Cataract Questions DNB

 Anatomy & Embryology

1. Write short note on lens development, anatomy, lens sutures and factors affecting lens transparency. 

2. **Briefly write on the development of crystalline lens. Enlist the biochemical mechanism of cataractogenesis. Briefly write about various congenial and developmental anomalies of lens. 

3+3+4

3. Discuss the metabolism of crystalline lens. Mention the factors responsible for cataract formation. What is the change that occurs in diabetic aetiology? 4+4+2 

4. a. **Anatomy of the crystalline lens. (3+3+4) 

b. Its physiology and how it remains clear. 

c. Its embryological development with suitable diagram(s).

Cataract

1. Etiopathogenesis of age related cataract.

2. **a) Describe various pathways of glucose metabolism in the lens. 

b) What metabolic abnormalities cause diabetic and galactosaemic cataract? 

c) Describe briefly various congenital and developmental anomalies of lens.

Anaesthesia

1. Describe the common agents and techniques for local anaesthesia for cataract surgery and their potential complications. (6+4) 

2. **What are the various types of anesthesia used for cataract surgery? Describe briefly merits and demerits of each. 2+4+4 

3. **Describe technique, advantages and disadvantages of topical, retrobulbar block, peribulbar block and facial block anaesthesia for ocular surgery. 

Cataract sx

1. What are the advantages & disadvantages of Phaco-emulsification compared to SICS and MICS? Who invented Phaco-emulsification and couching? (4+4+2) 

2. What is the role of laser in cataract surgery? Discuss its advantages with respect to conventional phacoemulsification. 

Complicated Cataract sx

1. Define complicated cataract. What are the various causes for it? How will you manage such cases? 2+4+4 

2. Management of subluxated cataractous lens. 

3. What precaution you will take while operating a case of cataract in PXF syndrome by phacoemusification. 

4. Enumerate special precaution you will take while performing phacoemulsification in a patient with age related cataract who has got poor endothelial count. 

5. **Name various systemic conditions associated with ectopia lentis. How will you manage a case of subluxated lens? (5+5) 

6. What is capsular block syndrome? Classify capsular block syndrome with respect to early, intra-operative and late causes. How are they avoided and/or managed? 

7. What are the factors affecting the SIA (Surgery Induced Astigmatism). How do you manage these cases having pre-operative astigmatism during the surgery for cataract? 5+5 

8. a) Describe various surgical difficulties encountered when doing a phacoemulsification in a small pupil. 

b) How do you manage a case of non dilating pupil for phacoemulsification.

        8.  ***Causes, clinical features and management of ectopia lentis. (3+2+5) 

Cataract sx Complications

1. Proper management of posterior capsular rent in cataract surgery. 

2. What are the causes of posterior capsular rupture and how you will manage it in a phacoemulsification surgery? 5+5 

3. A 76 Year old individual underwent phacoemulsification for grade 4 cataract. He received incompletely and developed diminution of vision 6 weeks after surgery. Discuss the causes of diminished vision and their management in brief. 

Phaco Machine

1. Define flow rate, vacuum, rise time, serge and duty cycle in phacoemulsification surgery. What are the basic principles in ultrasonic power modulations and advantages of these modulations? 

1+1+1+1+1+3+2

2. **Define in relation to Phacoemulsification: 2+2+2+4 

A. Flow rate and Vacuum 

B. B. Pulse mode and Burst mode 

C. Rise time and effective phaco time 

D. Surge (causes and prevention) 

Femto

1. **What is blade free cataract surgery? What are its advantages over conventional phacoemulsification? What are its disadvantages? 

IOLS

1. Describe various IOL power calculation formulae and how will you calculate IOL power in post refractive surgery patient? (7+3) 

2. Accomodative intraocular lenses. 

3. Discuss various materials and designs of intraocular lenses. (5+5) 

4. Discuss the principle of refractive and diffractive intraocular lenses. Give advantages and disadvantages of multifocal IOLS. 

5. **What are multifocal lOL’s and give principle of various types of multifocal lOL’s. Give advantages and disadvantages of these lOL’s. 

6. ***a) What are Multifocal IOLs? 

b) What are their types and their advantages? 

c) What Special Surgical Considerations will be utilized when implanting a multifocal IOL?

        7.  ****Indications, advantages, disadvantages and complications of a Toric multifocal intra  

             ocular lens implantation following cataract extraction. (2+3+3+2) 

PCO

1. Describe intraoperative and postoperative methods to reduce posterior capsule opacifications. 

Viscoelastics

1. What are viscoelastic? How do you classify them? Briefly give the indications of each and their side effects. 1+3+4+2 

2. **Broadly classify viscoelastic substances used in ophthalmic surgery. What is soft shell technique in cataract surgery and enlist important precautions while performing phacoemulsification in cases with low corneal endothelial counts. 2+(4+4) 

Miscellaneous

1. ***What is the nature of biochemical abnormality in homocystinuria? Discuss its ocular and systemic manifestations, genetics and management. 3+(4+2+1)