Retina & Vitreous MCQs

Ophthalmology · 29 free questions with answers & explanations.

1. A 55-year-old hypertensive woman presents with sudden painless loss of vision in the left eye. Fundoscopy reveals a diffuse retinal haemorrhage in all four quadrants in a 'blood and thunder' appearance, dilated tortuous veins, disc oedema, and multiple flame-shaped haemorrhages. The most likely diagnosis is:
2. A 62-year-old man presents with sudden, painless, complete loss of vision in one eye. Fundoscopy reveals a pale, oedematous retina with a cherry-red spot at the fovea. The optic disc appears normal. The most likely diagnosis and the vessel involved are:
3. A 30-year-old woman with poorly controlled Type 1 diabetes (HbA1c 10.2%) undergoes fundoscopy. The ophthalmologist notes microaneurysms, dot-blot haemorrhages, hard exudates in a circinate pattern around the fovea, and two areas of cotton wool spots. There are no new vessels. How should this be classified and managed?
4. A 68-year-old man presents with sudden onset of a curtain coming down from above in his right eye, preceded by a shower of floaters and photopsia. Fundoscopy reveals an elevated, grey, billowing retina with a horseshoe tear at 11 o'clock position. The appropriate surgical management is:
5. A 72-year-old woman notices progressive central visual distortion and difficulty reading. OCT shows disruption of the retinal pigment epithelium, fluid under and within the retina, and a subretinal hyper-reflective lesion. Fluorescein angiography reveals early hyperfluorescence with late leakage. The treatment of choice is:
6. A 45-year-old man presents with sudden painless visual loss in the right eye. Fundoscopy shows optic disc oedema, dilated tortuous retinal veins in all quadrants, multiple flame-shaped haemorrhages, and cotton wool spots. The most likely diagnosis is central retinal vein occlusion (CRVO). Which investigation differentiates ischaemic from non-ischaemic CRVO with the most clinical relevance for neovascularisation risk?
7. A 15-year-old girl is referred with leukocoria in the right eye. Ultrasonography shows intraocular calcification. Retinoblastoma is suspected. The most important indicator of high risk for metastasis after enucleation based on histopathological examination is:
8. A 75-year-old woman with neovascular AMD undergoes intravitreal anti-VEGF therapy. She develops a sharp decline in vision one week post-injection. Fundoscopy shows a submacular haemorrhage larger than 4 disc areas. The most appropriate management step to improve visual prognosis in this scenario is:
9. A 55-year-old hypertensive patient develops sudden painless vision loss in the right eye. Fundoscopy shows disc edema, flame-shaped hemorrhages in all four quadrants with a 'blood and thunder' fundus, dilated tortuous retinal veins, and cotton-wool spots. The most appropriate investigation to identify the underlying etiology is:
10. In retinoblastoma management, the D-E-E rule (IIRC classification groups D and E) indicates advanced intraocular disease. Which treatment modality is now preferred for group D unilateral retinoblastoma to avoid enucleation?
11. Epiretinal membrane (ERM) formation on OCT causes which characteristic distortion of the foveal contour, and what is the threshold for surgical intervention?
12. A 72-year-old presents with sudden painless monocular visual loss. Fundus shows diffuse retinal whitening, optic disc swelling, cherry-red spot at the fovea, and a 'box-carring' appearance of retinal arteries. The diagnosis is:
13. In rhegmatogenous retinal detachment (RRD), the subretinal fluid accumulates between which two layers?
14. Retinoblastoma showing the pathological finding of Homer-Wright rosettes (without a lumen) is classified as:
15. Age-related macular degeneration (AMD) — the 'wet' (exudative) form differs from dry AMD in that wet AMD is characterised by:
16. In retinoblastoma, 'trilateral retinoblastoma' refers to which combination?
17. In central retinal artery occlusion (CRAO), the fundus typically shows a 'cherry-red spot' at the fovea because:
18. Lattice degeneration of the retina is MOST commonly located where?
19. In age-related macular degeneration (AMD), drusen that are MOST predictive of progression to neovascular (wet) AMD are:
20. In age-related macular degeneration (AMD), the visual prognosis is dramatically worse in neovascular (wet) AMD compared to geographic atrophy (dry AMD) because:
21. Retinoblastoma presenting as leukocoria in a 2-year-old is confirmed by B-scan showing a highly reflective mass with calcification. The International Classification of Retinoblastoma (ICRB) Group E tumor is defined as:
22. A high myope presents with a flap (horseshoe) tear at the posterior edge of a vitreous syneresis zone. Immediate treatment with barrier laser photocoagulation around the tear is indicated because:
23. A 55-year-old hypertensive presents with sudden, painless visual loss in one eye. Fundoscopy shows diffuse retinal haemorrhages in all 4 quadrants ('blood and thunder' appearance), disc oedema, and dilated tortuous veins. FFA shows prolonged arteriovenous transit time. What is the diagnosis and preferred treatment?
24. In Terson syndrome, vitreous haemorrhage occurs in association with which intracranial event, and through which proposed anatomical mechanism?
25. A 40-year-old myopic man presents with sudden onset of photopsia and floaters followed by a field defect that starts superiorly and progresses toward fixation. Slit-lamp examination shows a Weiss ring in the vitreous. What type of retinal detachment is most likely?
26. Regarding the genetics of retinoblastoma, a child has bilateral retinoblastoma. He has a germline mutation in the RB1 gene. His sibling is unaffected. What is the probability that the unaffected sibling carries the germline mutation (assuming the proband's mutation arose de novo in the germline)?
27. A 30-year-old woman presents with sudden loss of central vision. Fundoscopy shows a cherry-red spot at the macula with a pale oedematous retina surrounding it. The cherry-red spot appears because:
28. A 65-year-old woman has dry AMD with multiple soft drusen and focal areas of geographic atrophy sparing the fovea. Which treatment has been shown to REDUCE the risk of progression to advanced AMD in this category?
29. Regarding rhegmatogenous retinal detachment, the MOST common break type causing RRD in a highly myopic young adult is: