FREE Board Certified Ophthalmologist Cornea and External Disease Questions and Answers

Question 1

A 24-year-old soft contact lens wearer presents with severe right eye pain that is disproportionate to clinical signs.
Slit-lamp examination reveals a stromal ring infiltrate and radial keratoneuritis.
What is the most specific diagnostic modality to confirm the suspected diagnosis?

Accepted Answer

In vivo confocal microscopy

Answer

Corneal scraping with Gram stain and culture

Answer

Polymerase chain reaction (PCR) for viral DNA

Answer

Specular microscopy of the endothelium

Question 2

Which of the following corneal dystrophies is characterized by an autosomal recessive inheritance pattern and the deposition of glycosaminoglycans (mucin) within the corneal stroma?

Accepted Answer

Macular Dystrophy

Answer

Lattice Dystrophy

Answer

Granular Dystrophy

Answer

Fuchs' Endothelial Dystrophy

Question 3

A 35-year-old male presents with progressive, painless blurring of vision. Refraction reveals high against-the-rule astigmatism. Corneal topography shows a narrow band of inferior thinning from the 4 o'clock to the 8 o'clock position, located 1-2 mm from the limbus, with steepening of the cornea just superior to this band. The central cornea is of normal thickness. This presentation is most characteristic of which condition?

Accepted Answer

Pellucid Marginal Degeneration

Answer

Keratoglobus

Answer

Central (nipple cone) Keratoconus

Answer

Posterior Keratoconus

Question 4

A 30-year-old patient is diagnosed with active herpes simplex virus (HSV) epithelial keratitis, characterized by a well-defined dendritic ulcer with terminal bulbs that stains with fluorescein. Which of the following interventions is strictly contraindicated in the management of this patient?

Accepted Answer

Topical prednisolone acetate

Answer

Oral valacyclovir

Answer

Topical ganciclovir gel

Answer

Corneal debridement

Question 5

A 72-year-old patient is seen on postoperative day 1 after Descemet's Membrane Endothelial Keratoplasty (DMEK). The cornea is edematous, and a large, partially detached but correctly oriented graft is noted in the anterior chamber. What is the most appropriate next step in management?

Accepted Answer

Perform a rebubbling procedure with air or gas

Answer

Proceed immediately with a full-thickness penetrating keratoplasty (PKP)

Answer

Prescribe topical hypertonic saline and observe for one week

Answer

Start high-dose oral corticosteroids to reduce inflammation

Question 6

Which of the following systemic autoimmune diseases is most frequently associated with the development of necrotizing scleritis?

Accepted Answer

Rheumatoid Arthritis

Answer

Systemic Lupus Erythematosus

Answer

Sarcoidosis

Answer

Inflammatory Bowel Disease

A 24-year-old soft contact lens wearer presents with severe right eye pain that is disproportionate to clinical signs.Slit-lamp examination reveals a stromal ring infiltrate and radial keratoneuritis.What is the most specific diagnostic modality to confirm the suspected diagnosis?

A 24-year-old soft contact lens wearer presents with severe right eye pain that is disproportionate to clinical signs.
Slit-lamp examination reveals a stromal ring infiltrate and radial keratoneuritis.
What is the most specific diagnostic modality to confirm the suspected diagnosis?