Master 40 advanced Optometry mcq bank Blood & Nerves (Q41–80) mcq on pupillary abnormalities, optic nerve lesions, cavernous sinus syndromes, and ocular blood supply. Essential for optometry, ophthalmology, and medical entrance exam preparation (NEET PG, AIIMS, NBEO). visit our index page to view topic wise mcq.
Pupillary Abnormalities
41. Adie’s tonic pupil shows:
A. Sluggish light reflex, preserved near response
B. No near response
C. Dilated fixed pupil
D. Miosis with anhidrosis
View answer
A. Sluggish light reflex, preserved near response ✅ Exp: Light–near dissociation with slow constriction.
42. Holmes-Adie syndrome includes:
A. Tonic pupil + absent deep tendon reflexes
B. Miosis + ptosis
C. Mydriasis + proptosis
D. Fixed pinpoint pupils
View Answer
A. Tonic pupil + absent deep tendon reflexes ✅ Exp: Neurological disorder with tonic pupil.
43. Hutchinson’s pupil indicates:
A. Uncal herniation compressing CN III
B. Trochlear palsy
C. Horner’s syndrome
D. Optic neuritis
View Answer
A. Uncal herniation compressing CN III ✅ Exp: Uncal herniation → ipsilateral dilated pupil.
44. Marcus Gunn pupil is due to:
A. Optic nerve lesion (afferent defect)
B. Oculomotor palsy
C. Trochlear palsy
D. Abducens palsy
View Answer
A. Optic nerve lesion (afferent defect) ✅ Exp: RAPD = defective afferent limb.
45. In Horner’s syndrome, anisocoria is more obvious:
A. In light
B. In dark
C. Same in both
D. Absent
View Answer
B. In dark ✅ Exp: Sympathetic defect → smaller pupil cannot dilate in dark.
Blood Supply – Clinical Aspects
46. Central retinal artery occlusion causes:
A. Sudden painless monocular blindness
B. Painful loss of vision
C. Diplopia
D. Gradual visual loss
View Answer
A. Sudden painless monocular blindness ✅ Exp: CRAO = acute, painless, severe loss.
47. Classic fundus sign in CRAO:
A. Cherry-red spot
B. Cotton wool spots
C. Drusen
D. Retinitis
View Answer
A. Cherry-red spot ✅ Exp: Cherry-red fovea due to intact choroidal supply.
48. Cilioretinal artery (when present) arises from: Exp: Variant branch from posterior ciliary circulation.
A. Ciliary circulation
B. Central retinal artery
C. Choroid only
D. Ophthalmic vein
View Answer
A. Ciliary circulation ✅
49. Cilioretinal artery protects central vision in:
A. Central retinal artery occlusion
B. Retinitis pigmentosa
C. Optic neuritis
D. Papilledema
View Answer
A. Central retinal artery occlusion ✅ Exp: Preserves macular supply.
50. Ischemic optic neuropathy results from occlusion of:
A. Short posterior ciliary arteries
B. Central retinal vein
C. Long posterior ciliary arteries
D. Anterior ciliary artery
View Answer
A. Short posterior ciliary arteries ✅ Exp: SPCAs supply optic nerve head.
Cavernous Sinus & Nerves
51. Nerve most commonly affected in cavernous sinus thrombosis:
A. Abducens (CN VI)
B. Trochlear
C. Oculomotor
D. Trigeminal
View Answer
A. Abducens (CN VI) ✅ Exp: CN VI lies centrally, highly vulnerable.
52. Nerves in lateral wall of cavernous sinus:
A. CN III, IV, V1, V2
B. CN II, III, IV, VI
C. CN V3, VII, IX
D. CN XI, XII
View Answer
A. CN III, IV, V1, V2 ✅ Exp: Lateral wall has III, IV, V1, V2.
53. Contents of cavernous sinus include all EXCEPT:
A. Abducens nerve
B. Internal carotid artery
C. Optic nerve
D. Sympathetic plexus
View Answer
C. Optic nerve ✅ Exp: CN II is outside cavernous sinus.
54. Pain sensation from cornea is carried by:
A. Nasociliary branch of V1
B. Lacrimal branch
C. Maxillary nerve
D. Facial nerve
View Answer
A. Nasociliary branch of V1 ✅ Exp: Nasociliary → long ciliary nerves.
55. Loss of corneal reflex (afferent limb) indicates lesion of:
A. Trigeminal nerve (ophthalmic division)
B. Facial nerve
C. Oculomotor nerve
D. Trochlear nerve
View Answer
A. Trigeminal nerve (ophthalmic division) ✅ Exp: Afferent V1, efferent CN VII.
56. Efferent limb of corneal reflex:
A. Facial nerve
B. Trigeminal nerve
C. Oculomotor nerve
D. Abducens
View Answer
A. Facial nerve ✅ Exp: Orbicularis oculi contraction by CN VII.
57. Ciliospinal reflex mediated by:
A. Sympathetic pathway
B. Parasympathetic
C. Trigeminal
D. Facial
View Answer
A. Sympathetic pathway ✅ Exp: Dilation of pupil on neck stimulation.
58. Swinging flashlight test is used to detect:
A. RAPD (Marcus Gunn pupil)
B. Horner’s syndrome
C. Argyll Robertson pupil
D. Adie’s pupil
View Answer
A. RAPD (Marcus Gunn pupil) ✅ Exp: Detects afferent pupillary defect.
59. Dilation lag after darkness is feature of:
A. Horner’s syndrome
B. Oculomotor palsy
C. Optic neuritis
D. Adie’s pupil
View Answer
A. Horner’s syndrome ✅ Exp: Sympathetic failure → delayed dilation.
60. Near reflex pathway includes:
A. Accommodation, convergence, miosis
B. Accommodation, mydriasis
C. Convergence, mydriasis
D. Miosis, abduction
View Answer
A. Accommodation, convergence, miosis ✅ Exp: Triad of near reflex.
61. Choroidal blood flow is:
A. Among highest in body
B. Lowest in body
C. Moderate
D. Absent
View Answer
A. Among highest in body ✅ Exp: High flow meets metabolic needs of retina.
62. Retinal circulation autoregulated mainly by:
A. Local metabolic factors
B. Autonomic nerves
C. Hormones
D. Lymphatics
View Answer
A. Local metabolic factors ✅ Exp: Retinal vessels autoregulate, unlike choroid.
63. Choroidal circulation is controlled by:
A. Autonomic nerves (sympathetic + parasympathetic)
B. Autoregulation
C. Local metabolic only
D. Pituitary
View Answer
A. Autonomic nerves (sympathetic + parasympathetic) ✅ Exp: Choroid richly autonomic innervated.
64. Blood-retinal barrier formed by:
A. Retinal capillary endothelium + RPE tight junctions
B. Choroidal endothelium
C. Bruch’s membrane only
D. Vitreous
View Answer
A. Retinal capillary endothelium + RPE tight junctions ✅ Exp: Dual barrier system.
65. Fenestrated capillaries in eye present in:
A. Choriocapillaris
B. Retina
C. Iris sphincter
D. Cornea
View Answer
A. Choriocapillaris ✅ Exp: Retina capillaries non-fenestrated; choroid fenestrated.
66. “Amaurosis fugax” usually due to:
A. Transient CRA embolism
B. Optic neuritis
C. Retinitis
D. Glaucoma
View Answer
A. Transient CRA embolism ✅ Exp: Transient monocular blindness.
67. Orbital apex syndrome involves:
A. CN II, III, IV, V1, VI
B. CN III, IV, VI only
C. CN V only
D. CN VII only
View Answer
A. CN II, III, IV, V1, VI ✅ Exp: Apex lesion → optic + orbital nerves.
68. Superior orbital fissure syndrome involves:
A. CN III, IV, VI, V1
B. CN II only
C. CN VII only
D. CN V3 only
View Answer
A. CN III, IV, VI, V1 ✅
69. Oculomotor nerve nucleus located in:
A. Midbrain (level of superior colliculus)
B. Pons
C. Medulla
D. Spinal cord
View Answer
A. Midbrain (level of superior colliculus) ✅ Exp: CN III nucleus at midbrain.
70. Trochlear nerve unique because:
A. Exits dorsally
B. Longest intracranial course
C. Crosses entirely
D. All above
View Answer
A. Exits dorsally ✅ Exp: All statements true.
71. Longest intracranial course of any CN:
A. Trochlear
B. Abducens
C. Oculomotor
D. Optic
View Answer
A. Trochlear Exp: CN IV is longest intracranial.
72. Nerve most prone to raised ICP:
A. Abducens (CN VI)
B. Trochlear
C. Oculomotor
D. Facial
View Answer
A. Abducens (CN VI) ✅ Exp: Long intracranial course, vulnerable to stretch.
73. Optic nerve is surrounded by:
A. Meninges (dura, arachnoid, pia)
B. Periorbita
C. Tenon’s capsule only
D. Orbital fascia only
View Answer
A. Meninges (dura, arachnoid, pia) ✅ Exp: CNS extension → meninges around CN II.
74. Raised ICP first seen as:
A. Papilledema
B. Optic atrophy
C. Central scotoma
D. Retinitis
View Answer
A. Papilledema ✅ Exp: CSF pressure transmitted via meninges.
75. “Onion skin” field loss seen in:
A. Chiasmal compression
B. Glaucoma
C. CRAO
D. Papilledema
View Answer
A. Chiasmal compression ✅ Exp: Concentric field loss from optic chiasma lesion.
76. Ocular ischemic syndrome due to:
A. Carotid artery stenosis
B. Vertebral stenosis
C. Basilar thrombosis
D. Cavernous sinus thrombosis
View Answer
A. Carotid artery stenosis ✅ Exp: Severe carotid stenosis → chronic hypoperfusion.
77. “Altitudinal field defect” typical of:
A. Anterior ischemic optic neuropathy
B. Glaucoma
C. Chiasmal compression
D. Retinitis
View Answer
A. Anterior ischemic optic neuropathy ✅ Exp: AION → altitudinal loss.
78. Orbital venous system is:
A. Valveless
B. With valves
C. Completely isolated
D. Independent of cavernous sinus
79. Which nerve supplies lacrimal gland sensation?
A. Lacrimal nerve (branch of V1)
B. Greater petrosal
C. Facial motor
D. Auriculotemporal
View Answer
A. Lacrimal nerve (branch of V1) ✅ Exp: Sensory by lacrimal (V1).
80. Parasympathetic ganglion for eye:
A. Ciliary ganglion
B. Pterygopalatine ganglion
C. Otic ganglion
D. Submandibular ganglion
View Answer
A. Ciliary ganglion ✅ Exp: Ciliary ganglion parasympathetic to sphincter & ciliary muscle.
Thank you for joining us on this continued journey through the intricate anatomy and physiology of the eye. In this segment, we’ve explored the deeper layers of pupillary abnormalities, vascular syndromes, and cranial nerve pathways — knowledge that forms the cornerstone of both clinical ophthalmology and optometry.
