Uveitis (Anterior, Posterior, Panuveitis) MCQs

Ophthalmology · 46 free questions with answers & explanations.

1. A 28-year-old man with HLA-B27-positive ankylosing spondylitis presents with acute pain, redness, photophobia, and miosis in the right eye. Slit-lamp examination shows fine keratic precipitates (KPs), 3+ cells and flare in the anterior chamber, and a fibrin exudate. This is best classified as:
2. A 32-year-old patient from South America with positive serology for Toxoplasma gondii presents with a focal necrotising chorioretinal lesion adjacent to a pigmented scar ('headlight in the fog' appearance). What is the mechanism of this classical fundus picture?
3. A 30-year-old male patient presents with bilateral granulomatous panuveitis, depigmented skin patches (vitiligo-like poliosis of the lashes), hearing loss, meningismus, and CSF pleocytosis. The most likely diagnosis and causative mechanism are:
4. A patient with Behcet's disease presents with a hypopyon in the right eye. Which distinctive feature of Behcet's uveitis distinguishes it from other causes of hypopyon?
5. A 25-year-old woman develops unilateral vitritis, snow-banking of the vitreous over the inferior pars plana, and 'string of pearls' vitreous exudate. Systemic evaluation is negative. This presentation is consistent with:
6. A 28-year-old male with known ankylosing spondylitis (HLA-B27 positive) presents with sudden onset right eye redness, pain, and photophobia for 3 days. Slit-lamp shows 3+ cells, 2+ flare, and a fibrin exudate in the pupillary area. Posterior segment is clear. He has had 3 similar episodes in the last 2 years, always in the same eye. What is the MOST appropriate chronic maintenance therapy to prevent recurrences?
7. A 45-year-old woman presents with bilateral painless visual loss and floaters. Fundoscopy shows multifocal choroidal lesions at the level of retinal pigment epithelium, disc edema, and exudative retinal detachment bilaterally. She has a history of vitiligo and poliosis. The mechanism of retinal detachment in this condition is:
8. In the classification of uveitis by the SUN (Standardization of Uveitis Nomenclature) Working Group, how is 'intermediate uveitis' anatomically defined?
9. In HLA-B27-associated acute anterior uveitis (AAU), which slit-lamp finding, if present, favors sarcoid or Fuchs heterochromic iridocyclitis rather than HLA-B27 AAU?
10. Sympathetic ophthalmia typically manifests how long after the inciting ocular injury, and which histopathological finding is pathognomonic?
11. In intermediate uveitis (pars planitis), the snowbank exudate along the inferior ora serrata is composed primarily of:
12. Vogt-Koyanagi-Harada (VKH) disease is a diffuse granulomatous panuveitis associated with melanocyte-rich tissue inflammation. The PATHOGNOMONIC early finding on fluorescein angiography in the acute uveitic phase is:
13. A patient on long-term hydroxychloroquine therapy for rheumatoid arthritis develops bull's eye maculopathy. The American Academy of Ophthalmology (AAO) 2016 revised screening guidelines recommend baseline screening and annual screening beginning at what duration of use?
14. In birdshot chorioretinopathy, the HLA association that is essentially pathognomonic (present in >95% of cases) is:
15. Behcet's disease-associated uveitis is classified as which type, and which feature on slit-lamp examination is considered pathognomonic of its acute attacks?
16. In Vogt-Koyanagi-Harada (VKH) disease, the sunset glow fundus appearance develops due to:
17. A 28-year-old man with HLA-B27-positive ankylosing spondylitis presents with recurrent acute anterior uveitis. The characteristic pattern of his uveitis compared to HLA-B27-negative anterior uveitis is:
18. Vogt-Koyanagi-Harada (VKH) disease involves autoimmune attack on melanocyte-containing tissues. Which immunopathological mechanism is primarily responsible?
19. In toxoplasma retinochoroiditis, the 'headlight in the fog' appearance on fundoscopy refers to:
20. In a patient with bilateral panuveitis, CNS white matter lesions on MRI, poliosis, vitiligo, and sensorineural hearing loss, the diagnosis is Vogt-Koyanagi-Harada (VKH) disease. The pathognomonic OCT finding in the acute phase is:
21. In Behcet's disease-associated uveitis, the characteristic retinal finding that distinguishes it from other forms of posterior uveitis is:
22. HLA-B27 associated acute anterior uveitis is characterized by all EXCEPT:
23. In Vogt-Koyanagi-Harada (VKH) syndrome, the characteristic choroidal thickening seen on enhanced depth imaging OCT (EDI-OCT) is most prominent during which phase?
24. Intermediate uveitis (pars planitis) is characterized by vitritis and 'snowbank' formation. The snowbank is composed of:
25. In ocular toxoplasmosis, the characteristic retinochoroiditis appears as a white fluffy lesion adjacent to an old chorioretinal scar ('headlight in fog'). The pathological explanation for this pattern is:
26. Vogt-Koyanagi-Harada (VKH) disease is a granulomatous panuveitis with characteristic systemic manifestations. The MOST specific early ocular finding in the acute uveitic phase is:
27. Vogt-Koyanagi-Harada (VKH) disease is a bilateral granulomatous panuveitis. Which systemic features in the prodromal phase help differentiate VKH from sympathetic ophthalmia?
28. Fuchs' heterochromic iridocyclitis (FHI) is a unilateral anterior uveitis that is characteristically DIFFERENT from other forms of anterior uveitis in which way?
29. A 25-year-old HLA-B27 positive man presents with recurrent acute anterior uveitis (AAU). Slit lamp shows 3+ cells in the anterior chamber, fibrinous exudate, and a hypopyon. He has also been diagnosed with ankylosing spondylitis. The CHARACTERISTIC feature that distinguishes HLA-B27-associated AAU from other forms is:
30. A 35-year-old Japanese woman develops bilateral progressive visual loss with headaches, hearing loss, and tinnitus over 4 weeks. Fundus shows bilateral disc edema and exudative retinal detachments. She is diagnosed with Vogt-Koyanagi-Harada (VKH) disease. The MOST appropriate initial treatment is:
31. A 28-year-old HLA-B27-positive man presents with recurrent acute anterior uveitis. The current episode shows 3+ cell and flare, hypopyon, and posterior synechiae. He also has bilateral sacroiliac joint tenderness. Which condition is he most likely to have, and which pattern of uveitis does it typically produce?
32. A 35-year-old woman presents with bilateral gradual visual blurring, chorioretinal lesions, and a 'sunset glow' fundus. She also has a history of poliosis (white eyelashes), vitiligo, and bilateral sudden onset of headaches with neck stiffness 6 months prior. The diagnosis is:
33. A 26-year-old HLA-B27 positive man presents with recurrent acute anterior uveitis (3rd episode). He has bilateral sacroiliac joint pain. The most important ophthalmological complication of chronic recurrent HLA-B27 associated anterior uveitis that must be monitored is:
34. A 35-year-old woman with Vogt-Koyanagi-Harada (VKH) disease in the acute uveitic phase presents with bilateral exudative retinal detachments, disc hyperaemia, and meningismus. The investigation finding most characteristic of VKH during the acute phase is:
35. A patient with recurrent HLA-B27-associated anterior uveitis presents with a red painful eye. Slit-lamp shows a hypopyon and keratic precipitates (KPs). The KPs in this case are most likely:
36. A 28-year-old woman presents with unilateral panuveitis, posterior synechiae, and a hypopyon. Chest X-ray shows bilateral hilar lymphadenopathy. Serum ACE and lysozyme are elevated. The MOST likely diagnosis causing her uveitis is:
37. Toxoplasma gondii posterior uveitis is characterised by which fundus appearance?
38. Vogt-Koyanagi-Harada (VKH) disease in the acute uveitic stage classically shows which finding on FFA?
39. Vogt-Koyanagi-Harada (VKH) disease is a systemic autoimmune condition targeting melanocytes. Its ocular phase is characterized by:
40. A 25-year-old man has recurrent unilateral anterior uveitis with posterior synechiae. HLA-B27 testing is positive. He also reports lower back pain that is worse in the morning. Which associated systemic condition should be most actively sought?
41. On slit-lamp examination of a patient with chronic panuveitis, large greasy 'mutton-fat' (granulomatous) KPs are seen on the corneal endothelium, together with iris nodules (Koeppe and Busacca), and posterior synechiae. Chest X-ray shows bilateral hilar lymphadenopathy. What is the diagnosis?
42. A 35-year-old HLA-B27 positive man presents with recurrent acute anterior uveitis. The CHARACTERISTIC slit-lamp finding distinguishing HLA-B27 associated uveitis from other causes is:
43. Vogt-Koyanagi-Harada (VKH) disease is a panuveitis syndrome. The PRODROMAL features before ocular inflammation begins include:
44. In Behcet's disease associated uveitis, the pathognomonic fundus finding that distinguishes it from other forms of panuveitis is:
45. Birdshot chorioretinopathy is strongly associated with HLA-A29 (>95% of cases). The characteristic fundus finding that distinguishes it from multifocal choroiditis is:
46. Inclusion conjunctivitis in a sexually active adult is caused by Chlamydia trachomatis serovars D–K. The characteristic clinical sign on upper tarsal examination that differentiates it from trachoma is: