Lacrimal Apparatus Disorders (NLD Block/Dacryocystitis) MCQ Quiz | Anterior Segment

Welcome to this specialized quiz on Lacrimal Apparatus Disorders, designed for MBBS students preparing for their Anterior Segment module. This quiz covers essential topics including congenital and acquired nasolacrimal duct (NLD) obstruction, as well as acute and chronic dacryocystitis. You will be tested on clinical presentation, diagnostic procedures, underlying pathophysiology, and management strategies from conservative approaches to surgical interventions like DCR. This assessment will help you solidify your understanding and identify areas for further study. After submitting your answers, you will receive your score and a detailed review of each question. You can also download all the questions with their correct answers in a PDF format for your revision.

1. A 6-week-old infant presents with persistent tearing and a mucopurulent discharge from the right eye since birth. On pressing the lacrimal sac area, mucoid material regurgitates. What is the MOST likely diagnosis?

2. What is the most common site of obstruction in congenital nasolacrimal duct (NLD) obstruction?

3. A 55-year-old female presents with acute, painful swelling at the medial canthus of her left eye, associated with redness and epiphora. What is the most appropriate initial management?

4. The Regurgitation on Pressure over Lacrimal Sac (ROPLAS) test is a key clinical sign for which condition?

5. What is the definitive treatment for chronic dacryocystitis with persistent epiphora?

6. Which diagnostic test involves irrigating the lacrimal system with saline to assess for patency?

7. The primary goal of a Dacryocystorhinostomy (DCR) is to create a fistula between the lacrimal sac and the:

8. In the Jones I dye test, a positive result (indicating a patent system) is confirmed by:

9. A potential severe complication of acute dacryocystitis, if left untreated, is:

10. Crigler’s massage is a conservative treatment aimed at:

11. Primary acquired nasolacrimal duct obstruction (PANDO) is most common in which demographic?

12. Which of the following is NOT a cause of secondary acquired NLD obstruction?

13. A dacryocystocele (or mucocele) of the lacrimal sac is best described as:

14. What is the ideal timing for probing in a child with congenital NLD obstruction who does not respond to conservative management?

15. A patient undergoing lacrimal syringing reports that saline passes into their throat, but only with significant pressure. This finding suggests:

16. The most common causative organism in acute dacryocystitis is:

17. In a Jones II test, after a negative Jones I test, saline is irrigated through the canaliculus. If clear saline is recovered from the nose, what does this indicate?

18. A patient requires surgery for a complete common canalicular obstruction. What is the most appropriate surgical procedure?

19. Dacryocystography (DCG) is primarily used to:

20. Which structure is incised to drain a lacrimal sac abscess that is pointing externally?

21. A patient with persistent epiphora has a patent lacrimal drainage system on syringing. Which of the following is a likely cause?

22. What is the main advantage of an endonasal DCR over an external DCR?

23. In congenital dacryocystocele, a bluish swelling is noted below the medial canthal tendon. This condition requires urgent attention due to the risk of:

24. The valve of Rosenmuller is located at the junction of the:

25. A patient complains of epiphora, and on examination, you notice “foaming” or “froth” at the medial canthus. This is suggestive of: