Opthalamology Lacrimal system
Lacrimal System
MCQS
1. What is the primary function of the lacrimal gland?
- A) Produce tears
- B) Drain tears
- C) Provide oxygen to the cornea
- D) Lubricate the eyelid
- **Answer: A) Produce tears
2. Which artery supplies blood to the lacrimal gland
- A) Facial artery
- B) Lacrimal branch of the ophthalmic artery
- C) Maxillary artery
- D) Superficial temporal artery
- **Answer: B) Lacrimal branch of the ophthalmic artery
3. Where are the accessory lacrimal glands of Krause primarily located?
- A) Upper fornix
- B) Lower fornix
- C) Conjunctival stroma near the fornices
- D) Tarsal plate
- **Answer: C) Conjunctival stroma near the fornices
4. What is the length of the nasolacrimal duct?
- A) 1 cm
- B) 2 cm
- C) 3 cm
- D) 4 cm
- ** Answer: B) 2 cm
5. Which layer of the tear film is primarily responsible for preventing evaporation?
- A) Aqueous layer - B) Lipid lay
- C) Mucin layer
- D) Protective layer
- ** Answer: B) Lipid layer
Dr Mohamed ElEssawy MCQs
Opthalamology Lacrimal system
6. What is the clinical term for excessive tearing?
- A) Epiphora
- B) Lacrimation
- C) Dacryocystitis
- D) Canaliculitis
- **Answer: A) Epiphora
7. Which condition is characterized by inflammation of the lacrimal sac?
- A) Canaliculitis
- B) Dacryocystitis
- C) Epiphora
- D) Keratoconjunctivitis
- **Answer: B) Dacryocystitis
8. What is the main causative agent in chronic dacryocystitis?
- A) Viral infections
- B) Pneumococci
- C) Fungal infections
- D) Allergies
- **Answer: B) Pneumococci
9. Which of the following is NOT a symptom of acute dacryocystitis?
- A) Severe pain
- B) Epiphora
- C) Photophobia
- D) Fever
- **Answer: C) Photophobia
10. What procedure is often performed for chronic dacryocystitis?
- A) Conjunctivoplasty
- B) Dacryocystorhinostomy (DCR)
- C) Canaliculoplasty
- D) Blepharoplasty
- **Answer: B) Dacryocystorhinostomy (DCR)
Dr Mohamed ElEssawy MCQs
Opthalamology Lacrimal system
11. The presence of sulfur granules in discharge from the lacrimal system is
indicative of:
- A) Canaliculitis
- B) Dacryocystitis
- C) Epiphora
- D) Keratitis
- **Answer: A) Canaliculitis
12. What is a common treatment for congenital nasolacrimal duct obstruction in
newborns?
- A) Surgical intervention immediately
- B) Lacrimal sac massage
- C) Systemic antibiotics
- D) Warm compresses
- **Answer: B) Lacrimal sac massage
13. Which of the following conditions can lead to dry eye syndrome?
- A) Ectropion
- B) Sjögren's syndrome
- C) Canaliculitis
- D) Dacryocystitis
- **Answer: B) Sjögren's syndrome
14. The lacrimal puncta are located:
- A) At the outer canthus
- B) About 6 mm from the inner canthus on each lid margin
- C) At the bottom of the lacrimal sac
- D) Near the tarsal plate
- **Answer: B) About 6 mm from the inner canthus on each lid margin
15. Which of the following is a potential complication of untreated dacryocystitis?
- A) Orbital cellulitis
- B) Conjunctivitis
- C) Pterygium
- D) Corneal abrasion
- **Answer: A) Orbital cellulitis
Dr Mohamed ElEssawy MCQs
Opthalamology Lacrimal system
16. What is the purpose of Hasner's valve in the nasolacrimal duct?
- A) To regulate tear production
- B) To prevent reflux of nasal secretions into the lacrimal system
- C) To facilitate drainage of tears
- D) To protect the puncta from foreign bodies
- **Answer: B) To prevent reflux of nasal secretions into the lacrimal system
17. What is the common age for tears to start being produced in newborns?
- A) 1 week
- B) 4 weeks
- C) 3 weeks
- D) 2 weeks
- **Answer: D) 2 weeks
18. Which of the following is an indicator of obstructive epiphora?
- A) Abnormal lid margin
- B) Increased tear production
- C) Inflammation of the conjunctiva
- D) Swelling of the lacrimal sac
- **Answer: A) Abnormal lid margin
19. What type of gland is primarily responsible for producing the mucin layer of the
tear film?
- A) Meibomian glands
- B) Golfer cells
- C) Lacrimal glands
- D) Accessory lacrimal glands
- **Answer: B) Goblet cells
20. The main symptom of punctal obstruction is:
- A) Diplopia
- B) Epiphora
- C) Photophobia
- D) Blurred vision
- **Answer: B) Epiphora
Dr Mohamed ElEssawy MCQs
Opthalamology Lacrimal system
Question Answers Question Answers
1 A 11 A
2 B 12 B
3 C 13 B
4 B 14 B
5 B 15 A
6 A 16 B
7 B 17 D
8 B 18 A
9 C 19 B
10 B 20 B
Dr Mohamed ElEssawy MCQs
Opthalamology Lacrimal system
Case scenarions
Case scenarions Discussion
Discussion
1. Case Scenario: A 30-year-old woman presents with a painful swelling
in the inner corner of her left eye. She reports excessive tearing and
difficulty opening her eye. Upon examination, there is marked redness
and tenderness over the lacrimal sac area.
A) Dacryocystitis
B) Canaliculitis
C) Conjunctivitis
D) Allergic reaction
- Diagnosis : Dacryocystitis
- Illustration : Symptoms of pain, swelling, and tenderness in the lacrimal sac area, along with
epiphora, indicate inflammation of the lacrimal sac.
2. Case Scenario: A newborn is brought to the clinic due to persistent
watering of the left eye since birth. The mother notes that the baby
has had a sticky discharge. On examination, the regurgitation test is
positive.
A) Congenital nasolacrimal duct obstruction
B) Dacryocystitis
C) Conjunctivitis
D) Blepharitis
- Diagnosis: Congenital nasolacrimal duct obstruction
- Illustration The age of the patient and the positive regurgitation test suggest a blockage in
the nasolacrimal duct, common in newborns.
3. Case Scenario: A 45-year-old male with a history of dry eye syndrome
reports worsening symptoms and irritation. He mentions frequent use
of artificial tears but finds limited relief. The Schirmer’s test shows
significantly low tear production.
o A) Aqueous deficient dry eye
o B) Evaporative dry eye
o C) Allergic conjunctivitis
o D) Bacterial conjunctivitis
- Diagnosis: Aqueous deficient dry eye
- Illustration: The patient’s symptoms and low tear production measured by the Schirmer’s
test indicate inadequate aqueous tear production
Dr Mohamed ElEssawy MCQs
Opthalamology Lacrimal system
4. Case Scenario: A 50-year-old woman with a history of rheumatoid
arthritis presents with dry eyes and mouth. On examination, there is
evidence of corneal epithelial damage. The patient is diagnosed with
Sjögren's syndrome.
o A) Dry eye syndrome
o B) Sjögren’s syndrome
o C) Dacryocystitis
o D) Keratitis
o
- Diagnosis: Sjögren’s syndrome
- Illustration: The combination of dry eyes, dry mouth, and corneal damage is classic for this
autoimmune condition affecting lacrimal and salivary glands.
5. Case Scenario: A 25-year-old male presents with a painful discharge
from his eye, along with sulfur granules in the discharge. He mentions
that the symptoms started after an injury to his eye while gardening .
o A) Canaliculitis
o B) Dacryocystitis
o C) Allergic conjunctivitis
o D) Keratitis
- Diagnosis: Canaliculitis
- Illustration: The presence of sulfur granules in the discharge, especially following trauma,
suggests a bacterial infection of the canaliculus.
5. Case Scenario: A patient in their 60s presents with a history of
excessive tearing and a sensation of a foreign body in the eye. Upon
examination, the puncta are found to be obstructed.
o A) Obstructive epiphora
o B) Allergic conjunctivitis
o C) Dry eye syndrome
o D) Blepharitis
- Diagnosis: Obstructive epiphora
- Illustration: The symptoms of excessive tearing and the finding of punctal obstruction
indicate that tears cannot drain properly.
Dr Mohamed ElEssawy MCQs
Opthalamology Lacrimal system
6. Case Scenario: A 3-year-old child is brought in for a follow-up after
conservative treatment for watery eyes. The mother notes the child
still has purulent discharge. The child has a positive regurgitation test.
o A) Infantile dacryocystitis
o B) Allergic conjunctivitis
o C) Viral conjunctivitis
o D) Bacterial conjunctivitis
o
- Diagnosis: Infantile dacryocystitis
- llustration: Persistent symptoms despite conservative treatment and a positive
regurgitation test indicate infection and blockage in the lacrimal system.
7. Case Scenario: A patient presents with a swollen lacrimal sac and
fever. Upon examination, there is significant redness around the sac,
and the patient expresses severe pain. The discharge is purulent.
o A) Acute dacryocystitis
o B) Canaliculitis
o C) Allergic conjunctivitis
o D) Dry eye syndrome
o
- Diagnosis: Acute dacryocystitis
- Illustration: The presence of fever, pain, and purulent discharge along with swelling in the
lacrimal sac points to acute inflammation.
8. Case Scenario: A 40-year-old woman with a history of allergies
presents with complaints of excessive lacrimation, especially during
allergy season. She denies any pain or history of eye surgery.
o A) Reflex lacrimation due to allergic conjunctivitis
o B) Canaliculitis
o C) Dacryocystitis
o D) Dry eye syndrome
- Diagnosis: Reflex lacrimation due to allergic conjunctivitis
- Illustration: The patient’s symptoms are consistent with allergic reactions causing increased
tear production without obstruction or infection.
Dr Mohamed ElEssawy MCQs
Opthalamology Lacrimal system
10 - Case Scenario: A 65-year-old male with a history of diabetes
presents with chronic dry eye symptoms. On examination, there is
punctate keratitis and a decreased tear film break-up time .
o A) Evaporative dry eye due to meibomian gland dysfunction
o B) Aqueous deficient dry eye
o C) Dacryocystitis
o D) Allergic conjunctivitis
o
- Diagnosis: Evaporative dry eye due to meibomian gland dysfunction
- Illustration: The combination of dry eye symptoms, punctate keratitis, and decreased BUT
indicates dysfunction of the lipid layer, leading to increased evaporation.
Dr Mohamed ElEssawy MCQs
Opthalamology Lacrimal system
Dr Mohamed ElEssawy MCQs
