📋 DSSSB Optometrist 2026 · Post Code 09/26
📄 2019 Paper
DSSSB Optometrist
Previous Year Paper 2019
Part 3 — Q41 to Q60
20 actual questions from DSSSB Optometrist 2019 covering Retinal Anatomy, Retinoscopy, Hypermetropia, JCC, Dispensing Optics, Binocular Vision, Instrumentation, Contact Lens & Community Optometry — click any option to reveal the answer instantly.
📅 Exam Year: 2019
❓ Questions: Q41–Q60
📌 Vacancies 2026: 15 Posts
⏰ Last Date: 28 Mar 2026
This blog contains questions Q41 to Q60 from the DSSSB Optometrist Previous Year Question Paper 2019 with correct answers and detailed explanations. Topics include: Neurosensory Retinal Layers, Working Lens in Retinoscopy, Refractive Errors vs Presbyopia, Jackson’s Cross Cylinder, Hypermetropia classification, Pinhole, Bifocal optical jump, Stenopaeic Slit, Progressive Lenses, Segment Height, Stereopsis, Refractive Surgery, Indirect Ophthalmoscopy, IOL formulae, CT/MRI indications, Hess chart, Contact Lens complications, SAFE strategy for Trachoma, and Corneal Sensation loss.
How to use: Click your chosen option → correct answer and full explanation appear immediately. Track your live accuracy with the floating scorecard on the right.
📑 Questions in This Part (Q41–Q60)
Answer your first question to begin →
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✓ Correct Answer: A. 9
The total retina = 10 layers. The outermost layer is the Retinal Pigment Epithelium (RPE), which is NOT part of the neurosensory retina. The remaining 9 inner layers = Neurosensory Retina: ① Photoreceptor layer ② External limiting membrane ③ Outer nuclear layer ④ Outer plexiform layer ⑤ Inner nuclear layer ⑥ Inner plexiform layer ⑦ Ganglion cell layer ⑧ Nerve fibre layer ⑨ Internal limiting membrane. Exam trap: “total retina = 10” vs “neurosensory retina = 9.”
AThe distance between patient and observer
BThe dioptric equivalent of distance between patient and observer
CAt 2/3 m distance, the working lens equals −1.5D
DAt 1 m distance, the working lens equals +1D
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✓ Correct Answer: C
The working lens must always be a plus (convex) lens. At 2/3 m working distance: Power = 1 ÷ 0.67 = +1.50D — NOT −1.50D as Option C states. Option D is TRUE: at 1 m, power = 1/1 = +1.00D. Formula to remember: Working lens (D) = 1 / working distance (m). Always positive. A negative value is a fundamental clinical error because the examiner needs plus power to neutralise their own proximity to the patient.
AMyopia
BAnisometropia
CPresbyopia
DHypermetropia
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✓ Correct Answer: C. Presbyopia
Presbyopia is NOT a refractive error — it is a normal, age-related physiological condition caused by progressive loss of crystalline lens elasticity → reduced accommodative amplitude → near vision difficulty. True refractive errors (ametropias): Myopia (axial/refractive), Hypermetropia, Astigmatism, Anisometropia (unequal RE between the two eyes). Presbyopia begins around 40–45 years and requires a reading addition, not a corrective lens for optical aberration.
AUsed to check the axis of the cylinder subjectively
BUsed to check the power of the cylinder subjectively
CCylinder power is twice that of sphere and of opposite sign
DA 0.50D cross-cylinder can be written as +0.25DS / −0.50DC
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✓ Correct Answer: D
A 0.50D cross-cylinder = +0.50DS / −1.00DC (NOT +0.25DS/−0.50DC). Rule: For a ±X cross-cylinder → Sphere = +X, Cylinder = −2X. So ±0.50D → +0.50 / −1.00DC. Options A & B TRUE: JCC checks both axis (handle between the two meridians) and power (handle along a principal meridian). Option C TRUE: cylinder is always twice the sphere and opposite sign — this is the defining property of a cross-cylinder. The half-power notation (+0.25/−0.50) is a common exam trap.
AManifest hypermetropia is the strongest plus lens the patient accepts to clear distance VA
BLatent hypermetropia is manifested with cycloplegic drugs
CFacultative hypermetropia cannot be corrected by accommodation
DAbsolute hypermetropia cannot be overcome by accommodation
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✓ Correct Answer: C
Facultative hypermetropia = the portion that CAN be overcome by accommodation — Option C is FALSE. The portion that CANNOT be overcome = Absolute hypermetropia. Classification mnemonic: Total H = Manifest + Latent. Manifest = Facultative + Absolute. Facultative: corrected by accommodation. Absolute: even maximum accommodation fails. Latent: only revealed with cycloplegia. Options A, B, D are all TRUE by definition.
AIn macular disease, VA decreases with pinhole
BNo improvement in vision always indicates macular disease
CIf pinhole is too small, it can affect vision through interference
DIt cannot improve vision in patients with hazy media
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✓ Correct Answer: B
Option B is FALSE — no improvement with pinhole does NOT always mean macular disease. It also occurs in: Dense cataract, severe media opacity, amblyopia, optic nerve disease. Option A TRUE: macular disease → pinhole reduces retinal image → worsens perception of macular distortion. Option C TRUE: too small a pinhole causes diffraction (wave interference) → blur. Option D TRUE: pinhole reduces blur circles but cannot correct light scatter from hazy media (e.g., corneal scar, mature cataract).
ASmall bifocal segment
BBlending the segment with no visible line of separation
CKeeping segment optical centre close to segment top
DPlacing segment top as close as possible to distance optical centre
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✓ Correct Answer: B
Blending the segment only hides the cosmetic line — it has absolutely no effect on optical jump. Optical jump = prismatic effect at segment top = determined by distance between segment OC and segment top edge. Ways to REDUCE jump: ① Small segment ② Segment OC as close to segment top as possible (Executive bifocal has OC at top → zero jump) ③ Segment top close to distance lens OC. Blending is purely cosmetic — the prismatic discontinuity at the segment boundary remains unchanged.
AIt is an elongated pinhole that increases blur in the axis of astigmatism
BCan be used to find best position for optical iridectomy
CUsed for subjective refraction
DCan be used to find principal axes of astigmatism
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✓ Correct Answer: A
The stenopaeic slit acts as a directional pinhole — it reduces blur (not increases it) in the meridian aligned with the slit by isolating that meridian and maximising depth of focus along it. Clinical uses: ① Subjective refraction in irregular astigmatism ② Finding principal axes of astigmatism ③ Finding the optimal position for optical iridectomy (corneal opacity cases) ④ Refraction through corneal scars. The patient rotates the slit until clearest vision is found in each principal meridian.
AThey have power for viewing at only three distances
BVisible line is not seen in these lenses
CThey are cosmetically superior to bifocals
DThey provide greater range of clear vision
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✓ Correct Answer: A
Progressive Addition Lenses (PALs) do NOT restrict vision to only 3 fixed distances — that is a trifocal lens. PALs provide a continuous, seamless gradient of power from distance (top) through intermediate to near (bottom), offering clear vision at an infinite range of focal distances. Options B, C, D are TRUE: No visible line (cosmetically superior to bifocals), and they provide a greater range of clear vision. Drawback: peripheral blur/distortion zones in PALs that trifocals/bifocals don’t have.
AIPD (Interpupillary distance)
BSegment height
CFrame height
DBoxing height
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✓ Correct Answer: B. Segment height
Segment height = vertical measurement from the lowest internal point of the lens/frame to the top of the reading segment (or beginning of progressive add in PALs). Critical dispensing measurement: if too high → near zone obscures distance vision; if too low → patient must uncomfortably tilt the head to use the near zone. Measured with the patient’s frame in place while looking straight ahead. Boxing height = total vertical lens dimension of the frame — different from segment height.
AIt is measured in arc seconds
BTNO test is based on monocular clues
CFrisby test is used after 4 years of age
DLang test is used in young children
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✓ Correct Answer: B
The TNO test uses random-dot stereograms with red-green anaglyph glasses — it completely eliminates all monocular clues and relies entirely on binocular disparity. Option B is FALSE. Options A, C, D TRUE: Stereopsis is measured in arc seconds (normal ≤60″). Frisby test uses real depth (no glasses needed), suitable from ~3–4 years. Lang test uses random dot principles without glasses — ideal for young children. Stereo tests summary: Titmus (monocular clues present), TNO (no monocular clues), Lang (no glasses), Frisby (real depth).
ALASIK
BLASEK
COrthokeratology
DPRK
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✓ Correct Answer: C. Orthokeratology
Orthokeratology (Ortho-K) is completely non-invasive and reversible — specially designed rigid gas-permeable contact lenses worn overnight temporarily reshape the corneal epithelium. No incision, no laser, no surgery. Surgical methods: LASIK (flap creation + excimer laser stromal ablation), LASEK (epithelial flap + surface excimer ablation), PRK (epithelium removed + excimer laser ablation). Other surgical options include SMILE, ICL (implantable collamer lens), and refractive lens exchange.
AMagnification is 15 times
BWider field of view
CImage is real and inverted
DPeripheral retina can be seen
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✓ Correct Answer: A
Indirect ophthalmoscopy magnification = 2×–5× (NOT 15×). It is Direct ophthalmoscopy that gives ~15× magnification. Key comparison: Direct = Virtual erect image · 15× magnification · Narrow field (5°) · No mydriasis needed. Indirect = Real inverted image · 2–5× magnification · Wide field (40–60°) · Requires mydriasis · Views peripheral retina · Used for RD and ROP screening. Options B, C, D are all TRUE for indirect ophthalmoscopy.
AKeratometry is required
BAxial length is measured
CIf axial length <24.5 mm, Hoffer Q is used
DIn high myopia, SRK II should be used
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✓ Correct Answer: D
SRK II is NOT recommended for high myopia — it systematically gives hyperopic surprises in long (myopic) eyes. For high myopia (axial length >26 mm): use SRK/T or Barrett Universal II. IOL formula guide: Short eyes (<22 mm) → Hoffer Q. Medium (22–24.5 mm) → Hoffer Q or Holladay 1. Normal (22–26 mm) → SRK/T, Holladay 1. Long (>26 mm) → SRK/T or Barrett Universal II. Options A, B, C are all TRUE.
AOrbital trauma
BEvaluation of EOM in thyroid eye disease (TED)
CPregnancy
DOrbital cellulitis
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✓ Correct Answer: C. Pregnancy
Pregnancy is a contraindication for elective CT scanning — ionising radiation carries teratogenic risk to the developing fetus. CT indications in ophthalmology: Orbital trauma (blow-out fracture, bone detail, metallic foreign body), Thyroid Eye Disease (EOM enlargement, orbital apex crowding, optic nerve compression), Orbital cellulitis (extent of infection, subperiosteal abscess). Rule: CT preferred for bone, metallic FB, acute trauma. MRI preferred for soft tissue, neural, vascular pathology.
AOptic nerve disease
BMeningioma of optic nerve
CIntracranial lesions
DMetallic foreign body
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✓ Correct Answer: D. Metallic foreign body
Metallic foreign body is an absolute contraindication for MRI. The powerful superconducting magnet can forcefully displace a retained intraocular/orbital metallic FB → catastrophic tearing of ocular tissues → irreversible blindness. MRI indications in ophthalmology: Optic nerve disease (demyelination in MS), Optic nerve meningioma (superior soft-tissue detail), Intracranial lesions (pituitary, chiasmal, and brain tumours). Rule: always screen for metallic FB with CT/X-ray before MRI, especially in any patient with metalwork history or industrial eye injuries.
ADifferentiates restrictive from paralytic myopathy
BPatient must have NRC and central fixation
CLarger field belongs to the abnormal eye
DDissociates using complementary colours
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✓ Correct Answer: C
In Hess chart interpretation: Smaller field = affected (paretic) eye. Larger field = unaffected eye (secondary overaction per Hering’s law of equal innervation). Option C states “larger field = abnormal eye” — this is FALSE. Options A, B, D are TRUE: Hess distinguishes restrictive from paralytic. Patient requires Normal Retinal Correspondence (NRC) and central fixation. Dissociation is achieved with red-green glasses (complementary colours). The chart with the smaller, restricted field = affected eye.
AGiant papillary conjunctivitis (GPC)
BCorneal abrasion
CDry eye syndrome
DAge-related macular degeneration (ARMD)
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✓ Correct Answer: D. ARMD
ARMD is a degenerative posterior segment disease — pathogenesis involves age, genetics, and oxidative stress of the RPE and photoreceptors. It is entirely unrelated to contact lens wear on the anterior surface. Contact lens complications: GPC (immune reaction to lens protein deposits), Corneal abrasion (mechanical trauma), Dry eye (tear film disruption, reduced aqueous meniscus), Microbial keratitis, CLPU, corneal neovascularisation, and hypoxic changes.
ASurgery of complications (trichiasis)
BCataract surgery
CEnvironmental hygiene
DAntibiotics
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✓ Correct Answer: B. Cataract surgery
WHO SAFE Strategy for trachoma elimination: S = Surgery for trichiasis (eyelid rotation to prevent corneal scarring from inturned lashes) · A = Antibiotics (single-dose azithromycin to clear Chlamydia trachomatis) · F = Facial cleanliness · E = Environmental improvement (water, sanitation, fly control). Cataract surgery is NOT part of SAFE — it belongs to VISION 2020 and general blindness prevention. Options A, C, D are all directly part of SAFE.
AHerpes simplex keratitis
BFungal keratitis
CBacterial keratitis
DMarginal keratitis
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✓ Correct Answer: A. Herpes simplex keratitis
HSV keratitis causes reduced or absent corneal sensation — a classic clinical hallmark. The neurotropic virus travels along the ophthalmic division of CN V and directly damages the subepithelial nerve plexus → corneal anaesthesia. Clinical clue: a painless dendritic ulcer should raise strong suspicion of HSV. Other causes of reduced sensation: Herpes zoster ophthalmicus, Acoustic neuroma, Leprosy, Riley-Day syndrome, long-term contact lens wear. Fungal, bacterial, and marginal keratitis are typically very painful — intact corneal sensation.
❓ Frequently Asked Questions
How many layers does the neurosensory retina have? ▼
The neurosensory retina has 9 layers. The total retina = 10 layers — the outermost being the Retinal Pigment Epithelium (RPE), which is NOT part of the neurosensory retina. The 9 neurosensory layers (outer to inner): Photoreceptors, External Limiting Membrane, Outer Nuclear, Outer Plexiform, Inner Nuclear, Inner Plexiform, Ganglion Cell Layer, Nerve Fibre Layer, Internal Limiting Membrane.
What is the correct notation for a 0.50D Jackson’s Cross Cylinder? ▼
A 0.50D cross-cylinder = +0.50DS / −1.00DC. Formula: For ±X cross-cylinder → Sphere = +X, Cylinder = −2X. So ±0.50 → +0.50/−1.00DC. The notation +0.25DS/−0.50DC is incorrect — a common exam trap.
What does the WHO SAFE strategy for trachoma stand for? ▼
S = Surgery for trichiasis · A = Antibiotics (azithromycin for Chlamydia trachomatis) · F = Facial cleanliness · E = Environmental improvement. Cataract surgery is NOT part of SAFE.
Which keratitis causes loss of corneal sensations? ▼
Herpes Simplex Virus (HSV) keratitis classically causes reduced or absent corneal sensation. The neurotropic virus damages the subepithelial nerve plexus of CN V. A painless dendritic ulcer is the key clinical clue. Other causes: Herpes zoster, acoustic neuroma, leprosy. Fungal, bacterial, and marginal keratitis are painful — sensation intact.