Master advanced Clinical Refraction with 40 new MCQs from astigmatism mcqs ophthalmology covering Astigmatism types, Duochrome & Jackson Cross Cylinder tests, Binocular Balancing, Accommodation & Retinoscopy. Perfect for NEET PG, NEXT, AIIMS, and Optometry exams.
Astigmatism mcqs– Advanced Concepts
351. Astigmatism is best corrected by using:
A. Spherical lenses
B. Cylindrical lenses
C. Plano-convex lenses
D. Prism lenses
View Answer
B. Cylindrical lenses ✅ Exp: Cylindrical lenses correct curvature differences in two meridians.
352. In compound myopic astigmatism, both focal lines:
A. Lie behind retina
B. Lie in front of retina
C. One on retina, one behind
D. One in front, one on retina
View Answer
B. Lie in front of retina ✅ Exp: Both meridians focus anterior to retina but at different points.
353. In simple hypermetropic astigmatism:
A. Both focal lines are behind retina
B. One on retina, one behind
C. One in front, one behind
D. Both on retina
View Answer
B. One on retina, one behind ✅ Exp: Only one meridian focuses normally; the other behind retina.
354. “With-the-rule” astigmatism means:
A. Vertical meridian is more curved
B. Horizontal meridian more curved
C. Both equal
D. None curved
View Answer
A. Vertical meridian is more curved ✅ Exp: Common in young adults; needs minus cylinder at 180° axis.
355. “Against-the-rule” astigmatism correction axis usually around:
A. 90°
B. 180°
C. 45°
D. 135°
View Answer
B. 180° ✅ Exp: Horizontal meridian more curved → correction at 180°.
356. Astigmatism in the old people tends to shift:
A. With-the-rule → Against-the-rule
B. Opposite
C. To oblique
D. None
View Answer
A. With-the-rule → Against-the-rule ✅ Exp: Lens changes and lid pressure reduce vertical curvature.
357. Oblique astigmatism has principal meridians at:
A. 0° and 90°
B. 45° and 135°
C. 30° and 60°
D. 15° and 105°
View Answer
B. 45° and 135° ✅ Exp: Axis not vertical/horizontal but at oblique angles.
357. Keratometric reading difference of 1.50 D between meridians indicates:
A. Regular astigmatism
B. Irregular astigmatism
C. Mixed astigmatism
D. Myopia
View Answer
A. Regular astigmatism ✅ Exp: Regular difference = regular astigmatism.
359. Best tool for measuring corneal astigmatism:
A. Retinoscope
B. Keratometer
C. Ophthalmoscope
D. Lensometer
View Answer
B. Keratometer ✅ Exp: Measures anterior corneal curvature and corneal power.
360. Irregular astigmatism occurs due to:
A. Unequal corneal meridians
B. Distorted corneal surface
C. Lens curvature
D. Short axial length
View Answer
B. Distorted corneal surface ✅ Exp: Seen in keratoconus, corneal scars.
361. Duochrome test checks:
A. Accommodation
B. Chromatic focus balance
C. Binocular vision
D. Spherical aberration
View Asnwer
B. Chromatic focus balance ✅ Exp: Red and green focus helps refine spherical correction.
362. If letters on red background are clearer in duochrome test, add:
A. Plus sphere
B. Minus sphere
C. No change
D. Cylinder
View Answer
B. Minus sphere ✅ Exp: Red focus behind retina → needs more minus.
363. Jackson Cross Cylinder is used to refine:
A. Sphere
B. Cylinder power & axis
C. Prism
D. Vertex distance
View Answer
B. Cylinder power & axis ✅ Exp: Cross cylinder tests two perpendicular axes for best clarity.
364. In cross-cylinder testing, if both positions equally blurred:
A. Axis correct
B. Axis wrong
C. Power excessive
D. Over-minused
View Answer
A. Axis correct ✅ Exp: Equal blur = correct cylinder axis position.
365. Binocular balancing aims to:
A. Equalize retinal image size
B. Equalize accommodation stimulus
C. Reduce prism effect
D. Check dominance
View Answer
B. Equalize accommodation stimulus ✅ Exp: Ensures both eyes contribute equally during refraction.
366. Fogging is used to:
A. Relax accommodation
B. Stimulate accommodation
C. Induce myopia
D. Detect diplopia
View Answer
A. Relax accommodation ✅ Exp: Plus lenses blur image, removing accommodative effort.
367. In subjective refraction, starting point taken from:
A. Retinoscopy
B. Autorefraction only
C. Previous glasses
D. Duochrome test
View Answer
A. Retinoscopy ✅ Exp: Retinoscopy gives objective baseline for subjective trial.
368. Binocular vision testing before final prescription helps detect:
A. Suppression & fusion anomalies
B. Cataract
C. Retinal hole
D. Myopia only
View Answer
A. Suppression & fusion anomalies ✅ Exp: Prevents diplopia and binocular imbalance in correction.
369. Final glasses prescribed after checking:
A. Monocular VA only
B. Binocular acceptance
C. Retinoscopy result
D. Keratometry
View Answer
B. Binocular acceptance ✅ Exp: Comfort and binocular clarity determine final Rx.
370. “Balance Point” in binocular refraction means:
A. Both eyes equal VA
B. One dominant eye
C. Myopic dominance
D. Cylinder balanced
View Answer
A. Both eyes equal VA ✅ Exp: Equal accommodative demand on both eyes.
🧠 Accommodation & Cycloplegia astigmatism mcqs
371. Accommodation occurs by:
A. Ciliary muscle relaxation
B. Ciliary muscle contraction
C. Iris constriction
D. Lens zonule tightening
View Answer
B. Ciliary muscle contraction ✅ Exp: Contraction releases zonular tension → lens becomes convex.
372. Normal amplitude of accommodation at 10 years =
A. 5 D
B. 10–14 D
C. 2–3 D
D. 7 D
View Answer
B. 10–14 D ✅ Exp: Young children have highest accommodative amplitude.
373. Cycloplegia abolishes:
A. Accommodation
B. Convergence
C. Pupil reflex
D. Fusion
View Answer
A. Accommodation ✅ Exp: Blocks ciliary muscle via parasympathetic inhibition.
374. Common cycloplegic used in children:
A. Homatropine
B. Atropine
C. Tropicamide
D. Phenylephrine
View Answer
B. Atropine ✅ Exp: Long-acting, strong effect for latent hypermetropia.
375. Cycloplegic refraction especially indicated in:
A. Adults
B. Children & hypermetropes
C. Myopes
D. Pseudophakia
View Answer
B. Children & hypermetropes ✅ Exp: Unmasks latent hypermetropia.
astigmatism mcqs
376. Drug of choice for cycloplegia in adults:
A. Tropicamide
B. Atropine
C. Cyclopentolate
D. Homatropine
View Answer
A. Tropicamide ✅ Exp: Quick onset, short duration — suitable for adults.
377. In accommodative spasm, the near point:
A. Moves away
B. Moves closer
C. Stays same
D. Disappears
View Answer
B. Moves closer ✅ Exp: Overactive accommodation → myopic shift.
378. Ill-sustained accommodation common in:
A. Hypermetropia
B. Myopia
C. Presbyopia
D. Aphakia
View Answer
A. Hypermetropia ✅ Exp: Fatigued ciliary response in latent hypermetropia.
379. Paralysis of accommodation caused by:
A. Parasympathomimetic
B. Anticholinergic
C. Adrenergic
D. Mydriatic only
View Answer
B. Anticholinergic ✅ Exp: Cycloplegic drugs (e.g., atropine) block ciliary function.
380. Stimulus for accommodation is:
A. Convergence
B. Blur of retinal image
C. Pupil constriction
D. Light intensity
View Answer
B. Blur of retinal image ✅ Exp: Eye adjusts to maintain sharp focus as object nears.
381. Fusion reserves tested by:
A. Prism bar cover test
B. Retinoscopy
C. Fogging
D. Keratometry
View Answer
A. Prism bar cover test ✅ Exp: Checks vergence capacity for comfortable binocular vision.
382. Convergence insufficiency best corrected by:
A. Base-in prism
B. Base-out prism
C. Cylindrical lenses
D. Near add
View Answer
B. Base-out prism ✅ Exp: Stimulates fusional convergence.
383. Monocular diplopia indicates:
A. Corneal irregularity
B. Extraocular palsy
C. Binocular imbalance
D. Accommodation spasm
View Answer
A. Corneal irregularity ✅ Exp: Persists when one eye closed — optical cause.
astigmatism mcqs
384. In binocular vision, sensory fusion means:
A. Combining two retinal images into one
B. Moving both eyes together
C. Convergence
D. Diplopia suppression
View Answer
A. Combining two retinal images into one ✅ Exp: Occurs in visual cortex.
386. Suppression scotoma appears in:
A. Strabismus
B. Amblyopia
C. Myopia
D. Hypermetropia
View Answer
A. Strabismus ✅ Exp: Brain ignores image from deviating eye to prevent diplopia.
386. Worth four-dot test used to detect:
A. Suppression & fusion
B. Refraction error
C. Accommodation
D. Visual field
View Answer
A. Suppression & fusion ✅ Exp: Simple test for binocular vision assessment.
387. Stereopsis depends on:
A. Equal VA in both eyes
B. Iris diameter
C. Retinal pigmentation
D. Lens power
View Answer
A. Equal VA in both eyes ✅ Exp: Requires fine foveal correspondence and equal clarity.
388. Near vision testing distance (Snellen type) =
A. 1 m
B. 33 cm
C. 50 cm
D. 25 cm
View Answer
B. 33 cm ✅ Exp: Equivalent to +3.00 D demand — standard near testing distance.
389. Pseudo-myopia can be caused by:
A. Accommodative spasm
B. Lens opacity
C. Axial elongation
D. High myopia
View Answer
A. Accommodative spasm ✅ Exp: Overactive accommodation mimics myopia temporarily.
390. Reflex reversal in retinoscopy indicates:
A. Neutralization point passed
B. Wrong working distance
C. Astigmatism
D. Over-minus lens
View Answer
A. Neutralization point passed ✅ Exp: Direction of reflex reverses after neutrality.
