Learn Clinical Refraction MCQs Prescribing Glasses (Adults & Children) through 40 high-yield Ophthalmology MCQs with answers & explanations. Covers myopia, hypermetropia, presbyopia, anisometropia & pediatric prescriptions—ideal for B.Sc optometry, Optometry & AIIMS exams. view More mcq on Clinical Refraction.
General Principles
121. The aim of refraction is to achieve:
A. The least minus or most plus for best vision
B. The most minus for clearest vision
C. The largest pupil size
D. The narrowest field
View Answer
A. The least minus or most plus for best vision ✅ Exp: To avoid over-correction and minimize accommodative strain.
122. The final prescription should be based on:
A. Objective refraction only
B. Subjective acceptance
C. Cycloplegic findings alone
D. Autorefraction
View Answer
B. Subjective acceptance ✅ Exp: The patient’s comfort and clarity decide the final prescription.
123. In emmetropic eyes, glasses are:
A. Always needed
B. Not required
C. Used only for protection
D. Used for cosmetic reason
View Answer
B. Not required ✅ Exp: Emmetropic eyes focus parallel rays on the retina naturally.
124. Over-minusing a myope causes:
A. Reduced accommodation
B. Asthenopia and spasm
C. Hypermetropic shift
D. Better night vision
View Answer
B. Asthenopia and spasm ✅ Exp: Excess minus power stimulates accommodation and causes eye strain.
125. Over-plussing a hypermetrope causes:
A. Blurred distance vision
B. Asthenopia
C. Diplopia
D. Myopic shift
View Answer
A. Blurred distance vision ✅ Exp: Too much plus lens moves focus anterior to retina.
Prescribing in Myopia
126. The general rule in myopia is to prescribe:
A. Full correction for distance
B. Partial correction
C. Over-minus
D. No correction
View Answer
A. Full correction for distance ✅ Exp: Full correction gives clear distant vision and reduces blur.
127. Myopic children should:
A. Be under-corrected
B. Be fully corrected
C. Avoid glasses
D. Wear bifocals
View Answer
B. Be fully corrected ✅ Exp: Full correction prevents progression and improves clarity.
128. High myopes may prefer:
A. Under-correction
B. Over-correction
C. Fogging
D. Cylindrical lenses
View Answer
A. Under-correction ✅ Exp: Some tolerate slight under-correction for comfort.
129. Spectacle correction for myopia reduces:
A. Retinal image size
B. Magnification
C. Accommodation
D. Corneal power
View Answer
A. Retinal image size ✅ Exp: Minus lenses minify images on the retina.
130. Contact lens correction in myopia results in:
A. Larger image size
B. Smaller image
C. Same size
D. Blurred image
View Answer
A. Larger image size ✅ Exp: Closer to eye → less minification.
Prescribing in Hypermetropia
131. Hypermetropes should be prescribed:
A. Most plus for best vision
B. Least plus
C. Minus lenses
D. Cylindrical lenses only
View Answer
A. Most plus for best vision ✅ Exp: Avoids accommodation strain and provides full correction
132. Young hypermetropes with good vision often have:
A. Latent hypermetropia
B. Simple myopia
C. Accommodative paresis
D. Amblyopia
View Answer
A. Latent hypermetropia ✅ Exp: Accommodation hides refractive error.
133. Full correction in hypermetropia is essential in:
A. Adults
B. Children
C. Presbyopes
D. Myopes
View Answer
B. Children ✅ Exp: Prevents accommodative esotropia and amblyopia.
134. In adults, partial correction is often prescribed for:
A. Latent hypermetropia
B. High myopia
C. Aphakia
D. Presbyopia
View Answer
A. Latent hypermetropia ✅ Exp: To avoid discomfort due to sudden change.
135. Latent hypermetropia is detected by:
A. Duochrome test
B. Cycloplegic refraction
C. Stenopaic slit
D. Retinoscopy without cycloplegia
View Answer
B. Cycloplegic refraction ✅ Exp: Accommodation must be paralyzed to reveal it.
Presbyopia Prescription
136. Presbyopia is corrected by:
A. Plus lenses for near
B. Minus lenses for near
C. Cylinders
D. Bifocal prisms
View Answer
A. Plus lenses for near ✅ Exp: Plus lenses bring near focus onto retina.
137. Near addition for a 40-year-old =
A. +0.75 D
B. +1.00 D
C. +2.00 D
D. +3.00 D
View Answer
B. +1.00 D ✅ Exp: Add ≈ +1 D at 40 years, increasing +0.25 every 5 years.
138. Near addition for 45-year-old:
A. +1.25 D
B. +1.50 D
C. +1.75 D
D. +2.00 D
View Answer
B. +1.50 D ✅ Exp: +0.25 D added every 5 years.
139. Presbyopia appears earliest in:
A. Hypermetropes
B. Myopes
C. Emmetropes
D. Aphakes
View Answer
A. Hypermetropes ✅ Exp: Already use accommodation → earlier fatigue.
140. Presbyopia appears latest in:
A. Hypermetropes
B. Myopes
C. Emmetropes
D. Aphakes
View Answer
B. Myopes ✅ Exp: Myopes can read near without accommodation.
Anisometropia & Aniseikonia
141. Anisometropia means:
A. Unequal refractive error between eyes
B. Unequal curvature
C. Different pupil sizes
D. Unequal accommodation
View Answer
A. Unequal refractive error between eyes ✅ Exp: Difference >1 D between the eyes.
142. Aniseikonia means:
A. Unequal image size
B. Unequal curvature
C. Different visual acuity
D. Diplopia
View Answer
A. Unequal image size ✅ Exp: Results from different magnifications between eyes.
143. Spectacle correction for >3 D anisometropia causes:
A. Diplopia
B. Aniseikonia
C. Hypermetropia
D. Accommodation imbalance
View Answer
B. Aniseikonia ✅ Exp: Large difference in image size → poor fusion.
144. Contact lenses are preferred in:
A. Anisometropia
B. Presbyopia
C. Aphakia only
D. Low hypermetropia
View Answer
A. Anisometropia ✅ Exp: Reduce image size difference by proximity to eye.
145. For unilateral aphakia, best correction is:
A. Spectacles
B. Contact lens
C. IOL only
D. Cylindrical lens
View Answer
B. Contact lens ✅ Exp: Prevents aniseikonia and diplopia.
Pediatric Prescriptions
146. Full correction must be given in:
A. Hypermetropic children
B. Myopic children
C. Adults
D. Presbyopic adults
View Answer
A. Hypermetropic children ✅ Exp: Prevents accommodative squint and amblyopia.
147. Partial correction may be given in:
A. Infants <2 years
B. School-age children
C. Adults
D. Myopes
View Answer
A. Infants <2 years ✅ Exp: Gradual adaptation in early visual development.
148. Myopic children’s glasses are used:
A. Full-time
B. Only for near
C. Only for distance
D. Not needed
View Answer
A. Full-time ✅ Exp: Improves distant clarity and reduces visual strain.
149. Hypermetropic children’s glasses are used:
A. Only for near
B. Constantly
C. Occasionally
D. Never
View Answer
B. Constantly ✅ Exp: Maintains binocular single vision.
150. In children with squint due to hypermetropia, prescribe:
A. Full cycloplegic correction
B. Half correction
C. No correction
D. Minus lenses
View Answer
A. Full cycloplegic correction ✅ Exp: Full plus correction relaxes accommodation, aligns eyes.
151. Pseudophakia usually requires:
A. Bifocals
B. Contact lenses
C. Plano glasses
D. Cylindrical lenses
View Answer
A. Bifocals ✅ Exp: For near addition due to loss of accommodation.
153. Aphakic correction magnifies images by:
A. 5%
B. 10%
C. 25–30%
D. 50%
View Answer
C. 25–30% ✅ Exp: High + lenses increase retinal image size.
153. Contact lenses for aphakia magnify images by:
A. 5–10%
B. 20%
C. 30%
D. None
View Answer
A. 5–10% ✅ Exp: Less vertex distance = less magnification.
154. Bilateral aphakia is corrected by:
A. Spectacles
B. Contact lenses
C. IOLs
D. Cylinders
View Answer
C. IOLs ✅ Exp: IOLs are the most physiological correction.
155. Progressive addition lenses are used in:
A. Presbyopia
B. Myopia
C. Aphakia
D. Astigmatism
View Answer
A. Presbyopia ✅ Exp: Provide gradual change from distance to near power.
156. In spectacles, OD stands for:
A. Oculus dexter (right eye)
B. Oculus sinister
C. Oculus uterque
D. Ocular deviation
View Answer
A. Oculus dexter (right eye) ✅ Exp: OD = right eye, OS = left eye.
157. “Plano” in prescription means:
A. No spherical power
B. No cylinder
C. Prism correction
D. Spherical error present
View Answer
A. No spherical power ✅ Exp: 0.00 D sphere.
158. “Sph” in lens notation denotes:
A. Spherical correction
B. Cylindrical
C. Prism
D. Base direction
View Answer
A. Spherical correction ✅ Exp: Indicates same curvature in all meridians.
159. “Cyl” in prescription refers to:
A. Astigmatic correction
B. Spherical correction
C. Prism base
D. Near add
View Answer
A. Astigmatic correction ✅ Exp: Used for power in one meridian only.
160. “Add” in lens notation indicates:
A. Near addition
B. Astigmatism
C. Distant correction
D. Prism
View Answer
A. Near addition ✅ Exp: Additional plus power for near in presbyopia.
