Clinical Refraction MCQs Optometry mcq questions and answers (Q471–500) final set covering accommodation & convergence disorders, refractive surgery, optics, and applied cases. Perfect for NEET PG, NEXT, AIIMS, INI-CET, M.Optom, and MRCSEd exam prep. also for ophthalmic officers and Optometrist post in RRB, and DHS, NHM, DMER Exams. more Ophthalmology mcq
Topics includes: Complex clinical cases, accommodation & convergence disorders, surgical refractive issues, advanced optics, and clinical application.
⚕️ Accommodation & Convergence Disorders
471 In accommodative esotropia, deviation disappears when:
A. Looking into distance
B. Accommodation is relaxed by cycloplegia
C. Fixation changes
D. Mydriasis
View Answer
B. Accommodation is relaxed by cycloplegia ✅ Exp: Cycloplegic refraction removes accommodation → convergence decreases → esotropia reduces.
Optometry mcq questions and answers
472. A patient with reduced amplitude of accommodation for age has:
A. Normal near vision
B. Early presbyopia
C. Accommodative spasm
D. Latent hypermetropia
View Answer
B. Early presbyopia ✅ Exp: Decreased accommodative power earlier than expected indicates presbyopic changes.
Optometry mcq questions and answers
473. Convergence excess type of esotropia is corrected by:
A. Base-in prism
B. Base-out prism and bifocals for near
C. Cycloplegia only
D. Minus lenses
View Answer
B. Base-out prism and bifocals for near ✅ Exp: Base-out prisms and bifocals relieve near convergence demand.
474. Divergence insufficiency causes:
A. Distance diplopia
B. Near diplopia
C. Esotropia
D. Exotropia
View Answer
A. Distance diplopia ✅ Exp: Difficulty maintaining divergence leads to distance double vision.
475. Accommodative insufficiency best treated with:
A. Minus lenses
B. Plus lenses for near (reading addition)
C. Cycloplegics
D. Prisms
View Answer
B. Plus lenses for near (reading addition) ✅ Exp: Near plus lenses assist weak accommodation during near tasks.
476. Excessive accommodation may lead to:
A. Pseudomyopia
B. True hypermetropia
C. Keratoconus
D. Irregular astigmatism
View Answer
A. Pseudomyopia ✅ Exp: Overactive ciliary tone induces temporary myopic shift.
477. The triad of accommodation includes:
A. Miosis, convergence, accommodation
B. Mydriasis, accommodation, divergence
C. Convergence, cycloplegia, dilation
D. None
View Answer
A. Miosis, convergence, accommodation ✅ Exp: Near response = convergence + accommodation + pupillary constriction.
478. Paralysis of accommodation is caused by:
A. Atropine or cycloplegic drugs
B. Pilocarpine
C. Myopia
D. Lens sclerosis only
View Answer
A. Atropine or cycloplegic drugs ✅ Exp: Anticholinergic agents paralyze ciliary muscle function.
479. The near point of accommodation in an emmetrope aged 40 years is around:
A. 10 cm
B. 25 cm
C. 50 cm
D. 100 cm
View Answer
B. 25 cm ✅ Exp: 1/Amp (4 D) ≈ 25 cm.
481. The near reflex (synkinesis) involves:
A. Pupillary dilation
B. Convergence, miosis, and accommodation
C. Mydriasis and divergence
D. Accommodation only
View Answer
B. Convergence, miosis, and accommodation ✅ Exp: Triad response for near focusing.
👁️ Refractive Surgery & Postoperative Optics
481. Myopic LASIK correction flattens:
A. Central cornea
B. Peripheral cornea
C. Lens
D. Sclera
View Answer
A. Central cornea ✅ Exp: Laser ablates central corneal tissue to reduce curvature and power.
482. Hypermetropic LASIK steepens:
A. Central cornea
B. Peripheral cornea
C. Posterior capsule
D. Retina
View Answer
A. Central cornea ✅ Exp: Ablation peripherally increases central curvature.
483. Corneal ectasia post-LASIK occurs due to:
A. Excessive corneal thinning
B. Infection
C. IOL instability
D. Tear film abnormality
View Answer
A. Excessive corneal thinning ✅ Exp: Over-ablation or thin residual stroma weakens biomechanical strength
484. Post-LASIK patient with residual −1.00 D myopia and stable cornea:
A. Needs immediate re-surgery
B. Can use glasses or minor enhancement
C. Requires IOL
D. Needs patching
View Answer
B. Can use glasses or minor enhancement ✅ Exp: Small residual refractive errors can be corrected with enhancement or spectacles.
485. PRK differs from LASIK because:
A. PRK involves corneal flap
B. PRK removes epithelium and ablates surface stroma
C. LASIK ablates surface directly
D. PRK always induces cataract
View Answer
B. PRK removes epithelium and ablates surface stroma ✅ Exp: PRK = no flap; ablation done after epithelial removal.
486. SMILE refractive surgery primarily corrects:
A. Hypermetropia
B. Myopia and astigmatism
C. Presbyopia
D. Aphakia
View Answer
B. Myopia and astigmatism ✅ Exp: Small incision lenticule extraction used for myopia/astigmatism correction.
487. Post-refractive surgery, dry eye occurs due to:
A. Tear gland atrophy
B. Corneal nerve disruption during flap creation
C. Posterior capsule tear
D. Accommodation failure
View Answer
B. Corneal nerve disruption during flap creation ✅ Exp: Corneal sensory nerve loss reduces tear secretion reflex.
488. Refractive surgery contraindicated in keratoconus because:
A. Corneal shape unstable
B. Axial length too long
C. Tear film thick
D. Anterior chamber deep
View Answer
A. Corneal shape unstable ✅ Exp: Ectatic cornea unstable → high risk of further thinning post-surgery.
489. Residual stromal bed after LASIK should be at least:
A. 100 µm
B. 250 µm
C. 150 µm
D. 400 µm
View Answer
B. 250 µm ✅ Exp: <250 µm risks ectasia and biomechanical failure.
490. Myopic regression post-LASIK due to:
A. Corneal remodeling and epithelial hyperplasia
B. IOL shift
C. Lens hardening
D. Scleral thinning
View Answer
A. Corneal remodeling and epithelial hyperplasia ✅ Exp: Healing causes mild regression toward myopia over time.
🧮 Clinical Application & Special Cases
491. Presbyopic patient with cataract benefits from:
A. Monofocal IOL
B. Multifocal or accommodative IOL
C. No IOL
D. Contact lens only
View Answer
B. Multifocal or accommodative IOL ✅ Exp: Multifocal IOL provides distance and near focus.
492. Post-vitrectomy myopic shift may occur due to:
A. Reduced axial length
B. IOL forward movement
C. Retina thinning
D. Corneal flattening
View Answer
B. IOL forward movement ✅ Exp: Surgical change in lens position increases effective power.
493. High myopes are prone to postoperative hyperopic shift if:
A. IOL placed posteriorly
B. Cornea steeper
C. Tear film thick
D. Mydriatic pupil
View Answer
A. IOL placed posteriorly ✅ Exp: Posterior IOL position decreases effective power → hyperopic shift.
494. Refraction should be delayed how long after cataract surgery for stable results?
A. 1 week
B. 3–6 weeks
C. 1 day
D. 2 months
View Answer
B. 3–6 weeks ✅ Exp: Refractive stability achieved after capsular and corneal healing.
495. Pseudophakic patient requesting near independence may be offered:
A. Reading glasses only
B. Multifocal or monovision strategy
C. Cylindrical lenses
D. Bifocals only
View Answer
B. Multifocal or monovision strategy ✅ Exp: Monovision or multifocal IOL options can reduce dependence on glasses.
Optometry mcq questions and answers
496. In a patient with pseudophakia and astigmatism, best correction is:
A. Spherical lenses
B. Toric IOL or cylinder glasses
C. Prism spectacles
D. Contact lens only
View Answer
B. Toric IOL or cylinder glasses ✅ Exp: Toric IOL corrects residual corneal astigmatism at surgery.
497. Vertex distance conversion is especially important when:
A. Spectacle power > ±4.00 D
B. Power < ±2.00 D
C. Plano lenses
D. Progressive lenses
View Answer
A. Spectacle power > ±4.00 D ✅ Exp: Effective power changes significantly in high prescriptions.
498. Contact lenses give better visual quality than spectacles because:
A. They magnify image
B. They eliminate vertex distance, prismatic, and magnification errors
C. They reduce tear film
D. They correct only cylinder
View Answer
B. They eliminate vertex distance, prismatic, and magnification errors ✅ Exp: Contacts sit on cornea → no vertex effect → natural field and image size.
499. When prescribing bifocals, segment size depends on:
A. Pupil diameter
B. Occupation and reading habits
C. IOL power
D. Tear volume
View Answer
B. Occupation and reading habits ✅ Exp: Near visual demand and working distance determine segment height/width.
500. The key principle of refraction for all patients is:
A. Maximum minus for best vision
B. Least minus or most plus lens for best visual acuity
C. Trial-and-error only
D. Overcorrection improves VA
View Answer
B. Least minus or most plus lens for best visual acuity ✅ Exp: Always prescribe the weakest lens power that provides clear, comfortable vision.
