DNB Ophthalmology Theory Question Papers — Recent Years (2021–2025)

• Paper I — Basic Sciences (Anatomy, Physiology, Biochemistry, Optics, Pharmacology, Pathology, Microbiology)
• Paper II — Clinical Sciences (Diseases of eye — anterior & posterior segment, neuro-ophthalmology, strabismus, oculoplastics)

Frequently Asked Topics (2021–2025)

Paper I — Basic Sciences

Paper II — Clinical Sciences

Anterior Segment / Cornea

• Fuchs' endothelial dystrophy — pathogenesis, specular microscopy, DMEK vs DSAEK
• Acanthamoeba keratitis — diagnosis, confocal microscopy, management
• Keratoconus — diagnosis (Amsler-Krumeich, Belin-Ambrosio), crosslinking (Dresden protocol vs accelerated), ICL vs TPRK
• Penetrating vs lamellar keratoplasty — indications, graft survival, rejection
• Dry eye disease — TFOS DEWS II classification, management algorithm

Cataract / Refractive

• Phacoemulsification — steps, complications (PCR, zonular dialysis, dropped nucleus)
• IOL power calculation — hyperopic shift, post-refractive surgery IOLs (Barrett True-K, Haigis-L)
• Premium IOLs — EDOF, trifocal, toric; patient selection
• LASIK vs SMILE vs PRK — comparison, flap complications, ectasia risk

Glaucoma

• Normal tension glaucoma — pathogenesis, workup, management
• Angle closure glaucoma — mechanisms, gonioscopy findings, laser PI, lens extraction
• Trabecular meshwork — anatomy, uveoscleral outflow, MIGS (trabecular bypass, Schlemm's canal)
• OCT of optic nerve head and RNFL — parameters, glaucoma detection, progression

Retina

• Diabetic macular edema — OCT classification (SRD, ERM), anti-VEGF (ETDRS/DRCR protocols), laser, steroids (Ozurdex)
• Age-related macular degeneration — dry AMD (GA, complement pathway), wet AMD (Treat-and-Extend, anti-VEGF agents — ranibizumab, bevacizumab, aflibercept, faricimab)
• Rhegmatogenous retinal detachment — scleral buckle vs vitrectomy, PVR, giant retinal tear
• Central retinal artery/vein occlusion — ischemic vs non-ischemic CRVO, anti-VEGF, pan-retinal photocoagulation
• Retinoblastoma — Reese-Ellsworth vs International Classification (IIRC), chemoreduction, intravitreal melphalan, enucleation

Neuro-ophthalmology

• Papilloedema vs pseudopapilloedema (buried drusen)
• Third nerve palsy — surgical vs medical, pupil-involving, MRI indications
• Internuclear ophthalmoplegia — MLF lesion, MS, MRI
• Visual field defects — localization (chiasmal, post-chiasmal)
• Idiopathic intracranial hypertension — LP, acetazolamide, optic nerve sheath fenestration

Oculoplastics / Orbit

• Thyroid eye disease — VISA/EUGOGO classification, orbital decompression, radiation
• Orbital cellulitis — preseptal vs postseptal, Chandler's classification, management
• Enucleation vs evisceration vs exenteration — indications, implants
• Dacryocystorhinostomy — external vs endoscopic, Jones tubes
• Ptosis — classification (aponeurotic, myogenic, neurogenic, mechanical), levator function, surgery selection

Paediatric / Strabismus

• Retinopathy of prematurity — ICROP3 classification, zones, stages, plus disease; anti-VEGF vs laser
• Amblyopia — types, critical period, occlusion therapy, penalisation
• Esotropia — infantile, accommodative (ACAT), decompensated phoria
• Exotropia — intermittent (X(T)), management (observation, surgery, patching)
• Nystagmus — sensory vs motor, null point, surgery (Kestenbaum-Anderson)

Specific High-Yield Questions (Frequently Repeated 2021–2025)

1. Classify and describe management of open angle glaucoma — target IOP concept, medical/laser/surgical stepladder
2. Diabetic retinopathy — Early Treatment Diabetic Retinopathy Study (ETDRS), Diabetic Retinopathy Study (DRS), recent anti-VEGF trials (PROTOCOL T, PANORAMA)
3. Retinoblastoma — genetics (RB1 gene, Knudson two-hit hypothesis), screening, classification, treatment
4. Penetrating keratoplasty — donor-recipient trephination, suturing technique, complications, graft rejection (episodes and treatment)
5. Anti-VEGF in ophthalmology — mechanism, agents (ranibizumab/bevacizumab/aflibercept/faricimab/brolucizumab), indications, CATT/IVAN/HAWK/HARRIER trials
6. Optical coherence tomography (OCT) — principle (time-domain vs spectral-domain vs swept-source), OCT angiography, interpretation
7. Accommodation and presbyopia — mechanism, loss with age, surgical correction (monovision, EDOF IOLs, corneal inlays)
8. Strabismus surgery — recession/resection, adjustable sutures, Faden procedure
9. Orbital fractures — blowout fracture, entrapment signs, timing of surgery
10. Electrophysiology — ERG (scotopic/photopic), mfERG, PERG, VEP — clinical applications

Where to Access Actual Past Papers

• NBE Official Website (nbems.org) — Check "DNB Broad Specialties" section for any published question papers
• DAMS (Delhi Academy of Medical Sciences) — Question paper compilations
• Ophthalmology DNB forums on Telegram — Groups like "DNB Ophthalmology" share scanned papers
• PrepLadder / Marrow — Some platforms have compiled DNB theory questions with model answers
• AIOS (All India Ophthalmological Society) — Educational resources
• Senior resident WhatsApp/Telegram groups — Batch-shared previous year papers

Format Note (Post-2020 Pattern)

• Recent classification systems (ICROP3 for ROP, EUGOGO for TED, TFOS DEWS II for dry eye)
• Evidence from landmark clinical trials
• OCT interpretation and imaging modalities
• Decision-making in complex cases