Welcome to your 👶 Childhood Blindness, Leukocoria & Amblyopia Arena — 40 Integrated MCQs
1.
A child has a large advanced unilateral retinoblastoma with little possibility of useful vision. Which treatment may be required?
2.
A 3-year-old child with untreated retinoblastoma develops increasing ocular pain and redness. Intraocular pressure is markedly elevated. Which complication most directly explains the new symptoms?
3.
A 6-month-old infant with congenital glaucoma has watering and photophobia. The cornea has become diffusely hazy as the intraocular pressure rises. What is the most likely explanation for this appearance?
4.
A child underwent surgery for a visually significant congenital cataract and achieved a clear visual axis. During long-term follow-up, which ocular complication should remain an important part of surveillance?
5.
A 20-month-old child presents with a white pupillary reflex. Fundus examination shows a creamy-white retinal mass. Which diagnosis is most likely?
6.
A congenital cataract involves a particular layer of the lens while adjacent layers remain relatively clear. Which type is described?
7.
A 3-month-old infant has a dense central congenital cataract. Which complication is of greatest concern if treatment is delayed?
8.
A 2-year-old child has leukocoria and a suspected intraocular mass. Which investigation is particularly useful for demonstrating calcification within the lesion?
9.
Which approach best summarizes the management of preventable or treatable childhood blindness?
10.
A 5-year-old boy presents with unilateral leukocoria and gradual visual deterioration. Fundus examination shows abnormal telangiectatic retinal vessels with extensive yellow subretinal exudation. Ocular ultrasonography shows no intraocular calcification. Which diagnosis best explains these findings?
11.
A child with suspected retinoblastoma requires assessment of possible optic-nerve and intracranial extension. Which investigation is most appropriate?
12.
A 9-month-old child born markedly premature develops poor visual behaviour. Examination shows bilateral retinal traction with advanced retinal detachment producing a white pupillary reflex. Which underlying disorder is most likely?
13.
A 7-month-old infant has primary congenital glaucoma with elevated intraocular pressure and progressive enlargement of the eye. The cornea remains sufficiently clear to visualize the anterior chamber angle. Which procedure most directly addresses the abnormal trabecular tissue from within the anterior chamber?
14.
What is the primary treatment priority in a child with retinoblastoma?
15.
A child presents with leukocoria. Examination shows that the white opacity lies within the crystalline lens. Which diagnosis is most likely?
16.
An infant presents with excessive tearing, intolerance of bright light and forceful eyelid closure. The cornea appears enlarged and hazy. Which diagnosis is most likely?
17.
A 2-year-old child is found to have an intraocular retinal mass highly suspicious for retinoblastoma. A tissue diagnosis is suggested before treatment. Which management principle is most appropriate?
18.
A child has a marked difference in refractive error between the two eyes. One eye receives a consistently blurred image during visual development. Which type of amblyopia may result?
19.
Which examination provides the most useful initial screening clue in a child suspected of having leukocoria?
20.
A 5-month-old infant is found to have a small peripheral congenital lens opacity. The central visual axis remains clear, fixation is good, and the red reflex is preserved. What is the most appropriate management?
21.
Which statement best defines amblyopia?
22.
A 10-month-old infant has had dense bilateral congenital cataracts since early infancy. Examination now reveals horizontal nystagmus despite anatomically normal optic nerves. Which mechanism best explains the development of the nystagmus?
23.
A 14-month-old child has multiple retinal tumours involving both eyes. A sibling was treated for retinoblastoma during infancy. Which explanation best accounts for this presentation?
24.
An infant with congenital glaucoma has enlarged corneas and curvilinear lines within the posterior cornea. Which structural change is responsible for these lines?
25.
A 4-month-old infant has unilateral leukocoria. The affected eye is smaller than the fellow eye, and examination reveals fibrovascular tissue behind the lens. Which condition is the most likely cause?
26.
A child with amblyopia has already received appropriate refractive correction. Which treatment may be used to encourage use of the poorer-seeing eye?
27.
A small retinoblastoma is detected early in a child. The lesion is localized, the eye has useful visual potential, and there is no evidence of extraocular extension. Which treatment approach is most appropriate for direct destruction of such a selected tumour?
28.
A child is diagnosed with retinoblastoma. Which genetic abnormality is most closely related to the development of this tumour?
29.
An 8-year-old child has severe bilateral visual impairment from an inherited retinal dystrophy. Ophthalmic assessment concludes that useful central vision cannot be restored by surgery or medication. What is the most appropriate next management principle?
30.
A 7-year-old child with unilateral amblyopia has received full refractive correction but continues to rely strongly on the better-seeing eye. Occlusion is poorly tolerated. Atropine is prescribed in the better eye. What is the therapeutic purpose of this treatment?
31.
A 5-year-old child has longstanding unilateral esotropia. Cycloplegic refraction shows no significant interocular refractive difference, and anterior segment and fundus examinations are normal. Visual acuity is substantially lower in the deviating eye. Which type of amblyopia is most likely?
32.
A 3-month-old infant has an opacity situated centrally at the posterior pole of the crystalline lens. The remainder of the lens is relatively clear. Which morphological type of congenital cataract is most consistent with this finding?
33.
Why may the eye become enlarged in congenital glaucoma?
34.
A child with bilateral retinoblastoma requires imaging to assess disease extent. The ophthalmologist wishes to minimize unnecessary ionizing radiation because hereditary disease is suspected. Which investigation strategy best fits this objective?
35.
Which description best defines congenital cataract?
36.
A 6-year-old child has reduced visual acuity in both eyes. Cycloplegic refraction reveals a high and approximately equal refractive error in both eyes. There is no strabismus and ocular structures are normal. Which form of amblyopia best explains the visual loss?
37.
A child undergoes surgery for a visually significant congenital cataract. Which additional measure is most important for achieving useful visual development?
38.
What is the main underlying abnormality in primary congenital glaucoma?
39.
A 2-year-old child is brought because the parents have noticed a white reflection from one pupil in photographs. What is the most appropriate interpretation of this finding?
40.
A 6-year-old child has unilateral visual loss and leukocoria. Fundus examination reveals a localized inflammatory retinal granuloma with vitreous inflammation rather than a solid calcified mass. Which diagnosis is most likely?
