled hypertension presents with sudden vision loss. Fundoscopy shows “blood and thunder” appearance. What is the most likely diagnosis?

Answer 7

Retinal vein occlusion.

Question 7

What systemic disease is commonly associated with retinal artery occlusion in elderly patients?

Answer 7

Giant cell arteritis

Question 7

What is the most concerning sign of hypertensive emergency on fundoscopy?

Answer 7

papilledema

Question 7

What is the most common cause of retinal artery occlusion?

Answer 7

Embolism (e.g., carotid artery atherosclerosis, cardiac emboli).

Question 7

What is the primary cause of central retinal vein occlusion?

Answer 7

thrombosis

Question 7

Why does the fovea appear red in central retinal artery occlusion?

Answer 7

It is supplied by the choroid, which remains perfused.

Question 7

What is the most common type of retinal detachment?

Answer 7

rhegmatogenous

Question 7

What systemic disease increases the risk of retinal vein occlusion?

Answer 7

HTN

Question 8

How does sclerosis of arterioles contribute to branch retinal vein occlusion?

Answer 8

Arteriovenous compression at crossing points leads to turbulent blood flow and thrombosis.

Question 8

What is the most appropriate treatment for retinal detachment?

Answer 8

Surgical reattachment.

Question 8

High myopia increases the risk of which type of retinal detachment?

Answer 8

rhegmatogenous

Question 8

A 20-year-old presents with progressive night blindness. Fundoscopy reveals bone-spicule pigmentation. What is the likely diagnosis?

Answer 8

Retinitis pigmentosa.

Question 9

What are two major fundoscopic findings in retinal detachment?

Answer 9

Wrinkling of the retina and changes in vessel direction

Question 9

A patient experiences flashes of light followed by a “dark curtain” over their vision. What is the most likely diagnosis?

Answer 9

Retinal detachement

Question 10

What genetic pattern is most commonly seen in retinitis pigmentosa?

Answer 10

Autosomal dominant or X-linked.

Question 11

What is the earliest symptom of retinitis pigmentosa?

Answer 11

Nyctalopia (night blindness).

Question 12

What causes bone-spicule pigmentation in retinitis pigmentosa?

Answer 12

Degeneration of photoreceptors leading to retinal pigment migration.

Question 13

What is the most common cause of childhood blindness worldwide?

Answer 13

retinitis pigmentosa

Question 14

A premature infant receiving supplemental oxygen develops abnormal retinal vascularization. What is the diagnosis?

Answer 14

Retinopathy of prematurity.

Question 15

What growth factor plays a key role in retinopathy of prematurity?

Answer 15

VEGF

Question 16

Why does supplemental oxygen therapy contribute to retinopathy of prematurity?

Answer 16

It suppresses VEGF, leading to abnormal retinal vessel growth upon re-exposure to hypoxia.

Question 17

What is the best method to prevent retinopathy of prematurity in preterm infants?

Answer 17

Careful oxygen supplementation to avoid hyperoxia.

Question 17

What is a major complication of retinopathy of prematurity if left untreated?

Answer 17

Tractional retinal detachment

Question 18

What is the most effective treatment for severe retinopathy of prematurity?

Answer 18

Laser photocoagulation or anti-VEGF therapy

Question 19

Retinopathy of prematurity primarily affects infants born before how many weeks of gestation?

Answer 19

Before 32 weeks. Preterm birth 29 week (UW)

Question 20

A 2-year-old child presents with leukocoria (white pupillary reflex). What is the most likely diagnosis?

Answer 20

retinoblastoma

Question 21

What is the inheritance pattern of familial retinoblastoma?

Answer 21

Autosomal dominant with incomplete penetrance.

Question 21

What is the genetic mutation responsible for retinoblastoma?

Answer 21

Mutation in both RB1 tumor suppressor genes on chromosome 13.

Question 22

What other malignancy is associated with hereditary retinoblastoma? UWORLD question co-incidently by ChatGPT 21.3.2025 12.50AM

Answer 22

Osteosarcoma.

Question 23

What is the first-line treatment for retinoblastoma?

Answer 23

Enucleation (if unilateral) or chemotherapy and laser therapy (if bilateral).

Question 24

What is the most common presenting symptom of retinoblastoma?

Answer 24

Leukocoria (white pupillary reflex).

Question 25

What eye movement abnormality may be seen in retinoblastoma?

Answer 25

Strabismus nystigmus

Question 26

What imaging modality is preferred for evaluating retinoblastoma?

Answer 26

MRI to avoid radiation exposure

Question 27

A 68-year-old man with a history of smoking presents with sudden vision loss and metamorphopsia. Fundoscopy reveals subretinal hemorrhage. What is the likely diagnosis?

Answer 27

Wet age-related macular degeneration.

Question 28

A 35-year-old patient with poorly controlled diabetes presents with blurry vision. Fundoscopy reveals microaneurysms, cotton-wool spots, and hard exudates. What is the most likely diagnosis?

Answer 28

Nonproliferative diabetic retinopathy.

Question 29

A patient with a history of uncontrolled hypertension presents with headaches and blurred vision. Fundoscopy reveals papilledema and a macular star. What is the most likely diagnosis?

Answer 29

Hypertensive retinopathy

Question 30

A 72-year-old man presents with sudden loss of vision in one eye. Fundoscopy reveals engorged retinal veins and widespread hemorrhages. What is the most likely diagnosis?

Answer 30

Central retinal vein occlusion.

Question 31

A child presents with progressive night blindness and peripheral vision loss. Fundoscopy reveals pigment accumulation in a bone-spicule pattern. What is the diagnosis?

Answer 31

retinitis pigmentosa

Question 31

A myopic 50-year-old man sees flashes of light followed by a dark curtain over his vision. What is the best immediate step in management?

Answer 31

Emergency ophthalmology consultation for retinal detachment.

Question 32

A 24-year-old woman with systemic lupus erythematosus experiences sudden, painless monocular vision loss. Fundoscopy shows a pale retina with a cherry-red spot. What is the most likely cause?

Answer 32

Retinal artery occlusion due to embolism or vasculitis.

Question 33

A premature infant is found to have abnormal retinal vascularization on screening. What is the best next step?

Answer 33

Close monitoring or laser therapy if severe (retinopathy of prematurity).

Question 34

A 2-year-old child with a family history of eye cancer presents with leukocoria. What is the most appropriate next step in management

Answer 34

retinoblastoma

Question 35

What is the most important risk factor for central retinal artery occlusion?

Answer 35

Carotid artery atherosclerosis.

Question 36

What is the best way to prevent diabetic retinopathy?

Answer 36

Strict blood glucose and blood pressure control.

Question 37

What is the first-line treatment for hypertensive retinopathy with papilledema?

Answer 37

Immediate blood pressure reduction with IV antihypertensives.

Question 38

A 10-year-old patient has an RB1 gene mutation. What two cancers is he at increased risk for

Answer 38

Retinoblastoma and osteosarcoma.

Question 39

What is the most common site of embolism in central retinal artery occlusion?

Answer 39

opthalmic artery

Question 40

A patient presents with sudden vision loss. Fundoscopy shows embolic plaques in retinal arterioles. What is the most likely source of emboli?

Answer 40

Carotid artery atherosclerosis or cardiac thrombi.

Question 41

A 65-year-old male with diabetes is found to have retinal neovascularization on fundoscopy. What is the best next step in management?

Answer 41

Anti-VEGF therapy or laser photocoagulation