FCPS Part 1 Ophthalmology: Neuro-ophthalmology & Orbit MCQs

Practice MCQs on neuro-ophthalmology and the orbit for FCPS Part 1: visual pathway lesions, pupil signs, cranial nerve palsies and proptosis.

Neuro-ophthalmology (about 200 questions) and orbit and oculoplastics (about 160) are two of the larger ophthalmology-specific subjects in HighYield's FCPS Part 1 bank. They reward one skill above all: localising a lesion from the visual field, pupil or eye movement finding. Here is a sample set.

Visual Pathway and Pupils

1. A bitemporal hemianopia indicates a lesion of the:

A) Optic nerve
B) Optic chiasm ✅
C) Optic tract
D) Occipital cortex

Crossing nasal retinal fibres are compressed at the chiasm, classically by a pituitary adenoma.

2. A homonymous hemianopia with macular sparing suggests a lesion in the:

A) Optic tract
B) Lateral geniculate body
C) Occipital cortex ✅
D) Optic chiasm

Dual blood supply to the occipital pole (posterior and middle cerebral arteries) spares the macula.

3. A relative afferent pupillary defect (Marcus Gunn pupil) indicates disease of the:

A) Cornea
B) Optic nerve or extensive retina ✅
C) Iris sphincter
D) Lens

4. Ptosis, miosis and anhidrosis together describe:

A) Adie's pupil
B) Horner's syndrome ✅
C) Third nerve palsy
D) Argyll Robertson pupil

Cranial Nerves and Optic Nerve Disease

5. A complete third nerve palsy causes an eye that is:

A) Up and in
B) Down and out with ptosis and a dilated pupil ✅
C) Adducted only
D) Abducted only

A dilated pupil suggests compression, for example by a posterior communicating artery aneurysm.

6. Pain on eye movement with reduced vision and colour desaturation in a young woman suggests:

A) Optic neuritis ✅
B) Papilloedema
C) Retinal detachment
D) Acute angle-closure glaucoma

Optic neuritis is strongly associated with multiple sclerosis.

7. Bilateral optic disc swelling from raised intracranial pressure is called:

A) Optic atrophy
B) Papilloedema ✅
C) Optic neuritis
D) Pseudopapilloedema

Orbit

8. The commonest cause of proptosis in an adult is:

A) Orbital cellulitis
B) Thyroid eye disease ✅
C) Orbital lymphoma
D) Cavernous haemangioma

Why This Area Is Worth Extra Time

These questions are structured puzzles: a field defect or pupil sign points to one site. Draw the visual pathway once, then practise localising from the finding. The free sample on the Neuro-ophthalmology subject page and the Orbit & Oculoplastics page give you the same timed, explained format as the full bank.

Practise With Explanations

HighYield's FCPS Part 1 Ophthalmology QBank has 2,100+ MCQs across every ophthalmic subject plus the shared basic sciences. Every question has a written explanation, and subject analytics show which area needs another pass. Your first 20 questions are free, no card required. See also our Glaucoma MCQs post.

Frequently Asked Questions

Is neuro-ophthalmology high-yield for FCPS Part 1?

Yes. At roughly 200 questions it is one of the largest ophthalmology-specific subjects in our bank, and it also links to basic-science neuroanatomy.

What is the best way to learn visual field defects?

Learn the pathway from retina to occipital cortex, then link each field defect to the site of the lesion.