Master Clinical Refraction ophthalmology mcq book with 70 high-yield MCQs (Q281–350) from A.K. Khurana 8th Edition — covering myopia, hypermetropia, presbyopia, astigmatism, LASIK, applied optics, pinhole test, and prism correction. Ideal for NEET PG, NEXT, and AIIMS exams.
Refractive Error Overview ophthalmology mcq book
281. The most common refractive error worldwide is:
A. Hypermetropia
B. Myopia
C. Astigmatism
D. Presbyopia
View Answer
B. Myopia ✅ Exp: Myopia prevalence is rapidly increasing due to near-work and genetics.
282. Hypermetropia is commonly associated with:
A. Long axial length
B. Short axial length
C. Steep cornea
D. Lens thickening
View Answer
B. Short axial length ✅ Exp: Short eyeball focuses light behind the retina.
283. Myopia occurs due to:
A. Short axial length
B. Long axial length
C. Corneal flattening
D. Shallow anterior chamber
View Answer
B. Long axial length ✅ Exp: Light focuses in front of retina because of elongation.
284. Index myopia occurs due to:
A. Increased corneal curvature
B. Change in lens refractive index
C. Axial elongation
D. Retinal thinning
View Answer
B. Change in lens refractive index ✅ Exp: Common in nuclear sclerosis when lens becomes denser.
285. Corneal curvature determines approximately:
A. 1/3 of refractive power
B. 2/3 of refractive power
C. 50%
D. 90%
View Answer
B. 2/3 of refractive power ✅ Exp: Cornea provides ~43 D of total +60 D refractive power.
Applied Clinical Refraction ophthalmology mcq book
286. Dynamic retinoscopy is useful for assessing:
A. Accommodation response
B. Static refraction
C. Binocular vision
D. Muscle imbalance
View Answer
A. Accommodation response ✅ Exp: Measures lag or lead of accommodation in near fixation.
287. Nott’s method is a type of:
A. Subjective refraction
B. Dynamic retinoscopy
C. Autorefraction
D. Duochrome test
View Answer
B. Dynamic retinoscopy ✅ Exp: Measures accommodation response by varying working distance.
288. Mohindra’s retinoscopy is done at:
A. 33 cm
B. 50 cm
C. 1 m
D. 67 cm
View Answer
B. 50 cm ✅ Exp: In dark room for infants; add +1.00 D correction.
289. Hypermetropia not corrected may cause:
A. Divergent squint
B. Convergent squint
C. Diplopia only
D. Presbyopia
View Answer
B. Convergent squint ✅ Exp: Excess accommodation → convergence → esotropia.
291. Uncorrected myopia in children may cause:
A. Amblyopia
B. Nystagmus
C. Hypermetropia
D. Photophobia
View Answer
A. Amblyopia ✅ Exp: Persistent blur suppresses retinal stimulation → lazy eye.
Optical Principles in Refraction ophthalmology mcq book
291. Vergence of light at 1 m from point source =
A. +1 D
B. –1 D
C. +2 D
D. –2 D
View Answer
B. –1 D ✅ Exp: Divergent rays → negative vergence (–1 D).
292. Converging beam of +2 D focuses at:
A. 1 m
B. 50 cm
C. 33 cm
D. Infinity
View Answer
B. 50 cm ✅ Exp: 1/f = 2 D → focal length = 0.5 m.
293. For parallel rays to converge at 50 cm, lens power required:
A. +1 D
B. +2 D
C. –1 D
D. +4 D
View Answer
B. +2 D ✅ Exp: F = 1/f = 1/0.5 = 2 D.
294. Far point in –2 D myopia =
A. 50 cm
B. 33 cm
C. 1 m
D. Infinity
View Answer
A. 50 cm ✅ Exp: 1/F = 1/0.5 = 2 D → far point = 0.5 m.
295. Near point for 40-year-old ≈
A. 10 cm
B. 25 cm
C. 40 cm
D. 60 cm
View Answer
B. 25 cm ✅ Exp: Accommodation decreases to ~4 D → near point ~25 cm.
296 Presbyopia onset age (average in India):
A. 35 years
B. 38–40 years
C. 45 years
D. 50 years
View Answer
B. 38–40 years ✅ Exp: Warm climate causes earlier onset (~2–3 years earlier).
297. Presbyopia results from:
A. Ciliary muscle paralysis
B. Lens sclerosis and loss of elasticity
C. Zonular rupture
D. Iris atrophy
View Answer
B. Lens sclerosis and loss of elasticity ✅ Exp: Lens becomes rigid → accommodation reduced.
298. Early symptom of presbyopia:
A. Blurred distance
B. Difficulty in near work
C. Diplopia
D. Eye pain
View Answer
B. Difficulty in near work ✅ Exp: Reading and near focusing difficulties are first noticed.
299. Presbyopia is corrected with:
A. Plus lenses for near
B. Minus lenses
C. Cylinders
D. Prisms
View Answer
A. Plus lenses for near ✅ Exp: Plus lenses restore near focus onto the retina.
300. Presbyopia occurs latest in:
A. Hypermetropes
B. Myopes
C. Emmetropes
D. Astigmats
View Answer
B. Myopes ✅ Exp: Myopes can read near without accommodation.
Astigmatism Applied Optics
301. Interval of Sturm is:
A. Distance between focal lines in astigmatism
B. Distance between retina and far point
C. Optical axis length
D. Lens vertex separation
View Answer
A. Distance between focal lines in astigmatism ✅ Exp: Represents separation between two line foci.
302. Circle of least confusion located at:
A. Midpoint of Sturm interval
B. First focal line
C. Retina
D. Lens
View Answer
A. Midpoint of Sturm interval ✅ Exp: Point of best average focus between two meridians.
303. Axis of cylinder lens corresponds to:
A. Meridian with no power
B. Strongest meridian
C. Weakest meridian
D. Focal plane
View Answer
A. Meridian with no power ✅ Exp: Axis lies 90° from the power meridian.
304. Mixed astigmatism correction uses:
A. Plus in one, minus in other meridian
B. Two pluses
C. Two minuses
D. Prism
View Answer
A. Plus in one, minus in other meridian ✅ Exp: Focus lines on either side of retina → need opposite powers.
305. Most common cause of irregular astigmatism:
A. Keratoconus
B. Aphakia
C. IOL displacement
D. Myopia
View Answer
A. Keratoconus ✅ Exp: Corneal ectasia distorts normal curvature.
Applied Clinical Practice
306. Subjective refraction should always follow:
A. Cycloplegic refraction
B. Autorefraction only
C. Retinoscopy alone
D. Duochrome first
View Answer
A. Cycloplegic refraction ✅ Exp: Confirms objective findings with patient feedback.
307. Asthenopia commonly results from:
A. Uncorrected refractive error
B. Iris coloboma
C. Mydriasis
D. Retinitis pigmentosa
View Answer
A. Uncorrected refractive error ✅ Exp: Eye strain, headache, and blur from focusing effort.
308. Pinhole test improves vision in:
A. Media opacity
B. Refractive error
C. Retinal disease
D. Optic atrophy
View Answer
B. Refractive error ✅ Exp: Eliminates peripheral rays → checks for refractive cause.
309. Pinhole visual acuity improvement confirms:
A. Retinal disease
B. Refractive error
C. Optic neuropathy
D. Glaucoma
View Answer
B. Refractive error ✅ Exp: Improvement suggests refractive or media clarity cause.
310. No improvement with pinhole suggests:
A. Refractive error
B. Retinal or neural pathology
C. Media opacity
D. Small pupil
View Answer
B. Retinal or neural pathology ✅ Exp: Indicates disease beyond refractive system.
Autorefraction & Modern Techniques ophthalmology mcq book
311. Autorefractometer works on:
A. Reflection of infrared light
B. Retinal fluorescence
C. Pupilometry
D. Chromatic aberration
View Answer
A. Reflection of infrared light ✅ Exp: Analyzes retinal reflection pattern to determine refractive error.
312. Autorefraction measures:
A. Subjective acceptance
B. Objective refraction
C. Accommodation amplitude
D. Binocular vision
View Answer
B. Objective refraction ✅ Exp: Requires no patient response.
313. Advantage of autorefractometer:
A. Quick and repeatable
B. Requires dark adaptation
C. Detects squint
D. Measures IOP
View Answer
A. Quick and repeatable ✅ Exp: Gives rapid baseline for subjective refinement.
314. Limitation of autorefraction:
A. Over-minus tendency
B. Inaccurate astigmatism
C. Large pupil requirement
D. Time-consuming
View Answer
A. Over-minus tendency ✅ Exp: Slight accommodation during test gives extra minus error.
315. Autorefraction result should always be:
A. Used as final Rx
B. Verified by subjective refraction
C. Rejected
D. Converted to spherical only
View Answer
B. Verified by subjective refraction ✅ Exp: Ensures patient comfort and accurate clarity.
316. Spherical equivalent =
A. Sphere + (½ cylinder)
B. Sphere – (½ cylinder)
C. Cylinder only
D. Axis × cylinder
View Answer
A. Sphere + (½ cylinder) ✅ Exp: Represents mean refractive power of spherocylindrical lens.
317. Example: +2.00 / –1.00 × 180 → spherical equivalent =
A. +2.50
B. +1.50
C. +1.00
D. +2.00
View Answer
B. +1.50 ✅ Exp: +2 + (–1/2) = +1.50 D.
318. In refraction, fogging helps:
A. Relax accommodation
B. Induce accommodation
C. Increase myopia
D. Check color vision
View Answer
A. Relax accommodation ✅ Exp: Plus lenses blur image to reduce ciliary tone.
319. Most accurate objective test of refraction:
A. Retinoscopy
B. Autorefraction
C. Subjective
D. Keratometry
View Answer
A. Retinoscopy ✅ Exp: Allows real-time observation of reflex neutrality.
3321. Red-green (Duochrome) test based on:
A. Chromatic aberration
B. Spherical aberration
C. Parallax
D. Diffraction
View Answer
A. Chromatic aberration ✅ Exp: Green rays focus anterior, red rays posterior.
321. Myopia correction by LASIK involves:
A. Flattening cornea
B. Steepening cornea
C. Lens removal
D. IOL implantation
View Answer
A. Flattening cornea ✅ Exp: Laser ablation reduces central corneal curvature.
322. Hypermetropia LASIK correction achieved by:
A. Central ablation
B. Peripheral ablation
C. Corneal flattening
D. Scleral reshaping
View Answer
B. Peripheral ablation ✅ Exp: Steepens central cornea by peripheral removal.
323. PresbyLASIK corrects:
A. Myopia
B. Presbyopia
C. Astigmatism
D. Amblyopia
View Answer
B. Presbyopia ✅ Exp: Multifocal corneal surface mimics reading addition.
324. After LASIK, corneal power measurement error due to:
A. Posterior surface change
B. Tear film
C. IOP
D. Pupil size
View Answer
A. Posterior surface change ✅ Exp: Standard keratometers measure only anterior curvature.
325. IOL power calculation post-LASIK needs:
A. Barrett True-K or Haigis-L formula
B. SRK-II
C. Retinoscopy only
D. Manual keratometry
View Answer
A. Barrett True-K or Haigis-L formula ✅ Exp: Accounts for altered corneal refractive index.
326. A 20-year-old has distance blur, near clear → diagnosis:
A. Myopia
B. Hypermetropia
C. Astigmatism
D. Presbyopia
View Answer
A. Myopia ✅ Exp: Myopes see near objects clearly without accommodation.
327. 10-year-old with squint, headache, +3.00 D hypermetropia → cause:
A. Accommodative esotropia
B. Divergent squint
C. Amblyopia
D. Myopia
View Answer
A. Accommodative esotropia ✅ Exp: Over-accommodation leads to excess convergence.
328. 55-year-old with difficulty reading, clear distance → cause:
A. Presbyopia
B. Myopia
C. Astigmatism
D. Cataract
View Answer
A. Presbyopia ✅ Exp: Age-related loss of accommodation.
329. Patient sees vertical lines clearer than horizontal → indicates:
A. Astigmatism
B. Presbyopia
C. Myopia
D. Cataract
View Answer
A. Astigmatism ✅ Exp: Difference in meridional power perception.
330. After cataract surgery with IOL, near blur → treatment:
A. Reading glasses
B. Minus lens
C. Cycloplegia
D. Bifocal prism
View Answer
A. Reading glasses ✅ Exp: Accommodation lost → near addition required.
331. Prism bends light:
A. Toward base
B. Toward apex
C. Parallel
D. Away from base
View Answer
B. Toward apex ✅ Exp: Image displaced toward apex; light refracted toward base.
332. Prismatic effect unwanted in spectacles if:
A. PD not centered
B. High plus lens
C. Cylinder axis wrong
D. Large vertex distance
View Answer
A. PD not centered ✅ Exp: Decentration acts like prism → discomfort.
ophthalmology mcq book
333. Base-in prisms relieve:
A. Convergence excess
B. Divergence excess
C. Divergent squint
D. Exophoria
View Answer
B. Divergence excess ✅ Exp: Used in exophoria or divergence insufficiency.
334. Base-out prisms used in:
A. Convergence insufficiency
B. Divergence excess
C. Vertical imbalance
D. Diplopia due to hyperphoria
View Answer
A. Convergence insufficiency ✅ Exp: Stimulate convergence.
335. Prentice’s Rule: Prism (Δ) =
A. c × F
B. F / c
C. 1 / (c × F)
D. F + c
View Answer
A. c × F ✅ Exp: Prism power (Δ) = decentration (cm) × lens power (D).
336. Hypermetropic child with esotropia should get:
A. Full cycloplegic correction
B. Partial plus
C. Minus correction
D. Prisms
View Answer
A. Full cycloplegic correction ✅ Exp: Full plus relaxes accommodation, reduces squint.
337. Uncorrected high myope likely complains of:
A. Eye strain
B. Distance blur
C. Diplopia
D. Photophobia
View Answer
B. Distance blur ✅ Exp: Distant rays focus before retina → blurred distance.
338. Cycloplegia unnecessary in:
A. Adults with myopia
B. Children
C. Latent hypermetropia
D. Pseudophakia
View Answer
A. Adults with myopia ✅ Exp: Myopes don’t accommodate for distance.
339. Presbyopia should be re-evaluated every:
A. 6 months
B. 2–3 years
C. 5 years
D. 1 year
View Answer
B. 2–3 years ✅ Exp: Add power increases with age.
340. Binocular diplopia on new glasses indicates:
A. Wrong prism/base direction
B. Wrong sphere
C. Wrong cylinder
D. Excess plus
View Answer
A. Wrong prism/base direction ✅ Exp: Base orientation error induces image separation.
341. Night myopia occurs due to:
A. Increased accommodation in dim light
B. Pupillary constriction
C. Lens hardening
D. Retinal changes
View Answer
A. Increased accommodation in dim light ✅ Exp: Eye over-accommodates in low illumination.
ophthalmology mcq book
342. Instrument myopia seen in:
A. Prolonged use of microscopes
B. Watching distance
C. Reading bright text
D. Television
View Answer
A. Prolonged use of microscopes ✅ Exp: Continuous near work induces accommodative spasm.
343. Index hypermetropia seen in:
A. Diabetes mellitus
B. Cataract
C. Myopia
D. Glaucoma
View Answer
A. Diabetes mellitus ✅ Exp: Lens hydration decreases refractive index → hyperopic shift.
ophthalmology mcq book
344. Accommodative spasm produces:
A. Pseudomyopia
B. True myopia
C. Hypermetropia
D. Astigmatism
View Answer
A. Pseudomyopia ✅ Exp: Sustained ciliary contraction simulates myopia.
345. Night vision improvement after mydriasis due to:
A. Larger pupil → more light
B. Less diffraction
C. Accommodation
D. Chromatic correction
View Answer
A. Larger pupil → more light ✅ Exp: More light enters, increasing retinal illumination.
346. 6-year-old with +4 D hypermetropia, squint → management:
A. Atropine refraction + full correction
B. Partial correction
C. Minus lenses
D. Contact lens
View Answer
A. Atropine refraction + full correction ✅ Exp: Prevents amblyopia and controls accommodative squint.
347. 30-year-old emmetrope complains of near blur → cause:
A. Early presbyopia
B. Myopia
C. Cycloplegia
D. Astigmatism
View Answer
A. Early presbyopia ✅ Exp: Early onset due to fatigue or hypermetropic tendency.
348. Post-LASIK patient needs glasses again after 5 years → cause:
A. Myopic regression
B. Hypermetropia
C. Cataract
D. Presbyopia
View Answer
A. Myopic regression ✅ Exp: Mild regression due to corneal remodeling.
349. Progressive spectacle users often complain of:
A. Peripheral distortion
B. Central blur
C. Double vision
D. Over-correction
View Answer
A. Peripheral distortion ✅ Exp: Due to varying power across zones.
350. Uncorrected anisometropia in children causes:
A. Amblyopia
B. Diplopia
C. Astigmatism
D. Myopia
View Answer
A. Amblyopia ✅ Exp: Brain suppresses blurred eye input → lazy eye develops.
