Board Certified Ophthalmologist Lens and Cataract Questions and Answers

Question 1

A 58-year-old patient with a history of severe rheumatoid arthritis, managed for over a decade with oral prednisone, presents with a chief complaint of disabling glare when driving at night and difficulty reading, which has worsened over the last year.
Visual acuity is 20/50 in the right eye and 20/40 in the left.
Slit-lamp examination is most likely to reveal which type of cataract?

Accepted Answer

Posterior subcapsular

Answer

Nuclear sclerotic

Answer

Cortical spoking

Answer

Traumatic rosette

Question 2

An 82-year-old man presents with a dense, white, mature cataract in his left eye, reducing vision to hand motion. The posterior segment cannot be visualized. Which of the following is the most critical ancillary test to perform to assess for co-existing posterior segment pathology before proceeding with cataract surgery?

Accepted Answer

B-scan ultrasonography

Answer

Corneal topography

Answer

Specular microscopy

Answer

Macular OCT

Question 3

The remarkable transparency and high refractive index of the human crystalline lens are primarily maintained by a high concentration of which family of water-soluble structural proteins?

Accepted Answer

Crystallins

Answer

Collagens

Answer

Albumins

Answer

Globulins

Question 4

A patient is evaluated on postoperative day 1 after uneventful phacoemulsification. They report minimal pain but significant blurriness. Examination reveals 20/200 vision, diffuse limbus-to-limbus corneal edema, and a deep, quiet anterior chamber with 1+ cell and no fibrin or hypopyon. What is the most likely diagnosis?

Accepted Answer

Toxic Anterior Segment Syndrome (TASS)

Answer

Infectious endophthalmitis

Answer

Retained cortical fragment

Answer

UGH (Uveitis-Glaucoma-Hyphema) Syndrome

Question 5

Which of the following is the LEAST established independent risk factor for the development of age-related cataracts?

Accepted Answer

Systemic hypertension

Answer

Diabetes mellitus

Answer

Chronic ultraviolet light exposure

Answer

Myopia

Question 6

A pediatrician refers a 2-month-old infant for evaluation of bilateral leukocoria. Examination under anesthesia confirms the presence of bilateral, dense, visually significant cataracts. Based on morphology, which type of congenital cataract is most commonly associated with the need for early surgical intervention?

Accepted Answer

Lamellar (zonular)

Answer

Sutural

Answer

Anterior polar

Answer

Cerulean (blue-dot)