Section 1: Corneal Tear Repair

1. 1. In a corneal laceration involving the visual axis, which of the following is the correct choice of suture size and placement:

• A. longer sutures are placed peripherally, and shorter passes are placed more centrally

• B. shorter sutures are placed peripherally, and longer passes are placed more centrally

• C. Equal size and depth of sutures throughout the wound

• D. None of the above

2. 2. Which clinical feature most reliably differentiates a partial-thickness from a full-thickness corneal laceration?

•    A. Iris incarceration

•    B. Conjunctival chemosis

•    C. Positive fluorescein staining without Seidel leak

• D. Shallow anterior chamber with IOP elevation

3. A patient presents with a self-sealing paracentral full-thickness laceration. What is the best rationale for still considering surgical repair?

• A. To prevent endothelial cell loss

• B. To reduce risk of microbial entry and endophthalmitis

• C. To minimize epithelial regeneration time

• D. To prevent cataract formation

4. In which of the following cases is cyanoacrylate glue contraindicated as a substitute for sutures?

• A. Central sterile corneal melt with 1 mm perforation

• B. Full-thickness corneal tear with iris prolapse

• C. Paracentral wound without aqueous leak

• D. Peripheral laceration <1.5 mm in size

5. What is the best position for placing sutures in a corneal laceration?

• A. Parallel to the wound edges

• B. Diagonal across the wound

• C. Perpendicular and evenly spaced across the wound

• D. Only on one side of the wound