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Saudi Board Ophthalmology – Part One: free practice test

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Practice test questions with answers and explanations

Try the questions in the test above first, then open each one here to see the correct answer and why every other option is wrong.

01A 68-year-old man reports gradual blurring of distance vision and says he can now read without his glasses. Slit-lamp examination shows yellow-brown central lens opacity. Which cataract type is most likely?

Practice question Unit: Anterior segment

  1. AAnterior polar cataract present since early childhood

    A childhood polar opacity does not fit new age-related central yellow-brown lens change.

  2. BCortical cataract

    Cortical cataracts usually form peripheral spoke-like opacities rather than a brown central nucleus.

  3. CNuclear sclerotic cataract ✓ Correct answer

    Nuclear sclerosis increases lens refractive power, causing a myopic shift and temporary improvement in unaided near vision.

  4. DPosterior subcapsular cataract

    Posterior subcapsular cataracts often cause disproportionate glare; the described brown central nucleus points elsewhere.

Reference: Saudi Board Ophthalmology – Part One, Anterior segment – Lens and cataract

02A man on tamsulosin is listed for cataract surgery. Which intraoperative problem should the surgeon anticipate?

Practice question Unit: Anterior segment

  1. AZonular dialysis

    Zonular weakness is not the characteristic complication associated with tamsulosin.

  2. BSuprachoroidal haemorrhage

    Suprachoroidal haemorrhage is a different surgical complication, not the typical tamsulosin association.

  3. CCorneal endothelial decompensation

    Endothelial failure is not the characteristic alpha-blocker-related problem.

  4. DIntraoperative floppy iris syndrome ✓ Correct answer

    Tamsulosin blocks iris-dilator alpha-1 receptors and is associated with a floppy iris, progressive miosis and iris prolapse.

Reference: Saudi Board Ophthalmology – Part One, Anterior segment – Lens and cataract

03A patient has bilateral superotemporal lens subluxation, tall stature and long fingers. Which diagnosis is most likely?

Practice question Unit: Anterior segment

  1. ASulfite oxidase deficiency with severe seizures from birth

    Sulfite oxidase deficiency usually causes severe early neurological disease, not this marfanoid presentation.

  2. BHomocystinuria

    Homocystinuria can resemble Marfan syndrome, but the lens displacement is classically inferonasal.

  3. CMarfan syndrome ✓ Correct answer

    Marfanoid habitus with superotemporal ectopia lentis is characteristic of Marfan syndrome.

  4. DWeill–Marchesani syndrome

    Weill–Marchesani syndrome typically features short stature and microspherophakia rather than tall stature and long fingers.

Reference: Saudi Board Ophthalmology – Part One, Anterior segment – Lens and cataract

04Which IOL is most appropriate for a patient with 2.5 D of regular corneal astigmatism wanting spectacle independence for distance?

Practice question Unit: Anterior segment

  1. ANon-toric multifocal IOL

    Multifocality alone does not correct regular corneal astigmatism without a toric component.

  2. BStandard anterior-chamber IOL

    Anterior-chamber placement is not itself an astigmatism-correcting optical design.

  3. CSpherical monofocal IOL

    A standard spherical monofocal lens leaves significant regular corneal astigmatism uncorrected.

  4. DToric monofocal IOL ✓ Correct answer

    A correctly selected and aligned toric IOL compensates for regular corneal astigmatism to improve unaided distance vision.

Reference: Saudi Board Ophthalmology – Part One, Anterior segment – Lens and cataract

05A 62-year-old has IOP 28 mmHg, open angles, and inferior neuroretinal rim thinning with a superior arcuate field defect. What is the diagnosis?

Practice question Unit: Glaucoma

  1. APrimary open-angle glaucoma ✓ Correct answer

    Open angles with characteristic optic-disc damage and matching arcuate field loss support open-angle glaucoma.

  2. BAnterior ischemic optic neuropathy with altitudinal loss

    Ischaemic optic neuropathy more often has acute onset and an altitudinal defect rather than typical glaucomatous rim loss.

  3. COcular hypertension

    Ocular hypertension has raised pressure without established glaucomatous disc or field damage.

  4. DNormal-tension glaucoma

    Normal-tension glaucoma has glaucomatous damage despite pressures within the usual normal range; 28 mmHg is raised.

Reference: Saudi Board Ophthalmology – Part One, Glaucoma – Primary open- and angle-closure glaucoma

06A diabetic has new vessels on the disc greater than one-third disc area with vitreous hemorrhage. What is the risk category per DRS?

Practice question Unit: Retina

  1. ALow-risk proliferative diabetic retinopathy

    Large disc neovascularisation with vitreous haemorrhage exceeds a low-risk proliferative pattern.

  2. BHigh-risk proliferative diabetic retinopathy ✓ Correct answer

    Disc neovascularisation of this extent, with vitreous haemorrhage, meets DRS high-risk proliferative characteristics.

  3. CModerate non-proliferative diabetic retinopathy

    Any definite retinal or disc neovascularisation makes the disease proliferative rather than moderate NPDR.

  4. DSevere non-proliferative diabetic retinopathy

    Severe NPDR lacks neovascularisation; new disc vessels establish proliferative disease.

Reference: Saudi Board Ophthalmology – Part One, Retina – Diabetic retinopathy and vascular occlusions

07A 4-year-old has 6/24 vision in the right eye and 6/6 in the left, with +5.00 D right and +1.00 D left and no strabismus. What is the diagnosis?

Practice question Unit: Pediatric Ophthalmology

  1. ADeprivation amblyopia

    Deprivation amblyopia requires obstruction of the visual axis, which is not described.

  2. BAnisometropic amblyopia ✓ Correct answer

    Greater uncorrected hyperopia causes chronic blur in the right eye during visual development.

  3. CBilateral isoametropic amblyopia caused by high hyperopia in both eyes

    Bilateral isoametropic amblyopia involves similar high refractive errors in both eyes, not this marked asymmetry.

  4. DStrabismic amblyopia

    Strabismic amblyopia follows ocular misalignment, but this child has no strabismus.

Reference: Saudi Board Ophthalmology – Part One, Pediatric Ophthalmology – Strabismus and amblyopia

08A 70-year-old has bilateral ptosis with a high upper lid crease and good levator function (15 mm). What is the most likely cause?

Practice question Unit: Oculoplastic

  1. AAponeurotic (involutional) ptosis ✓ Correct answer

    Age-related levator aponeurosis stretching or detachment gives a high crease despite good muscle function.

  2. BMyasthenia gravis

    Myasthenic ptosis typically varies or fatigues; a high crease with preserved levator action favours aponeurotic ptosis.

  3. CCongenital ptosis

    Congenital ptosis generally begins early and often has reduced levator function.

  4. DThird nerve palsy with a dilated pupil

    Third-nerve palsy usually has associated ocular-movement abnormalities and sometimes a dilated pupil.

Reference: Saudi Board Ophthalmology – Part One, Oculoplastic – Eyelid malposition and ptosis

09A 28-year-old woman has painful eye movements and reduced vision over 3 days, with RAPD and a normal-appearing disc. What is the most likely diagnosis?

Practice question Unit: Neuro-ophthalmology

  1. ALeber hereditary optic neuropathy

    Leber optic neuropathy is usually painless, unlike the painful eye movements described.

  2. BNAION

    NAION usually affects older patients, is painless and has acute optic-disc swelling.

  3. CCentral serous chorioretinopathy with a serous macular detachment

    A macular serous detachment causes central visual distortion and does not explain painful eye movements well.

  4. DRetrobulbar optic neuritis ✓ Correct answer

    Pain on movement, subacute visual loss and RAPD with a normal disc fit retrobulbar optic neuritis.

Reference: Saudi Board Ophthalmology – Part One, Neuro-ophthalmology – Optic neuropathies and papilloedema

10Mutton-fat keratic precipitates and iris nodules suggest which type of uveitis?

Practice question Unit: Uveitis

  1. AHLA-B27 acute anterior uveitis

    HLA-B27 anterior uveitis is typically non-granulomatous, not the classic mutton-fat pattern.

  2. BGranulomatous ✓ Correct answer

    Large greasy keratic precipitates and iris nodules are characteristic granulomatous inflammatory signs.

  3. CIntermediate

    Intermediate describes the main anatomic site of inflammation, not this granulomatous morphology.

  4. DNon-granulomatous

    Non-granulomatous inflammation usually has finer precipitates rather than large mutton-fat deposits.

Reference: Saudi Board Ophthalmology – Part One, Uveitis – Anterior and posterior uveitis

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