Learn everything about Accommodation and Presbyopia mcq in this detailed collection of Ophthalmology & Optometry MCQs with answers and explanations. Covers key topics like near reflex, amplitude of accommodation, AC/A ratio, Helmholtz theory, presbyopia correction, bifocal lenses, and progressive addition lenses. Perfect for Optometry students, AIIMS, RRB, and other competitive exams.
Basics of Accommodation
1. Accommodation is mainly brought about by:
A. Corneal curvature
B. Lens thickness change
C. Iris sphincter
D. Vitreous body
View Answer
B. Lens thickness change ✅ Exp: Ciliary muscle contraction → zonule relaxation → lens thickens.
2. The maximum accommodative power in children is:
A. 4 D
B. 6 D
C. 10–14 D
D. 20 D
View Answer
C. 10–14 D ✅ Exp: Children have high accommodation (up to 14 D).
3. Amplitude of accommodation at age 10 years:
A. ~2 D
B. ~6 D
C. ~14 D
D. ~20 D
View Answer
C. ~14 D ✅ Exp: Amplitude declines with age.
4. At 40 years, average amplitude of accommodation is:
A. 2 D
B. 6 D
C. 8 D
D. 12 D
View Answer
A. 2 D ✅ Exp: By 40 years, only ~2 D remains.
5. Near point of accommodation in emmetropic young adult:
A. 25 cm
B. 50 cm
C. 1 m
D. Infinity
View Answer
A. 25 cm ✅ Exp: Normal near point ≈ 25 cm.
6. Near triad includes:
A. Accommodation, convergence, miosis
B. Accommodation, divergence, dilation
C. Convergence, cycloplegia, dilation
D. Accommodation, miosis, divergence
View Answer
A. Accommodation, convergence, miosis ✅ Exp: Classical triad of near reflex.
7. Convergence is controlled by which cranial nerve?
A. III
B. IV
C. VI
D. V
View Answer
A. III ✅ Exp: Medial rectus (CN III) → convergence.
8. Pupillary miosis during near reflex improves:
A. Chromatic aberration
B. Depth of focus
C. Image magnification
D. Accommodation amplitude
View Answer
B. Depth of focus ✅ Exp: Small pupil increases depth of focus.
9. Synkinetic reflex means:
A. Same response in both eyes
B. Same response in one eye
C. Independent eye movement
D. Random reflex
View Answer
A. Same response in both eyes ✅ Exp: Both eyes respond together (e.g., accommodation).
10. Accommodative convergence/accommodation (AC/A) ratio normally:
A. 1:1
B. 2–6:1
C. 10:1
D. Variable, no standard
View Answer
B. 2–6:1 ✅ Exp: Normal AC/A = 2–6:1.
11. Presbyopia is due to:
A. Increased lens elasticity
B. Decreased lens elasticity
C. Shorter axial length
D. Corneal flattening
View Answer
B. Decreased lens elasticity ✅ Exp: Lens becomes less elastic with age.
12. Average onset of presbyopia in emmetropes:
A. 30 years
B. 40 years
C. 50 years
D. 60 years
View Answer
B. 40 years ✅ Exp: Presbyopia begins ~40 years.
13. Presbyopia occurs earlier in:
A. Hypermetropes
B. Myopes
C. Astigmatics
D. Emmetropes
View Answer
A. Hypermetropes ✅ Exp: Hyperopes need accommodation earlier.
14. Presbyopia is delayed in:
A. Myopes
B. Hyperopes
C. Aphakes
D. Children
View Answer
A. Myopes ✅ Exp: Myopes use distance correction for near work.
15. Presbyopia occurs earlier in:
A. Hot climates
B. Cold climates
C. High altitude
D. At sea level
View Answer
A. Hot climates ✅ Exp: Heat accelerates lens sclerosis.
Correction of Presbyopia
16. Presbyopia is corrected by:
A. Cylindrical lenses
B. Plus spherical lenses
C. Minus lenses
D. Prism lenses
View Answer
B. Plus spherical lenses ✅ Exp: Near add with convex lenses.
17. Near addition for presbyopia at 40 years is:
A. +0.50 D
B. +1.00 D
C. +2.00 D
D. +3.00 D
View Answer
B. +1.00 D ✅ Exp: Near add increases with age.
18. Near addition at 50 years is typically:
A. +1.00 D
B. +2.00 D
C. +3.00 D
D. +4.00 D
View Answer
B. +2.00 D ✅ Exp: Standard near add at 50 years = +2 D.
19. By 60 years, near add required:
A. +1.00 D
B. +2.00 D
C. +3.00 D
D. +4.00 D
View Answer
C. +3.00 D ✅ Exp: Maximum near add ~+3 D.
20. Bifocal spectacles correct:
A. Distance only
B. Near only
C. Both distance & near
D. Astigmatism only
View Answer
C. Both distance & near ✅ Exp: Upper segment distance, lower segment near.
Types of Bifocals & Additions
21. The first bifocal was invented by:
A. Newton
B. Franklin
C. Snellen
D. Donders
View Answer
B. Franklin ✅ Exp: Franklin invented bifocal lenses.
22. Executive bifocal has:
A. Segment across full lens width
B. Segment in small circular area
C. Invisible boundary
D. Progressive addition
View Answer
A. Segment across full lens width ✅ Exp: Wide near zone, sharp junction.
23. Segmental bifocal advantage:
A. Cosmetically better
B. Stronger optics
C. Less distortion
D. More magnification
View Answer
A. Cosmetically better ✅ Exp: Small segment, less visible.
24. Progressive addition lenses provide:
A. Smooth power transition
B. Sharp demarcation
C. Only distance correction
D. Only near correction
View Answer
A. Smooth power transition ✅ Exp: No visible line; all distances.
25. Disadvantage of progressive lenses:
A. Peripheral distortion
B. Ring scotoma
C. Image magnification
D. Poor cosmetics
View Answer
A. Peripheral distortion ✅ Exp: Distortion at lens periphery.
26. Presbyopia correction in uncorrected myope:
A. Needs near add early
B. Removes glasses for near
C. Needs bifocals at 30
D. Always progressive lenses
View Answer
B. Removes glasses for near ✅ Exp: Myope can read without distance correction.
27. Aphakic presbyopia is corrected by:
A. High convex spectacles
B. Contact lenses
C. IOLs
D. All of the above
View Answer
D. All of the above ✅ Exp: Options include spectacles, CLs, IOLs.
28. Presbyopia in high hypermetropia occurs:
A. Early
B. Late
C. Never
D. Same as emmetropes
View Answer
A. Early ✅ Exp: Already using accommodation → earlier presbyopia.
29. Early presbyopia may also be seen in:
A. Diabetics
B. Myopes
C. Infants
D. Elderly only
View Answer
A. Diabetics ✅ Exp: Diabetes alters lens elasticity.
30. Delayed presbyopia may be seen in:
A. Albinism
B. High myopia
C. Glaucoma
D. Cataract
View Answer
B. High myopia ✅ Exp: Myopia delays presbyopia onset.
31. Range of accommodation is distance between:
A. Far and near points
B. Near point only
C. Far point only
D. Infinity and retina
View Answer
A. Far and near points ✅ Exp: Range = near → far points.
32. Amplitude of accommodation is measured in:
A. Diopters
B. Millimeters
C. Degrees
D. Prism diopters
View Answer
A. Diopters ✅ Exp: Amplitude = reciprocal of near point in meters.
33. Push-up method is used to test:
A. Accommodation amplitude
B. AC/A ratio
C. IOP
D. Astigmatism
View Answer
A. Accommodation amplitude ✅ Exp: Near point determined by push-up test.
34. Dynamic retinoscopy assesses:
A. Static refraction
B. Accommodative response
C. Axial length
D. Corneal power
View Answer
B. Accommodative response ✅ Exp: Measures near accommodative accuracy.
35. Amplitude of accommodation at birth:
A. ~10 D
B. ~14 D
C. ~6 D
D. ~4 D
View Answer
B. ~14 D ✅ Exp: Maximum in infants.
36. Presbyopia is considered complete by:
A. 50 years
B. 60 years
C. 70 years
D. 80 years
View Answer
B. 60 years ✅ Exp: Near add stabilizes around +3 D by 60 years.
37. Helmholtz’s theory of accommodation states:
A. Lens flattens during accommodation
B. Lens increases curvature during accommodation
C. Lens is pulled taut
D. Vitreous pushes lens
View Answer
B. Lens increases curvature during accommodation ✅ Exp: Lens becomes more convex with ciliary action.
38. Schachar’s theory of accommodation emphasizes:
A. Equatorial zonular tension
B. Anterior curvature only
C. Vitreous role
D. Lens capsule thickening
View Answer
A. Equatorial zonular tension ✅ Exp: Accommodation linked to increased equatorial tension.
39. Presbyopia is physiologically due to:
A. Ciliary muscle weakness
B. Lens sclerosis
C. Corneal flattening
D. Vitreous liquefaction
View Answer
B. Lens sclerosis ✅ Exp: Lens loses elasticity.
40. Convex lens for presbyopia shifts near point:
A. Closer
B. Farther away
C. No change
D. To infinity
View Answer
B. Farther away ✅ Exp: Plus lens moves near point closer to comfortable range.
