Ocular Injury (Perforating/Concussional) MCQ Quiz | Emergencies

Welcome to the Ocular Injury Quiz, designed for MBBS students navigating the critical field of Emergency Medicine. This quiz covers essential concepts related to perforating and concussional eye injuries, from initial assessment and diagnosis to urgent management and potential complications. You will be tested on key clinical signs like Seidel’s test and teardrop pupils, appropriate imaging modalities, and management principles for conditions such as open globe injuries, hyphema, and orbital fractures. This assessment will help solidify your understanding and prepare you for high-stakes clinical scenarios. After completing the quiz, you can review your score and download all the questions with their correct answers in a convenient PDF format for future study and revision.

1. A 25-year-old male presents after a fistfight. Which of the following findings is most definitive for an open globe injury?

2. A positive Seidel’s test, where fluorescein dye is applied to the cornea, is used to detect what?

3. What is the most appropriate immediate action for managing a suspected perforating eye injury in the field before transport to a hospital?

4. Sympathetic ophthalmia is a delayed, bilateral granulomatous uveitis following a penetrating injury to one eye. What is the primary cell type mediating this autoimmune response?

5. A patient presents with a history of blunt trauma from a squash ball and has a visible layer of blood in the anterior chamber. What is this condition called?

6. A circular ring of iris pigment imprinted on the anterior lens capsule following blunt trauma is known as a:

7. Berlin’s edema (Commotio retinae) is a contrecoup injury seen after blunt ocular trauma. On fundoscopy, it appears as:

8. Which imaging modality is strictly contraindicated in a patient with a suspected intraocular metallic foreign body?

9. A patient with a blowout fracture of the orbital floor, causing entrapment of the inferior rectus muscle, is most likely to experience vertical diplopia on:

10. A “teardrop” or “peaked” pupil is a classic sign highly suggestive of:

11. Which class of antibiotics is commonly administered systemically for prophylaxis against post-traumatic endophthalmitis in open globe injuries?

12. A patient complains of monocular diplopia and exhibits iridodonesis (a tremulous iris) following severe blunt trauma. What is the most likely diagnosis?

13. Which type of chemical injury is generally more severe and why?

14. What is the single most important immediate action for a chemical splash to the eye?

15. Following a concussional injury, a patient presents with ciliary flush, photophobia, pain, and cells and flare in the anterior chamber. This is characteristic of:

16. A long-term complication of blunt ocular trauma, resulting from cleavage of the ciliary body and damage to the trabecular meshwork, is:

17. A markedly low intraocular pressure (hypotony), for example, 2 mmHg, following trauma is highly suggestive of:

18. A patient presents with severe proptosis, reduced vision, an afferent pupillary defect, and extremely high intraocular pressure following orbital trauma. What is the most urgent intervention?

19. Purtscher’s retinopathy, characterized by cotton-wool spots and retinal hemorrhages, is associated with severe compressive trauma (e.g., chest compression) and is caused by:

20. The most common anatomical site of injury in indirect traumatic optic neuropathy is the:

21. Post-traumatic endophthalmitis is most commonly caused by which type of organism?

22. According to the Birmingham Eye Trauma Terminology System (BETTS), an injury where a single, sharp-object wound does not exit the eye is termed a:

23. In the medical management of a traumatic hyphema, which medication is generally contraindicated due to its anti-platelet effect, which can increase the risk of a re-bleed?

24. A crescent-shaped, yellow-white subretinal lesion, often concentric to the optic disc, seen on fundoscopy after significant blunt trauma, is characteristic of a:

25. A patient is hit in the eye with a champagne cork. Examination reveals a fixed, mid-dilated pupil that is non-reactive to light. This condition is known as: