Clinical Refraction MCQs fully explained answers and Optometry mcq questions test covering post-surgical & pseudophakic refraction, amblyopia, accommodation anomalies, high ametropia, and advanced optics. Best for NEET PG, NEXT, AIIMS, INI-CET, FMGE, and M.Optom aspirants on MCQZone. For more Optometry and Ophthalmology mcq
⚕️ Post-Surgical & Pseudophakic Refraction Optometry mcq questions test
431. After cataract surgery with posterior chamber IOL, the expected effective lens position is:
A. Anterior to natural lens
B. Slightly posterior to natural crystalline lens
C. Exactly at the same plane
D. On the iris plane
View Answer
B. Slightly posterior to natural crystalline lens ✅ Exp: The IOL is placed slightly posterior to the natural lens position; affects IOL power calculation.
432. Myopic shift following cataract surgery is most likely due to:
A. Overestimated corneal power or shorter IOL position
B. Long axial length
C. Underestimated anterior chamber depth
D. Increased tear film
View Answer
A. Overestimated corneal power or shorter IOL position ✅ Exp: If IOL sits more anteriorly, effective power increases → myopic outcome.
433. A hypermetropic surprise post-surgery indicates:
A. IOL power underestimation
B. Longer axial length
C. Shorter cornea
D. Macular edema
View Answer
A. IOL power underestimation ✅ Exp: Low IOL power leads to hyperopic postoperative refraction.
434. In post-keratoplasty (corneal transplant), early refraction is avoided because:
A. The corneal curvature is still unstable
B. IOL not stable
C. Pupil is dilated
D. Tear film dry
View Answer
A. The corneal curvature is still unstable ✅ Exp: Corneal healing and suture tension alter curvature for several weeks/months.
435. “Residual astigmatism” after cataract surgery with toric IOL commonly occurs because:
A. Posterior capsule opacity
B. Toric IOL rotation
C. Zonular dehiscence
D. Irregular pupil
View Answer
B. Toric IOL rotation ✅ Exp: Even small axis rotation in toric IOLs significantly changes effective astigmatic correction.
436. For pseudophakic eyes with residual +1.00 D hyperopia, patient mainly complains of:
A. Distance blur
B. Near blur only
C. Color distortion
D. Binocular diplopia
View Answer
A. Distance blur ✅ Exp: Hyperopia under-correction leads to distance blur as image focuses behind retina.
437. Spherical equivalent of +2.50 / –1.00 × 180 is:
A. +1.50 D
B. +2.00 D
C. +1.00 D
D. +2.25 D
View Answer
A. +1.50 D ✅ Exp: SE = +2.50 + (–1.00 / 2) = +2.00 D, but final corrected lens often prescribed around +1.50–2.00 D depending on acuity and comfort.
438. If postoperative refraction shows +1.50 DS, but near VA is excellent, most likely patient has:
A. Myopic correction
B. Slight residual myopia (monovision effect)
C. High hypermetropia
D. Astigmatism
View Answer
B. Slight residual myopia (monovision effect) ✅ Exp: Mild myopia (–0.75 D) aids near vision with clear distance compromise.
439. In pseudophakia, depth of field increases with:
A. Small pupil (miosis)
B. Large pupil
C. High plus lens
D. Dilated iris
View Answer
A. Small pupil (miosis) ✅ Exp: Small pupils create pinhole effect, improving depth of focus and tolerance to defocus.
440. After YAG capsulotomy, transient myopic shift occurs because:
A. Change in IOL position due to posterior capsule opening
B. Corneal edema
C. Aqueous flare
D. Vitreous floaters
View Answer
A. Change in IOL position due to posterior capsule opening ✅ Exp: IOL slightly moves anteriorly after posterior capsule release.
👶 Optometry mcq questions test Pediatric & Amblyopia-related Refraction
441. Uncorrected anisometropia during childhood leads to:
A. Diplopia
B. Suppression and amblyopia
C. Myopia
D. Strabismus always
View Answer
B. Suppression and amblyopia ✅ Exp: Brain suppresses blurred image from one eye → amblyopia development.
442. Critical period for visual development extends up to approximately:
A. 2 years
B. 8 years
C. 12 years
D. 15 years
View Answer
B. 8 years ✅ Exp: Most visual cortical plasticity persists till ~7–8 years.
443. Best test for detecting amblyopia in non-verbal children:
A. Snellen chart
B. Preferential looking or visual evoked potential
C. Refraction only
D. Keratometry
View Answer
B. Preferential looking or visual evoked potential ✅ Exp: Objective methods like VEP and PL tests are used in preverbal children.
444. Full correction of refractive error in amblyopia is essential because:
A. It reduces diplopia
B. It provides proper retinal image stimulation
C. It reduces astigmatism
D. It alters corneal curvature
View Answer
B. It provides proper retinal image stimulation ✅ Exp: Equal clear images in both eyes allow cortical reactivation and recovery.
445. Occlusion therapy (patching) is most effective when started:
A. After age 10
B. Before age 7
C. At puberty
D. In adults
View Answer
B. Before age 7 ✅ Exp: Visual plasticity allows best recovery before visual cortex maturation.
446. Reverse occlusion (patching good eye intermittently) is indicated in:
A. Amblyopia treatment phase
B. Myopia
C. Aphakia
D. Strabismus surgery planning
View Answer
A. Amblyopia treatment phase ✅ Exp: Forcing amblyopic eye use stimulates cortical activity.
447. Best refractive management in anisometropic amblyopia:
A. Spectacles only
B. Contact lenses or refractive surgery if large difference
C. Prism correction
D. No correction needed
View Answer
B. Contact lenses or refractive surgery if large difference ✅ Exp: Contact lenses reduce aniseikonia and improve binocular input.
448. In pediatric refraction, plus lenses blur near vision but are prescribed fully because:
A. The child adapts by increased accommodation
B. Minus lens always needed
C. It improves convergence
D. To reduce distance clarity
View Answer
A. The child adapts by increased accommodation ✅ Exp: Children can accommodate to maintain near vision while benefiting from full hyperopic correction.
449. In infants <6 months, physiological hypermetropia is considered normal up to:
A. +1.00 D
B. +2.50 D
C. +5.00 D
D. Plano
View Answer
B. +2.50 D ✅ Exp: Normal growth-related axial length increase gradually reduces hypermetropia by age 6–7.
450. Premature infants are at higher risk of:
A. Myopia of prematurity
B. Presbyopia
C. Hypermetropia
D. Astigmatism only
View Answer
A. Myopia of prematurity ✅ Exp: Premature eyes have short axial length and high myopia due to abnormal retinal vascularization.
🧮 Advanced Optical Principles & Calculations
451. Power of a combination of +4.00 D and +6.00 D thin lenses separated by 10 cm is approximately:
A. +10.0 D
B. +9.76 D
C. +8.00 D
D. +10.25 D
View Answer
B. +9.76 D ✅ Exp: Combined power = F₁ + F₂ – (d × F₁ × F₂), where d in meters = 0.1.
452. Principal planes of a thick lens move anteriorly when:
A. Lens curvature decreases
B. Lens thickness or refractive index increases
C. Lens becomes plano
D. Light wavelength decreases
View Answer
B. Lens thickness or refractive index increases ✅ Exp: Greater optical density pushes principal planes forward.
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453. In retinoscopy, reversal of reflex occurs at:
A. Far point
B. Infinity
C. Retina
D. Near point
View Answer
A. Far point ✅ Exp: When light rays focus exactly on observer’s pupil plane = neutrality (far point).
454. To maintain accuracy, working distance correction in retinoscopy (at 67 cm) equals:
A. +1.00 D
B. +1.50 D
C. +2.00 D
D. +0.50 D
View Answer
B. +1.50 D ✅ Exp: 1 / 0.67 ≈ 1.50 D subtracted from gross finding for net refraction.
455. Streak retinoscope movement “with” indicates:
A. Myopia > 1 D
B. Hypermetropia or low myopia < 1 D
C. High myopia > 1 D
D. Astigmatism
View Answer
B. Hypermetropia or low myopia < 1 D ✅ Exp: “With” movement → image behind retina → plus lens needed.
Optometry mcq questions test
456. Retinoscopy performed through undilated pupil may lead to:
A. Over-minus correction due to accommodation
B. Under-correction of myopia
C. Exact result
D. No effect
View Answer
A. Over-minus correction due to accommodation ✅ Exp: Small pupils increase accommodation; hence more minus found.
.457. Cycloplegic refraction removes:
A. Axial ametropia
B. Accommodative element
C. Corneal curvature error
D. Lens thickness error
View Answer
B. Accommodative element ✅ Exp: Eliminates accommodation to reveal true refractive error.
458. When performing retinoscopy in a child, what should be ensured?
A. Full dark adaptation
B. Steady fixation and control of accommodation
C. Dilated pupil only
D. Testing without working distance
View Answer
B. Steady fixation and control of accommodation ✅ Exp: Attention and accommodation control critical for accuracy.
459. If retinoscopy reveals “against” motion neutralized by +2.00 D lens, the eye’s refractive error (at 50 cm working distance) is:
A. +2.00 D
B. +0.00 D
C. +0.50 D
D. –0.50 D
View Answer
C. +0.50 D ✅ Exp: Subtract 2.00 D (1 / 0.5 m) from gross finding → +0.00 – 1.50 ≈ +0.50 D net.
460. When two meridians neutralize at +2.00 D and +3.00 D, the cylinder power is:
A. +1.00 D
B. +0.50 D
C. –1.00 D
D. +2.00 D
View Answer
A. +1.00 D ✅ Exp: Difference between principal meridians = cylinder power (1 D).
👓 Practical Prescribing & Troubleshooting
461. A patient over-corrected with minus lenses typically reports:
A. Distance blur
B. Headache, asthenopia, and near blur
C. Better near vision
D. Color distortion
View Answer
B. Headache, asthenopia, and near blur ✅ Exp: Over-minusing strains accommodation and convergence.
Optometry mcq questions test
462. Excess plus lens correction causes:
A. Distance blur
B. Increased field
C. Eye strain relief
D. Enhanced depth perception
View Answer
A. Distance blur ✅ Exp: Focus shifts behind retina → blurred distance image.
463. When prescribing bifocals, segment height is measured from:
A. Eyelid margin
B. Lower limbus or inferior pupil margin
C. Frame bottom
D. Eyebrow
View Answer
B. Lower limbus or inferior pupil margin ✅ Exp: Ensures near segment aligns with reading gaze.
464. Progressive lenses differ from bifocals because they:
A. Have visible segment line
B. Provide smooth continuous power transition for near and distance
C. Reduce peripheral distortion completely
D. Are always cheaper
View Answer
B. Provide smooth continuous power transition for near and distance ✅ Exp: Progressives gradually change power, no visible demarcation.
465. Anisometropia correction tolerance in spectacles usually acceptable up to:
A. 1.00 D
B. 3.00 D
C. 5.00 D
D. 0.50 D
View Answer
B. 3.00 D ✅ Exp: Beyond 3 D difference, binocular disparity and aniseikonia problematic.
466. Spectacle magnification for +10 D lens (vertex 12 mm) roughly equals:
A. 5%
B. 10%
C. 20%
D. 1%
View Answer
B. 10% ✅ Exp: Magnification ≈ 1 + (vertex × power); 0.012 × 10 = 0.12 ≈ 12%.
467. When prescribing prisms, base direction is specified relative to:
A. Optical center
B. The patient’s view (base in/out/up/down)
C. Frame edge
D. Axis notation
View Answer
B. The patient’s view (base in/out/up/down) ✅ Exp: Prism base described as seen from patient’s side.
468. Main optical drawback of high-index lenses:
A. Thicker
B. Higher chromatic aberration
C. Heavier always
D. Fragile only
View Answer
B. Higher chromatic aberration ✅ Exp: High-index materials bend light more but disperse wavelengths more → aberrations.
469. Blue-light filter coatings primarily aim to:
A. Enhance night driving glare reduction
B. Increase near vision
C. Prevent retinal detachment
D. Increase brightness
View Answer
A. Enhance night driving glare reduction ✅ Exp: Reduce short-wavelength scatter and glare from digital screens.
470. Polarized sunglasses benefit most in:
A. Indoor tasks
B. Reducing reflected glare from horizontal surfaces (roads, water)
C. Increasing contrast at night
D. Correcting refractive error
View Answer
B. Reducing reflected glare from horizontal surfaces (roads, water) ✅ Exp: Polarization blocks horizontally reflected glare for better outdoor clarity.
