Q.1 Which of the following is the most important risk factor for primary open-angle glaucoma?
High myopia
Increased intraocular pressure
Diabetes mellitus
Family history of cataract
Explanation - Raised intraocular pressure is the most significant modifiable risk factor for primary open-angle glaucoma, although not all patients with elevated IOP develop the disease.
Correct answer is: Increased intraocular pressure
Q.2 What is the typical appearance of the optic disc in advanced glaucoma?
Disc swelling
Cup-to-disc ratio enlargement
Disc pallor with sharp margins
Small crowded disc
Explanation - Glaucoma leads to progressive optic nerve head cupping, causing an increased cup-to-disc ratio.
Correct answer is: Cup-to-disc ratio enlargement
Q.3 Which of the following is considered a first-line treatment for primary open-angle glaucoma?
Laser photocoagulation
Topical beta-blockers
Systemic corticosteroids
Vitrectomy
Explanation - Topical beta-blockers (like timolol) are among the first-line treatments to reduce intraocular pressure in primary open-angle glaucoma.
Correct answer is: Topical beta-blockers
Q.4 Which nerve is primarily affected in glaucoma?
Optic nerve
Oculomotor nerve
Abducens nerve
Trochlear nerve
Explanation - Glaucoma is a progressive optic neuropathy characterized by damage to the optic nerve head.
Correct answer is: Optic nerve
Q.5 What type of visual field defect is commonly seen in glaucoma?
Central scotoma
Bitemporal hemianopia
Arcuate scotoma
Altitudinal defect
Explanation - Glaucoma typically causes arcuate scotomas due to selective loss of retinal nerve fibers in characteristic patterns.
Correct answer is: Arcuate scotoma
Q.6 Which medication can precipitate angle-closure glaucoma in susceptible individuals?
Atropine
Pilocarpine
Timolol
Brimonidine
Explanation - Mydriatic drugs like atropine can precipitate acute angle-closure glaucoma by narrowing the anterior chamber angle.
Correct answer is: Atropine
Q.7 Which surgical procedure is most commonly performed for glaucoma when medications fail?
Trabeculectomy
LASIK
Keratoplasty
Scleral buckle
Explanation - Trabeculectomy is the standard surgical procedure used to lower intraocular pressure when medical therapy is insufficient.
Correct answer is: Trabeculectomy
Q.8 What is the normal range of intraocular pressure?
5-10 mmHg
10-21 mmHg
20-30 mmHg
30-40 mmHg
Explanation - Normal intraocular pressure ranges between 10-21 mmHg, with levels above this considered suspicious for glaucoma.
Correct answer is: 10-21 mmHg
Q.9 Which imaging technique is commonly used to assess optic nerve damage in glaucoma?
OCT (Optical Coherence Tomography)
Fundus fluorescein angiography
Ultrasound biomicroscopy
CT scan
Explanation - OCT provides high-resolution images of the retinal nerve fiber layer and optic nerve head, useful for glaucoma evaluation.
Correct answer is: OCT (Optical Coherence Tomography)
Q.10 Which symptom is most typical of acute angle-closure glaucoma?
Gradual loss of vision
Eye pain with halos around lights
Painless central vision loss
Asymptomatic progression
Explanation - Acute angle-closure glaucoma presents with severe eye pain, blurred vision, halos, and systemic symptoms like nausea.
Correct answer is: Eye pain with halos around lights
Q.11 In glaucoma, which part of the visual field is often affected first?
Central vision
Peripheral vision
Color vision
Binocular vision
Explanation - Glaucoma characteristically causes peripheral visual field loss before central vision is affected.
Correct answer is: Peripheral vision
Q.12 Which drug class reduces aqueous humor production?
Carbonic anhydrase inhibitors
Miotics
Prostaglandin analogs
Alpha-adrenergic agonists
Explanation - Carbonic anhydrase inhibitors (like acetazolamide, dorzolamide) lower IOP by reducing aqueous humor secretion.
Correct answer is: Carbonic anhydrase inhibitors
Q.13 What is the major site of aqueous humor outflow?
Iris root
Canal of Schlemm
Corneal stroma
Posterior chamber
Explanation - The conventional pathway of aqueous humor drainage is via trabecular meshwork into the Canal of Schlemm.
Correct answer is: Canal of Schlemm
Q.14 Which test is the gold standard for measuring intraocular pressure?
Non-contact tonometry
Applanation tonometry
Indentation tonometry
Ocular response analyzer
Explanation - Goldmann applanation tonometry is considered the gold standard for IOP measurement.
Correct answer is: Applanation tonometry
Q.15 What is the most common type of glaucoma worldwide?
Primary open-angle glaucoma
Primary angle-closure glaucoma
Congenital glaucoma
Secondary glaucoma
Explanation - Primary open-angle glaucoma is the most common type globally, particularly in Western populations.
Correct answer is: Primary open-angle glaucoma
Q.16 Which of the following is a risk factor for angle-closure glaucoma?
Deep anterior chamber
Hyperopia
Myopia
Male sex
Explanation - Hyperopia is associated with a shallow anterior chamber, predisposing to angle-closure glaucoma.
Correct answer is: Hyperopia
Q.17 Which glaucoma medication increases uveoscleral outflow?
Prostaglandin analogs
Beta-blockers
Carbonic anhydrase inhibitors
Miotics
Explanation - Prostaglandin analogs (e.g., latanoprost) reduce IOP by enhancing uveoscleral outflow.
Correct answer is: Prostaglandin analogs
Q.18 In congenital glaucoma, what is the classical triad of symptoms?
Photophobia, epiphora, blepharospasm
Pain, redness, halos
Headache, vomiting, blurred vision
Ptosis, strabismus, diplopia
Explanation - The triad of congenital glaucoma is photophobia, excessive tearing, and blepharospasm.
Correct answer is: Photophobia, epiphora, blepharospasm
Q.19 Which of the following is NOT a common risk factor for glaucoma?
Positive family history
Old age
Hypertension
Astigmatism
Explanation - Astigmatism is a refractive error and is not associated with an increased risk of glaucoma.
Correct answer is: Astigmatism
Q.20 Which finding differentiates optic atrophy due to glaucoma from other causes?
Pale disc
Increased cup-to-disc ratio
Retinal hemorrhages
Macular involvement
Explanation - Glaucomatous optic atrophy is specifically characterized by cupping, not just pallor.
Correct answer is: Increased cup-to-disc ratio
Q.21 Which angle-closure glaucoma treatment is definitive?
Topical beta-blockers
IV acetazolamide
Laser peripheral iridotomy
Oral glycerol
Explanation - Laser iridotomy relieves pupillary block and is the definitive treatment for angle-closure glaucoma.
Correct answer is: Laser peripheral iridotomy
Q.22 What is the earliest structural change in the optic disc in glaucoma?
Disc pallor
Notching of neuroretinal rim
Total cupping
Peripapillary atrophy
Explanation - Early glaucomatous changes involve localized thinning or notching of the neuroretinal rim.
Correct answer is: Notching of neuroretinal rim
Q.23 Which visual field test is most sensitive for early glaucoma?
Confrontation test
Goldmann perimetry
Automated perimetry
Tangent screen test
Explanation - Automated perimetry provides reproducible and detailed assessment of visual fields, making it sensitive for early glaucoma.
Correct answer is: Automated perimetry
Q.24 Which condition is known as 'secondary glaucoma'?
Glaucoma after uveitis
Congenital glaucoma
Juvenile open-angle glaucoma
Normal tension glaucoma
Explanation - Glaucoma developing as a result of another ocular disease like uveitis is called secondary glaucoma.
Correct answer is: Glaucoma after uveitis
Q.25 What is the pathophysiology behind normal-tension glaucoma?
Raised IOP damages optic nerve
Optic nerve ischemia despite normal IOP
Congenital angle anomaly
Uveoscleral outflow obstruction
Explanation - Normal-tension glaucoma is thought to result from optic nerve susceptibility to ischemia and vascular dysregulation at normal pressures.
Correct answer is: Optic nerve ischemia despite normal IOP