YEAR 04 • MAJOR CLINICAL DISCIPLINES

Ophthalmology

20 learning units • 100 chapter sections • 200 explained questions. Assess visual symptoms, recognise sight-threatening disease and plan safe treatment, referral and follow-up.

Original RAHBAR study material for the Year 4 learning pathway. Clinical cases support supervised undergraduate learning. Treatment choices, doses and procedures must follow current local protocols and the responsible clinical team. References & further reading ↓

MODULE 14 / 20

Optic Nerve, Pupils & Visual Fields

Use neuro-ophthalmic findings to localise disease and recognise urgent neurological presentations.

Answer all 10 questions, then submit to see your score and explanations. This is a self-study exercise; results are not saved.

Question 01. A relative afferent pupillary defect indicates what? A. Asymmetric afferent visual pathway dysfunctionB. A specific diagnosis of cataract in every caseC. Normal retinal function in both eyesD. Presbyopia alone

Question 02. Can symmetrical bilateral optic nerve disease lack an RAPD? A. No, an RAPD is mandatoryB. Only if the lids are closedC. YesD. Only with corneal infection

Question 03. Pain on eye movement with subacute visual loss and reduced colour saturation suggests what? A. Simple allergic conjunctivitisB. Optic neuritisC. Uncomplicated chalazionD. Stable presbyopia

Question 04. Can the optic disc appear normal in optic neuritis? A. No, swelling is always obviousB. Only after retinal surgeryC. Yes, with retrobulbar involvementD. Only if visual acuity is perfect

Question 05. What does papilloedema mean specifically? A. Every pale optic discB. Any corneal oedemaC. Any retinal haemorrhageD. Disc swelling due to raised intracranial pressure

Question 06. Why may imaging be needed before lumbar puncture in suspected raised intracranial pressure? A. To measure spectacle powerB. To replace all neurological examinationC. To guarantee normal cerebrospinal fluidD. To assess for causes and contraindications such as a mass lesion

Question 07. A homonymous visual field defect localises concern where? A. Only the corneal epitheliumB. Only the lacrimal sacC. Behind the optic chiasmD. Only the eyelid margin

Question 08. Bitemporal field loss raises concern for which structure? A. Lower eyelid aloneB. Corneal endothelium aloneC. Optic chiasmD. Nasolacrimal duct

Question 09. A painful third-nerve palsy with a dilated pupil requires what? A. Routine refraction onlyB. Emergency evaluation for a compressive causeC. Reassurance because diplopia is commonD. Review after six months

Question 10. Does pupil sparing guarantee an acute ocular motor palsy is benign? A. NoB. Yes, in all agesC. Yes, if there is headacheD. Only if vision is blurred

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References & Further Reading

Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.

Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.