1- Which of the following is the least specific optic disc sign for glaucoma? A- Optic disc hemorrhage B- Alpha zone type of peripapillary atrophy C-Cup asymmetry between the two eyes D-Notch of the neural rim 2- What is the easiest way to evaluate the nerve fiber layer for glaucomatous damage? A- Direct ophthalmoscope B- Color stereo photographs C- 78 D lens at slit lamp D- Monochromatic, monoscopic high contrast photographs 3- Which is the best automated method with which to detect NFL abnormalities? A- Confocal scanning laser B- Yet to be determined C- Nerve fiber layer polarimetry D- Optical coherence tomography 4- Disc hemorrhages occur most frequently in patients with: A- Diabetes mellitus B- Ocular hypertension C- Posterior vitreous detachment D- Normal pressure glaucoma 5- A risk factor for the development of glaucoma is: A- Obesity B- High blood pressure C- Cigarette smoking D- Family history of glaucoma E- Diabetes 6- The least important risk factor for open-angle glaucoma is: A- Level of intraocular pressure B- Optic nerve cup size C- Family history D- Age 7- Which is false with regard to target pressure? A- Choice of target pressure is influenced by the degree of ocular damage B- Once a target pressure is chosen, it should be maintained for the remainder of the patients' lifetime C- Target pressure may fluctuate from time to time D- The proof of glaucoma control can only be obtained retrospectively by examination of the optic nerve and visual field 8-There is strong unequivocal evidence to suggest that NTG and POAG are fundamentally different. A- True B- False 9- There is a consensus on the definition of NTG and POAG. A- True B- False 10- Non-glaucomatous mechanisms of optic disc cupping include all of the following except: A- Dominant optic atrophy B- Optic nerve infarction C- Optic nerve compression D- Optic disc drusen 11- All of the following represent specific signs of glaucomatous optic disc cupping except: A- Optic disc hemorrhage B- Dyschromatopsia C- Nerve fiber bundle visual field defect D- Vertical neural rim loss 12- Which age group is most likely to be diagnosed with pigment dispersion or pigmentary glaucoma? A- Age 0-10 years B- Age 10-20 years C- Age 30-50 D- Age 60-80 E- Age 80 and older 13- What is the expected refractive error for the majority of patients with pigmentary dispersion syndrome? A- Hypertropic B- Emmetropic C- High astigmatism D- Low to moderate myopia (1.00 to -4.00) E- High myopia (-8.00 and over) 14- Immediately after laser iridotomy in pigmentary glaucoma: A- Fluid rushes into the posterior chamber B- Iris flattening occurs in one month C- The lens moves forward D- IOP lowers in one day 15- Which drug both lowers IOP and flattens the iris in pigmentary glaucoma? A- Brimonidine B- Dapiprazole C- Pilocarpine D- Timolol 16- Neuroprotection has been proven to be of clinical benefit in most: A- Neurological diseases B- Ophthalmological diseases C- Neuro-ophthalmological diseases D- None of the above 17- Which of the following provide the best evidence for assessing claims of neuroprotection: A- Cell culture studies with retinal ganglion cells B- Rodent models of glaucoma C- Primate models of glaucoma D- Randomized controlled trials in patients with glaucoma 18- Current thinking ascribes the major resistance to aqueous outflow to: A- Inner wall endothelium of Schlemm's canal. B- Uveal portion of the trabecular meshwork. C- Corneoscleral portion of the trabecular meshwork. D- Juxtacanalicular region of the trabecular meshwork. 19- Perturbation of the actin cytoskeleton in the trabecular meshwork leads to: A- Compaction of the meshwork and increased outflow resistance B- Expansion of the meshwork and decreased outflow resistance C- Collapse of Schlemm's canal and increased outflow resistance D- Contraction of the ciliary muscle, causing meshwork collapse and increased outflow resistance 20- Familial juvenile primary open angle glaucoma is usually inherited in what manner? A- Autosomal recessive B- X-linked recessive C- Autosomal dominant D- Mitochondrial 21- Acute Angle Closure Glaucoma is more frequent among: A- Adults in the sixth or seventh decades of life B- Females C- Hyperopes D- All of the above 22- The proper method to differentiate appositional from synechiael angle closure is: A- Indentation gonioscopy B- The Van Herick Technique C- Gonioscopy D- None of the above 23- Sequelae associated with laser iridotomy may include the following except: A- Perception of horizontal colored streaks B- Retinal detachment C- Disruption of extensive posterior synechiae D- Gradual closure of patent iridotomy 24- Pupillary-block acute angle-closure glaucoma may be definitively treated by all of the following except: A- Medical therapy followed by laser iridoplasty B- Medical therapy followed by laser iridotomy C- Medical therapy followed by surgical iridectomy D- Laser iridoplasty followed by laser iridotomy 25- Hypotony maculopathy is a serious complication of antimetabolite filtering surgery. A- To be recognized and treated immediately B- Responds to simple measures of therapy C- Vitreous surgery with intraocular gas is helpful D- Visual prognosis is improved if hypotony is reversed 26- Bleb leaks can result in many vision threatening sequelae except: A- Bleb-related infection B- Retinal detachment with MVR C- Chronic hypotony with maculopathy D- Spontaneous resolution and recurrent leaks 27- Which of the following is not true for trabeculectomy? A- Comparative studies lead to the replacement of full thickness filtration pressures B- 30 years of experience C- Antimetabolite use increases success rate in high risk cases D- Effectiveness in lowering intraocular pressure depends on the removal of trabecular meshwork 28- What is peculiar to Viscocanalostomy? A- It is an easy and quick surgery B- It is non-penetrating and its outcome unrelated to bleb formation C- It requires a surgical iridectomy D- It has been extensively investigated 29- Compared with primary open-angle glaucoma, the clinical course of exfoliation with glaucoma may be characterized as: A- More severe B- The same C- Less severe D- Not known 30- In patients with exfoliation found on clinical examination, electron microscopy may show characteristic deposits of exfoliation material in: A- The anterior lens capsule B- The conjunctiva C- The skin and visceral organs D- All of the above 31- What is true about management of exfoliative glaucoma? A- Good and long term response to medical treatment B- There is specific treatment to prevent exfoliation material deposition C- Laser iridotomy is first choice in all cases D- Surgical treatment is often needed to control the disease 32- What describes best the response of exfoliative glaucoma to laser trabeculoplasty? A- Difficult to perform B- Significantly better long term effect than in POAG C- Good initial hypotensive effect that decreases with time D- No pressure spikes have been described after treatment 33- Which is NOT a result of using anti-metabolites in filtering surgery? A- Low target pressures more often achieved B- Increased risks of hypotony and bleb infection C- Reduced frequency of post-operative visits D- Reduced risk of cataract formation 34- Which of the following is the least risk factor for failure of glaucoma filtration surgery? A- Afro-Caribbean origin B- Previous topical Beta blocker usage C- Conjunctival inflammation D- Previous conjunctival surgery 35- Which of the following is TRUE about 5-fluorouracil? A- The commonest concentration for injection is 5 mg/ml B- It has to be reconstituted from powder before use C- It has a pH of 9 D- It is only stable at room temperature for 1 week E- It is more expensive than Mitomycin C 36- The most common complication of diode transscleral cyclophotocoagulation is: A- Bleeding B- Inflammation C- Phthisis D- Vision loss 37- What is the overall initial success rate of diode transscleral cyclophotocoagulation in refractory glaucoma? A- 25% B- 50% C- 65% D- 85% 38- Mitomycin C in Trabeculectomy provides all the following EXCEPT? A- Lower intraocular pressure B- Less postoperative glaucoma medication needed C- Lower postoperative complication rate D- Lower filter failure rate 39- Which condition is most likely to need intraoperative management during trabeculectomy in a pseudophakic eye? A- Opacified posterior chamber B- Vitreous in the anterior chamber C- Posterior synechiae D- Peripheral anterior synechiae 40- Drainage devices with valve-like mechanisms may cause: A- Strabismus B- Ocular hypotony C- Neither A or B D- Both A and B 41- Which of the following is not recognized as a prognostic factor for glaucoma surgery failure? A- Race B- Prior intraocular surgeries C- Gender D- Type of glaucoma 42- Commercially available image analysis systems for optic nerve or nerve fiber layer include: A- Confocal scanning laser topography B- Scanning laser polarimetry C- Optical coherence tomography D- All of the above 43- Published prospective multicentered clinical trials have proven that progressive glaucomatous damage can always be detected by: A- Confocal scanning laser topography B- Scanning laser polarimetry C- Optical coherence tomography D- None of the above 44- Objective measures of visual function include all of the following except: A- Multifocal ERG B- Short Wave Length Automated Perimetry C- Pupil Perimetry D- Full Flash ERG E- Visual Evoked Potential 45- Multifocal Electroretinograms: A- Combine traditional ERG technology with automated perimetry B- Measures ERG responses to local luminance modulation C- Allows the clinician to differentiate various forms of glaucoma D- Correlates well with perimetric measures in late glaucoma 46- Which of the following can respond paradoxically to pilocarpine with worsening of the angleclosure glaucoma? A- Pupillary block B- Plateau iris syndrome C- Aqueous misdirection D- A and C 47- Chronic angle closure glaucoma can occur as a result of all of the following EXCEPT: A- Creeping angle-closure B- Subacute attacks of angle-closure C- Chronic miotic therapy D- Pigment dispersion syndrome 48- HLA-B27 testing should be considered when: A- There is evidence of herpes B- Fuch's heterochromic iridocyclitis is suspected C- There is anterior iritis associated with arthritis D- There is evidence of posterior uveitis 49- The following statements regarding medical therapy of inflammatory glaucoma are TRUE except: A- Reducing or stopping topical corticosteroids may improve the IOP control B- Miotics and prostaglandin analogs are usually beneficial C- Beta-adrenergic antagonists are useful in open and closed angle glaucoma D- An Alpha-2 antagonist may be used as primary or adjunctive therapy 50- What factor is the most important directing the treatment of neovascular glaucoma? A- Level of IOP B- Amount of inflammation C- Visual potential including acuity D- Status of angle 51- Initial surgery for primary congenital glaucoma should be which one of the following: A- Diode laser cyclophotocoagulation B- Mitomycin-C augmented trabeculectomy C- Ahmed valve D- Trabeculotomy 52- When an eye is experiencing hypotony in the first month after tube-shunt implantation, which of the following would NOT be an indication for surgical intervention? A- Flat anterior chamber with IOL touch to the cornea B- Tube touch to the cornea C- "Kissing" choroidals D- An IOP of 2 mmHg 53- Clinical situations that are particularly challenging for tube-shunt implantation include all of the following EXCEPT: A- Active rubeosis B- History of previous cyclodestruction C- The presence of an IOL D- The presence of a scleral buckle 54- Indications for bleb needling include all of the following EXCEPT: A- Episcleral fibrosis B- Encapsulated bleb C- Subconjunctival fibrosis D- Vitreous to the sclerostomy 55- Reported complications of bleb needling include all of the following EXCEPT: A- Hyphema B- Endophthalmitis C- Aqueous misdirection D- Choroidal hemorrhage 56- Diagnostic criteria for bleb-related endophthalmitis include the following EXCEPT: A- Rapidly progressive symptoms B- Mininmal anterior chamber reaction C- Pain D- Loss of vision
