Multiple choice questions in optometry:

In every question there are 4 options. You have to tell which one is correct. Some
questions are set in such a way that they may have more than one correct option.

1. At 20 feet, the smallest letters that a child can read is the 20/60 line. You have the child
walk toward the eye chart. How far does she walk before she can see the 20/20 line?

A) 15 feet

B) 7 feet

C) 13 feet

D) 5 feet

2. An adult has diplopia and a left hypertropia of 6∆. Which combination of prisms in his
glasses would help to align the two images for him?

OD OS

A)

3∆ base- up 3∆ base-up

B)

6∆ base-down Nothing

C)

4∆ base-down 2∆base-down

D)

3∆ base- up 3∆base-down
3. You measure a patient with a cranial VI nerve palsy to have an 8∆ distance esotropia.
How far apart do the images of a fixation light at 6 m appear to the patient?

A) 48 cm

B) 8 cm

C) 24 cm

D) 36 cm

4. A 6∆ base-out and an 8∆ base-down prism are replaced by a single prism. What is the
power of this prism?

A) 10∆

B) 14∆

C) 7∆

D) 2∆

5. An object is located 20 cm to the left of a -2.00 D lens. Where is the image located?

A) 20 cm to the right of the lens

B) 50 cm to the right of the lens

C) 33 cm to the left of the lens

D) 14 cm to the left of the lens

6. Without correction, a child complains that objects closer than 33 cm are blurry.
Cycloplegic refraction measured + 6.00 D sphere OU. How much accommodation does
this child have?

A) 6.00 D

B) 12.00 D
 C) 3.00 D

D) 9.00 D

7. What is the accommodative amplitude of a patient with a far point 20 cm behind the eye
and a near point at infinity?

A) 5 D

B) 1 D

C) 4 D

D) 2.5 D

8. What reading add is needed to his corrected distance prescription so that at 40 cm this
patient uses half of his accommodative amplitude?

A) +2.50 D

B) +1.75 D

C) +2.00 D

D) No reading add needed

9. When looking at an object at 25 cm, a patient has an esotropia of 30∆. With + 3.00 D
glasses, his esotropia decreases to 15∆. What is his distance esodeviation without
glasses?

A) 6∆

B) 10∆

C) 18∆

D) 36∆

10. A Galilean telescope is constructed with a +5.00 D objective and a - 10.00 D eyepiece.
What is the magnification of this telescope?
 A) ½×

B) 50×

C) 2×

D) 5×

11. You have a +10 D lens and a +20 D lens. You want to make a 2× magnifier. What is the
distance between the lenses to produce this magnification?

A) 10 cm

B) 15 cm

C) 5 cm

D) 25 cm

12. How much accommodation is required to view an object 1 m in front of the + 10 D lens?

A) 2 D

B) 10 D

C) 5 D

D) 8 D

13. Prescription swimming goggles are constructed from plastic (n = 1.45) planoconcave
lenses. They measure -2.00 D in air. What is the power of the goggles when worn
underwater (nwater = 1.33)?

A) -1.50 D

B) -2.25 D

C) -2.00 D

D) -3.33 D
14. A phakic patient undergoes a vitrectomy with replacement of his vitreous fluid (n = 1.34)
with silicone oil (n= 1.40). What change occurs in his prescription?

A) Myopic shift

B) Hyperopic shift

C) No significant change in prescription

D) Cannot be determined with the information given

15. You use the duochrome test to refine the refraction of a patient. The patient says the red
letters are much clearer than the green letters. The patient:

A) Is overplussed

B) Is overminused

C) is anisometropic

D) is presbyopic

16. You hold a +1.00 D lens in front of a patient. At a working distance of 67 cm, you see
against motion with the streak oriented at 90° and less against movement with the streak
oriented at 180°. Which situation exists for this patient?

A) Simple myopic astigmatism

B) Compound myopic astigmatism

C) Simple hyperopic astigmatism

D) Compound hyperopic astigmatism

17. You perform streak retinoscopy on a cyclopleged infant. With the streak oriented
vertically at 90°, you neutralize the reflex with a -2.00 D lens (after subtracting the
working distance), and with the horizontal streak, +3.00 D lens. What is the cycloplegic
refraction?
 A) +3.00 - 2.00 × 180°

B) -2.00 + 3.00 × 90°

C) -2.00 + 5.00 × 180°

D) +3.00 - 5.00 × 180°

18. A patient wears +3.00 + 2.25 × 60°. If all of her astigmatism is corneal, what could her
keratometry measure?

A) 38.50 D at 120°, 43.75 D at 30°

B) 40.00 D at 60°, 42.25 D at 150°

C) 45.75 D at 30°, 48.00 D at 120°

D) 41.25 D at 150°, 43.50 D at 60°

19. An uncorrected, cyclopleged patient looks at an Amsler grid 40 cm away. The vertical
lines are focused sharply when a +4.75 D sphere is held in front of this eye. The
horizontal lines are sharpest with a +6.00 D sphere. What is her distance correction?

A) +4.75 + 1.25 × 180°

B) +2.25 + 3.75 × 90°

C) +2.25 + 1.25 × 180°

D) +1.25 + 2.50 × 90°

20. A -4.00 D myopic patient has +2.00 D reading adds ground into his lenses. Which type of
bifocal segment will minimize image displacement?

A) Round-top

B) Slab-off

C) Flat-top
 D) Franklin

21. A 65-year-old hyperopic patient undergoes cataract surgery in his left eye. Following
surgery his refraction measures:

+4.00 + 0.50 × 90

-2.25 + 1.00 × 90

Progressive bifocal, +2.50 add

He complains of difficulty adjusting to his new glasses. With each eye tested
individually, his acuity is 20/20. Which of the following would best solve his problem?

A) Slab-off prism

B) Contact lenses

C) Flat-top bifocal

D) Cycloplegic refraction

22. A patient wears the following prescription:

- 1.00 + 2.00 × 180°

- 2.50 + 1.00 × 90° Add + 3.00 OU

His bifocal segment is located 10 mm inferior to the optical center of the glasses. How
much relative prism is induced when he looks through the top of his bifocal?

B) 1.50∆ right base- up

C) 2.00∆ left base-up

D) 2.50∆ right base- up

E) 3.50∆ right base- up

23. An aphakic patient wears +10.00 D glasses at a vertex distance of 10 mm. What power of
contact lens should be ordered to fit on K's?

A) +9.0 D

B) +10.0 D

C) +11.0 D

D) +9.5 D

24. A patient has K's of 42.00 D at 90°/40.00 D at 180° and refraction of - 1.50 + 0.50 × 90°.
A plano hard contact lens is fit on the flatter K. What over-refraction is measured?

A) -1.00 + 1.50 × 180°

B) +1.50 - 0.50 × 90°

C) -0.50 + 0.50 × 180°

D) +0.50 + 1.50 × 90°

25. Which change would allow a hard contact lens to fit more tightly to a cornea?

A) Decreasing the diameter from 8.80 mm to 8.40 mm

B) Decreasing the base curve from 8.20 mm to 8.00 mm

C) Increasing the optical zone from 8.20 mm to 8.40 mm

D) Increasing the power from -3.00 D to -3.50 D

26. Which one of the following single changes results in the selection of a lens more
powerful than intended?

A) Using an A-constant of 116.8 instead of 117.3

B) Axial length measured as 20.5 mm rather than 20.2 mm

C) Average keratometry of 44.50 D in place of 44.00 D

 D) Placing the lens in the anterior chamber instead of in the capsular bag

27. A patient wears aspheric bifocal contact lenses in both eyes. All of the following could be
expected with these lenses EXCEPT:

A) multiple images

B) difficulty in dim light

C) glare with headlights

D) different image sizes between the eyes

28. What strength of lens is needed so that a patient with 20/160 visual acuity can read
newsprint without accommodation?

A) +5.00 D

B) +8.00 D

C) +10.00 D

D) +12.50 D

29. Which optical principle is the basis for antireflective coatings on glasses and lenses?

A) Coherence

B) Diffraction

C) Interference

D) Polarization

30. A patient purchased a pair of sunglasses with a dark blue tint. Which of these colors
would be the hardest to see?

A) Red

B) Blue
 C) Green

D) Purple

31. A patient who had bilateral LASIK is complaining of haloes and starbursts while driving
at night. Which of the following measures could improve his symptoms?

A) Wear polarized glasses

B) Constrict pupil

C) Turn on the interior reading light in car

D) Treat with a larger ablation zone

32. A patient has a red Maddox rod with the cylinders oriented horizontally placed over her
left eye. What does she see when she views a distant white fixation light?

A) Red light, horizontal white line

B) Red light, vertical white line

C) White light, horizontal red line

D) White light, vertical red line

33. Which of the following statement regarding the electromagnetic radiation is correct

A) Velocity of all electromagnetic radiation is same

B) Wavelength of blue light is longer than that of red light

C) UV A radiation reaches the retina of phakic eyes.

D) IR A radiation is absorbed by the crystalline lens

34. Which of the following statement regarding the pinhole is correct

A) Pinhole increases the depth of focus but decreases the depth of field

B) Standard British pinhole size is 1.35 mm

 C) Pinhole decreases the size of blur circle on retina

D) By reducing the size of pinhole , effects of diffraction are minimized

35. Which of the following statement regarding polarization of light is correct

A) Plane and linearly polarized light are identical

B) Amblyopic eye cannot detect polarized light

C) Reflection at horizontal surfaces produces vertically polarized light

D) Haidinger’s brushes is an entopic phenomena produced by blue light

36. Which of the following statement regarding scattering is correct

A) Light scattering is independent of the wavelength of incident light

B) Large diameter collagen fibrils increase light scattering rendering the sclera
opaque.

C) Vitreous collagen fibrils are of large diameter

D) Presence of lens opacities may cause symptoms of glare

37. Which of the following statement regarding clinical uses of reflection is correct

A) The first purkinje image is real and inverted

B) The first purkinje image may be used to assess squint

C) Keratoscopy utilizes the second purkinje image

D) The third and fourth purkinje images have no application in ophthalmology.

38. Which of the following statement regarding refraction is correct

A) A light ray refracted by a glass plate emerges parallel and is laterally displaced

B) The Helmholtz keratometer uses two rotating glass plate to produce a double
image
 C) During instrumentation of the anterior chamber objects appear deeper than they
really are.

D) The surface power of an optical interface is independent of its radius of curvature

39. A 2x magnifying lens is positioned 10 cm from book. If the reference near point is 25 cm
which statement is correct

A) Accommodative effort is induced in the emmetropic reader

B) Image is inverted

C) Power of lens measured with lensometer is +2D.

D) Observer’s depth of focus is increased.

40. Which of the following statement concerning the design of spectacle lens is correct

A) Meniscus lens have fewer aberration than plano spherical lens

B) Biconvex lens are used to correct low hypermetropia

C) Minus cylinder form is preferable in the correction of both myopia and

hypermetropia

D) Base curve in toric design is usually the steepest curvature o n lens surface.

41. Which of the following statement concerning ocular resolution is correct

A) Diameter of cone is approx 1.5µm

B) Wave theory assumes light to be composed of individual quanta

C) Image formed from a point source of light is in the form of Airy disc

D) Vernier acuity measurement has a greater angle of resolution than that detected by
Snellen acuity.

42. Which of the following statement about Stile- Crawford effect is correct
 A) It reduces the effect of chromatic aberration

B) It may be important in the pathogenesis of amblyopia

C) Monochromatic light changes its subjective hue with a change in angle of

incidence.

D) Rods and cones are more sensitive to paraxial light.

43. Which of the following statement concerning Purkinje shift is correct

A) It refers to patient visualization of retinal blood vessel when the eye is

illuminated.

B) During scotopic condition the eye is most sensitive to blue green light at 510 nm.

C) It is the change of peak sensitivity of retina under photopic and scotopic condition

D) During photopic condition the eye is most sensitive to red light at 590 nm.

44. Which of the following statement regarding basic retinoscopy is correct

A) The projection phase of retinoscopy describes the formation of an image at the far
point of eye.

B) The point of reversal occurs when the patient nodal point is coincident with the
observer far point.

C) The point of reversal is seen with a – 4D myope examining a + 5D hypermetrope

using a +1D trial lens.

D) A with movement is seen at a 50 cm working distance examining a + 1D patient.

45. An emmetropic patient has amplitude of accommodation of 1.50D measured using the
RAF rule. The patient works for 6 hours each day at computer screen at a distance of 50
cm and views reading material at a distance of 33 cm. Which of the following statement
is correct?
 A) This patient is likely to be about 45 years old in light of the accommodative
amplitude.

B) For viewing the computer screen, no lens will be required in theory.

C) For viewing reading material, a reading addition of +2.25DS is likely to be

required.

D) Bifocals of power + 1.25 DS with an addition of +1DS would theoretically suit

this patient if he wished to have only one pair of glasses.

46. When prescribing spectacles

A) Attention need only be paid to lens Centration when the lens power exceeds 4D in
any one meridian.

B) A decentration of 5 mm UP on a +1DS lens will produce a prismatic effect of

0.5∆UP

C) A prismatic error of 0.5∆UP would be expected to produce significant symptoms

in the majority of patients.

D) Photochromics should not be prescribed to children.

47. A 71 year old patient has VA of 6/18 R and L due to age related macular degeneration:

A) For watching television, this patient would benefit from a pair of 2x telescopes
mounted in a spectacle frame as this would give an equivalent 6/6 acuity.

B) A pair of 4x telescopes would be useful for shopping.

C) This patient should be advised that their vision will make night driving difficult,
but that driving in bright sunlight will be relatively easy.

D) A + 12D magnifying lens would give about 2x or 3x magnification for reading.

48. If a 6 year old patient has manifest squint measuring 20 PD esotropia:

A) One eye should be occluded during retinoscopy.

 B) Cycloplegia should be used to obtain the most accurate objective result.

C) The minimum plus power that gives good distance VA should be prescribed.

D) Pinhole test cannot usually be performed with a child of this age.

49. A 52 year old computer operator is -1.00DS myopic. His accommodative amplitude is
2D. Which of the following prescription is appropriate for this patient:

A) Bifocals, -1.00DS with a +3.00DS addition for reading at 33 cm.

B) Single vision lenses, + 2.50DS for reading at 33 cm.

C) Single vision lens, +2.00DS for reading a computer screen at 50 cm.

D) Bifocals, Plano with a +1.00DS addition for reading a computer screen at 50 cm

and reading at 33 cm.

50. An object is 12.5 cm from a +3 D lens that is 10 cm from a plane mirror. How far apart
is the image and object?

A) 187.5 cm

B) 100 cm

C) 52.5 cm

D) 22.5 cm