(G Johnson)

• What is the World Health Organization's definition of blindness?

1. less than 6/60

2. 3/60

3. less than 3/60

4. 1/60

5. less than 1/60

• What is the estimate of the number of blind people in the world in 2001?

6. 20 million

7. 45 million

8. 50 million

9. 75 million

10. 100 million

• What is the Cataract Surgical Rate (CSR) in the UK?

11. 450

12. 3100

13. 3800

14. 5500

15. 7000

16. exposure to sunlight

17. diabetes

18. lack of vitamins

19. age

20. female

• Which of the following is not usually considered to be a barrier to the uptake of cataract surgery?

21. the religion of the surgeon

22. the cost of transport

23. fear of surgery

24. fear of complications

25. a neighbour having poor visual outcome after surgery

• Vision 2020: which of the following major causes of blindness is not included as a priority in the first 5 years of this WHO/IAPB programme?

26. onchocerciasis

27. diabetic retinopathy

28. trachoma

29. cataract

30. childhood blindness

(Darwin C Minassian and Angela Reidy)

• In calculating the prevalence of cataract cases in a population, the numerator is:

31. The number of existing cataract cases

32. The number of new cases expected in 1 year

33. The total population, minus the number of existing cataract cases

34. The total population, minus the number of new case expected in 1 year

35. The total population without cataract

• According to Projections from The North London Eye Study, how many have impaired vision (<6/12) from cataract in one or both eyes among the elderly population of England and Wales?

36. More than 3.5 million

37. About 3.0 million

38. About 2.4 million

39. About 1.1 million

40. Less than 1 million

• The 1-year cumulative incidence of cataract cases in a given elderly population is:

41. The total number of cataract cases in the elderly population.

42. The number of new cataract cases appearing in 1 year, expressed as a proportion of the elderly population.

43. The number of new cataract cases appearing in 1 year, expressed as a proportion of the total number of cataract cases.

44. The total number of cataract cases plus the number of new cases expected in 1 year.

45. The total number of cataract cases appearing in 1 year minus the total number appearing in the previous year.

• What is the estimated 5-year cumulative incidence of sight-impairing cataract (<6/12 in one or both eyes) in the population aged 65 and older in England and Wales?

46. About 1.1 million new cases

47. About 2.4 million cases

48. About 3.5 million cases

49. Less than 0.5 million new cases

50. More than 3.5 million cases

• How many cataract extraction operations were performed within the NHS in the UK in the year 1999-2000?

51. About 148,000

52. About 189,000

53. About 220,000

54. More than 220,000

55. Less than 148,000

• In the UK, approximately what proportion of cataract operations are performed on eyes with visual acuity better than 6/12?

56. 13%

57. 18%

58. 27%

59. Less than 20%

60. More than 35%

(K PesudovsD & B Elliott)

• In the majority of cases, results or findings from which test or procedure should determine referral of a patient with age-related cataract? (Which is true?).

61. Case history.

62. The patients age.

63. Habitual visual acuity.

64. Slit-lamp examination.

65. Contrast sensitivity.

• Which of the following is known to be associated with cortical cataract? (Which is true?).

66. Steroid intake.

67. Smoking.

68. Male gender.

69. Ultraviolet light exposure.

70. Intake of vitamin A

• Which of the following is NOT a risk factor for posterior subcapsular cataract?

71. Steroid intake.

72. Smoking.

73. Diabetes.

74. Female gender.75. Age.

•The myopic shift associated with nuclear cataract is known as? (Which is true?).

76. Adult onset myopia.

77. Pathological myopia.

78. Index myopia.

79. Nuclear myopia.

80. Empty field myopia.

• A patient presents with obvious cortical cataract, but no visual disability. Which of the following management strategies is appropriate?

81. Same day referral to emergency department of local hospital.

82. Never be referred for cataract surgery.

83. Refer to ophthalmologist via GP.

84. Review patient in 1 year and report to GP.

85. Review patient in 2 years.

• Vision loss in cataract is chiefly caused by which optical phenomenon? (Which is true?).

86. Backscatter.

87. Forward scatter.

88. Reflection.

89. Refraction.

90. Absorption.

(G Munton)

• Surgical intervention is how old?

91. 1000 years

92. 2000 years

93. 3000 years

94. 4000 years

95. 5000 years

• In Roman times which herb or drug was used to prepare the eye for surgery?

96. Calabar

97. Atropine

98. Hyocyamus

99. Cannabis

100. Belladonna Atropa

• In which region is couching for cataract still commonly practiced?

101. Sth America

102. Asia

102. E. Europe

104. Africa

105. Australasia

• From where was the ancient knowledge of cataract passed to Europe at the end of the middle ages?

106. Arabia

107. Greece

108. Rome

109. N. Africa

110. Asia minor

• Extracapsular cataract surgery was practiced by?

111. Celsus

112. Susruta

113. Daviel

114. Hippocrates

115. Plato.

• The first successful lens implant surgery was performed?

116. 1886

117. 1940

118. 1949

119. 1953

120. 1965

(M Lavin)

• Phacoemulsification: (Which is false?)

121. Is "closed system" surgery

122 Allows reliable intraocular lens positioning

123. Requires a different range of surgical skills to be learnt by the surgeon

124. Is always the best type of cataract extraction

125. Is currently the routine method of cataract removal.

• A "closed system" of surgery. (Which is false?)

126. Prevents excessive movement of iris and capsule during surgery

127. Can lead to a rise in intraocular pressure during the procedure

128. Allows a safer procedure in patients who may have problems lying still

129. Aids post surgical recovery with reduced inflammation

130. Reduces fluid movement in or out of the eye.

• The phacoemulsification machine: (Which is false?)

131. Produces ultrasound energy in the range of 28 000 to 60 000 Hz

132. Fluid is infused into the eye and aspirated out through the same port

133. Settings that produce bursts or pulses of ultrasound energy reduce the amount of energy delivered to the eye during the operation.

134. Uses the same probe for removal of nucleus and cortex

• The capsulorrhexis (Which is false?)

135. Helps create a stable capsular bag

136. Cannot be performed in mature, white cataracts

139. Has a role in preventing lens decentration post-op

140. Is difficult to perform in patients with any fibrosis of the anterior capsule

141. Is easier to perform with the aid of a viscoelastic.

• In phacoemulsification surgery for people with high refractive errors: (Which is false?)

142. Myopic patients may have unstable lenses

143. The range of foldable lenses goes down to zero

144. Piggyback lenses are commonly used in high myopes.

145. Interlenticular opacification may result in a hypermetropic shift in refraction

146. High levels of energy used during the procedure may result in a corneal burn

• During the procedure: (Which is false?)

147. Hydrodissection is performed by injecting a stream of balanced salt solution under the posterior capsule

148. The divide-and-conquer technique of nucleus removal is the technique of choice for dense cataracts

149. Nucleus and cortex removal is aided by previous hydrodissection

150. It is important to ensure the haptics of the IOL are in the bag

151. A different probe (without energy) is used for removing the final thin layer of cortex.

• Posterior capsule opacification (PCO): (Which is false?)

152. Results from lens epithelial cell proliferation

153. A large capsulorrhexis helps reduce the risk of PCO

154. A square edge to the lens optic reduces the risk of PCO

155. PCO is reduced by hydrodissection

156. The rate of PCO formation with rigid PMMA IOLs is 10% over 5 years

• In challenging cases: (Which is false?)

157. Capsule tension rings are a useful device for small pupils

158. Mechanically stretching the pupil can help in the case of a small pupil

159. Capsule tension rings that can be sutured may be useful in patients with Marfan’s syndrome

160. Pseudoexfoliation may cause a small pupil and weak zonules

161. Cystoid macular oedema can result from posterior capsular rupture

(Clare Green)

• Which of the following statements regarding post-operative corneal oedema is false?

162. It may be caused by prolonged phacoemulsification

163. It commonly persists for several weeks

164. Pre-existing corneal endothelial abnormalities predispose a patient to post-op corneal oedema

165. It causes no or only mild discomfort

166. It is a common complication of cataract surgery.

• Which of the following statements regarding post-operative intraocular pressure (IOP) is true?

167. IOP normally falls sharply immediately following cataract surgery

168. IOP in the range 21-30 mmHg at one day post-op must be treated

169. Paracentesis may be performed in cases of troublesome raised post-operative IOP

170. Glaucoma patients should not resume their ocular hypotensive therapy for two weeks following cataract surgery

171. Retained viscoelastic substances do not affect the post-operative IOP.

• Which of the following statements regarding wound closure is false?

172. Post-operative wound leakage is rarely seen with self-sealing small incision surgery

173. Inadequate wound closure increases the risk of endophthalmitis

174. The Seidel test is used to detect tight sutures

175. In the presence of wound leakage, insertion of a bandage contact lens will reduce the risk of serious post-operative infection

176. Marked leakage may require suturing.

• Which of the following statements regarding cystoid macular oedema (CMO) is false?

177. 15 to 30% of extra-capsular extractions suffer marked visual deficit in the short term from CMO

176. Prolonged surgery is a risk factor for post-operative CMO

179. 75% of post-operative CMO cases spontaneously improve within six weeks

180. Persisting CMO may progress to a lamellar macular hole

181. Diabetes mellitus is a risk factor for post-operative CMO

• Which of the following statements regarding endophthalmitis following cataract surgery is false?

182. It may occur at any stage from within two days to a few months of surgery

183. The risk increases in pre-existing blepharitis

184. The risk is greater following primary lens implantation than secondary lens implantation

185. Approximately 50% of cases result in a blind eye

186. Early recognition is the key to improved outcomes.

• Which of the following statements regarding posterior capsular opacification and its treatment is false?

187. It occurs post-operatively in between 5% and 50% of adult cataract patients

188. It occurs between three months to four years post-op

189. Nd:YAG capsulotomy may lead to retinal detachment

190. Nd:YAG treatment may lead to pitting of the IOL.

191. Paediatric patients rarely experience posterior capsule opacification following cataract extraction

(S P Percival)

• Unwanted optical imagery is most likely to result from which of the following design features:

192. Angulation of haptics

193. Refraction index of 1.46

194. Refractive index of 1.55

195. High water content of lens material

196. Low water content of lens material

• Anterior capsule contraction syndrome (capsular phimosis) is most likely to develop following which of the following foldable lens types:

197. Pure HEMA lenses

198. Heparin lenses

199. Silicone lenses

200 Hydrophobic acrylic lenses

201. Hydrophilic acrylic lenses

• Which of the following design features leads to greatest implant stability when within the lens capsule:

202. A single-piece uniplanar lens with slotted haptics, loop span 12.0 mm

203. A uniplanar plate haptic lens, length 11.0 mm

204. A three-piece angulated lens, loop span 13.0 mm

205. A single-piece angulated lens, overall diameter 10.5 mm

206. An angulated hydrophillic overall diameter 12.0 mm

• Which of the following is important in modern IOL design:

207. Biocompatibility

208. Optical image quality

209. Dioptric accuracy

210. Injectability through a small wound

211. All of the above

• Silicone oil is most likely to adhere to the surface of:

212. Human lens capsule

213. Pure HEMA

214. Heparin surface modification

215. Pure PMMA

216. Thermolabile foldable hydrophobic acrylic

• Which of the following are least likely to be associated with secondary surgical intervention:

217. Square cut edges to the optic associated with a high refractive index

218. Square cut edges to the optic associated with a low refractive index

219. Multifocal design

220. Silicone lens with osymnotric copsular hexis

221. plate haptic toric design