Continue mastering Physiology of Eye and Vision with next 30 advanced MCQs (Q31–60) on Pupillary Reflexes mcq, Light and Dark Adaptation, and related ocular conditions. Covers sympathetic and parasympathetic pupil control, Horner’s syndrome, Argyll Robertson and Adie’s pupils, dark adaptation curve, nyctalopia, and Parinaud’s syndrome — essential for NEET PG, AIIMS, and ophthalmology exam preparation. visit our index page to find ophthalmology mcq.
Pupillary Reflex Pathways
31. Dilation of pupil is mediated by:
A. Parasympathetic fibers
B. Sympathetic fibers
C. Optic nerve
D. Ciliary ganglion
View Answer
B. Sympathetic fibers ✅ Exp: Sympathetic innervation to dilator pupillae causes mydriasis.
32. Preganglionic sympathetic fibers for pupil dilation synapse at:
A. Edinger-Westphal nucleus
B. Superior cervical ganglion
C. Ciliary ganglion
D. Pterygopalatine ganglion
View Answer
B. Superior cervical ganglion ✅ Exp: Postganglionic fibers travel with internal carotid plexus.
33. Horner’s syndrome results from lesion in:
A. Sympathetic pathway
B. Parasympathetic pathway
C. Optic nerve
D. Ciliary ganglion
View Answer
A. Sympathetic pathway ✅ Exp: Classic triad: miosis, ptosis, anhidrosis.
34. First-order neuron of sympathetic pathway originates in:
A. Hypothalamus
B. Edinger-Westphal nucleus
C. Superior cervical ganglion
D. Midbrain tectum
View Answer
A. Hypothalamus ✅ Exp: Hypothalamus → spinal cord → sympathetic chain.
35. Second-order neuron of sympathetic pupillary pathway ends in:
A. Ciliary ganglion
B. Superior cervical ganglion
C. Pterygopalatine ganglion
D. Ciliary body
View Answer
B. Superior cervical ganglion ✅ Exp: Preganglionic fibers synapse in SCG.
36. The ciliospinal reflex is:
A. Pupil dilatation on pinching neck
B. Constriction on light
C. Constriction on near effort
D. None of the above
View Answer
36. The ciliospinal reflex is: Exp: Sympathetic reflex tested by neck pain stimulus.
37. Hippus refers to:
A. Rhythmic oscillation of pupil size
B. Fixed dilated pupil
C. Absent pupillary reflex
D. Ptosis with miosis
View Answer
A. Rhythmic oscillation of pupil size ✅ Exp: Normal spontaneous fluctuation of pupil.
38. Mid-dilated fixed pupil is characteristic of:
A. Acute angle closure glaucoma
B. Horner’s syndrome
C. Adie’s pupil
D. Argyll Robertson pupil
View Answer
A. Acute angle closure glaucoma ✅ Exp: Ischemic sphincter paralysis → mid-dilated pupil.
39. Which drug can produce pinpoint pupils?
A. Morphine
B. Atropine
C. Tropicamide
D. Cocaine
View Answer
39. Which drug can produce pinpoint pupils? Exp: Opiates stimulate parasympathetic dominance → miosis.
40. Mydriasis is caused by all except:
A. Atropine
B. Tropicamide
C. Pilocarpine
D. Cocaine
View Answer
C. Pilocarpine ✅ Exp: Pilocarpine causes miosis.
Light & Dark Adaptation
41. Dark adaptation curve is biphasic because:
A. Rods and cones adapt at different rates
B. Cones adapt faster than rods
C. Rods adapt faster than cones
D. Only cones adapt
View Answer
A. Rods and cones adapt at different rates ✅ B. Cones adapt faster than rods ✅Exp: Cones adapt first (fast), rods adapt later (slow).
42. During early dark adaptation, vision is mediated by:
A. Rods
B. Cones
C. Muller cells
D. Bipolar cells
View Answer
B. Cones ✅ Exp: Cones adapt first but saturate quickly.
43. During late dark adaptation, vision is mediated by:
A. Rods
B. Cones
C. Amacrine cells
D. RPE
View Answer
A. Rods ✅ Exp: Rods dominate after ~10 min, full adaptation by 30 min.
44. Which vitamin deficiency impairs dark adaptation first?
A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin D
View Answer
A. Vitamin A ✅ Exp: Vitamin A needed for rhodopsin regeneration.
45. Electrophysiological test for dark adaptation:
A. ERG
B. EOG
C. VEP
D. OCT
View Answer
A. ERG ✅ Exp: ERG measures rod-cone responses in adaptation.
46. Maximum sensitivity of rods in scotopic vision is at:
A. 400 nm
B. 507 nm
C. 555 nm
D. 600 nm
View Answer
B. 507 nm ✅ Exp: Rod peak at 507 nm (blue-green).
47. Maximum sensitivity of cones in photopic vision is at:
A. 400 nm
B. 507 nm
C. 555 nm
D. 600 nm
View Answer
C. 555 nm ✅ Exp: Cones peak in yellow-green (~555 nm).
48. Nyctalopia is caused by:
A. Rod dysfunction
B. Cone dysfunction
C. Bipolar cell defect
D. Ganglion cell loss
View Answer
A. Rod dysfunction ✅ Exp: Rod degeneration or Vitamin A deficiency → night blindness.
49. Hemeralopia (day blindness) is seen in:
A. Cone dysfunction
B. Rod dysfunction
C. RPE dysfunction
D. Retinal detachment
View Answer
A. Cone dysfunction ✅ Exp: Cone dystrophy → poor day vision.
50. Retinitis pigmentosa affects:
A. Rods first
B. Cones first
C. Ganglion cells
D. Muller cells
View Answer
A. Rods first ✅ Exp: Rod degeneration → night blindness → peripheral loss.
51. In Argyll Robertson pupil, the reflex lost is:
A. Light reflex
B. Near reflex
C. Both reflexes
D. None
View Answer
A. Light reflex ✅ Exp: Pupils accommodate but don’t react to light.
52. Argyll Robertson pupil is small because of:
A. Iris sphincter overaction
B. Sympathetic lesion
C. Lens sclerosis
D. Excess aqueous humor
View Answer
B. Sympathetic lesion ✅ Exp: Sympathetic underaction → miotic pupil.
53. Adie’s tonic pupil is hypersensitive to:
A. 0.125% pilocarpine
B. Atropine
C. Tropicamide
D. Cocaine
View Answer
A. 0.125% pilocarpine ✅ Exp: Denervation hypersensitivity to dilute cholinergic.
54. Holmes-Adie pupil is usually:
A. Unilateral
B. Bilateral always
C. Seen only in children
D. Associated with Horner’s
View Answer
A. Unilateral ✅ Exp: Most cases unilateral, in young adults.
55. Light-near dissociation is a hallmark of:
A. Argyll Robertson pupil
B. Adie’s tonic pupil
C. Both A & B
D. Horner’s syndrome
View Answer
C. Both A & B ✅ Exp: Present in both conditions.
56. In optic atrophy, pupils are:
A. RAPD present
B. Argyll Robertson
C. Adie’s tonic pupil
D. Mid-dilated and fixed
View Answer
A. RAPD present ✅ Exp: Afferent defect → RAPD.
57. Hutchinson’s pupil indicates:
A. Uncal herniation with CN III compression
B. CN VI palsy
C. Optic neuritis
D. Horner’s syndrome
View Answer
A. Uncal herniation with CN III compression ✅ Exp: Early sign of tentorial herniation.
58. In oculomotor nerve palsy, pupil is:
A. Dilated & unreactive
B. Constricted
C. Normal
D. Mid-dilated with light-near dissociation
View Answer
A. Dilated & unreactive ✅ Exp: Parasympathetic loss → dilated pupil.
59. Amaurotic pupil occurs in:
A. Total optic nerve lesion
B. Oculomotor palsy
C. Horner’s syndrome
D. Adie’s pupil
View Answer
A. Total optic nerve lesion ✅ Exp: No direct/consensual light reflex in blind eye.
60. Parinaud’s syndrome shows:
A. Light-near dissociation
B. RAPD
C. Argyll Robertson pupil
D. Hippus
View Answer
A. Light-near dissociation ✅ Exp: Dorsal midbrain lesion → impaired light reflex but preserved near response.
