KMU Past Paper Practice
MCQ 1
A 31-year-old man presents with a painful red eye and photophobia. Redness is most intense around the limbus rather than in the fornices. Which interpretation of this vascular pattern is most appropriate?
Options:
It suggests corneal or anterior uveal involvement
Circumcorneal or ciliary injection reflects deeper anterior-segment inflammation and is more concerning than diffuse superficial conjunctival redness.
MCQ 2
A patient with a red eye has mild grittiness and discharge but reads the same visual-acuity line as previously. Which feature most strongly supports a superficial conjunctival process rather than significant corneal disease?
Options:
Preserved visual acuity with a clear cornea
Uncomplicated conjunctival inflammation generally leaves the cornea clear and vision intact; reduced acuity should prompt a search for deeper disease.
MCQ 3
A patient has persistent unilateral conjunctival inflammation after soil contamination. Routine antibacterial treatment has failed, and the ophthalmologist suspects an uncommon fungal conjunctival infection. Which investigation is most appropriate to establish the cause?
Options:
Conjunctival sampling for microscopy and culture
Atypical chronic conjunctivitis suspected to be fungal requires direct examination and culture of conjunctival material to identify the organism.
MCQ 4
A welder develops severe bilateral ocular pain, watering and photophobia several hours after working without eye protection. Slit-lamp examination shows diffuse punctate epithelial staining without a focal infiltrate. Which diagnosis best fits this presentation?
Options:
Ultraviolet photokeratitis
UV injury damages corneal epithelial cells and typically causes delayed bilateral pain, photophobia and diffuse punctate epithelial defects.
MCQ 5
A central bacterial corneal ulcer heals after appropriate antimicrobial therapy. Infection resolves, but the patient’s vision remains reduced. Which residual change most directly explains the persistent visual impairment?
Options:
Central stromal scarring
A healed ulcer can leave an opaque stromal scar; when it lies in the visual axis, corneal transparency and visual acuity remain impaired.
MCQ 6
A patient with a large corneal ulcer has intense pain from associated anterior segment inflammation. In addition to antimicrobial therapy, a cycloplegic is prescribed. What is the principal benefit of this drug in this setting?
Options:
Reduction of painful ciliary spasm
Cycloplegia relaxes the ciliary body and reduces pain from associated anterior uveal irritation; it does not replace antimicrobial treatment.
MCQ 7
A patient with severe microbial keratitis has a layered collection of inflammatory cells in the inferior anterior chamber. Which term correctly describes this finding?
Options:
Hypopyon
A hypopyon is a visible collection of inflammatory cells in the inferior anterior chamber and indicates severe anterior-segment inflammation.
MCQ 8
An infant has persistent epiphora and mucous reflux from the punctum. The ophthalmologist explains lacrimal sac massage to the parents. How can effective massage help relieve the obstruction?
Options:
It raises hydrostatic pressure against the distal membrane
Proper sac massage increases pressure within the lacrimal system and may help rupture the persistent distal membrane causing congenital obstruction.
MCQ 9
An adult with long-standing epiphora and mucopurulent reflux has confirmed persistent nasolacrimal duct obstruction. Recurrent symptoms continue despite treatment of intermittent infection. Which procedure most directly provides definitive drainage?
Options:
Dacryocystorhinostomy
DCR bypasses the obstructed nasolacrimal duct by creating a new drainage pathway between the lacrimal sac and the nasal cavity.
MCQ 10
A patient with chronic dacryocystitis is scheduled for elective intraocular surgery. Why should persistent lacrimal sac infection be addressed before the operation?
Options:
It can repeatedly contaminate the ocular surface
An infected lacrimal sac acts as a reservoir of organisms that can contaminate the ocular surface and increase the risk of intraocular infection.
MCQ 11
A 50-year-old office worker has fluctuating vision and ocular irritation. Fluorescein examination shows that the uniform tear film breaks into dry spots rapidly after a blink. What aspect of ocular-surface function is this test primarily assessing?
Options:
Tear-film stability
Tear-film break-up assessment measures how rapidly the precorneal tear film loses uniformity after blinking and is therefore a test of tear-film stability.
MCQ 12
A patient with dry-eye symptoms reports excessive watering when exposed to wind. Which explanation best accounts for this apparently contradictory symptom?
Options:
Surface irritation triggers reflex lacrimal secretion
An unstable dry ocular surface stimulates reflex tearing, so patients with dry eye may paradoxically complain of intermittent epiphora.
MCQ 13
A child with poor nutrition develops ocular-surface dryness. Which normal ocular-surface function is most directly impaired by vitamin A deficiency before severe corneal destruction occurs?
Options:
Maintenance of epithelial and goblet-cell differentiation
Vitamin A supports normal conjunctival and corneal epithelial differentiation and goblet-cell function; deficiency promotes xerosis and keratinization.
MCQ 14
A patient with chronic posterior blepharitis has thickened meibomian secretions and recurrent ocular irritation. Which initial measure best addresses the obstructed gland secretions?
Options:
Warm compresses with lid massage
Heat softens abnormal meibomian secretions and massage promotes gland expression, making these core measures for posterior blepharitis.
MCQ 15
A 43-year-old man has crusting around the eyelashes, scales at the lash bases and chronic lid-margin redness. The meibomian gland openings are relatively normal. Which form of lid disease is most consistent with these findings?
Options:
Anterior blepharitis
Anterior blepharitis primarily involves the lash follicles and anterior lid margin, producing scales, crusts and lid-margin inflammation.
MCQ 16
An outdoor worker has a slowly enlarging fibrovascular conjunctival lesion approaching the visual axis. Corneal topography is not required for this question; clinically, his refraction shows increasing astigmatic error. What is the most appropriate management principle?
Options:
Consider surgical excision because the lesion is affecting vision
Progressive pterygium can distort the cornea and induce astigmatism; visual interference is an accepted indication to consider excision.
MCQ 17
A 46-year-old woman with rheumatoid arthritis develops recurrent severe ocular inflammation involving the sclera. Which aspect of her history is most important when planning further assessment?
Options:
Presence of an associated systemic autoimmune disorder
Scleritis may accompany systemic autoimmune disease, so identifying and treating the associated systemic disorder is an important part of management.
MCQ 18
A 29-year-old man presents with a painless triangular nasal conjunctival growth extending toward the cornea. He works outdoors in intense sunlight. Which environmental factor is most closely associated with development of this lesion?
Options:
Chronic ultraviolet exposure
Pterygium is strongly associated with chronic UV exposure as well as dust and environmental surface irritation.
MCQ 19
A patient with severe ocular-surface disease has diffuse punctate fluorescein staining but no microbial infiltrate. What does the staining demonstrate at the tissue level?
Options:
Areas of corneal epithelial disruption
Fluorescein highlights areas where the normal corneal epithelial barrier is absent or damaged, making punctate surface injury visible.
MCQ 20
A patient with recurrent deep scleral inflammation is being considered for anti-inflammatory and immunosuppressive treatment. Which possibility should be specifically excluded before such therapy is intensified?
Options:
Infectious scleritis
Immunosuppression can worsen an unrecognized infection, so infectious scleritis must be excluded before escalating immunosuppressive treatment.