This document contains 25 multiple choice questions related to glaucoma. The questions cover topics such as risk factors for progression of primary open-angle glaucoma, inheritance patterns of genetic disorders associated with glaucoma, components of the modified Goldmann equation, examination techniques for the optic nerve head, criteria used in glaucoma clinical trials, genes associated with pseudoexfoliation syndrome, causes of glaucoma associated with tumors of the ciliary body, types of glaucoma caused by lens abnormalities, diagnosis of acute angle closure glaucoma, treatment of angle closure disorders, monitoring of children after surgery for congenital glaucoma, contraindications of glaucoma medications in children, side effects of ocular hypotensive

1. GLAUCOMA questions 2019-2020
1. Prospective trials have found several risk factors for the development or progression of
primary open-angle glaucoma (POAG). What factor is associated with a critical risk of
progression in POAG?
a. young age
b. thicker cornea
c. decreased perfusion pressure
d. elevated intracranial pressure
2. What is the mode of inheritance of Axenfeld-Rieger syndrome?
a. X-linked
b. sporadic
c. autosomal recessive
d. autosomal dominant
3. Which parameter of the modified Goldmann equation cannot be directly measured clinically
and must be calculated from the other parameters of this equation?
a. outflow facility
b. aqueous humor formation rate
c. uveoscleral flow rate
d. episcleral venous pressure
4. What is the rate of aqueous humor formation during sleep, compared with the rate during
waking hours?
a. the same as during waking hours
b. decreased by approximately 50%
c. increased by approximately 50%
d. increased by 25%
5. What type of tonometer utilizes the Imbert-Fick principle for measurement of intraocular
pressure (IOP)?
a. pneumatonometer
b. Schiøtz tonometer
c. Perkins tonometer
d. dynamic contour tonometer
6. When is a false-positive error recorded in perimetry?
a. when the patient responds even though no visual stimulus was presented
b. when the patient moves his or her eyes from the central fixation point
c. when, on retesting, the patient does not respond to a stimulus that was previously seen
d. when the patient falsely responds to a visual stimulus presented in the blind spot

2. 7. What is the best way to examine the optic nerve head (also called optic disc) in routine
clinical practice?
a. with a slit-lamp biomicroscope and a high-magnification (eg, 60.00, 78.00, or 90.00 D)
posterior pole lens
b. with the indirect ophthalmoscope
c. with the direct ophthalmoscope and low magnification
d. with the direct ophthalmoscope and high magnification
8. What is the criterion that was used in the Ocular Hypertension Treatment Study (OHTS) for
identification of a visual field defect on standard automated perimetry?
a. presence of a Glaucoma Hemifield Test (GHT) with abnormally low sensitivity
b. presence of a Pattern Standard Deviation (PSD) with P < 5% or presence of a GHT with a
result outside normal limits
c. presence of a cluster of 2 abnormal points on the pattern deviation plot
d. diffuse loss of sensitivity with a mean deviation with P < 5%
9. Mutations in which gene are associated with pseudoexfoliation syndrome?
a. CYP1B1
b. FOXC1
c. LOXL1
d. PITX2
10. What is the most common cause of glaucoma associated with primary or metastatic tumors
of the ciliary body?
a. angle closure by rotation of the ciliary body
b. deposition of tumor cells and inflammatory cells in the trabecular meshwork
c. direct invasion of the anterior chamber angle
d. neovascularization of the angle Study Questions
11. Which type of glaucoma is caused by leakage of lens protein through the capsule of a
mature or hypermature cataract?
a. phacomorphic glaucoma
b. lens particle glaucoma
c. ectopia lentis
d. phacolytic glaucoma
12. In the assessment of a patient with acute bilateral angle closure and a normal axial length,
what additional step is critical to reaching an accurate diagnosis?
a. Perform an immediate bilateral paracentesis.
b. Perform iris angiography.
c. Take a medication history.
d. Perform ultrasound biomicroscopy.

3. 13. Peripheral iridotomy is the treatment of choice for what disorder?
a. secondary angle closure following dense panretinal photocoagulation
b. iridocorneal endothelial dystrophy
c. phacoanaphylactic glaucoma
d. phacomorphic glaucoma
14. What is the most important factor in determining when to perform a laser peripheral
iridotomy in an eye with a narrow angle?
a. gonioscopic findings
b. amount of glaucomatous optic nerve cupping
c. amount of glaucomatous visual field loss
d. IOP level
15. What type of primary angle closure (PAC) occurs independent of pupillary block?
a. acute PAC
b. intermittent PAC
c. plateau iris syndrome
d. subacute PAC
16. What type of glaucoma is unlikely to resolve after cataract extraction?
a. primary angle-closure glaucoma
b. phacolytic glaucoma
c. an eye with angle recession and phacodonesis after blunt trauma
d. microspherophakia with glaucoma 232
17. What finding on examination of a patient with congenital glaucoma can continue to change
and indicate progressive glaucoma even though the IOP appears to be controlled?
a. axial length
b. corneal thickness
c. gonioscopic findings
d. myopia
18. After successful surgery for congenital glaucoma, for how many years should a child be
monitored?
a. 5 years
b. 10 years
c. 20 years
d. for life

4. 19. What glaucoma medication is contraindicated in the treatment of glaucoma in a toddler?
a. brimonidine
b. dorzolamide
c. latanoprost
d. timolol
20. Which class of ocular hypotensive agents is associated with the development of apnea in
infants and young children?
a. α 2 -selective adrenergic agonists
b. nonselective β-antagonists
c. carbonic anhydrase inhibitors
d. cholinergic agonists
21. Compared with nonselective adrenergic antagonists, which topical β 1 -selective adrenergic
antagonist is less likely to induce bronchospasm in patients with mild asthma?
a. timolol
b. carteolol
c. betaxolol
d. levobunolol
22. In a patient undergoing trabeculectomy for a preoperative IOP of 50 mm Hg, which
crystalline lens status and postoperative IOP level pose the greatest risk for development of
a suprachoroidal hemorrhage?
a. phakic eye with a postoperative IOP in the mid teens
b. phakic eye with a postoperative IOP in the single digits
c. aphakic eye with a postoperative IOP in the mid teens
d. aphakic eye with a postoperative IOP in the single digits Study Questions
23. Five years after laser trabeculoplasty, what percentage of treated patients are expected to
maintain a lower IOP?
a. 20%
b. 30%
c. 40%
d. 50%
24. Who is the best candidate for a trabeculectomy with mitomycin C?
a. aphakic contact lens wearer
b. patient with neovascular glaucoma
c. patient with previous failed trabeculectomy without antifibrotics
d. patient with active uveitis

5. 25. What patient profile has the most success with laser trabeculoplasty?
a. aphakic patient who is intolerant of multiple medications and whose current IOP is above
the target pressure
b. patient with a 10° central island of vision who is on maximally tolerated core medical
therapy
c. patient with POAG who is intolerant of multiple medications and whose current IOP is
above the target pressure
d. patient with uveitic glaucoma
Answer Sheet
Questions
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Answers
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