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Cornea questions and external disease MCQs for residents

Cornea and external disease covers the eyelid margin, conjunctiva, ocular surface and cornea: infectious and immune-mediated keratitis and conjunctivitis, dry eye and blepharitis, corneal dystrophies and degenerations, ectatic disorders, ocular surface tumors, chemical and mechanical injury, and the principles of keratoplasty. It corresponds to BCSC Section 8, External Disease and Cornea.

Board exams emphasize pattern recognition and management decisions. Expect vignettes built around a slit-lamp description or photograph, such as a dendrite versus a pseudodendrite, a ring infiltrate in a contact lens wearer, or a stromal dystrophy with a characteristic deposit, followed by a question on the likely organism, the histopathologic stain, the inheritance pattern or the next step in management. Keratoplasty, graft rejection and endothelial disease are recurring themes.

Use practice questions to sharpen discrimination between look-alike entities rather than to memorize lists. After each question, work out why every distractor is wrong, map the answer onto a decision flowchart for red eye or keratitis, and let spaced repetition bring back the dystrophy genetics and staining facts you are most likely to forget.

Free cornea & external disease practice questions

Cornea & external disease questions are in the OphthoMentor app: create a free account to practise them with explanations, flowcharts and spaced-repetition review.

High-yield cornea & external disease topics for boards

  • Herpes simplex keratitis: epithelial dendrite, stromal and endothelial disease patterns
  • Herpes zoster ophthalmicus: Hutchinson sign and risk of ocular involvement
  • Acanthamoeba keratitis: contact lens wear, severe pain, radial keratoneuritis, ring infiltrate
  • Fungal keratitis: vegetable-matter trauma, feathery margins, satellite lesions
  • Bacterial keratitis in contact lens wearers: Pseudomonas, corneal scraping and culture
  • Adenoviral conjunctivitis: follicles, preauricular node, subepithelial infiltrates
  • Neonatal conjunctivitis: chemical, gonococcal, chlamydial and herpetic causes by timing
  • Stromal dystrophies: granular, lattice, macular — deposits, stains, inheritance
  • Fuchs endothelial corneal dystrophy: guttae, stromal edema, endothelial keratoplasty
  • Keratoconus: Vogt striae, Fleischer ring, Munson sign, acute hydrops, cross-linking
  • Pellucid marginal degeneration: inferior thinning, against-the-rule astigmatism
  • Corneal graft rejection: Khodadoust line, keratic precipitates, rejection types
  • Chemical injury: alkali versus acid, limbal ischemia, immediate copious irrigation
  • Cicatrizing conjunctivitis: mucous membrane pemphigoid and Stevens-Johnson syndrome
  • Dry eye: aqueous-deficient versus evaporative disease, meibomian gland dysfunction
  • Neurotrophic keratopathy: reduced corneal sensation, persistent epithelial defects
  • Peripheral ulcerative keratitis versus Mooren ulcer: exclude systemic autoimmune disease
  • Ocular surface squamous neoplasia: gelatinous or leukoplakic limbal lesion, management
  • Band keratopathy: calcium in Bowman layer, underlying causes, EDTA chelation
  • Corneal deposits in systemic disease: Kayser-Fleischer ring, cystinosis, vortex keratopathy

How cornea & external disease is examined

Cornea and external disease (BCSC Section 8) is tested on the OKAP and ABO written exams commonly through clinical vignettes and slit-lamp images: identify the lesion, name the organism or dystrophy, and choose the next diagnostic or therapeutic step. Content overlaps with ophthalmic pathology, so stains, deposits and inheritance patterns are often tested alongside the clinical picture.

EBOD and FRCOphth written papers draw on the same core material, including the management of microbial keratitis, ocular surface disease and the indications for different keratoplasty techniques. In oral and clinical formats, candidates are commonly shown an external or slit-lamp photograph and asked to describe the findings systematically, offer a differential diagnosis and outline investigation and treatment.