NMS 39 - MCQs

22. Compare acid vs alkali burns. Answer: Acid: Coagulates proteins → limits penetration Alkali: Deep penetration → more severe damage

21. State the most important prognostic factor in chemical burns. Answer: Speed and adequacy of irrigation.

20. Outline management of chemical burns of the eye. Answer: Immediate irrigation (15–30 min) Remove particles Antibiotic drops Topical steroids Lubricants and vitamin C Surgical options in severe cases

19. Enumerate complications of open globe injury. Answer: Permanent vision loss Loss of eye Endophthalmitis Sympathetic ophthalmia

18. Outline treatment of open globe injury. Answer: Urgent stabilization Analgesia Systemic antibiotics Urgent surgical repair

17. Enumerate clinical features of open globe injury. Answer: Deformed eye with fluid loss Prolapsed uvea Decreased vision Afferent pupillary defect Distorted pupil

16. Define open globe injury. Answer: Full-thickness laceration or perforation of the ocular wall.

15. Give an account of treatment of orbital floor fracture. Answer: Stabilization Antibiotics, steroids, nasal decongestants Avoid nose blowing Surgery if persistent diplopia or enophthalmos

14. Outline investigations of orbital floor fracture. Answer: CT scan Hess test

13. List causes of diplopia in orbital floor fracture. Answer: Edema and hemorrhage Muscle entrapment Direct muscle injury

12. Enumerate clinical features of orbital floor fracture. Answer: Periocular ecchymosis, edema Infraorbital nerve anesthesia Diplopia Enophthalmos (late) Subcutaneous emphysema

11. Explain mechanism of orbital floor fracture. Answer: Sudden increase in orbital pressure from blunt object (>5 cm, e.g., fist/ball).

10. Define orbital floor (blowout) fracture. Answer: Fracture of the orbital floor causing herniation of orbital contents.

9. Outline prognosis of commotio retinae. Answer: Usually resolves within 3–4 weeks Requires follow-up due to risk of retinal detachment

8. Enumerate clinical features of commotio retinae. Answer: Decreased vision after hours Fundoscopy: retinal whitening and swelling

7. Define commotio retinae. Answer: Traumatic edema of the retina/macula following ocular contusion.

6. Enumerate posterior segment complications of blunt trauma. Answer: Vitreous hemorrhage Retinal detachment or breaks Macular hole Optic neuropathy Choroidal rupture Commotio retinae

5. Enumerate anterior segment complications of blunt trauma. Answer: Hyphema Lens dislocation (anterior) Traumatic cataract Iridodialysis Traumatic iridocyclitis Secondary glaucoma

4. List corneal and scleral findings in blunt trauma. Answer: Cornea: Abrasion, edema, partial laceration, blood staining Sclera: Partial thickness laceration