Slit lamp examination revealed diffuse epithelial edema, stromal infiltrate, and epithelial defect. The appropriate treatment is topical antibiotic and steroid drops.

1. EED Part 1
Loba euy….

2. 1. A 35-year-old patient presents with chronic unilateral follicular
conjunctivitis. Slit-lamp examination is remarkable for an ipsilateral
eyelid nodule with central umbilication. What would biopsy of the eyelid
lesion most likely reveal?
a. eosinophilic intracytoplasmic inclusions within epidermal cells
surrounding a necrotic core
b. vacuolization of keratinocyte cytoplasm with multinucleated cells and
nuclear inclusions
c. histiocytes with foamy, lipid-laden cytoplasm surrounding blood vessels
d. hyperkeratosis and acanthosis with a papillary growth pattern

3. • A patient with AIDS developed unilateral cytomegalovirus (CMV) retinitis. He was
treated with oral valganciclovir and 3 intraocular injections of foscarnet, which
halted the retinitis. At that time, his CD4+ T-lymphocyte count was 49 cells/μL. He
has since started antiretroviral treatment, with an improvement in CD4+ T-
lymphocyte count to 103 cells/μL. He presents with complaints of floaters in the
eye with prior CMV and now exhibits a robust vitritis, although the prior area of
CMV retinitis looks stable. What is the best initial therapy for this patient?
• a. Pars plana vitrectomy with intravitreal injection of foscarnet
• b. continuation of oral valganciclovir and starting systemic corticosteroids
• c. discontinuation of oral valganciclovir and injection of intraocular triamcinolone
4mg
• d. discontinuation of antiretroviral treatment and starting systemic
corticosteroids

4. • Seorang pasien laki-laki 39 tahun dengan psoriatic arthritis dan ulkus
genitalia dikonsulkan ke poliklinik mata dengan keluhan kedua mata merah,
nyeri, silau, dan kabur. Pada pemeriksaan oftalmologik didapatkan injeksi
siliar dan sinekia posterior. Pada funduskopi didapatkan gambaran
perdarahan retina dot dan blot, infiltrat retina, perivascular sheating.
Apakah diagnosis yang paling tepat untuk pasien ini?
a. Uveitis anterior
b. Sindroma VKH
c. Sindrom Behcet
d. Oftalmia simpatika
e. Posner-Schlossman syndrome

5. • Seorang pasien laki-laki 39 tahun dengan psoriatic arthritis dan ulkus
genitalia dikonsulkan ke poliklinik mata dengan keluhan kedua mata merah,
nyeri, silau, dan kabur. Pada pemeriksaan oftalmologik didapatkan injeksi
siliar dan sinekia posterior. Pada funduskopi didapatkan gambaran
perdarahan retina dot dan blot, infiltrat retina, perivascular sheating.
Gambaran apakah yang paling mungkin didapatkan pada pemeriksaan FFA?
• a. Hyperfluorescence
• b. Window defect
c. Leakage
d. Staining
• e. Pooling

6. • Female, 40 years old complain of painfull on her right eye and
photophobia. Slitlamp examination revealed diffuse punctate
epitheliopathy and dendritic epithelial lesions. The stromal infection
is found in the central area of the cornea, a ring-shaped infiltrate in
the paracentral cornea. What is the diagnose of this patient?
a) Fungal Keratitis
b) Bacterial Keratitis
c) Exposure Keratitis
d) Acantamoeba Keratitis

7. • 55 years old woman, with chief complain red eye on left eye for a few days
but really started to hurt today, was worse in the morning. Also has a
headache that is more on left side of her head. VA RE 5/40, LE 5/20, IOP
within normal limit. From anterior segment we found scleral nodule with
red-purple color, cannot be moved with cotton- tipped, vessel don’t blanch
with phenylephrine. What is the diagnosis?
a. Necrotizing scleritis with inflammation
b. Nodular anterior scleritis
c. Diffuse anterior scleritis
d. Necrotizing scleritis without inflammation

8. • A 10 yo white boy had a history of bilateral red eyes for a month at
examination. One year prior, he had acutely lost all of his hearing and had
undergone cochlear implant in his right ear. VA RE 20/30 and LE 20/20. He
had bilateral iritis with posterior synechiae in the LE. There were no corneal
lesions and the dilated fundus examination finding were normal. Blood
studies were performed and levels of rheumatoid factor, fluorescent
treponemal antibody absorption, angiotensin- converting enzyme, and CBC
were all normal. The iritis resolved quickly with topical dilating and
corticosteroid drops. What is the diagnosis?
a. Reiter syndrome
b. Cogan syndrome
c. Multiple viral etiologies (mumps, EBV, rubeola, herpes zoster)
d. Wegener’s granulomatosis

9. • Male, 60 yo, came with burning sensation on both eyes. There were
dry sensation, photophobia, and blurred vision. The symptoms tend
to get worse at the end of the day. From slit lamp examination of the
inferior meniscus, the height is around 0.6 mm and schirmer test was
10 seconds. The appropriate managements are :
a. Artificial tears + lubrication ointment
b. Artificial tears+ lubrication ointment + cyclosporine A
c. Artificial tears + lubrication ointment + punctual occlusion
d. All of the above

10. • 60 yo male come with blurred vision of the left eye, accompanied
with edema of eyelid, hyperemia conjunctiva, copious secrete, and
punctate lesionon the cornea. Sensitivity test reveals hypoesthesia.
What is the most appropriate treatment of the patient?
a) Trifluridine 1% eye dro 8 times a day for 10-14 days, valacyclovir
oral 3x800 mg for 10 days
b) Levofloxacin eyedrop 6 times a day evaluate for 7 days
c) Prednisolone acetate 1% 3 times a day for 7 days
d) Tobramycin eye drop 6 times a day for 10-14 days

11. • A 40-year old woman presents with follicular conjunctivitis.
Mucopurulent discharge (+), palpable preauricular adenopathy.
Follicles in the bulbar conjunctiva and semilunar fold (+). In the
cornea, coarse epithelial infiltrate (+), kertaitis in superior cornea (+).
A micropannus, extending less than 3 mm from the superior cornea
(+). What is the recommended treatment for her, except :
a) Azithromycin 1000 mg single dose
b) Doxycycline 100 mg twice daily for 7 days
c) Tetracycline 250 mg 4 times daily for 7 days
d) Levofloxacin 500 mg 2 times daily for 7 days

12. • 22 yo woman came to hospital with chief complain burning, itching, and
foreign body sensation particularly when awakening. This complain has
established for a month. Slit lamp exam: crust surrounding cilia, injection
and teleangiectasis of the anterior posterior eyelid margin, white lashes,
lash loss and trichiasis. What is the diagnosis?
a. Gonococcal conjunctivitis
b. Acute purulent conjunctivitis
c. Staphylococcal blepharitis
d. Chronic conjunctivitis
e. keratitis

13. • A 12-year-old boy comes to clinic with complaints of redness in eyes
followed by foreign body sensation in both eyes. In clinical
examination, founded follicular reaction in conjunctiva and abberant
lashes with mild corneal opacification. Patient lived in a rural area
with poor sanitation and poor hygiene. The correct management to
the patient ?
a) Spontaneously resolved in 16-18 months
b) Topical 1% tetracyclin for 2 months + Azithromycin oral 1000 mg single dose
c) Topical Gentamicyn + Azithromycin oral 500 mg once a day for 3 days
d) Topical 1% tetracyclin for 2 weeks + Azithromycin oral 1000 mg single dose
e) Ceftriaxone 1 gram injection single dose

14. • A 30-year-old immunocompetent patient presents with a 1-day
history of vesicular lesions on his upper lip and the third recurrence
within the past year of a dendritic epithelial lesion of his right cornea.
Which of the following options would be the most appropriate
treatment at this time?
a. Topical ophthalmic ganciclovir ointment 0.15% 5 times a day for 1 week
b. Topical trifluridine eyedrops 1% 9 times a day for 3 weeks
c. Systemic famciclovir 500 mg 3 times daily for 10 days
d. Systemic valacyclovir 500 mg 3 times daily for 10 days followed by
maintenance dosing

15. A 34-year-old male presented with redness in both eyes for the past 10 weeks. It was associated with
mild dull aching pain and slight blurring of vision in both eyes. There was a history of weight loss of
approximately 6 kg along with intermittent episodes of dry cough over the past 1 year. There was no
history of fever/rash/anorexia/joint pains or haemoptysis. On examination, visual acuity was 20/20 OU.
There was a mild circumcorneal ciliary congestion in both eyes. Mutton fat (KPs) (+), koeppe and busacca
iris nodule, snowball appearance in the anterior vitreous of both the eyes. The IOP was 34 mm and 28
mm of Hg. The chest radiograph revealed bilateral hilar lymphadenopathy which was confirmed by CT
scan chest. Negative tuberculin test. Serum ACE level was raised to 108 U/L.
What is the diagnose of this patient?
a. Sarcoidosis
2.Sympathetic ophtalmia
3.VKH Syndrome
4.Behcet Disease

16. • 40 yo male patient with pain, photophobia, and sudden visual loss.
Funduscopic examination reveal bilateral uveitis with vitritis and optic
disc edema. This condition associated with dermatological
manifestation w/o any history of trauma. What is the most possible
diagnosis?
a. Sarcoid panuveitis
b. Behcet disease
c. c. Intermediate uveitis
d. d. VKH syndrome

17. • Pasien dengan gejala scleromalasia nekrotikans non inflamasi dengan
gambaran coin lesion + cavity di foto thorax. Pemeriksaan tambahan
apa yang perlu dilakukan?
a. ANA
b. RF
c. Pemeriksaan TB
d. ANCA

18. • Pasien dengan gejala scleromalasia nekrotikans non inflamasi dengan
gambaran coin lesion + cavity di foto thorax. Terapi apa yang sesuai?
a. Kortikostreoid
b. Anti TB
c. Antibiotic
d. Anti VEGF

19. • Pasien dengan gejalan uveitis anterior & serous detachment di
posterior pole. Terapi yang sesuai?
a. Kortikosteroid dosis tinggi IV turunkan perlahan
b. Antibiotic sistemik
c. Kortikosteroid oral dosis turunkan perlahan
d. Anti VEGF
e. Imunomodulator

20. • Pasien dengan penurunan visus mata kanan, secret copious mucoid,
BMD dangkal, ada bayangan iris. Mata kiri kornea jernih. Terapi yang
sesuai adalah
a. Ceftriaxone 1 gr IM, subperiosteal graft segera, rawat inap
b. Ceftriaxone 1 gr IM, irigasi saline, rawat inap
c. Ceftriaxone 1 gr IM, single dose, irigasi saline, rawat jalan
d. Ceftriaxone 1 gr IM, subperiosteal graft segera, rawat jalan

21. • Pasien dengan penurunan visus mata kanan, secret copious mucoid,
BMD dangkal, ada bayangan iris. Mata kiri kornea jernih.
Penyebabnya adalah
a. Bakteri diplokokus intraselular gram (-)
b. Bakteri diplokokus intraselular gram (+)
c. Bakteri batang gram (-)
d. Bakteri batang gram (+)

22. • Pasien dengan Riwayat trauma kimia, kelainannya adalah
a. Limbal stem cell deficiency
b. Corneal Distrofi
c. ICE syndrome
d. Corneal edema

23. • Pasien dengan penurunan visus, lesi di hidung, mulut dan mata.
Penyebabnya
a. Keratitis ec acantameba
b. Keratitis ec jamur
c. Keratitis ec herpes simplex
d. Keratitis ec bakteri

24. • Pasien denga nada gambaran telangiectasis di palpebra dengan
keluhan rasa mengganjal, ada gambaran obstruksi kelenjar meibom.
Terapi lain yang sesuai
a. IPL
b. Kauter
c. CXL
d. Fine needle diathermi

25. • Pasien dengan Riwayat mengganti kosmetik, saat ini keluhan gatal,
ada gambaran sleeves dengan ada ketombe di bulu mata.
Penyebabnya?
a. Stafilokokus aureus
b. Streptococcus
c. Jamur berhifa
d. Demodex folicularis

26. • Pasien denga nada gambaran telangiectasis di palpebra dengan
keluhan rasa mengganjal, ada gambaran obstruksi kelenjar meibom.
Terapi yang sesuai
a. Kompres hangat
b. Azitromisin topical
c. Kortikosteroid
d. Kombinasi steroid - antibiotik

27. • Pasien dengan Riwayat mengganti kosmetik, saat ini keluhan gatal,
ada gambaran sleeves dengan ada ketombe di bulu mata. Terapi yang
sesuai
a. Antibiotic topical
b. Tea tree oil
c. Cuci dengan shampoo anti ketombe
d. Kompres hangat

28. • Pasien pengguna lensa kontak dan lupa melepas sepanjang malam,
saat ini mata merah dengan adanya keratitis supuratif. Terapi?
a. Lfx ed
b. Kortikosteroid ed
c. Cyclon
d. Kortikosteroid oral

29. A patient control to the infection immunologic clinic and after read the
medical record, patient was diagnosed with recurrent panuveitis in the both
eyes. Based on sun working group, what is the description of recurrent in
uveitis?
a. Persistent uveitis with relapse in < 3 months after discontinuing
treatment
b. Repeated episodes separated by periods of inactivity without treatment
≥ 3 months duration
c. Episodes characterized by sudden onset and limited duration
d. Repeated episodes separated by periods of inactivity without treatment
≤ 3 months duration
e. Inactive disease for ≥ 3 months after discontinuing all treatment for eye
disease

30. Seorang laki laki usia 17 tahun datang dengan keluhan kedua mata
merah. Pasien juga mengeluh mata berair dan keluar kotoran. Keluhan
ini sudah lama dirasakan tapi memberat sejak seminggu lalu. Hasil
pemeriksaan menunjukkan adanya art line pada konjungtiva tarsal
superior, Herbert pits, panus dan infiltrate di epitel kornea. Apakah
diagnosis yang tepat pada pasien ini?
a. Trachoma
b. Chlamydial conjunctivitis
c. Vernal keratoconjunctivitis
d. Ocular pemphigoid

31. Mikroorganisme yang sering menyebabkan konyungtivitis bakterial
dengan onset akut (< 3 minggu) adalah…
• a. Enterobacter
• b. Pseudomonas
• c. N. GO
• d. H. influenza

32. A male, 25 years old, came to outpatient clinic with vision blurred 3
days after LASIK. This patient also complained about pain and
photophobia. From examination there was corneal haze, with infiltrate
under the flap, flap was intact and in place. The initial procedure the
surgeon can do is……
a. Antibiotic irrigation under the flap
b. Topical antibiotic
c. Flap amputation
d. Systemic antibiotic

33. • Seorang pasien laki-laki 39 tahun dengan psoriatic arthritis dan ulkus
genitalia dikonsulkan ke poliklinik mata dengan keluhan kedua mata
merah, nyeri, silau, dan kabur. Pada pemeriksaan oftalmologik
didapatkan injeksi siliar dan sinekia posterior. Pada funduskopi
didapatkan gambaran perdarahan retina dot dan blot, infiltrat retina,
perivascular sheating. Apakah diagnosis yang paling tepat untuk
pasien ini?
a. Uveitis anterior
b. Sindroma VKH
c. Sindrom Behcet
d. Oftalmia simpatika
e. Posner-Schlossman syndrome

34. • Seorang pasien laki-laki 39 tahun dengan psoriatic arthritis dan ulkus
genitalia dikonsulkan ke poliklinik mata dengan keluhan kedua mata
merah, nyeri, silau, dan kabur. Pada pemeriksaan oftalmologik
didapatkan injeksi siliar dan sinekia posterior. Pada funduskopi
didapatkan gambaran perdarahan retina dot dan blot, infiltrat retina,
perivascular sheating. Gambaran apakah yang paling mungkin
didapatkan pada pemeriksaan FFA?
a. Hyperfluorescence
b. Window defect
c. Leakage
d. Staining
e. Pooling

35. • A 40-year-old woman came with a chief complaint of foreign body
sensation and whitening in her right eye. AVOD 20/100, pericorneal
injection, and peripheral corneal thinning on the limbus at 3-6 o'clock
without lucid interval. The patient had rheumatoid arthritis and did
not control regularly to the rheumatologist. The most possible
diagnosis is:
a. Mooren ulcer
b. Marginal corneal ulcer
c. Wagener granulomatosis
d. Terrien marginal degeneration
e. Peripheral ulcerative keratitis

36. • Pria 30 tahun datang dengan keluhan kedua mata sangat sakit,
merah, dan berair sejak 1 minggu. Keluhan tersebut sudah pernah
dialami 2 kali sebelumnya. Tidak didapatkan riwayat penyakit
sistemik dan hasil pemeriksaan laboratorium dalam batas normal.
AVODS 6/6, konjungtiva hiperemis. Tampak defek menggaung di tepi
kornea OD jam 4-7, dan OS jam 7-9 hingga limbus. Diagnosis pada
pasien ini adalah:
a. Mooren ulcer
b. Marginal keratitis
c. Interstitial keratitis
d. Peripheral ulcerative keratitis
e. Terrien marginal degeneration

37. • Fifty year-old woman came to the clinic with pain, redness and
decreased vision of the right eye since 3 days ago. She was febrile
with a temperature of 390 C . She had chronic recurrences of
pneumonia. On examination, the RE eyelid was swollen, with severe
conjunctival and cilliary injection, corneal edema, and marked
hypopion of 3 mm. USG examination showed dense vitreous opacity.
The most likely diagnosis of this patient is:
a. Orbital cellulitis
b. Infectious Panuveitis
c. Vitreous hemorrhage
d. Masquerade syndrome
e. Endogenous endophthalmitis

38. • A 24-year-old man came to ophthalmologist with chief complain
blurred and floaters in his left eye. Ophthalmology examination
showed 1+ vitreous cells. Funduscopic examination revealed
opacification of retina with area of hemorrhage, exudate and necrosis
along the vascular arcade. CD4 count were 40 cells/mm and anti-HIV
was positive. What is the most likely diagnosis for this patient?
a. Cytomegalovirus retinitis
b. Disseminated choroiditis
c. Frosted branch angiitis
d. Acute retinal necrosis
e. Syphilitic retinitis

39. • A 24-year-old man came to ophthalmologist with chief complain
blurred and floaters in his left eye. Ophthalmology examination
showed 1+ vitreous cells. Funduscopic examination revealed
opacification of retina with area of hemorrhage, exudate and necrosis
along the vascular arcade. CD4 count were 40 cells/mm and anti-HIV
was positive. What is the most proper therapy for this patient?
a. Oral valgancyclovir
b. Intravenous acyclovir
c. Intravenous foscarnet
d. Intravitreal gancyclovir
e. Intravenous valcyclovir

40. • Seorang anak perempuan berusia 6 tahun datang diantar ibunya
dengan keluhan kedua mata kabur. Pasien mengalami gangguan
pergerakan di pergelangan tangan. Pada pemeriksaan didapatkan
injeksi siliar ringan pada kedua mata, keratic precipitates halus, sel 2+,
sinekia posterior dan kekeruhan lensa. Terapi imunosupresif apakah
yang dapat diberikan untuk mengurangi komplikasi akibat pemakaian
steroid ?
a. Azatioprin
b. Siklosporin
c. Klorambusil
d. Metotreksat
e. Mikofenolat mofetil

41. • A 51-year-old-man comes to the clinic with blurred vision and
photophobic in his right eye for 3 weeks. There are scars in the right
eyelid and forehead. Examination reveals VAOD is CF. Slit lamp
examination in his right eye revealed oval central corneal defect with
rolled up edge and was stained with fluorescein dye. What
examination should be done to establish the diagnosis?
a. Corneal sensibility
b. Conjunctival biopsy
c. Corneal topography
d. Gram stain and KOH stain
e. Culture examination and sensitivity test

42. • A 51-year-old-man comes to the clinic with blurred vision and
photophobic in his right eye for 3 weeks. There are scars in the right
eyelid and forehead. Examination reveals VAOD is CF. Slit lamp
examination in his right eye revealed oval central corneal defect with
rolled up edge and was stained with fluorescein dye. What is the most
likey diagnosis?
a. Shield ulcer
b. Neurotropic keratopathy
c. Persistent epithelial defect
d. Necrotizing stromal keratitis
e. Limbal stem cell deficiency

43. • A 72 yo man is referred from general physician with decreasing vision and
redness of the right eye since 1 days before. The patient also has pain in of
the right scalp and several new pimples on his forehead with painful
vesicular. The least likely ocular finding in this conditions is:
a. Cranial nerve (CN) III palsy
b. Nummular corneal infiltrates
c. Anterior uveitis with increased IOP
d. Pars planitis
e. Chronic condition can lead to corneal neovascularization and corneal
opacity

44. A 72 yo man is referred from general physician with decreasing vision
and redness of the right eye since 1 days before. The patient also has
pain in of the right scalp and several new pimples on his forehead with
painful vesicular. The management of this patient is:
a. Gatifloxacin eye drop 6 times a day
b. Topical acyclovir, 5 times a day
c. Oral famciclovir 500 mg 3 times per day
d. Topical trifluridine, 8 times a days
e. Oral acyclovir 400 mg 5 times per day for 2 weeks

45. The B scan ultrasound image from an 18 yo old man who presented
with complains of ocular pain, redness, mild proptosis and decreased
vision RE of 2 weeks duration are localizwd posterior scleral thickening,
retrobulbar edema surrounding the optic nerve producing
characteristic ‘T sign’. There are several laboratory test are generally
recommended as an initial screening. The following test would be least
helpful work up for this patient is
a. ANCA test
b. HLA typing
c. ANA test
d. Rheumatoid factors
e. Serum uric acid